Professor Foster’s cost-benefit analysis for the Victorian parliament.

[below the exact text (with different font/highlight) as Gigi Foster’s submission to the Victorian parliamentary library in mid-August here. To see her health-related notes, including on topics like non-linearities and Sweden, see here, and to see all documents of that inquiry, see here. I helped write some of this and largely agree. So this is the place you can raise objections and suggest additions.]

Cost-Benefit Analysis Executive Summary.

NOTE: The analysis presented here is based on only a partial accounting of the costs of lockdowns. A comprehensive cost-benefit analysis should factor in many additional costs, as detailed below (see “Other costs not tabulated explicitly here, but that should count in the government’s calculus”).

For all of Australia, the minimum cost of a month’s worth of wholesale lockdown is estimated at 110,495 QALYs. This includes:

83,333 QALYs lost due to reduced wellbeing in the immediate term [2 million QALYs lost per year divided by 12 (to recover QALYs lost per month) divided by 2 (to attribute only half of this reduction to lockdowns per se)]

25,812 QALYs lost due to reductions in economic activity directly attributable to government restrictions

600 QALYs lost due to increased suicides during lockdowns

750 QALYs lost in the form of foregone wages of children suffering disrupted schooling during lockdowns.

For all of Australia, the estimated benefit of locking down “ad infinitum” (not only per month) is 50,000 QALYs.

Hence the minimum cost *per six weeks* of wholesale lockdown is at least three times greater than the benefit in terms of Covid-related welfare that could potentially be saved *in total* by wholesale lockdown. For Victoria alone, simply multiply both costs and benefits by the fraction of the Australian population resident in Victoria.

Costs

Mental stress. Mental stress associated with being locked away from the broader social sphere captures one dimension of the impact of increased domestic violence risk, anxiety about the future, loss of contact with friends and family, concerns about financial and health security, increased unemployment, loneliness and so on that are either caused directly by or further fuelled by wholesale lockdowns.

Assume that life satisfaction of Australians is 0.5 points (on the typical 0-to-10-point scale) lower than usual on average during wholesale lockdown (sources: Clark et al 2018, UK Office of National Statistics).

0.5 multiplied by the Australian population (25 million) = 12,500,000 WELLBYs sacrificed per year of lockdown.

One year of average healthy life in Australia equates to approximately 6 WELLBYs (6 WELLBYs equals one QALY), so the human cost of this increased mental stress is equivalent to the sacrifice of 12,500,000/6 = slightly over 2 million average healthy life-years (QALYs) sacrificed per year of lockdown.

How many full lives is this worth? A full life is assumed to be 80 years of average healthy life, hence 2,000,000/80 = 26,000 full lives lost per year of lockdown.

This translates to 26,000/12 = 2,170 full lives lost in each month of wholesale lockdown due to declines in wellbeing. Recognising that an average Covid death represents a sacrifice of 5 remaining healthy life-years (QALYs) (equivalent to 30 WELLBYs), 173,000 healthy life years represents the equivalent of approximately 34,600 Covid deaths sacrificed in each month of wholesale lockdown due to declines in wellbeing.

If we assume conservatively that only half of this figure is attributable to the lockdowns per se, then each month of wholesale lockdown causes the destruction of 17,300 lives of the type typically lostdue to Covid.

Reductions in GDP. Falls in GDP mean falls in both public and private spending that would have translated into more human welfare this year, and continued lagging of GDP in future years, until we catch up to where we would have been in the absence of Covid.

Assume that half the projected loss to Australian GDP is due to the lockdowns per se (see Appendix for full argument). Present projections of GDP falls, coupled with a conservative assumption that only government expenditure, not private expenditure, buys welfare, the minimum projected loss per month of lockdowns is estimated at 25,812 QALYs, or 5,162 lives of the type typically lost due to Covid.

Violence. When mental stress becomes extreme, suicides and domestic violence can be the result.

Lifeline (https://www.lifeline.org.au/resources/data-and-statistics/) reports that there are 8 suicides per day on average in normal times. Professor Ian Hickie, co-director of the Brain and Mind Centre at the University of Sydney, says suicides are expected to rise 25% over the next five years (https://www.news.com.au/lifestyle/health/health-problems/the-silent-death-toll-of-covid19-revealed-huge-25-per-cent-jump-in-suicides-each-year/news-story/b4154626a16c9cc25c3b79b7880041ef).

Assuming that the increase in suicides due to wholesale lockdowns per se is only 10% from the baseline level of 8 per day, this translates to an additional 24 suicides per month directly attributable to lockdown. Suicide typically claims people far younger (average age 44) than those claimed by Covid-19. Assuming that the average person lost to suicide has 25 healthy life years remaining (as compared to 5 healthy life years for an average person lost to Covid), each month of wholesale lockdown is estimated to produce (24 x 25)/5 =)120 lives lost of the type typically lost to Covid, from suicide. This equates to 120x 5 = 600 QALYs lost per month.

Further studies about the link between the Covid crisis and suicide are available here: https://lifeinmind.org.au/research/australian-covid-19-suicide-research/covid-19-suicide-research-papers-guidance-notes

Losses due to schooling disruptions. When children stay home from school, their learning suffers and their parents’ productivity suffers.

Looking only at the cost of children’s online rather than face-to-face learning in terms of foregone wages, I have estimated a conservative future cost of $75 million in a peer-reviewed paper recently accepted to the Australian Journal of Labour Economics. Assuming a high willingness-to-pay of $100,000 per QALY, this cost represents the cost of saving 750 QALYs, or (recalling that a Covid death on average represents a sacrifice of 5 QALYs) 150 lives lost of the type typically lost to Covid, in the form of foregone wages of children who have suffered disrupted schooling during lockdowns.

Other costs not tabulated explicitly here, but that should count in the government’s calculus

Increased non-lethal self-harm during lockdowns

Increased (lethal and non-lethal) domestic violence during lockdowns

Reduced worker productivity during lockdowns

Crowded-out healthcare during lockdowns (missed cancer screenings, stroke treatments, surgeries, etc) resulting in more deaths and suffering of non-Covid causes

IVF babies not born due to the inability to attend fertility treatments during lockdown, and age-based expiration of fertility opportunities during the wait

The negative effects now and in future years of bad habits inculcated during lockdowns in both children (less play, less outside time, less sociability, less health, more fear) and workers (less productivity, less health,and less motivation)

Increased mental stress, self-harm, and violence in future months when people face higher unemployment created by the lockdowns (https://www.bloomberg.com/news/articles/2020-07-13/australia-s-effective-unemployment-rate-13-3-frydenberg-says, Clark et al 2018), including the decade-long “scarring effect” of entering a job market in the midst of a recession

Benefits (again using conservative assumptions, biased in favour of lockdowns):

An average “Covid death” (given people who die of Covidare on average older and with co-morbidities) represents a loss of five QALYs. Assume that the equivalent of 10,000 Covid deaths in Australia –0.04% of the country’s entire population –were avoided directly by wholesale lockdowns per se. This assumes that the vast majority of the difference between our recorded per-capita deaths to date and those recorded in Sweden –deaths which totalled .056% of their population –would occur in the absence of wholesale lockdowns, which is an assumption extremely biased in favour of wholesale lockdowns saving lives on net relative to the alternative of targeted protection of the vulnerable, in spite of the lack of solid evidence for this assumption.

This assumption of 10,000 deaths can alternatively be thought of as an aggregate figure that includes not only actual deaths, but also the “death equivalent” of aggregated lower quality of life in the short run for those who become symptomatic but do not die, and for those suffering longer-run damage from the virus.

This translates to a maximum of 50,000 QALYs saved in total by wholesale lockdowns.

Given that one QALY equates to about 6 WELLBYs in Australia, this translates to an estimate of 300,000 WELLBYs saved directly by wholesale lockdowns.

What would society usually be willing to pay to save 50,000 QALYs? At a very high rate of $100,000 per QALY, saving this amount of human welfare would be worth paying $5 billion –equivalent to 0.34% of GDP.

APPENDIX

What fraction of the current and future economic contraction is directly attributable to lockdowns per se?

The Imperial College study of Miles et al (2020) into the costs and benefits of lockdowns in the UK finds the direct effect of lockdowns on economic activity to be direct and large:

Deb et al (2020) found that lockdowns reduced economic activity in the UK by 15% in the 30 days after they were adopted. They find that stay-at-home requirements and workplace closures are the costliest in economic terms. Preliminary estimates from the UK Office for National Statistics showed a slightly more than 20% fall in GDP in April 2020, the first full month after the lockdown. Tracking the immediate effects of policies (and not the external environment) across countries, Bonadio et al (2020) put the impact on output and incomes (i.e. GDP) of policies to counter the spread of the infection on GDP averaged across 64 countries even higher, at around 30%.

Aum et al (2020) estimate that around one-half of all job losses in the UK and US can be attributed to lockdowns. Coibion et al (2020a) estimate that there were 20 million lost jobs in the US by April 8th triggered overwhelmingly by government restrictions. In a follow-up paper the same authors undertake surveys of behaviour and economic outcomes across US regions with different degrees of restrictions. They conclude:

“We observe a dramatic decline in employment and consumer spending as well as a bleak outlook for the next few years. Our estimates suggest that this economic catastrophe can be largely accounted by lockdowns.”

This is now also the consensus in the economic forecasting literature. Economic pain like unemployment and GDP contraction remain while restrictive policies remain, with strong recovery only coming after that, and stalling if restrictions are reimposed. The main Bank of England scenarios, for example, depict economic recovery as being dependent on the lifting of restrictions (Table 1A, Bank of England May Monetary Policy Report).

In Australia too, the consensus is that restrictions and economic decline are causally linked. The Reserve Bank of Australia says in its projections that “The initial phase of the recovery is likely to be primarily driven by the easing in restrictions, which will lead to an improvement in employment outcomes as businesses re-open, as well as a pick-up in household spending.”

The RBA’s most recent forecasts indicate that the Australian economy is losing 6% GDP on an annualised basis in the months of lockdowns. Taking the very conservative view that further lockdowns do not mean the eventual recovery will take any longer, we can then attribute a 6/12% GDP loss to an additional month of lockdown. That 0.5% of GDP is just over $7 billion, implying$2.5 billion in reduced future government spending using the rule of thumb that government expenditure equates to 36% of GDP.

Ignoring all welfare lost due to reduced private expenditure, and using the conservative estimate of $100,000 as the value for a statistical life year, the reductions in future government services alone will imply a loss of approximately 25,812 QALYs per month of lockdowns.

References

Clark, A. E., Flèche, S., Layard, R., Powdthavee, N., & Ward, G. (2018). The Origins of Happiness: The Science of Well-Being Over the Life Course, Princeton, NJ: Princeton University Press.

Pragyan Deb, Davide Furceri, Jonathan D. Ostry and Nour Tawk (2020), “The economic effects of Covid-19 containment measures”. COVID Economics, CEPR, vol 24. May 2020.

Barthélémy Bonadio, Zhen Huo, Andrei A. Levchenko, Nitya Pandalai-Nayar(2020), “Global Supply Chains in the Pandemic”, NBER Working Paper 27224, May 2020.

Sangmin Aum, Sang Yoon (Tim) Lee, Yongseok Shin (2020), “Doesn’t Need Lockdowns to Destroy Jobs: The Effect of Local Outbreaks in Korea”, CEPR Discussion Paper 14822.

Olivier Coibion, Yuriy Gorodnichenko and Michael Weber (2020a), “Labor markets during the Covid-19 crisis: A preliminary view”, COVID Economics, vol 21,May 2020.

Olivier Coibion, Yuriy Gorodnichenko and Michael Weber (2020b), “The cost of the COVID-19 crisis: Lockdowns, macroeconomic expectations, and consumer spending”, COVID Economics, vol 20, May 2020.

https://www.bankofengland.co.uk/-/media/boe/files/monetary-policy-report/2020/may/monetary-policy-report-may-2020

https://www.rba.gov.au/publications/smp/2020/may/economic-outlook.html

Miles et al (2020): https://journal.sketchingscience.org/users/333926/articles/460021-living-with-covid-19-balancing-costs-against-benefits-in-the-face-of-the-virus

UK wellbeing reports: https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing

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158 Responses to Professor Foster’s cost-benefit analysis for the Victorian parliament.

  1. Bruce Bradbury says:

    It’s very hard to evaluate this without a clear discussion of the counterfactual. Does the counterfactual include removing all govt-imposed restrictions (eg including international travel)? Or is the counterfactual a continuation of the restrictions in place prior to the current lock-down escalation in Vic?
    If the former, I would anticipate much higher death rates in Vic than in Sweden (which still has some restrictions and a more ‘responsible’ population).

    • paul frijters says:

      whilst it is true that Foster’s calculation does not tell you who would have won the AFL grand final in the absence of lock downs, the lack fo a complete counterfactual holds for all decision making systems and all choices. She does sketch a pretty clear counterfactual, one that is actually artificially loaded towards making lock downs look good.
      Foster’s story on the optimal scenario is in the link given at the start, essentially a combination of Sweden’s “no lock downs” policy that keeps the economy going, plus the measures of countries like Germany and Denmark for the most vulnerable population in aged care-homes and such (which was the main failing of the Swedish approach). You should note the lock downs in Germany and Denmark were quite short-lived and much less invasive than the French or British version. It lead to far fewer deaths than in France or the UK, though that probably also has something to do with prior immunity rather than policy “success”.

      Just try and come up with a reasonable scenario in which the lock downs save net lives. Its damned hard. Even the UK government has given up on that idea. Having experienced a higher death rate than Sweden or almost anywhere else, they for instance recently admitted that

      “…when morbidity is taken into account, the estimates for the health impacts from a lockdown and lockdown induced recession are greater in terms of QALYs than the direct COVID-19 deaths.”

      https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/907616/s0650-direct-indirect-impacts-covid-19-excess-deaths-morbidity-sage-48.pdf

  2. I am and will always be Not Trampis says:

    the article is a crock.
    UNSW must be different to other Unis as news articles were never accepted as a source!

    Does Ms Foster not know that suicides did not rise at all during the national lockdown. Why would they this time in Victoria?

    How about family violence. It was not counted in previous recessions so we are flying blind. We know increased drink fuels it however reduced gambling has the opposite effect.
    What is the net effect and has the lockdowns had an effect?
    Ms foster, like Paul has it backwards, When does crowding out occur in hospitals? when the virus is spreading rapidly. It doesn’t in a lockdown. They fall.
    She misses the L/T effects of the virus on children as well!
    and as Bruce says what is the counterfactual?

  3. It’s good to see the cost-benefit analysis that underlies Gigi’s policy proposals and your similar calls. Here are some thoughts in the spirit of respectful discussion (which seems too rare on this topic)!

    This is not intended as a comprehensive summary of issues with Gigi’s analysis – more some thoughts about applying the WELLBY approach in this context. I have some sympathy for the WELLBY approach as advocated by you and others – it is at least a useful extension to using QALYs to facilitate a broader analysis of the effects of public policy options.

    But my issues:

    The estimated *short run* cost in wellbeing is completely speculative

    In this analysis, the estimated costs of lockdown are mostly driven by an assumed temporary fall in wellbeing. Wellbeing in this context is measured by survey questions on subjective general life satisfaction (on a scale of 0 to 10). The magnitude of the decrease in wellbeing due to lockdown (relative to not locking down) is assumed to be 0.5 on average (for the duration of the lockdown). This is completely speculative. Where does the 0.5 come from? It’s certainly not good enough to look at subjective wellbeing before and again during a lockdown, since lockdown is a response to a virus escalating out of control. It might even be possible that not doing anything would actually be worse even in the short run, as people’s mental health and stress escalate from a perceived lack of government response.

    No Dynamics – really?

    The obvious criticism of the analysis seems to be the absence of discussion about dynamic wellbeing effects. Take the case of Victoria now – any short term pain of lockdowns should be soon offset by a new era in which wellbeing is higher than it would have been in a counterfactual in which the virus is rampant, perhaps for a long time. How long is hard to say – which illustrates how hard it is to actually do reliable cost-benefit analysis here. The obvious thing to do in the presence of such uncertainty is to be risk averse and avoid the potentially enormous consequences of not locking down. But it’s clearly not adequate to ignore dynamics altogether in this analysis.

    Double Counting?

    Correct me if I’m wrong, but the wellbeing approach to public policy advocated by you and others is to use wellbeing (life years) as *the* metric for public policy analysis. Unlike QALYs, the WELLBY approach already captures losses in income, violence, suicide, indeed everything else you want to measure as a cost leads to a reduction in wellbeing – so wellbeing should be only one item here on the cost side.

    Interdependency in wellbeing

    To say that each Covid death is worth 4 QALYs is to ignore interdependencies in wellbeing. If one elderly person dies as a consequence of a particular policy choice, it effects their relatives and friends, and indeed all sorts of people who may see this as inappropriate. This problem could be avoided if we could calculate the total wellbeing effect of each life lost, but we can’t.

    The Good Life

    Maybe lifetime wellbeing is more complicated that summing subjective assessments made at each life year? In this case, is it possible that some self-sacrifice as part of a collective response to tackle a global problem will lead people to later on assess their life in a more positive way? You could think of this as another type of (ignored) dynamic effect of the policy of wellbeing.

    I’ll leave it there for now.

    • Hi Peter,

      nice to see you engaging again!

      Some quick answers. The 0.5 WELLBY loss of lock downs was predicted ex ante (by myself in April) but by now its a lower-bound based on quite a few studies of what happened in the UK and elsewhere. The key identifying information is the sudden drop in wellbeing in the initial weeks of lock downs and the comparison between those forced to stay at home versus those with an “essential job” who can carry on as before. I did an LSE student union presentation on this with some latest numbers. Want to get the slides? There is also some key data here: https://whatworkswellbeing.org/blog/the-wellbeing-costs-of-physical-distancing/

      On the issue of dynamics, one point to note is that we see no wellbeing uptick in lock down land, so that again is now born out by data (though totally anticipated: people do not get used in terms of wellbeing to no social contacts. If anything, they get worse as we are not a solitary species). The second is that yes, one can try and specify a whole dynamic path (I have done so various times, particularly when it comes to unemployment), but all one really needs to argue for the main conclusion is that lock downs delay the return to normalcy rather than speed it. That’s really all you need for the argument, not any particulars on the dynamics. The main arguments saying lock downs delay normalcy are that i) it means the spread of the virus is slower, so disruption simply lasts longer as one gets more waves and more lock downs, and ii) the lock downs cost jobs and gdp which mean more longer term hurt (for which Gigi gives a lot of references). Now would you want to argue that lock downs are a quicker way to return to normal than controlled spread via no lock downs (the Swedish approach, but also implicitly the German, Dutch and Brazil approach)? The only realistic way to argue that lock downs return you to normal to quicker is to presume they dont work on the virus front!
      Now, on double counting, not quite: loneliness and mental health costs is for the whole population during lock downs, death and GDP is for the years to come.
      On the 4 QALY loss of a covid death, Gigi actually says the loss is 5 QALY, which is generous. True, one can argue there are grief costs in terms of loss to close people, but that would be double counting because death is inevitable for all of us. There is no scenario in which anyone lives forever, so the grief associated with deaths is inevitable. That is also why Gigi didnt count the grief costs of future suicides or of the health costs.
      On the wellbeing benefits of sacrifice, all I can say is that we dont see that in the data, plus of course its a futile sacrifice so there is a future loss coming when it becomes clearer how in vain the sacrifice was. Lest we forget :-)

      Now, how about going beyond asking questions and putting up your own CBA? Try for as much dynamics as you want and dont hesitate to try and put up numbers for supposed added benefits of lock downs (like clean air). It really is damn hard to come up with any CBA that makes the lock downs look good, which is why around the world you see estimates of costs to benefit ratios of 50 to 1 or higher. Even when Holden and Preston tried their hands at it, they effectively came up with the conclusion that the lock downs were not worth it once you correct for their basic mistakes in how they interpreted empirical numbers on the statistical value of life.

      • It seems likely the immediate costs of lockdown are very large. But let’s explore the dynamics and the counterfactual just a bit – keeping in mind that Gig’s case rests almost entirely on the assumed short-run reduction in wellbeing. Let’s stay with the specific case of Victoria.

        Consider two periods: Period 1: lockdown period (6 weeks) and Period 2: post-lockdown (let’s say 8 months – you’ll see why I chose 8 below). Beyond this may be vaccine period and things get more uncertain, so let’s stay with short and medium term.

        Consider two scenarios- Scenario A: Victoria’s actual chosen path of lockdown, versus Scenario B: the counterfactual of no lockdown. Victoria is halfway through the lockdown and looks to be on track to return to a low-infection equilibrium at the end of Period 1. It will hopefully begin Period 2 looking more like NSW does now – with low but sustained numbers of new daily cases (double figures at most), with intensive regimes of testing, tracking and tracing, but fairly liberal restrictions on most activities.

        In the *counterfactual* (Scenario B), Victoria’s new case numbers increase near exponentially (or at least linearly) throughout Period 1, and well into Period 2. In this counterfactual, roughly speaking, Victoria enters period 2 with perhaps 2000 new cases per day, and has then presumably lost its opportunity to control new infections and new case numbers will stay high throughout Period 2. Under Gigi’s calculations, people’s wellbeing in period 2 is essentially the same under both scenarios – except for the prolonged negative consequences of economic damage caused by the lockdown, and the extra deaths directly due to Covid.

        In my mind, people behave very differently in period 2 under the two scenarios – probably enough to completely overturn the CBA without even needing to quantify health effects of Covid. Even if you take the extreme view that people are deluded, hysterically fearful of a virus that isn’t really so bad – consider how people would actually behave in the counterfactual period 2 – they will be fearful, on average they will self-isolate far more than they would under scenario A, with implications for economic activity, mental health etc etc throughout period 2. This would be mirrored by the severity of government enforced restrictions under the 2 scenarios throughout Period 2. Dissent and anger towards the government grows as people compare their covid statistics to neighbouring states and countries. Externalities flow to neighbouring states due to prolonged border closures as well as likely violations of those border controls. This seems likely enough for counterfactual (Scenario B) wellbeing throughout period 2 to be at least 0.05 points lower than under Scenario A – (maybe much more than 0.05). Since period 2 is assumed 5 times longer than period 1, this offsets a Period 1 reduction in wellbeing of 0.25 (note that Gigi’s calculations refer to a 0.5 point reduction, but then an assumption is made that half of this is due to the lockdown).

        The numbers are all speculative. My point is its very easy to imagine plausible states of the world in which the conclusion of this CBA is reversed, whilst sticking with the wellbeing approach. And again, this is without even bringing the health costs of Covid into the equation at all.

        • Nicholas Gruen says:

          Agreed Peter,

          While I think it’s great that Paul and Gigi are making this case, I think it’s a real pity that, at least here, Paul can’t get beyond describing lockdown as a piece of behaviour that’s trivially foolish.

          I haven’t read the material above carefully, but for me the critical matter seems to be the construction of the counterfactual. Now it seems self-evident that if we’re such a hysterical species – or if we’re going through a hysterical stage in our history – then if we don’t have a lockdown lots of hysteria will be worse. Paul links to Gigi’s material on Sweden here and it is advocacy rather than careful consideration of how one might construct the counterfactual.

          There it says this

          On the point about Sweden’s economic performance relative to Europe:
          The European Commission forecasts a better economic result for Sweden in 2020 (-5.3%) than many other comparable European countries (France, GDP fall of 10.6% in 2020; Finland -6.3%; Austria –
          7.1%; Germany -6.3%; the Netherlands -6.8%; Italy -11.2%; Denmark -5.2% (emphasis added))

          Whoops – well Denmark which is right next to Sweden and had a hard lockdown is forecast to do (marginally) better, though other forecasts have it different.

          One can also add ‘eradication’ to your scenarios Peter – as one of the low infection equilibria. There one needn’t be certain that one can eradicate forever, but one eradicates from fast, early action and then one is vigilant and tries to avoid the incompetence of NSW on the Ruby Princess and Victoria and New Zealand on hotel quarantine. One then waits and watches as information comes in about the likelihood of a vaccine turning up. Paul seems to think that this is a large cost, but it’s one that’s being born pretty generally at present – without much hint of being predicated on pursuing eradication.

          Eradication may be a foolish aim in vast interconnected places like Europe and the USA and places where COVID has become endemic – though I have an open mind about it and it’s something that I understand Yaneer Bar-Yam is still arguing. In any event, it seems it has been effectively done in Australia and New Zealand.

          And as we’ve seen in NSW and as you are arguing, when eradication breaks down it defaults to your ‘low infection’ equilibrium if you are not as incompetent as the Victorian effort in testing and tracing.

          • From what I’ve read technically ‘eradication’ means extinct in the wild, and ‘elimination’ means not present in a nation.
            For example small pox has been eliminated is extinct whereas polio has been eliminated from most of the world but is still active in parts of Pakistan and Afghanistan.

            We still have hundreds of known active cases and god only knows how many undetected cases. And we have a lot of expats that have every right to return.

            Eradication of viruses like Covid19 a member of the corona family is apparently very unlikely, they mutate like crazy.

            If a vaccine does eventuate it’s more likely to be like the flu vaccine better than nothing but hardly perfect.

            • Conrad says:

              Who cares if the vaccine isn’t perfect? If it reduces the effect of the virus 50%, it means almost no-one will die and there will be few serious cases anymore. So people can keep on working until they get a better one.

              I believe this is what happened when they released the influenza vaccine that wasn’t perfect a few years back — people got sick but still had a reduction in symptoms. Also, coronavirus mutates much more slowly than influenza, so this situation is less likely to happen (and it is pretty rare with influenza).

        • paul frijters says:

          good, now we’re talking engagement. I respond in a new thread so as not to hit the margins :)

  4. Paul Peter
    Am staying at the Pilliga Pub which has about eight customers and a Covid19 Marshall 😀.

    your conversation seems to me to be assuming, that lockdowns actually have an measurable effect on illness death outcomes , rather than just a correlation ? Am I wrong ?

    Looking at the differences between for example Japan, the UK and Sweden the picture seems more like ‘chance and necessity’.

    BTW re suicide that can take decades to pan out for example Pompey Elliot suicided in 1931 more than a decade after ww1.

    What I can say from direct experience is that the kind of existential stress : the fear, panic and loss of clarity of thought, we are all under has costs that must be paid one way or another.

    • yes, Gigi is being extremely generous to lock downs by saying they would have saved all the lives actually lost to covid in Europe. Of course that assumption is ridiculously generous to lock downs. If one is more realistic one would have to say blanket lock downs cost lives and prevent very few covid deaths as well. In a way, Gigi is just being polite.

      I do think the scientific community is edging to a more reasonable point of view, but the vast majority of the population is not. So whilst the UK government has implicitly admitted lock downs have hurt health more than the virus, the all-parliamentary group on the issue has been reported to want to continue these failed policies. Lock downs, track and trace, the whole shebang. There have been no significant excess deaths in the UK for almost 3 months now, but the population remains in thrall. So the political parties have made the calculation that the population expects continued theater on covid (they have been reported to advocate a “zero-covid” policy to “reassure” and bring “clarity”. Let’s hope the reports are wrong…). You see more and more despairing newspaper articles in the Financial Times and elsewhere of commentators realising the scale of the disaster that the UK is now in. Their hope is that a vaccine, though far too late to have much medical impact, will snap the population out of their obsession and at least allow a recovery to take place.

  5. A Spaniard says:

    Thanks again Paul for the effort. This is really appreciated. I did not have yet time to meditate on the numbers, although as I mentioned in a previous comment, I largely agree a priori with the main ideas. To the best of my knowledge, the supporters of the “general lockdowns + dance” strategy have rarely provided a detailed CBA, and the examples I know were unconvincing. This is hardly a positive signal.

    My question goes however on a different direction. From my (limited) experience, this type of CBA has attracted little or no attention in the media -in Spain, at least, newspapers never talked about this kind of things. Why is this happening? Is it because readers find abhorrent the idea of a ‘price of life’? The idea that resources are scarce is so obvious that it should not be difficult to argue that one has to set a limit here, right? So, what is the problem? Is the analysis too complex and the concepts arcane, or what? Probably you have some first-hand experiences on this.

    • Hi Spaniard :-)

      yes, I have some first-hand experience. There is the general issue that few academic economists actually do any CBAs or know how they are used in government, so few academic economists know how to do them well, understand them, or will support the ones they see. The art of doing one’s best to get reasonable answers is simply not done much in academia anymore and is somehow seen as a bit dirty, so you get little real academic support, even at times like this. I talk more in depth about that here: https://clubtroppo.com.au/2020/06/29/from-being-to-seeming-why-empirical-scientists-failed-in-times-of-covid/

      Still, its not no support as there are always a few economists who do like to see such applied things and think their students should be exposed to them. Also, all the competent CBAs out there give the same answer (which is that lock downs are terrible ideas. The case is too overwhelming to be in the grey area). I thus been asked by a few top unis to give their students a guest lecture on this stuff, usually with some senior member of staff thinking CBAs are a good idea. Yet, only in government are the CBAs standard and government economists have to toe the line the government wants them to tow, so they cant be seen to endorse any that go against the government. At least not officially. Unofficially, I got a lot of backing from government economists. In Australia too, quite a few of the economists in government are very sympathetic to CBAs in this area. Why do you think Gigi keeps being asked as an expert all the time? Because she is giving an actually quite standard economic story.

      A related issue is that many academic economists have blindly followed the medics in the government circles and the general hysteria, for all kinds of reasons. Wisdom of crowds, attraction of power, desinterest, folly of crowds, conviction that so many government medical advisers cant be wrong, whatever. That group has to be the majority. By giving up their role as judging for themselves they then stop having much of real interest to say as the bottom line is determined by what governments and their medics exude, so all is left is the intellectual crumbs. I have even seen the odd academic economists in this group doing fake CBAs, using mainstream estimates and multiply them by 20 to get the desired answer. Eg. https://clubtroppo.com.au/2020/05/18/the-corona-cost-benefit-analyses-of-richard-holden-bruce-preston-and-neil-bailey-ooops/

      Why the media is not interested? They are not just uninterested in CBAs, they also ignore the central bank economists and the stories of medics and educators that go against the hysteria, so I dont think its because CBAs are too hard but generally because they believe the hysteria sells (and it does). Best guess why that is? Here: https://clubtroppo.com.au/2020/06/17/what-kind-of-crowd-are-we-now-seeing-the-5-surprises-in-this-pandemic/

  6. Conrad says:

    To me the benefits are underestimated given the longer term effects seem to be becoming worse than anyone initially thought (e.g. neurological damage, longer-term heart inflammation occurring in most patients, including asymptomatic ones, etc.).

    For example, let’s say I get 1 million extra cases of Covid before a vaccine turns up because of poor attempts to reduce it’s spread. Let’s now say this costs people a mere 3 QALYs. I’m already at 3 million QALYs.

    • Conrad any actual data on this?, for example Sweden is meticulous re data, yet I’ve seen nothing to suggest that serious long term effects ,particularly for those who didn’t need hospital treatment , are common.

      • Conrad says:

        The virus obviously hasn’t been around long enough to know.
        You’ve obviously seen the neurological stuff floating around, but the heart stuff is interesting too given it can occur in aysymptomatic people: https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916 .

        You can get heart damage from other viruses too incidentally, but I believe that’s typically when you exercise when you are sick (i.e., the OCD hard training crowd..). It would be curious to know what happens here to otherwise asymptomatic people.

        The big studies monitoring people in the long term are just starting as far as I can tell (presumably due to funding and getting such studies going)

        • That study involved people who had a severe case of Covid19.

          No question that infections (including bacterial infections) can trigger chronic inflammatory conditions. Would need to get a sense of what is the normal background level of such conditions before we could judge whether Covid19 is significantly worse etc.

          All of this ‘might happen’ needs to be balanced against what we know for sure for example: the large number of cancers not being properly treated , neglect of Alzheimer’s patients because of understaffing and heart attack victims that did not go to hospital because of the restrictions and widespread fear.

          Also the mental health impacts of the lockdowns are still very much in the future for example there are people who seemed ok immediately after Vietnam but years later topped themselves .

          • Conrad says:

            That’s not correct — half the sample was severe, and the other half wasn’t (some asymptomatic). But the severity of covid symptoms did not predict the heart symptoms. So presumably you can be 20, indestructable and fine, but your heart is getting battered.

    • Conrad
      Further to this, our media are very quick to report scary outlier deaths- the thirty year old who died of Covid19 and the like- yet reports of thirty year old survivors scared for life seem very thin on the ground.

      You keep talking about long term effects ,and by now there must be ten thousand Australians who have had it and apparently recovered, yet all you have supplied to date are small samples with obvious selection problems.

      • Conrad says:

        It’s not outlier deaths I care about — it the overall effect of greater cognitive decline in old age, increased dementia etc. . They are both well linked to neurological problems and neurological insults like concussion. They are also linked indirectly to heart problems (high blood pressure etc. .).

        • Conrad the question : how frequent are serious long term effects for younger people who have recovered ( the vast majority of total infections) is critical to judging whether lockdowns , with their large collateral adverse effects on health , are justified.

          Am also sceptical about whether lockdowns more extreme than what Sweden did, actually in themselves made any difference to national outcomes. Evidence doesn’t back that at all.

          • Conrad says:

            Sure — I agree. People will need to keep on looking at it. As an example of how long effects last, there’s heaps of data from concussion and TBIs now, including stuff that occurred early in people’slives and their effect on various later performance measures rather than just end-of-life misery. Basically, the worse it is the bigger the effects, and the effects are cumulative from more than one impact (the latter of which is important if people lose immunity quickly). Of course concussion is different to covid, and we don’t really know the responsible mechanism in the first case and we certainly don’t in the second. So who knows, but if it had no effect it would be surprising given our brains don’t repair quickly (or at all) like other parts of the body.

            In terms of lockdowns — obviously hard lockdowns (NZ) and moderate lockdowns (Aus) can work but I imagine the lockdown you need is country specific and there is lots of variance and things that don’t do much apart from annoy people. That’s why I’m disappointed we can’t be more like Japan or Korea, in which case things would be much better (and since I’m in Adelaide now, that’s just from looking on!).

    • Saupreiss says:

      An interesting point but it all hinges on the assumption of how large the fraction of long haulers is. We seem to know very little about this, and for that matter, the various manifestations …

      • Saupreiss says:

        My comment was to Conrad’s original post

      • Saupreiss
        Lockdowns were adopted as policy well before there was any evidence of long term harm to those who recover.
        A more suspicious untrusting person might wonder : is evidence justifying that lockdown policy, being retroactively constructed ?

        • Conrad says:

          Surely the initial response to a relatively unknown virus (whose cousin SARs was especially deadly in comparison) is to err on the safety side. Once you know what it is, it then obviously makes sense to look at trade-offs because you actually have some idea of what they might be.

        • Saupreiss says:

          JRW,
          fair point about long haulers not factoring in the original lockdown decision. That said, you have to be really untrusting — not that I blame you — to believe the existence of longhaulers has been a construct for expost justification of lockdowns. I know personally at least one person who has been struggling with respiratory issues for month*s* and there is huge amounts of anecdotal data out there pointing in this direction. As I say elsewhere, I would like to see hard data about the percentage of people who are affected in the long run. Obviously it is still too early for that.

          • Saupreiss
            Am told that on a population basis it’s quite normal for a very wide range of individual reactions to a virus ( and to various drug treatments as well) to manifest. Over the years I’ve known many people who developed post viral syndrome(s). And we also now know that at least a few viruses play a role in causing cancers.

            I don’t question that post viral syndromes are real or that they can be extremely bad for those that have them. Rather I wonder ;
            could there be reasons why this well known long term effect of viral infections, for some , is currently getting much more attention than it normally does?

  7. Conrad
    If the asymptomatic group in the german study you linked to are truly a random ,representative sample then there must be hundreds of thousands of Europeans with serious heart problems and the like as the result of recovering from Covid19.

    And in general Covid19 must be a disease that ,while killing very few of those under say 50 leaves a huge number of them with serious long term side effects . Yet after about seven months reports that back that very large story are as thin as hens teeth.

    The story about serious long term effects in the very group that are at negligible risk of death seems a bit to ‘made to order ‘to my eye. It requires me to believe that Covid19 can at the same time kill next to nobody under forty yet can also be a serious threat to their health, possible I guess, but way too convenient for the group that, without evidence went for lockdowns back in March.
    Whole thing smells of, just so.

  8. paul frijters says:

    Peter,

    let’s take the two scenarios you have in mind: 6 weeks of either no lock downs or 6 weeks of the draconian version you now have in Victoria, followed by 8 months. Your essential argument is that after 6 weeks of no lock downs, cases are high and population worry and anxiety forces all kinds of further government action that does even more harm than in the ensuing 8 months after the 6 weeks of intense harm. And let’s supposed you are right that no lock downs indeed lead to a high case load, etc. But since you want to follow Gigi’s scenario, let us then also be fair to the scenario and consider that it would include a clear public campaign against the fear, with measures for nursing homes, retirement homes, etc..

    What do we now know from Europe and US states about how the virus progresses? The experience has been that in any concentrated place (like a large city or a densely connected country where the spread is very quick), the peak in deaths is reached after about a month, taking another month to return to the historical average. Whether in NY, Brazil state capitals, Paris, or Stockholm, excess death is essentially over after 2 months.

    Note that since we’re now in the Foster scenario of following world-best for the most vulnerable and pushing against the fear, the government would thus be able to say after 2 months that the loss from the virus has occurred and that remaining new cases are largely among those with very low risks, though the most vulnerable will have to make their own decisions on what they are willing to do going forward. Probably something like 0.02% would have died prematurely due to the virus (which would be 1300 people in Victoria), and the government and population can brag they held their nerve. Life would slowly return to reasonably normal, as it has in Sweden, Switzerland, much of Europe where anxiety levels have returned to normal and the economic recovery has started.

    Would there then be huge remaining anxiety? Europe and the US show that anxiety is not a given and can be countered. Not merely has Sweden shown the way in having a proud population take its own responsibility and accepting that life has risks, but the same realisation broke out in Norway, Switzerland, and some other places. Key is that the health authorities and the government are toeing the line, which they would had they adopted the line in the first place. So if Australian governments are going to avoid future lock downs, they must also surround themselves with different medics and marketers (the PlanB people in New Zealand would make a good team to fly in!).

    So there is a clear precedent for Gigi’s proposal based on standard virology, the actual path the virus took, new insights on what to do with the most vulnerable, and a clear public campaign against the fear (you will see that plan in her additional notes linked to at the start of the post).

    Would wellbeing then not also suffer greatly? Much less because the three elements that lead to the huge downturn in wellbeing, which is anxiety, forced loneliness, and forced unemployment are then largely absent. We even see this in the various anxiety graphs we now have for European countries (though its not as clean as the wellbeing data for the UK, but its there).

    Now let’s explore your counter-proposal then, which is the path Victoria is on. The 6 weeks of extreme pain for the population in Victoria to keep case numbers down. I understand, btw, that it will last to mid-October at least, so its not 6 weeks but more like 12. However, let’s suppose its 6.

    First, you should then be honest and admit that you accept something like 20,000 covid-equivalent deaths in terms of the reduction in future public services, delayed or cancelled operations, fear-induced bad health habits (like not getting checkups and gaining weight), disrupted education leading to child suffering, etc. So you take a hit easily 10 times higher than the no lock down scenario. It would be deeply immoral and heartless to pretend that loss is not there, as if the suffering immediately caused and done to children, the weak, and the future does not exist. Those in favour of these lock downs should accept some responsibility for this damage they are willing to inflict on neighbours, their own children, and others. And that’s not even taking issues like freedom and civil rights seriously.

    Second, one then ends up with no or very little immunity in the general population. So the virus will come back, as it has everywhere that has “successfully” pushed the virus down. Nowhere is there a fool-proof system to keep the virus out because it is so infectious. Places that seemed successful (like South Korea or Taiwan) got later waves and are now basically thought to have a large degree of prior immunity anyway explaining why they had such extremely low death rates and low virus-replication numbers (something that may also hold for Australians, we dont know). Also, of course, the supposed success stories have adopted policies that do continued harm to their economy like border closures. They too have inflicted a hurt on themselves that is enormous and ongoing.

    So another 8 months of heaven after 6 weeks of pain is not a realistic trajectory but a fantasy. More likely you’ll see further waves where you then are effectively back at square one because of no developed immunity. You then already took a death and wellbeing hit 10 times the damage one wanted to prevent, and one has to do it again and again. Meanwhile you’ve buggered the neighbours and trading partners as well with the economic hit forced on them.

    So in fact that anxiety is higher in the 8 months following in your lock down scenario as one has fanned the flames of fear for this virus meaning everyone is on the lookout for the return of it, which causes a lot of angst too. Lots of highly costly measures, like border controls and social distancing habits and rules remain in place, continuously hurting social life and the economy. Sound familiar? I am sketching life in Australia the last 4 months which was essentially maintained by huge additional public borrowing.

    Now, does a vaccine truly help you in your lock down scenario? Only if it comes extremely quickly because of the immense hit you take so quickly when you give in to anxiety, lock downs, and social distancing. So a vaccine in March 2020 would have been wonderful. A vaccine next January, which is about the quickest Australia can hope for as something available in large quantities, means 5 more months of economic and social suicide that will cost you a vast multiple of what you are trying to prevent. Essentially one loses more per week via draconian actions than one can realistically prevent in terms of suffering. That’s how enormous the costs loom of lock downs and social distancing relative to being more sang froid.

    Does a vaccine actually solve the problem? One hopes so but its very uncertain for several reasons: i) vaccines might help with the young who had no high-risk anyway, but might actually prove ineffective with the most vulnerable because their immune system is highly compromised and might not latch on to the vaccine (that’s why they are the most vulnerable: their immune system doesnt work so well anymore). ii) coronaviruses mutate and come back, like the cold and the flu so the next wave might be a variety the vaccine is not so useful for anymore. iii) you may have problems with uptake, dosage, effectiveness and side-effects. iv) convention treatments improve over time as well, as they have already, so the disease is less and less worth the effort to protect against. v) a vaccine wont be enough to stop the fear because you will need to tell people all is safe, which will mean waiting some more weeks to see what actually happens.

    Indeed, the message of “hang on, a vaccine is around the corner” is actually a highly damaging one because it belittles the hurt done to the population right now since it depicts it as unfortunate necessary collateral damage, and it sets people up for the notion of a miracle cure from above. If you’d take that attitude to every new virus or bacteria in the future, the country would be bankrupt soon as new versions of the flu, the cold, and hundreds of other pathogens appear each year. Countries and population cannot afford the policies of Victoria for long. That includes Victoria.

    • Now we’re at a point where the argument rests on claims about the natural path of the virus, so it’s clearly time for some humility. Being an economist with knowledge of cost benefit analysis and health economics does not make one a virologist, especially at a time when the understanding of a novel virus is both fresh and evolving. Any credible CBA (with informed counterfactual scenarios) needs to be compiled in close collaboration with virologists at the cutting edge of this thing. Doing otherwise seems irresponsible.

      That’s the last main point I want to make. I’ll just add that it’s strange you cite New York and Paris as evidence of the virus running its natural course in two months. You’re citing these places as evidence for what happens without a lockdown. But the policy responses in NY and Paris were hard lock downs – the opposite scenario!

      • Hi Peter,

        not really: for any detailed counterfactual you of course have to engage with likely dynamics of the virus and one must have some knowledge of it to paint any picture. One needs some knowledge of many other elements, like the suffering caused in other ways and the dynamics of the economy. Bringing lots of knowledge together is an element of any complex choice situation, which in fact is a strong argument against what has occured, ie almost total reliance on quite particular immunologists/virologists whose predictions have proven out by an order of magnitude.

        But is it necessary to be totally accurate about each element of the cost-benefit? Not when the relativities are so skewed. Change any aspect of my story 3 times in the direction you want and you still come out saying lockdowns and social distancing are bad. The case does not rest on the particular path. So what matters is not to be totally ridiculous on the path of the virus, definitely. The key judgment call that is the real sticking point is that there is no ultimate victory in terms of quick elimination possible. That was already clear in february and is not contentious. That was clear the moment it was called a pandemic.

        Its funny that you bring up how NY and Paris were hard lock downs. Indeed, but in NY it was far too late as they had near total infection already and in Paris they might have been lucky/unlucky enough to have low levels of immunity meaning they get further waves. The two cities show you two different follies. The point of roping those two in was to illustrate that the length of the wave from beginning to end is very similar whether you lock down or not (so the “emergency” is as just long) but you can either be more open and have immunity at the end with little disruption to social life during the emergency, or inflict huge damage (NY) and possibly still be in a near endless cycle (like Paris).

        Now why dont you tell me the damage of the lock downs and social distancing you agree that exists. Per week of lock downs and social distancing. Give me the number you think is reasonable. And convert it into years of life. Have a go. See if you can come up with something that does not immediately dwarf these virus numbers in terms of importance. Or are you saying economists should not be involved in matters of public choice?

        there is also the question who should prove the case: those advocating the experiment that is proven to be damaging and for which there is very little evidence that they have positive effects? Or those who argue against the experiment?

      • Saupreiss says:

        “Being an economist with knowledge of cost benefit analysis and health economics does not make one a virologist, especially at a time when the understanding of a novel virus is both fresh and evolving. Any credible CBA (with informed counterfactual scenarios) needs to be compiled in close collaboration with virologists at the cutting edge of this thing. Doing otherwise seems irresponsible.”

        Surely that argument can be easily turned on its head:
        Being a virologist — which one exactly, Ferguson and his ilk? — does not make one an economist with knowledge of CBA or health economics or for that matter an economist who understands how people behave. Hence the spectacular failure of some of the first epi models which clearly did not take into account that people would, especially if properly guided and informed, act in a pre-cautionary manner.

        Truth be told, having worked decades ago already with dynamic models of various kinds, has left me singularly unimpressed by some of the models that (local) virologists or epidemiologists work with. That original IC model for example seems to have been really cobbled together badly, and it bothers me deeply that these models are not in the public domain and that the fiddling with parameters seems driven rather ad hoc and ex post (and behind closed doors).

  9. Nicholas
    Evidence that increasing the severity and or length of lockdowns makes even a jot of difference to longer term ( or even short term) health outcomes is , contentious.
    On the other hand evidence of the numerous widespread and serious adverse effects on health , deaths, directly attributable to lockdown is unarguable.

  10. A Spaniard says:

    It seems that Australia and NZ want to be like Denmark, Lithuania, etc. in what regards the outcome of their lockdowns and the pandemic **so far**. Although open to debate, it is perhaps understandable that they want to give that option a try. But what the experience from countries like France, Italy, Spain or UK apparently says is that one has at least to set clear temporal limits: perhaps no more than 4-5 weeks of lockdown overall? If you need more time to control the virus, then probably it is so spread that you have to admit that the war is lost: you have to live with the virus, because the remedy is otherwise worse than the disease.

    Regardless, I think that Paul is too optimistic in what concerns the effectiveness of the campaign against fear; this point seems crucial and merits more attention. Surely I have to read your previous posts to make a more informed comment, but it seems to me that the success of such campaign would be extremely conditional on the response by the (i) media, (ii) experts, and (iii) Opposition. In Spain, for instance, schools are supposed to open in about 15 days. But the government, which is extremely weak, is too afraid to say that the risk for the kids is negligible, because if one of them ends in the ICU, the newspapers and the Opposition leader will say: “Look what happened!!”

    Sweden looks like an anomaly: Apparently a substantial consensus was reached among experts and political parties (I do not know what happened with the mass media; were they also supportive?); how did they manage to achieve it? I find this is an important question for the future.

    • Hi Spaniard,

      yes, the question of how to counter fear is important. Denmark is actually not such a bad example. Much closer to Sweden than people realise. Their lock downs were very short and they sent their kids back to school in April. They never tried elimination and basically decided to live with it. Why their covid-death numbers are so low is still a bit of a mystery (the idea that its policy seems quite unlikely). Rather, like Germany, the better bet is that they already had a high level of cross-immunity. Interestingly, like Germany, their actual life expectancy pre-covid was among the lowest in Europe (much lower than Spain), suggesting a fragile group in Denmark hadnt survived till now whilst that group did survive in Spain and Italy. Just a speculative thought for another day though….

      To get the Australians over their fear, after continuous feeding of that fear by their own governments, is of course a very important task and, I agree, not an easy one given what has happened so far. My best suggestion on how to get that going is here: https://clubtroppo.com.au/2020/08/07/how-can-the-covid-policies-be-countered-with-the-help-of-big-money/
      The government can start by getting rid of the medical advisers around them and get better ones. you can hardly do worse in terms of predictions or policy advice than the current mob they’ve got. Mind you, the prediction record on pandemic of the WHO has been similarly dismal the last 50 years.

      • Conrad says:

        As far as I can tell, there are no serious groups of medical specialists that are advocating what you suggest, so unless you get medical advisors that are not doctors, it’s hard to see how you would that.

        Here’s a list of other reason that would make life hard:

        1) People don’t trust the governments in most places. In the Anglosphere, you’re talking Boris of Brexit will make us rich fame, Trump… Who could blame them for not listening.
        2) People do trust doctors
        3) People don’t trust economists
        4) Economists never have a unified public stance on anything so it will hopeless convincing people, even if the currently unknown parameters turn out in your favour.
        5) People don’t understand what an opportunity costs is in general.
        6) Even people that do don’t act upon it (I’ll bet you waste heaps of time at the LSE doing stuff you could pay someone $20 p/h to do. Now remember back to UQ…)
        7) If you got people to understand what an opportunity cost is, you’d also need them to understand simple sums….
        8) About 30% of your population are in the “covid is crap for me” category, and would vote any government out that suggested they catch it. You’re not dealing with a homogenous group and some whose personal safety is at risk will never agree with you.
        9) Why do you assume people actually care about the global in the future good anyway? Are we all socialists now? Many people care about themselves and immediate family/friends. So if 90% of them still have jobs etc., why would they risk something else? They’d out vote the losers from Covid lockdowns any day.
        10) In the Anglosphere at least, the losers give people a good negative comparison and people justify it to themselves by assuming they deserved it for being lazy etc. (i.e. favourite political fodder). How are you going to increase sympathy for these people.
        11) People have high implicit discount rates on the future. That’s why we don’t do anything about global warming unless it essentially free (e.g., solar on our roofs). So who cares about the future unemployment of someone else when I could catch Covid today?
        12) Unless you can conclusively prove vaccines will fail, most people would prefer to wait around for one than think about catching a nasty disease.
        13) There is probably another relatively large group of people who think Covid is good because it stops immigration/internationalisation. The loony vote in France, for example, I seem to remember is about 30%, and they care a lot about that sort of issue.

        • Hi Conrad,

          oh, there’s plenty of medics giving similar advice, quite of few of which have in previous months commented on some of my pieces here on Troppo. You can also just look at some of the co-signatories (more than 1000 now) on that open petition. The PlanB people in New Zealand just ran a conference with some. A quite early one is here: https://www.telegraph.co.uk/news/2020/04/11/german-scientist-predicted-european-epidemic-calls-end-lockdown/ Its an ongoing battle inside these fields. Indeed, you will find pre-2020 WHO reports basically judging lock downs to be futile once a virus has gone pandemic.

          However, I do actually agree with many of your judgments in your 13 points, such as the distrust of economists and the hopelessness of getting most people to understand opportunity costs. Where I disagree most is the idea that people are totally stuck now in their opinions. Herds are herds and just as the herd went hysteric, it can be lead elsewhere. The weak point of the herd is the internal communication and the current manipulated flood of fear images. The public advertising space is simply for sale. Bombard people with images of the reality of the suffering of lock downs and social distancing, and they will soon come up with their own reasons to disown the lock downs and the “experts” that lead them astray. Public moods can be shifted, but it certainly takes an effort. And it would take quite a bit of advertising money, which neither you nor I have in the quantities needed :-)

          I also fundamentally disagree with the fatalism you display. The role of scientists is not to see everything that happened in the past as inevitable, or to see a bad future as now set in stone, but to give hope and sketch a better way forward. The very idea of scientific discovery is a form of hope and of malleability of the future.
          Have you truly lost hope?

          • Conrad says:

            In terms of this question, yes I have very little hope that opinion in Australia will change before other things take it over anyway.

            That’s just a probability game though, not something unscientific. I would rate the likelihood of a vaccine working, drugs making it far less deadly, or, alternatively, the virus breaking out in a way that is essentially uncontrollable so most people catch it anyway as more likely within the same time-span (for this, you’d only need a small percentage of the population as dissenters).

            I don’t see the future as bad either way incidentally — people will forget about Covid once it is over quickly enough. I lived in HK when SARs was on, and everything went back to normal quickly enough (obviously, it didn’t have massive regulations like some places). Even in Adelaide now things are pretty normal.

            There are also worse problems than Covid, although Covid is perpetuating them — like people thinking governments with power like the CCP are good idea.

          • Conrad says:

            By the way, I just saw it, but the world’s first case of someone catching Coronavirus twice occurred and was confirmed and today (4.5 months apart — two different strands ). So it looks like you can give up on herd immunity if it turns out to be real –it may end up like influenza.

            https://www.bloomberg.com/news/articles/2020-08-24/hong-kong-reports-first-coronavirus-re-infection-in-it-worker

            It is some of the other HK news sources as well.

            • paul frijters says:

              we’ll have to see how prevalent this is, of course, but its certainly an important possibility when thinking ahead.

              This is where the economists’ notion of equilibrium helps: if it turns out that a sizeable proportion of the population only develops short-run immunity to variants of this virus after infection, how does that change what the “stable situation” looks like? What are the optimising long-run arrangements around that reality? In economic parlance, what is then the equilibrium path with endogenous optimised policy and population reactions?

              This is one of the many possibilities I scanned and tried to answer when this thing went big end of March, but before I give you my answers, how about you tell me what you think the resulting optimised equilibrium then looks like? Would it make suppression more reasonable or even more futile?

              • Conrad says:

                I like equilibriums — there is some very nice maths and they are conceptually a good idea for many things :).

                There are lots of possibilities — obviously with N=1 no-one can say much, although he had symptoms the first time and none the second, so he may have got cross-immunity (which would be great), or it may just be randomness. Learning about that would be really important (they should track more people going to and from Asia/Europe). If we don’t get some cross-resistance and still lose immunity quickly, that would be surprising but clearly make life quite different (I think that’s a low probability event — although I’m willing to be told I’m wrong by someone that knows better than me!). People that get infected twice also need symptoms checked that might not be obvious so we get a profile of likely long term damage.

                The longer -term equilibrium is that like most other viruses, I assume we get used to them. I’m led to believe that most viruses tend to mutate so they are less harmful to the recipient over time and for things like influenza which mutate fast (much faster than coronavirus), we get cross resistance (apart from the occasional species jumper). I think this could be done slowly through mainly behavioral measures that don’t cost massive amounts (it works for many Asian countries who are not trying to show how marvelous they are like China — where they clearly won’t be able to get rid of it anyway). That’s my preferred solution, and the outcomes are no worse than many other things that hurt public health (probably one of the reasons people in Asia understand it better — they’re used to obvious ones like air pollution etc.).

                I also assume drugs that treat the symptoms will be found and work reasonably making this more palatable for people. We have antivirals already for influenza that work really well and I don’t see why they won’t be invented (or found) for Covid.

                Obviously, assuming mutations are happening and we are just going to get reinfected, I also don’t see a great role for trying to get to zero as you would just get reinfected again. I don’t think this is an achievable equilibrium unless vaccines come along quickly and they work for longer than 3 months, as a super spreader just needs to come in from overseas and it all restarts. Even with vaccines that worked for a year, it would be hard. That being said, even short lasting vaccines give people an opportunity not to catch things, so those that care about not catching Covid could take them and this would be fairer as everyone would then have a choice.

                There are obvious exceptions that could change the dynamics quickly. For example, more modern vaccines for influenza (c.f., the type people are talking about now which are getting tested for Covid) which have never been through trials apparently target a different part of the virus that should make us immune to all types of influenza . It’s hard to predict future biotechnology advances, but if that happened with Covid then obviously you would equilibrium would be naturally much lower, and you wouldn’t get near-miss vaccines as happened with influenza a few years ago.

                • Saupreiss says:

                  + 1
                  Of course, it is all quite speculative and lest we get some hard data about how likely any of the events are that you describe, we have to stay with guesswork (and practice some epistemic humility).

    • Saupreiss says:

      (responding to A Spaniard) “Apparently a substantial consensus was reached among experts and political parties (I do not know what happened with the mass media; were they also supportive?); how did they manage to achieve it?”

      For starters, pollies were not really involved in the strategy discussion. The strategy was developped by the Public Health Authority and the much maligend Anders Tegnell.

      The Public Health Authority approval rating has stayed at a very high level (close to 70 percent approval) and it is likely to stay there with the excess deaths have recently turned into negative territory.

      In contrast the current gov’t has less than 30 percent approval rating. Swedes are smart like that.

  11. I am and will always be Not Trampis says:

    I am interested why hospitals would be overrun under a lockdown yet not when over a 1000 people are getting each day and perhaps 60-80 people are dying as well.

    Moreover a policy that has lockdown yet has a policy of ‘protecting vulnerable people would fail.
    Why you ask?
    1) well for one thing it sounds suspiciously like what Sweden attempted and was an unmitigated disaster.
    2) next we come to Victoria. Are we really expected to believe such a campaign would be successful when the results in NSW were wellknown and people turned up for work with the virus
    3) The mixed messages would be disastrous. The government is okay with over a 1000 people getting the virus and people therefore dying from it but want a lockdown of sorts for vulnerable people. how would that work given most elderly people and those with disabilities live at home.
    The bureaucratic costs would be enormous.

  12. I am and will always be Not Trampis says:

    This analysis does not look as though it took into account the massive Government Support.

    We know household incomes held up unlike any recession we have seen.
    Indeed this is possibly the reason suicides which were widely predicted to rise considerably , as they have in previous recessions , did not rise at all.
    Apart from the deputy health officer for mental health I have not heard anyone in this field try to explain why they got this so badly wrong. She could not.

    • government support is in there mainly via the reduced future public services that more support now means. The expected 800 billion new debt will have to be paid back leading to future reductions in services.
      The effect of the government support on wellbeing is smallish but priced into the 0.5 (otherwise it would be even higher). Mainly the support takes away the notion of an economic crisis, which is probably not good to take away as it gives people a false sense of security that prevents them from feeling the effects of tradeoff choices.

      Predicting suicides is a tricky business, which is why I havent put it in my own calculations. The data is also very tricky, with lots of late measurement and non-measurement. Comparisons between countries and over time are then hampered by poor data comparability. And what holds at the individual level (the more miserable are more likely to commit suicide) does not hold at the aggregate level (more miserable countries dont have more suicides. There is not much that explains national variations). It is true that the unemployment peak normally speaking will lead to more suicides in the years to come (the small effect Professor Foster puts in her CBA).

      • I am and will always be Not Trampis says:

        Thus we come what is the counterfactual.

        Fro, legal and behavioural reasons a herd immunity or let it rip strategy is impossible.

        The counterfactual to a formal olckdown is an informal lockdown alah Sweden.

        The Australian choice is then wins handdown.

        • I think you should read up on Sweden a bit more. Seems pretty likely they reached herd immunity now because they didnt close down and had a lot of social interaction happening. Their levels of voluntary distancing, which were nowhere near the distancing you now see in Victoria, simply meant it took them longer than it should have to reach that immunity. Other European countries are now discovering they have some catching up to do (and yes, that is the right way to think about it: catching up with the immunity levels of Sweden. The current measure of success in Europe is having previously had a failed policy of suppression of community transmission among the non-vulnerable).

          Have you asked yourself, Homer, whether you truly want to live like this the rest of your life? Do you truly want to give up on the joys Australians previously had with packed sports stadiums, raucous bbqs, children playing together at school, packed weddings, etc.? Dont you miss the fullness of life?

  13. paul frijters says:

    Conrad seems to have difficulties finding medics who are willing to say lockdowns were a mistake. There’s a deluge of them everyday. For instance in the UK, one of the “SAGE” advisers to the government Mark Woolhouse said today:

    Mark Woolhouse said lockdown was a “panic measure” but admitted it was the only option at the time because “we couldn’t think of anything better to do”.

    Prof Woolhouse OBE, a member of the Scientific Pandemic Influenza Group on Behaviours that advises the Government, said: “Lockdown was a panic measure and I believe history will say trying to control Covid-19 through lockdown was a monumental mistake on a global scale, the cure was worse than the disease.

    “I never want to see national lockdown again. It was always a temporary measure that simply delayed the stage of the epidemic we see now. It was never going to change anything fundamentally, however low we drove down the number of cases, and now we know more about the virus and how to track it we should not be in this position again.

    “We absolutely should never return to a position where children cannot play or go to school.”

    “We couldn’t think of anything better to do”…. Sigh. So, as I said in March and April, they were happy to advise an unproven mass experiment that decimated the economy and caused perfectly predictable suffering on a huge scale. Now he tells us. What a perfect illustration of the banality of bureaucracy.

    • Gather that victoria intends to extend the state of emergency for another twelve months. That suggests that they are still not confident that they can do suppression containment reasonably well. When this started the lockdowns were presented as a way to buy time while systems were brought up to speed.
      At the moment the costs of lockdowns are still abstract for most, however if they continue, on and off for say a year from now public mood could change . Even more the case if the situation in NSW continues to be better managed ( obviously that is a big if).
      My gut feeling is still that the long term judgement on the benefits of extreme lockdowns will be null hypothesis.

  14. Paul
    From the AFR “need to know” feed:

    The world truly has changed. A leading businessman is comparing Melbourne to Kabul as the city’s rich flee the lockdown. A woman was jailed for six months for sneaking across Western Australia’s closed border. And KFC is no longer “finger lickin’ good”.

    Tensions are rising between the Morrison and Victorian governments as frustration at the state’s quarantine and contact tracing failures that allowed the second COVID-19 wave shreds whatever remained of national unity. Deputy Prime Minister Michael McCormack calling the restrictions in regional Victoria “unjustifiable” was one of several jabs by federal ministers.

    Those who can leave are doing so. CEOs, entrepreneurs and Rich Listers are getting out of Melbourne, as concern rises about Victorian Premier Daniel Andrews’ push for 12 more months of lockdown powers.”
    Don’t know how much longer the Melbourne club can continue to kick the can down the road but the road will end and I’m glad I’m not a member.

    • that does not sound good. Sooner or later this sort of thing turns violent. Australians are a meek lot but 12 months of lock downs? Of course, those with some power and influence seem to be leaving right now. If they can. Where are they escaping to and how? Private jets to where?

    • Saupreiss says:

      Yes, Andrews plans are unsettling and you don’t have to be McCormack to find them unjustifiable … I doubt though he will get ’em passed. But, yes, happy not to live in Melbourne right now.

    • Nikki says:

      Those who can leave are doing so? Your opinion and assumptions are not accurate. The lockdowns are clearly working, and the restrictions being referred to as ‘unjustifiable’ is just as you say, a jab. A childish, political jab! Yes, there is frustration, but we are almost at the final stage and we can slowly reopen. Doctors, aged care workers, dentists, and any health care worker (absolutely including us nurses) are thankful for the restrictions. Yes Daniel Andrews now has extended the State Of Disater for a further 6 months. That’s not to hold power over Victorians, it’s needed as a safety measure. You all treat this as a purely economical inconvenience and care nothing of the human aspect. Yes, the patients, their family and friends, but the workers, carers, the doctors and nurses experiencing living hell watching people die in the most horrific way, basically drowning in their own mucus. You only hear of the deaths, and have an opinion that they are the ones taking all the covid beds. No. Young people are taking them, being intubated, and months after being covid negative are still suffering with damage they will carry for their lives. There was mention of the individual who has tested positive to covid twice… there are many, many people who have contracted this more than once.
      Heaven forbid you had to be the one that holds your patients hand while they take their last breath, of have the horrendous honour of holding a phone up to their face so their family can say their last ever goodbyes.
      Always walking through the doors thinking today is the day I might contract this just like many of my staff members have. Imagine had Andrews not locked us down. The hospitals would become overwhelmed, and not necessarily due to shortage of beds or equipment, but the staff now quarantined, or burnt out, suffering trauma from what they have seen, also leaving the field entirely.
      Sweden admits too many people died and their decision was too hasty. They also do have restrictions in place.
      Our state will recover, our country will recover, the ones who we have lost to this (which you all callously put a dollar sign on) are lost forever.
      I’m disappointed I happened to come across this link.
      Do the right thing for every person and social distance, regular effective hand hygiene, and wear a mask if you are required. Keep everyone as safe as possible. We are all human beings, not dollar signs!

  15. I am and will always be Not Trampis says:

    Herd Immunity ( and remember this is but a theory) means at least 70% of the population gets the virus.

    If we are conservative and assume only 1% die then we get a number of around 175,000.

    yep that’s right.

    To this we should add those who also die because the hospitals cannot take then as they are vastly overrun however we run into too many assumptions needed.

    Firstly to add yet again Sweden did not get within cooee of the 70% number.
    Secondly you can see straight away why social conservatives utterly reject this theory.

  16. I am and will always be Not Trampis says:

    as to what herd immunity is I can only go by the experts and that is what they have said.

    As to the death rate I have been quite conservative. I have only assumed 1% for a deadly virus. Many would say too conservative.

    • A Spaniard says:

      Sorry to ask this, but I haven’t followed the debate from the start: What is your proposal? Take for instance the case of Spain (or France, UK, Italy, or Belgium). Do you think that a general lockdown was the best option available?

  17. Conrad
    Some NZ thoughts re long term effects of Covid19
    http://offsettingbehaviour.blogspot.com/2020/08/covid-and-co-morbidities.html

    By now it’s getting stranger and stranger that there is still so little in the way of proper studies and data on this subject.

  18. Regarding the proposed twelve month extension of Victoria’s emergency it’s clear that if it was to be agreed to in full ( seems unlikely) then normal rule of law and parliament would be very reduced.
    The effect of such extreme measures is to shift the burden from Victorias government systems , systems that clearly are not up to it, to the general public, nothing more.

  19. paul frijters says:

    I saw this poignant comment today regarding dignity and face-masks:

    To everyone who has been posting here for months, Thank you. I have been taking heart from your comments every day.
    I am posting today for the first time. I want to encourage everyone else who reads but doesn’t post to do it at least once. It will encourage us all to know how many of us there are.
    There’s often very interesting and substantial discussion here of the nature of lockdown scepticism as a political position. I usually vote Labour, because to me that party best represents the values of mutual responsibility and care for human vulnerability that make for a decent society. That is why I am so astonished and alienated by Labour’s total failure to oppose the government’s lockdown policies since March. Lockdown was an assault on the most basic structures of human community, with the exception of the nuclear family, which was idealised and totalised as the natural unit of domestic existence. The public sphere was virtually abrogated. Social life was prohibited. People who live alone were condemned to an extraordinary state of isolation, their suffering ideologically invisible to the state and to the mainstream media. Lockdown purports to act in the interests of community, but it acts in fact to destroy community. It affects to attend to human vulnerability (as against a concern ‘for the economy’) but it not only ignores the most fundamental human need for contact and companionship but actively exacerbates that vulnerability, entrenching and mandating a terrible loss of individual and collective wellbeing.
    As a feminist, my disgust at and rejection of everyday mask-wearing could not be more intense, or more resolute. The face is the primary site of expression and communication in Anglo-European (and many other) cultures. The face represents our humanity and our belonging, our right to be seen and heard in our communities. It requires us to take responsibility for ourselves as participants in the social sphere, and it enables us to do so meaningfully and powerfully.
    Everyday mask-wearing is a metastasization of lockdown. The barriers to community – in lockdown, the walls of each family or individual’s home – have been relocated to the faces of the people around us: in shops, on trains, at the post office, more and more in the street. My workplace, a university, has now mandated masks throughout the campus. I face a term of teaching in which I may never see the faces of my students, my colleagues, the librarians, or the nice women in the campus cafe from whom I buy a coffee twice a day. ‘I face’: our language is richly structured by terms like this. As social creatures, as language-users, we face the world with a language of the face.
    There has never been a liberal, progressive or honourably conservative instance of mandatory everyday mask-wearing. It is a gross assault on bodily integrity. This is the absolute base-level of the political: the state versus my body.
    My body, my choice.

    • Conrad says:

      The dilemmas white people face. Typhoid Mary probably thought the same thing.

    • I am and will always be Not Trampis says:

      Paul,

      You and this writer do not seem to understand so let me make it personal.

      Assume I live in Melbourne and I meet said woman walking down the street without mask. Let us further assume she has the virus bit not the symptoms. As she walks past me she coughs and the droplets hit me.

      I then get the virus, I go to hospital and am in the ICU on a ventilator about to experience a horrible way of dying.

      I do not mind dying indeed I look forward but not through corona.
      I die because of this woman’s selfishness.

      Perhaps you and this woman do not realise how good the masks are at stopping the virus but that is not good enough. If you are going to encourage people not to wear masks you must understnd the consequences.

    • Nicholas Gruen says:

      How poignant can you get?

      This woman should head to the US where she also gets gun rights. What’s there not to like.

      Srsly, it’s not that I don’t appreciate the points she’s making – I feel the same way about the human face in public and am disappointed it plays such a small role in discussion of the burkha in our society.

      But making those arguments without any regard for the countervailing considerations is a kind of modern psychosis. Rights exist in a context. They exist as part of some expression of the possibilities of human betterment.

      That the woman who posted them didn’t feel the need to even mention the possibility that there might be another side to this is sad, but typical of ‘sceptic’ websites where everyone retires to lament how stupid and venal the other side is. At least from what I’ve read, masks are mostly efficacious in protecting others, not oneself. But if I were in your position, I’d have been embarrassed to put this up without mentioning the other side.

      Quick question Paul – with all else being held equal, at what case fatality rate would you join the lockdown proponents?

      • The UK has had a higher per-capita fatality rate than Sweden .
        Masks have never been compulsory in NSW yet infections are much less than in Victoria.
        Where is the evidence that the measures you support have made a jot of difference ?

        • Conrad says:

          John, why don’t you tell us what measures you would use to keep the virus suppressed to a level the public is happy with.

          • Roughly what NSW or south Korea are doing. I.e tactically ,flexible, targeted and smart.

            The son of a friend went for a jog in Melbourne, stopped long enough to take a photo of the sunrise and was fined $1600 for that act. A woman and her daughter went for a driving lesson and were fined $1600 , yes that one was later revoked but that’s not the point.
            Evidence that that kind of whole of society measure has any benefit at all is non existent.

            Don’t forget extreme lockdowns in themselves have and are killing people.

            As for your use of the phrase “ Typhoid Mary “ to describe somebody who sounds like she is simply at the end of her tether , everybody has their limits
            . Count yourself lucky if you’ve never been pushed that far.

            • Conrad says:

              When I’m at the end of my tether, my actions don’t kill or make other people sick.

              The person sound like a whinger cretin of the “me” generation. If the worst thing that happens to you is that you have to wear a mask, then HTFU, and if people won’t do it, now you know why the government has all these fines. I personally think they could have used an inside-outside rule like France and the 1 hour exersize limit seems silly, but if a smallish percentage of the public abuse the rules then this is what happens.

              Personally, I have friends in HK getting tear gas sprayed in their face, shot by rubber bullets, beaten up by the police, and truly afraid for their lives, and yet they still manage to wear masks so other people that might not want to get sick don’t get sick. None of them have mentioned how mask wearing oppresses them. They have real problems.

            • Conrad says:

              This is the original joke about white people’s dilemmas incidentally. I’m not sure how widespread it is and it is typically used in education circles by Asian parents.

              But basically, when white parents argue about how teaching their children maths makes them unhappy, or whether they should make their children study harder to get a better mark etc., some Asian parents who think the answer is obvious think it is funny that white people are so worried about a bit of HTFU.

              This reminds me of wearing masks, where people in Asia don’t even bother to have arguments about whether they work or not. Hence, white people’s dilemma.

            • agreed. Conrad is right when he basically says that what is deeply affronting to one person is a harmless habit to others, but so what? Who are we to say what this person is supposed to feel and think? Society as a whole must balance conflicting effects when it sets rules, but we should not pretend the rules the collective sets do no harm.
              Like you John, this person just sounds at the end of her tether to me, feeling she has been stripped of her dignity and place in society in the name of a higher good. She is putting her hurt on the table. That is being done increasingly in the UK and all over the world, and I think is the way out of this nightmare: for the personal hurt that is being inflicted to become visible.

              • Conrad says:

                There’s tyranny of the masses, legitamite grievances, and post-modern grievance culture, which your example appears to be.

                I personally find it hard to imagine using post modern grievance culture would swing opinion too much (especially, as you’ve already noted sensational stories of dead families works better than more or less anything else).

                Even if it did, you might wonder what you’ll be left with — in fact you don’t need to, since you can already see the damage that modern right and left wing post modernism has caused.

                For example, I like your general evaluation — not because I agree with it or the assumptions you make, but because it is nicely spelt out and you make the assumptions clear. So I really can consider them and evaluate it. That’s clearly a good start in any area, even if turns out to be wrong.

                But with grievance culture, I don’t need to worry about that. I just need to explain my story about how I don’t want to catch covid etc., and then that story is as reasonable as your more thoughtful analysis, because we don’t need analyses anymore, or base truths, we just need stories. So the problem is grievance culture works both ways, and neither way is based on getting the best outcome.

                Given this strategy is now used politically for any number of things, the problem you have won’t be trying to fight off people with opposing grievances (“My grandmother died because this person wouldn’t wear mask”), but trying to bring reality to people.

                • I didnt see the post as grievance culture (which I, like yourself, hate with a passion), but more a particular way of expressing her sense of loneliness and alienation. Perhaps I was too generous to her, but it is how I read it.

                  I agree with you that I can play no other role than that of the classic Western scientist who tries to set out what he thinks is going on and what can be done. It suits me and its my job. Besides, grievance would sound a bit silly in my case given how full my life still is (though I do miss my trips and more socialising!).

                  But there is the practical question of how our society gets to change its general opinion about things, particularly when one side of the argument has been cemented in images and in the media. To use an argument Nick often pushes, emotions are the impetus for politics. If it bleeds, it leads. Given how dominant one side of the argument has been in the media and politics, I have difficulty seeing how else “my side” of the argument can find a stronger presence at the table other than also engaging in the emotional tugging game. I can’t play that game myself but I do want others on my side to play that game. The hope is that a greater sense of emotional balance (hurt versus hurt) creates the space needed for deliberation, and allows lots of people who were somewhat on the fence anyway to re-evaluate. The fear is of course that it polarises, which it probably does in the short-run as any challenge to a dominant narrative is initially greeted with rejection.

                • Conrad
                  For some women ,being forced to spend most of your time indoors and then on the rare occasions when you are allowed out, you must cover your face is a deeply emotional trigger.

                • conrad says:

                  The basic problem with changing the narrative is that it takes time. For example, in my lifetime, many attitudes have changed for the better, e.g., what we think of aboriginals, gay people, our diets, immigrants, our economy, … . But they take ages.

                  Occasionally politicians would just do things (Howard and the GST) that wern’t so popular, but they were rare and happened after years of debate. Most of the time things only change when there is a desperate need — so you might see things happen in a recession but the perceived and noticeable effect of that is still some way off for the general public.

                  That being said — all of this takes lots of time. At least with Covid, I suspect things will move so quickly that changes of attitudes will be taken over by events, not because where we are today will be more or less the same as in 2 years if we don’t do anything (let alone 5 years).

      • Conrad says:

        It’s a stupid argument even on the side of those that don’t want a lockdown. Politically, if people behave such that suppression doesn’t work, then the obvious thing that will happen in places like Australia is that we will have harsher rolling lockdowns and the restrictions on travelling overseas etc. will remain.

        https://www.theguardian.com/australia-news/2020/aug/12/essential-poll-victorians-overwhelmingly-support-harsh-restrictions-to-curb-covid-second-wave

      • A Spaniard says:

        Hi Nicholas, I think that it is great that you make questions about numbers. I probably have a few to do as well. Before that however, can you clarify me what your policy proposal is? Again, take for instance the case of Spain (or France, UK, Italy, or Belgium). Do you think that a general lockdown was the best option available? From one of your prior comments I guess this is not the case, but I would like to understand better what policy you find optimal. If you mentioned it in some prior comment I have not seen, just copy-paste it, please.

      • paul frijters says:

        Nick,

        I do think its a poignant post but tastes differ. She is simply putting her hurt on the table, feeling she is losing her place in society. Her despair is what loneliness does to people and millions of more lonely people should count for something.

        You ask what fatality rate I would need to support lockdowns. I have indeed done such calculations (and put them in a handbook forthcoming next year), as you might expect. Let me preamble and then give you a calculation.

        A big if in such calculations is whether you believe general lockdowns reduce fatality rates at all or simply delay fatality, or even increase fatality of this virus in the longer run. I largely think that the way they have been done means they delay fatality and thus inflict harm for no gain. That is based on the argument that one cannot keep this virus out, that permanent social distancing is not workable, and that the only end-game is herd immunity.
        One can make the argument that lock downs actually increase deaths from this virus by preventing the majority from gaining immunity and thus failing to create a cadre of people who we can safely send to interact with the most vulnerable, so that the vulnerable in fact have an even longer period of loneliness and longer period of danger that someone exposes them. Also, lock downs themselves will weaken the most vulnerable (loneliness is not good for the immune system), making them more susceptible.
        On balance though, I believe general lockdowns are purely a delay when it comes to fatality of this virus. All they do when done well is to buy time (time bought at a high cost), which means their benefit relies on that time being used to find new technology. So the main scenario I see wherein general lockdowns have fatality benefits is if a successful vaccine is likely found within months of initial infections, such that the temporary suppression allows one to get new technology (the vaccine) that prevents fatalities from occurring at all. An additional benefit of the time bought is that someone somewhere might find treatments that reduce fatality rates.
        In terms of already protecting the most vulnerable though, it seems to me we now already know how to do that reasonably well without general lock downs, so the most honest answer to your question is that I dont think there is any fatality rate for this particular virus (given who is vulnerable to it) that rationalises lockdowns of the general population.

        Let me be generous to your question though and thus not presume what I believe but presume that general lockdowns delay the spread of the virus enough so that time is bought within which a perfectly successful vaccine is found that then prevents all the fatalities a virus would have had. How high should the fatality rate be in no lock downs versus, say, 3 months of lockdowns to make the benefits higher than the costs?

        In my calculations it would have to be about 0.2% of the happy life-years of the whole population to, roughly speaking, compensate for the ten days taken away from everyone during the 3 months of lock downs and the additional 20 days taken away via the loss of jobs and government revenue in following years. In a virus that attacks the youngest who have 80 years to go rather than the 40 years or so of the average person in the population, that would thus be a population fatality rate of 0.1%. In a virus that attacks the oldest who had an average 4 more good years to go, that would be a population fatality rate over 2%.

        Of course such calculations depend heavily on what one thinks is reasonable about the effects of lock downs on jobs, on the speed of return to normality in different scenarios, etc. Yet above I am being very generous towards the potential benefits of lock downs and still get at 2% fatality from this virus (as a % of the whole population) as needed for super-successful lock downs to do more good than harm. There is just no way that the low fatality numbers we have seen for the coronavirus are anywhere near the level needed for general lock downs to be worth it. Its a reflection of how painful loneliness is to people and how fragile the economic system is to this kind of disruption.

  20. Suspect that the following gives the real, unspoken, reasons why lockdowns ‘ are the only thing that works‘

    Burton on the bureaus
    This is the sort of thing that should wind up on the syllabus in politics and public administration classes. Tony Burton on how government departments really work:

    In the days after the Nazis surrendered in 1945 the allies had a lot to do, so there was a curious period when the senior bureaucrats of the old regime, holed up in a nice castle in north Germany, were left alone. So what did those bureaucrats do as their country lay in smouldering, starved ruins?

    “… in a former school room still smelling of chalk, we solemnly met on the dot of ten every morning, sat down on brightly coloured straight chairs around a brightly painted square table and discussed the non-existent plans of a non-existent country.” (Albert Speer quoted in Sereny 1995)

    One suspects that after the border control debacle there are New Zealand ministers wondering if something similar is happening in the streets around the Beehive. The government’s strategy had two parts. The hard part was largely achieved by the “team of five million” agreeing to stay at home at the risk of large scale unemployment. The second part, the seemingly simpler task for an island country four thousand kilometres of ocean away from its nearest neighbour, closing the borders. The first part of the plan has succeeded beyond expectations. The second part, not so much.

    When I was part of the government machine I was struck by how little understanding even those receiving the eye-watering fees to teach “Masters in Public Policy” have of the way government operates. (If you want an example, look up “policy cycle” in a textbook on government where you will find a hamster wheel schematic and text describing how, apparently, government is run by hamster bureaucrats scuttling round it.)

    To get from the Minister to a person providing a service, say a person at the border, takes anything between five to ten of these layers. That is, five to ten people, each with a range of jobs, one of which is to “cover off” a policy like the border controls to keep out Covid. Apparently this was not bureaucratic enough, so since last week’s Public Service Act came into force, the State Services Commissioner has been added as an additional layer between Ministers and the departments that deliver services.

    To understand what happened at the border it helps to look at the writings of a neo-liberal. The term “neo-liberal” is now used so promiscuously it has become the left’s contribution to a dumb and dumber act with the right’s “political correct”. But at one point it described a mid-twentieth century approach to government whose proponents included a bureaucrat turned academic called Frederick Hayek. Contrary to myth he would have been a sceptic about the 1980s reforms in New Zealand, not the reduction in the size of government but any “rational choice“ thinking behind the new model for departments, and his views on the power of convention would probably have led him to predict the recent reversion back to a more British style civil service.

    Unlike Keynes, and many others who theorise on the role of government, Hayek spent his time in the civil service working as an administrative cog in a typical silo of government, in his case the department that managed Austria’s government debt. This gave him an insight into how little relevant information is available for most administrative purposes and he applied this to his thinking on both government and private sectors. The key problem government organisations face, that private organisations do not, is lack of incentives to find and use the information they need to do their job properly.

    Less abstractly, imagine you work on the front line of the New Zealand Customs Service and want to play your part in keeping New Zealand free of Covid-19. If you spotted gaps in the system, you would be required to “work through the line”, so your manager could pass the information up the managerial hierarchy.

    Those managers are expected to spend 40% of their time “managing up”, that is making those above them in the hierarchy happy. So, at each point that information on border deficiencies rises, it competes with agency and departmental priorities of far greater importance to people in that line, like team budgets, annual performance reviews and “strategic visions”. At the end what is left are abstracted summaries designed to make senior bureaucrats feel powerful and ministers feel in control.

    Worse, it is rare for departments to spontaneously present bad news, particularly to ministers. No-one wants to be known for telling the government that its policies are not working. At its most extreme, a former Chief Executive of MSD commanded “no problems without solutions” so only problems that had already been solved could be presented to senior managers. More commonly, there are long delays as senior officials angst over how to present the information in a way that does not show the department in a bad light. Even if good information somehow gets to the upper reaches of the hierarchy, it will not necessarily reach those who need it in a coherent or timely form.

    This works the other way too. Ministers very rarely talk to people at the front line. Their decisions are largely informed by meetings with people at the upper end of the hierarchy who are equally ignorant of what is happening where services are delivered. Decisions are and are then passed down that line of five to ten people. Anyone who has played Chinese whispers will know some of the problems with that. Unlike the children’s game, the whispers will be carefully “messaging” to promote executives, their teams and their department.

    The miracle is that this ever works. We observed one reason over the last couple of weeks: if those administering the system go too far from the real world, the real world tends to tap them on the shoulder and remind them of its existence.

    http://offsettingbehaviour.blogspot.com/2020/08/burton-on-bureaus.html

    • conrad says:

      Now just imagine that in a place with a higher level of corruption (e.g., South of France) where the messangers typically get killed (e.g., China) and don’t just try and shift the blame.

      • Very true. I’d guess that NZ is too small doesn’t have enough rent, for non-performance of critical functions to go on unchecked for too long , though I could be wrong.

        Nonetheless if you come from a pragmatic background of making things that need to function reasonably well, nearly all the time , the pervasive active suppression-punishment of feedback in so many government and corporate systems is startling.
        Makes me feel that it can surely only mean that much of what they do is in real world terms of no real consequence i.e. it doesn’t matter if it works or not, Its mostly just ceremonial decorative or ritualistic rather than functional.

    • yes, very interesting. Almost none of this is taught to academic economists in forceful enough way to make an impression. PhDs in economics by and large have no idea of the world of state and corporate bureaucracies (or university bureaucracies for that matter: all of it is fairly mysterious to most). I only really learned about these things when I was past 30, and yet before then I fancied myself as quite applied and worldly-wise because I had traveled to countries, written government reports, and had been willing to ignore received academic wisdom. I had no idea how clueless I still was until others put in a lot of effort to force me to acknowledge glimpses of how it really worked. Even reading about it made no real impression at all. Amazing how sometimes we have to experience something for a quite a while before we believe it.

      • Paul
        can you tell me, if elimination is not realistically possible ( and NZ demonstrates how hard it is) then what is the point of repeated extreme lockdowns?
        (apart from delaying the inevitable at an ever increasing cost, particularly in lives lost because of lockdowns )

        And what is the test for ending it as a strategy?

        • paul frijters says:

          extreme lock downs follow the logic of the sacrifice. “this looks painful, so it must be good for us. Oh, you tell us it is even more painful than we thought? Good, must be that much more beneficial and necessary then”.

          Dont underestimate how rational this logic sounds to many people and how hard it is not to leap from “this is painful” to “this is useful”.

  21. I am and will always be Not Trampis says:

    If you inadvertently give the virus to someone and they die it will haunt you for a long time.

    It still haunts the poor soul who works at Newmarch.

  22. The below is too long to copy and paste. Feel it’s in spirit correct, there are no clear’ best policy options’ re how to approach covid. All approaches have large costs and very uncertain benefits outcomes.

    http://offsettingbehaviour.blogspot.com/2020/08/not-enough-worst-case-thinking.html

  23. I am and will always be Not Trampis says:

    Variable Variability on Herd Immunity

  24. I am and will always be Not Trampis says:

    Joshua Gans on Reproduction numbers

  25. Conrad
    Regarding longer term effects of Covid19.
    By now a lot of Australians have had and survived Covid19 many of them, probably, have a GP .
    Do you think it possible that GPs could be surveyed re the prevalence of significant longer term effects for their patients?
    Would guess that we already have the official communication channels needed for that kind of survey and that it would not be that expensive to do ,in the scheme of things.
    Could it be done?

    • Conrad says:

      Sure, although it is not done for many things because problems caused now can appear decades later. For example, if you got concussion, you would probably feel fine in a month or so. But you would lose out later in your life. There are also studies that look at various anatomical correlates of neurological damage, although apart from a few areas of the brain, they are not very interpretable in terms of what they do and there is lots of individual variation. For example, there are studies like this, but they don’t say much for obvious reasons.

      Also, there are already web-sites set up where people write down their symptoms, but since they are self report, it’s not clear what can be learnt from them quantitatively.

      • Conrad
        No offence but can you please stick to the subject I.e. could a survey of GPs give us an idea of the significance of post Covid19 symptoms?

        BTW
        I don’t understand why you keep banging on about concussion , as analogies to viral infections go ,physical blows to the head ,seems very long bow to draw.

        • Conrad says:

          I don’t see how a survey of GPs is going to help you anymore than what we know now give the more sick people are, the more likely they will go to the GP. But we already know the basic distribution of symptoms.

          Any number of things can do damage to your brain. This includes other viruses, and I’m just pointing out that, like many other things that damage your brain, you won’t know the problems after 6 months. Indeed, if you look at the history of things like concussion and cardiovascular disease on your brain, you’ll find that people didn’t start worrying about them for ages. So it is not a bad analogy — indeed, even in the sphere of viruses, there have been hypotheses around for ages about some being precursors to even more serious forms of neurological disorders (e.g., MS) and a few where the link is established (CJD). So in this respect, they’re potentially worse than concussion or cardiovascular disease. Here’s some people noting this all the way back in April. .

          • While it would have to be an undercount ,We have some idea of the total number of infections.

            So surely a sense of the percent of the ten thousand or so who are listed as recovered, who after say three months still feel crook enough to want to see their GP would be useful.

        • Conrad says:

          Here’s some more stuff for you John.

          Try looking here which summarises the ways Covid is working (quite fascinating really). If it is institutional access only, then I’ve copied bits from the two paragraph of note for you (it may give you the preprint):

          “What are the long-term neurological and neuropsychiatric consequences of COVID-19? Respiratory virus infections are associated with neurological and psychiatric sequelae, including Parkinsonism, dementia, depression, post-traumatic stress disorder and anxiety (Limphaibool et al., 2019; Rogers et al., 2020). Brain infection is not required for these long-term effects. Inflammation and cytokine elevation in sepsis survivors are linked to subsequent hippocampal atrophy and cognitive impairment (Iwashyna et al., 2010). Experimental studies suggest a link between activation of the NLRP3 inflammasome, which may occur in COVID-19, and Alzheimer pathology (Ising et al., 2019). ARDS survivors also exhibit increased incidence of long-term depression, anxiety and cognitive impairment (Hopkins et al., 2005). Whether these late manifestations are related to non-resolving inflammation or a low-grade immune process driven by molecular mimicry or dysregulated adaptive immunity remains to be established. Chronic damage to systemic organs can also harm the brain through chronic hypoxia, metabolic dysfunction and hormonal dysregulation. Based on these considerations, significant long-term neurological and psychiatric sequelae have to be anticipated in COVID-19, especially in survivors of severe disease.”

          “there is a pressing need to develop animal models that are amenable to investigate not only the effects of SARS-CoV-2 on brain cells, but also the systemic effects of the infection and the long-term neuropsychiatric consequences” … so basically no-one knows.

  26. David Duffy says:

    So I am trying to understand all the differences between this model and that of
    Kompas et al (the June 23rd version), which reaches completely the opposite conclusions. Obviously their use of VSLs is a large one (“there are identified challenges, including fairness, in the application of QALY measures”). If 4.6% of infected cases are hospitalized (I have seen one US series where half of hospital admissions are under 60, even though mortality is low), and recovered cases lose 18 sick days on average, isn’t that already something like 31000 years of full health lost, with bed costs of $14B in Kompas et al’s “no suppression” scenario, not even counting any mortality (assuming 60% of the population eventually infected)?

    • paul frijters says:

      Hi David,

      thanks for alerting me to this paper (https://www.medrxiv.org/content/10.1101/2020.06.21.20136549v1.full.pdf). These authors were nice enough to cite me :-)

      There are many things to critique that paper on, the main one being that they say total elimination is possible and, once achieved, is permanent in their model no matter what further policies are done. That is why they get such huge “averted death” numbers and low economic costs: they are saying once elimination is achieved one can return to normal as quick as one wants. Lock everyone up for 2 weeks and you’re done, is their message! If only!

      Another major assumption for their bottom line is their assumed fatality infection rate of 1.7%, translating to about 1.2% for the whole population (they effectively take 30% of the population to be “non-infectable” (kids). So they say 200,000 to 300,000 Australians would have died without lock downs. An outlandishly large number, even in May 2020 when they will have written this paper. An exaggeration of at least a factor of 10.

      There is also no real policy in the paper. Within their model there is thus no difference between the vulnerable population and the non-vulnerable part, nor between measures aimed at the most vulnerable (in care homes and such) and the general population. Their model says every adult has a 1.7% of dying, with it being pure accident that the average age at death was 76.

      Another big element in their bottom line is their set of assumptions on the economic effect of lock downs. They basically hold a snap recovery to be possible such that the economy could be back in a month or so to (almost) where it was before. Also, they assume the first 6% of yearly GDP loss to be purely the effect of foreign demand and nothing to do with domestic policy (in a situation where you still eventually undo quarantines). How convenient, but not based on what the IMF (whom they quote) take as the causal structure of those GDP losses. This assumption gives them an economic loss less than 1/10th of what was reasonable to assume (or that their own sources would have them say was reasonable!).

      They also indeed take a very high SVLY which came from a number that is applied to very few government decisions, rather than the much more important thresholds for medical purchases, or the estimates for the effects of public health expenses (ie the actual value of government spending).

      And they leave out most of the actual costs of lock downs. So no mental health effect of loneliness, no misery from unemployment, do effect on children from school disruptions, no cancer deaths or other health loses caused by lock downs, only “additional” GDP loss itself. You might say they presume death is costly but living a meaningful life is worthless.

      So yeah, when you presume away 80% of the sources of costs of lock downs, presume away 90% of the remaining 20% of the costs of the lock downs, inflate the estimates of fatality you are avoiding via lock downs by a factor of 10, quadruple the benefits of those avoided deaths, and assume that once you have driven infections to zero the virus is gone for always, then you indeed will get a conclusion that makes no sense.

      I also find some outright technical mistakes in the paper btw. Their equation 14 and 16 for instance do not line up. Their high estimates of the remaining length of life of those who died with covid is similarly suspect. Etc.

      I would be more than happy to debate these authors in an open forum on their paper and their forecasts. I suspect though that they will by now be wishing their paper is quietly forgotten. Perhaps they should write another one to avoid this paper becoming their last written word on the topic. :-)

      • David Duffy says:

        I cannot see where you draw this 1.7% infection fatality rate from – they only ever cite the consensus overall 0.7%. I doubt lower numbers, such as your “equivalent of 10,000 Covid deaths in Australia –0.04% of the country’s entire population”. If I apply New York City covid-19 death rates from
        https://www.statista.com/statistics/1109867/coronavirus-death-rates-by-age-new-york-city/
        to the age structure of Greater Melbourne from
        3235.0 – Regional Population by Age and Sex, Australia, 2019
        I get 11000 deaths for Melbourne alone. I choose NYC because the high rates of seroconversion there suggest it might best reflect the final number of deaths associated with moving to herd immunity, and one might describe their containment strategy as intermediate in stringency. I have no feel for how true the latter is. The only other question is whether you think New Zealand’s strategy is faulty, and whether Australia is much far off them.

        • “f is the rate at which infected people die because of the virus,where f 1.67%, as given from reported data in late April,”

          page 5 in their paper. Now, not everyone would be infected in their “no policy” scenario because their R is not infinite, so 300,000 would die only if everyone were infected. Given the R they have a zero-policy scenario would kill about 260,000.

          So on page 10 they say

          ” Fatalities without control, are roughly 260,000 (assuming Australia’s current reported mortality rate, or reported deaths as a fraction of reported cases)”

          clear now?

          • David Duffy says:

            “f 1.67%” – indeed yes. I was confused because they use 0.7% twice later in S4.2.

            As to NYC being a poor choice, neither Germany or Sweden have as large a seroconverted proportion of the population AIUI*, so “worst affected” is surely a benefit given the thesis that lockdowns are an inappropriate intervention.

            * Orlowski et al
            https://journals.sagepub.com/doi/full/10.1177/0141076820945282
            seem to suggest 15-20% seroconversion in Sweden by May, which means they may more gradually approach the NYC experience (A comparison of crude (?) mortality rates on today’s ABC news seems to suggest Sweden, UK and overall US are fairly comparable at the moment).

            • there is a big unknown here, which is how much immunity Australians already have. The main studies which tell you that are the seroprevalence studies combined with the T-cell studies (of which there are only a few) and the death data. The T-cell studies largely tell you of prior immunity, which is high in Singapore, Germany, and probably in much of East Asia (studies yet to come out but nothing much else rationalises their low rates and death counts: the virus is dying out in those populations way faster than makes sense without prior immunity, even with lock downs and such). T-cell immunity is medium level in Sweden and (probably) in much of Southern Europe, and very low in Latin America (no studies yet but it seems likely because of the high death rates almost everywhere there) and New York (which is why the seroprevalence is so high in NY: people got sick and got high anti-bodies or died partially because they lacked prior immunity).

              The seroprevalance studies are hence widely misinterpreted as they tell a very different story to the one the mainstream media tells (basically the MSM are usually a few months behind in their understanding and give you the old interpretations, like that seroprevalence is the main measure of how many people have been exposed to the virus or how many are now immune). Its now clear the T-cells with the seroprevalence together tell you about current immunity levels.

              Seroprevalence will of course be near zero in Australia. I am not aware of any T-cell study in Australia, so its largely guesswork as to what prior immunity might be. Prior immunity might be quite high with all those Chinese and Asian migrants and students of the last 10 years, or it might be very low with all those Europeans and young people running around in the city centres. The high variability within Europe suggests both are possible, ie that you get regional concentrations of low and high immunity among the elderly.

              All kinds of factors might play a further role here because what matters for the death rates now is not necessarily average immunity levels but more the immunity levels amongst the most vulnerable and whether they can be shielded. So it might matter where old people lived at certain times (perhaps the 60-80 range living in suburbs was largely unaffected by prior corona waves in the cities, meaning that by the time they are in care homes they are not immune. That might explain the Swedish patterns).
              So quite a few factors are involved that are very hard to guess. My numbers above and in previous analyses basically always take my best-guess on such things, which is that Australia probably is inbetween Germany and Sweden when it comes to prior immunity and how the elderly are organised. Also, Australia had the advantage in April of being able to copy better-practice and thus avoid the UK and NY scenarios.

        • oh, and New York is of course the worst affected region in the world, very densely populated with poorly ventilated housing, and with a disastrous policy of sending sick people into care homes where they infected others. Australia would not make that mistake, nor are the cities so dense or the houses so poorly ventilated (courtesy of the climate and lots of space), so I think its reasonable to assume Australia would be somewhere between Germany (0.01%) and Sweden (0.06).

  27. Conrad thanks for the link to that study re longer term effects of Covid19, yes we don’t really know enough.
    However that needs to be balanced against the deaths resulting from lockdowns in themselves, something that will also mount in time . People will die prematurely because of lockdowns, for example of a cancer that was not detected when it was still small, because of lockdowns .
    Again it’s too early to tell how many but it’s likely to be a significant number.

    So pragmatically the case for lockdowns seems to rest on elimination for more than a few weeks at a time being achievable.

    And elimination seems very unlikely ; government systems re quarantine and track and trace are unlikely to ever be flexible and sharp enough to cut it.
    The practical organisation problems are huge, for example high rise hotels ;all those lifts, narrow corridors and little in the way of fresh air and sunlight, are not good places to hold thousands of potentially infectious people for weeks at a time.
    If we wanted to properly process say two thousand arrivals a fortnight we’d need the rough equivalent of the country town I live in so as to give them enough space sunlight and fresh air.
    And fifty thousand arrivals a year is not many, don’t how many Australian citizens live OS but it must much more than fifty thousand.

    • Conrad says:

      Elimination seems to have worked fine in Adelaide — There are now no active cases. Everything feels more or less back to normal, as it has for quite some time apart from the fact some workplaces are now allowing their employees to work from home more (which seems like a good thing).

      • Conrad how many OS flights make Adelaide their first landing in Australia?

        • Conrad says:

          Not many — some have — they learnt from Victoria and tightened up the quarantine procedure for the international flights.

        • The chances of elimination for even 100 days seems about the same as the chances of eliminating wildfire in all of SE australia.

          All of the options re Covid19 involve serious costs in lives lost either directly from the virus or in long term collateral damage . And we will never know whether any of the options in the long term saved more lives than it lost.

          Odds are that Covid19 will be with us or will be lurking just outside our borders for a long time to come, could be years. Maybe a working vaccine will turn up but there is no certainty that it will or when. Or that a vaccine will be strong enough to really make a big difference ( do wonder if a vaccine could really protect against the long term effects of apparently mild infections that you have talked about)

          Therefore it seems that the question needs to be framed as : none of the available options are that good ,they all come with large human costs, so what policy approach is the most sustainable for what could possibly be years to come?

          • Conrad says:

            In terms of community acquired cases, apart from two people, I think Covid probably has been eliminated for a 100 days in Adelaide (although I haven’t counted — I can’t find the cases conventiently on hand to check. Here is the total) without where they came from. This same is more or less true for WA and NT.

            People have been more or less going back to their normal lives for some months (certainly the traffic restarted ages ago). This shows it is worthwhile having low numbers of cases in which case people won’t be too paranoid anymore to act normally. This was all done without massive restrictions apart from right at the start. Obviously things like export markets are still hammered so things will be difficult.

            In terms of policy, I suspect they will simply keep going with more or less what they have now apart from letting in more special groups easily (students etc) until a vaccine turns up and letting groups from very low covid areas in easily.

            I agree, vaccines are a risk, but even if they only work for a few months (like influenza), that will certainly be vastly better than nothing. For example, if they work for 3 months and most people have them, you can probably largely get rid of Covid in that time. If you are old or have a likely predisposition to bad effects and don’t want to catch it, you could get it as much as you want. This way you could test easier restrictions if you wanted.

            • It’s great that things are ok in SA, however,
              does Adelaide have facilities quarantining say a thousand OS arrivals every two weeks?

              God knows how many Australians currently OS will need to return in the next year, for example they have an elderly parent who needs to go into care and there is nobody else who can make the arrangements ,or they need specialised medical treatment that’s simply not available where they are currently domiciled.
              At the moment there seems to be a de facto rationing system for those who need to return, if you can afford a full very exy price biz ticket you can get on a flight.

              A serious problem with elimination as a strategy is that it , in the case of Victoria and possibly NZ , did result in official complacency . Hopefully Victoria can improve it’s systems performance re suppression containment.

              However if we are going to shut intra state borders or lockdown, every time there is the inevitable small outbreak then things look pretty grim. (My wife’s father is in Qld, he’s 94 , we haven’t seen him for ages. We live in a area of NSW that has to date had no cases, our nearest city is Canberra which has not had anything for ages yet we really don’t know if we will be able to see him before Christmas or even at all- Anne is coping ,we zoom him a lot, but it really distresses her.)

              BTW
              There are also signs in the UK of a growing spike of excess deaths that are not Covid19 related but could be due to the longer term effects of the lockdowns.

              • Conrad says:

                If large numbers of people are going to come back and they are going to overwhelm the system, then the obvious solution is to move them away from populated areas (although thousands a week to Adelaide seems rather unlikely). We spend gargantuan sums sticking refugees in weird places off the Australian mainland so I don’t see why setting something up outside the populated areas would be impossible. I imagine many of the hotels etc. in largely tourist areas would be begging to be chosen right now.

                At least for Adelaide you can apply for special exemptions — one of the Covid cases was in fact someone that return from the UK to see a dying parent if I remember correctly, although not surprisingly they isolated themselves enough that things didn’t spread.

                • Expect your correct about Adelaide .

                  The use of underused existing tourist facilities might be an idea.
                  However hotels, resorts and detention centres in general were never designed with the quarantining of large numbers of possibly highly infectious people for weeks at a time as a primary purpose.
                  (I’d also guess that not everyone would welcome a ‘quarantine station’ near their small town.)

                  The rules for Qld re compassionate exemptions are tough.

  28. I am and will always be Not Trampis says:

    Interesting theory on Sweden’s high covid death rates HERE

    courtesy of Tyler Cowen and his excellent blog

  29. Conrad
    To give a sense of the scale of better designed quarantine facilities for returning expats that we will need if we really want to do elimination seriously.
    I offer this well done accomodation facility for about 900 temporary workers just outside Narrabri as an example .
    It’s about one k long and about half a k wide.

    https://goo.gl/maps/TnPKSJ2jyobKRTuc6

    Civeo Narrabri Village
    96 Old Gunnedah Rd, Narrabri NSW 2390
    (02) 6792 9900
    https://goo.gl/maps/ew389kgQw8bf8EKKA

  30. Paul regarding MDs who are opposed to Victoria’s apparent strategy, a news report:

    500 Vic doctors push for change
    Alexis Carey

    Hundreds of senior medics in Victoria have written to the Premier to criticise the state’s handling of the pandemic.

    One of the doctors, Eamonn Mathieson, told Today the letter was a “cry from the heart”.

    He said the group believed the Victorian approach was “defying the six basic principles of good medical practice”.

    First, do no harm. To be vigilant. Pay attention to the treatment, to be open and honest, to be collaborative amongst your colleagues,” he explained.

    “This is one of the major problems. We practise medicine in a way that we confer with our peers….We don’t even know the basis on which they are making these decisions.

    “Everyone is thinking the same thing. This attempt for viral elimination is irrational and unachievable. And simply it is madness and it needs to stop.”

    • we’ve seen similar petitions by medics in Germany, the Netherlands, Belgium, the UK, the US, pretty much everywhere. Its very interesting how it makes virtually no difference anywhere. Particularly revealing is how the supposed medical hierarchy shrugs its shoulders at such outcries. Where is the Australian Medical Association (AMA) for instance on this debate? Their website (ama.com.au) reads like a dystopian nightmare, as if we’re in the clutches of a plague. They are loving the panic, fanning it, being completely irresponsible. Not a mention of those Vic doctors.

      • Paul
        The AFR reports
        “ Mr Andrews also conceded on Tuesday that his government had cut staff from its contact tracing unit back in June, thinking that the virus had been beaten.”

        While people are describing the Victorian approach as very cautious, in reality their strategy is utterly reckless . Hence the need to suppress feedback and ruthlessly maintain group think ( mainly via fear panic)

        • yes, I agree John. The net effect of these harsh lockdowns is clearly negative. To think lockdowns are positive once must pretend that deaths, disease, and despair dont count unless one is infected with covid. Otherwise the “collateral misery” is easy to spot.

          Even just on covid deaths, it is now a reasonable argument that lockdowns dont prevent them but cause more of them. The shining example is Peru, with the worlds harshest lock down and the highest proportion of covid deaths. Lock downs dont prevent the covid deaths because they simply push them into the future (smearing them out over waves), because they actually weaken the immune systems of the population and so make (covid) deaths more likely, and because they prevent the speedier emergence of a large group of immune people to interact with the vulnerable elderly, which increases the risks to them as well. In all, lock downs are turning into a totalitarian instrument with nothing but bad effects all round.

          But lock downs remain popular and people go out of their way to make excuses for them. It’s like watching a death cult.

  31. I am and will always be Not Trampis says:

    reckless???

    just how many cases did you want?

    just remember after all this discussion the alternative is more dearths with very little upside on the economy..

    • “Mr Andrews also conceded on Tuesday that his government had cut staff from its contact tracing unit back in June, thinking that the virus had been beaten.”

      These guys don’t think through the complexities , before acting. They can only see one thing at a time.

      There will be a steadily increasing number of premature deaths for years to come as a result of the lockdowns, people who did not get treatments soon enough.

      BTW normally “cases” means infections that are serious enough to need significant medical intervention.

      • conrad says:

        I guess this will be an empirical question — I presume you are predicting here that places like France or Spain will not be worse off than Victoria in the long term even though they appear happy to allow a few thousand cases a day.

        • Conrad it is similar to war , all options are not that good. People will die, some from Covid and some from the side effects of the treatments.
          However of all the strategies Elimination is reckless: chances of success ( for more than a few weeks) are very low, the costs human as well as economic are very large and if elimination is committed to there is no exit strategy – no room to maneuver.
          Its exactly the sort of approach that appeals to people as careless about attention to the nitty gritty of ‘réaliser’ as the Victorian authorities have proven to be, hence “reckless ” is the right term.

          • conrad says:

            So do you agree France/Spain etc. are a good comparisons case or not?

            • There is little evidence of even ,a correlation between the severity of lockdowns and outcomes. So I don’t agree with the assumptions that underpin your question.

              • conrad says:

                If you think there is little correlation in the strength of the lockdown and outcomes, then I assume your prediction is that Victoria should be economically affected more than France, because the cost of the lockdown now is more in Victoria.

                However, because the current lockdown is clearly working to reduce cases, I’ll assume that you think that Victoria will get reinfected again to a reasonable degree, so the current expensive lockdown will essentially be a waste of time.

                So as far as I can tell, as much as you don’t seem to want extrapolate your predictions, you should be predicting Victoria will be worse than other second-wave countries.

                If you’re not willing to predict that, then why complain about the lockdown?

          • conrad says:

            That is, even ignoring long term damage as happens with various other viruses that affect the brain (which I can’t see why you wouldn’t add as a cost, but I’ll leave it for now), what do you consider a fair comparison that we can empirically evaluate in the future.

            I’m saying most of these countries that are willing to put up with higher numbers of cases in a second wave are a good comparison. Will that affect their economy/population health more or less over time than what Andrews is doing now? This is clearly an empirical question and we don’t and won’t know the answer into the future. However, when the future comes, we can see whose predictions were better.

      • conrad says:

        For a bit of extra thought, you might also like to predict the long-long term effects of covid, and why young people might not be as indestructable as they think.

        There’s a good summary of recent stuff on dementia and HSV here:

        https://www.frontiersin.org/articles/10.3389/fnagi.2018.00324/full

        One might wonder whether covid will be similar (and this article is just on dementia — not even cognitive decline).

  32. I am and will always be Not Trampis says:

    John. contract tracing works when you only have a few cases like we have in NSW.

    It doesn’t work when you have a lot of cases such as in Victoria. There is simply not enough people.

  33. Paul Conrad
    An excerpt from todays AFR editorial serves to sum my thoughts on this :
    … the Victorian road map practises disproportionate public health risk aversion, and struggles to pass a rational cost-benefit test of the necessary trade-offs between health and the economy. Other than some sort of public health cult, Mr Andrews’ extreme position could be explained by wanting to avoid the political risks that any fresh spike in contagion would further expose the shortfalls in the Victorian government’s pen-and-paper-based contact tracing systems.

    It beggars belief that the state’s contact tracing capacity was wound down at the end of the first wave in June, and that only now is Mr Andrews rushing to enlist the help of the private sector to ramp up and digitise the system. With prominent Victorian business figures leading the backlash against the eliminationist strategy amid fraying community cohesion, Mr Andrews faces a major crisis of confidence in his leadership of the virus response as Victorian federal Labor MPs, led by Bill Shorten, seek to distance themselves from the Premier.

    As if Victoria was a failing banana republic overwhelmed by a natural disaster, some commentators have suggested the federal government use its Section 51 quarantine power to take over managing the pandemic. A constitutional crisis is the last thing needed right now. Instead, Mr Andrews should cease going it alone and pretending he has all the answers. Accepting more federal help from Commonwealth Chief Scientist Alan Finkel and Australia Defence Force leaders to boost contact tracing, and sending Victorian health officials to look and learn from NSW, are welcome steps.

    But the Premier also needs to consult more widely with business and a larger pool of experts, and not simply take advice from pro-eliminationist modellers and epidemiologists. Mr Andrews must also translate his promise to bring Victoria’s contact tracing up to speed into meaningful policy. This requires committing to a revised set of reopening targets and timetable that clearly signals a switch from an elimination to a genuine suppression strategy as part of a national recovery from the pandemic recession of 2020.“

    It beggars belief that after all this time and all the things we have learnt, the only tool in Victoria’s toolbox is ‘ freeze nobody move, that’s an order’

    • “Accepting more federal help from Commonwealth Chief Scientist Alan Finkel and Australia Defence Force leaders to boost contact tracing, and sending Victorian health officials to look and learn from NSW, are welcome steps.”

      I disagree with that bit. Not army involvement as well! Or even more Victorian official on this case! And how useful has Finkel been so far? Its like advocating to hose down a forest fire with petrol. The AFR still doesn’t get it.

      • Paul
        Victoria’s handling of track and trace and the quarantine hotels was and is not fit for purpose .
        It seems that Victoria’s approach has been characterised by a narrow ,we know best attitude, so any willingness to accept outside advice help is an improvement.

        Seems to me that they have relied too much on modelling that shows if you severely restrict human movements for long enough, by that alone, you can achieve elimination . The flaws in that modelling, when transferred to the real world are so large so obvious that they don’t need detailing .

  34. vivi a. says:

    A proper analysis would have considered the marginal effects of one extra dollar in GDP, or one extra hour at school. I would argue that the average dollar of GDP delivers more utility than the marginal dollar. Average hour at school is worth more than the marginal hour at school, and therefore translates into less “QALYs”. I would even argue that the worth of the marginal hour at school or the marginal dollar GDP are a tiny fractions of the average ones. The analysis is fundamentally flawed since it does not take this basic economic notion into account.

    • you are clearly totally ignorant of how statistical values of life or costs of QALYs are calculated (ie as marginal values). Gigi is using very generous measures of those marginal values. Don’t worry, you are not alone in insisting that only one outcome is acceptable and that its ok to ask 50 silly questions of any other outcome. The excuses people find to justify a status quo…..

      • vivi a. says:

        I don’s see how my ignorance of QALYs matters here. Seems to me that if the GDP loss would double then the amount of QALYs loss would double as well. Even though the welfare loss (relying on standard economic theory) would have more than doubled.
        My question might seem silly to someone who relies on QALYs to measure aggregate utility losses. But QALYs, designed to evaluate costs and benefits of a particular treatment, might not be the best tool to evaluate the costs of a crisis or recession.

        • “Even though the welfare loss (relying on standard economic theory) would have more than doubled.”

          which in fact would strengthen Gigi’s case because she basically relies on the marginal effects of loses at the margin, holding those constant to lower levels of GDP.
          As I said, she is using very generous assumptions that favour lock-down.

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