11 Million Covid-19 Cases?

April 4, 2020 at 9:01 pm

Michael Mina, MD, PhD, assistant professor of epidemiology at Harvard T. H. Chan School of Public Health, assistant professor in immunology and infectious diseases at Harvard T. H. Chan School of Public Health, tweets: "*speculative* – given very limited testing and relatively short windows of time to capture virus in a nasal swab, I really won't be surprised if even 50x more people have acquired the virus than cases confirmed If so ~11 million in US could have acquired #COVID19."

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Let There Be Light

April 3, 2020 at 3:35 pm

From a New York Times news article about how the emergency medical technicians in Paterson, N.J., are coping with Covid-19:

As soon as the ambulance dropped off the patient, it rushed to the firehouse to be decontaminated. During the trip, an E.M.T. scrubbed the interior with disinfectant wipes. Once at the firehouse, the decontaminator team posted a warning sign on the rear of the vehicle: Dirty Bus.

Inside it, they hung an ultraviolet light.

Six minutes of ultraviolet light should clean the interior properly, but department protocol requires 20 minutes.

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A Coronavirus Team B

April 1, 2020 at 12:24 am

William Galston, writing in the Wall Street Journal, suggests "a coronavirus 9/11 commission" to "examine what went wrong" and make recommendations on future preparedness.

That sounds fine for eventually, as Galston suggests, after "the dust settles and passions cool." But the more urgent, immediate need is not a 9/11 commission but a Team B.

Richard Pipes, the Harvard history professor who chaired the 1976 Team B on Soviet strategic objectives, tells the story well in an October 1986 Commentary article, "Team B: The Reality Behind the Myth."

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To Beat Virus and China, Lean in to Freedom

March 31, 2020 at 9:52 am

"President Trump has an opportunity both to defeat the novel coronavirus and to gain advantage for the United States in the competition with China for global influence," I write in my column this week. Please check out the full column at the New York Sun, at the New Boston Post, and at Newsmax.

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Siddhartha Mukherjee on the Coronavirus

March 29, 2020 at 11:59 am

Cancer doctor Siddhartha Mukherjee, who won a Pulitzer Prize for his book The Emperor of All Maladies, writes in the New Yorker:

is there a relationship between that initial "dose" of virus and the severity of the disease—that is, does more exposure result in graver illness?...

Most epidemiologists, given the paucity of data, have been forced to model the spread of the new coronavirus as if it were a binary phenomenon: individuals are either exposed or unexposed, infected or uninfected, symptomatic patients or asymptomatic carriers.

Actually, though, "The doctor and medical researcher in me—as a graduate student, I was trained in viral immunology—wanted to know...what was the severity of disease in each case?"

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"A Really Bad Cold"

March 28, 2020 at 11:11 pm

Here is part of an article by Dr. Lisa Sanders, an internist on the faculty of Yale medical school, that appeared in the March 24, 2020 New York Times Science section:

The symptoms of Covid-19, the disease caused by the new coronavirus, clearly cover a broad spectrum of illness, ranging from life-threatening pneumonia to what seems like a really bad cold....

As a physician, a close look at these cases taught me new things. While I knew that there were milder cases of Covid-19, I didn't know what the mild form would look like. None of the Facebook cohort had a cough or chest pain. None felt short of breath. I thought these lower respiratory symptoms were the sine qua non of the infection. They're not. They are the characteristics of the serious edge of the illness.

These folks had none of that. They had body aches; most had a fever; many had nausea; some, vomiting. Widespread testing showed us the milder version of the disease, and that's been useful.

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Rationing, Bare Shelves in U.S. Supermarkets

March 27, 2020 at 8:09 am

Of all the many things to say "wow" about at the moment—rapid movement of $2 trillion legislation, a rising death toll, large one-day swings in the stock market—the presence of bare shelves and rationing in American supermarkets may be low on the list, but it's nonetheless worth marking.

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Unemployment and Incentives

March 25, 2020 at 10:48 pm

Senators Sasse, Tim Scott, Rick Scott, and Lindsey Graham are objecting to a provision in the congressional Covid-19 rescue package that would provide unemployment benefits that in some cases are larger than the wages workers were getting paid.

As Senator Tim Scott put it, "What this bill says without fixing it, is, it simply says, you can earn more money by being on unemployment than you can while working. That is an incentive that is perverse."

Of course the senators are correct; the longer-term and more generous the payout of the unemployment insurance, the lower the incentives to re-enter the workforce, and the more difficult it is for the private sector to create new jobs.

Here is how one prominent politician assessed the situation back in 2011:

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Coronavirus and the Commerce Clause

March 23, 2020 at 10:01 pm

The response to the coronavirus increasingly risks trampling on the Constitution, from government restrictions on the First Amendment freedom of assembly to the related freedom of religion. Now there's news that the governor of Rhode Island considered closing her state's border with Massachusetts. The governor, of whom I am generally a big fan, stopped short of ordering the border closed. That is a good thing, because she'd have collided pretty hard with the Interstate Commerce Clause in Article I of the Constitution, which gives Congress the power "to regulate commerce...among the several States." When states have argued that that language in the Constitution grants Congress a power that is non-exclusive—in other words, that Congress can regulate interstate commerce, but a state also has that power—the federal courts have generally told them to get lost.

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Play Ball

March 23, 2020 at 9:16 pm

"Announcing a certain date, soon, for the opening of the baseball season would be a symbolic way for the president to offer some hope, to get the country out of the clubhouse and back in the batter's box," I write in my column this week.

Please check out the full column at the New Boston Post (here), Newsmax (here), and the New York Sun (here).

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Ambassador Kenneth Weinstein

March 21, 2020 at 10:37 pm

President Trump on Wednesday sent the Senate his nomination of Ken Weinstein to be Ambassador Extraordinary and Plenipotentiary of the United States of America to Japan.

There were a lot of other things going on this past week, so I actually missed this news until I read it today in the Jewish Press of Brooklyn, where it appeared at the top of page 23 under the memorable headline, "Trump To Nominate Former Jewish School President As Ambassador To Japan."

What a terrific nomination. I've known Weinstein since the mid-1990s. He's bright, loyal, an independent thinker, a mensch, and a patriotic American with one of the quickest wits in Washington. He bravely endured attacks from those who thought it "appalling" that the Hudson Institute, a think tank of which he is CEO, might invite to speak representatives from the Trump administration.

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Atul Gawande on the Coronavirus

March 21, 2020 at 8:15 pm

Author and surgeon Atul Gawande writes in the New Yorker of hopeful news from Hong Kong and Singapore:

this coronavirus, even though it appears to be more contagious than the flu, can still be managed by the standard public-health playbook: social distancing, basic hand hygiene and cleaning, targeted isolation and quarantine of the ill and those with high-risk exposure, a surge in health-care capacity (supplies, testing, personnel, wards), and coördinated, unified public communications with clear, transparent, up-to-date guidelines and data....Those of us who must go out into the world and have contact with people don't have to panic if we find out that someone with the coronavirus has been in the same room or stood closer than we wanted for a moment. Transmission seems to occur primarily through sustained exposure in the absence of basic protection or through the lack of hand hygiene after contact with secretions.

Also, he writes, "the risk of asymptomatic contagion could be much lower than we thought."

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Coronavirus Dissenters

March 20, 2020 at 4:31 pm

David L. Katz MD, MPH, FACPM, FACP, FACLM, founding director of Yale University's Yale-Griffin Prevention Research Center, writing in the New York Times: "I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. ...I believe we may be ineffectively fighting the contagion even as we are causing economic collapse."

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Two More Optimistic Views on the Coronavirus

March 19, 2020 at 4:43 pm

From an interview with "Nobel laureate Michael Levitt, an American-British-Israeli biophysicist who teaches structural biology at Stanford University":

"In exponential growth models, you assume that new people can be infected every day, because you keep meeting new people. But, if you consider your own social circle, you basically meet the same people every day. You can meet new people on public transportation, for example; but even on the bus, after some time most passengers will either be infected or immune."

Another reason the infection rate has slowed has to do with the physical distance guidelines. "You don't hug every person you meet on the street now, and you'll avoid meeting face to face with someone that has a cold, like we did," Levitt said. "The more you adhere, the more you can keep infection in check. So, under these circumstances, a carrier will only infect 1.5 people every three days and the rate will keep going down."

As for Italy:

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The Tom Brady Tax Angle

March 17, 2020 at 8:29 pm

Back on February 10, I noted that a lot of the teams Tom Brady might leave Massachusetts for were places with zero state and local income tax. That means a lot for someone who makes as much money as Brady. I wrote then:

States go after athletes with so-called "jock taxes," so Brady can wind up paying state tax when he plays away games in other states, anyway, but a zero state income tax versus 5.05% on home games could amount to more than half a million dollars a year for a guy like Brady.

I'm not saying it's the only factor. But it seems to be part of the conversation. Top talent, like capital, flows to where it is well treated.

Sure enough, it looks like Brady is going to end up with the Tampa Bay, Florida, Buccaneers. Florida has no state income tax.

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