As someone who’s naturally contrarian, and who is friends with or follows a lot of other contrarians, it’s interesting to follow how people are evaluating the risks of coronavirus. One potential split noted in this Tyler Cowen column is between “base-raters” and “growthers.” Another is partisanship: right-leaning people seem to be more dismissive of the risk, perhaps taking their cue directly or indirectly from Trump himself. (The response is far from uniform; see Michael Brendan Dougherty at NRO, for example.)
Much of my own writing has focused on debunking health panics: on secondhand smoke, on vaping. You might expect I’d take a similar position on this, too, and conclude that fears of coronavirus are overblown. But facing the decision of whether or not to travel this week — I planned to work at SXSW in Austin and visit family in Houston — I’ve been reading about it obsessively, and I’m persuaded right now that the case for taking preventive measures is strong. I’ve cancelled my own trip in part because of the virus. Though I’m not an authority, I’ve talked with a lot of other people who are unsure how to plan and I thought it worth writing out my reasoning. Some reasons I’m in the “growther” camp who’s worried that the US is not yet taking this epidemic seriously enough:
1) Potential spread of the virus is exponential. From data published by Max Roser and Hannah Ritchie at Our World in Data, the case doubling time is currently 5 days in some contexts, excluding China which has taken extreme measures to restrict its spread. (The page at Our World in Data is one of the best resources I’ve found for understanding the virus.)
2) Rates of testing have been extremely low in the US and there is evidence of community spread. Oregon, where I live, can test only 40 people per day. Over the weekend, the amount of known cases doubled twice. The absolute number of known cases is still low, but one has to wonder how many additional cases are out there.
3) The fact that many cases exhibit mild symptoms increases the chances that people may unknowingly spread the disease. Viruses with higher, faster fatality rates can seem scarier, but a virus that doesn’t kill its hosts quickly with debilitating symptoms has potential to spread more widely, doing more damage in the long-run. Relatively mild symptoms plus a long period of shedding may combine to make this virus difficult to contain.
4) Dismissive comparisons to the flu are unconvincing. First, the flu is quite bad to begin with! Second, even some optimistic case fatality rates for COVID-19 are about 10 times that of the flu. Unlike the flu, we do not have a vaccine for COVID-19. Also unlike the flu, it’s uncertain whether it will be seasonal. Absolute mortality is lower than the flu now, but given the factors above, there are plausible scenarios where it will grow alarmingly quickly. (See, again, Our World in Data.)
5) As a relatively young and healthy person, I’m not particularly worried about my own risks. I am worried about transmission to others. Observed fatality rates increase dramatically with age and certain medical conditions. Potential mortality among older populations is one of the most compelling reasons to take steps now to prevent the spread; see conditions at the Life Care nursing center in Washington or in Italian hospitals.
6) In addition to the direct risks of coronavirus, there will be second order effects if the medical system is overwhelmed. Patients suffering from other illnesses or accidents will be unable to get the care they need. If medical staff are also exposed to the virus, these patients then face even more risk, and challenges to the medical system will be compounded by shortages of doctors, nurses, and other staff. One thread on Twitter memorably describes this as “The Pinch.”
7) Perhaps, like the president, you believe that fear of the coronavirus is the product of the “Fake News Media and their partner, the Democrat Party.” Perhaps you distrust the media. Do you also distrust markets? Stocks have fallen and the 10-year bond yield fell to a record low. It’s not always possible to read the message of the markets, but right now it seems pretty clear: investors expect coronavirus to have large, lasting detrimental economic effects, and they are flocking to the safest assets.
8) Given all of the above, there’s a compelling case for mitigation. The below image, also from Our World in Data, is an abstract visualization of the benefits of slowing the spread of the virus, a.k.a “flattening the curve.” This prevents the hospital system from being overwhelmed and buys time to develop treatments and hopefully an effective vaccine.
9) I see a lot of discussion about what the “real” case fatality rate of this virus is, as if that is an independent fact about the virus rather than a figure at least partially determined by the resources available to treat the sick. The rate is contextual and preventing the hospital system from being overwhelmed is one strategy for keeping it low.
10) We’re still learning what methods are effective for mitigating the spread of the virus, but improved sanitation and social distancing are smart approaches at minimum. Forgoing unnecessary travel strikes me as an obvious response, and it’s one reason I’m not going to Texas this week as I’d planned. Avoiding and cancelling mass gatherings, as costly as it is the short-run, is also the responsible decision right now. (See Yascha Mounk, “Cancel Everything.”)
11) I haven’t yet figured out how to incorporate this into the rest of my daily life. I expect a lot of people who can will start working from home. I have that option with writing, but all of my other work is public-facing to some degree. Even for my writing, events sell books. My other work is related directly or indirectly to hospitality: I tended bar last night. I have several small events planned or in the works. I still play soccer on weekends, though I suspect that may not last. How much of that is going to seem foolish from the perspective of a few weeks or months from now? I’m not sure. I’m arguing against interest by advocating for social distancing — my non-writing work is premised almost exclusively on encouraging the opposite of that — and I expect the next few months will be challenging. But at least I have writing! Many of my friends own or work in bars and restaurants full-time, and this is going to be very hard on them.
12) It’s possible that I’m overreacting. But as Yascha Mounk concluded in his own thread about this on Twitter, “If we all do the right thing, corona might yet pass without mass casualties. Like Y2K, it’ll become a punchline. (Let’s hope it will!) But consider two points: • Y2K passed without a hitch in part because we invested vast resources into preventing problems. • It’s rational to invest in avoiding the tail-end risk of a catastrophic outcome even if it pretty—or very!—likely that it’ll never come to pass.”
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