Two questions

Scott Gottlieb poses an excellent question:

He’s right.

Here’s another good question:

What if the US began taking coronavirus seriously on February 20, when we had 15 reported cases, instead of waiting three weeks until the NBA shut down, by which time we had 1630 reported cases. (I understand that we actually had many more than 15 cases on February 20, but it’s also true that we had many more than 1630 cases on March 12.)

And here’s one more question:

Is it more inexplicable to be slow in reacting to a new and poorly understood virus, or slow in reacting to a virus that has been very well understood for more than a month?

[And don’t give me a “public choice” model to excuse our slow response, unless you plan to apply that public choice model to Wuhan/Beijing conflicts within China as well.]

PS. Check out this excellent David Beckworth interview of Alex Tabarrok. I particularly liked the discussion of how we in America reacted to the Chinese coronavirus outbreak.

Update: Great article on how Azar tried to warn Trump in January, and top Trump aides told him to avoid giving the president any bad news. Trump doesn’t like bad news. I’ve always known that the Trump administration was a clown show, but it’s even worse than I imagined.

Oh, and the medical people in the Trump administration knew this was a problem from early January, so the Chinese “cover-up” is not an excuse.


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50 Responses to “Two questions”

  1. Gravatar of Christian List Christian List
    14. April 2020 at 16:01

    I don’t find stories of this kind very plausible. If Azar had really known what was going to happen, he would have called a massive alarm, and if Trump had not reacted, he would have gone through the media. So why didn’t he? Because he didn’t really see what was going to happen, like everyone else in the West.

    The CCP can’t be accused of much except that they have been collecting natural viruses without the proper security measures. And that they massively obstruct research and transparency and free sprech. And that they tried to cover up the incident for weeks. They still do. And that they let critical doctors and journalists disappear, not to say that they kill them off. So yeah, not too much. Poor, poor CCP, they get the blame for everything. In the sad reality, they are far from getting the blame they deserve.

  2. Gravatar of Benjamin Cole Benjamin Cole
    14. April 2020 at 16:39

    What if President Trump had indeed listened to experts?

    Luigi Zingales is a prof at University of Chicago-Booth.

    He posited on March 13, on the basis of projections made by credentialed public-health experts:

    “Even the simplest cost-benefit analysis suggests that the US government should be willing to spend up to $65 trillion and lock down the country to avoid extra deaths.”

    Zingales also posited: “Thus, avoiding hospital congestion has the potential of saving 7.2 million lives.”

    https://promarket.org/captured-western-governments-are-failing-the-coronavirus-test/

    —30—

    So, had President Trump had listened to Professor Zingales from the University of Chicago-Booth… then, say, reducing GDP for the next 12 years by 25% would be a reasonable trade-off…

    I’m not here to defend President Trump, whose personality is not really defensible. Go ahead and put Joe Biden in. But whether you get better policies is a question. And you will get a lot less entertainment value.

  3. Gravatar of foosion foosion
    14. April 2020 at 16:45

    It’s interesting seeing Trump supporters blame Trump’s incompetence on the impeachment trial. For example, Lindsey Graham: When it comes to the month of February, most Democrats and the media were more worried about impeaching President @realDonaldTrump than coronavirus.

    The impeachment trial ended February 5

  4. Gravatar of Matthias Görgens Matthias Görgens
    14. April 2020 at 16:56

    Scott, off course an earlier response would have been better.

    The two examples show the tragedy of relying mainly on the public sector for fighting a pandemic.

    The Chinese coverup is a government cover up. And the Americans eg had their government monopolise testing and then fail to deliver enough tests.

    The very NBA shutdown you mention is a good example of private reactions. Of course, it’s not all fun and games: you mentioned earlier how the East Coast and West Coast differed in their reactions, and that difference is more down to culture than the government.

    In this pandemic, Germany is a good example for some good cooperation between private and public sector. From what I’ve read they got lucky with their institutions: healthcare is organised locally, so there’s no single centralised institution to eg ban tests.

    The Germans have the centralised Robert Koch institute, and they provide coordination and advice. They don’t have the power to monopolise and ban.

  5. Gravatar of Brian Brian
    14. April 2020 at 16:56

    In the U.S. context, I wonder what acting early would feasibly comprise. Public compliance with a lockdown seems impossible until there are scary videos of, perhaps necessarily, similar looking people of a similar culture in huge numbers on ventilators and others unable to get into overcrowded hospitals. Force of law applied to mask wearing and hand washing and self-quarantine upon the slightest symptom and a ban on large gatherings and six foot distancing and lots of public service announcements seems slightly more feasible but again without scary videos the public will balk at aggressive enforcement. Expecting huge compliance problems sort of prevents leadership from choosing the force of law solution.

  6. Gravatar of Brian Brian
    14. April 2020 at 17:15

    To answer my own question: Acting early by cutting it off at the airport (Taiwan style) might be the least disruptive.

  7. Gravatar of Mark Mark
    14. April 2020 at 17:19

    The choice of words in that tweet hides a lot: “intervened,” “acted,” etc. are quite vague. What does “intervened” and “acted” mean? The paper that the tweet references analyzes specifically the lockdown of Hubei Province, which was very draconian, far more draconian than what any other country has done, and which was roundly criticized at the time (and not without reason) as being a significant violation of human rights. Would it have been reasonable to have that kind of lockdown one, two, or even three weeks earlier, at the first inkling of trouble? No, it would not have been. In fact, no other country has put in such a lockdown, even now, when the US and most European countries clearly have more cases than China had on January 23 when the Chinese lockdown began. A less vague tweet that read “If China had cut off all travel from Hubei Province and started forcing everyone with a high temperature in Wuhan into mass quarantine centers three weeks earlier…” would seem ridiculous on its face. But that is what the tweet and the study cited are actually saying. Moreover, if China had locked down Wuhan and shut down international travel at the beginning of January, it would not only have been violating its own people’s freedoms, but Western governments would have harshly criticized it (and rightly so) for trapping many Western citizens in Wuhan and violating their freedom of movement too.

    The stuff about transparency is a distraction. Yes, China should have been more transparent, but it’s clear that this virus has spread plenty well in countries that were transparent. I actually blame the narrative, which was spread by the government and media across the political spectrum, that “this can’t happen in countries with a free press” for why so many countries with a free press (and individuals within those countries such as myself) were unprepared. The fact that people are still taking that position is mind-boggling.

    To sum up, I don’t blame China for the virus. The thing China did wrong (lack of transparency at the start) did not cause the spread of the virus, and the thing that caused the spread of the virus (failure to lockdown at the first sign of trouble) was reasonable and something that virtually every other country did too. China is like a drunk driver that was hit by a truck while stopped in his correct lane at a red light. Sure, the driver should not have been driving drunk, but the drunkenness did not cause that accident. The push to blame China only exists to distract from our own lack of preparation and made the spread in the US worse than it could’ve been.

  8. Gravatar of Brian Brian
    14. April 2020 at 17:47

    Wuhan was locked down on Jan. 23. Taiwan banned flights from Wuhan on Jan. 26, earlier than any other country according to NBC. They had inspections of passengers from Dec. 31. So we have a limitation on freedoms in the context of an uncertain rate of spread but since it only affects some people it’s more politically acceptable to both sides.

  9. Gravatar of Benjamin Cole Benjamin Cole
    14. April 2020 at 18:23

    Brian-

    Islands and small countries have certain advantages.

    The US can not even close off its border with Mexico, where perhaps 3,000 people a day crossover though unofficial channels.

    The problem with lockdowns is that you still end up with a naive population and a novel virus, a virus that is becoming endemic globally.

    If a vaccine is in the offing, lockdowns may make sense. No one is confident we can make a vaccine in under 18 months. Some say the prospects are poor even for a virus in 18 months.

    Given that global pandemics are the new norm, like anybody else I wonder if “insta-vaccines” should be a national goal. Maybe a gigantic X-prize for the company or group that develops a method for rapid development of working vaccines for cold viruses). How about a $100 billion prize?

    But in real life, in the here and now, there are no exit strategies from lockdowns .They look like a dead end.

    We can hope the virus has already hit the low-hanging fruit and the worst is behind us, but the lockdowns may have thwarted that natural progression.

    But, the good news is we might have saved an unknown number of lives, although at the cost of a known economic catastrophe.

  10. Gravatar of Student Student
    14. April 2020 at 22:12

    It’s fair to ask if the public would have paid attention to any warnings prior to March… maybe, maybe not… but certainly it would have been better not to encourage their ignoring any advice by continually calling covid19 a fake new hoax and that it was the normal flu and would be over by April. Simply not doing that would have been 50% better to start.

    The perhaps, oh I don’t know, developing… a plan… That would seem to have been appropriate. How many lives might have been saved and how many trillions of dollars. This plan was, apparently, drafted in a week.

  11. Gravatar of P Burgos P Burgos
    15. April 2020 at 04:07

    It is plausible that the US could have delayed major outbreaks of the virus with more testing and contact tracing earlier on. That ultimately does fall on the President for not taking the side of the CDC against the FDA in the testing debacle. The US also could have started earlier in trying to hire more contact tracers and in ramping up production of PPE and ventilators.

    I doubt that much could have been achieved earlier on the social distancing front, and I think that we merely would have ended up at where we are now just a week or two later. Earlier success at testing and tracing would have lead to later adoption of social distancing and hence more spread of the disease.

  12. Gravatar of P Burgos P Burgos
    15. April 2020 at 04:46

    Maybe things in Italy and Spain would have been sufficient to scare folks in the US into adopting social distancing measures even if the US had been better at slowing the spread in February and early March.

  13. Gravatar of Christian List Christian List
    15. April 2020 at 06:02

    There are other major differences:

    The CCP could have prevented a global pandemic, not to say it was their obligation. The US “intelligence” could have prevented infections in the US, which is nice, but doesn’t help the world much, not to mention that many people from other countries are not interested in the US and vice versa.

    The investigation also appears to be kind of biased:

    “The investigation found that improved disease detection, isolation of cases and social distancing (e.g. cancellation of major public events, homework and school closures) were likely to have had a far greater positive impact on containment than travel restrictions.”

    First of all, why mix up two or even three different measures and then put them up against one single measure? Not really fair, doesn’t make sense.

    Secondly, nothing is as effective as complete travel controls with a 14-day quarantine. If this had been carried out correctly, as in Taiwan, or now even in CCP China, the disease is under control in no time and doesn’t even break out.

  14. Gravatar of Michael Rulle Michael Rulle
    15. April 2020 at 06:17

    Unlike many people, I am in favor of “whataboutism” arguments. Therefore two things may be correct—Trump too late and China are a lying bunch of thugs. Both are bad and one is worse. My point however, is Scott will never let an opportunity pass to somehow give China some kind of benefit of the doubt. I would have preferred he respond to the accusation on China explicitly, before saying how poorly Trump did. Both can be true, to repeat myself, but Scott cares more about blaming Trump than Xi_—

  15. Gravatar of mbka mbka
    15. April 2020 at 06:42

    To the above commenters.

    That’s what them “deep state” intelligence agencies are for – to get intelligence without relying on the official channels of countries. I mean, it’s a bit silly to suggest one should have to wait for an official, complete and truthful statement from the Chinese government before doing anything.

    How about the US having early warning since _November 2019_ and Trump ignoring it? https://abcnews.go.com/Politics/intelligence-report-warned-coronavirus-crisis-early-november-sources/story?id=70031273

    But no, that’s not worse than China having a wavering period of six days (!) between sobering internal news and official reaction. I’m not excusing this delay but it has to be put in context. Compare what happened in Europe. Icelandic authorities had warned Austrian authorities that travelers had returned from a Tyrol ski resort with the virus. Authorities took a week to shut down the relevant bar where these people all had congregated, and that led to a few hundred (!) more infections to be spread all over Europe. That’s how all the Nordic countries got their viruses. Similar delay, easily explained by ordinary governmental inertia. Not a good thing, for sure, but not out of this world either. Yes, they’ll get sued. But. Hindsight is a beautiful thing.

  16. Gravatar of BB BB
    15. April 2020 at 07:00

    Scott,
    The answer to your question is very simple. If we responded in a timely manner, followed the standard epidemic playbook (which we followed in the past), and did so without violating any norms associated with a well functioning democracy, we would look like South Korea or Germany. South Korea (population 50M) has 225 deaths. Germany (population 80M) has 3,200 deaths. The US (population 330M) has 26,000.
    The incompetence of Trump and the Trump administration has cost thousands of lives.
    I don’t buy arguments that we couldn’t do social distancing before it got bad. A real leader could have called attention to what was happening in Italy three weeks before we started to social distance.
    I’ll add that 8 years of government shutdowns, continuing resolutions, and sequestration did tremendous damage to our ability to respond.
    Eliminating the Pandemic Response Team was stupid and cost lives.
    The blame is well deserved.

  17. Gravatar of mbka mbka
    15. April 2020 at 07:20

    BB,

    “Eliminating the Pandemic Response Team was stupid and cost lives.”

    And they keep on bashing the CDC and the WHO, basically demanding that China itself should tell the US what to do, because for the life of it, the US won’t pay for means to figure it out themselves.

  18. Gravatar of Carl Carl
    15. April 2020 at 08:25

    I don’t know what the CCP will do next, probably something to bolster their claims that they were heroic in this crisis. I expect the White House to call for more government bureaucracy to bolster its claims that it was let down by the bureaucracy. And, I expect the Democrats to call for more socialization of the medical system to bolster their claim that our only-partially socialized system undermined our ability to react the way the best socialized systems did. In the end, we will end up with an even less agile system the next time this happens. But we will have learned enough to fail differently for the next few novel viruses.

  19. Gravatar of ssumner ssumner
    15. April 2020 at 09:46

    Christian, You are very good at making excuses for the West. Very good at blaming everything on the Chinese. But then that’s always been your agenda. You used to bash China on human rights while turning a blind eye to all the murderous dictators that Trump cozies up to.

    I bash all authoritarian regimes, in all parts of the world.

    Matthias, I agree about Germany. Taiwan is an even better example.

    Brian, I agree.

    Mark, Excellent comment. What a refreshing contrast with Christian’s agenda-driven rantings.

    Michael, LOL, people like you and Christian are so blind. After the accusation against China, I said:

    “He’s right.”

    And how did you respond:

    “Scott will never let an opportunity pass to somehow give China some kind of benefit of the doubt. I would have preferred he respond to the accusation on China explicitly, before saying how poorly Trump did.”

    I give up.

    mbka, Excellent comment.

  20. Gravatar of Christian List Christian List
    15. April 2020 at 11:23

    You are very good at making excuses for the West. Very good at blaming everything on the Chinese.

    Scott,

    I’m not accusing “the Chinese” of anything. If your questionable reading skills give you that impression, it’s not my fault at all. I’m clearly talking about the CCP.

    It’s super funny and totally absurd that someone like you, who has written a good dozen comments and articles on the subject of how “the Chinese” don’t exist, and how others are super-ignorant and super-racist for using this term, uses the term himself, and even better, uses the term against me, a guy who only speaks about the CCP. This is very telling and doesn’t surprise me at all, but one has to say that this is such a pathetic, disgusting double standard.

    It is unfortunately also another obvious example that you are actually defending the CCP, although you always love to deny it. Your real words and actions unfortunately speak against it over and over again.

    You even defend them quite obviously, despite the horrendous crimes they do commit, which I have listed here in parts, and which you love to ignore, in your old well-known manner.

    I bash all authoritarian regimes, in all parts of the world.

    No, you’re not. You like to draw a moral equidistance between democratic governments, which may be very incompetent, and vicious dictatorial regimes like the CCP, which are so malicious that they are among the worst regimes the world has ever seen.

    This is something different entirely. It is, of course, a serious mistake, an obvious trivialization of the worst regimes in the world and an attack on our democratic systems. The fact that you don’t even recognize this in the slightest, makes it even worse and basically a hopeless case, not so much different from the poison that Chomsky likes to spew.

    How about the US having early warning since November 2019 and Trump ignoring it? But no, that’s not worse than China having a wavering period of six days (!) between sobering internal news and official reaction.

    mbka,

    I’m seriously trying to understand on which planet this comment would make any sense. You cannot seriously mean what is written there? Since Scott seems to love your comment once again (like always), one must assume that you actually mean what you wrote. Can you elaborate on this a bit more or maybe explain it in other words, do you mean it, what (?), someone pinch me.

    we would look like South Korea or Germany.

    BB,

    Germany is an outlier in Europe that has not yet been understood at all. South Korea is part of a specific region in Asia, which deals very well with the disease yes, but which is also very hard to compare to Western areas.

    In terms of deaths per capita, the USA is ahead of Western countries such as the UK, Spain, France, Belgium, Italy, Sweden, the Netherlands, Luxembourg and Switzerland, and often very clearly ahead.

    The USA is not even that far away from Germany, a country you just praised so much.

    The Swiss have 140 deaths per one million inhabitants, the Spanish almost 400, the Germans 40, the Irish 90, the Americans 80.

    You don’t write comments about how idiotic the Swiss government supposedly is, so why write such comments about the American one, which has much fewer deaths as of now? It doesn’t make any sense.

    One of the most interesting Western areas is Sweden right now, with currently 120 deaths per one million inhabitants, and the government there has done the least of all the other governments mentioned.

    Now this really interesting indeed, and could be an indication that the reaction of the Western governments might not be as relevant as some people think.

  21. Gravatar of BB BB
    15. April 2020 at 11:55

    Carl,
    I think your concern that more funding will make us less agile is misplaced. Having experts in place makes us more agile. Having experts with standing relationships with both foreign and state and local counterparts would make us more agile. Having a maintained stockpile of supplies would make us more agile.
    And there is no need to “fail differently”. Public health and epidemiology are established disciplines. While other recent outbreaks were not as dangerous as this one, they were managed much more effectvively and with much better results.
    And I can’t imagine how you could possibly think our current employer based health insurance system is serving us well right now?

  22. Gravatar of Todd Kreider Todd Kreider
    15. April 2020 at 12:07

    Scott wrote: “Oh, and the medical people in the Trump administration knew this was a problem from early January, so the Chinese “cover-up” is not an excuse.”

    “There’s no chance in the world that we could do that to Chicago or to New York or to San Francisco, but they’re doing it [shutting down Wuhan, China]. So, let’s see what happens — the CDC, as usual, is on top of things.” – Dr. Fauci on January 23, 2020

    “it’s a very, very low risk to the United States. … It isn’t something the American public needs to worry about or be frightened about. Because we have ways of preparing and screening of people coming in [from China].” – Dr. Fauci, January, 26, 2020

    “The threat of this virus is minuscule… We have more kids dying of flu this year at this time than in the last decade or more,” he said. “At the same time people are worrying about going to a Chinese restaurant. The threat is (we have) a pretty bad influenza season, particularly dangerous for our children.” – Dr. Fauci, February 18, 2020.

    (Fauci also said in that February 18th interview that if the virus slips into the U.S. then “We’ve got a problem.”)

  23. Gravatar of BB BB
    15. April 2020 at 12:20

    Christian,
    It’s not complicated. During the Ebola outbreak and other recent outbreaks we did test and trace along with targeting screening of travelers and it was very effective. South Korea pursued an aggressive program of test and trace and to date has had remarkable success. Germany aggressively increased their testing capacity as soon as the test was available, and they appear to be having better results than their neighbors. The US has more than double the death rate of Germany, which is very “far away”. And I don’t write about the Swiss government because I don’t live there. Please refer me to a non-tiny country that has made testing widely available (while not doing something really stupid to offset) that has as many deaths as us. Otherwise, I stand by my opinion that Trump was stupid not to ramp up testing and other measures when he could have and it has cost thousands of lives with more to come.

  24. Gravatar of Carl Carl
    15. April 2020 at 12:52

    @BB
    Thanks for your comments.
    I hope you’re right about how the money will be spent. I went back to do a quick sampling of CDC budgets over the last 20 years and It may not have been a case of steady increases as I had thought (I say “may” because the reports have changed over the years). So, perhaps more money will be spent wisely.
    Again I hope you’re right about failing differently. We had a recent scare with Ebola that should have prepared us to handle this crisis but we failed to learn the right lessons for this crisis. Or, at least, the decision maker(s) that mattered failed to learn the right lesson.
    I’m not a fan of our employer-based healthcare system. I would prefer a system that broke the tie between employment and healthcare, but I don’t think that requires a more socialized system.

  25. Gravatar of Christian List Christian List
    15. April 2020 at 13:43

    Please refer me to a non-tiny country that has made testing widely available (while not doing something really stupid to offset) that has as many deaths as us. Otherwise, I stand by my opinion that Trump was stupid not to ramp up testing and other measures when he could have and it has cost thousands of lives with more to come.

    BB,

    It is not even clear what testing really achieves. We in Germany do not test as much as is always claimed. I have many patients who would like to have tests but they don’t get any. I do most of the tests with help of the public health department, because they get the most tests, but the criteria are very strict, usually the criteria are “typical symptoms plus contact with a person who was already tested positive”. You can easily imagine how many people fall through such a grid, but we don’t have many more tests. Yet we have so few deaths. So again: Testing can’t be that important. The leading German virologist says: Test with brains, this is more important than quantity.

    I certainly won’t deny that Trump is a magnificent buffoon. But as with economic policy, it is a completely different question how much influence this buffoon has on the actual results. I have given you all the major Western countries that clearly indicate that his influence is rather minimal. He could have certainly saved some lives if he was a miraculous genius, smarter than all the others. But his results are not a particularly negative outlier, even though he is such a buffoon. And that’s actually the interesting point.

    Add to all this the fact that the US has a bit of bad luck because they have an extraordinary cluster in NYC, what percentage of cases are in this region? This should have more to do with specific factors in NYC than anything else.

    And Ebola is a particularly bad example because Ebola was not a pandemic at all. Ebola did not break out in any Western country, which is mainly due to Ebola itself (and maybe the WHO), and not because of Western governments. Again: Looking at other large Western countries indicates that Trump is a big buffoon, but that his results, interestingly enough, are not a particular outlier, neither in a positive nor a negative direction. These are the simple facts, if you leave agendas and ideologies aside.

  26. Gravatar of Tom Brown Tom Brown
    15. April 2020 at 14:30

    Regardless of what China did or said, how is it possible that our government didn’t have a damn good idea of what was going on there? Surely we have agents and contacts there. Plus we have satellites monitoring their traffic, RF communications (cell phones and otherwise), traffic in and out of hospitals and along common work commutes, and heat produced by their factories. I cannot imagine that we didn’t have a very good idea of what was really happening in China regardless of what their government said.

    Now whether or not Trump could be persuaded to stop watching Fox & Friends talk adoringly about him for half a second to listen to his daily intelligence briefing is another matter entirely.

  27. Gravatar of Christian List Christian List
    15. April 2020 at 14:46

    @Tom Brown
    This surprised me a bit as well, that Western intelligence is apparently this useless. It wasn’t just in the US, it was everywhere. Maybe we should spend all those billions on something else?

    If they do not see something like this coming, one must really ask: What in the world would they see coming?

    Just think of deliberate attacks, which take place in much shorter periods of time. This virus originated most likely in November and it took until the end of February or even March for Western governments to realize what it meant.

    Even now the Western intelligence takes too long to tell us what really happened in Wuhan. When will we learn the truth? In 20, 30, 50 years, if the Chinese become democratic and open their archives?

  28. Gravatar of K.G. K.G.
    15. April 2020 at 15:14

    In my view the latest AP scoop which relies on internal CCP memos [1] effectively absolves China of the most serious ‘deliberate cover-up’ charge. The key question to ask is: delay of six whole days before revealing *what*? 1. Revealing that the disease is *possibly* h2h? But Wuhan government stated the very next day (Jan 15) that they’ve identified a possible case of h2h (https://abcnews.go.com/amp/Health/wireStory/china-virus-spread-humans-68293043?__twitter_impression=true) 2. Revealing that the disease *in fact* is h2h? But as the AP’s own scoop shows, China was in no position to “reveal” that on Jan 14, since even secret internal memos at that time were taking about h2h as something “evidence suggests” is “possible”.

    [1] https://apnews.com/68a9e1b91de4ffc166acd6012d82c2f9?utm_campaign=SocialFlow&utm_source=Twitter&utm_medium=AP

  29. Gravatar of K.G. K.G.
    15. April 2020 at 15:18

    A relevant reaction (as addendum to the above comment)

    > So what this means is, the heads of the CCP genuinely didn’t know prior to Jan 14 that there was H2H transmission…?

    > Honestly this seems like a huge exhonoration for Xi if not the CCP. Seems like a genuine failure within the bureaucracy rather than coordinated lies.

    https://mobile.twitter.com/lagginator/status/1250360193935802368

  30. Gravatar of mbka mbka
    15. April 2020 at 17:13

    Christian List & Tom Brown,

    scroll up to my previous comment – US Intelligence DID warn as early as November (!!!) Trump ignored it in hysteria over deep state, probably. Here is the link again, many others exist: https://abcnews.go.com/Politics/intelligence-report-warned-coronavirus-crisis-early-november-sources/story?id=70031273

    Ignoring what you said about my longer comment (just read it with kind eyes, it does make sense), Christian List you may be onto something that government responses doesn’t seem to square much with the results. In testing and even barring travelers, Italy wasn’t bad at all. And Netherlands and Sweden had some of the most relaxed policies and aren’t at the worst end of the numbers. Singapore had a well planned and watertight response early on, albeit with no lockdown, but the curve remained exponential, just a slower exponential. So now there is a partial lockdown too. Whatever measures there be in any country, their effect seems to be really lossy.

  31. Gravatar of Bob OBrien Bob OBrien
    15. April 2020 at 17:36

    “What if the US began taking coronavirus seriously on February 20, when we had 15 reported cases, instead of waiting three weeks until the NBA shut down..”

    We shut down flights from China in late January. Is this not “taking coronavirus seriously” ????

  32. Gravatar of Lorenzo from Oz Lorenzo from Oz
    15. April 2020 at 18:48

    Isn’t there are time line problem with Azar article?

    “January 23: The CDC sought a “special emergency authorization” from the FDA to allow states to use its newly developed coronavirus test.

    January 27: President Trump tweeted that he made an offer to President Xi Jinping to send experts to China to investigate the coronavirus outbreak.

    January 27: The CDC issued a level III travel health notice urging Americans to avoid all nonessential travel to China due to the coronavirus.

    January 27: The White House Coronavirus Task Force started meeting to help monitor and contain the spread of the virus and provide updates to the President.

    January 29: The White House announced the formation of the Coronavirus Task Force to help monitor and contain the spread of the virus and provide updates to the President.

    January 31: The Trump Administration:

    Declared the coronavirus a public health emergency.

    Announced Chinese travel restrictions.

    Suspended entry into the United States for foreign nationals who pose a risk of transmitting the coronavirus.”

    https://www.donaldjtrump.com/media/timeline-the-trump-administrations-decisive-actions-to-combat-the-coronavirus/

  33. Gravatar of ssumner ssumner
    15. April 2020 at 21:59

    Christian, You can claim I defend the CCP until you are blue in the face. But isn’t it odd than in 11 years of blogging, with many 1000s of posts, you cannot find a single sentence where I defend the CCP. Not one? Isn’t that odd? Meanwhile, I can cite 100s of examples where I trash the CCP.

    But none of that matters, as your mind is made up.

    In contrast, you do defend Trump’s support for murderous thugs.

    Tom, Good point. Taiwan was warning anyone who would listen as far back as late December. And Taiwan is a close ally of the US. And Trump blames the WHO. This is getting ridiculous. (I blame the WHO too, but they aren’t the cause of America’s problems.)

    K.G. Yes. The CCP is really is evil, but only an idiot would think they are evil in the way the China haters suggest. This was a disaster for China itself (including the CCP); they didn’t want this mistake to occur. The real reason the CCP is evil is that they allow local governments in places like Wuhan to censor doctors. The idea that the Beijing government purposely let this thing get out of control by denying the problem they knew existed is just silly. They informed the world as to how bad it was at virtually the same time they took aggressive steps to control it in their own country.

    Bob, The flight ban may or may not have been helpful (it perhaps stopped a handful of cases from China, at most, as Wuhan was already under a tight quarantine.) But it was of trivial importance compared to aggressive testing and other measures. The virus was already in America by January 31, with most of the cases coming from Europe, and without aggressive measures it would spread like wildfire. We didn’t take aggressive measures, so it spread like wildfire.

    Travel bans are simply not a big factor without local control. Yes, if you can get the local situation under control, then a travel ban can help. I expect Australia and New Zealand will rely on this approach. But you need local control of the virus.

    Lorenzo. You consider that decisive action? Really? Even during all of February and early March, Trump and the rest of the federal government did nothing to prepare America for the disaster that was on our doorstep. We sat around twiddling our thumbs. Maybe nothing could have been done, given the political reality. But let’s not pretend the US government was taking this seriously.

  34. Gravatar of maynardGkeynes maynardGkeynes
    16. April 2020 at 06:59

    FWIW, unlike the Chinese bureaucracy, Chinese medical research labs have received widespread praise from researchers in the US and elsewhere for the open and rapid dissemination of critical information via established international research communication channels. This may well have been allowed simply because the stifling local and national authorities were unaware of that channel. However tardy official Chines governmental notifications may have been, the US medical research community had a pretty big heads up early on. What went wrong after that is worth looking at.

  35. Gravatar of P Burgos P Burgos
    16. April 2020 at 07:08

    @KG

    I think that failure within the CCP bureaucracy is more damning of Xi’s rule than a deliberate central party policy of lying. I think a narrative of the central party lying might be more damaging for the party’s image with the masses. I would guess for the internal politics of the CCP the failure of the bureaucracy somewhat tarnishes Xi’s project of attempting to consolidate power and emphasizing “party discipline”. You need to have something of an opposition party for bad news to be reliably reported in a timely fashion.

  36. Gravatar of Tom Brown Tom Brown
    16. April 2020 at 09:53

    mbka, Christian and Lorenzo,

    I noticed this today as the top headline in the Times of Israel:

    https://www.timesofisrael.com/liveblog-april-16-2020/

    If that’s true our intelligence agencies were on top of this really early and they were telling anyone who’d listen (like Israel for example). Too bad they couldn’t get through to Trump. They should have gone straight to Fox & Friends with the information so Trump would see it.

  37. Gravatar of Tom Brown Tom Brown
    16. April 2020 at 09:55

    And regarding Trump’s miracle cure: it looks more and more like he was taken in by quacks: https://www.timesofisrael.com/trials-halted-for-drug-stockpiled-in-israel-as-potential-covid-19-treatment/

  38. Gravatar of myb6 myb6
    16. April 2020 at 11:22

    Getting local control is much easier with fewer infections. Travel bans help slow things down when there aren’t many domestic infections yet, very likely the case in the US as late as 3/4 (judging by de-lagged death count).

    Our problem with travel bans wasn’t that Trump was racist against China, it was that he WASN’T racist against Europe.

  39. Gravatar of Christian List Christian List
    16. April 2020 at 11:23

    @Tom Brown
    US intelligence reminds me strongly of nearly all the bad traits of Trump. They resemble Trump himself, but split up into thousands of morons.

    Like Trump, they do nothing, see nothing, and then at the end of the day, when the disaster has happened and with hindsight 20/20, they get up in front of the press and say: “You know what guys, we saw this coming from the very beginning and we were on top of it all along.”

    You can’t deny that they really have a great sense of humor.

    And your link about hydroxychloroquine is equally absurd. It has been known for weeks that hydroxychloroquine is most likely useless. There’s no evidence that it’s relevantly effective whatsoever.

    And it is very unlikely that this will change. The best study on the subject says that this drug might maybe shorten the disease from 14 to 13.5 days. This result has been known for weeks. That’s not a relevant effect, especially with the known side effects.

    And all the side effects listed in your link are the typical side effects of this drug: it attacks the retina of the eye, it causes headaches, it can cause severe heart arrhythmias. All this has been known for 50 years.

    The really funny thing about Trump was that he recommended the combination of hydroxychloroquine and azithromycin. Both drugs cause the same type of severe heart arrhythmias. It’s a real killer combination.

    No doctor who’s not a total nut job would give those drugs in combination, and especially not against Covid-19, because the virus itself is also said to put a lot of stress on the heart. Maybe this was the plan of the intelligence all along? Infect Trump with corona, then feed him hydroxychloroquine and azithromycin. Now that would be a creative idea for once. But don’t worry, they are too incompetent for even that.

  40. Gravatar of Christian List Christian List
    16. April 2020 at 13:45

    You can claim I defend the CCP until you are blue in the face. But isn’t it odd than in 11 years of blogging, with many 1000s of posts, you cannot find a single sentence where I defend the CCP. Not one? Isn’t that odd?

    Scott,

    You’re not stupid, of course. You’re a highly intelligent man. You don’t do it directly, you play “over gangs” as we say in German, like in billiards, you know. You play the game indirectly. If, for example, someone like me criticizes the CCP directly and explicitly, you play the racist card and lecture me that one cannot talk about “the Chinese” in this way. This is so absurd and 1:1 from the CCP playbook. The CCP is not “the Chinese”. If anything, it is the worst enemy of “the Chinese”.

    And no, I almost never decide on something permanently and forever. If your arguments and facts are convincing, I immediately change my mind. But until then I suspect that the idea that the CCP is quite evil (by our standards) is not such a bold assumption. Of course we both believe in determinism, and the human construct named “evil” is relative and subjective, but I think you know what I mean nevertheless.

    @myb6
    I thought something similar. I never thought in my life that we would ever see the day when a person like Trump, is not “racist” and “tough” enough for people like mbka and Scott. Of course, they will extremely disagree, but that’s what they basically wrote, even though they’ll deny it and won’t realize it. It’s amusing.

    Of course, all entries should have been checked already in January and February, and a 14-day quarantine should have been imposed on all those entering. But the knowledge was not there, and it was not politically acceptable at all, not to mention what the media, the GOP, the Democrats, and people like Scott and mbka would have said. It would have been the shitstorm of the century. Trump would have done it anyway, with a sadistic grin on his face, but based on what information? Even someone like Trump must have gotten cold feet to some degree, and that actually says a lot about the topic.

  41. Gravatar of ssumner ssumner
    16. April 2020 at 13:54

    Maynard, Good point.

    Burgos, I agree with that.

    Christian, So I don’t actually defend the CCP, it’s just that in your overheated imagination you believe I am defending them? OK, I can agree with that.

    But please don’t read my rely to Burgos, it might cause your head to explode.

  42. Gravatar of Christian List Christian List
    16. April 2020 at 14:18

    Okay, okay, so you didn’t write that I am “very good at blaming everything on the Chinese”, when my whole comment was explicitly about the CCP. Good to know.

    I could not have included the term CCP more often in my comment. CCP, CCP, CCP, and I didn’t even use the word “Chinese”, so yes, it’s all in my “overheated imagination”. I’m really sorry.

    @maynardGkeynes
    They have provided the information needed to create a test. But they also needed a test urgently. So that’s that. The security measures at some CCP virus labs have been criticized for years. And a lot of information is still missing. Who was Patient zero? What happened to the first samples of the virus? Were samples destroyed and why? Why were newspaper reports and research papers retracted? Where are certain researchers and journalists right now, did the earth swallow them? The list goes on and on, you can fill whole books with it.

    The praise of the scientists is very limited, except some corrupt WHO doctors. “Taiwan? What? Sorry I can’t hear you, the CCP money is clogging my ears.”

  43. Gravatar of bb bb
    16. April 2020 at 14:18

    @Carl,
    We agree on the employer based insurance. I like the public option. I was previously more skeptical of socialized medicine, but the ACA created a private option in the exchanges and a public option in medicaid expansion, and it’s hard to argue that the medicaid expansion wasn’t more successful. But the current system is unacceptable for a variety of reasons.
    And you’re right that me may fail a different way. What has surprised me this time is how we simply discarded the plan that was put in place and used successfully in the past. I didn’t expect that, even from Trump.
    @Christian,
    It sounds like you have a better view of German health care than I do. BTW: Married to a German and been there quite a bit. Love Germany.
    I tried to pull some numbers on testing, but they seem to be inconsistent. When WHO first made the test available back in February, Merkell announced that Germany intended to purchase the tests and pursue a plan of test and contact trace. It’s possible that the execution of that plan didn’t come to fruition, but to date the numbers appear to be better. And Germany has a better reputation for competent governance that most other European states to inlude Italy. The “test with brains” comment is consistent with the guidance I’ve read. I’ll note that I know people who had symptoms and contact but were unable to get a test here. I will also note, that all of the actions that have been take in the US have been by governors. DeWine, Hogan, Newsome, Whimer, and Inslee agressively moved to shutdown schools, cancel events, put lock downs in place, and build out capacity to respond. Other governors followed their queue to include Cuomo. Trump was very late to get on board, and was even critical of their actions. If the states followed Trumps lead it would be even worse. That said, I still believe that eliminating the Pandemic Response Team, failing to maintain our stockpile of supplies and choosing not to purchase the WHO test has cost countless American lives. I agree with you that it’s not over yet, but my bet is that Germany will continue to have much better numbers than the US. Unfortunately, this question won’t be settled for a while. Take care.

  44. Gravatar of Christian List Christian List
    16. April 2020 at 15:04

    @BB

    The commentary by Matthias Görgens is very good. Germany is actually very similar to the US in many respects, it is a very federal system where the individual states are allowed to decide a lot and the chancellors/presidents decides relatively little, even less than in the US.

    I personally do not like Merkel very much, as any long-term commentator here knows, but I cannot attack her in this crisis because she does not have the power. A great deal of power lies with the federal states. But similar points apply to Trump, he may be able to close the external borders, that’s within his power, but nobody will seriously claim that this buffoon doesn’t like to close all borders at every chance he gets. So he would have done it immediately if he had the information for it.

    Now again about the federal system, I think Scott will like this point, the German federal system has worked relatively well in this crisis. I was surprised by this, but I think that’s what the facts are so far.

    So why has it worked? Matthias has already made a very important point: The German federal system has some very centralized institutions, like the Robert Koch Institute (RKI) for example, but they mostly provide coordination and advice only. In the case of the RKI, they don’t have the power to monopolize and ban so much. I think that is one essential difference to the US.

    It’s similar with Merkel, she could often just give speeches and say: “I recommend”. The concrete laws had to be passed by the states.

    The second important advantage of the federal system, which I didn’t imagine before the crisis, is this: We have 16 states, and 15 of those states were sleeping very deeply, but state number 16, namely Bavaria (who else?), at a certain point, put a lot of pressure on everyone and said: “We have to close the schools right NOW, we have to do social distancing right NOW”, etc. Bavaria was hated for this by politicians from the other states, but one can see now that they made the right decisions.

    This one state saved all the others, because it created a spiral in which all the other 15 states had to follow suit very quickly, because the citizens wondered why certain rules existed in Bavaria, but not in their states. It was kind of ingenious.

    I haven’t seen federalism in this clarity before. It’s a bit like the Tenth Man principle in Israel. Correctly designed it might help to institutionalize contrarian thinking. GREAT idea.

    When WHO first made the test available back in February, Merkell announced that Germany intended to purchase the tests

    The test was even co-developed in Germany, because a very important corona researcher happens to be German. Germany was simply lucky here. The approval authority is almost as nightmarish as in the US, but there are bureaucratic loopholes regarding tests, which aren’t really that intentional, and furthermore, the authorities did not dare to contradict this one researcher who said “We need those tests right now. Shut up for once, bureaucrats.” So that’s that. L.U.C.K.

    I would also marry an American (or a Chinese or Japanese) immediately if the opportunity arose. Lovely people. Take care as well.

  45. Gravatar of bb bb
    17. April 2020 at 05:30

    @Christian,
    What you and Mathias wrote mostly jives with what I’ve read. We probably agree on more than we disagree on.
    BTW: Have German hospitals been overwhelmed as they have in parts of the US? Are they running out of PPE, ICU beds, and ventilators?

  46. Gravatar of Michael Rulle Michael Rulle
    17. April 2020 at 05:32

    Scott—-You are correct——-you did say the critique of Xi was accurate—-and I read it clearly, before I wrote what I wrote, considered factoring it in as a mitigation against my “critique” and knew you would see I ignored it—(see, I know you as a reader as well) but still chose to Ignore it.

    Why? I DO believe you agree that China’s Xi and the party are a pathetic drag on the potential of China and worse.

    But I wish your critique of China had a bunch more of “whatever it takes” to let the world know how bad they are for the world——-as you know I like the term opportunity cost with China—-and their’s is very great—-against not just their people but many other people’s as well.

    So do

  47. Gravatar of myb6 myb6
    17. April 2020 at 07:30

    @Christian, yeah I wish Trump had taken entry restrictions much more seriously much earlier (whatever his motivations) and I agree that up until maybe late February, it would’ve been an uphill battle in public opinion.

    Interesting reading your stuff on chloroquine and on Germany, thanks!

  48. Gravatar of Christian List Christian List
    17. April 2020 at 11:51

    @bb

    BTW: Have German hospitals been overwhelmed as they have in parts of the US? Are they running out of PPE, ICU beds, and ventilators?

    No, thank God this did not happen, although many people expected it, including me. The calculations predicted that it would most likely happen this week or last week, but luckily the reality was different. It was extremely quiet in the hospitals. My sister works in one of the best hospitals in Germany, and she says that it was as quiet as never before in her life, because all scheduled procedures were cancelled to make room for corona patients who then never came. Better this way than the other way round.

    Of course we are not safe yet, I’m a bit afraid of a second or third wave. I worry that people will become sloppy now and that we will be surprised.

    A lot of people don’t understand exponential growth, if the intensive care units are empty first, and then in very few days you have 60% corona patients, then this almost certainly means that you will be brutally overrun just 1-2 days later. So again: Germany was lucky here, some parts of Germany came pretty close.

    After all, most hospitals in America are not overflowing either, as you correctly said. There’s this very bad cluster in NYC, I have good friends right in Brooklyn, one friend wrote me just a few days ago: “It’s getting pretty apocalyptic here. We hear the siren of ambulances all day and night. We haven’t left the apartment at all for over a month now.”

    In Germany it’s the opposite, I live in the south, we are “strongly affected” from a German perspective, but I can do anything I want. I work, I move freely, I don’t hear any sirens.

    In the GP’s practice I work it is as quiet as never before in my life, because people finally only come to the practice when they are sick. We have relatively socialized medicine, as you may know, which unfortunately means that many people go to the doctor far too often.

    But now, finally, it is quiet. I’ve been saying for weeks now: “Guys if this is corona, we should do this every year from now on, how about forever?”

    Scott has to suffer the most from my corona “vacation”, because that’s why I’m writing here so much more than usual. Sorry, Scott.

    😂

    @myb6
    No problem, you’re welcome.

  49. Gravatar of bb bb
    17. April 2020 at 13:23

    @Christian,
    I came across a Vox article comparing France and Germany on Covid. They have good stats on testing. And the graph can be manipulated to add or remove different countries.
    https://www.vox.com/2020/4/17/21223915/coronavirus-germany-france-cases-death-rate

    It appears that Germany started testing at a high rate earlier than others which may have allowed them to avoid a situation where testing became overwhelmed. The graph comes from a site with good data on Covid, with graphs that you can manipulate.

  50. Gravatar of bb bb
    17. April 2020 at 13:35

    Interesting note. They are testing all 4,800 sailors on the Roosevelt Carrier. 60% of those who tested positive are asymptomatic, which is significantly higher than previous estimates.

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