SARS CoV-2

As of the middle of April, I think our goal at this point should be to delay what infections we can at relatively low cost. That means eliminating most government controls and letting people make their own judgments about how to do that. The delay gives us a shot a getting lucky that we find therapies or vaccines that work, but that is not assured.

I think this approach will dictated by some new knowledge we have gained over the past month:

(1) Lockdowns (at least in the West) don’t appear that effective. At best they push R down slightly below 1 and come at great cost. That is the experience of Europe. The great cost is evident in the drastic decline in US employment and the growing political pressure to lift them.

(2) Distancing doesn’t require lockdowns. Data pre-lockdown in most areas show that people were already doing significant distancing at the expense of things like conventions and restaurant reservations. This made the marginal effect of lockdowns small, and means that lifting them won’t restore normal levels of economic activity.

(3) SARS CoV2 is significantly more infectious than we thought. This makes attempts to stamp out the virus likely to fail even when done well (see Singapore). Even were one successful, you would have to isolate your country from the rest of the world (as China is now trying to do) which imposes significant costs itself.

(4) SARS CoV2 is significantly less deadly than we thought– especially to healthy young people. The IFR is probably between 0.3% and 0.6% overall and much lower for the healthy young. This means it makes sense for many to run the risk of infection and build toward herd immunity. It also means it makes more sense to concentrate efforts on protecting the vulnerable (even if that is a lot of people).

(5) The dynamics of building toward herd immunity mean that as more people recover from infection and become immune, R falls because there a fewer people to infect. As the number of recovered people increases, the safer it is for the vulnerable. This is a reason to flatten the curve of infection (ideally with people that recover) rather than to bend it down.

I think things will be better the sooner that government imposed lockdowns end. As in other cases where you eliminate harsh regulation, people will adapt in innovative ways to these new circumstances in ways that make their lives better.

BUT, I think that absent finding a great vaccine or great therapies, the facts outlined above mean that you probably have 100,000-500,000 Americans dying and significant losses to the welfare of the living as they adapt to a distanced world.

I wouldn’t end lockdowns because I think that will make things great and return to normal. I would end lockdowns because they make a bad situation worse.

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