The Weekly Sift

COVID-19 reached my town this weekend. There’s been a case at the regional hospital and some local household is self-quarantining while waiting for test results. We’re still a long way from people dropping dead in the streets — I’ve read Defoe’s A Journal of the Plague Year, so my imagination drifts in that direction — but nearby cases do get my attention. Preparations that seemed speculative a week ago are looking more pragmatic.

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The current information, as of this morning, from Live Science:

About 564 people in the U.S. have been confirmed to have the virus. Of those, 22 people have died, with deaths in Washington (18), California (1) and Florida (2). (Globally, more than 111,000 cases have been confirmed, with 3,892 deaths.)

The percentage of US deaths (22/564 = 4%) is higher than you would expect, which probably indicates that we actually have many more cases, but haven’t found them yet. That would be because of the glitches in our testing process.

However, on Saturday (March 7), Dr. Stephen M. Hahn, FDA Commissioner, said that 1,583 people in the U.S. have been tested for COVID-19 through the CDC tests.

For comparison, South Korea is testing 15,000 people per day, and has tested 196,000 to date. The containment efforts of American local health officials have been undercut by the lack of tests. As a result, some people are being quarantined unnecessarily while others are undiagnosed and spreading the virus freely.

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Just about everything connected with the virus is uncertain, so any projections should be taken with a grain of salt. I haven’t been able to find much in the way of numerical projections by qualified experts, so I will pass along (with reservations) a link to the calculations of bio-engineer (not epidemiologist) Liz Specht, who is getting quoted by a number of other people. Her main point is that if current trends hold, the US healthcare system will get swamped.

She assumes 2000 US cases on March 6 — acknowledging that the number of confirmed cases is much lower, but increasing it to adjust for the lack of testing. From there she assumes that cases double every six days which is “a typical doubling time across several epidemiological studies“. Obviously, doubling like that can’t go on forever, because the number of cases would eventually exceed the population of the planet. But it could go on for quite a while, as long as the number of infected people remains small relative to the general population.

We’re looking at about 1M US cases by the end of April, 2M by ~May 5, 4M by ~May 11, and so on.

Bad as that sounds, it’s in some ways less alarming than the projection on a slide that was presented at an American Hospital Association webinar on February 26 by Dr. James Lawler of the University of Nebraska Medical Center:

(Business Insider published the slide, but doesn’t appear to have Lawler’s cooperation; the associated article doesn’t fully explain what the slide means. I’ll observe that since Lawler’s doubling time is longer than Spect’s, his epidemic has to continue well into the summer to get 96 million cases. Some people are still hoping for seasonality, noting Singapore’s success containing the virus in a hot climate. But the World Health Organization is skeptical: “It’s a false hope to say, yes, that it will disappear like the flu. We hope it does. That would be a godsend. But we can’t make that assumption. And there is no evidence.”)

Anyway, Spect continues:

The US has about 2.8 hospital beds per 1000 people. With a population of 330M, this is ~1M beds. At any given time, 65% of those beds are already occupied. That leaves about 330k beds available nationwide (perhaps a bit fewer this time of year with regular flu season, etc). Let’s trust Italy’s numbers and assume that about 10% of cases are serious enough to require hospitalization. [Lawler’s slide estimates 5%.] … By this estimate, by about May 8th, all open hospital beds in the US will be filled.

A similar calculation has American hospitals running out of masks for its workers to wear while treating COVID-19 patients. That means health-care workers will start getting sick in fairly large numbers, leading to a shortage of them too.

Her point is not that we should all panic, but that we should all pitch in and do whatever we can to slow the spread, in hopes of mitigating the worst possibilities. So: wash your hands, stay out of crowds, cancel unnecessary gatherings, and so on. If you get sick, plan on self-quarantining and riding it out at home if you possibly can.

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Now, about that lack of testing. The World Health Organization had a COVID-19 test that it was shipping all over the world — but not to the US — by the end of February. The initial batch of tests made by the CDC were defective, so all over the country, public health officials have been proceeding on guesswork: We can’t be sure who is infected and who isn’t, so our efforts to track and contain the virus have been crippled from the start.

Why the United States declined to use the WHO test, even temporarily as a bridge until the Centers for Disease Control and Prevention could produce its own test, remains a perplexing question … But neither the CDC nor the coronavirus task force chaired by Vice President Mike Pence would say who made the decision to forgo the WHO test and instead begin a protracted process of producing an American test, one that got delayed by manufacturing problems, possible lab contamination and logistical delays.

Reportedly, many more tests will be available soon. But in the meantime, Trump’s solution is to lie about it:

But I think, importantly, anybody, right now and yesterday, that needs a test gets a test. They’re there, they have the tests, and the tests are beautiful. Anybody that needs a test gets a test.

That claim was made Friday, during a tour of the CDC Trump did while wearing his campaign hat “Keep America Great”. Wired reporter Adam Rogers commented:

As a reporter, in general I’m not supposed to say something like this, but: The president’s statements to the press were terrifying. That press availability was a repudiation of good science and good crisis management from inside one of the world’s most respected scientific institutions. It was full of Dear Leader-ish compliments, non-sequitorial defenses of unrelated matters, attacks on an American governor, and—most importantly—misinformation about the virus and the US response. That’s particularly painful coming from inside the CDC, a longtime powerhouse in global public health now reduced to being a backdrop for grubby politics.

The Dear Leader bragged: “I like this stuff. I really get it. People are surprised that I understand it. Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability. Maybe I should have done that instead of running for president.” (If his meeting Monday with pharmaceutical executives was any indication, more likely the doctors were surprised by how incredibly ignorant Trump is.)

He clearly cared much more about his own credit or blame than about Americans facing a potentially deadly disease:

Trump repeatedly sought to judge his administration’s performance by the numbers of how many have been shown to have contracted the virus and comparing it to other nations — and, in doing so, appeared to be making judgments based solely on that scorecard.

He declared he would prefer to keep the thousands of passengers and crew on the cruise ship [Grand Princess] off the California coast aboard the vessel rather than bring them ashore for quarantine, though he acknowledged that Vice President Pence and other top aides were arguing for the ship to be brought to port.

“I like the numbers being where they are,” Trump said. “I don’t need the numbers to double because of one ship that wasn’t our fault.”

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Trump’s attempt (amplified by Fox News) to minimize the danger of the virus has real-world consequences. Jelani Cobb tweeted:

Overheard from the person in front of me on line at CPAC last week: “I don’t believe anything the CDC says about this virus. It’s full of deep staters who want to use this to create a recession to bring down the President.”

Meanwhile, Senator Ted Cruz is self-quarantining after coming into contact with a carrier of the virus at CPAC.

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Now we get to the economic effects.

You may be wondering why the virus is causing such huge disruptions in the investment markets. No matter how bad the outbreak gets, the worst will probably be over in a few months. In a year (or at most two), COVID-19 should be gone completely, with the vast majority of people fully recovered and ready to be as productive as ever. (The worst epidemic in modern history, the Spanish Flu of 1918-1919, was followed by the Roaring 20s.) So why are stock markets plunging and long-term interest rates at record lows?

The answer is that the virus is a shock to the system, and it’s hard to predict what else might break because of that shock. Say you run an airline. A year from now people are probably going to be flying at the same rates as before and your airline should be as profitable as ever. But what if you don’t get there? Airplanes are expensive and you borrowed a bunch of money to buy yours. That looked like a sound investment decision at the time, because your company had plenty of profits to pay the interest with. But now people afraid of catching COVID-19 have stopped flying, companies have cancelled business trips, and all your profits have gone poof.

But your debt is still there, demanding repayment. And so you may be bankrupt by the time air travel picks up again. Viruses infect people, not airlines. But an airline might die from the secondary effects. Ditto for small businesses that rely on people going out in public, like restaurants and bars. Demand for their services will certainly return to normal in 2021, but they might be out of business by then. And once businesses start closing and companies start going bankrupt, a cascade can start. One company lays off its employees, and then the businesses that serve those employees are in trouble too. One defaults on its debts, and now its creditors face bankruptcy as well. When the dominoes start falling, it’s hard to predict how far the collapse will go.

The Great Recession of 2008 may have started with people defaulting on their mortgages. But things didn’t really break until Lehman Brothers went bankrupt. Eventually, people who had nothing to do with real estate were losing their jobs. The demand-drop and supply-disruption caused by the virus is like the mortgage defaults. We’re waiting to see if this cycle will have its own Lehman Brothers.

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Over the weekend, one possible candidate raised its head: Russia and Saudi Arabia have been arguing about how to play the drop in the oil market, with the Saudis wanting oil-exporting countries to cut production and prop up the price, and Russia hoping to use the price drop to drive more expensive producers (like the shale-oil companies in the US) into bankruptcy. This weekend, the Saudis essentially said, “If that’s what you want, Mr. Putin, we’ll give it to you good and hard.” They increased production and drove the world oil price down to $27 a barrel. (It was $63 in January.)

The US stock market opened down about 7%, with the Dow falling over 1800 points.

Such a huge price drop in oil is its own shock to the system, and it’s hard to predict what might shake loose next.