The Weekly Sift

Trump’s rhetoric is quite different from what his “Opening Up America Again” plan actually says. The confusion he’s creating doesn’t help fight the virus or boost the economy. (Quite the opposite.) But it will allow him to claim credit for good outcomes while avoiding responsibility for bad ones.

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Thursday, the White House released the long-awaited guidelines Opening Up America Again. It was rolled out in a quintessentially Trumpian way, one that will allow him to claim credit for any successes and blame someone else for any failures. This sleight-of-hand is achieved by a simple trick: What the document says is very different from what Trump says about it.

He says it’s a plan by which parts of the country can start relaxing stay-at-home orders almost immediately — even before his previously stated goal of May 1. But if you read the document (and how many MAGA-hatters will bother?) it lists a set of criteria not much different from those put forward by public-health experts all over the world — or by Joe Biden a week ago: a downward trend in cases, a rebuilt stockpile of medical equipment, extensive testing even of those with no symptoms, and exhaustive contact-tracing of those who test positive.

Since no state is anywhere near achieving those criteria, none can use these guidelines to justify opening up anytime in the near future.

You might expect all this open-up/stay-closed confusion to hinder both the economy and the fight against the virus — and you’d be right — but jobs and lives are not the point. The primary goal is to allow Trump to claim vindication no matter what happens.

• If a state reopens its economy soon and everything works fine, then Trump takes credit for all the jobs gained, because he told them to reopen. Even better, he overruled both Democrats and scientists, who were wrong when he was right. The stable genius wins again!
• If a state relaxes its lockdown rules, sees a spike in infections and deaths, and has to lock down again, it’s not Trump’s fault that the governor misapplied what was clearly written down in the guidelines. Blame that loser, even if he’s been a loyal Trumpist like Ron DeSantis or Greg Abbott.
• If a state doesn’t reopen soon, then any economic or psychological distress caused by the continued lockdown is also the governor’s fault, and Trump is the champion of the suffering people trapped in their homes. Liberate Michigan!

It’s a neat trick. Let’s look a little deeper at how it works.

What he says. First off, here’s what Trump is saying:

I think 29 states are in that ballgame, not open enough for opening, but I think they’ll be able to open relatively soon.

Of course “not open enough for opening” is already a big enough loophole to excuse whatever happens. But when asked, he also wouldn’t name any of the 29 states. So no rigorous fact-checking is possible. If you point to, say, South Dakota, which appeared to be in good shape until a sudden explosion of cases this week, he can easily absolve himself with something like: “I didn’t say South Dakota.”

And when is “relatively soon”? Well, on a phone call to the governors, he said:

Some of you are in very, very good shape to open quickly and, if you’d like, according to the guidelines, you could open before the date of May 1.

Once again, though, he didn’t say who “some of you” are. So if any of you open up and it goes badly, you’re not the ones he meant.

And who’s standing in the way of people getting their jobs back, going to the church potluck dinner, or starting the baseball season? Why Democratic governors, of course. Organizations allied with Trump have sponsored anti-lockdown rallies (where some protesters openly carry rifles), and Trump has endorsed them, tweeting “LIBERATE MICHIGAN!“, “LIBERATE MINNESOTA!“, and “LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!“. [1]

So if you’re facing real hardship during this crisis — or if you’re just bored and resent that you can’t get your hair cut — Trump wants you to know that he’s on your side. If it were up to him, the economy would be booming again. People would be gathering in bars, flying coast-to-coast, and buying standing-room-only tickets for country music festivals. [2]

And the virus? Oh, never mind all that. Trump’s propaganda network is telling his base that the virus is no big deal — pulling false statistics out of their butts, and using the merely 60 thousand deaths predictions of the most optimistic if-we-lock-down models to argue that we don’t need to lock down. [3]

What the guidelines say. In contrast to what Trump himself implies, or the things said explicitly by his mouthpieces at Fox News, the administration’s guidelines take the virus seriously. They set criteria for opening that no state can currently meet, and which probably won’t be achievable for some while.

The guidelines have three phases. To enter Phase 1 (or to progress from one phase to the next), a state has to meet (and then maintain) these criteria:

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SYMPTOMS

Downward trajectory of influenza-like illnesses (ILI) reported within a 14-day period

AND

Downward trajectory of covid-like syndromic cases reported within a 14-day period

CASES

Downward trajectory of documented cases within a 14-day period

OR

Downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests)

HOSPITALS

Treat all patients without crisis care

AND

Robust testing program in place for at-risk healthcare workers, including emerging antibody testing

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In other words, the virus has to have been in retreat for two weeks, and you have to be prepared for the possibility that loosening restrictions will lead to a new outbreak. But that’s not all. The “Core State Preparedness Responsibilities” section assigns key responsibilities to the states. This is, in essence, a second set of criteria. If you can’t do these things — and no state currently can — you’ve got no business opening up.

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TESTING & CONTACT TRACING

• Ability to quickly set up safe and efficient screening and testing sites for symptomatic individuals and trace contacts of COVID+ results
• Ability to test Syndromic/ILI-indicated persons for COVID and trace contacts of COVID+ results
• Ensure sentinel surveillance sites are screening for asymptomatic cases and contacts for COVID+ results are traced (sites operate at locations that serve older individuals, lower-income Americans, racial minorities, and Native Americans)

HEALTHCARE SYSTEM CAPACITY

• Ability to quickly and independently supply sufficient Personal Protective Equipment and critical medical equipment to handle dramatic surge in need
• Ability to surge ICU capacity

PLANS

• Protect the health and safety of workers in critical industries
• Protect the health and safety of those living and working in high-risk facilities (e.g., senior care facilities)
• Protect employees and users of mass transit
• Advise citizens regarding protocols for social distancing and face coverings
• Monitor conditions and immediately take steps to limit and mitigate any rebounds or outbreaks by restarting a phase or returning to an earlier phase, depending on severity

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In short, Opening Up America Again says exactly what nearly all the experts (and Biden) have been saying: We need to be doing lots more testing (about triple what we’re doing now, according to one Harvard report), including testing people without symptoms, so that we can figure out who has the virus and spot new outbreaks quickly. Healthcare workers and nursing home workers need antibody testing that is only just now becoming available, and may not be available in the needed quantities for some time. We need to be set up to do extensive contact-tracing, so that we track down everybody who might be infected (again, whether they have symptoms or not).

The healthcare system needs to have slack capacity and rebuilt stockpiles of protective equipment. Key systems like public transportation need to be reconfigured for safe use. Industrial plants (like the meat-packing plant that triggered the South Dakota outbreak) need to be reconfigured to protect workers.

The guidelines also say that public behavior can’t return to normal; you still need to keep away from people when you can and wear masks when you can’t. Keep washing your hands constantly, and self-quarantine if you feel sick.

Businesses that want to reopen need to keep limiting business travel, and shut down or regularly disinfect common areas where workers might otherwise congregate. The guidelines recommend temperature checks at the door for workers and perhaps customers as well.

Does any of that sound like the vision Trump has been putting forward in public? No, of course not. But if states loosen up their stay-at-home orders and something goes wrong, you can bet Trump will point to these Biden-like guidelines as what he really proposed, and completely forget all his contrary statements. “I never told you to do that,” he’ll say. And Fox News and right-wing talk radio will back him up: “None of us ever said to do that.”

And if that butt-covering action requires throwing some Republican governors under the bus — I’m looking at you, Ron DeSantis of Florida — Trump will be more than willing to do it. Whether in business or politics, backing Trump’s play has always been a risky strategy.

The phases. A state needs two weeks of good testing to start Phase 1, then two more weeks to get to Phase 2, then two more to get to Phase 3. So if nothing at all goes wrong, no state can get back to anything resembling normal for six weeks.

In Phase 1, lots of stuff stays closed: schools, day-care centers, camps, bars. Nursing homes and hospitals are locked down against visitors. Gyms, churches, and arenas can open only if “strict physical distancing protocols” are maintained. (Picture a stadium or theater with about 1/10th of the seats occupied and no concession stand.) Out-patient elective surgeries are OK, but not ones that require hospitalization. Businesses should still encourage telework, and redesign their on-site processes for social distancing. As for individuals, you shouldn’t socialize in groups of 10 or more, and keep your distance from people even then. Avoid non-essential travel. Vulnerable people should stay home, and if you live with vulnerable people you need to be able to isolate yourself from them.

In Phase 2, schools can reopen, the limit on social gatherings rises to 50, and you get to travel non-essentially again. Common areas at work should still be closed, and telework continued. Elective surgery with hospitalization is OK. You still can’t visit Mom at the nursing home. Bars can reopen “with diminished standing-room occupancy”, whatever that means. Social distancing protocols for large venues can now be “moderate” rather than “strict”. Vulnerable people should still stay home.

In Phase 3, vulnerable people can come out if they’re careful, and everybody else should minimize time in crowds when not avoiding them altogether. Workplaces can resume “unrestricted staffing”. Bars and gyms can go back to more-or-less normal, but large venues should still maintain “limited” social-distancing practices. You can visit Mom again, if you’re “diligent regarding hygiene” (which Mom always nagged you about anyway).

States are on their own. By listing those “Core State Preparedness Responsibilities”, the Trump administration is denying any responsibility for its failure to create the prerequisites for reopening. Testing, contact tracing, building up PPE stockpiles — those are state responsibilities. So the states shouldn’t count on the federal government to help them get ready to reopen.

But some governors made it clear they are not ready to break out the roadmap, saying they badly need help from Washington in expanding testing.

[New York Governor Andrew] Cuomo, whose state is the most lethal hot spot in the nation and is still seeing over 600 deaths a day, accused the federal government of “passing the buck without passing the bucks.”

“The federal government cannot wipe its hands of this and say, `Oh, the states are responsible for testing.′ We cannot do it. We cannot do it without federal help,” the governor said.

However, Trump will incite citizens to demand — perhaps violently — that their states reopen whether they are ready or not. [4]

Governors out on a limb. In spite of the fact that no state fulfills the prerequisites for Phase 1, several states are announcing some kind of reopening.

Despite Florida hitting a new high for new Covid-19 cases Friday, beaches in Jacksonville, Florida reopened for limited hours. (“This is really a crazy bad idea,” said one resident.) CNN did not see much social distancing. The NY Post reported: “Aerial photos show hundreds of people packing the sand to swim, stroll, surf and fish. Many were without masks.”

Texas Governor Greg Abbott appears to see the trap Trump has laid for him, and so far is doing the same thing Trump is doing: talking in favor of aggressive reopening, but not yet committing himself to anything specific.

Instead of kicking off a full restart, the Texas governor announced that a group of medical and economic experts will guide him through a series of incremental steps aimed at slowly reopening the state’s economy. The group’s aggressive name, the “Strike Force to Open Texas,” belies Abbott’s surprisingly cautious framework. Plans to restart business won’t come until April 27, and Abbott stressed they will be determined by “data and by doctors.”

But unlike Trump, Abbott has no one to pass the buck to. And his base, which belongs more to Trump than to him, is getting restless.

Through the week, as Abbott’s public messaging made it sound less likely that he would announce a grand reopening, he began taking fire from members of his own party who say he’s moved too slowly to reinvigorate the economy and has been overly deferential to public health experts. On Thursday for example, Don Huffines, a former Texas Republican state senator who represented Dallas County, wrote a blistering op-ed for the Austin American-Statesman, excoriated Abbott for his handling of the coronavirus crisis.

Some Republican governors — Mike DeWine in Ohio for one — are standing by their lockdown decisions without waffling. And they are not immune to the Trump-inspired protests, as this Pulitzer-worthy photo from Columbus makes clear.

But they also must know that Trump will shamelessly throw them under the bus if reopening leads to a new wave of deaths. He has already laid the groundwork to do just that.

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[1] If any of this leads to actual violence, of course, that’s not Trump’s fault either. It never is.

Trump advisor Stephen Moore calls these protesters “modern-day Rosa Parks“, because staying home and watching Netflix for a month is exactly like living your whole life under Jim Crow.

And one more thing: None of these demonstrations around the country were more than a few hundred people. Would a similar number of liberals demonstrating for a liberal cause get this much attention? I doubt it.

[2] This vision, of course, is a complete fantasy. The economy can’t recover if we don’t beat the virus.

It’s worth noting that no one has locked down the airlines, but traffic has drastically dropped off anyway, because people very sensibly don’t want to spend hours trapped in a small space with possible carriers of the virus. Iowa has been one of the slower states to respond to the virus, and is not usually considered a hub of liberal hysteria, but The Des Moines Register reports:

Facing a 95% reduction in passenger traffic, Des Moines International Airport officials have closed a terminal, shut down services and delayed projects — including a planned Allegiant Air crew base — to save money during the coronavirus pandemic.

The unprecedented decrease in travelers while Iowans are practicing social distancing follows three years of record-breaking traffic at the state’s largest airport.

Bill Gates makes the point like this:

It’s very tough to say to people, “Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is what really counts.”

And Thursday morning I heard CNBC’s Jim Cramer say:

You don’t want to think, “If I go to the movies, I might die.” We’ve got to take dying off the table.

[3] Bill Bennett and Seth Leibsohn write:

The Institute for Health Metrics and Evaluation in Washington state is now projecting 68,841 potential deaths in America. It is also estimating lower ranges than that. The flu season of 2017-2018 took 61,099 American lives. For this we have scared the hell out of the American people, shut down the economy, ended over 17 million jobs, taken trillions of dollars out of the economy, closed places of worship, and massively disrupted civic life as we know it.

But National Review’s Rich Lowry (not usually one of my favorite writers) notes that the lockdown might have had something to do with keeping the death toll down to where it is, and then elaborates:

Consider the perversity of [Bennett and Leibsohn’s] reasoning a different way. If we had shut down the country a month sooner and there had been, say, only 2,000 deaths, then on their terms they’d have an even stronger argument, i.e., “We did all this, and there were only a couple of thousand fatalities?”

In other words, the more effective a lockdown would have been, the more opposed Bennett and Leibsohn would be to it.

[4] Brazil’s President Jair Bolsonaro, who is often likened to Trump, is taking one more step: He’s appearing at anti-lockdown demonstrations that openly call for a return to military rule.

Political observers say the protesters were right-wing Bolsonaro supporters who called for military intervention on behalf of the president because they view the country’s supreme court and legislature as obstacles to his campaign against pandemic lockdown measures, despite the fact that the country has more than 35,000 confirmed cases and over 2,300 deaths as of April 19.

“Now it is the people in power. It’s more than your right — it’s your obligation to fight for your country,” Bolsonaro said, standing on a pickup truck outside the Army headquarters. “We don’t want to negotiate anything. We want action for Brazil.”

Update: My test came back negative. I don’t have the virus.

Let me begin this post by saying that, as best I can tell, I’m doing fine. I’ve quarantined myself since Tuesday, but so far my symptoms are somewhere between minor and imaginary. Nonetheless, I got tested Friday, and I should hear results Tuesday or Wednesday.

OK, let’s go back and tell the story from the beginning: My wife has a large number of risk factors, so we are terrified of what would happen should she catch Covid-19. Both of us are in our 60s. She had a lung collapse during surgery several years ago, and it never fully reinflated, so essentially she gets by on one-and-a-half lungs. A different medical problem resulted in half her liver being removed. And she takes a drug that drags on her immune system (though I don’t think it’s that bad; she throws off colds fairly well).

So our household is hyper-vigilant. That gets tricky, because I have a number of conditions that mimic coronavirus symptoms: An allergy causes me to wake up congested every morning and spend my first waking hour coughing and blowing my nose. If I sleep in the wrong position, I’ll have a muscle ache when I do that coughing. As for aches and pains in general, I already mentioned that I’m over 60. In short, most of the early-warning symptoms of Covid-19 are normal for me.

That leaves me focused on the one symptom I don’t ordinarily have, which is fever. Quite the opposite, in fact: My body typically runs cool. A normal morning temperature for me is below 98, and can run as low as 97.4. It tends to rise through the day, but hardly ever hits 98.6.

Anyway, first thing Tuesday, I’m having my morning cough and feeling a little more discomfort in it than usual. I take my temperature and it’s 98.3 — fine for anybody else; not fine for me. And I think “Probably nothing, but …”. And then I think “If you wait until you’re sure, you’ll have waited too long.”

So I call over to my wife, tell her to keep her distance, and explain what’s happening. She grabs some stuff, and goes to occupy a room on the second floor. (While our new apartment is under construction, we’re living on the top floor of a friend’s three-story Victorian. It was bought years ago for a family with five boys, and only two of them are still here.) Except for one trip I’ll describe later on, I’ve been up here by myself ever since. My housemates prepare plates of food and leave them on the steps; I retrieve them like a caged animal. Thank God there’s a bathroom up here.

I expected the temperature thing to resolve itself by Tuesday afternoon, but it didn’t. I kept getting readings that would top out at 99 or 99.1 in the mid-afternoons. (Again, no emergency for anybody else.) Friday afternoon, the digital ear-thermometer I was using went completely wild — I couldn’t get the same reading twice — raising the possibility that the whole episode is an equipment malfunction. By the time I got hold of an old-style mercury thermometer, I was showing more normal temperature patterns, which have continued for the last few days. What to think?

Anyway, Thursday afternoon I emailed my doctor, who did a Zoom-meeting with me Friday morning. She agreed with me that (1) these are pretty sketchy symptoms, and (2) I’m in a situation where I should pay attention to sketchy symptoms. Apparently, though, tests are now plentiful enough to justify getting me one. I suspect that wouldn’t have been true a week before.

There is a drive-through testing site at Holy Family Hospital in Haverhill, Massachusetts, about a 40-minute drive away. (I should add, though, that you can’t just drive up unannounced. They require a physician order.) I went downstairs for the first time in days, was careful to touch nothing until I reached my car, and drove myself to Haverhill.

The picture above is one I took through the windshield. I had to wait in line behind two or maybe three other cars. A young woman swathed in protective garb talked to me through my open window, had me sign a form (with a pen she refused to take back), and stuck a long Q-tip-like thing up each of my nostrils. It was fast, and while I would never do it for fun, it wasn’t that bad. She told me to expect results Tuesday or Wednesday. (Those 15-minute tests you’ve been hearing about apparently aren’t in wide use yet.) Results would go to my doctor, and I shouldn’t call Holy Family. Meanwhile, she said, I should consider myself quarantined for 14 days or until I get a no-infection result.

So now I wait. And in truth, I’m not even sure what I’m rooting for. No infection would be nice, but in some ways the best result of all would be to get away with a minor-symptom case and then have some kind of immunity. On the other hand, I also have heard stories of minor symptoms that suddenly turn bad, so I get anxious every time I start to feel tired. It would be nice to have that over with.

I’ll update this post when my results come in.

It’s not going to happen soon or fast, but maybe the process begins by June.

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Sadly, any serious article about restarting the economy has to begin by brushing aside the misinformation coming from the White House.

Disclaimers. The economy cannot be restarted safely any time soon.

It won’t happen on Easter (as the President was envisioning Tuesday, but has since backed off of). We won’t even reach the peak daily death total by Easter (as he predicted yesterday). If we’re lucky, we might see the daily new-cases totals peak by then, but deaths trail diagnoses by at least a week. (Italy’s new-cases peak was March 21. Deaths might or might not be peaking now.)

Public health experts agree that certain conditions and capabilities need to be in place before it will be safe to relax social distancing practices, open non-essential businesses, or allow people to start congregating. Those conditions and capabilities aren’t in place now and won’t be for at least several weeks, and probably longer. Trump’s notion that the country will be “well on our way to recovery” by June 1 seems wildly optimistic.

The talking point that shutting down the economy to stop the virus is “worse than the problem itself” (which Trump tweeted a week ago yesterday) is nonsense. COVID-19, unchecked, could kill millions of Americans (which Trump finally admitted yesterday: “Think of the number: 2.2 million people, potentially, if we did nothing.”) The idea that the economy might putter along normally while people are dying in those numbers is just absurd. (I think of this as the Masque of the Red Death theory.)

The supporting talking point that “You are going to lose a number of people to the flu [i.e., coronavirus], but you are going to lose more people by putting a country into a massive recession or depression” is likewise nonsense. Not only won’t a depression kill millions of Americans, the effect usually goes the other way: Lower economic activity means fewer overall deaths, mostly because traffic deaths and heart attacks go down.

We find that in areas where the unemployment rate is growing faster, mortality rates decline faster. So during the Great Recession in the U.S., we saw increases in the unemployment rate of about 4-5 percentage points, so that translates to about 50,000 to 60,000 fewer deaths per year

Smithsonian magazine looked further back and found that “The Great Depression had little effect on death rates.”

Prerequisites. OK, now that the decks have been cleared of some widely distributed bad information, we can start talking sensibly about how the economy restarts

Let’s start with the prerequisite conditions. Dr. Thomas Inglesby of Johns Hopkins listed five:

• The number of new cases starts going down over time.
• The health system can quickly and reliably test people who may have been exposed to the virus, even if their symptoms are minor or non-existent.
• Caretakers have a sufficient supply of masks and other protective equipment.
• Hospitals have sufficient resources: ventilators, ICU beds, etc.
• Systems are in place to trace the contacts of any new cases.

These five conditions are consistent with what Anthony Fauci and other public-health experts have been saying. Together, they paint a picture of a South-Korea-like containment: The virus hasn’t been eliminated, but the public health system has identified and isolated almost everyone in a region who is infected. As new outbreaks happen, they can be quickly found and traced, so that the newly infected can also be identified and isolated. Moreover, public health workers have the means to protect themselves, so that a new virus outbreak won’t break the system.

It should be obvious that those conditions don’t exist now. Even in New Rochelle and Seattle, early hotspots that took early action, the optimistic story is that the rate of increase in cases is down, not that the number of cases has actually peaked. (The curve is being bent sideways rather than bent down.) Some parts of the country, particularly rural areas, have not seen large numbers of cases yet. But their numbers are increasing and none of them have the virus contained in the way the experts envision. Tests are not as rare as they were a week or two ago, but the number needed has grown to stay ahead of the number provided, so they still are not plentiful. Better and quicker tests have been developed, but are still not widely available.

Perhaps the best evidence that ventilators and masks are scarce is that Trump has stopped denying it and started finding other people to blame for it.

It’s worth pointing out what’s not on this list: a vaccine or a magic anti-viral treatment that changes the whole nature of the struggle. Such advances will happen eventually, but almost certainly not in the next few months, and maybe not for a year or more.

First steps. So it’s not happening tomorrow or next week, but you don’t have to wear rose-colored glasses to imagine a time when the prerequisites have been fulfilled. No matter how bad the pandemic gets, the number of cases has to peak eventually. Tests exist and are being manufactured in ever larger numbers. Ditto for hospital equipment. Infection-tracking systems work in other countries and could work here.

So it’s anybody’s guess how long it will take to get there, but we will get there. And what happens then?

Ezekiel Emmanuel envisions how a restarting process might go. He pictures a nationwide shelter-in-place policy lasting until about June (except in places — are there any? — with so few cases that public-health officials can already track them all), during which he imagines achieving more-or-less the same things Dr. Inglesby described:

State and local health departments then need to deploy thousands of teams to trace contacts of all new Covid-19 cases using cellphone data, social media data, and data from thermometer tests and the like. We also need to get infected people to inform their own contacts. It would be easier to lift the national quarantine if we isolate new cases, find and test all their contacts, and isolate any of them who may be infected.

The national quarantine would give hospitals time to stock up on supplies and equipment, find more beds and room to treat people, get better organized and give clinical staff a respite to recuperate for the next onslaught of Covid-19 care. Without these measures, any Covid-19 resurgence would be far harsher, and economically damaging.

Whether all that happens by June or not is debatable. But even with those capabilities in place, the restart happens gradually. Nobody flips a switch or makes an all-clear announcement.

The first people Emmanuel would send back to work are those who have recovered from the virus and provably have anti-bodies to resist reinfection. And even they would need some rigorous training in safe working procedures: frequent hand-washing, avoiding unnecessary contact with others, etc.

Next, low-risk parts of the population could be allowed to congregate, while higher-risk people continue to shelter in place: Colleges might be allowed to hold in-person summer sessions. Summer school, camp, and daycare for K-12 children could be attempted — with ubiquitous testing to spot any viral resurgence.

If that works — it might not, and then retreats would have to happen — public venues could slowly start returning to almost-normal: Offices, libraries and museums, and bars and restaurants could re-open, but with reduced occupancy limits. (I heard a Starbucks executive interviewed on CNBC. He described the gradual reopening of Starbucks outlets in China: First take-out only, then dine-in with one person per table, then dine-in with at most two people per table.)

This is hardly a let-it-rip vision, and I think that it ultimately relies on some kind of treatment or vaccine developing: The economy isn’t completely closed down, but limps along for a year or so until medical developments rescue it.

Herd immunity. Thomas Friedman has tried to popularize a more ambitious opening envisioned by David Katz, who IMO gives way too much credence to the economic-contraction-will-cost-lives theory. The argument here is to focus on protecting the vulnerable (mainly the elderly), while letting the less-vulnerable behave more-or-less normally.

Even here, though, the same ideas show up: A period of lockdown, during which ubiquitous testing and research give us a much better idea of who has the virus, how it spreads, and who the vulnerable really are. (Some young people are dying too.) There is, I think, too much optimism about how quickly this period could be brought to a close. (Katz proposed two weeks, which is already about to expire without the kind of testing availability his plan needs.)

Once the vulnerable are sequestered — how you keep vulnerable parents away from their virus-exposed children and grandchildren is never specified — the virus spreads more-or-less harmlessly among the rest of the population, resulting in ever more recoveries with corresponding immunity. (We’re not totally positive immunity happens or how long it lasts, but it’s a reasonable theory.) The ultimate result is a general population with enough herd immunity that the virus no longer spreads like wildfire. As time goes by, then, more and more of the vulnerable can return to society.

Science Alert’s Gideon Meyerowitz-Katz dissents on this view: Herd immunity requires something like 90% of the population to be immune, and 20% of COVID-19 infections are serious enough to require hospitalization. So if you picture even the minimal overlap, about 10% of the population winds up being hospitalized. That will break the health-care system, even if it manages to save almost everybody — which it probably won’t.

So again, I think some kind of treatment or vaccine has to appear before the economy gets back to hitting on all cylinders.

Summing up. In every re-opening vision I’ve seen, conditions more-or-less like Dr. Inglesby’s have to be met first, and it’s hard to picture that happening much before June. By then, the $1,200 checks the government is sending out will have been used up long ago, so another trillion or two or three will have to be spent, both to keep people eating and to supply the public-health system with what it needs to get through the crisis.

And there’s not going to be an everybody-come-out-now announcement. Re-opening will happen slowly, and probably in fits and starts. Some things will reopen too quickly, start a new outbreak, and have to close again. Some new habits will have to continue for a long time, and maybe we will never go back to washing (or not washing) our hands the way we used to. Cubicle-farm offices may never reopen with the same density. Business travel may never recover. Working from home may become permanent for many jobs, or working-from-home augmented by rare trips to the home office.

When will we be able to pack into stadiums again? Or elbow-fight for armrest-space in theaters? That will probably have to wait for a vaccine, which is at least a year away.

You don’t really need to know any of this, but I found it engaging.

The major media is sensitive to the criticism that they’re raising panic, so they garnish their we’re-all-going-to-die coverage with practical information for those of us stuck at home. These public-minded segments answer important practical questions like: What should I do if I get sick? What’s the right way to wash my hands? What disinfectants kill the virus? How should I practice social distancing? And so on.

I’m sure you’ve seen most of those questions discussed more than once, so I’ve just linked to sample articles without rehashing. That kind of stuff isn’t what this post is about.

But you can’t have this many people focusing on a single subject without a few interesting things getting written. The questions below may not have the practical importance as the ones above — some are entirely frivolous — but in my purely idiosyncratic opinion, they’re fascinating.

Why are people hoarding toilet paper? I’ve observed it locally and heard reports from all over the world: Hoarders have been cleaning out stores’ supplies of toilet paper. Numerous Facebook friends posted pictures of empty shelves, while others traded tips about which stores might still have a few rolls.

Most of the other empty shelves in the supermarket have made some kind of sense: There are clear reasons why wipes and hand sanitizers are in demand. And masks; you can argue about how effective they are, but they’re an obvious thing to try. Everybody suddenly wants to disinfect their counters and other surfaces, so it’s been hard to find bleach. (All those over-priced organic no-harsh-chemicals cleaning products are suddenly much less desirable.)

But hoarding toilet paper? Economist Jay Zagorsky points out in The Boston Globe that classical supply-and-demand economics has no justification for it. Other than the hoarding itself, there’s no demand problem: The pandemic doesn’t make us use additional toilet paper. There’s also no supply problem: The US makes 90% of its own toilet paper, and most of what we import comes from Canada and Mexico, where transportation is working just fine.

So why, then? When pragmatic thinking comes up short, it’s tempting to look for psychological explanations. So Time goes Freudian:

What is it about toilet paper—specifically the prospect of an inadequate supply of it—that makes us so anxious? Some of the answer is obvious. Toilet paper has primal—even infantile—associations, connected with what is arguably the body’s least agreeable function in a way we’ve been taught from toddlerhood.

And Niki Edwards from the Queensland University of Technology (evidently they’re hoarding toilet paper “down under” too) echoes:

Toilet paper symbolises control. We use it to “tidy up” and “clean up”. It deals with a bodily function that is somewhat taboo. When people hear about the coronavirus, they are afraid of losing control. And toilet paper feels like a way to maintain control over hygiene and cleanliness.

Other writers (I’ve lost the references) point out that while hoarding toilet paper is an irrational response to the pandemic, it’s not that irrational: Toilet paper is easy to store, it doesn’t go bad, and you will eventually use it up.

But I think Zagorsky ultimately has the best explanation. It’s economic, but comes from behavioral economics rather than classical economics: When people feel endangered, they instinctively want to eliminate the risk rather than mitigate it. So when faced with a risk we can’t eliminate completely, we are tempted to divert our attention to a related risk we can eliminate, even if it’s not the main thing that threatens us. (The economic term for this is zero-risk bias.) So the logic of the toilet-paper hoarder is most likely to go something like this: “Maybe we are all going to die, but at least I won’t run out of toilet paper.”

How does soap kill viruses? Most of us learned about soap long before we learned about science, so soap holds an almost magical significance for us. But now that we’re washing our hands twenty times a day, it’s hard not to wonder if we’re being superstitious: I know Mom said it was important, but … really?

The answer turns out to be: Yeah, really. Simple soap, the stuff that’s older than recorded history, kills all sorts of viruses. The NYT’s Ferris Jabr covers this pretty well. The full article has a lot of fascinating detail, but here’s the gist:

Soap is made of pin-shaped molecules, each of which has a hydrophilic head — it readily bonds with water — and a hydrophobic tail, which shuns water and prefers to link up with oils and fats. … When you wash your hands with soap and water, you surround any microorganisms on your skin with soap molecules. The hydrophobic tails of the free-floating soap molecules attempt to evade water; in the process, they wedge themselves into the lipid envelopes of certain microbes and viruses, prying them apart.

Now that I can’t go to bars, restaurants, and performances, what should I binge-watch on TV? If you’d asked me last fall, I would have picked out March as a particularly good time to be housebound, because I usually spend large chunks of the month couch-potatoing in front of the NCAA basketball tournament. If I have any TV time still available, NBA teams are maneuvering for playoff positions, and hope springs eternal in baseball’s spring-training games.

Well, that plan didn’t work out. But in the streaming era we still have plenty of choices about what to watch.

There are two basic theories here: One says you should use the opportunity social distancing provides to catch up on all the high-quality classics you’ve missed. The other says that life in near-quarantine is stressful enough, so you should chill out by watching stuff as comforting and unchallenging as possible. (In other words, “The Walking Dead” or “The Strain” might not be a good choice right now.)

If you go the high-quality route, I recommend signing up with HBO and watching all five seasons of “The Wire”. Now that “Game of Thrones” is complete, going back to the beginning and seeing how it all hangs together is a worthy project I still haven’t tackled. I’ve also recently gotten the PBS app, through which I’ve streamed “Poldark”, “Sanditon”, “Vienna Blood”, “Modus”, and now “Beecham House”.

But that’s just me. For expert advice, check out The Guardian’s “100 best TV shows of the 21st Century“.

On the other hand, comfort TV (like comfort food) is too personal to find on some expert’s list. I recommend thinking back to some long lost era of your life and recalling what your favorite show was back then. When I ask that question, I drift back to the 80s and remember that I haven’t seen most episodes of “Star Trek: The Next Generation” in at least 30 years.

A third option entirely is to surprise yourself with something you’ve never heard of before. Decider has 10 suggestions, most of which you can find on NetFlix. (I can vouch for “Slings and Arrows”.)

What is “flattening the curve”? And why does it help? The whole point of everything closing and people staying home is to “flatten the curve”. A bunch of sources have images that illustrate curve-flattening. Here’s the one from Wired:

(The Washington Post also has some fabulous graphics that simulate disease spread.)

Left to their own devices, epidemics spread exponentially as long as there are still plenty of new people to infect. And when something bad grows exponentially “everything looks fine until it doesn’t.” The mistake Italy made was to wait until it had a significant number of cases before it started shutting everything down. The right time to shut everything down is when that still seems like a ridiculous over-reaction. (If you do it right, the spike in cases never arrives, and critics conclude that you didn’t know what you were talking about.)

If the number of cases rises too fast, the healthcare system gets swamped, which leads to a whole new set of problems. (It’s bad enough to be sick, but it’s much worse to be sick when nobody has any place to put you.) Social distancing is supposed to slow down the spread, in hopes that the healthcare system might be able to deal with it.

That’s why you eliminate big-arena sports events and other large gatherings — so that one sick guy can’t infect 50 or 100 others. If you can’t stop the virus, make it work harder — it will spread by infecting two people here and three people there, not dozens at a time.

There’s also some hope that if you slow down the virus enough, you can affect not just the distribution of cases, but their total number as well. That’s the lesson of how two cities handled the 1918 Spanish flu.

What the heck did the UK just decide to do? Experts around the world advise that governments shut down places where people meet, encourage social distancing, and hope to flatten the curve. But in United Kingdom, Prime Minister Boris Johnson’s government has a different idea.

On Friday, the UK government’s chief science adviser, Sir Patrick Vallance, said on BBC Radio 4 that one of “the key things we need to do” is to “build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission.”

The “herd immunity” notion is easy to make fun of, because it sounds like a let-the-virus-run-wild model. But it’s a little more nuanced than that.

A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it. … The [UK’s model] wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection. That’s herd immunity. Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate.

I understand this through a thought experiment: Imagine that you had some foolproof way to keep the uninfected-but-vulnerable part of the population safe for a limited time. (Imagine you shot them into orbit or something, but you couldn’t leave them up there forever.) One thing you might try is to have the rest of the population — the Earth-bound part — get sick and recover as fast as possible. Then when the vulnerable people came back, the virus would have a hard time finding them, because they’d be surrounded by people who had developed immunity.

Go back to the Philadelphia/St.Louis graph above. Philadelphia certainly made the wrong choice for its citizens, but if you had managed to hide in a deep mine shaft until November 20 or so, after you came out you’d do much better in Philadelphia.

So the UK government is advising people over 70 (and other vulnerable folks, I suspect) to “self-isolate” while younger and stronger people get sick.

It’s not a completely insane idea, but I’ll be amazed if it works.

How did the Federal Reserve “inject” $1.5 trillion into the economy? And where’s my share? On Thursday, the Fed announced that it was “injecting” $1.5 trillion into the economy. Immediately, progressive social media lit up with comparisons to the cost of Medicare For All or the Green New Deal. Bernie Sanders, for example, tweeted:

When we say it’s time to provide health care to all our people, we’re told we can’t afford it. But if the stock market is in trouble, no problem! The government can just hand out $1.5 trillion to calm bankers on Wall Street.

Vox explains why this is an apples-to-oranges comparison. The Fed didn’t spend the money, it loaned it to banks (at interest, with collateral). The point of the Fed’s move is that loan demand is about to spike: As events get cancelled and people stop traveling and going out, businesses that used to make a profit are going to lose money for a while. The only way they’ll keep going is if they get loans. The Fed’s loans to banks will turn into business loans that hopefully will make the difference between, say, Jet Blue having a disappointing quarter and Jet Blue declaring bankruptcy.

If things work out as expected — the disruption from COVID-19 lasts for a quarter or two, and then the economy more-or-less goes back to normal — all the loans will be repaid and the Fed will get its money back.

That wouldn’t happen if the Fed created money and spent it on healthcare or infrastructure or something else. Whether or not those things would be good ideas, they’re not anything like creating money and loaning it to banks.

It should be fairly obvious that a repo market intervention isn’t like, say, printing $1.5 trillion to pay for an expansion of health care. If the Fed funded Medicare-for-all that way, it would not get $1.5 trillion back plus interest. It would just spend a whole lot of money on doctor’s and nurse’s salaries, MRI equipment, hospital mortgages, etc., and never get it back.

A better comparison might have been the housing crisis of 2008-2009. If the homeowners who couldn’t pay their mortgages were good bets to have future income, and if the houses themselves were worth enough to cover the loans, then it might have made sense to create money to keep those households going until the Great Recession was over. That would have been a similar loan-and-get-repaid scenario. But that kind of retail transaction would require a different kind of institution: something more like the post-office banks Senator Warren has proposed.

What does the COVID-19 virus actually look like? Part of the terror of classic plagues like the Black Death was their invisibility: You barricaded yourself in your home to hide from something you couldn’t see. But with today’s advanced microscopy, we’re not only able to see the virus, but to start designing the antibodies we need to beat it.

Let’s blow that last quadrant up a little more: