Unending nightmares

Sep 19 JDN 2459477

We are living in a time of unending nightmares.

As I write this, we have just passed the 20th anniversary of 9/11. Yet only in the past month were US troops finally withdrawn from Afghanistan—and that withdrawal was immediately followed by a total collapse of the Afghan government and a reinstatement of the Taliban. The United States had been at war for nearly 20 years, spending trillions of dollars and causing thousands of deaths—and seems to have accomplished precisely nothing.

Some left-wing circles have been saying that the Taliban offered surrender all the way back in 2001; this is not accurate. Alternet even refers to it as an “unconditional surrender” which is utter nonsense. No one in their right mind—not even the most die-hard imperialist—would ever refuse an unconditional surrender, and the US most certainly did nothing of the sort.)

The Taliban did offer a peace deal in 2001, which would have involved giving the US control of Kandahar and turning Osama bin Laden over to a neutral country (not to the US or any US ally). It would also have granted amnesty to a number of high-level Taliban leaders, which was a major sticking point for the US. In hindsight, should they have taken the deal? Obviously. But I don’t think that was nearly so clear at the time—nor would it have been particularly palatable to most of the American public to leave Osama bin Laden under house arrest in some neutral country (which they never specified by the way; somewhere without US extradition, presumably?) and grant amnesty to the top leaders of the Taliban.

Thus, even after the 20-year nightmare of the war that refused to end, we are still back to the nightmare we were in before—Afghanistan ruled by fanatics who will oppress millions.

Yet somehow this isn’t even the worst unending nightmare, for after a year and a half we are still in the throes of a global pandemic which has now caused over 4.6 million deaths. We are still wearing masks wherever we go—at least, those of us who are complying with the rules. We have gotten vaccinated already, but likely will need booster shots—at least, those of us who believe in vaccines.

The most disturbing part of it all is how many people still aren’t willing to follow the most basic demands of public health agencies.

In case you thought this was just an American phenomenon: Just a few days ago I looked out the window of my apartment to see a protest in front of the Scottish Parliament complaining about vaccine and mask mandates, with signs declaring it all a hoax. (Yes, my current temporary apartment overlooks the Scottish Parliament.)

Some of those signs displayed a perplexing innumeracy. One sign claimed that the vaccines must be stopped because they had killed 1,400 people in the UK. This is not actually true; while there have been 1,400 people in the UK who died after receiving a vaccine, 48 million people in the UK have gotten the vaccine, and many of them were old and/or sick, so, purely by statistics, we’d expect some of them to die shortly afterward. Less than 100 of these deaths are in any way attributable to the vaccine. But suppose for a moment that we took the figure at face value, and assumed, quite implausibly, that everyone who died shortly after getting the vaccine was in fact killed by the vaccine. This 1,400 figure needs to be compared against the 156,000 UK deaths attributable to COVID itself. Since 7 million people in the UK have tested positive for the virus, this is a fatality rate of over 2%. Even if we suppose that literally everyone in the UK who hasn’t been vaccinated in fact had the virus, that would still only be 20 million (the UK population of 68 million – the 48 million vaccinated) people, so the death rate for COVID itself would still be at least 0.8%—a staggeringly high fatality rate for a pandemic airborne virus. Meanwhile, even on this ridiculous overestimate of the deaths caused by the vaccine, the fatality rate for vaccination would be at most 0.003%. Thus, even by the anti-vaxers’ own claims, the vaccine is nearly 300 times safer than catching the virus. If we use the official estimates of a 1.9% COVID fatality rate and 100 deaths caused by the vaccines, the vaccines are in fact over 9000 times safer.

Yet it does seem to be worse in the United States, as while 22% of Americans described themselves as opposed to vaccination in general, only about 2% of Britons said the same.

But this did not translate to such a large difference in actual vaccination: While 70% of people in the UK have received the vaccine, 64% of people in the US have. Both of these figures are tantalizingly close to, yet clearly below, the at least 84% necessary to achieve herd immunity. (Actually some early estimates thought 60-70% might be enough—but epidemiologists no longer believe this, and some think that even 90% wouldn’t be enough.)

Indeed, the predominant tone I get from trying to keep up on the current news in epidemiology is fatalism: It’s too late, we’ve already failed to contain the virus, we won’t reach herd immunity, we won’t ever eradicate it. At this point they now all seem to think that COVID is going to become the new influenza, always with us, a major cause of death that somehow recedes into the background and seems normal to us—but COVID, unlike influenza, may stick around all year long. The one glimmer of hope is that influenza itself was severely hampered by the anti-pandemic procedures, and influenza cases and deaths are indeed down in both the US and UK (though not zero, nor as drastically reduced as many have reported).

The contrast between terrorism and pandemics is a sobering one, as pandemics kill far more people, yet somehow don’t provoke anywhere near as committed a response.

9/11 was a massive outlier in terrorism, at 3,000 deaths on a single day; otherwise the average annual death rate by terrorism is about 20,000 worldwide, mostly committed by Islamist groups. Yet the threat is not actually to Americans in particular; annual deaths due to terrorism in the US are less than 100—and most of these by right-wing domestic terrorists, not international Islamists.

Meanwhile, in an ordinary year, influenza would kill 50,000 Americans and somewhere between 300,000 and 700,000 people worldwide. COVID in the past year and a half has killed over 650,000 Americans and 4.6 million people worldwide—annualize that and it would be 400,000 per year in the US and 3 million per year worldwide.

Yet in response to terrorism we as a country were prepared to spend $2.3 trillion dollars, lose nearly 4,000 US and allied troops, and kill nearly 50,000 civilians—not even counting the over 60,000 enemy soldiers killed. It’s not even clear that this accomplished anything as far as reducing terrorism—by some estimates it actually made it worse.

Were we prepared to respond so aggressively to pandemics? Certainly not to influenza; we somehow treat all those deaths are normal or inevitable. In response to COVID we did spend a great deal of money, even more than the wars in fact—a total of nearly $6 trillion. This was a very pleasant surprise to me (it’s the first time in my lifetime I’ve witnessed a serious, not watered-down Keynesian fiscal stimulus in the United States). And we imposed lockdowns—but these were all-too quickly removed, despite the pleading of public health officials. It seems to be that our governments tried to impose an aggressive response, but then too many of the citizens pushed back against it, unwilling to give up their “freedom” (read: convenience) in the name of public safety.

For the wars, all most of us had to do was pay some taxes and sit back and watch; but for the pandemic we were actually expected to stay home, wear masks, and get shots? Forget it.

Politics was clearly a very big factor here: In the US, the COVID death rate map and the 2020 election map look almost equivalent: By and large, people who voted for Biden have been wearing masks and getting vaccinated, while people who voted for Trump have not.

But pandemic response is precisely the sort of thing you can’t do halfway. If one area is containing a virus and another isn’t, the virus will still remain uncontained. (As some have remarked, it’s rather like having a “peeing section” of a swimming pool. Much worse, actually, as urine contains relatively few bacteria—but not zero—and is quickly diluted by the huge quantities of water in a swimming pool.)

Indeed, that seems to be what has happened, and why we can’t seem to return to normal life despite months of isolation. Since enough people are refusing to make any effort to contain the virus, the virus remains uncontained, and the only way to protect ourselves from it is to continue keeping restrictions in place indefinitely.

Had we simply kept the original lockdowns in place awhile longer and then made sure everyone got the vaccine—preferably by paying them for doing it, rather than punishing them for not—we might have been able to actually contain the virus and then bring things back to normal.

But as it is, this is what I think is going to happen: At some point, we’re just going to give up. We’ll see that the virus isn’t getting any more contained than it ever was, and we’ll be so tired of living in isolation that we’ll finally just give up on doing it anymore and take our chances. Some of us will continue to get our annual vaccines, but some won’t. Some of us will continue to wear masks, but most won’t. The virus will become a part of our lives, just as influenza did, and we’ll convince ourselves that millions of deaths is no big deal.

And then the nightmare will truly never end.

No, unemployment doesn’t kill people

Jun 14 JDN 2459015

Some people have argued that lockdown measures were unnecessary, or ineffective. The data definitely leans the other direction, but there’s enough uncertainty in all this that I can at least consider that a serious possibility. That doesn’t mean we were wrong to use them; in the presence of high uncertainty, assuming the worst-case scenario is often the best strategy. Far better to overreact than underreact. And indeed, I’d say that right now we still can’t be confident enough that things are safe to really re-open most of the economy. Re-opening too early could make things far worse.

There’s another argument for re-opening the economy which seems far more seductive: What about the people harmed by the lockdowns? This massive unemployment is terrible too, isn’t it? In fact, what if we’re killing more people by unemployment than we are saving from the virus? The Mises Institute warns: “Unemployment Kills”. Others have speculated that the recession could cause more deaths than the virus.

But in fact, unemployment does not kill. The evidence on this is quite clear. Even in the Great Depression, with massive unemployment, terrible monetary policy, and only the most minimal social welfare measures in place, death rates did not increase. In fact, for all causes except suicide, death rates decrease during recessions—probably because pollution, traffic accidents, and work-related injury and illness go down. And the suicide rate increase isn’t enough to increase the overall death rate.

Of course, dying by suicide is not the same thing as dying from cancer—and indeed, they are most likely different people being affected in each case. So in that sense unemployment can kill people; but it typically saves more people than it kills. Almost any policy choice will cause some deaths and prevent others, so really the best we can do is look at the overall aggregate and see whether our QALY have gone up or down.

This doesn’t mean that we should go out of our way to have recessions in order to save lives; the number of lives saved is small and the loss in quality of life is probably large enough to compensate for it. (That’s why we use quality-adjusted life years after all.) But this recession isn’t arbitrary; it’s the result of trying to stop a global pandemic, so that we don’t have a repeat of what influenza did in 1918.


When the CDC says it’s okay to open back up, by all means, let’s do that. They have issued guidelines for what we need to do in order to make that happen. But until then, let’s trust in the experts—the epidemiologists who say that we still need lockdown measures, and the economists who agree that it’s worth the cost.