A couple of weeks ago, I reported that my friend M. was in self-imposed isolation after exposure to someone who subsequently tested positive for Covid-19. M. was sure he had Covid-19 because he spent two hours in a confined space with the other person, although the symptoms he reported to me were mild to non-existent. I noticed more misspellings in his messages. Was that a result of Covid-19? Was M. losing his marbles? Maybe I was just looking for bad symptoms since the worst M. reported was “feeling weird.”
A week into self-isolation and still presenting few symptoms, M. took a Covid-19 PCR test. He described the swab as a range of stimulations, from uncomfortable to mildly enjoyable. A day later the result came back negative. Like the swab, the results provided M. a range of feelings. He was both relieved that he didn’t have Covid-19 and let down because he didn’t get away with a pleasantly asymptomatic case.
After the negative test, M. was incredulous for quite a while because the circumstances for Covid-19 transmission seemed so clear. Two hours in a confined space is much, much longer than the 15 minutes public health officials have said it takes to risk transmission. What’s more, with the new, more contagious strains from UK, South Africa, and Brazil, public health officials now think Covid-19 transmission can happen in seconds.
Why was there no transmission during M.’s confined meeting? It could be because his friend had a Covid-19 vaccination a week before their meeting. It could be because the friend’s test was a false-positive. It could be that the friend was infected, but the meeting was before or after reaching peak viral load. It could be luck of the draw.
This is a major frustrations of Covid-19. Just when you’re sure about something, as M. was about having a Covid-19 infection, it turns out to be different.
Another example of being sure about something that turns out to be different: reinfection from the new Covid-19 strain in South Africa. Based on the placebo group results in the Novavax Covid-19 vaccine trial there, scientists now worry that the virus is mutating in ways that improve the chance for reinfection. Just as I was getting comfortable with the idea that even if I got Covid-19, a Covid-19 reinfection could be in my future, I read this thread.
So, yes, there is Covid-19 reinfection (which we’ve known for a while and so far it’s been a tiny problem), but, no, the Novavax trial data don’t give us proof that cross-strain immunity has gone out the window.
By the way, the Novavax Covid-19 vaccine uses a technology distinct from the mRNA vaccines (Pfizer, Moderna) and the viral vector vaccines (AstraZeneca, Johnson&Johnson). Here’s how it works.
Covid-19 restrictions (aka, lockdowns) are another topic that people seem sure about. For example, I’m pretty sure they are a good approach.
Last Sunday, just after I posted last week’s blog post, right-wing groups in Vienna protested Covid-19 restrictions. Police lost control as the protest turned into a riot. For a little while, it seemed to this American like Vienna could be having a replay of the US Capitol resurrection. Clearly the Viennese protesters have a different take on Covid-19 restrctions from mine.
The thorniest political issue of the pandemic has been the imposition of Covid-19 restrictions and, in particular, masking and limiting gatherings.
The economy is often cited as the most important reason not to impose Covid-19 restrictions. A recent National Bureau for Economic Research (NBER) study found that Covid-19 restrictions in California are related to sales declines in specific segments. NBER is best known as the non-profit organization that determines the start and end dates of US recessions.
[Study] results suggest that local implementation and enforcement of lockdown restrictions and voluntary behavioral responses as reactions to the perceived local COVID-19 spread both played a role, but enforcement of mandatory restrictions may have had a larger impact on sales losses.Robert W. Fairlie & Frank M. Fossen, “Sales Losses in the First Quarter of the COVID-19 Pandemic: Evidence from California Administrative Data,” National Bureau for Economic Research, January 2021.
The Foundation for Economic Education (FEE) combines NBER’s study with other articles and opinion pieces to conclude that the medicine was worse than the cure, as it were, that lockdowns were at the root of the 2020 US recession, not Covid-19. The FEE article points to a December 2020 study of Covid-19 and economic statistics by US state.
This December 2020 thread asserts that Covid-19 restrictions were authoritarian and more destructive than Covid-19 itself, an argument has been made since the first lockdowns last year. Besides characterizing public health lockdowns as “authoritarian,” the thread says Covid-19’s “impact appears to be independent of government or personal behavior.” Based on multiple studies showing that Covid-19 cases decreased in regions that mandated masks compared to regions that did not, that claim is false on its face.
I want to counter anti-lockdown arguments a few ways. One is that the Twitter thread above cherry picks Oxford study data. The severe lockdowns were in March and April when, with great uncertainty about the transmission and virulence of the virus, lockdowns were the only known way to bring community spread under control. One thing was clear from the early Italian Covid-19 outbreak: the failure to stop community spread led to a catastrophic breakdown of its healthcare system.
The spring 2020 lockdowns successfully stopped Covid-19 community spread in Asia, Europe, and North America. Unfortunately, afterwards only a few countries implemented adequate test-and-trace protocols to contain Covid-19. Community spread of Covid-19 reoccurred in countries that didn’t implement the test-and-trace protocols properly.
Of course, the spring 2020 lockdowns also slammed the world economy. The political question after these lockdowns was whether to prioritize economic recovery or public health. The Twitter thread above says that more restrictive US states ended up with the same Covid-19 death rates. The analysis then says that, since unemployment claims were worse in restrictive states, the restrictions did nothing for public health and harmed the economy.
Using a different data set from the NBER and FEE anti-lockdown arguments above, let’s look at recent world GDP data. Below is the estimated 2020 GDP growth for the world’s largest economies in order of Covid-19 deaths per million. For reasons explained below, I’ve added Sweden and Spain to the chart.
Instead of giving exact mortality numbers, I’ve grouped the countries into five per capita mortality bands of different colors (shown in the legend), countries with low Covid-19 mortality at the top of the chart and countries with high mortality at the bottom. The range of the first two mortality bands is larger (500) than the other three bands (250).
This chart shows that as per capita Covid-19 deaths increase, GDP growth tends to decrease. The inverse relationship appears loosely correlative (correlation isn’t causation disclaimer applies!), especially if you remove the GDP outliers, US and China on the high side, Sweden and Spain on the low side (see below).
If this relationship holds generally, it is strong evidence that lockdowns don’t hurt economies. In fact, it looks like they are beneficial for economic performance. Before I remove the two largest and two smallest economies on the chart, I want to discuss them in more detail.
Both the US and China 2020 GDPs performed significantly better than peers in their respective Covid-19 mortality bands. At over US$20 trillion, the US economy is as large as the next seven economies excluding China. At over US$9 trillion, the Chinese economy is as large as Japan and Germany. The significantly larger size of these two economies probably provided the US and China with diversification and “deep pockets” to buffer against large GDP drop offs in the face of the lockdowns.
Neither Spain nor Sweden are in good company in the chart above. I included Sweden because anti-lockdown advocates cited Sweden so often as an example of how well an economy performs without restrictions. It is true that, compared to peers in its Covid-19 mortality band in the chart above, Sweden had significantly less economic contraction.
However, Sweden is much smaller than France and Brazil, so let’s look at Sweden versus its geographic and social peers, the other Scandinavian countries.
|Country||2020 GDP growth||Covid-19 deaths per million|
While Sweden enjoyed a slightly better economic outcome in 2020 than its Scandinavian neighbors that imposed stricter Covid-19 restrictions, it came at a significantly worse loss of life. Also, because of Covid-19 outbreaks this winter, Sweden forecasts a slower 2021 recovery than its neighbors. I think the strongest claim anti-lockdown supporters can make about Sweden is that its light Covid-19 restrictions may have improved its 2020 economic performance versus peers, but at a cost of both a large loss of life and a much riskier 2021 recovery.
I included Spain because of its particular interest to me, but also because it makes an important point about market concentration. The contraction of the economy here is severe, the worst on the chart above.
About 10% of Spain’s economy is tourism and most of its tourists come from the UK. As the chart above notes, the UK economy contracted nearly as much as the Spanish economy. It’s likely the decline in Spain’s tourism was primarily due to Covid-19 (as a proxy, air travel is off by about 60% everywhere) and compounded by UK’s poor economy (Spain’s tourism revenue is off by more that 75%).
My point here is that in smaller economies that have concentrations in Covid-19 sensitive market segments like tourism, it’s difficult to compare the impact of restrictions on economic growth to other countries. This points out the problem with the NBER report above. NBER is trying to tease out a single relationship between Covid-19 restriction and economic growth across different parts of California with very different economies. I’m sure they tried hard, but I think larger, more diversified economies provide a better point of comparison.
So, let’s look at a revised version of the chart above, this time removing the two largest and two smallest countries.
The correlation between GDP growth and Covid-19 deaths per million in this version of the chart is more clear. These countries are reasonably good peers. Their economies are in the range of US$2 trillion to US$5 trillion and most have public health systems. Assuming Covid-19 deaths per million is a good proxy for government restrictions, arguably Covid-19 restrictions lead to better economic results.
While we’re on the topic of restrictions, another contentious aspect of Covid-19 restrictions has been whether to close schools and childcare. Here’s a good Twitter thread about studies of children and transmission.
In response to the protests against Covid-19 restrictions, there are public health workers and researchers working on new approaches to get to zero Covid-19. The researches advocate a ground-up NO-COVID campaign that starts with a 4-6 week lockdown to suppress community spread of Covid-19 and then enlists citizens to keep Covid-19 infections levels near zero.
- The first does of the Oxford / AstraZeneca Covid-19 vaccine reduces transmission by 67% and, similar to the Johnson & Johnson vaccine, is 76% effective. The reduction in transmission was for symptomatic cases. Asymptomatic transmission remained the same. Will public health officials allow a single-dose regime even though it wasn’t part of the trial?
- The Russian “Sputnik” Covid-19 vaccine is safe and effective. In a trial of 20,000 people published in Lancet, the vaccine was 91% effective. The formal trial was started in September, weeks after Russia started administering the vaccine.
- The ovarian cancer drug EXO-CD24 cured 29 of 30 severe Covid-19 cases at a Tel Aviv hospital. The drug is inhaled once a day for five days and mitigates cytokines storms caused by the virus. Further human trials are needed.
- Nigeria is the most recent country to face severe oxygen shortages due to Covid-19 outbreaks.
- Because the Biden administration is providing quality data about Covid-19 in the US, the Covid Tracking Project will stop its tracking next month.
- In a move to increase production and conserve vials, Moderna plans to put 15 doses of Covid-19 vaccine in each vial instead of 10.
- New AI breast cancer prediction models could be used to help women who missed mammograms during the Covid-19 pandemic.
- Ford applied to patent a clear mask that provides the same protection as an N95 mask, but allows for users’ lips to be seen. The car manufacturer also “is sharing an inexpensive open-source design for a fan and HVAC filter combination that could help reduce virus particle concentrations in enclosed spaces.”
- The Biden administration is paying US$231m to the Australian company Ellume for its 15 minute Covid-19 test. The FDA approved the at-home test in December. Funding enables Ellume to build a US factory that will provide 500,000 tests per day.
Happy Superbowl Sunday. 22,000 fans will get to watch Superbowl LV live. If you’re watching with friends, please consider watching together on video chat!
I write this for my sanity and to create a record of living during the Covid-19 pandemic. If you like it, please pass along to family and friends. For more frequent Covid-19 updates, follow me on Twitter.