Relevant and even prescient commentary on news, politics and the economy.

Impeachment now?

What about impeachment?  There is no question that Congress can impeach Trump for his role in encouraging today’s assault on Congress.  What are the arguments for and against? 

For impeachment:

There is a real possibility that Trump will do something dangerous in the final days of his presidency.

If he is impeached and convicted, he could be barred from running for President again. 

Presumably impeaching him would have some precedential / deterrent value going forward.

Against impeachment:

A politically divisive impeachment would divert attention from Trump’s now oh-so-evident wrongdoing and breath new life into the grievance narrative that motivates him and his base.  It could bolster his political support.  It could also fail.

So what to do?  Removal under the 25th amendment would avoid charges of partisanship (since it would be done by Pence and Trump’s cabinet).  It would hasten Trump’s fall from power within the GOP.  If removal under the 25th amendment is not in the cards, I think Democrats should only impeach if Republican Senators commit to removing him from office and if McConnell agrees to bring the matter to a timely vote.  Arguably, Democrats should insist that some reasonable number of Republicans (say, 50%) agree in advance to removal, to kill the partisan grievance narrative and keep the focus on Trump’s wrongdoing.  If Democrats challenge Republicans to commit to remove Trump from office and they refuse then the failure to impeach and remove would make them complicit in yesterday’s thuggish attack on democracy.  But proceeding with a doomed, democratic impeachment without Senate removal would have no precedential or deterrence value and it would be a political gift to Trump and his base.

Why resign?

Several White House aides and policymakers have resigned in the past 24 hours.  Frankly, I don’t get it. 

First, it’s way too late to salvage your reputation.  Second, at this point you can (arguably) do more to protect your reputation by saying that you are staying to prevent Trump from doing something crazy in the final days of his presidency.

The events at the Capitol

The events at the capitol today are horrifying, and to many of us seem like the natural outcome of Trumpism and the morally degenerate enabling of the Republican party.  But the events today may well end up strengthening our democracy.

I suspect that Trump has badly overplayed his hand.  The images of thugs running loose through the capital will horrify a significant part of Trump’s law and order base.  In the court of public opinion, this will be worse than Charlottesville.  His appeal for peace emphasizing his election grievances will not help much; it was the least he could have done, another Trump hostage video.  

Trump will also lose at least some support from Republican pols.  This was bound to happen anyway, but today’s events will accelerate the process.  It will be interesting to see how Cruz and Hawley react.  I think it is possible, though perhaps not likely, that some Republicans will drop their objections to Biden’s electors.  In any event, this may haunt Trump’s enablers for years.  Let’s hope.

The police preparations were shockingly bad. 

Yes, there is clearly a double standard, with people peacefully protesting police brutality getting treated far more harshly than illegally armed rightwing thugs threatening the peaceful transfer of democratic power.  But at the end of the day, a harsh police response today would have diverted attention and condemnation from Trump and his extremist supporters.

Those – including Biden – who have emphasized that the words of politicians matter have new evidence to support their position.  Trump supporters do not believe the election was rigged because they have independent evidence of vote fraud; they believe it because Trump tells them it was rigged.  They showed up in DC and stormed the capitol at his urging.  McConnell gave a good speech defending democratic procedures tonight, but only after weeks of refusing to challenge Trump’s false election fraud claims.  It is as if he told an energetic, poorly behaved toddler that people can fly by waving their arms, brought the toddler to the top of a tall cliff with no fencing, and then sternly advised the poor child to stay clear of the edge.  Those playing footsie with Trump for short term political advantage need to rethink their priorities and the way they assess probabilities.  In fact, the all-too-common willingness of establishment politicians to accommodate authoritarian outsiders – a main theme in How Democracies Die – may partly reflect the general human inability to think clearly about uncertain events, such as the risk of a democratic collapse.

Status quo bias and vaccine supplies

Here is a simple thought experiment on the use of scarce vaccine supplies.

Suppose that we had tested the Pfizer/Moderna vaccines with one dose per person and discovered that they were 85% effective at preventing covid-19. However, due to an administrative error, we gave some people two doses, and when we analyzed the data it turned out that a two-dose regimen was 95% effective at preventing covid-19.

Only 200 million doses of vaccine will be available over the next six months.

Under these circumstances, the idea that we should switch from our initial vaccination plan of one dose per person to two doses would be regarded as insane. It is clearly better to give 200 million people 85% protection than it is to give 100 million people 95% protection.

Yet today, many people believe that we should vaccinate half as many people using two doses per person, simply because this was our initial plan. This certainly seems like an irrational framing effect, or a status quo bias of some kind, or hidebound, bureaucratic thinking, and it seems likely to lead to thousands of unnecessary deaths and prolong our social and economic misery by months.

Come on people! Let’s think outside the box.

Yes, let’s vaccinate twice as many people against covid-19

I am very sympathetic to Robert Waldmann’s argument that we should give twice as many people one dose of the new Pfizer/Moderna vaccines, at least until supply constraints are eased, instead of following the FDA approved vaccination protocol and giving everyone two doses right from the beginning. What follows is a rough way of thinking about the logic and perhaps the magnitudes involved. Let me emphasize that this is just a finger exercise and I am not an epidemiologist, but with those important caveats I will share my work.

Here are my assumptions. The reproduction number of the virus is currently 1. This means that if behavior, transmissibility, and natural and vaccine acquired immunity are all unchanged, the number of people getting infected each day will remain the same. I assume that there are 300 million people in the United States, 40 million of whom are currently immune due to prior infection, and 260 of whom are susceptible. There are 400,000 new actual infections each day (two times the reported number of cases). These infections lead to 3,000 deaths per day (roughly the current number).

Covid update

I seem to be through the worst of it. My fever is down and my cough is subsiding. If I hadn’t gotten a covid test I would have thought I had a moderately bad cold. With a bit of luck, it’s all over except the quarantine. Thanks to everyone for their good wishes.

Paying people to get vaccinated?

Apparently there are proposals circulating to pay people to get vaccinated. (Summary here.) The pro/con story is familiar enough. Monetary incentives might increase the uptake rate; but they might also increase suspicion and backfire, or at least not be very effective. Given the large cost involved – the number cited in the linked article is $1,000, which could cost well over a hundred billion depending on eligibility – a small increase in vaccination rates might not be worth it.

Here is an alternative suggestive. When people get vaccinated, give them cash cards worth $100 that can only be used to purchase restaurant food for 10 days, beginning 5 days after they get vaccinated. The framing of this might be more positive than a simple cash incentive – we are paying you to go out and help jump start your local economy, especially the businesses that have been struggling so much in the epidemic. It helps to emphasize the pro-social aspect of getting vaccinated. Plus it would be much cheaper than giving everyone $1,000, and support from restaurants might help push it into the end zone in Congress.

I have covid . . .

I’m fairly certain I picked it up this past Tuesday.   Wednesday night I had a slight throat-clearing cough.  Not sure if this was covid related or not.  Saturday I had a fever of 100.5, along with some achiness.  I got tested on Saturday and received the positive test result on Sunday.  Last night was a bit worse than the night before.  I had chills and aches.  When I am not sick I am usually more or less pain free; when I get a cold or flu all my old aches and pains come back for an encore.  That happened last night.  In addition, the cough moved into my lungs and became deeper, and I got just a bit wheezy.  This morning with the help of acetaminophen I feel pretty good – if you dropped me into my body without telling me that I had covid it might take me a while to notice that I was sick.  I don’t have any other symptoms.

My initial reaction to my diagnosis was fairly optimistic.  I thought it was likely I would have a mild case and would soon be able to visit family and friends again, including a favorite uncle who is quite sick.  Having read a bit on disease progression, I think my initial take may have been a bit optimistic.  I am still early in the course of the disease; things could definitely go south over the next 3 to 5 days.  My sense is that I have a small chance (maybe 10% to 20%) of ending up in the hospital, and other than that an even chance of skating through relatively unscathed or spending several days struggling to breath but pulling through at home. Having the cough move to my chest last night was sobering.

Although I hope to get through this relatively easily and to enjoy a real benefit from immunity (I would not be vaccine-eligible for months) I would not have chosen to get sick.  The prospect of gasping for breath for a several days at home is very unappealing, choking to death alone would be oh-so-much worse.  I would rather have waited for a vaccine.  Be careful out there!

Should we worry about hospitals being overwhelmed with COVID-19 Patients? Libertarian: Nah.

Our friend Donald Boudreaux is at it again, dispensing misleading statistics that just so happen to favor libertarian outcomes.

Two days ago Boudreaux posted some data on hospital capacity that seem to suggest that we do not need to worry about hospitals getting overwhelmed with COVID patients because capacity utilization over time is flat.  As Boudreaux puts it:

The bottom line is that, when broken down to the state level – at least for the period November 4th through December 4th – there is no evidence that hospitals in the U.S. are close to running out of beds for patients.

Of course, there are other possibilities that Boudreaux does not flag for his readers.  For example, to take a wild possibility at random, it may be that hospitals are not admitting as many sick COVID patients as they fill up. 

Ashish Jha in the Washington Post:

What is happening is pretty simple: As hospitals fill up, they are admitting fewer and fewer people. As any doctor or nurse will tell you, as the demand for beds soars, the threshold for admission rises with it. . . .

One theory that some have advanced is that better treatment is leading to fewer hospitalizations or that more testing is identifying milder cases, and that’s why hospitalization rates are dropping. But outpatient treatment of covid has not changed meaningfully in the past month. The most promising potential outpatient treatment, monoclonal antibodies, has yet to see wide usage. Testing has increased, with more than 2 million tests conducted on some recent days, but case numbers and test positive rates have been rising even more steeply, indicating that we are still missing many more cases — especially mild and asymptomatic cases — so there is no evidence that more testing explains the change in rates of hospitalization.

What is happening is that patients who would have been admitted to hospitals earlier in the year are not being admitted now. Indeed, by my best calculation, between a third and half of covid-19 patients who would have been admitted in the beginning of October are now being sent home instead. This is really bad for patients. Some will get much sicker at home. Some may die there.

And from the Grey Lady:

More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show, revealing a newly detailed picture of the nation’s hospital crisis during the deadliest week of the Covid-19 epidemic.

Hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week, according to a Times analysis of data reported by hospitals and released by the Department of Health and Human Services. . . . 

There is some evidence physicians are already limiting care, Dr. Tsai said. For the last several weeks, the rate at which Covid-19 patients are going to hospitals has started decreasing. “That suggests that there’s some rationing and stricter triage criteria about who gets admitted as hospitals remain full,” he said.

We can debate what is happening and how the government should respond.  But Boudreaux just can’t seem to acknowledge that there might, possibly, be a reasonable case for aggressive public health measures to slow the epidemic.  Instead, he keeps the anti-government rhetoric dialed up to 11 (“tyranny!”), and continues to stoke outrage with misleading statistics.  This is especially perverse given the rise in right wing extremism and the fact that vaccines will soon become widely available.  

Credit where credit is due

I am often critical of libertarian economist Donald Boudreaux. This morning, I sent him an email criticizing a post of his in which he cited a study claiming that pcr tests for covid have a false positive rate of 80% or more. I pointed out that this is obvious nonsense, since overall test positivity rates, which include both false and true positives, have generally been in the 4% to 10% range. I also criticized him quite harshly for passing this (mis)information on in an uncritical manner. To his considerable credit, he published my comment in full on his blog and removed the link from his initial post.