Flattening the Coronavirus Curve Is Not Enough
h/t Instapundit
[MIT press reader] - This is a post about the hard part of the economics of Covid-19. You may think that everything up to now hasn’t been exactly a picnic, but from a hard-nosed perspective, big challenges await. There are two: (1) we need to minimize the short-term (this year’s) cost of the pandemic and (2) we need to minimize the medium-term (after this year’s) cost of the pandemic. Not surprisingly, the two are in conflict with one another. In this post, I will explain that the mentality of everyone is to move to a war footing ‐ especially from governments. We have seen a glimpse of this from China in dealing with (1). But we need to worry about (2) as well.

By now you have already heard about the main response to the pandemic which is to flatten the curve. That is described nicely in a diagram like the one below, from Vox. The idea is that we reduce the rate of infection through the population which spreads out the time of the pandemic but, most critically, the number of sick at any one time. The rationale for this is that it is very costly to have a high number of sick people at one time. This goes for providing essential economic services but, as this diagram shows, it is really all about health care system capacity. As Italy has shown us, people die essentially because they cannot get hospital-level care. If the infection rate is too high, health care capacity becomes quickly overwhelmed and doctors have to engage in triage, a word which now means choosing who will live and who will die.
That triage includes medical staff in the worst-hit countries, who are increasingly falling ill with the disease they are trying to treat in their patients. Becoming a doctor or nurse should not be a martyrdom operation.
...Second, flattening the curve assumes that you actually don’t go too far and that much of the population actually becomes infected and then immune. Immunity from Covid-19 is still an open scientific question but, let’s assume that is more likely to be true than not. If you reduce the infection rate too far, then most of the population does not become infected and that means that once you stop policies such as social distancing the virus can emerge once more and we all have to do this again.
But, by then - after we bought time with quarantine measures - we expect to have a vaccine (several, in fact)
Or at least treatments...
...Now for the bad news. The flattening the curve diagram is potentially misleading. ... The health care system capacity is likely way lower than the diagram is showing beyond what flattening the curve can actually achieve. This differs by country. ... Some countries have four to five times the capacity than others. One imagines that intra-country regional variation is just as big. There are nuances when it comes to ICUs and ventilators, etc. But the bottom line is: Even in optimistic flattening the curve scenarios, the curve cannot flatten enough. And this constraint is coming up quickly. I did some calculations for Canada and my most optimistic projection had current capacity being overwhelmed in mid to late April. Absent other choices you are left with (a) running out of capacity and having a large share of elderly die or (b) crushing the curve and doing all of this again later in the year. For Europe, North America and Australia, there is no longer a choice and (b) is pretty much off the table.

...When everything is laid out this way, the policy solution is obvious. If we can’t flatten the curve enough, we must dramatically increase health care capacity.
Which is exactly what being done. In particular, in Israel, they're working on automation allowing doctors & nurses (neither of which grows on trees or can be build in a hurry) to take care of more patients per provider. What they did in China, Albert, is strip the rest of the country from medical personnel to staff their new hospitals.

Posted by: g(r)omgoru 2020-03-22