Answer: It depends on the question we’re trying to answer.
In a post about Covid-19 deaths, Tyler Cowen writes:
By the way, deaths as a percentage of population isn’t the right metric here. Losing 320,000 lives (including excess deaths) has about the same moral import, whether or not there are a billion Morlocks living under the earth’s surface, though that fact would change the loss greatly as measured in percentage terms and of course make it look much smaller.
Let’s start with a question that absolute deaths is the relevant metric for.
A murderer in Andorra kills 10 people. A murderer in China kills 10 people. In each case the victims are innocent.
Question: Is the murderer in Andorra, who has killed a much higher percent of Andorra’s population, more evil than the murderer in China who has killed a much lower percent of China’s population?
Answer: No.
So here’s where Tyler Cowen’s point is correct. And of course, to his credit, he makes clear that he’s talking about the moral point.
But let’s ask a different question: Which country do you want to live in if you know that there’s a murderer at large who plans to murder 10 people in that country? (Assume everything else about these countries is the same so that we can isolate the effect of the 10 murders.) Would you want to live in Andorra or in China?
READER COMMENTS
AMT
Nov 12 2020 at 7:59pm
Honestly this isn’t a good counter to his point. You just need to point out that is very misleading and will take you away from a correct cost/benefit analysis because it ignores costs. The correct counter is to point out that percentage deaths are extremely relevant in determining optimal policy, because in this instance the costs are borne by the entire population.
e.g. Is a lockdown of a city of 5,000 worthwhile to save 5 lives? Is a lockdown of a city of 5,000,000 worthwhile to save 5 lives? The benefit is the same in both cases, but the cost varies proportionally to the population, so percentages are indispensable.
David Henderson
Nov 12 2020 at 10:51pm
You wrote:
You’re right. I wrote my piece too quickly.
Alan Goldhammer
Nov 12 2020 at 8:04pm
The more appropriate question to ask is whether you would want to live in an area where there is a massive outbreak of SARS-CoV-2 and the hospital system in the area can no longer function. This is what happened in NYC in March/April and what is now happening in many interior states. Healthcare workers cannot easily deal with these numbers.
The dream of ‘herd immunity’ has consequences and the virus really doesn’t care; it just wants a host to propagate in.
suddyan
Nov 13 2020 at 7:05am
[The more appropriate question to ask is whether you would want to live in an area where there is a massive outbreak of SARS-CoV-2…]
Frankly, the hospital system in the country I live in – which, according to government “communication” and reporting in the press, experienced a rather severe outbreak – is in quite a sorry state. However, it does not bother me much since I have no irrational fear of SARS-CoV-2, which is far from the devastating killer virus many alarmists make it out to be.
On the other hand, the over-the-top “we must do something” response to it by governments, politicians, and some “experts” in the medical fraternity, has sadly been devastating.
[This is what happened in NYC in March/April and what is now happening in many interior states.]
I am aware of one specific hospital in NYC which was struggling to deal with the situation way, way back at the beginning. In retrospect, a significant part of their “struggling” was due to their own panicking response – for instance, there was no need to intubate so many patients.
I have also read of one hospital in England, and largely one in a specific region of Italy that “struggled.” But that was essentially it for hospitals really “struggling” worldwide. Also, to have complete contextual understanding, the hospitals in Italy often “struggle” during disease seasons (such as more severe influenza).
Such “struggling” situations are not unique to SARS-CoV-2. Rather it is endemic to subpar planning and preparedness, resource constraints (surely on Econlib I should not have to highlight the economic concept of scarcity?), and sometimes poor reaction in perceived “emergencies.”
By the way, any “now happening in many interior states” that I have read up on have – thus far – all turned out to be overhyped.
[The dream of ‘herd immunity’…]
It is not a “dream.”
Feel free, for others’ benefit, to make your argument again, but this time based on the actual epidemiological concept of herd immunity, rather than on a rhetorical trope. It would be to your advantage if you also incorporated how critical herd immunity is as a contributory factor to the success of any good vaccine (which some of them may be).
robc
Nov 13 2020 at 7:50am
Dont forget idiotic certificate of need laws.
robc
Nov 13 2020 at 7:53am
If the new vaccine is actually good, and is really 90% effective, then it is absolutely relying on herd immunity.
Any approach that relies on immunity existing is relying on reaching herd immunity, one way or another.
Fred_in_PA
Nov 13 2020 at 9:52pm
Isn’t the herd immunity portion of the Great Barrington debate something of a side-effect — nice if & when we get it but hardly the main point?
Isn’t the main point that lockdowns themselves kill? And that the number of deaths caused by blanket lockdowns may well exceed the number of deaths they were intended to prevent? That the cure may be worse than the disease?
I admit that it’s hard to know, since the deaths caused by the lockdowns often involve causal chains and time displacement. E.g., the lockdown causes Jones to lose his job, and he turns to drink. Drunk, frustrated & angry, he beats his wife. The drinking & beatings (& his inability to support the family) lead her to divorce him. Which leads to his becoming homeless. Homeless and alcoholic he now has little hope of work. And a year after the pandemic was over, cold, hungry & lonely, at age 30, he steps in front of a freight train. Did the lockdown cause that? Would it have happened to a healthy and happily married twenty-something without it?
Brenner’s work in the mid-70’s (which he says does not directly apply) implies that our unemployment rate near 10% could be responsible for roughly 400,000 excess deaths. We know that suicides & domestic abuse are up (although I’d appreciate help finding credible current numbers). Excess deaths are up due to people not being able or willing to seek help for their medical conditions. By some estimates, we may be in the process of wiping out some 8 million small businesses (or about 25,000,000 jobs) and the life’s work (& savings) of their proprietors. And who knows the damage we’re causing our children by chopping a year’s worth of schooling out of their life-preparation.
(And worse, the 400,000 we’re sacrificing had an average of 41 years of life ahead of them, while the 200,000 we’re trying to save had an average of 17. Looks like a very bad trade to me. Or maybe it just shows that the folks making the decisions trend older.)
Rob Rawlings
Nov 12 2020 at 8:33pm
I don’t think the use of the word ‘moral’ saves Cowen’s point. If one asked ‘Is it immoral to refuse to use half your nations GDP to save 100,000 lives’ it would be odd if the answer were the same whether 100,000 lives was >25% of your population (as it would be for Iceland) or <0.01 % of your population (as it would be for India).
Having said that: The scary and believable numbers that Cowen projects plus the immanence of the vaccine is making me wobble a bit on my generally anti-lockdown views.
krishnan chittur
Nov 13 2020 at 2:48pm
scary numbers – yes – projections believable? That is a different story – it will depend on models used and data used to fit the past and project into the future – not at all sure how reliable the data is for accurate modeling (look at covidtracking com and national and state data – CA is higher than national for e.g. there may be other mines buried there somewhere) – ferguson (ICL) was way off – and yet we learn that a scary projection even if way way wrong seems better accepted than a realistic projection that is just a bit off (being wrong is OK if instead of 2 million deaths, the numbers are about a tenth – being wrong by about 30 to 50% is considered worse) – I am at a point where I am not sure I believe any of the numbers being used to create policies – https://www.wsj.com/articles/case-for-mask-mandate-rests-on-bad-data-11605113310?mod=hp_opin_pos_3 – data should be reported accurately – but we have crossed the rubicon on that front
Chris
Nov 12 2020 at 8:46pm
So, extending the metaphor, the Great Barrington Declaration is tantamount to declaring the murderer only has enough energy to murder 10 people and then will cease murdering?
krishnan chittur
Nov 13 2020 at 3:20pm
Far from it. But yes, sooner or later, the murderer will indeed lose steam and stop. I cannot remember a viral epidemic, pandemic that spread and killed everyone. We can argue as to why the 1918 pandemic stopped, dissipated way before we had antivirals or other chemicals – and we can argue as to which city did a better job of containment – but viruses will spread no matter what we try (we may be able to in some cases slow it down – but never stop it). No one on the Barrington declaration wanted to see death and destruction – they were expressing an alternate approach – and is worth considering.
Kevin Dick
Nov 12 2020 at 9:35pm
Or more pointedly, where would you like to live:
(a) A country with 100M people and a murder rate of 1 per 100K. Which is to say a country with a population of 100M and 1000 murders per year.
(b) A country with 10M people and a murder rate of 5 per 100K. Which is to say a country with a population of 10M and 500 murders.
Apparently, Tyler choses country (b)
Mactoul
Nov 13 2020 at 12:38am
“Losing 320,000 lives (including excess deaths) has about the same moral import”
I am unclear about the “moral import”. Why does losing people in epidemic carry any moral import whatsoever?
Thomas Hutcheson
Nov 13 2020 at 6:35am
Of course not. What matters is the cost of preventing that number of deaths.
Richard A.
Nov 13 2020 at 7:56am
Is the covid test accurate?
Elon Musk
@elonmusk
Something extremely bogus is going on. Was tested for covid four times today. Two tests came back negative, two came back positive. Same machine, same test, same nurse. Rapid antigen test from BD.
9:47 PM · Nov 12, 2020
maej
Nov 13 2020 at 9:47am
I’ve been a bit curious about this as I’ve seen the city in which I reside begin reporting rapid antigen tests as between 20 and 30% of the daily tests total. On one hand, rapid and cheap and lower accuracy certainly has its uses, and I very much wish such a test were available for me as a home consumer. On the other hand, I worry about whether inclusion of low accuracy results will lead to inappropriate demand for policy responses from public officials. To be clear, I do not know whether switching to antigen based testing is likely to undercount or over count cases.
krishnan chittur
Nov 13 2020 at 1:24pm
The PCR tests are not perfect – the antigen test is even less so. The CDC started with requiring two regions of the virus to be detected – now they require one – there may be good reasons for it (they now ask to look for flu(A and B) and controls. There are multiple ways to do PCR – and yes, sample type can be a confounder (they do use internal controls) – but you normally do not know the number of cycles used (Ct values) – there are many details. The PCR method is amazing for sure – but not perfect – and in this current rush I suspect many errors are being made – worse, no one seems to question the results for fear of being ostracized OR yelled at – How dare does someone even question the testing protocols.
krishnan chittur
Nov 13 2020 at 4:10pm
This is a bit old now (09/09/2020)
https://freakonomics.com/podcast/nfl-restart/
there is mention about false positives (lab specific)
PCR is amazing for sure – but not perfect. PCR on the same sample done in different labs are not likely to agree (Ct values may be different – how the sample was prepped for analysis may contribute to differences in results also)
Jon Murphy
Nov 13 2020 at 9:02am
Comparing war deaths to pandemic deaths is comparing apples to oranges. It is incorrect to say that a death in war is equally immoral to a death in a pandemic. In war, the death is entirely avoidable; it comes about because of human action and agency. In a pandemic, the death is not due to human action or agency. It’s a natural result.
Consider the following:
Which person is worse:
1) A person who is asymptomatic (and thus does not know they have the disease), accidently spreads it to someone else who subsequently dies.
2) A person who is symptomatic and deliberately spreads the disease.
I argue the first person carries no moral guilt. The second person does. The two actions are not morally equivalent. The two deaths, while both tragic, are not morally equivalent.
Greg G
Nov 13 2020 at 1:54pm
Jon, your example is far too simple to describe the most common or interesting moral choices faced by people in this pandemic. Or even in wartime for that matter.
The overwhelming majority of people know very well that they could be asymptomatic and infectious without knowing it. In fact this is how the disease spreads in the majority of cases. Whatever choice they make, they have at least as much agency as soldiers in war who may be draftees, may be acting in self defense, or may be subject to being shot if they refuse to follow orders.
Jon Murphy
Nov 13 2020 at 2:00pm
Greg, i agree. The example is simple. But complicating it doesn’t change my point: not all deaths are morally equal. Agency, fortune, and many other circumstances play into whether the action is blameworthy or not.
Greg G
Nov 13 2020 at 2:23pm
Ok, I agree that not all deaths are morally equal. I didn’t understand anyone in the conversation to be arguing that they were.
I think what everybody is really interested in is what are everyone’s ethical obligations in a pandemic and I rarely see an analysis from anyone that doesn’t oversimplify that calculation.
Jon Murphy
Nov 13 2020 at 2:46pm
I understand Tyler to be saying that they are with this sentence:
Greg G
Nov 13 2020 at 4:52pm
Jon, when Tyler refers to the moral import of a statistical number of lives lost I think he is simply saying that we should view the moral import of those lives lost as being equal to one another.
There are other ways than moral value to value lives which are clearly legitimately unequal like economic productivity for example. So this invoking of the moral import of a life by Tyler is more like the Christian idea that all souls have equal value in the eyes of God or the democratic idea that all citizens are equal before the law.
I don’t think this quote from Tyler is any kind of claim that all the different ways you could be guilty of causing someone’s death have equal moral import in terms of the moral import of the guilt of a person causing the death. That’s a different thing altogether. Tyler deserves a much more charitable reading.
David Seltzer
Nov 13 2020 at 6:18pm
Jon, if I may, a plane carrying 300 passengers experiences a mid air bird strike. The pilots do everything they can to land but fail. All are killed. Clearly no moral guilt. A person decides to climb a bell tower with a high powered rifle and kills 50 people. He is morally guilty as he CHOSE to kill those people
AMT
Nov 14 2020 at 3:14pm
I agree with this, and just want to add what I think is an even more important failure of Tyler in his post. By directly comparing deaths of soldiers to this pandemic, he implicitly eschews any QALY analysis and equally values the lives of 18 year olds and 99 year olds. If this was a trolley problem, I can’t imagine many people being completely indifferent to which life is saved, but apparently Tyler would be indifferent. To me, that makes him a moral monster, and we know for sure that Tyler ascribes to nothing remotely close to utilitarianism. I have never been impressed by Tyler, and only frequent MR for the interesting links, but I would never, especially now, place any weight on his opinion or analysis of anything.
Stanley Willis
Nov 13 2020 at 12:00pm
SARS COV2 will be suppressed by immunity. call it “herd immunity” or not, whether it is aquired naturally or stimulted by a vaccine. The current upsurge in cases is in less vulnerable sectors of the population, so the second wave is in fact creating immunity. By the time vaccines become generally available. I suspect very few people will need them.
Remember. death is inevitable, we can’t prevent it. We can only change the time and manner of it. Even that is limited. There is no reason to believe anything could have been done, given our always limited knowledge, to prevent this pandemic. All we can do is cope with it. A much less fearful, panicy and dishonest policy approach would have helped.
krishnan chittur
Nov 13 2020 at 1:19pm
Then there is this problem with the data itself … One example.
https://covidtracking.com/data/download has national and state data
national-history.csv – for Nov 12 2020 – hospitalizedCurrently is 67096 hospitalizedCumulative is 507933
all-states-history.csv – for Nov 12 2020 – for CA – hospitalizedCurrently is 113052 hospitalizedCumulative is 19350463
I know ONE example – but CA’s numbers are HIGHER than National (??) and
CA hospitalizedCumulative is more than 19 MILLION?
The data may be reported by someone else – and gathered, analyzed – but this is so glaring that it is surprising no one has noticed. You begin to wonder about the data itself – ALL of the data being reported. We have no choice BUT to rely on data – but not much of an idea how right or wrong it is.
And this story https://thefederalist.com/2020/11/13/la-times-blames-seven-covid-deaths-on-small-maine-wedding-that-victims-did-not-attend/ – The CDC report concluded that None of the persons who were hospitalized or died had attended the event.” (yea, there are caveats to this conclusion). And this https://www.wsj.com/articles/case-for-mask-mandate-rests-on-bad-data-11605113310?mod=hp_opin_pos_3 Why low ball the percentage of americans who are already covering their faces? Presumably to use the projections to impose a mask mandate. This appears to be a deliberate attempt at using incorrect data to come up with a policy – and a mandate. This type of scientific pollution will cause significantly more harm in the future – and reflects a basic disregard for truth and distrust in the people to science and scientific expertise. Masks work – you do not have to make up the reasons for such.
There is a problem (IMO) with data that is available for analysis – it is becoming increasingly difficult to believe anything – yes, a few errors perhaps are to be expected – but we do see (IMO) what appears to be deliberate attempts at misleading people through data that is incorrect.
krishnan chittur
Nov 13 2020 at 2:22pm
What also matters are the numbers themselves (I did post something – that may or may not have gotten through)
I have looked at covidtracking com data download – examined national and all-states data (in csv format) – the numbers for CA are higher than national numbers – (cannot see if they have ignored CA numbers) – the hospitalizedCumulative in CA is 19 MILLION + (national shows 507933 (there are other discrepancies).
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