How to Stay Sane as a Libertarian on Lockdown
2020-03-27 · Guest: Jacob Sullum (Senior Editor, Reason magazine) · 52:21
COVID-19 mortality rates and public policy challenges
This episode features Jacob Sullum, senior editor at Reason magazine, discussing the profound uncertainties surrounding the COVID-19 pandemic’s true mortality rate and the resulting challenges for public policy. Bob and Jacob explore the economic and social trade-offs of lockdown measures, the importance of accurate testing to determine the “denominator” of infections, and how the crisis has necessitated the temporary relaxation of various government regulations.
Topics: COVID-19, public health policy, epidemiology, economic lockdowns, death rate estimates, regulatory reform, libertarianism, value of a statistical life.
Speakers:
- Bob Zadek – Host
- Jacob Sullum – Senior Editor, Reason magazine
Introduction and the “Great Unknown” [00:18]
Bob Zadek: Hello everyone, welcome to the Bob Zadek Show, the longest-running live libertarian talk radio show on all of radio. Live means live, not pre-recorded, not rehearsed, and up to the second. Thank you so much for listening this Sunday morning.
Needless to say, the coronavirus is in the news all of the time, and there is so much information out there that for the population—for all of us who are in part frightened, in part concerned about our economic well-being, our physical well-being, the well-being of those we care about the most on the planet—what’s going to happen in the future? The future seems so murky right now. There is so much uncertainty, so much bad information, so much, in many ways, the absence of quality information. I thought I would do my best this Sunday morning to help us sort through some of the noise, some of the quality information, and help us all better understand how we got here, what the future holds, and what we should be doing right now.
I thought of no one better to help us than this morning’s guest, Jacob Sullum. Jacob has been on my show many times before. Jacob has written extensively on the coronavirus and on public health in general. He’s the senior editor at Reason magazine and he’s also a nationally syndicated columnist. He’s written two critically acclaimed books. In 1998, with incredible prescience, his book was entitled For Your Own Good: The Anti-Smoking Crusade and the Tyranny of Public Health. More recently, in 2004, Jacob wrote Saying Yes: In Defense of Drug Use. Jacob, you are my go-to person for this topic. You are so informed and you can help all of us sort through what’s going on. So, Jacob, welcome to the show this morning.
Jacob Sullum: Thank you.
Bob Zadek: And I should mention Jacob is on his cell phone speaking to us from Texas, but you’ll certainly be able to—the clarity is very good and you’ll be able to understand and hear Jacob. Now, Jacob, we hear a lot—there’s been a lot, of course, coronavirus has been in the news all of the time, as it should be. And there is a lot which is known, but most importantly, there is some crucial information which is, as we speak this morning, not known. And without nailing down this massive unknown, the rest of the conversation in the media and in public—the rest of the conversation has a bit of a speculative aspect to it. So, what is the great unknown and why is it unknown?
Jacob Sullum: Well, the most important thing that we don’t know is exactly how deadly this virus is. Meaning, what percentage of people who are infected can be expected to die? It seems pretty clear that it is more deadly than the seasonal flu, for example. The seasonal flu has what they call a case fatality rate of about 0.1%. The public health officials in the United States are saying that the best estimates indicate that the case fatality rate for COVID-19 is somewhere between 0.1%—in other words, around that of the seasonal flu—up to 1%. Now, that’s a huge range. And the fact that we have not been able to nail that down better suggests how poor our data collection has been so far.
There are some epidemiologists, by the way, who think the lower end of that range is actually less than 0.1% and might be as low as 0.05%, which would make COVID-19 actually less deadly than the seasonal flu. But presumably—we just say this because we don’t know—it’s somewhere between there. So, depending upon which case fatality rate you use to make projections, the number of deaths you predict varies very widely. So, it can range all the way up to—I’m sure people have seen the estimates in the worst-case scenario. According to the CDC, they foresaw 1.7 million deaths in the U.S. A group at Imperial College headed by Neil Ferguson did a projection for the U.S. where they said there could be 2.2 million deaths.
Now, I think those scenarios are implausible for two main reasons. First of all, they’re assuming a relatively high case fatality rate. The CDC assumed 0.8%. The Imperial College group assumed 0.9%. Maybe that’s right, but it is also possible that it’s half that or less. The other major thing that figures into their projections is how many—what percentage of the population do you think will ultimately be infected? The CDC assumed 65% in their worst-case scenario, but that’s based on the assumption that basically nothing is done that’s effective. And I think it does not adequately take into account changes in behavior—voluntary changes in behavior—that have already happened and that will continue. Right? So, if people are reducing social contact, if they are limiting their errands, if they are washing their hands frequently, if they’re doing everything that they’ve been told they’re supposed to do—even if not everyone is doing that, even if not everyone is the best at washing their hands—those sorts of changes are bound to have an effect on the transmission rate and how many people ultimately will be infected.
So, these are all the big unknowns, which is why you see such a big range in estimates of how many people might die. I’m talking about in the United States—a few thousand in the United States to maybe 20,000, all the way up to the CDC’s worst-case scenario of 1.7 million. Now, so you look at that and you think, how can you possibly rationally make policy when you don’t know how big the problem is that you’re confronting? And you really can’t. That’s one of the things I’ve been trying to emphasize: that when there’s such a high level of uncertainty, you’re really operating in the dark. You don’t know how many Americans are infected. You don’t know what percentage of those people will ultimately die. So, you can’t know whether what you’re doing is actually worth the cost.
And there are enormous costs to these aggressive interventions like shutdowns or lockdowns or whatever you want to call them. Shutting down the economy, or much of the economy, for weeks or months even, has a really severe impact on millions of people. People are out of work, their businesses are no longer operating, they may be driven into bankruptcy. We are looking at a severe recession as bad as the one in 2008-2009, or possibly worse. So, that particular recession cost an estimated $22 trillion. So, we’re sort of doing that to ourselves. Some of this effect is just a response that would have happened anyway to the virus, but a lot of this is government-mandated—that businesses must close, that people must stay home, and so on. So, if you’re trying to figure out, is it worth doing that given the huge cost, and you don’t know what the problem is that you’re avoiding, what the magnitude of that problem is, it’s really hard to make rational policy decisions. And I think it’s a mistake to say, like Andrew Cuomo does, that we’re going to do whatever it takes for as long as it takes, no matter the cost. That cannot possibly be right. Because if the cost is huge and the benefit is small, we shouldn’t be doing those things. So, we have to think of and talk about this in a more balanced way, taking into account not only what lives could possibly be saved by these measures, but also what is the cost of doing it.
The Problem with the Denominator [03:51]
Bob Zadek: And the missing piece, the math is 10th-grade algebra. It’s a numerator and a denominator, and you divide the numerator by the denominator, and that’s the percentage. The problem is the numerator is the number of deaths. That we kind of know. We know how many people have died, and we know if they have died from the disease, or at least have the disease be a major contributing factor. There are often many factors. It’s the denominator that’s the challenge, because the denominator ought to be the number of people who have been infected. And we don’t know, without testing, how many people have been infected. So, we have a missing denominator, and the equation cannot be calculated except with guesswork. And the reason is the news media report every day “new coronavirus cases.” That’s false. That statement is missing a key word. Jacob, and please help us understand that the missing word is “newly discovered cases.” The cases have been there for some time, perhaps. We just didn’t know about them. It’s the discovery that’s missing from the conversation, and that’s what makes the calculation impossible.
Jacob Sullum: Right. I mean, the cases that we know about are the cases that have been identified because they came to official attention. Well, how does that happen? If people get sick and they think “I might have this virus” and they go to be tested, well, now you have a case that’s been identified. But typically, this virus does not lead to severe symptoms. Last I looked at the worldwide data, they were saying 95% of known cases—again, this is known cases—involved mild symptoms. Now, there are lots of other people who are never identified, so they don’t figure into that calculation, who have mild symptoms or no symptoms at all. So, if you have mild symptoms, you think “I have a cold” or “I have the flu,” you don’t go to the doctor, you don’t get tested, you’ll never be identified unless they start doing widespread testing.
So, that’s the basic problem. Given that they’re not doing either testing of everybody or testing of a representative sample, you can’t know how many infections there actually are. So, this is all guesswork. And it is very scary to watch, you know, the number of deaths climbing and also, by the way, recently the crude case fatality rate—so that simple calculation—that number has been going up. So, it’s about two—it’s nearly 2% now, I think. That’s going to change too and may go up, may go down. But it’s very misleading to use that calculation because the vast majority of the cases of infection have not been identified. And this is something that may incubate for up to two weeks. So, the cases you’re identifying now are these are people who have—who may have been infected as long as two weeks ago. So, you’re sort of getting a picture of what happened two weeks ago, and you’re not even getting an accurate picture of that because you don’t know what percentage of the population has been infected. So, until they start doing wide testing—ideally, they should test everyone; they don’t have the capacity to do anything like that yet—but if they can’t do that right now, they should at least be trying to get a representative sample of Americans and test them. Now, if you do that—and that includes people who have no symptoms, who have mild symptoms, who may be infected, may not be infected—but if you test a representative sample, then you have an idea of what percentage of Americans have been infected at this point. You’d have an idea of, among the people who are infected, how many develop symptoms? How many don’t develop symptoms at all? Among the people who develop symptoms, how many of them will have symptoms serious enough that they have to go to the hospital? And how many can stay home and recover? You really don’t have any clear idea of any of those things unless you look at a representative sample.
Policy Uncertainty and Economic Costs [07:00]
Bob Zadek: Now, Jacob, let us assume—and this is an opinion show, I have guests because their opinions count for more than many other people’s, and you are in that short list—I’m going to ask your opinion on something, and you’re allowed to be wrong, you’re allowed to speculate, but your opinion is of great value to myself and to our listeners. It is, of course, possible that if we knew—if we had a regime for extensive testing—we could know that the death rate, the scary word, the death rate is much lower than we feared. Because right now, the death rate is a fake number. It’s a number that should not even be reported because it’s based upon, as we said earlier, such flawed and imprecise data. It’s not news. So, let us assume, because it’s possible—we can’t talk about probable, but it’s possible—that the death rate of this virus will be shown to be in the lower range. Wouldn’t that make, or would that make, all that we are doing now—the economic disruption and the social disruption—would that make it wrong, wasteful, and very destructive on our life as a nation? Or is it possible that the death rate will be shown to be low because we have taken these measures? Can we speculate in that way, or is it just folly because we cannot tell?
Jacob Sullum: Well, I think if it turned out that the true mortality rate was in the vicinity of the mortality rate for the seasonal flu—so maybe somewhat larger, but not a lot larger, which is within the range that the epidemiologists are talking about—yes, it would be an enormous mistake to have plunged the country into a severe recession over this. We don’t do that with the flu, as people have frequently said, even though, you know, a substantial, not insignificant number of people are dying every year from the seasonal flu. Now, I think that COVID-19 will turn out to be more deadly. The question is how much more deadly? And the answer to that question really has a dramatic impact on which policies make sense or don’t.
I mean, part of this is, what do you do when you’re facing a tremendous amount of uncertainty? Should the bias be toward intervening and intervening as aggressively as possible and doing that for as long as possible? I mean, I think if you listen to Andrew Cuomo, that’s his inclination. He thinks, given the uncertainty, that we just need to focus on preventing deaths, saving lives, and ignore everything else. But I think that is clearly irrational because, you know, when the government imposes regulation aimed at protecting public safety and health, they routinely take into account not just how many lives we think this is going to save, but also how much is this going to cost. And they will assign a dollar value, usually around $8 or $9 million, to each life they think can be saved or each death they think can be prevented by this regulation. And if it turns out that, you know, you’re spending billions of dollars but you’re only saving a handful of lives, they’re not going to—or they’re not supposed to anyway—impose that regulation, right? And so, this is what we’re talking about, but in a much larger context. Governments at different levels are imposing regulations that are aimed at protecting public health, aimed at preventing deaths. And if we don’t know how many deaths they can reasonably be expected to prevent, it’s very difficult to weigh the costs and benefits. But we know that there are costs. We know that there are huge costs to these policies. The question is, what’s the benefit?
So, I think over the shorter term, something that is maybe easier to get a handle on is: have we succeeded in preventing hospitals from being overwhelmed by COVID-19 cases? This is the main concern, I think, over the shorter term, because that not only means that you may not be able to treat everyone with COVID-19, but it means that people with other serious health conditions may end up not getting the treatment they need. So, that can lead to additional deaths in itself. So, you can get some idea of how many cases are they seeing in a hospital in a particular area. After we institute these measures, do we see a decline in new ICU cases? Even if we don’t actually know whether that would—it might have happened anyway, we don’t know. But we can surmise that now that people are—we think we’ve imposed measures that are going to reduce transmission, we’re seeing fewer cases in the ICU, we think that this is working, right?
So, but then the question becomes: how do you get from that situation where you’ve imposed sweeping restrictions on people to one where people are allowed to earn a living again? How do you get from total lockdown to a more or less functioning economy? And it has to, I think, involve testing at a level that they have not been able to do so far in this country. But you could start to do things like start to do antibody tests, for example. Now you’re identifying people who were infected and have recovered, right? And presumably have immunity. That’s another completely unknown thing, right? Because if you’re doing the standard test and you have somebody who had it and then recovered, it’s not going to show the virus, but it would show antibodies if you do the antibody test. You start to identify those people, well, they can go back to work, right? They’re not going to get it, they’re not going to transmit it to other people. What about the people who are—who test negative, meaning they don’t have it, they could still get it? Well, maybe they can go back to work with certain precautions about maintaining distance, maybe using masks, right? And I mean, the other way of approaching this is you can start to talk about the people who are at most risk. And how do we protect them instead of locking down the whole economy? Is there a way of protecting the elderly, people with serious pre-existing medical conditions? Because those are the people who really are facing significant risk of dying as a result of this disease. Are there more narrowly tailored approaches that could protect those people without shutting down everything? And I think we’re going to have to start to talk about some of those alternative policies rather than it being all or nothing, where either we’re shutting down the economy or everything is as it was before. And I don’t see enough discussion of that by politicians.
The Trade-off: Lives v. Livelihoods [13:51]
Bob Zadek: And that’s exactly true because it’s hard. That discussion is hard. And just to reduce it to some really clear examples: we have been discussing for a long time in this country what should be our approach to healthcare—everything from a total free market on one extreme, if that’s an extreme, to Medicare or Medicaid for all, another extreme. Both of those discussions have implicit in the conversation the concept of rationing. That is, some people will get suboptimal healthcare, some people will die. We can save them, but we cannot spend the money to save them. So, we make decisions as a society all the time.
Even in a more clear example: we have about, I think, 55,000 deaths from driving in this country. I think that’s the right number. It doesn’t matter. We have X deaths per year from driving. We could reduce that to zero—just prohibit driving. Now, why wouldn’t we? Well, that’s absurd. The effect on the economy would be devastating. It’s not worth the 55,000 lives. The 55,000 lives—we’ll try to make it lower, but 55,000 people will die as a conscious decision because the cause of their death is more valuable to society—that is, driving—than the loss of their life. We make those decisions all the time. We don’t do it consciously because it’s too painful, but we make those decisions.
So, the decision that Jacob is talking about, which is: put people back to work because the benefit to all of us is infinitely greater than the additional lives that may be lost as a result of that. That is a legitimate, indeed essential, decision for us to discuss and to make. Instead, we seem to have assumed, as Governor Cuomo—and I’m not meaning to single him out, he’s doing his darndest to take care of the people of his state, this is not about Cuomo, just because New York is the most devastated, so he comes to mind—but also the Governor of Pennsylvania has said, “First we save lives, then we save livelihoods.” That statement is false. That’s not the process. The process is you decide what is for all of society the better of two unpleasant choices, but you make that analysis instead of just defaulting to “saving one life is sufficient.” So, that is the hard decision that all of us, through the political system, have to make. But it has to be discussed instead of just assumed.
Hospital Capacity and Exit Strategies [18:09]
Bob Zadek: This is Bob Zadek. I’m speaking with Jacob Sullum this morning. Jacob is an associate editor of Reason magazine. He has written extensively on COVID-19 virus, on the policy, the political issues involved, the human issues involved. We will explore this hard but important topic in 30 short seconds. Please stay tuned. Lots more to follow.
[Commercial Break]
Bob Zadek: Welcome back to the Bob Zadek Show, the longest-running live libertarian talk radio show on all of radio. This morning we are speaking with Jacob Sullum. Jacob is an associate editor of Reason magazine. He has written extensively on the COVID-19 epidemic, how we got here, how we get out of this mess, and what are the hard decisions to be made as a country, as a political body, to get through this. And most importantly, and the reason Jacob is speaking with us this morning is that Jacob’s approach is rational, it’s reasoned, it’s thoughtful. And if we are to be governed by a rational mind, sometimes we have to make painfully hard decisions. They cannot be avoided. And right now, too much of what’s happening in the political arena are not thoughtful decisions, but are decisions that have a political calculation but not a “what’s best for the country” approach. So, it’s our hope this morning to introduce a bit more reason and rationality into the conversation.
Now, Jacob, as you have pointed out earlier before the break, the problem is we are desperately in need of quality, reliable information. Specifically, testing to determine how many people are presently infected so we can determine the death rate, not based upon discovered cases, but actual cases that exist, and then we can determine what is the best cure. Now, since we have woefully few tests available now—and we might get into that if we have time, why we have so few tests in a country with such vast resources, that’s a somewhat different conversation, we may get into that—but given that we have to ration, if you will, testing, how best should we use the testing that’s available as more and more testing comes online and available to the healthcare community?
Jacob Sullum: Well, what you ultimately want to be doing—not only ultimately, but ultimately you want to test the whole population, I think, or at least a representative sample. But given that that can’t be done now, what you want to do is test people who are—with symptoms who think they have it, then say, “Who have you been in contact with?” And then ask those people, “Who have you been in contact with?” All of those people should be tested. So then you start to get a sense of how many cases there actually are and also how transmissible it is. And you can try to avoid transmission by tracking contacts, tracing contacts like South Korea did, and saying, “You just stay in place for two weeks because we think you were in touch with this person who in fact was infected.” Now we have some information. Right now we’re telling the entire population to do this. If you actually knew who was infected and who they had contact with, you would have—you could have a much more focused approach. So, I would like to see that.
One other issue we mentioned before that the COVID-19 deaths are strongly concentrated among older people and people with serious pre-existing medical conditions. And I’m going to attribute this to Neil Ferguson, the British epidemiologist who brought the point up, because it’s a very touchy point. So, I’m going to attribute it to him, although I think it’s a very valid point that needs to be considered. He testified before a parliamentary committee last week, and one of the things he pointed out—first of all, he said, you know, it’s clear you cannot keep the country in lockdown for a year. Some people read the report from his research group at Imperial College as implying we need to do this until we have a vaccine, which is, you know, possibly 18 months or longer. But he said that clearly is not a feasible option, and we need to start talking about how do we get people back to work and how do we allow them to earn their livelihoods again. But one of the points he made in terms of the impact of the epidemic is he said we don’t know yet how many excess deaths there will be. Not only do we not know how many people will die as a result of this virus, but we don’t know at the end of the year how many more deaths there would be than we would otherwise have expected because of the epidemic. And what he said is because this is primarily affecting people who are near the end of their lives, and he estimated it could be half or two-thirds—half to two-thirds of the deaths from COVID-19 could occur in people who would have been dead by the end of the year in any case.
Now, that’s a very touchy thing to bring up, but it is obviously relevant in trying to assess the harm that is caused by the epidemic and how much you’re willing to pay in terms of economic stopping economic activity, throwing people out of their jobs, causing, you know, severe recession and so on, in order to prevent that cost, to avoid that cost. So, what he was saying, which I thought quite interesting, is that you know, in their initial analysis, his group at Imperial College, they did not consider economic or ethical issues at all. They just said, “Here are different scenarios, different kinds of policies we could adopt, and here’s a range of reproduction numbers,” which is how many people do you think the average carrier typically will infect. So, they had a range of those numbers, they had a range of policies, and they said, “In these different scenarios, here’s how many deaths we project.” That’s all they did. So, they didn’t talk about economic effects at all, and they also did not talk about the impact—you know, where these deaths occur and whether they’re actually excess deaths or whether they are mostly deaths that actually would have happened anyway by the end of the year. So, these are all very serious issues that you need to consider. And I mean, one way of thinking about it is if you had an epidemic that was affecting primarily healthy children, teenagers, young adults, and middle-aged people, the cost of that, the loss from that, would obviously be much greater than one that primarily affects people who are elderly or sickly. I think nobody would deny that—that we would have a much more serious problem if you have an epidemic that’s killing children and young adults primarily. That would be worse. So, given that that is worse, you would be willing to bear a much greater cost than in the situation we actually face. So, these are all things that people really ought to be talking about, even though it’s uncomfortable and it’s touchy. It does not mean that, “Oh, if you’re sick and you’re old, your life is expendable.” This is how Andrew Cuomo puts it. That’s not what I’m saying, and certainly not what Neil Ferguson is saying. But you do have to try to get a handle on what kind of costs would be caused or imposed by this epidemic versus how much does it take—how much does it cost to prevent that outcome.
Individual Risk v. Collective Policy [40:06]
Bob Zadek: And while it’s, of course, as you pointed out, Jacob, terribly uncomfortable, painfully uncomfortable for us individually and then therefore collectively through the democratic process to put a price on human life, we really do it every single day, almost every single election. To give just one example as a hypothetical—and I ask all of our listeners and friends out there, just think of this hypothetical: assuming we are told we could cure some disease, we could therefore save lives, we could cure a strain of cancer. In order to do so, we have to spend enormous amounts of money and we have to raise the tax rate, the income tax rate, to 80%. So, everybody in America will give 80% of their income into this fund to—which will, and accept it as a given, cure cancer. And we have to do that for five years. Would you vote for or against that? If you vote against it, which I dare say most people would do—but I don’t know—if you vote against it, you are saying saving a life does have a value, and the cost of saving the life is to me individually and to us collectively simply too expensive. So, we make that decision every day in our political life. So, what Jacob is suggesting or inviting us to think about is nothing new. It’s just very out there and very tangible. And so the conversation about the economy or human lives is a decision we make frequently.
Now, Jacob, it seems that we have sort of by default at the national level and certainly at the state level in New York, in California, and in most other but not all other states, we have decided the needs of economic life, however severe they are, however much they’re compromised, have to be subordinate to saving lives in some amount we don’t even know. So, haven’t we in effect made that decision right now and we have decided, as the Governor of Pennsylvania has said, irrespective of cost—and that’s the most important phrase, irrespective of economic cost—saving a life, even one life, is more important than economic life, than keeping the economic engine alive, and the economic engine saves us all. Haven’t we in effect made that decision flying blind?
Jacob Sullum: Yes, for sure. Politicians are definitely making these decisions in the dark because they don’t know—they don’t have crucial information. And given that, you know, you have to kind of—I don’t want to say split the difference, but you have to at least give some weight to the cost of the policy when you don’t know what the actual benefit of the policy is going to be. And like you said, I mean, it’s simply irrational to say we’ll pay whatever it costs. Resources are finite. Money used for one thing cannot be used for another thing. People make decisions all the time that entail some risk to their own lives, some risk that they’re going to die. Every time you get in a car, every time you get in—less so every time you get in an airplane—but for sure every time you get in a car, there’s a certain risk that you’re going to die that day. But we surmise from that that people don’t put an infinite value on life. And one of the ways that they try to calculate the value per life saved that they use when they’re evaluating the cost-effectiveness of regulations is by looking at how do people actually behave. So, for example, how much of a premium do people demand as a wage for a relatively hazardous job where you have a relatively high risk of dying versus a safer job? Right? So, you can look at how people actually behave and you can see from there that even in terms of their own lives, they don’t attach an infinite value, right? So, obviously, when you’re making broader decisions that affect many people, you have to keep that in mind. There is not an infinite value to every life, even to your own. You know, if that were true, then you would never do anything because everything has some level of risk, right? So, I think we understand that generally speaking, in terms of our own lives and in terms of policy in ordinary times, you don’t want to impose a regulation that is, you know, costs billions of dollars but only saves a handful of lives, right? I think most people can see that. But the same principle ought to apply in this situation as well, even though we’re operating on very limited data and so there’s a tremendous amount of uncertainty. Just because of the uncertainty, you can’t say all bets are off, we’re going to spend whatever it takes, we’re going to shut down the economy for however long is necessary. Because there’s tremendous uncertainty on both sides. You don’t know how big the death toll would otherwise be. You don’t know what the long-term economic effects are going to be. Short-term, obviously, millions of people through no fault of their own are out of work. When this is over, they may not have jobs to go back to, they may not have businesses to go back to. The government is trying to ameliorate that to some extent by handing out checks and making loans and all this sort of thing, and thereby, you know, making the debt even bigger than it was before. These are all these things have both short-term and intermediate-term and long-term costs, and we can’t pretend those costs don’t exist. So, I think it’s very clear that it’s wrong for policymakers to be saying the cost doesn’t matter. The cost does matter. Now, they can say, “I think it’s worth it, and here’s why I think it’s worth it,” but whatever projection they have is going to be highly uncertain.
Regulatory Relaxation [49:48]
Bob Zadek: And what’s interesting also, Jacob, is I have seen some interesting literature dealing with the following or presenting the following: assuming we posed a question to all Americans, here is the alternative you have. Right now, I will make up a number. Let’s assume that the average American—if there is such a thing, but I’m going to have to use it because I have no other concept to use—if the average American, if their chance of dying from the virus is 1%. So, you have now one chance in a hundred of dying from a virus, more than you had before the virus. If that’s what you’re told, and the choice is: are you willing to assume that 1% risk and keep your job, keep your life basically the same with some modifications? How would you vote? What if it was one-tenth of 1% chance of dying? But that’s kind of the decision that we’re being asked to make as a country. So, it’s not about the people who might die; it’s about the country. The decision is not whether to put one person to death; it’s what to do for the country. And that crucial decision that affects 330 million Americans is being made blind, with no public debate, no discussion. And politicians, who basically their job is really easy—it’s a piece of cake to be in the political life in America, an elected official—once in a while, once in a while, you have to make the hard decision. And I would implore them, just make it rationally. For the first time, do not calculate votes. Make a rational decision and show us your work papers. Show us the process by which you made the decision. And that’s the record you run on. And wouldn’t you say, Jacob, that approach—show us the work papers and run on that decision—is the Americans are denied the work papers as to how these decisions are made?
Jacob Sullum: Yes, I mean, I think people are reacting—I don’t want to say in a panic, but they are faced with what a severe problem, especially in a place like New York or Louisiana. You’ve got a severe problem right now, and the main thing that I mentioned that you’re worried about right now is: will hospitals be overwhelmed by these cases? And we want to avoid that. So, it’s understandable that they want to act quickly. But having imposed these restrictions, there is time then to talk about: how do we get out of them? How do we relax these restrictions? What’s a rational way to do that? How much benefit are we seeing from these policies? Can we get the same benefit or approximately the same benefit with fewer restrictions if we institute certain precautions for the workplace? That’s the conversation we need to start having. I mean, they’ve already done this. They’ve done this where I am, they’ve done it in New York and California, a bunch of other states, a bunch of other local governments have imposed these rules—these basically “have to stay at home” except for essential reasons, right? They’ve done that already. So, they can’t go back to that decision, but you can ask for how long does it make sense to have these restrictions? Are they doing what they’re supposed to be doing? Are there other ways of achieving similar results with a less severe economic impact? So, I’m hoping we will start to see a conversation like that. And I’m hoping we will have more information on which to base those decisions.
I should mention, I guess, you mentioned the risk to the average person is quite low. People in the high-risk groups, as the name suggests, have high risk—people who are elderly, people with pre-existing serious medical conditions. So, for the average person, it’s right, it’s not—if they didn’t care about all these other people at all, it would be clear what their decision would be: that they would just take their risk and at least go about their lives. Because for young people and healthy people and healthy middle-aged people, the risk is quite low. So, you know, that’s one way of looking at the issue—what kind of risk would you yourself be willing to expose yourself to? But then that also relates to this broader issue of the conflict between suppressing the epidemic, which is what they’re trying to do in places like New York, and achieving herd immunity, which is something they also want to happen. But if you have restrictions that are aimed at preventing transmission and they actually do prevent transmission, then you never get herd immunity. So, how—I mean, it’s not clear how you go back to normal in that situation. So, they have to also balance the goal of preventing hospitals from being overwhelmed by reducing transmission with the goal of having enough immunity in the general population so that this is no longer a significant problem. And these two goals are in conflict with each other, and you have to try to balance them in some way, especially as you talk about getting people back to work, allowing businesses to operate again. How can you do that not necessarily in a way that’s going to prevent transmission, because you’re relying on transmission to achieve herd immunity, right? So, all these things need to be balanced against each other. It’s not simply a matter of saying we have to stop the epidemic and prevent these deaths.
Bob Zadek: Jacob, you said in that last statement you made, you made two, in my opinion, crucially important points. Very important. And I’m going to repeat them because they have to—these points, when the audience turns off their receiver at the end of this show, these two points must remain with them. Point number one: anybody listening to this show, anybody absorbing the media, has a very, very low likelihood of contracting number one and, more importantly, dying from the disease. So, individually, in the selfishness of our own body, we have a very low risk. This is not a very high statistical threat to anybody. It is collectively there’s a number that seems large when you talk about the whole country, but on an individual level, the risk is very low. Number two, Jacob, you used the word “balance.” That is what I am pleading for. I am pleading for balance. Now, balance means reason. Balance means determining the effects and making a judgment, weighing two unpleasant chores or two unpleasant alternatives and picking the least unpleasant. And most importantly, you said—and I really get a lot of hope from this, Jacob—you said, “Okay, now we’re in the extreme: quarantine, shut down the economy. Now we start to leave that gradually, one step at a time, but inexorably, we leave the extreme that we have now and we slowly, in baby steps but clearly one after the other, we reduce the extreme quarantine we have now and we start to move slowly back to, dare I say, normal.” And there, as you pointed out, there are steps being taken. We’re kind of running out of time, unfortunately, but there’s been a lot of examples of where extreme regulations that existed before the virus are now being determined to be, well, they’re not so important. And we are seeing one by one by one regulations that were perhaps irrational to begin with are falling by the wayside because, well, they’re not important considering the alternative. So, Jacob, in the few minutes we have left, if you could list for us examples of where we are coming to our senses and realizing that, on balance—your word—the regulations we are getting rid of do more damage than benefit. And help our friends out there see some of the examples of those chipping away at these regulations that never made sense to begin with.
Jacob Sullum: Well, probably the most important example is the FDA easing its restrictions on testing. The CDC also at first had very narrow guidelines and they were insisting on a particular kind of test; they shipped a test that didn’t work and so on. So, obviously, there’s a huge role for the private sector in developing these tests and getting these tests out there. So, they belatedly have reduced those regulations so that companies can do this more quickly and try to increase our testing capability. So, that was crucially important. You’re seeing a bunch of states relax rules about who can practice medicine and respecting healthcare workers’ licensing from other states automatically instead of having to go through some kind of accreditation process. On a somewhat more trivial level, the TSA waived its rule about fluids on flights for hand sanitizer, right? That was one example where you kind of wonder whether that rule ever really made sense if they can relax it in this case without worrying about any security threat. Also, telemedicine, right? And at a less serious level, although this is serious too for people stuck at home, relaxing rules about what can be delivered. So, instead of people going to bars, in many places they can now get cocktails delivered to them from restaurants. That was—there was just a ban on that for no particular reason, some vague, you know, prohibitionist sentiment that motivated that. So, that’s encouraging. Yes, so I think when you’re in a crisis, you start to think which of these rules actually are necessary and make sense and which can be dispensed with in the interest of addressing the emergency. And the hope is that that experience will encourage people to—
Bob Zadek: Jacob, Jacob, we’re going to have to run out of time. How could our audience follow you, follow your writings?
Jacob Sullum: Go to reason.com and we’ve got a lot of coronavirus coverage by me and by my colleagues, and we have a separate section on the main page there that’ll take you right to those stories.
Bob Zadek: Thank you very much, Jacob. Thanks for sharing an hour of your time this Sunday morning. Bob Zadek saying so long for now.