Should We Aim to Defeat the Flu?

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The campaign against coronavirus has had the side effect of reducing the spread of contagious disease more generally. The standard longterm plan for containing coronavirus involves a massive increase in testing so that we can identify and isolate those who have the virus. When disease rates become low enough, massive testing regimes, taking advantage of techniques such as test pooling, can be used to identify cases and prevent spread. If we are undertaking such testing for COVID-19, should we simultaneously be testing for flu? And if we do so, should we maintain such testing even after COVID-19 is defeated?

Globally, flu kills between 290,000 and 650,000 people per year. Placed in perspective, this is less than one-hundredth of one percent of the population. There is a strong argument that the costs of maintaining a test, trace, and isolate policy would not be worth that level of risk. The costs include the maintenance of testing equipment, the operation of such equipment, the hassle of periodic testing (more frequent when outbreaks are observed), any loss in privacy associated with the need to maintain records, and the loss of freedom inherent in quarantine policies (especially "smart quarantine" policies). Some of these will be offset by reduced treatment costs (roughly $10 billion per year in the U.S.) and reduced death and suffering as a result of containing the outbreak.

Yet perhaps the strongest argument for aiming to defeat the flu is that the annual exercise might leave us much better prepared to address a future pandemic, including one that could be worse than COVID-19, such as one that is the result of bioengineering, including bioterrorism. The COVID-19 pandemic has illustrated the proverb "for want of a nail." For want of hand sanitizer, masks, ventilators and the like, we have suffered massive consequences in both economics and health as we have sought to "flatten the curve." Even without any of those items, if massive testing capability had been deployable early in the year, we could have identified and contained small outbreaks.

In principle, we can increase our ability to fight the next pandemic without going after the flu each year. Increasing funding for the National Stockpile is a simple solution and need not be terribly expensive. If N95 respirators sell for 50 cents each, then a mere $1 billion a year would be enough to stock up on billions of masks over a few years, for example. But this solution requires constant vigilance. We can't change course in tough economic times when few are thinking about pandemics anymore. Moreover, merely having the relevant supplies is not enough. We need to make sure that we know how to deploy them at scale. For testing, this means not just having a much larger number of RT-PCR machines and supplies than currently exist, but also labs and personnel capable of using them.

A policy of attacking the flu could serve as a fire drill to prevent a more serious pandemic later on. If we can contain outbreaks of flu, then we will be in better position to contain some future virus early on. Of course, there is no guarantee. Flu is less contagious than COVID-19. If we rely on national testing capacity that can handle only a few local outbreaks simultaneously, then that provides no guarantee that we will be able to handle a greater challenge. The goal must be to be able to contain outbreaks locally, without the need to break in the CDC or even a state agency. In a regime in which flu outbreaks are used as drills for other more serious outbreaks, failure to achieve local containment ideally would be seen as a failure leading to a policy response. Local officials could learn from their own failures and from the failures of others.

Flu would not just serve as a drill to ensure that we have sufficient equipment and well-trained personnel. It would also serve as a drill for the legal system. In the COVID-19 pandemic, there have been many questions about the permissible and appropriate use of legal power, and more such questions await a "test, trace, and isolate" regime. When should we start a policy of social distancing? What should social distancing entail? Should workplaces have mandatory testing? What sick leave should those who test positive receive? Should we reduce privacy protections when an outbreak is suspected and if so, in what ways? How should we test new vaccines, and should we mandate or subsidize them? An annual flu outbreak would give an opportunity to address these questions, leaving both our medical and our legal apparatus better situated to handle more serious challenges.

I am not at all sure that an annual battle against the flu would be justified. The battle may not be winnable, given the high number of flu cases. Another concern is that if we start preventing the flu annually but then stop, our natural defenses might be considerably weaker. There is also a danger that we might focus our energies too much on potential dangers that look a lot like the flu, ignoring other dangers. But in looking at our past response to the pandemic danger, the problem has not been that we only considered the most obvious scenario; the problem has been that we ignored the most obvious scenario. The cost-benefit analysis must take into account costs and benefits beyond those focused specifically on the fight against flu. The real value of an annual battle to defeat the flu would be in better preparing ourselves for the next COVID-19 or worse.

Still, there is a danger of sacrificing too much to defeat the flu and to gain practice in defeating the next pandemic. While we're at it, should we attack the common cold? How about bacterial infections such as strep throat? There is some danger that in attacking small medical risks, we might adopt the principle that no amount is too much to spend to save a life. We do face trade-offs, and the conventional wisdom right now is that COVID-19 is worth containing, but the flu is not. My point here is merely that learning to contain lesser threats may help us learn to contain greater threats.

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  1. “the conventional wisdom right now is that COVID-19 is worth containing, but the flu is not”

    I sense strong likelihood there is no conventional wisdom regarding this point because few people have considered it and few people have enough information and training to generate any relevant wisdom. That could be where education and leadership come in.

    This is a good contribution to important public debate, Prof. Abramowicz.

    1. If we only let police officers execute criminals on the spot, we’d have so much less crime and hence a much better society…

      Same thing — just sacrifice a little bit of our freedom and liberty for a good cause and we will all benefit, and a little bit more, and a little bit more…

      1. People seem to be forgetting this is about not overwhelming hospitals, not stopping an unfortunate disease from moving through the population.

        “You don’t get to move. You must be tracked with a phone.” These are not things we want the government doing, and certainly not for weak reasons less than total catastrophe. The worst catastrophes are governments that have these powers and use them easily.

        1. EXACTLY!

          And I hope people realize I was being sarcastic — I do NOT want a “Drudge Dredd” society!

  2. “The battle may not be winnable, given the high number of flu cases.”

    The high number of cases isn’t the problem. The problem is that the flu mutates rapidly, so you’re going after a moving target. If the flu only mutated as rapidly as smallpox, we could have rendered it extinct by now.

    But going after the flu in a serious way would still be a good training exercise to keep our pandemic resistance up. As a moving target, it offers continual challenge.

    The key point here, I think, is that we’ve allowed bureaucratic inertia and CYA to bring the progress of medical science in terms of application nearly to a halt. Covid-19 just exposed this.

    We shouldn’t let things return to normal on that front after Covid 19 is gone. We’ve had our wakeup call, we shouldn’t fall back asleep. We need to push the bureaucrats out of the way.

    1. we’ve allowed bureaucratic inertia and CYA to bring the progress of medical science in terms of application nearly to a halt.

      Very much untrue. It’s been focused elsewhere. Among other things, on cancer, heart disease, Alzheimer’s, and Parkinson’s.

      We spend more on medical research than any other area, and we get results.

      1. No, the CDC was focusing on things like gun control and racism in medical student recruitment. That is a fact.

        1. Dr.Ed : “No, the CDC was focusing on things like gun control and racism in medical student recruitment. That is a fact”

          In its FY 2019 budget, the CD is funding a $12.5 million study of gun violence – the first such study they’ve funded in over twenty years.

          Meanwhile, the same CDC budget funds the Division of Cancer Prevention and Control (DCPC) at $371 million – in addition to multiple other programs of research and prevent.

          I list these numbers because you can never be sure if Right-types are dumb enough to believe their own agitprop. You’d like to think they understand that half of everything they say is complete nonsense, but ya just can’t be sure.

          1. “…on things like…”

            Leftists clearly don’t know how to read….

            Nor understand what line items can be buried in a $371M budget…

            (Although I never knew that Cancer was an airborne virus from Wuhan…)

            1. (1) Sarcastr0 : We spend massive amounts of money on cancer research, etc.
              (2) Dr.Ed : No, the CDC is focusing on things like gun control, etc.
              (3) grb : That’s nonsense
              (4) Dr.Ed : More stream-of-conscious nonsense

              Incidentally, the same CDC budget passed in December has a $200 million dollar funding allocation to continue the research on a universal influenza vaccine. The legislation calls for a total investment of $1 billion, with $200,000,000 allocated for each of fiscal years 2020 through 2024. I can’t WAIT to see what drivel you come up with in response to THAT…..

              1. “Incidentally, the same CDC budget passed in December has a $200 million dollar funding allocation to continue the research on a universal influenza vaccine. The legislation calls for a total investment of $1 billion, with $200,000,000 allocated for each of fiscal years 2020 through 2024. I can’t WAIT to see what drivel you come up with in response to THAT…..”

                Epidemiology is quite different from researching new drugs, including new vaccines. Both are valuable, don’t get me wrong, but spending $200M researching how to build better fire trucks doesn’t help put out fires *now* — having guys (and gals) in the fire station ready to roll does.

                And if the firefighters go out and do other things (say, teach PE in the elementary schools, a noble thing), they’re not going to be in the fire station when needed.

                It’s called the CDC, not the CDP&E — the purpose is to *control* diseases, not prevent & eliminate them. To deal with epidemics, not to deal with other forms of morbidity and mortality, be they cancer or gun violence. They are supposed to be the SWAT team for viral epidemics — anything else is a distraction from that.

                And a lot of mischief can be done with a $200M budget if a bureaucracy is so inclined.

                1. ” the purpose is to *control* diseases, not prevent & eliminate them.”

                  I dunno. This taxpayer is A-OK with, say, smallpox being eliminated, rather than just dealing with smallpox epidemics as they happen.

                  Ditto for preventing the flu by developing better vaccines.

                2. “It’s called the CDC, not the CDP&E — the purpose is to *control* diseases, not prevent & eliminate them.”

                  Sounds like an argument that comes in the jumbo pack at Dumbass Wholesale Supply.

                3. Dr. Ed: “It’s called the CDC, not the CDP&E — the purpose is to *control* diseases, not prevent & eliminate them. ”

                  Jesus, man! The full name is the “Centers for Disease Control and Prevention.”

                  You can look it us if you want. Here — I’ll help: https://www.cdc.gov/.

              2. Obesity, smoking and tobbacco use, other substance abuse…

                Cancer and Diabetes. These are serious health issues, but they are not communicable diseases.

                These are all things taken from the CDC’s own website. https://www.cdc.gov/

                “In its FY 2019 budget, the CD is funding a $12.5 million study of gun violence – the first such study they’ve funded in over twenty years.”

                Which implies that they were funding gun violence research 20 years ago.

                The CDC has been spending a significant chunk of it’s research budget on a host of things that are not communicable diseases for decades.

                Perhaps if they had maintained their focus on communicable diseases, they would be better prepared to deal with pandemics.

          2. “In its FY 2019 budget, the CD is funding a $12.5 million study of gun violence – the first such study they’ve funded in over twenty years.”

            No, in 2013 Pres. Obama issued an exec order granting the CDC $10m for firearm violence research, and the results were published: https://www.nap.edu/read/18319/chapter/1 . There have been other CDC firearm studies, too, since 1996.

            The CDC was never barred from studying gun violence, and the Dickey amendment is merely this restriction: “None of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.” But don’t believe me, believe DE Dem. Senator Tom Carper back in 2017, in an article in The Hill from 17th June 2016 (I wish there weren’t a one-URL limit here). In that article Carper refers to a CDC gun violence study done in DE a few months prior.

            The necessity for the Dickey amendment was based on the CDC research having become politicized at the time. The most blatant evidence supporting that view is this a statement by Dr. Patrick O’Carroll in the Feb. 1989 issue of JAMA: “We’re going to systematically build a case that owning firearms causes deaths. We’re doing the most we can do, given the political realities.” At the time, O’Carroll was Acting Section Head of Division of Injury Control at the CDC. That statement asserts an intent to find evidence to back a preconceived conclusion, which isn’t science, it’s religion.

            Here’s a salient quote from an April 1997 reason.com (back when they were mostly Libertarian) article titled “Public Health Pot Shots”: “Contrary to this picture of dispassionate scientists under assault by the Neanderthal NRA and its know-nothing allies in Congress, serious scholars have been criticizing the CDC’s ‘public health’ approach to gun research for years. In a presentation at the American Society of Criminology’s 1994 meeting, for example, University of Illinois sociologist David Bordua and epidemiologist David Cowan called the public health literature on guns ‘advocacy based on political beliefs rather than scientific fact.’ Bordua and Cowan noted that The New England Journal of Medicine and the Journal of the American Medical Association, the main outlets for CDC-funded studies of firearms, are consistent supporters of strict gun control. They found that ‘reports with findings not supporting the position of the journal are rarely cited,’ ‘little is cited from the criminological or sociological field,’ and the articles that are cited ‘are almost always by medical or public health researchers.'”

            None of this detracts from your other points about CDC funding, but it is a common misconception that the CDC is restricted from conducting gun violence studies. For some (not saying this is you), it’s an often repeated lie which can be trivially stated, but isn’t so easy for most people to debunk. I just happen to keep relevant 2A references on hand.

        2. Was that why the pandemic office was stripped three years ago — to focus on gun control and racism at the expense of infectious disease research and preparedness? Sounds legit. Maybe alert Hannity so he can get the word out to ‘real heartland America.’

          1. Dude, partisan lies are ineffective when they’re trivially debunked: https://www.washingtonpost.com/opinions/2020/03/16/no-white-house-didnt-dissolve-its-pandemic-response-office/ . Future general election loser Joe Biden has told that same lie, so I guess you’re in “good company”, if we can call it that.

        3. That’s because almost all real progress happens in university and private labs, not government-run ones. The CDC and FDA should be abolished or at least see their funding and jurisdiction significantly reduced. (It’s not going to happen, but it should.) We already know our covid-19 response would have been stronger *without them*, it’s pretty hard to justify their continued existence in their current form.

          1. How much of an appetite does mainstream America have for the musings of anti-government cranks at this moment?

          2. Guess who gives out the grants for that university work?

            This is just some naiive libertarian windmill tilting.

            Enjoy your unregulated meat, weirdo.

        4. You know who does most of our medical research? It’s not the CDC!

    2. Well, the high mutation rate, and the incredible number of refuges that non-human hosts provide. Civilization giving up on pork and poultry might be enough to help, but even that’s not obvious.

  3. We have vaccines against the flu and if more people would take advantage of them there would be fewer deaths. Many people do not view the flu as a serious illness.

    Eventually there will be a vaccine against the novel coronavirus, unfortunately like all virus’ it will continue to mutate, possibly become less virulent and possibly less communicable as herd immunity develops. It will become just another regular illness until the next virulent novel virus emerges from some far corner of the world.

    1. next virulent novel virus emerges from some far corner of the world.

      No. With the exception of Ebola, evidence suggests that they emerge from China. Perhaps it is time for a heavy-handed “Pax Americana” approach of either imposing world standards of sanitation upon China, with the understanding that they will become a pariah like South Africa if they don’t.

      All South Africa did was treat its own citizens badly (and still is) while China killed Americans. (Including Black Americans, reportedly in a disproportionate rate.) Now which harmed/harms America worse — South African Apartied or China hatching virulent viri? And this assumes the CCP version of the Wuhan Virus emerging from Bat Soup.

      Apartied didn’t kill any Americans…..

      1. And when Swine Flu originated in the U.S. should we have become a pariah? I’m trying to understand your reasoning here….

        Also, all research continues to find the Coronavirus has natural origins and was not engineered. The current obsession from Right-Wing-World is pushing the “possibility” that the natural virus escaped from careless lab security in China. Since this is a possibility only it’s sad to see the sweaty desperation of the Right’s relentless promotion of a theory supported by no evidence.

        I guess a virus just isn’t cartoon villain enough for the lizard part of their brains. Or maybe they think no global catastrophe should go unused for a little xenophobic fun. Or maybe its just a distraction from Trump’s lying and oafish incompetence, now more obvious than ever before……

        1. And when Swine Flu originated in the U.S.

          It didn’t — initially believed to have started in Mexico, it was later traced to Asia — i.e. China.

          Also, all research continues to find the Coronavirus has natural origins and was not engineered.

          Humanity has been using “natural origins” to engineer desired plants and animals for centuries. The “stud fees” that a winning race horse earns serves as but one such example. Roses and tulips serve as other examples of how selective breeding has led to things which didn’t naturally exist, i.e. single-color tulips and most varieties of roses.

          “The current obsession from Right-Wing-World is pushing the “possibility” that the natural virus escaped from careless lab security in China.”

          It’s happened twice before — that we know of.

          Imagine that Exxon had *two* tankers fetch up on ledges and spill lots of oil (not just the Valdez — and then there was a major oil slick downwind of yet another of their tankers. And Exxon said that it was actually seeping out of the earth. Maybe, but would you believe them?

          1. I would if a lot of independent geologists and other knowledgeable scientists and engineers inspected the spill and said Exxon was telling the truth.

            1. And if Exxon wouldn’t let them in (like China wouldn’t)?

        2. Also, all research continues to find the Coronavirus has natural origins and was not engineered.

          The stuff I’ve read so far all seems to be along the lines of “it’s too clever to have been engineered — we can’t imagine how to design something like this!” and “if someone was going to engineer one, we can’t imagine why they would have done X rather than Y!” Oh, and then there’s “it can’t have been engineered, because it looks EXACTLY like what we would expect a wild virus to look like!”

          None of that is particularly reassuring, in that it largely relies on the knowledge, creativity, and technology available to a bad actor being no greater than that of the writer(s). If there’s anything on a more objective and evolved level, I’d truly like to read it.

          1. Nice. So you’ve decided it’s impossible to prove, therefore you cant help but speculate.

            I mean, you do realize why something like this makes a really crappy bio-weapon, no?

            1. So you’ve decided it’s impossible to prove, therefore you cant help but speculate.

              It seems hard for a good-faith reader of the words I actually wrote to reach that conclusion. My post: (1) listed the general explanations I’ve seen to date; (2) explained why I don’t (and, I should hope, most intellectually honest people would not) find them persuasive; and (3) asked for anything outside that envelope that I may have missed. Based on your reply, it sounds like you don’t know of anything else.

              I mean, you do realize why something like this makes a really crappy bio-weapon, no?

              Well, it’s hard to say, Sparky — why don’t you fill us in on what the acceptable uses and goals for a bio-weapon are, and then maybe I’ll have a better sense of what particularly clever point you think you’re making.

      2. You probably shouldn’t talk about race in public, Dr. Ed. — at least not voluntarily. Are you try to persuade top 100 law schools never to hire another movement conservative.

        It’s probably still safe for you to discuss race, gender, homosexuality, and the like in safe spaces, such as private homes, militia gatherings, and local Republican Committee meetings.

        1. Maybe you were lucky, and missed the post where Dr. Ed speculated the Coronavirus was bio-warfare research by the Chinese commies to developed a virus that only attacks White people.

          And from there it’s only a small step to a virus that attacks only right-thinking God-fearing Republican-voting Fox-watching White people, which I bet is Ed’s core concern…..

          1. That’s libelous — I *NEVER* speculated about “a virus that only attacks White people.” Instead, I wrote about research into viri that were “racially specific” — without saying WHAT race…

            I was very careful not to do that — so careful that you have no idea what I’m thinking.

            Fact #1: Black Americans are reportedly dying from the Wuhan Virus at up to *four times* the rate of White Americans. While higher levels of Diabetes and hypertension (both inherited) may be a factor, I don’t think it’s the only factor.

            Fact #2: The CCP wishes to expand into Sub-Saharan Africa, and has spent a LOT of money there. These are not stable countries, and sovereign countries have been known to nationalize foreign assets — as happened to American oil companies in Saudi Arabia and elsewhere.

            Can anyone figure out what Ed really is wondering about…..

            1. While higher levels of Diabetes and hypertension (both inherited) may be a factor, I don’t think it’s the only factor.

              Sure. More crowded living quarters. Fewer economic resources making it harder to isolate, other factors.

            2. “Can anyone figure out what Ed really is wondering about…..”

              There’s no point trying to figure out what some lunatic imbecile is thinking. Your pointless, daily rants on this website are ruining it for the rest of us. I’m considering leaving because it’s embarrassing to try and have serious discussions in the comments threads while you’re polluting them with your stream-of-thought journal. If you don’t leave, I will.

              1. “If you don’t leave, I will.”

                FWIW, I hope you don’t.

                I really wish it was practical to have a daily quota of 10 comments per person per day or something. Or an ignore user function.

        2. “You probably shouldn’t talk about race in public, Dr. Ed. — at least not voluntarily. Are you try to persuade top 100 law schools never to hire another movement conservative.

          This may not be the most popular thing to say here, but I don’t think those top 100 law schools will have anywhere near the importance or relevance twenty years ago that they do today. First, much of the law school education, as it existed circa 1985, is not even relevant anymore.

          Circa 1985, a good chunk of a law school education literally was librarian training, how to follow the obscure cross-references between statutes and decisions and Shepardizing the latter, along with using the legal encyclopedias and the rest. It was how to look stuff up — which the layman had no idea how to do.

          Then came LEXIS, which was not only expensive but written in FORTRAN in a pre-GUI era — you not only had to know how to do Boolean searches but know the textual commands (e.g. “w/3”) and this generally required being taught.

          Today, an amazing amount of information is openly available on the internet, much of it valid (if you know how to tell the difference). There is Google and its competitors (I prefer Duckduckgo.com) and an intrepid middle school student can now do more legal research in an hour than a circa-1985 lawyer could in a day. Possibly a week if travel to distant law libraries was involved…

          Second, people need to understand what the Jacksonian Democracy really was all about. When Andrew Jackson was finally elected in 1828, he (much like Trump) was an outsider, every other President had been from either Boston or Tidewater Virginia. Jackson was the leader of a populist movement which sought to (and largely did) oust the established aristocracy, that’s what the infamous Spoils System largely did.

          This is also when/where you started seeing the popular election of judges, or at least the end of lifetime tenure. For example, Maine (struck off from Massachusetts as part of the Missouri Compromise) rejected Massachusetts’ lifetime appointment and instead went with 7-year renewable appointments.

          It’s a reversal of the established social order. FDR did the same thing, as is Trump. Hence just because Harvard & Yale Law were influential in the 1970’s & 1980’s neither means that they are influential today, nor will be 20 years from now. No more than being the son (or grandson) of someone who’d signed the Deceleration of Independence still meant anything in the 1830’s.

          And third, about half the country openly despises higher education, and my guess is that it’s an even higher percentage for law schools. Law schools will not exist without money, and their students won’t have it unless the government loans it to them — a practice now opposed by both the political left and right, albeit for different reasons. And the country is broke.

          We don’t have the money to keep spending as we currently do, and even if it didn’t hold it in contempt, an aging population isn’t going to fund higher education at the expense of its own entitlements such as Social Security and Medicare.

          So this may not be as serious a threat as you realize….

          1. ” about half the country openly despises higher education ”

            The better half, in your estimation.

            Education has consequences. Enjoy continuing to get stomped in the culture war by the ttwo-thirds of America that is not the bigoted, poorly educated, superstitious, stale-thinking Trump base. While awaiting the glorious Great Awakening that is to cause Harvard, Berkeley, and Yale to bow to Liberty, Hillsdale, and Ouachita Baptist.

    2. “We have vaccines against the flu and if more people would take advantage of them there would be fewer deaths.”

      The total number of doses available in the US for the 2019-2020 flu season was only enough for about half the population.

      1. Which is about the fraction of the population that wanted to get immunized. At least locally, there was no shortage – it seemed like every drug and grocery store had a sign up advertising free[1] flu shots, as they do every year. Docs push them at your annual physical if you haven’t had one. Was there a shortage in your location, or are you advocating annually producing many more doses than people will use?

        [1]The ‘free’ is the same as ‘free’ windshield chip repair, i.e. it assumes your insurance will cover 100% of the cost, which many – including medicare – will.

        1. Yeah – pretty sure the Flu vaccine is demand limited, not supply limited.

  4. If you want to talk about violating civil rights for the common good, let’s just ban China.

    Seriously, have the US and EU establish a “shoot on sight” perimeter around the country and shoot anyone who crosses it — either way. Physically isolate everyone in China and there would be no more of these viri leaving there to plague the rest of the world.

    ALL of this stuff origination in China, and has for the past century. Stop mammals (including humans) from leaving China and none of the stuff that starts in China will leave China — problem solved.

    Yes solved at the expense of principles which we claim to support, but then, what is different about what you are proposing here?

    1. ALL of this stuff origination in China, and has for the past century.

      Nope. Simply false. Try Africa on for size ….

      1. Name one.

        No, these virulent airborne viri are all coming from China.
        Even Ebola is spread by contact with body fluids, AIDS is, as are West Nile and other Mosquito-vectored diseases.

        Even the Spanish Flu is said to have originated in China…

        1. The Spanish Flu originated in Kansas, but was reported in Spain because American war censorship prohibited it being reported in America.

          1. The Kansas theory is interesting, but China is more credible.

  5. “a future pandemic, including one that could be worse than COVID-19, such as one that is the result of bioengineering, including bioterrorism”

    Don’t worry. If and when that happens, the perpetrator will likely be ready at hand with the vaccine or “cure.”

    1. You know, the Mossad has a documented history of sabotaging such efforts, going back to bombing an Iraqi nuke reactor in 1981, if not further.

      If someone just happened to have such plans, say in Wuhan, “accidentally” releasing it would be an effective asymmetric way of stopping it, wouldn’t it?

      Just speculating here…

      1. Let’s see.

        Israel discovers that China is secretly developing a virus to use as a bioweapon. To stop this they plan to somehow release the virus, thereby killing 100,000 people – so far – and doing massive damage to the world economy.

        Yeah, that makes sense.

  6. Broken window fallacy

  7. If N95 respirators sell for 50 cents each, then a mere $1 billion a year would be enough to stock up on billions of masks over a few years

    Did you factor in the costs of storage, maintenance, and replacement upon expiration?
    What else could that billion a year be spent on? Medical research on diseases that kill more people?

    1. Some of the “expiration” cost could probably be dealt with by specifying masks with a long expiration date (presumably it’s the cheap elastic that goes first?). Then two years or so before expiration, sell them as government surplus, likely at less than original purchase price. Labs, medical providers, and industrial users that go through lots of masks would probably happily buy them at discounted prices in quantities they would use before the expiration date was hit.

      1. “Some of the “expiration” cost could probably be dealt with by specifying masks with a long expiration date (presumably it’s the cheap elastic that goes first?).”

        Elastic is what I have heard.

        I would hope that, going forward, hospitals would at least keep N years of normal use (where N=the expiration period) worth on hand, just always using the oldest ones. Perhaps the accreditation folks will make that a line item.

        Another possibility is for the feds to contract with a vendor(s) to procure between x and 10x million per year. The contract pays for the (hopefully) unneeded capacity.

  8. When GWB came to office we had a strong terrorism response team with well established procedures to detect, avoid, and respond to terrorist threats. And support from all levels of government. And proactively assessing new intelligence gathered both domestically and internationally. Trump/Cheney tossed the plan and degraded the organization. That was a Clinton thing and we don’t do Clinton things anymore. Then 9/11.

    Same with GWB and FEMA. A competent FEMA was a Clinton thing and we don’t do Clinton things anymore. They couldn’t get rid of it but they put an incompetent crony in charge. Then Katrina.

    When Trump came to office we had a strong pandemic response team with a written out plan of what the government should do in outbreaks. And support from all levels of government. And proactively assessing new intelligence gathered both domestically and internationally. Trump tossed the plan and dismissed all the team members. That was an Obama thing and we don’t do Obama things. Then COVID-19.

    Does anyone see a pattern here? You can address terrorism, pandemics, and natural disasters but what you need to do first is get rid of movement conservatism. Until you do that nothing is going to work because movement conservatism is fully based on the idea that “government is always the problem not the solution” unless of course it diverts money to people they like.

    P.S. you don’t really need to get rid of movement conservatism but you do need to shrink it down to size so that you can drown it in the bathtub if you need to.

    1. The fact that you seem to think that Trump is a small government “movement conservative” is highly amusing.

      1. As the NRO pointed out in 2016 Trump has no identifiable ideology to which he is permanently tethered other than the greater aggrandizment of himself.

        However movement conservatives might complain about Trump in one way or another they totally back him 100%. Trump is not the problem it his deluded followers and corrupt supporters. Without them Trump would be nothing.

    2. “Trump/Cheney doesn’t do Clinton things” shows where your brain is at.

      1. You neglect to mention that Obama drained the mask stockpile and did not replenish it.

        Maybe you can blame your lapses on TDS.

        1. The last thing Obama said to Trump was “Oh,yeah, don’t forget to replenish the mask stockpile, I got too busy the last five years.”

        2. So that’s it? Whatever Obama did, under, it’s worth noting, ridiculous budget pressure from Tea party morons, excuses Trump’s failures?

          Why didn’t Trump replenish it? He had three years. I guess he was too busy trying to cut the CDC budget. But you don’t want to talk about that. All Obama’s fault.

          Do you even realize how idiotic that makes you sound?

          1. “Do you even realize how idiotic that makes you sound?”

            Of course they don’t.

            I mean, the reason they sound like idiots is because of Hillary.

            Duh!

          2. “under, it’s worth noting, ridiculous budget pressure from Tea party morons,”

            The 111th Congress, sitting from 2009 to 2011 – the time when the masks were expended – consisted of 57 D and 41 R senators while the House was 256 D, 178 R.

            There’s plenty of blame to go around for both parties.

            1. Republicans gained control of the House in 2010, and also reduced the Democrats’ Senate majority by quite a bit. So Obama had about a two-year window to do something.

              As I recall, that was a fairly busy period.

              1. If I use a fire extinguisher, I replace it right away.

                If it had been Covid-11 instead of Covid-19, still mostly the Republican’s fault?

      2. Funny how a typo can still be accurate, right?

    3. Pardon me….but what is a ‘movement conservative’? Please name a few.

      1. That is actually a good question.

        There are other definitions, but the best one is that a movement conservative will often cite conservative values as their ideology but in fact vote against those principles as long as their party wins. They crave being part of a powerful movement and don’t really sweat the details.

        Names? You can find your own but here is a starting list: every current Republican senator except one. In the senate trial they put party over country in the face of overwhelming evidence that Trump should have been removed from office on the merits of the case brought against him. A few of them actually admitted as much. I won’t bore you with the list because I am reasonably sure that you will be in denial about all of it, and if pressed will retreat into “but Obama” or “but Hillary” types of arguments.

        It used to be conservative values held that nobody was above the law, not even the president. Movement conservative vote: nah.

        It used to be conservative values held that the president act to serve the public interest, not his personal interest. Movement conservative vote: so what.

        It used to be conservative values felt that lying, obstructing justice, defying lawful subpoenas and ordering others to do the same was a totally impeachable offense. Movement conservative vote: not really important.

        Conservative values used to value honor and dignity in the White House. Any evidence of that among movement conservatives is nonexistent.

        Get the idea? There’s much much more but this isn’t my job.

      2. What is a movement conservative — a RINO….

  9. Can we defeat the flu? Sure. We have had the technology to do so now for at least 30-40 years. The operative question is do we have the drive, dedication, and resources to conquer the flu? That is more questionable. If we used universal vaccination, adjusting mid year when we know what strains are “live” for the season, have front line workers take prophylaxis anti-virals, and seek to root out the environmental reservoirs, then yes. To accomplish it though you would have to force vaccination so insert images of some kid being chained up and shot up against their will. Probably would need to eradicate a few species of birds and burn down some rainforest. And also have some deaths from vaccine and drug side effects. But, yes, you can accomplish it.

    1. Eradicating a few species of birds and burning down the rainforest is what would prevent this. Look at bedbugs — we *have* DDT, and it was its widespread usage outdoors on croplands that endangered the Bald Eagle.

      I wonder how much of this would be eliminated were we to merely root out the environmental reservoirs. If we went back to “slow boat” travel from China, with quarantine upon arrival, wouldn’t we eliminate almost all of this?

      Conversely, if we could just get China to clean up its act, wouldn’t the same happen?

      1. Well, what is more important, Bald Eagle eggs, or millions of Africans dying from malaria?

    2. ROI for defeating the flu is just not there.
      Most who get hospitalized, spend time in an ICU, or die are infirm and expensive to care for in the first place. So might not be a lot of health savings to be had. Everyone is going to have a last month of life that is going to be expensive. This just eliminates the expense that would occur leading up to the last month for a few.

      ROI for reducing the impact of the flu is certainly there. Best bang for the buck is getting kids vaccinated, so that health adults are not taking time off from work to care for sick kids. But that’s trickier for employers to finagle. But definitely most employers should hold immunization fairs at the workplace, with some nominal incentive, like a gift card, (or 4 rolls of toilet paper).

      But if half of the public felt strongly about the flu, then more than 40% would get the annual shot.

  10. flu kills between 290,000 and 650,000 people per year.

    It would be worth knowing how the rates for vaccinated and unvaccinated individuals compare. I can’t find that, though I have found suggestions that 80% of children who die are unvaccinated.

    The point is that we need to know if universal vaccination (except for obvious medical exceptions) would make a big dent in the mortality numbers, including by reducing deaths in the unvaccinated, when deciding what resources to devote to increased efforts.

    1. If only we had a nationwide data base to refer to, like say, polio?

      1. I don’t think we do on that matter. If I’ve missed it I’d appreciate a link.

        What I’ve read is that flu deaths are estimated based on overall mortality figures, so they probably don’t tell us how many were unvaccinated.

    2. “I can’t find that, though I have found suggestions that 80% of children who die are unvaccinated.”

      Given that that it’s an annual vaccination and there are only enough doses produced to cover around half the US population, that would not be surprising.

  11. rhinoviruses (flu) mutate to frequently for the battle to be winnable. In fact, there are flu vaccines, but the virus mutates too quickly and often people are vaccinated against last years strain, which provides limited protection .

    1. Influenza is not a rhinovirus, though both do mutate frequently. Rhinoviruses are among those that cause the common cold (so do some coronaviruses).

    2. So the key is twofold:

      1.) Routinely sequence any viral infection bad enough to cause somebody to seek medical attention, so that the medical profession knows what is out there, and where, and when a new strain appears it is identified immediately.

      Perfectly feasible, DNA and RNA sequencing has become dirt cheap. Seriously, imagine how bad the weather forecasts would be if the weather service only bothered checking the temperature when a tornado strikes. That’s how we treat infectious diseases: The medical profession basically has no interest at all in what you’re infected with until you’re on the verge of death.

      2) Shorten the time to produce and distribute new vaccines from months to days or weeks.

      Also feasible, with advances like RNA vaccines.

      Do both of these, and new pathogens would be caught early, and stomped early.

  12. “Name one.

    No, these virulent airborne viri are all coming from China.
    Even Ebola is spread by contact with body fluids, AIDS is, as are West Nile and other Mosquito-vectored diseases.

    Even the Spanish Flu is said to have originated in China…”

    No one knows where the Spanish Flu originated; however, prevailing hypotheses pinpoint it at either Kansas or Europe. Neither of which is “China.”

    It is not true that all influenza viruses originate from China. They can origins in the Netherlands (H7N7), Canada (H7N3), and many other places.

    Some very virulent, and recent, airborne respiratory illnesses have not originated from China. It should go without saying, but MERS-CoV (Middle East Respiratory Syndrome) was first identified in, um, the MIDDLE EAST (specifically, Saudi Arabia).

    Now, all of that said, it is true that China, with almost 1.5 billion people, and with a great amount of wildlife (including traditional methods of preparing chickens), a great population density, and, unfortunately, the use of “wet markets” that can include exotic animals … has particular issues.

    But you comment really says so much more about you than it does anything else.

    1. This guy works in education.

  13. Instead of a “drill”, changes in social sanitation habits would probably be more effective in the long term. Professor Volokh had suggested getting rid of the handshake. That sounds like a good idea. Also when someone sneezes, instead of saying “God bless you” say “God damn you”

  14. Defeat is not the term I’d use. Reduce, for certain. I hope that we can reduce the influenza death rate by practicing a somewhat looser (that is, don’t shut down the economy) form of the 30-days to slow the spread guidelines. Simple stuff like:

    Wash your hands frequently
    Do not, do not, do not shake hands
    Cough/sneeze into tissue, toss tissue, immediately wash hands
    If you are sick, self-isolate

    My question. Is American culture ready for ‘nemaste’?
    What alternative do you recommend to shaking hands to show respect?

    1. The elbow bump is quick and effective.

      1. And, a 2:00 minor penalty in hockey.

      2. Yeah, I’ve done the elbow bump in shul.

  15. The main problem is also anti-science liberals. That is the tools that we have to use to stop these sort of pandemics will run afoul of identity politics. Heck, with a full blown pandemic in China we were barely able to ban travel from their hot zones because of….racism. And we can’t name a virus by the geographical region from which it originated because of….racism.

    Putting in standard quarantines from third world countries with horrible sanitation where weird illnesses just seem to appear is definitely going to raise the identity politics alarm (that is unless it was say Northern Europe and it just affected white men then the identity politics liberals would be all for it).

    The matter is really resolve. Do we have enough to see out the full solution? Maybe now seeing how this pandemic almost wreck the entire economy (and still might do that). We are going to have to do a “gut check” though and realize that the solution is going to require some “not so nice” societal side effects.

    1. “The main problem is also anti-science liberals.”

      Nailed it!

      The main problem we have today are those darn liberals in charge of the Executive branch, and how anti-science they are. If only those darn liberals weren’t in charge of everything, then we could really make America Great Again!

      Maybe, in 2020, we can vote in a Conservative, pro-science President.

      Your modern “it’s someone else’s fault” Conservative: Making 11 year old tweens look like the paragon of rational decision making and responsibility.

      1. I take your decision to not address my main comment as a concession that I am 100% correct in that assertion.

        1. I am sure you do!

          I am sure you see everything as evidence that you are 100% correct.

          After all, what should you believe: the real world or your lying brain?

    2. What we need is a “flu new deal”. Free testing for everyone, at every public entrance. Those who have touched any unclean thing shall be unclean for seven days.

      1. In other words, we need a clean new deal, instead of a green new deal.

    3. Ending the flu by screwing with nonwhite people.

      I mean, this is impressive.

  16. It’s a fair suggestion. We might have some success. The exercise may be useful as the author suggests.

    But there are many hazards in this world, not just disease. Many of them would benefit from similar scruitiny. Many times the research in those hazards might have benefits. But the researches take time, money, and effort. If we do too many of these research projects, we won’t have money left to provide ourselves with food or shelter.

    The engineering approach is to rank risks according to cost-benefit ratio. The biggest benfit with the least cost gets funded first. But that usually means that the first 100 items in ranked order are things like slipping in the bathtub, or smoking, or recreation. Things that are risky, but risks that the public willingly accepts. So nobody ever lets engineers pick the priorities for how to spend tax money. That’s why Kirk is captain of The Enterprise, not Spock.

  17. I think we are very lucky that this pandemic did not happen sooner. As Tom Friedman pointed out the world is getter flatter. There is massive movements of goods and people around the world. Couple that with the powerful force of evolution. The fact is that microbes will be developing that spread quicker and are more deadly. We can image enemies from other countries but don’t recognize that microbes and virus might be our greatest enemies. So, as the author suggests, taking on the flu will be good preparation for the next pandemic. The next microorganism attacking might be much worse than the CV19.

    1. ” As Tom Friedman pointed out the world is getter flatter.”
      For the time being! Modelers don’t like to run their model time horizons out to 18 months. And they don’t tell us what measures are assumed to prevent rebounds.

  18. The writer’s piece begins with the now familiar political screed:
    “The standard long–term plan for containing coronavirus involves a massive increase in testing so that we can identify and isolate those who have the virus. ”

    This trope is repeated endlessly as if testing prevents the spread of the disease. Testing 330,00,000 Americans not just once but multiple times is not going to happen regardless of who is POTUS. Moreover, there needs to be a serious national discussion of whether and why such tests will a ~30% false negative rate justify abridging the constitutional rights of American citizens. Realistically no politician really wants to discuss how rebounds are prevented or how subsequent sequestration orders over the next 12 to 18 months will likely convert today’s large unemployment figures into systemic unemployment. As we begin to hear cries for anti-body tests, we do not hear of scientific evidence of whether and for how long immunity is conferred from a previous infection.

    Instead the airways and internet are fill with scapegoating and comments such as “this outbreak could have been avoided.” (on the BBC last night.

  19. Hey!
    I do not like you conservative brat
    I do not like your crazy tin hat
    I do not like you at the shore
    I do not want you at my door
    I do not like your average life
    I hope you do not take a wife
    I hope you don’t decide to breed
    Cause that’s one thing we do not need

    I do not like you radical
    I hate you and your goober school
    You’re wrong about the working class
    I hope they kick your geezer ass
    I do not like you on this world of ours
    I’d rather send you to the planet Mars
    Where you’d die from lack of oxygen
    Than breathe the air of other men
    Hey!

  20. Any “government” program that collects physical samples from citizens will lead to this:
    – police find DNA at a crime scene, check their registry and discover that it belongs to Jim. “This is Jim’s DNA, go and arrest him”
    – “Knock Knock, Hi Jims’ dad, where is Jim?”
    – “Jim was a criminal. We can tell from your DNA that you are Jim’s son …”
    I do not want to be in a government DNA registry. Infinite abuse opportunities exist. There is no obvious way to prevent abuse.

  21. The cure will be worse than the disease. This world is different now. The “lockdown” was caused by the social/media mob driving the science and government. It may never be analysed honestly.

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