1. One of the challenges with exiting the lockdown is about managing the normalcy restoration path for different types of economic activities. This is a very good graphic in the US context about the likelihood of infection risk across different occupation categories.
Having something like this for India would be useful.
2. Interesting snippet about the influence of Arabs in Israeli medical field,
Arabs make up only a fifth of Israel’s population, but represent half the country’s pharmacists, a quarter of its nurses and just under a fifth of its doctors, according to the Central Bureau of Statistics. Some of the nation’s largest hospitals have Arab doctors heading major departments, and the country’s leading virologist is Arab.
Arabs are disproportionately represented in the medical community because attaining professional qualifications has been one way to push back against political marginalisation, Arab doctors said. Many trained in Jordan after the two countries signed a peace deal in 1994 and Israel’s Arab community continues to hold medical workers in high regard.
4. For those recommending mass testing, here is a reality check on antibody testing,
The first problem with antibody tests is there aren't any that work at scale, but even if they did there are potential issues. There are no guarantees that if you have antibodies against the coronavirus that you are completely immune. And even if your antibodies do protect you from becoming sick, then you may be able to harbour the virus in your body and pass it to others. There will be many challenges before immunity passports - when if you pass the antibody test you can go back to life as normal - will be practical. This is the problem with a virus that has only been around for a couple of months - there is still too much we do not understand. However, the main appeal of antibody testing is to find out how many people have really been infected with the virus.
5. Fascinating graphics on the traffic from various transportation modes in New York in the backdrop of the Covid 19 outbreak.
6. The story of how ventilators, a device invented in the 1920s, have proved so difficult to mobilise in the aftermath of the pandemic is instructive (HT: Mostly Economics),
In fact, in 2006, following the 2003 SARS outbreak, the Biomedical Advanced Research and Development Authority (BARDA), a newly created division within the US Department of Health and Human Services... produced a design for a ventilator that would be affordable, mobile, and simple enough to be stockpiled and quickly deployed... Soon thereafter, a private company was awarded a multi-million-dollar government contract to develop a more affordable and usable ventilator, and by 2011, it had presented a prototype to US government officials. In 2012, however, the company was acquired by a large medical-device manufacturer that produced “traditional” ventilators, as part of a wider process of industry concentration that has raised questions related to competition and antitrust law. The prototype project was eventually terminated, raising suspicions among government officials and other device manufacturers that the takeover bid had been motivated by precisely that goal.
Owing to our reliance on market forces to allocate resources for innovation, we now only produce ventilators that are expensive, immobile, proprietary, highly technical, and difficult to use, when what we really need are affordable, mobile, simple, user-friendly machines. In attempting to develop such a device, the US government relied on market mechanisms and profit-driven private firms whose incentives turned out to run counter to the interests of public health... We also need new international mechanisms to promote innovations that make technology more affordable, easier to produce and maintain, and simpler to use, rather than merely more profitable and more complex. A technology that was invented a century ago should not still be beyond the reach of most countries in the world.
7. Ajay Shah outlines a testing strategy - clinical detection with PCR tests, pooled PCR testing at workplaces, panel measurements of random samples to test incidence and progression with both PCR and antibody testing, individual-driven demand-based PCR or antibody testing.
The caution against one-size-fits-all exit strategies is very important. Government of India should outline the principles and then let go of the exit implementation and leave it to states to pick and choose and support them.
Some things you can say flatly for the whole country. I think we are pretty certain that there should be no [opening of] places of worship, no weddings; there are some things we understand all over India. But the complexity of reopening the economy is about local questions, local conversations, local trade-offs, and local discussions. Now, on top of that, in my opinion what we are going to see all over India is a chequerboard pattern of different disease episodes and events happening in different parts of the country. Once again there is a need for local data, local thinking, and local response. Maybe my district will see an incipient flare-up. I will need good data about my district. So all the four strategies of testing need to be there. Then a municipal commissioner, district collector, local political leadership of the district of all parties need to come together and look at the data and think: do we need to go into a more extreme lockdown now because we are at the beginning of a disease surge?
... So think of a chequerboard map all over India, where there will be different stories of this disease and we need the local government to lead the way on the kind of social distancing procedures. Imagine there is a kind of red, blue, green manual in Kolhapur district, in Parbhani district saying that based on local conditions, local trade-offs on our livelihood, our activities, we will have a red manual, blue manual and a green manual. Then the local leadership will look at the data on an ongoing basis and keep making decisions all through the year. I think that is the way we should think about reopening the economy... During the Second World War, there were German bombers going over London. And there is this irresistible imagery of people wearing a business suit, carrying a briefcase, walking on the street, going to work while the bombers are going overhead and the bombs are going off. And I think that is the worldview we have got to bring for two or three years.
Largely agree. But on the local response, it is unrealistic to expect cities and local regions to have the capacity to do this in any reasonable degree of satisfaction at the local level. So the local response would largely have to come by way of being reactive to spikes in cases (as observed in local hospitals) and responding with varying degrees of tightening of restrictions on movement of people and conduct of economic activities. The mandatory practice of wearing masks will have to become a constant of life for the foreseeable future.
This is a good summary of the confusion that has surrounded the Covid 19 response - in terms of problems with co-ordination between the centre and states. Unless sorted out, this will worsen things as the country exits the lockdown, when such co-ordination is critical.
8. Good graphic that captures the destination of out of pocket health care spending in India.
9. Pratap Phanu Mehta writes about the Tacitus Trap facing many governments, especially China and also the US,
But when the dynamics of the Thucydides Trap were being analysed, few had imagined that this competition would break out when both the Chinese and the American political systems would be facing deep internal challenges. This opens up the possibility of overlaying what is known as the Tacitus Trap over the Thucydides Trap. The Chinese coined the term, “Tacitus Trap,” in homage to the great Roman historian, Tacitus. This trap describes a condition where a government has lost credibility to the point where it is deemed to be lying, even if it speaks the truth. President Xi Jinping himself used this term as a call to arms to the Chinese government to maintain its credibility... But even the Chinese coiners of the term could not have imagined that the Tacitus Trap might not just be a challenge facing China. It could become the defining political condition of our time. Authoritarian governments would face a credibility crisis because of their propensity to control information. Many democratic governments face a different credibility crisis: Hyper-partisanship would simply make truth or lies a function of which side was saying it, making sober collective action difficult. The existence of a possible Tacitus Trap exacerbates the risks of the Thucydides Trap.10. A SIR model predictions for several countries points to the Covid 19 pandemic in India having peaked now and easing off by mid-May.
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