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Sunday, March 29, 2020

Some Encouraging News from 1918

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In a 2007 National Academy of Sciences study of the Spanish Flu, researchers used  data on the timing  of 19 classes of NPIs in 17 U.S. cities during the 1918 pandemic to test whether early implementation of multiple NPI interventions was associated with reduced disease transmission. Indeed, the researchers found that “cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates 50% lower than those that did not and had less-steep epidemic curves.” In other words, the timely introduction of NPI measures reduced peak mortality in the surveyed cities.

The finding of reduced peak mortality seems to confirm that the timely introduction of multiple interventions does indeed buy time to prepare for the peak of the pandemic and in this sense plays a positive role. The finding does not rule out that NPIs simply transfer illness and death to later dates and hence does not lower cumulative mortality.

On this point, researchers find that “cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (20%) and less statistically signi´Čücant than that for peak mortality.”

The lower cumulative mortality rate is the most encouraging finding from the 1918 flu experience, although this finding is less robust than the effect on peak mortality.

Should we follow the Swiss in dealing with COVID-19?

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Within Europe, the Swiss are caricatured as deliberate, unemotional, and  imperturbable. Their reaction to the Corona Virus pandemic fits this stereotype. Of course, it helps that the Swiss are better positioned than other countries with a debt to GDP ratio of 40 percent (versus 81 percent for the US) and a fully funded unemployment insurance fund. (In the US, impending shortfalls at the state level will require huge federal bailouts).

Unlike raucous US politics, the Swiss formed a swift national consensus, and their rescue package is already underway, at an estimated cost of 5 percent of GDP. At this juncture, the US rescue package awaits approval by the House at a cost  that will well exceed ten percent of GDP.