Do You Feel Lucky, Punk?

A recent influential report posed the key Covid-19 issue today as: to mitigate or suppress? Should we focus on “flattening the curve” under the assumption that most everyone will get it soon, or adopt even stronger measures in an attempt to squash it, so most never get it.

Some simple obvious considerations are:

1. if successful, squashing saves many more lives,

2. you have to do a lot more to squash than to flatten,

3. while flattening policies need be maintained only for a few months, squashing policies must be maintained until a strong treatment is available, probably years, and

4. squashing is far easier when you have only a few infected and when your trading, travel, and physical neighbors don’t have many infected.

Several nations, mostly Asian, seem to have successfully squashed so far, though they started when they had few infected. China and perhaps S. Korea are the main examples of squashing more than a tiny number of infected, though even they had far fewer than we do now in the West where so many are suddenly eager to squash. China had much recent experience with mass surveillance, controlling population movements, and enforcing strict rules. Even so, they screwed up badly early on, and it isn’t at all obvious that China’s squashing will keep working as they let people go back to work, or when many big neighbors get highly infected.

The main point I want to make in this post is that trying to get your Western government to suppress Covid-19 in the usual way is making a big bet on the quality of they and typical neighboring governments. And also of your public’s commitment. As in the famous Dirty Harry (non-)quote, I ask: “Do you feel lucky, punk?”

Western government agencies and expert communities so far have had a bad record dealing with Covid-19. At first they criticized China’s strong measures and focused on signaling political correctness. The US government badly screwed up the generation and regulation of tests and masks, and the West continues to fail to cut regulation preventing rapid expansion of medical personnel and resources. Western governments only changed policies when public opinion changed, and even now seem more focused on handing out cash to allies, and symbolic but useless acts like banning bicycles.

As with most policy, you must expect that the details matter a lot. So even if you see China policy as a success, you shouldn’t have high hopes if your government merely copies a few surface features of China policy. That only works if this is a simple problem, with simple solutions, and few problems are that simple. This is not just a problem of insufficient moral fervor.

You should have higher hopes if they copied the whole China policy package relatively exactly, and even higher if the Chinese officials who managed their policy implementation personally came to manage implementation here. Even then climate, cultural, or infrastructure differences might mean their policies don’t work here. But no government seems even interested in copying the exact China package, and in my recent poll, 80% of 927 opposed this last idea of Chinese management.

Dear Western citizen, your government has already demonstrated incompetence at dealing with this in the absence of public pressure, and public pressure will mainly push them to do what they guess they would be most blamed by the public for not doing if things go badly. Regardless of whether that actually works; the public may never learn what actually works.

This pandemic has already been allowed to get much bigger than any that has ever been squashed before, and it is harder to squash than most, passing via the air, living on surfaces for days, and with infected folks showing no symptoms for over a week. And in contrast to China, your government doesn’t have much recent experience with the mass surveillance, movement controls, and strict rule enforcement.

And yet now at this late date, you are considering if to authorize these same governments to oversee not just large efforts to flatten the curve, but the more extreme efforts required to squash it. Even knowing that to make it work you’ll need very strong public support in a far less-communal culture than those that have so far managed to squash.

Mind you, you are now considering this not because you have great confidence in your government’s competence, or your public’s support. But mostly, it seems, because it would look morally bad for you to give up hope on the millions who will die even if we flatten the curve well. Really, do you feel lucky, punk?

Also consider: even if your local government manages to successfully squash its internal infections temporarily, what happens if half of its neighbors fail, and become mostly infected? Or what if they succeed for a while, but half of their neighbors fail? What will it take to keep external infections from overwhelming you then? Or what will it take for your government and others to coordinate to ensure that most governments succeed? Remember, these are the governments who have so far largely failed to prevent massive illegal immigration, and who continue to fail to coordinate to limit global warming, war, and ocean overfishing, or to promote global innovation.

This wouldn’t matter much if the policies for squashing looked much like the policies to flatten, so we could actually flatten but pretend for a while that we were trying to squash. But there are policies that could help to flatten that look obviously bad for squashing, such as deliberate exposure, which might cut 3/4 of life-years lost. And locking down the economy and social contacts for many years at a level that looks at all like it might succeed in squashing is going to involve enormous costs to the economy and your freedoms.

In my recent polls, 73% and 74% of 393 and 533 respondents predicted US and world (respectively) will become >25% infected before an >80% effective treatment was given to >80% of world. So 3 in 4 agree that global containment just isn’t going to happen. Yet, to show that they care, most governments are giving lip service to squashing as their goal, not flattening. How far will we all go in paying huge costs to pretend that this is at all likely?

Before we all jump off this cliff together, can we at least collect and publish some honest estimates of our chances of success? Such as perhaps via conditional betting markets? If you aren’t willing to exactly copy the whole China policy, or have them manage it, how serious could you really be about succeess?

Look, this is like starting a war. Its not enough to ask “would it be nice to win such a war”; we also need to ask “can we actually win?” Don’t start what you can’t finish.

I fear suppression is a monkey trap; afraid to let go the nut of saving everyone, we’ll be trapped in the gourd of not saving nearly as many as we could have.

Added 20Mar: Note that the many responses defending suppression talk about how many lives could be saved, and how they can imagine a plan that would work, but none address the issue of how competent is our government to implement such plans. Amazing how easily people slip from “it could be done” to “my government could do this”.