COVID19: Optimal New Case Rate

The consensus among most of the countries is that the correct goal for COVID19, being a new virus, is to reach zero new cases and zero new deaths.   This goal is brings the world back to the state it was before this virus was introduced.

Zero new cases is definitely an attractive goal that no one will object if that were achievable.   Given that the virus is dispersed world wide and distributed among the entire population, the only way to get to zero would be for us to develop a vaccine and vaccinate the entire population.   Optimistically, such a vaccination will have a 1 in 10,000 chance of causing harm or it will affect 700,000 people.   Many of whom may not have had any problem dealing with the disease and given the fact that it may be another year before the vaccine can be ready, many of them would have already had the infection without knowing it and thus would end up accepting the adverse consequences for something they didn’t need in the first place.

The proposed vaccines are new in that they inject bare RNA instead of dead or disabled viruses for the body to react to.  In addition, the strength of the vaccine will have to be amplified to improve the immunization of the most vulnerable whose immune systems are already weak.    I imagine that this vaccine will be over administered to others.   Also, I suspect it will affect adversely more like 1 in 500 people instead of 1 out of 10,000, or a total of  14 million people.

I worry that we may choose to accept 14 million adverse reactions to a man-made and government mandated vaccine in order to avoid a fewer number of deaths from the now-natural presence of this virus.    Science-based governments have a bias to accept more harm from man-made and man-decided policies than from natural causes.

The question that needs to be asked is what is the acceptable level of excessive cases and excessive cases from a new virus.   This question was answered before it was asked and the answer is zero.    This might be the only answer possible in a democratic government as we have seen in recent press conferences where any single new case or death is considered to be a failure by the government.

[Added after publication]   Government demands zero new deaths for a new virus because it is a natural novelty.   There is no comparable demand for new technological innovations.  For example, in recent years they has been a comparable pandemic-scale introduction of an innovation of the form of rentable electric scooters that have resulted in many injuries and death and yet there is no outcry to get these numbers to zero.  [End added].

The enlightenment-style governments (guided by democracy and established science) has no mechanism to find an optimal value that is larger than zero.   This condemns us until global vaccination is achieved to having grocery stores as the only allowable social gather place but waiting in lines standing six-feet apart, so that no more than a certain number may be in the store at any time.   All non-essential workers must suspend their earnings and career development to wait at home until the zero-new-cases is achieved through vaccination.

What mechanism does a modern government have to arrive at a more optimal value over zero?   Democracy only elects certain representative on a schedule unrelated to the crisis.   The representatives really have no choice but to follow the guidance from the select few permanent bureaucratic class that decides the applicable science.   As seen in recent press conferences, any deviation from the advice of the bureaucrats will not be tolerated.    The bureaucrats in turn make their recommendations based on what is scientifically known.   The nature of scientific knowledge is that it is very narrow in order to be tested.   Thus the decisions are inevitably narrow minded.

There is no science of optimizing an entire economy, especially terms of satisfying and pacifying the entire population.   Some things may claim to be science at that scale, but it is impossible to do controlled double-blind studies of alternatives at that scale.   There is no science of government but we have no choice but govern as if there were.

An advantage of my fantasy government by data and urgency is that it is capable of arriving at a non-zero answer to the question of the optimal value of new cases and new deaths.   In a recent post, I suggested that it would decide that a non-zero value of new cases and new deaths would be more optimal than zero.   In particular, the optimal value of new cases is to match the closed cases so that there is a steady utilization of the available capacity.   That utilization is less than full capacity to make room for occasional surges but it is only slightly less than full capacity.  The benefits are

  1. A steady and diverse population of new patients for the medical staff to treat and to train new staff.   This population also gives opportunities to evaluate and improve new treatments to reduce the worst case outcomes.
  2. A growing development of herd immunity, or perhaps more properly termed herd resilience eventually reducing new cases either because people are more resilient or they are less likely to pass it to others.
  3. A more energetic economy enabling the replenishing and re-engineering of supply chains while also innovating new business models that match the current reality.   More importantly, this provides the necessary opportunity for people to continue to build their careers with experience and training to meet their future goals that will benefit the population with future prosperity.

The government by data and urgency can arrive at this conclusion using both data and urgency.

  • Data is distinct from science in that it measures what is currently available and it is not constrained by what can be scientifically explained or tested.   The data will tell us that many people getting infected are not severely affected by it, and that we are getting better at treating the ones that need more medical attention.   From the data, we can see that a non-zero case load can be acceptable.
  • Urgency is something that science can not answer at all.   Democracy through fixed election dates is unable to answer urgency either.   Once elected, the representatives serve through new crises that did not exist when they were elected.   Even if the crisis coincides with the election season, the popular choice is for people not policies.   In contrast, a government by data and urgency continuously gather fresh data and part of that data is a periodic assessment of popular sentiment of urgency.

As I mentioned in several previous posts, I concede that a government by data and urgency likely would have enacted similar lock-down policies limiting people to only essential activities.   In my fantasy government, this lock-down is a direct result of the urgency at the time plus the algorithmic assessment that a lock-down serves like a civil-defense siren to alert the population of a new normal to deal with.   The lock down would need to be about a month to really condition the population that there is a new challenge.

The difference between my fantasy government and the current governments is that my fantasy government reassesses the urgency after the first month of lock down.   The population likely will be not as alarmed by the condition especially when they see that the system is not being as overwhelmed as first feared.    The government by data and urgency may find that there is no longer an urgency among the population.   This is how it arrives at the conclusion that the current levels of new cases (far from zero) are tolerable for the time being.   The government by data and urgency will continue to monitor the population in case urgency heightens in the future but for the interim it may decide the current levels are acceptable.

In contrast, our current choices of governments of elected representatives following science selected by bureaucratic are stuck at permanent level of urgency.   The rationale is inevitable because the initial urgency was based on science and science is presumed to be permanent so the conclusion of urgency must be permanent.   Science set the initial goal of zero new cases and now we must continue policies as long as needed to balance this scientific equation.

Government by data and urgency is not constrained by science.  Obviously, the data collected and the popular sentiments are informed by abundant science.   The difference is that any decisions are not expected to be scientific and thus are not expected to be permanent.

In the current crisis, the goal of zero new cases had justification in that it was a new problem and that there was a narrow window of time when the cases were isolated enough that it was conceivable that the virus could be contained.    Unfortunately, the virus escaped containment long before most countries started their lock down so the only justification for lock down (from perspective of data and urgency) was to address the urgency felt by the population.

It is debatable whether we are at this time at a point of popular comfort with the new normal to make the situation no longer an urgent matter.   I do think that time will come quickly.

My fantasy government would quickly respond to the new sense of comfort that we can live with this new normal without having to exhaust our entire future pursuing a goal of zero new cases.   That makes it a real fantasy in that I think we would be better off with that kind of decision.

Unfortunately, we are stuck with the current governments that have already committed to a goal that may never be achievable at all, but if it is achievable it requires us to sacrifice our future while we wait for the scientifically-promised vaccine that will come in about a year or so.

It is crazy to me that we accept the notion of a government that leads by telling everyone to sit and wait for up to two years when it will finally be safe to go back about our lives because the zero new cases was finally achieved.

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