Paul Romer Comes Out Against Contact Tracing in the United States (which Biden Supports)
By Lambert Strether of Corrente.
I had been intending to write a post on lesser-evilism, but then I saw the tweet storm from Paul Romer that follows, and I thought I should but it before you immediately. (However, if we have any philosphers or theologians in the readership who are familiar with the problem of evil, especially institutional evil, I’d love to hear them.) Paul Romer is an economist that NC can actually appreicate; hard to believe, I know, especiallly because Romer won a “Nobel,” and was formerly chief economist at the World Bank. Nevertheless, Romer (with co-author George Akerlof, here, here, and here) wrote the paper (“Looting: The Economic Underworld of Bankruptcy for Profit“) that Yves calls “seminal’ to understanding “who wins no matter what” in our “current hypertrophied financial system.” Bill Black discusses Romer’s demolition of mainstream macro here (while noting that Romer is not on the left; far from it.) So there’s a lot to like about an economist who elucidated accounting control fraud (a form of looting) well before the Crash and the foreclosure crisis.
Well-done contact tracing has been an effective policy, deployed by some Asian countries which still enjoy admirable infection rates. In some cases, these model countries never implemented full lockdowns. Yet countries that have adopted the neoliberal playbook have demonstrated their inability to do contact tracing effectively, largely because they cannot figure out a way to monetise the process (see here for a representative criticism, among the multiple posts I have written on the topic).
And so to Romer’s tweet-storm. First, given the failure of contact tracing in the United States, he poses two alternatives:
4. A reasonable person can either:
(i) keep trying to persuade more people in the US to cooperate; or
(ii) identify policies that can work even when contact tracing is impossible.
The debate between backers of (i) and (ii) must take place, even if it ruffles feathers.
And no one alive writes about the American meritocracy with more insight than does Thomas Frank. His summary of their ways is worthy of memorization: “For them, merit is always synonymous with orthodoxy: the best and the brightest are, in their [own] minds, always those who went to Harvard, who got the big foundation grant, whose books are featured on NPR” (Listen, Liberal, p. 39). These are the men and women who, for going on seven decades now, have formed the Professional Class, the Expert Class, the Liberal Class, the Creative Class, the Learning Class, the Opinion Class, and so on and so forth — they are, in short, the hipper, cooler (and now woker) half of the American Ruling Class. Bottom line: Not only are they way richer and more powerful than you, they are way than you, both intellectually and morally. At least they see it that way.
Most non-elite Americans, however, because they have, at this point in our history, endured over two generations of breathtakingly spectacular meritocratic failures — including the unending trillion-dollar wars that the elites never fight in and never win, including the elites’ financialized ransacking of the once-industrial American heartland, including the elites’ perversion of medical care and higher education into grotesque unaffordable rackets — would, if asked, give a more precise answer to the intriguing question of class nomenclature — Liberal Class? Creative Class? Learning Class? — by describing the ascendant meritocracy as our gleefully parasitic Fuck-Up Class.
So, “the public’s” rebellion is not without reason. You can come up with your own evidence, I am sure, but here is Romer:
7. Evidence that experts persuasion is failing:
– Backlash against economic experts in the Brexit vote.
– Growth of the anti-vax movement despite unified expert exhortation re value of vaccines.
I keep coming back to the same theme, which is that experts tell us, you know, the sort of people who call themselves experts, the professional class, let’s put it that way, people with advanced degrees who basically make the world that you and I live in. They are the ones who make our laws, who design our buildings, who set up our corporations, the people that Richard Hofstadter thought he was writing a manifesto for, this class of people presents themselves to us as neutral, disinterested experts. They will make the right decision on our behalf.
And what I have said again and again and again is that like any other social cohort, these people will act in their own self-interest and they will help each other out, and they will help themselves when the chips are down. And you saw that in the financial crisis, in the most extraordinary way, where one set of elites bailed out another set of elites and there was zero accountability. There is zero accountability for these people who had crashed the global economy. None of them got “canceled”. They’re all still there, they still have theIr goddamn jobs. It’s the most amazing thing.
My message is that these people act as a class, think as a class, and they’re doing it. They’re manifestly doing it in a way that is so patently obvious right now. Anyhow, that’s my joyous message under the world.
And back to Romer:
I hope we have a new administration that succeeds.
I am terrified that frustrated experts will send it on a kamikaze mission that gives expert exhortation the force of law.
Claim 4: This use of the law will not restore expert legitimacy and might destroy our democracy
(I hope so too, for the same reason I hope that Operation Warp Speed produces a safe and effective vaccine or treatment; the country faces ruin otherwise.) And speaking of expert kamikaze missions, from the New England Journal of Medicine, “Ensuring Uptake of Vaccines against SARS-CoV-2“:
. Mandatory vaccination has proven effective in ensuring high childhood immunization rates in many high-income countries. However, except for influenza vaccination of health care workers, mandates have not been widely used for adults.
We believe that six substantive criteria should be met before a state imposes a SARS-CoV-2 vaccine mandate
“Substantive” is doing a lot of work, there, but one thing it is not — hold onto your hats, here, folks — is democratic. Here they are; I’ve helpfully annotated them [thus]:
1. Covid-19 is not adequately[A] contained in the state.
2. The Advisory Committee on Immunization Practices[B] has recommended vaccination for the groups for which a mandate is being considered.
3. The supply of vaccine is sufficient to cover the population groups for which a mandate is being considered.
4. Available evidence about the safety and efficacy of the vaccine has been transparently communicated[C].
5. The state has created infrastructure to provide access to vaccination without financial or logistic barriers, compensation to workers who have adverse effects from a required vaccine, and real-time surveillance of vaccine side effects.
6. In a time-limited evaluation, voluntary uptake of the vaccine among high-priority groups has fallen short of the level required[D] to prevent epidemic spread.
NOTES [A] As decided by whom? [B] A “magic board”! [C] So “transparency,” as opposed to acceptance, is all that’s required? [D] As decided by whom?
To be fair, I should give credit to the NEJM for not trying to screw over the workers too hard — paid leave for the vaccination? — but this is simply not a democratic process. It’s also not a national mandate, so it’s not clear to me how the NEJM proposal will work in a Federal system. What about non-vaccinated “hot states”? Will there be internal passport?
Build a National Contact Tracing Workforce: Once COVID-19 infected people are identified, we need to find those to whom they might have unwittingly spread the disease. Contact tracing is a core component of a robust nationwide data-driven disease surveillance system. Given the massive unemployment problem that Trump generated and the incredible need for contact tracers, Biden would:
Create a U.S. Public Health Jobs Corps. Through this Corps, the federal government will closely coordinate with state, tribal, and local leaders, as well as unions, to mobilize at least 100,000 people — and many more, if necessary — to support the public health response including by ensuring contract tracing reaches every community in America. Corps members should come from the communities they serve in order to ensure that they create trust and are as effective as possible.
(I have no idea if 100,000 is enough. I doubt it.) Does Biden propose to emphasize exhortation by experts? Yes. From “The Biden Plan to Combat Coronavirus (Covid-19) and Prepare for Future Global Health Threats”:
Biden knows how to mount an effective crisis response and elevate the voices of scientists, public health experts, and first responders.
Biden believes we must immediately put scientists and public health leaders front and center in communication with the American people in order to provide regular guidance and deliver timely public health updates, including by immediately establishing daily, expert-led press briefings.
If Romer is correct, the “horns effect” of exhortation by justifiably mistrusted experts will undercut the effectiveness of the National Contact Tracing Workforce (NCTW). We should, of course, all hope that Romer is wrong. We might also hope that the NCTW is so recruited and empowered that the contact tracers can win the trust of recalcitrant communities. We should also hope that Biden, FDR-like, can say that “It is common sense to take a method and try it. If it fails, admit it frankly and try another.” Sadly, our Professional Managerial Class is not known for that.
 As a sidebar, Romer supports testing:
On 9/21, at the request of an intermediary, I made a last ditch attempt to explain the value of testing to WH advisor Scott Atlas.
Predictably, it had no effect. He was already dead set on chasing herd immunity
[W]e show that as patients receiving dialysis have monthly blood draws, without fail and without bias, and are a population with increased representation of racial and ethnic minorities, repeated cross-sectional analyses of seroprevalence within this sentinel population can be implemented as a practical and unbiased surveillance strategy in the USA.
[O]ur findings comport with other seroprevalence estimates. We confirm that as in other studies from COVID-19 hotspots, a minority of the population has evidence of exposure and immune response, and a vast majority, including people at high risk for mortality (ie, the population on dialysis), remain vulnerable. In fact, even if the seroprevalence estimates derived from the US dialysis population overestimated true seroprevalence in the overall US adult population, has seroconverted as of July, 2020, and herd immunity remains out of reach, as has been the conclusion from large international surveys from the UK and Spain, where intense outbreaks of COVID-19 occurred during the spring and summer of 2020.
[It’s way] too late for contract tracing to work. Joseph Norman, Yaneer Bar-Yam, and Nassim Nicholas Taleb pointed out in a January paper that contact tracing was ineffective once a disease reached pandemic scale:
Standard individual-scale policy approaches such as isolation, contact tracing and monitoring are rapidly (computationally) overwhelmed in the face of mass infection, and thus also cannot be relied upon to stop a pandemic. Multiscale population approaches including drastically pruning contact networks using collective boundaries and social behavior change, and community self-monitoring, are essential.