----- 4 stars -----
A Missionary on Trial / New Yorker
Excellent reporting; what starts out sounding like a ProPublica exposé is actually a well-researched, reasonably dispassionate chronicle of a complex situation. While the author does seem to have concluded whether or not Bach is guilty, multiple points-of-view are well served:
Renée Bach went to Uganda to save children—but many in her care died. Was she responsible? [...] Twalali was one of more than a hundred babies who died at Serving His Children between 2010 and 2015. The facility began not as a registered health clinic but as the home of Renée Bach—who was not a doctor but a homeschooled missionary, and who had arrived in Uganda at the age of nineteen and started an N.G.O. with money raised through her church in Bedford, Virginia. She’d felt called to Africa to help the needy, and she believed that it was Jesus’ will for her to treat malnourished children. Bach told their stories on a blog that she started. “I hooked the baby up to oxygen and got to work,” she wrote in 2011. “I took her temperature, started an IV, checked her blood sugar, tested for malaria, and looked at her HB count.” In January, 2019, that blog post was submitted as evidence in a lawsuit filed against Bach and Serving His Children in Ugandan civil court. [...] A gardener who worked there for three years asserts that Bach posed as a doctor: “She dressed in a clinical coat, often had a stethoscope around her neck, and on a daily basis I would see her medicating children.” An American nurse who volunteered at S.H.C. states that Bach “felt God would tell her what to do for a child.” A Ugandan driver says that, for eight years, “on average I would drive at least seven to ten dead bodies of children back to their villages each week.” The story became an international sensation. “How could a young American with no medical training even contemplate caring for critically ill children in a foreign country?” NPR asked last August. The Guardian pointed to a “growing unease about the behavior of so-called ‘white saviors’ in Africa.” A headline in the Atlanta Black Star charged Bach with “ ‘Playing Doctor’ for Years in Uganda.” The local news in Virginia reported that Bach was accused of actions “leading to the deaths of hundreds of children.” [...] Bach’s critics accuse her of luring mothers from Nalufenya to her own facility. Tagoola, who has been a pediatrician for twenty years, said that the idea was ludicrous. “If a mother knows that she is likely to get free food and she’s going to get free medicine—what would you do?” He shook his head. “Some of these things are contextual. In America, they can’t believe a baby can just die. Here, they can die.” He clapped his hands hard and fast. Every time a child died, it made other parents warier of the hospital. Pointing at three babies on a cot, he said, “If one dies, a mother—a real mother—why would she stay? She says, ‘I have to go look for where there is support.’ ” [...] I didn’t have time to go to the bank; I had another meeting planned, with a man named Semei Jolley Kyebakola—a former gardener for S.H.C., who filed an affidavit against the group and served as the translator when the dead children’s guardians filed their court documents. He’d also built a sideline taking journalists to the villages outside Jinja to meet these women, along with several others who stepped forward after they heard about the case. [...] I felt uncomfortable getting in a car with Kyebakola, knowing that the police had reported to him on my activities. When I told him that I would not go with him to the villages, he said angrily that I had come only to protect my fellow-mzungu. “And you call yourself a Christian!” he yelled. (I told him several times: I call myself a Jew.) “The problem is, whites, you claim you are Christian, but you are not. How do you expect me to live? You are telling me to go steal! As a Christian, you should pay. There is no money which is enough—but try! If you see Renée, tell her: it is better to settle out of court.” A few minutes after I parted ways with Kyebakola, Hudson sent a message letting me know that he would not be supplying a copy of the police report.
I'm not into beatboxing at all (maybe I should be), and yet I found this fascinating:
This is fantastic: former beatboxing world champion Butterscotch explains the 13 levels of complexity involved in beatboxing, from the simple “bass drum” to how to breathe while beatboxing to singing to emulating real instruments. Expert beatboxers go so fast that it’s amazing to see someone with Butterscotch’s skill level break this down — like watching a water balloon bursting in slow motion. Her short explanation & demonstration of “breathing within the beat” bleeeewww my tiny little mind. Also, she is soooo good — what a treat to watch.
As Case and Deaton recount in their new book, “Deaths of Despair and the Future of Capitalism” (Princeton), they dug deeper into national vital statistics and compared rates of suicide with those of other causes of mortality. “To our astonishment, it was not only suicide that was rising among middle-aged whites; it was all deaths,” they write. This was nearly unfathomable. Outside of wars or pandemics, death rates for large populations across the world have been consistently falling for decades. Yet working-age white men and women without college degrees were dying from suicide, drug overdoses, and alcohol-related liver disease at such rates that, for three consecutive years, life expectancy for the U.S. population as a whole had fallen. [...] Sure enough, when the paper came out it was discussed on television, talk radio, and social media, drawing the sort of public response that seldom greets economic research. It had put numbers on a long-simmering but inchoate sense among many people that something had gone profoundly wrong with the American Dream. But what, exactly? Why was this happening here and not elsewhere? Case and Deaton’s original paper offered no explanation, but their new book does. And their explanation begins by dismantling several others. [...] Among advanced economies, this deterioration in pay and job stability is unique to the United States. In the past four decades, Americans without bachelor’s degrees—the majority of the working-age population—have seen themselves become ever less valued in our economy. Their effort and experience provide smaller rewards than before, and they encounter longer periods between employment. It should come as no surprise that fewer continue to seek employment, and that more succumb to despair. The problem isn’t that people are not the way they used to be. It’s that the economy and the structure of work are not the way they used to be. [...] Yet why has the steep rise in deaths of despair been so uniquely American? Case and Deaton identify a few factors. The United States has provided unusually casual access to means of death. The availability of opioids has indeed played a role, and the same goes for firearms (involved in more than half of suicides); we all but load the weapons of self-destruction for people in misery. [...] When it comes to people whose lives aren’t going well, American culture is a harsh judge: if you can’t find enough work, if your wages are too low, if you can’t be counted on to support a family, if you don’t have a promising future, then there must be something wrong with you. When people discover that they can numb negative feelings with alcohol or drugs, only to find that addiction has made them even more powerless, it seems to confirm that they are to blame. We Americans are reluctant to acknowledge that our economy serves the educated classes and penalizes the rest.
----- 2 stars -----
The Mystery of the Millionaire Hermit / Bloomberg Businessweek
He spent years scrimping and saving. But without a will, where’s his money going? [...] The neighborhood mail carrier was the one who’d called the police. Every day, Brown would wait for her in a chair by his door, and the two would exchange pleasantries. But for the past five days, there’d been no sign of him. Police did a welfare check and discovered his body in a pool of dried blood by the toilet. Members of the coroner’s office who were dispatched to the house determined that he died of a stroke, but not before breaking his nose in a nasty fall. They did a quick search for a will and contact information for family members and friends—return addresses on envelopes, phone numbers jotted on scraps of paper. Not finding anything, they called Tisserand and Rodrigue. Many counties in the U.S. have public administrators, though a lot of people don’t know they exist. They operate within the murky ecosystem of public agencies and private businesses that kick into gear when someone dies: locksmiths, biohazard and trauma cleanup services, trash haulers, auctioneers, real estate agents, courts, attorneys, and banks. Tisserand and Rodrigue were in Brown’s house to locate his will and heirs, which can be difficult when people die alone. They would also oversee his estate. Even a simple death, something peaceful in your sleep, requires the assistance of an awful lot of people. [...] Upon receiving Brown’s case from the coroner, Rodrigue and Tisserand took their usual first step of arranging for a locksmith to meet them at the house; changing the locks lets them take control of the property and ward off squatters. They rerouted Brown’s mail to their office, since a get-well card or bank statement could provide valuable information about relatives and assets. Then they began their search. The vast majority of houses Rodrigue and Tisserand see are in severe disrepair. [...] The investigators brought their hazmat suits to Brown’s house but could tell from the meticulously trimmed bushes and recently mowed front lawn that they wouldn’t be needed.
More strikingly, it revised its most recent estimates for the ultimate coronavirus death toll downward by 11,765, or roughly 15 percent: from 93,531 to 81,766. A couple of days later, it revised them even more dramatically, from 81,766 to 60,415, or roughly 25 percent more. These revisions may be eye-opening, in addition to being encouraging, because as recently as a week or two ago, the projections discussed by most public-health officials were much, much higher. [...] The WHO has long maintained that asymptomatic carriers of the disease represent about a quarter of all infected — which would suggest that, in a perfect and universal testing environment, we’d find a third more carriers of the disease than we’d find just by testing those presenting with symptoms. This would be a significant increase of the infected population, but not one that radically changes our picture of the severity of the disease. In Iceland, such a system as been instituted, and though only one percent of those tested were found positive, the number for asymptomatic carriers is higher: 50 percent of infected Icelanders don’t know they are carrying COVID-19. This is twice as high as the WHO figure, as so, by this logic, relatively good news. But even a doubling of the denominator does not change our picture of the disease that dramatically — it is not Bill Ackman’s 50X, in other words, let alone the Economist’s 200X. It is also in line with a new CDC “renanalysis” suggesting that the infectiousness of the disease might be twice as high as conventional wisdom recently held — a striking revision for those who remember the concern-trolling around those raising earlier alarms about elevated infectiousness rates, though not one that amounts to a basic reconceptualization of the nature of the disease or what we can expect from it. A new, small-sample serological survey in Germany holds more promising results: 14 percent of those tested carried coronavirus antibodies, meaning they’d already been exposed the disease, orders of magnitude more than is suggested by their confirmed case count of less than one-tenth of one percent of their population.
In the April 5, 2020 issue of the kottke.org newsletter, I asked readers if they would share what they've been up to during the pandemic and how their families and communities are coping. I received a bunch of responses and beginning today, I'm going to publish some of their experiences here.
Humans get a surprising number of very infectious diseases from bats. We get SARS (including the recent COVID-19/SARS-CoV2), Ebola, rabies, and possibly mumps. These are all incredibly infectious, deadly diseases. This seems weird because human beings aren’t in particularly close contact with bats. They’re nocturnal, don’t have large city populations (for the most part), and humans don’t eat them that often. It should be harder for diseases to pass from them to us. They’re also not very similar to us genetically, so their diseases shouldn’t be able to leap to us so easily. [...] The more important part of the answer is that bats are “reservoirs” of some particularly virulent viruses. Bats live with long-term infections of SARS or Ebola and are seemingly ok with it. [...] There’s an interesting question, though: why don’t these viruses kill bats? Ebola, SARS, and rabies all kill their hosts pretty quickly. How can bats live with these viruses year after year? [...] Last question, and here’s the most interesting one. Why are bats like this? What made their immune system so weird? Well, it actually has to do with their flying. Bats are the only mammals that fly. Flying is a really energetic process and can raise bats’ internal body temperature up to 41 degrees Celsius (106 degrees Fahrenheit) for an extended period of time. That’s really hot. In humans, that would cause serious brain damage. In bats, it’s enough to damage DNA through the production of reactive oxygen species, as well as to release the DNA into the cytoplasm or bloodstream. This meant obviously that bats had to be really good at regularly repairing their DNA, a tricky process that can lead to cancer. But it also meant that bats couldn’t rely on the classic immune system trick of recognizing foreign pieces of DNA. In other animals, those were likely strands of DNA from a virus or bacteria. In bats, those were likely just pieces of bat DNA that had been damaged and let loose in the wrong place. Recognition couldn’t work in the same way. So bats’ immune systems decided to be always on, instead. Then, to avoid the problems with that, bats’ immune system also evolved to never reach the same levels of inflammation as other mammals. The end result was that bats were much more able to live with deadly viruses, neither ignoring nor overreacting to them. Neat, huh?
America was watching, shocked, as doctors and nurses pleaded for protective gear and medical equipment such as ventilators. Ries was asked to help start a Web site that would match hospitals and suppliers. Sure, Ries said, he could have something up and running by Monday. What followed over the next two weeks was an inside glimpse of the dysfunction emanating from Trump’s Washington in the midst of the pandemic, a crash course in the breakdown that has led to nurses in one of the wealthiest countries in the world wearing garbage bags to protect themselves from a virus whose outbreak the President downplayed until it was too late to prepare for its consequences. Ries’s first phone conversation demonstrated how awry things had gone. He reached out to a White House contact, and, when he mentioned the Trump Administration’s coronavirus task force that was asking for Silicon Valley’s help, the response was, “Which one?” Trump had enlisted his son-in-law, Jared Kushner, to help with the pandemic response, and his murky new effort, which was not yet public, was already seen as working at cross-purposes with the official task force, overseen by Vice-President Mike Pence. [...] Earlier this week, the office of the inspector general for the Department of Health and Human Services released a survey of three hundred and twenty-three hospitals in forty-six states, D.C., and Puerto Rico, and it found “widespread shortages of PPE,” and also of other equipment. After the report was released, Trump claimed it was “wrong,” tweeted that it was “Another Fake Dossier!,” and attacked the principal deputy I.G. who prepared it because she had also served during the Obama Administration. Trump, of course, omitted the fact that she is a career official who also served in the Clinton and George W. Bush Administrations. All of this was predicted. On February 13th, the Center for Global Development, a nonpartisan Washington think tank, warned in a report about the “urgent but closing window” for the U.S. government to prepare, including specifically recommending an immediate review of the P.P.E. supply chain; the creation of a plan for distribution of supplies and the public communication of that plan; and the development of “options for addressing PPE shortfalls,” which ranged from increasing manufacturing to coming up with new “parameters for reuse in crisis conditions.” This was in mid-February, a full month before Trump deputized Kushner to step in and the first orders went out. [...] A few weeks ago, it was already apparent that the federal response to the pandemic was late, disorganized, and putting large numbers of American lives at risk. What is becoming apparent now is something just as unthinkable: Trump’s reluctance to have the federal government play the role for which it was designed in such an emergency.
Over the past few days, I’ve been reading the major plans for what comes after social distancing. You can read them, too. There’s one from the right-leaning American Enterprise Institute, the left-leaning Center for American Progress, Harvard University’s Safra Center for Ethics, and Nobel Prize-winning economist Paul Romer. I thought, perhaps naively, that reading them would be a comfort — at least then I’d be able to imagine the path back to normal. But it wasn’t. In different ways, all these plans say the same thing: Even if you can imagine the herculean political, social, and economic changes necessary to manage our way through this crisis effectively, there is no normal for the foreseeable future. Until there’s a vaccine, the United States either needs economically ruinous levels of social distancing, a digital surveillance state of shocking size and scope, or a mass testing apparatus of even more shocking size and intrusiveness. [...] My point isn’t to criticize these plans when I have nothing better to offer. Indeed, my point isn’t to criticize them at all. It’s simply to note that these aren’t plans for returning to anything even approaching normal. They either envision life under a surveillance and testing state of dystopian (but perhaps necessary!) proportions, or they envision a long period of economic and public health pain, as we wrestle the disease down only to see it roar back, as seems to be happening in Singapore. What’s even scarier to consider is that the debate between these plans is far beyond the political debate we’re actually having. As of now, the White House has neither chosen nor begun executing on a plan of its own. That’s a terrible abdication of leadership, but reading through the various proposals, you can see why it’s happened. Imagine you’re the president of the United States in an election year. Which of these futures, with all its costs and risks and pain, would you want to try and sell to the American people?
Did the left broadly and Sanders and Warren in particular blow the 2020 campaign? Or did Sanders, Warren and the left always have a narrow path to victory because Democrats have tended to prefer more centrist candidates, and the period between Nevada and Super Tuesday a bit of a mirage? Let’s look at both perspectives.
Why I do not favor variolation for Covid-19 / Marginal Revolution
Always fun when two intellectual heavyweights like Tyler Cowen and Robin Hanson battle it out. (In case you're interested, Hanson responds, to which Cowen says, "I am happy to give Robin the last word (since I think it is obvious that I am correct)."):
So the scenario is this: Hero Hotels welcome sufficiently young and healthy volunteers. Friends and family can enter together, and remain together. A cohort enters together, and is briefly isolated individually for as long as it takes to verify that they’ve been infected with a very small dose of the virus. They can then interact freely with each other, those those that show symptoms are isolated more. They can’t leave until tests show they have recovered. In a Hero Hotel, volunteers have a room, food, internet connection, and full medical care. Depending on available funding from government or philanthropic sources, volunteers might either pay to enter, get everything for free, or be paid a bonus to enter. Health plans of volunteers may even contribute to the expense. [...] 4. Does small/marginal amounts of variolation do much good compared to simply a weaker lockdown enforcement for activities that involve the young disproportionately? Just tell the local police not to crack down on those soccer games out in the park (NB: I am not recommending this, rather it is the more practical version of what Robin is recommending; both in my view are bad ideas.) Robin’s idea has the “Heroes Hotel” attached, but that is a deus ex machina that simply assumes a “free space” (both a literal free space and a legally free space) is available for experimentation, which it is not. 5. Society can only absorb a small number of very blunt messages from its leaders. You can’t have the President saying “this is terrible and you all must hide” and “we’re going to expose our young” and expect any kind of coherent response. People are already confused enough from mixed messages from leaders such as presidents and governors.
What do Germany, Taiwan and New Zealand have in common? Well, they’ve all got female leaders and they’re all doing an exceptional job in their response to the coronavirus crisis. Tsai Ing-Wen, a former law professor, became the first female president of Taiwan in 2016 – the same year America got its first reality TV president. Tsai has spearheaded a swift and successful defence to the pandemic; despite Taiwan’s proximity to mainland China it has largely contained the virus and has just under 400 confirmed cases. It is so well prepared that it is donating 10m masks to the US and 11 European countries. New Zealand, led by Jacinda Ardern, is also a world leader in combating the virus. The country has had only one Covid-19 death so far. [...] As one wag on Twitter joked: if you’re asking why death rates are so low in Germany and so high in America, it’s “because their president used to be a quantum chemist and your president used to be a reality television host”. Angela Merkel, who has a doctorate in quantum chemistry, is actually the chancellor not the president, but the sentiment still holds.
Nicky Case, working with security & privacy researcher Carmela Troncoso and epidemiologist Marcel Salathé, came up with this fantastic explanation of how we can use apps to automatically do contact tracing for Covid-19 infections while protecting people’s privacy.
Singapore had been a master class in how to handle the Covid-19 outbreak. Before the disease even had a name, the country had stringent travel restrictions and an efficient contact-tracing operation which contained the virus's spread. But in recent days, the number of confirmed cases has rocketed. Thursday brought the highest day of new infections to date at 287, up from 142 the day before. Mostly, these are coming from densely-packed migrant worker accommodation. Having avoided it for months, Singapore is now under a partial lockdown, with schools and non-essential businesses closed, and people urged to stay at home. Experts say one of the world's wealthiest nations - which seemed to be doing everything right - has important lessons for poorer countries, and there's still time to put them in place.
Tightened border controls, agile health departments, tech platforms, and a hand-washing song that went viral have added up to a frugal but highly effective response to the threat of COVID-19. The country's success provides a model that other developing and emerging economies should follow.
Sweden's Relaxed Approach to the Coronavirus Could Already Be Backfiring / Time
I object to the title, which makes no sense; this is otherwise an interesting look at Sweden:
As many public spaces throughout Europe empty out—with citizens only leaving home for essential groceries or medication—life in Sweden is carrying on, mostly as usual. Children walk to school while adults meet up for dinner at their local bar. Only the vulnerable have been advised to isolate and some are working from home. Yet in Sweden, where there are 9,141 confirmed cases and 793 people have died, experts worry weaker measures may be leading to a more severe outbreak in the country of just 10 million citizens.
I have had fringe contact with more epidemiology than usual as of late, for obvious reasons, and I do understand this is only one corner of the discipline. I don’t mean this as a complaint dump, because most of economics suffers from similar problems, but here are a few limitations I see in the mainline epidemiological models put before us.