Wednesday, March 17, 2021

When a Virus Stays Viral

Last year I posted "When a Virus Goes Viral"   - 

Since then, I grew and shaved a corona beard:

I created parody songs - "Coronaville" (below),  "My Corona" (which I made for my coworkers and has some inside references) and I put a spin on some holiday favorites ( like Baby There's Covid Outside).

I made some good progress on my Netflix backlog. 

It seem the rest of the world has been doing the best it can to get through the pandemic. How are you doing folks? 

I wanted to do some reflecting and revisiting. As a recap, there are 3 items that I was curious about: 

  1. Irrationality
  2. Evolutions in risk modeling
  3. The post-COVID world. 

Disclaimers: These observations are U.S. oriented.

Decision Making Under Uncertainty (and Consequences)

Did we overreact or underreact to Corona?  

I have no idea. 

Obviously, this is a bit of a loaded question.  They key ingredient to answering this question is the yardstick by which you measure it. And in many dimensions, I don't think we had any specific targets to hit. 
  1. Did we 'flatten the curve'? Let's imagine that Corona would cause a million hospitalizations, no matter what. The only 'control' you have is to spread out when those hospitalizations occur over some time horizon. I would argue that we were generally successful in buying time for vaccine research and for hospitals to stock up on supplies. I want to try to be objective, so let's say the goal was to delay the peak of hospitalizations by six months, then I think we were able to do that in most cases.

  2. Have we lost too many lives? This is a tough question to answer. It may be tempting to compare death rates in states that have strong interventions vs. states that do not, but for a variety of reasons those type of comparisons may be misleading. I find a lot of the death reporting to be frustrating.  Things like comparing total deaths from COVID to 9/11 or World Wars isn't particularly helpful. In the same way that you track a stock against industry benchmarks, we need compare Covid-19's fatality rate against other similar infectious diseases.

    At the time of outbreak, we weren't sure what to expect. But we started with a couple of benchmarks: 1918 Flu or something like Seasonal Flu or Pneumonia. Knowing what we know now, it seems somewhere in between, but very dependent on age of death. The Case Fatality Rate, crudely, seems to be settling at around 2%.

    The expected value of deaths would be the number we'd want to track our experience against. Then we can assess what drives the distance between observed fatalities and expected. Probably best viewed by age cohorts.

This can help us gauge how deadly the disease is. But case fatality is only one dimension. Deadliness become more of an issue based on how easy it is for the disease to spread. And while there have been multiple debates about what deters spreading vs encourages it, the asymptomatic carriers have made this little spikey guy a fairly adept spreader. This is particularly troubling when there is an outbreak in nursing care homes. This brings us to LOCKDOWNS...

3. Did the lockdown measures increase NON-COVID deaths? Estimating the "toll" of shutdown is hard math to do.  It is hard because it is difficult to measure and it is hard because you have to pick who dies. There are some people looking at this type of concept, a sort of price tag or risk tolerance on saving lives. Others say any human life is priceless. I don't know what the right answer is, but if you are arguing for restaurants and bars to open up, tell me how many grandma's you are willing to kill. Conversely, if you want to save your grandma's life, tell me how many of your neighbors should lose their homes or jobs. 

Most importantly, I think in the discussions, we need to be careful to avoid resulting. Instead, try to discuss the approach instead of the outcome. When the next pandemic hits, what strategy will give us the best odds of getting good results?

Risk Modeling:

Over the past year there have been some crazy modeling debates and scrutiny over extrapolation and issues with excel files.  For a recap on all the issues with modeling challenges, I recommend the 538 piece. "Why It's Hard to make a Good COVID-19 model"

Things I am seeing:
  • Extended/long term shocks vs. immediate large hits
    • "long COVID" impairments
  • Narrative based scenarios
  • Cluster based/super spreader epidemiology models
  • Asynchronous economic impact modeling (retail goes down except for Amazon, restaurants down but grocery is up)
As an aside, I also got the chance to be part of a professionalism webcast where we considered to what degree an actuary might rely on or use an epidemiological model. For more on reliance, see the ASB website.

The World Post-COVID

From time to time people say that they are eager to get 'back-to-normal.' Last year I made the claim that "normal" as we knew it was dead. I stand by that. Many things have changed permanently. 
  • Prevalence of Remote Workers: White collar industries went remote basically overnight. Some other downstream/tangential effects:
    • Remote working technology will continue to improve
    • Hiring/labor sourcing practices will continue to evolve
    • Exodus from cities if commuting is no longer a concern
    • Healthcare delivery, teladoc as primary family care mechanism?
  • Domination of the online economy:
    • Companies moving to online ordering - fewer jobs for retail/in-person banking/servers
    • Gaming/entertainment revenues - shift to streaming
    • Closer to a cashless economy?
  • New education models:
    • More remote learning options at all levels
    • Universities will need to adapt
    • More alternative school schedules (less than full time)
  • Travel practices:
    • Always masking (more masks in public)
    • Bailouts/consolidations ahead - cruise lines, airlines
  • Health/hygiene
    • Managing sickness in care facilities
    • Changes in labor force in healthcare (burnout, new levels of care)
    • Digital and robo-health
    • Increased emphasis on mental illness/loneliness issues
    • More RNA style vaccinations
  • Family Dynamics
    • Cohabitations: kids or parents moving in with each other
    • Increase in 'stay-at-home' parents
Probably more, but for today's reflection I think this should be enough.  As we enter 'vaccination phase' of the pandemic, I expect that the bigger concerns in the next year will be as follow us:

  1. ECONOMIC RECOVERY post pandemic (how do we recover all the bailout, relief money?)
    1. How do rental markets/evictions unfold?
    2. Relocation effects?
    3. Company Mergers/Acquisitions - particularly in travel and entertainment
  2. COVID MUTATIONS and evolution.
Personally, I just hope we can get back to live music again!

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