Managing Population Immunity

Flavio Toxvaerd and Robert Rowthorn present a new paper analysing the effects of treatment of and vaccination against infectious diseases, such as COVID-19, on herd immunity. They also discuss socially optimal policies for such pharmaceutical interventions in contrast to non-pharmaceutical interventions (NPIs) like lockdowns or social distancing.

Do social distancing laws reduce consumer spending? Not necessarily! Lessons from Sweden and Denmark

Using transaction data from a big Scandinavian bank, Asger Lau Andersen, Emil Toft Hansen, Niels Johannesen, Adam Sheridan compare the impact of social distancing laws on consumer spending in Sweden and Denmark, two countries that chose vastly different approaches in containing the pandemic. Their findings suggest that most of the economic contraction is caused by the virus itself and occurs regardless of social distancing laws.

German study relates easing of restrictions to economic costs and benefits: Step-by-step re-opening preferable

A study by the ifo Institute and the Helmholtz Centre for Infection Research (HZI), conducted in April 2020, finds that economic interests and health policy objectives are not necessarily in conflict when it comes to the speed of easing of restrictions: Their scenarios show that a quick re-opening, promising short-term economic benefits, increases the overall costs in the long-run. A gradual relaxation of measures, in turn, limits economic costs while helping the containment of the virus. 

Underestimated option? Repurposing drugs for treatment of COVID-19

With the main focus on finding a COVID-19 vaccine, policy makers and industry have paid less attention to the development of therapeutics. Within this field, Susan Athey, Rena Conti, Richard Frank and Jonathan Gruber show, the repurosing of existing drugs for treatment of COVID-19 diserves special attention, as the safety of these drugs is already established and their manufacturing well understood. Given that this path is less attractive for private sector investors in comparison to the development of new drugs that can be sold at higher prizes, the authors propose a three-part plan for the U.S. government to incentivice investment and studies into repurposing drugs for COVID-19 treatment. The plan suggests among other things public-private partnerships, clinical development networks and premiums paid for successfully bringing repurposed drugs to the market.

Contact Tracing Apps: A Technology in Need of Testing and Trust

by Augustina Baker of (USA)

The past few months have put the world on a red alert.

Almost all countries have been hit with cases of the novel coronavirus. A sense of panic spread as the daily numbers grew exponentially for a short period.

Right now, governments and healthcare workers are more on top of things. With that, though, the curve is not yet flattened.

That has birthed different concepts of how to eradicate the virus, one of which is the contact tracing apps.

The Tech Behind Contact Tracing Apps

Contract tracing apps are used to trace contacts digitally. What contacts, though?

Manual contact tracing has long been established as an evidence-based approach to defeating the spread of infectious diseases. The COVID-19 is not the first global outbreak, which has given the healthcare sector the time and practical experience to perfect manual contact tracing.

Under this program, healthcare workers seek to identify those that might have come in contact with a confirmed infected case so that they can be isolated.

The diseases that require such measures are highly infectious ones. If the contacts are not moving, they won’t be infecting others. When they aren’t infecting others, the numbers keep going down.

While areas like California, New York, and Massachusetts have thrown a lot of manpower behind manual contact tracing, a majority of regional and national administrations may be waiting on digital contact tracing to get the job done.

That is where these apps come in.

Using the Bluetooth and GPS function on smartphones, healthcare officers can identify those that a positive contact has been around in the recent past. All smartphones with these apps on them will interact with one another in the background, storing data that allows them to be used to map one another later. Should one of the smartphones belong to an infected person, it is used to identify all other smartphones that might have been in the same areas as this infected person.

The course of action from here could be to send a message to such contacts to observe self-isolation for 14 days to be sure they do not have the virus already. An alternate course of action would be the evacuation of said persons by healthcare officials to designated isolation centers where they could be better monitored.

The Flaws of Contact Tracing Apps

However, with exposed backdoors in hardware and the increasingly commonplace nature of facial recognition systems, people have lost trust in government’s use of surveillance technologies over the years.

An ExpressVPN survey on contact tracing apps shows that more than 80% of the American adult population are positive that the government will tap into the data generated by these apps. Not even the promise from Apple and Google that the data will be locally stored on user’s phones is dissuading that thought.

The problem with this mindset is that the adoption rate of the app is affected. For digital contact tracing to work, about 80% of all smart phone users need to download and use the app. Take out the numbers that do not trust the government and big tech companies, and the adoption rate drops well below the required threshold. Even Singapore, which has had a head start on this project, has yet to attain a 30% adoption rate.

Say government intrusion and privacy were no issues. The numbers still do not account for people in rural areas, and those who do not have smartphones. After all, to get those apps means using an Android or iOS device. Even for those who have one, it would have to be a relatively new unit so that it is up to the task.

Final Word

This is not the time to throw all our weight behind an untested system, which the public is not warming up to. There needs to be more time for testing, integration with the public, and reinforcement of privacy-focused promises. Else, contact tracing apps will just become another lofty idea.

Uncertainty and decision-making during the COVID-19 crisis

COVID-19 has become a major challenge to policymaking. In a context of high uncertainty, rapidly changing circumstances and a highly fluid base of evidence and scientifically-grounded predictions – policy-makers have to take decisions on which human lives and the economy depend. Using ideas and constructs from modern decision theory, the authors of this paper propose ways to arrive at decisions that remain valid for a wide range of futures and keep options open, while allowing for a responsible and transparent policy-making process.

Rotation as Contagion Mitigation

In their new paper, Jeffrey Ely, Andrea Galeotti and Jakub Steiner study how to organize workforce rotation in order to minimize the risk of contagion. Frequent rotation may be advisable if an organization is able to detect/react to infections quickly. Infrequent rotation is optimal when organisations react slowly.

Triage Protocol Design for Pandemic Rationing – new scheme practiced by hospitals of the University of Pittsburgh

Rationing of medical resources is a critical issue in the COVID-19 pandemic. In this paper, Parag A. Pathak, Tayfun Sönmez, M. Utku Unver, M. Bumin Yenmez develop a model for rationing through a reserve system rather than the so far dominant priority point system. In a reserve system, resources are placed into multiple categories. Priorities guiding allocation of units can reflect different ethical values between these categories. A reserve system provides greater flexibility because it does not dictate a single priority order for the allocation of all units. Instead it allows to balance competing objectives. The paper also discusses several practical considerations with triage protocol design.

The proposed reserve system has been put to a test when the 40 hospitals of the University of Pittsburgh Medical Center recently had to ration the antiviral Rendesivir and employed the system to steer allocation.

Plasma Shot and Market Design – proposed scheme now in practice

A promising new quasi-vaccine technology is to use anti-bodies from recovering covid-19 patients to provide vaccine-like protection. This technology is entering clinical trials. Effective supply is quite limited due to the need to acquire plasma from recovering patients: how to increase availabitity of COVID-19 convalescent plasma (CCP) and how best to allocate it is studied by Scott Kominers, Parag Pathak, Tayfun Sönmez, and Utku Ünver. This research is a fusion of medical science and social science and illustrates the benefits of collaboration.

The researchers’ proposed incentive based scheme to increase access to CCP therapy has had remarkable impact latey, as the US-based Covid Plasma Initiave decided to adopt the scheme.