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You are here: Home / Anderson On Health Insurance / Asymmetry of risk

Asymmetry of risk

by David Anderson|  March 3, 20218:48 am| 64 Comments

This post is in: Anderson On Health Insurance, COVID-19 Coronavirus

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Right now, US COVID case counts are done to early Fall levels. We have a lot of good news on the vaccine front.

Three weeks ago, I announced we would have enough vaccine supply for all Americans by the end of July.

Now, with our efforts to ramp up production, we will have enough vaccines for every American by the end of May.

— President Biden (@POTUS) March 2, 2021

We are starting to see a drop in deaths due to vaccination of the most at risk populations.

We have a significant risk of variants leading to immune evasion and vaccine efficacy reduction. Variants are more likely to occur and if they do occur, more likely to be widespread if there is a high background level of spread and infection.

We have a major COVID relief bill likely to be signed in the next ten days.

We have states that want to YOLO it.

As Texas and Mississippi move to open "100%" and lift mask mandates, health officials warn: "It’s still too early." https://t.co/4Mn3JyJOeG

— The Washington Post (@washingtonpost) March 3, 2021

We have an asymmetry of risk. A state re-opening too early by a week has far more consequences than a state re-opening a week too late. A state re-opening too early will marginally increase the risk of variant spread and variant emergence. That risk is not limited to only the state or only the people in the state whose behavior changes. It could generate large and negative externalities. And if there is an increase in cases, the return of normal commerce won’t happen as people are mostly following relative risk instead of public policy. A state that re-opens a week too late may have some small and mostly internalized costs but they are not generating negative public health externalities.

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Reader Interactions

64Comments

  1. 1.

    Another Scott

    March 3, 2021 at 8:58 am

    Yup.

    Abbott and the rest of the RWNJs in office can tell people that masks make you a girly man, but people have their own agency.

    Here’s hoping that sensible people keep telling people the truth and avoid getting into the mud with the trolls.  The truth will come out and be unavoidable over the next 3-6 weeks…  :-(

    Thanks.

    Cheers,
    Scott.

  2. 2.

    Starfish

    March 3, 2021 at 9:04 am

    The problem with states like Texas and Mississippi is that they have grown men wandering around in public BULLYING people for wearing masks. Somehow, these manly men, think bullying seventy-year-old women for wearing masks in the Walmart during senior hours is okay. Instead of addressing their culture of anti-mask bullying, these governors are siding with the bullies whose peckers will fall off if they put a piece of cloth over their stupid faces.

    This is the head of the department of public health in Mississippi shortly after the governor opened his mouth.

    To prevent COVID transmission and protect patients – MSDH guidance still necessitates the use of masks and other measures to prevent COVID-19 transmission in healthcare settings.

    Please see https://t.co/hfl3hivFVL for details.

    Thanks, TDobbs
    — thomas dobbs (@TCBPubHealth) March 3, 2021

  3. 3.

    Mousebumples

    March 3, 2021 at 9:11 am

    https://twitter.com/alamodrafthouse/status/1366957115747799044?s=19

    Alamo Drafthouse is ignoring the Governor and following the science. I don’t live in Texas, but I would expect that people like me (and us, probably, based on what I hear from most Juicers) would support them over others, especially as we get vaccinated.

  4. 4.

    bbleh

    March 3, 2021 at 9:12 am

    Lol, and since when have Republicans ever cared about externalities? See also under environmental pollution etc.

  5. 5.

    Starfish

    March 3, 2021 at 9:16 am

    @Mousebumples: The governors doing this are foisting the work on the mayors and the corporations. What we learned earlier this year is that this piecemeal district-by-district, city-by-city regulation does not work because the anti-maskiest people will just go to the least restrictive place nearby.

  6. 6.

    ant

    March 3, 2021 at 9:27 am

    It’s certainly problematic that Republican politicians are not held accountable for bad policy decisions.

    All Republican voters care about is that white men are in charge, and that those white men keep everyone else in their place.

     

    Covid and vaccine distribution is an irresistible vehicle for reinforcing inequality for conservatives.

  7. 7.

    🐾BillinGlendaleCA

    March 3, 2021 at 9:29 am

    Conservatives and Libertarians do not understand externalities, they all took the Econ survey course in college and did quite well and thought they’d mastered the subject.  Unfortunately, when the professor waved off externalities and said they’d be covered in the principles course, they thought he was saying hi and waved back.

  8. 8.

    David Anderson

    March 3, 2021 at 9:32 am

    @Starfish: One of the best things my parents did as parents to me was insist that they were always willing to take the blame for being uncool and restrictive if I ever felt like I was in a weird spot and needed a face saving exit excuse.  As a 15 year old, blaming the parents for being uncool was far easier to do than explicitly standing up to my peers and their occassionally shitty ideas.

     

    A good chunk of law is like that.  It puts backbone into peer-pressurable people because the blame is directed elsewhere.

  9. 9.

    evodevo

    March 3, 2021 at 9:42 am

    @David Anderson: ​
      Yes. This. A small business cannot afford to anger the maskless idiot customers and lose them, and possibly have to close. But if they can say they are just following the state/federal mandate, well…. This applied bigly during the desegregation era…you might want to desegregate on your own, but local pressure would prevent that….having the CRA to point to, however, took the burden off you and all the other locals, and you could just point out that you were following the law…and if the local Klan tried anything, the Fibbies were technically supposed to come in and investigate and force them to toe the line. It’s the ONLY way to get something done sometimes…and we are rapidly approaching that era again, unfortunately.

  10. 10.

    Cheryl Rofer

    March 3, 2021 at 9:43 am

    @David Anderson: Absolutely! Works in bureaucracies too! “It’s company policy.”

    What Abbot and Reeves are doing is clearly coordinated – they made their announcements a half-hour apart. The Republican Party in New Mexico also was whining at our governor to remove the oppressive public health mandates yesterday. It would be interesting to know how far coordinated this is. Looks like Biden may be able to get a handle on the pandemic with the vaccine rollouts and generally good behavior. Can’t allow any triumphs to Democrats, even if it means that some (others) are going to die.

  11. 11.

    Freemark

    March 3, 2021 at 9:43 am

    @bbleh: According to Republicans negative externalities don’t matter. If they even exist. I mean streams,rivers,bays, oceans can hold infinite amounts of pollution and that pollution will have no effect on anything else.

  12. 12.

    🐾BillinGlendaleCA

    March 3, 2021 at 9:47 am

    @Cheryl Rofer: They’re trying to recall our Governor for the state mandates and closures.

  13. 13.

    Freemark

    March 3, 2021 at 9:48 am

    @🐾BillinGlendaleCA: ​
     You are so right. I’ve had numerous Republican and libertarians tell me how they have a great understanding of economics. But mention externalities and they are like ‘huh, what’. I’ve even been told I made the idea up.

  14. 14.

    Redshift

    March 3, 2021 at 9:50 am

    Someone yesterday commented that the Abbott wing of the GOP believe that restrictions and “lockdowns,” not the pandemic, are the cause of all the economic woes.

    In fact, it’s not just Abbott types, it’s now the absolutely mainstream Republican belief, along with the certainty that the only reason schools weren’t open six months ago is because Democrats are under the thumb of “powerful” teachers unions.

    The least crazy GOP candidate for governor of Virginia (where the GOP is far from the craziest in the country) is running on these two points, along with the usual culture-war BS and being “pro-police.”

  15. 15.

    rikyrah

    March 3, 2021 at 9:51 am

    The muthaphuckin’ EVIL of dropping COVID restrictions NOW

    After both those muthaphuckas have been vaccinated.

    While the Capitol City of Jackson hasn’t had drinking water in TWO PHUCKING WEEKS.

    I simply despise them.

  16. 16.

    Goku (aka Amerikan Baka)

    March 3, 2021 at 9:56 am

    @🐾BillinGlendaleCA:

    Are you concerned about that yet? What are the chances the GOP could shove a Republican into the CA governorship?

  17. 17.

    Anonymous At Work

    March 3, 2021 at 9:59 am

    But like all externalities, market-failures by definition, the cost is borne by “other people”, so the leadership of Texas and Mississippi have an asymmetrical benefit from publicity whoredom and cries of “FREEDUMb!!!”  And, like externalities tend to show, people respond to their actual incentives, not the ones that neoclassical economists theorize that they do.

  18. 18.

    The Moar You Know

    March 3, 2021 at 10:00 am

    I think the GOP plan for good governance is to kill as many Americans is possible and I’m not joking about that.

  19. 19.

    Almost Retired

    March 3, 2021 at 10:00 am

    Ugh.  Texas.  We had plans to go to Austin and San Antonio for Spring Break in early April, but since I’m unvaccinated, those plans were canceled (cancel culture!).  I really want to go all Grapes of Wrath on their asses and position the LA County Sheriff’s office on the West Bank of the Colorado River to keep any Texans and Mississippians from entering the state.

  20. 20.

    Nicole

    March 3, 2021 at 10:03 am

    @The Moar You Know:

    I think the GOP plan for good governance is to kill as many Americans is possible and I’m not joking about that.

    I would wager money that some conservative think tank did at least a preliminary “analysis” of whether so many seniors dying from Covid would reduce Social Security obligations.

  21. 21.

    BruceFromOhio

    March 3, 2021 at 10:05 am

    @The Moar You Know: ​
      This, and neither is the GQP.

  22. 22.

    🐾BillinGlendaleCA

    March 3, 2021 at 10:07 am

    @Goku (aka Amerikan Baka):

    Are you concerned about that yet?

    No.

    What are the chances the GOP could shove a Republican into the CA governorship?

    Only if they could come up with another Governator, they don’t have another Governator.

    The reason for the recall is the restaurants and gyms are pissed off due to being closed.  I understand many of them are taking it in the shorts(still having to pay rent, even if it’s deferred), but Gov Gav is the wrong target.

  23. 23.

    The Moar You Know

    March 3, 2021 at 10:10 am

    What are the chances the GOP could shove a Republican into the CA governorship?

    @Goku (aka Amerikan Baka):  Zero.  If they succeed with a recall my hope is that they will get another and frankly a much better Democrat for their pains.  But we’ll probably just get more Gavin.

    They won’t succeed either.

    And yes, what was said above, all this shit is about not giving Dems the win on COVID.  Because the media are irresponsible shitheads, they gave Trump’s Surgeon General a platform to bawl out that half doses of vaccine are all anyone needs.  They really are trying to sabotage this as hard as they can.

  24. 24.

    Rick

    March 3, 2021 at 10:12 am

    Well, it will likely largely be Repubs who get infected so let’s let God and Darwin sort them out.  Fewer Repubs voting in November…

  25. 25.

    JKC

    March 3, 2021 at 10:15 am

    @The Moar You Know: I would love to say that you are engaging in hyperbole. Alas, the evidence suggests otherwise.

  26. 26.

    BruceFromOhio

    March 3, 2021 at 10:17 am

    I’m informally connected to a group of creative folk in Austin, TX. Having just survived the snowpocalypse, to a person each is stunned and angry that TX leadership would do this. Some interesting messaging going around is “they tried to kill us by fucking up the electrical grid, now they are trying to kill us with COVID.”

    And any business owner trying to enforce masking may just as well paint a giant target on their business, their employees, their back and chest for every knuckle-dragging gun-toting Dog-fearing TEXAS MANLY MAN, as those soulless sonsabitches are gonna treat this like a holiday for being even shittier human beings. Forecast a spike in infections and incidents of violence by anti-maskers.

  27. 27.

    A Ghost to Most

    March 3, 2021 at 10:26 am

    @Almost Retired: Those Texassan assholes consider CO their playground, and their selfishness really shows on the 4×4 roads. The redeeming value is the number of Texassans who die here every year doing assholish things.

  28. 28.

    Goku (aka Amerikan Baka)

    March 3, 2021 at 10:33 am

    @The Moar You Know:

    They won’t succeed either.

    Why do you think this?

    @The Moar You Know:

    And yes, what was said above, all this shit is about not giving Dems the win on COVID.  Because the media are irresponsible shitheads, they gave Trump’s Surgeon General a platform to bawl out that half doses of vaccine are all anyone needs.  They really are trying to sabotage this as hard as they can.

    Probably. But I don’t think it’s going to work tbh. Republicans are absolutely pissed right now that Biden and the Dems will get credit for ending the pandemic and saving the economy

  29. 29.

    dexwood

    March 3, 2021 at 10:38 am

    An old  lamentation still rings true for my state sometimes, though, I know some pretty damn good Texans.

    “Poor New Mexico! So far from heaven, so close to Texas!”  Manuel Armijo, Mexican governor of the territory of Nuevo Mexico, 1841.

  30. 30.

    Goku (aka Amerikan Baka)

    March 3, 2021 at 10:38 am

    @🐾BillinGlendaleCA:

    Well, I’m glad that this won’t likely succeed in shoving in a Republican at least

  31. 31.

    Barbara

    March 3, 2021 at 10:40 am

    You can expand opening of restaurants and other public spaces while still mandating masks, which is what we have been doing in Virginia. But this “all or nothing” approach to public health demonstrates without any doubt, IMO, that Abbott is chasing the political equivalent of a sugar high in a desperate quest to change the topic from the calamitous failure of the state’s power grid, and the regulatory body that is under the direction of people that were mostly appointed by him. Like promising your kids they can eat dessert at every meal in order to distract them from the fact that you are refusing to pay child support to their mom and that’s why she can’t afford to buy them new shoes.

  32. 32.

    taumaturgo

    March 3, 2021 at 10:40 am

    Get the vaccine, keep social distance and wear your mask. If you go out and don’t see these 3 rules implemented, walk away and allow the fools to be the only way they can be. Remember, “this too shall pass.”

  33. 33.

    Ksmiami

    March 3, 2021 at 10:40 am

    @Another Scott: if I were Biden, I’d threaten to withhold aid to these states and I’d threaten to move bases unless they reinstated the ban. These governors endanger  us all

  34. 34.

    JMG

    March 3, 2021 at 10:41 am

    Here in Mass., Gov. Baker has FINALLY made teachers and school staff vaccination eligible. I think Biden shamed into it with yesterday’s announcements. I’ve had a lot of good times in Texas, so it saddens me I probably won’t be able/willing to go back — like ever.

  35. 35.

    WaterGirl

    March 3, 2021 at 10:43 am

    @Ksmiami: I think Joe will give states another week or two and then will step in with more vaccination sites that follow CDC recommendations and not state recommendations.

  36. 36.

    BruceFromOhio

    March 3, 2021 at 10:45 am

    @Goku (aka Amerikan Baka): ​
     

    Republicans are absolutely pissed right now that Biden and the Dems will get credit for ending the pandemic and saving the economy

    This would be fascinating if it wasn’t so deadly, the GQP had all last year with all three branches of government to do the same, and not only decided NOT to do much about it (okay, yes, they did pass some economic relief) but vehemently fought against doing more.

    It seems irony is alive and well, chilling on the beach somewhere, letting all calls roll to voicemail.

  37. 37.

    Barbara

    March 3, 2021 at 10:45 am

    @JMG: Charlie Baker and Larry Hogan may be outliers in the Republican party, but their record in vaccinations really brings home that they are still Republicans, and still not above sticking it to people who are unlikely to vote for them.

  38. 38.

    Another Scott

    March 3, 2021 at 10:49 am

    @Ksmiami: Biden should continue to do his job and ignore the performance politics of people like Abbott.  Abbott wants distraction and culture war stuff.  Biden can do a lot of good without giving Abbott what he wants.

    If he does play hardball, he should do it quietly, behind the scenes.

    We don’t win by letting the RWNJs set the term of the contest.

    My $0.02.

    Cheers,

    Scott.

  39. 39.

    trollhattan

    March 3, 2021 at 10:52 am

    It’s not news that Greg Abbott is a monster, but he’s an aggressive enough monster to warrant pointing it out more or less continuously. He’s hellbent on killing more Texans. Odd, that.

  40. 40.

    Frank Wilhoit

    March 3, 2021 at 10:58 am

    David,

    Suppose — just suppose — someone who lives in a relatively “safe” state travels to Texas, contracts COViD, spends months in hospital, runs up top-line charges in the seven figures…

    …and their insurer subrogates to the state government of Texas?

    I quite realize how deeply hypothetical that all is, but how, in principle, might something like that work?

  41. 41.

    burnspbesq

    March 3, 2021 at 10:59 am

    @Mousebumples:

    Paxton will find some pretext on which to sue businesses that try to exercise common sense.

  42. 42.

    Lyrebird

    March 3, 2021 at 11:01 am

    @David Anderson: A good chunk of law is like that. It puts backbone into peer-pressurable people because the blame is directed elsewhere.

    Yes it sure seemed back in the fall like some R governors who are *not* sickos at the Noem level were really really hoping Biden would win so they could blame him but also get the death rates down in their states!

  43. 43.

    Benw

    March 3, 2021 at 11:02 am

    @rikyrah: it’s monstrous. I want them held accountable for mass murder

  44. 44.

    burnspbesq

    March 3, 2021 at 11:03 am

    @Almost Retired:

    position the LA County Sheriff’s office on the West Bank of the Colorado River to keep any Texans and Mississippians from entering the state.

    San Berdoo and Riverside County guys not good enough for ya?

  45. 45.

    Freemark

    March 3, 2021 at 11:04 am

    Of course you need to remember that to Republicans YOLO means ‘Yell Out Loud Often’.

  46. 46.

    Soprano2

    March 3, 2021 at 11:07 am

    @The Moar You Know: It’s actually to kill as many of “those people” as possible. In MO, the big vaccination events are being held at least 80-100 miles from any large city. That’s on purpose, they want all the yahoos in the sticks to get vaccinated before the people in the cities can get it. Which is dumb, since the two largest cities both have more than one sports stadium sitting empty and unused right now, they could be using them as vaccination sites and their right in the cities! But, you know, that would help “those people” and the mayors of those cities, who are also “those people”, so of course we can’t be having that at all.

  47. 47.

    burnspbesq

    March 3, 2021 at 11:08 am

    @Frank Wilhoit:

    Wouldn’t the state have sovereign immunity?

  48. 48.

    Almost Retired

    March 3, 2021 at 11:10 am

    @burnspbesq:  Actually, I botched my history and my Steinbeck reference.  It was the LAPD that instituted the “bum blockade” at the state border in the mid 1930’s.

  49. 49.

    burnspbesq

    March 3, 2021 at 11:12 am

    @Soprano2:

    True around here as well. If you live east of I-35 in metro Austin, good luck finding a place to get vaccinated.

  50. 50.

    Almost Retired

    March 3, 2021 at 11:19 am

    @Soprano2:  That seems to be a trend.  Here in Los Angeles, the vaccination rates in some of the affluent communities on the Westside are approaching 30%, while rates in working class neighborhoods to the east and and southeast are in the single digits, despite the concentration of front line workers in those neighborhoods.  Some of it can, I suppose, be attributed to the older population in affluent neighborhoods, but it sure looks like white Angelenos are doing quite well in the vaccination derby.

  51. 51.

    James E Powell

    March 3, 2021 at 11:26 am

    @Almost Retired:

    I have seen & heard people talking about these disparities, but haven’t seen where the data is coming from. Do you have a source? 30% seems awful high.

  52. 52.

    Almost Retired

    March 3, 2021 at 11:29 am

    @James E Powell:   This morning’s Los Angeles Times.  28% in Brentwood, 24% in South Pasadena vs. less than 7% in parts of South LA.

  53. 53.

    🐾BillinGlendaleCA

    March 3, 2021 at 11:31 am

    @James E Powell: Those numbers are correct, I mentioned it last night after looking at the LA County website.

  54. 54.

    🐾BillinGlendaleCA

    March 3, 2021 at 11:33 am

    @Almost Retired: I think Beverly Hills, PV, and PV Estates were at about 30%.

  55. 55.

    Ksmiami

    March 3, 2021 at 11:48 am

    @Another Scott:  we don’t win by not pushing back on GOP monsters either – in fact our silence enables the monsters to grow stronger

  56. 56.

    cmorenc

    March 3, 2021 at 11:53 am

    I’m freshly back from a week in Grand Junction, Colorado, where the big-box Home Depot Hardware store had clear signs at the front door “mask required for entry” and all employees and by my rough but accurate estimate 70% of customers were fully compliant and about 20% in partial compliance (mouth covered, but noses completely sticking out) – but about 10% of the customers brazenly walked in and about with no mask on nor in possession of such, and no apparent intention to comply. Store employees at customer service or otherwise going about the normal business of stocking shelves and helping customers didn’t seem to be making the slightest effort to even tactfully challenge the brazen non-compliers. BTW: Grand Junction is in Colorado’s 3rd Congressional district, which elected the RW gun-toting loon Lauren Bobert by about 6% over democrat Diane Bush.

    By contrast, back here in Raleigh at my local Home Depot, there is 100% at least nominal compliance (the qualification being that some aren’t trying very hard to keep their the nose covered). And so, perhaps the staff simply isn’t very often faced with instances of maskless people brazenly walking in and around the store – so I don’t know how firm they would be if faced with such instances as I witnessed in Grand Junction. I find myself going to HD for something or other at least once every week, so I am going by that limited sample of experiences

  57. 57.

    Barbara

    March 3, 2021 at 12:11 pm

    @Lyrebird: ​ I am even more cynical. I think Trump and Republican governors hoped that Biden would get sick. I am sure Biden’s team realized that as well and responded by being even more cautious. I think it was the right thing to do, but I am certain that the asymmetry in campaign intensity in the last month hurt Democratic results. One and all, these people belong in Hell.

  58. 58.

    Barbara

    March 3, 2021 at 12:19 pm

    @Almost Retired: ​ There is no way that disparity will not occur when you create eligibility criteria hoops to jump through. A lot of people most in need of being vaccinated are least able to jump through those hoops. When supply is limited, you can still argue that eligibility filters are the better, more responsible and ethical choice, but you do have to realize that a lot of people are being left out not because they don’t qualify but because they cannot navigate the maze.

    How many people have posted here that they accepted an offer of the vaccine even thought they felt a certain amount of inquietude that someone in greater need has not had it yet? What would the alternative be, exactly, to not taking the vaccine when it is offered? Many of those white, wealthy Angelenos probably have the same feelings.

  59. 59.

    Almost Retired

    March 3, 2021 at 12:44 pm

    @Barbara:  Yes, all this is true.  But it still seems like with a little administrative creativity, the County (or City or whoever) could supplement the current computer-and-stadium format with some low tech outreach to those communities (phone appointments, pop-up vaccination clinics in low-income neighborhoods, etc).  I don’t know if that’s feasible, insofar as I have no experience in public health or immunology.  But it’s not like that’s going to stop me from throwing around lightly-informed opinions!  That’s what blog comments are for!!

  60. 60.

    JaneE

    March 3, 2021 at 1:10 pm

    @trollhattan: I don’t find it odd at all.  I think Republicans know that something like 70% of the people will take the vaccine when they can get it and want to run up the body count before that happens.  Yes, I do believe that they want to kill people, or at least want them to die.

  61. 61.

    ColoradoGuy

    March 3, 2021 at 2:27 pm

    I have to agree with JaneE. Yes, the Republicans are that vicious. They would start a civil war tomorrow if they could. As it is, they’ll settle for pandemicide.

  62. 62.

    Chris T.

    March 3, 2021 at 4:09 pm

    @bbleh: Lol, and since when have Republicans ever cared about externalities? See also under environmental pollution etc.

    How to get a Republican to care about externalities:

    1. Build your house next to theirs (in a rural area with septic).
    2. Don’t put in a septic system. Just run pipes from your toilets to the edge of your yard so that the waste spills into their yard.

    When they complain, tell them you plan to Live Free Or Die, there ain’t gonna be no gummint interference, etc.

  63. 63.

    West of the Cascades

    March 3, 2021 at 5:33 pm

    You know what I’d like to see Oregon’s Governor Brown do? Order the cancellation of all incoming flights from Texas, and bar Texas residents from coming into Oregon. It would be blatantly unconstitutional, but I’d just like to see her order those fuckers to stay as far away from us as possible.

  64. 64.

    West of the Cascades

    March 3, 2021 at 5:34 pm

    @Chris T.: Best make sure you have a few guns first, and that someone in your house is awake at all hours.

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