 Okay, we're back. We're live to give in Wednesday. I'm Jay Fidel. This is Community Matters. We have Mike DeWerd, our Chief Scientist. We're going to talk about the relationship between economic activity in reopening and increased mortality in COVID cases. It's very important discussion. Before we do that, I just want to make a historical benchmark. Today was the day the Department of Justice asked David E. Gay to stop imposing quarantine on trips from the mainland. First, the administration says, you governors, you go do things. And if you don't do them right, we'll blame you. We take the credit, you take the blame sort of thing. And we did do something. The Department of Justice tells them not to do what they wanted to do. But my favorite part is the Court of Appeals reversed Judge Sullivan and said that he had to treat the charges against Mike Flynn as withdrawn, which is a violation of the rule of law. The rule of law she has gone is a terrible day. Mike and I will get over that. We're going to talk about this. Maybe this will make us feel better, Mike. Maybe, but they call economics a dismal science for a reason. So we've had this discussion on the periphery before. We've talked about what the numbers say and projections for how the cases and mortality numbers are increasing or will increase. And surely that's happening now. But the very important discussion is to adjust reopening and with the mortality figures and to try to figure out what's in our toolkit so that we can adjust the reopening in such a way as to keep the mortality cases and the mortality numbers at acceptable levels. This is not easy. I don't think the government thinks like this, but Mike has made an analysis and we really have to hear it and the government should hear it also. So tell us your latest thinking on the relationship, Mike. Well let's go review what we talked about in June 1st. The first slide sort of review of that. We know that to achieve herd immunity via infection in Hawaii will probably have a million people get sick. And if we have the current death rate, we have 26,000 of them die on route to herd immunity. Now herd immunity is a pretty darn defensive term applied to human beings and not just fungible production units like cattle to be treated as one more, one less who cares. So this is really serious. If we do manage to cut the death rate in half towards only the New Zealand death rate of 1.3%, we still lose 13,000 people. So we're asking thousands of our fellow citizens to die in order to reopen the economy quickly. And to put it in context, as we mentioned in June 1st, the annual death rate in Hawaii from all causes before COVID-19 was like 11,500. So 13,500 is more than a whole year's worth of casualties from all of the causes put together. And that's what we're asking for in the best case, the healthcare system doesn't collapse. So and what we also went over on June 1st was that economic recessions, even as bad as the Great Depression, save lives that don't cost lives. Mortality goes down, went down during the Great Depression and life expectancy at birth went up during the Great Depression. And the effects are bigger for minority communities. Minority people gain seven years of life expectancy, whites gain four years of life expectancy during the Great Depression. And these are huge numbers for any kind of public health policy. So when you look at the face of it, look at lives versus lives, there's no contest. Keep the economy locked down as much as you need to to keep the death rate from going up. And that's hard to ask. So then that brings up today's question as well. If we decide to open up the economy and we're going to accept casualties, what is the cost of a human life? What is the value of human life? That's a serious question that economists have actually looked at and studied. So we can't really set an objective value in human life. There's no criteria for saying what is human life worth? But you can ask, you can ask people how much they're willing to accept in order to risk their lives. And an economist named Tom Schelling, who got a Nobel Prize in 2005, actually did this in 1981. He went and he looked at jobs that required similar skills but at different levels of risk. You know, you're more likely to die in this job versus that job even though you need the same skills to do them. And he looked at the pay difference required to entice people into that riskier job. And he found that in 1981, the implied value of a human life was about $3.1 million. Now, since then, other economists have updated the analysis, done more sophisticated versions of it. And in 2020 dollars, the value of human life is about $10 million. So that's where we are. So the value of human life, now there's a few catches and gotchas, rich people tend to accept lower risk. Poor people tend to be a little more desperate except more risk. That implies that poor people's lives are worth less than rich people's lives. That's simply not an acceptable thing for our society to implement. So let's go with the $10 million for human life. In that article, there's a law and analysis done in Wired Magazine on May 11 on this. So they've applied this kind of method. It's called a value of a statistical life, VSL method to the COVID-19 virus. And this was done at University of Wyoming and being done at other places too. But University of Wyoming with it is they computed the cost of not doing anything in terms of dollars. Our economy will take a hit because if 2% of your customers die, well, okay, it's 2% less GDP. And all the other things that go with letting people just die let the virus run. So the cost of doing nothing plus the cost of the lives loss if you do nothing, they compared that to the cost of social distancing. They can find it to that plus the cost of life saved through social distancing and made some pretty fairly optimistic assumptions about how many lives it could save. But they did make realistic assumptions but a little on the optimistic side of it. And they found that the difference between shutting the economy down and saving lives and letting the economy run and whatever happens happens is about over $5 trillion. $5 trillion saved with the shutdown, social distancing and reducing the casualties. That's far more than the stimulus so far. And that's with regard to both the debit side and the credit side. The $5 trillion is a net out number. Right, yeah, net out number, $5 trillion is the net when you take the economic cost plus value of life saved or lives lost. This case may be. Now I've been seeing a similar analysis for Hawaii economists. I hope that you hear a little more working on this, that they are the part keeping it quiet. Because if we assume that we lose 26,000 people by doing nothing, and that's an optimistic assumption because that assumes the healthcare system completely collapse. That's that value of that 26,000 times 10 million dollars is something like 260 billion dollars, 260 billion dollars, 260 billion dollars. And if we cut that in half, we're only losing 130 billion dollars of lives lost. Our entire economy in 19 and 2016, 2016 was only worth like 73 billion dollars. I mean, the value of the lives we're saving by going slow and reopening in a way that only gives us 13,000 casualties is twice, almost twice our gross domestic product for a whole year. And we know the economy isn't going to go to zero. So the value is far greater of what we're going to save by leaving the economy shut down or opening it up carefully and slowly with regard to how many people are going to lose. Now in places where they tried to open quickly, they've had some bad consequences like in Serbia and Croatia, they let Novak Djokovic, the number one tennis player in the world, organize a charity tour of tennis pros playing throughout the Adriatic countries. They had no social distancing. The players partied at night. They played basketball together at night. They danced with their shirts off, swinging them over their heads at the disco. They let the audience come in, thousands of people with no masks, no social distancing. Well, Novak Djokovic came down coronavirus. His wife came down coronavirus. His coach came down coronavirus. Three other highly ranked players came down coronavirus. And one of their coaches came down coronavirus. And there's no word yet on the audience how many came down coronavirus. So we had an example. We have a sporting event. We expected maybe we could do some sporting events. Well, here's a sporting event where they just totally ignored any kind of controls. And they've had consequence number one player in the world has coronavirus. And by the way, this guy, Novak Djokovic also is an anti-vaxxer. He had declared that he would not get the coronavirus vaccine if it was available. Even it was required for him to go to international tournaments. Now, this is, this is hubris. It's also delusion of insulating privilege. He thinks because he's young and fit, you won't die of it. Well, that's great for him. But what about the people you may give it to? What about his wife? What about his family? So this, this is a cautionary tale. Now, other tennis tournaments are going on in the world, but in France, for example, there's no audience. There's nobody in the stands. The players aren't allowed to shake hands. The players are supposed to maintain social distance when they're not on the court. And the balls, they don't, they don't touch the balls except, you know, if a player has touched the ball, nobody else touches it. It gets scooped up and put away without a person touching it. So they're really careful about maintaining social distance. And the U.S. Open has declared, U.S. Open Tennis Tournament is going to do a tournament in August. Well, they're going to have to have it without an audience. And that's going to be very interesting. Be in New York with no, no crowd. The French Open has declared they're going to go in, in September. Well, we'll see how that goes. You'll see how they do right now with the tournaments they are doing with social distancing right now around France and see how that goes. And this isn't just, I'm not, I don't want to just pick on Serbia and Croatia. We're seeing this in this country, Arizona, Florida, California, Texas, they're all seeing big spikes when they try to open the economies. And just this morning in the news, in the Star Advertisers article at Myrtle Beach, they opened Myrtle Beach up for tourism. And you see tourists crowded with no masks, with a swimwear on, just breathing into each other's faces in the elevators. They've had a big spike in coronavirus cases. Right now, they're having their cases double every nine days in Myrtle Beach. And West Virginia traced a bunch of cases in West Virginia to people who had gone to Myrtle Beach for vacation. And now the caution people, you don't do that. It's, it's, we're seeing the effects. And now this is, this could be an example for Hawaii, you know, Myrtle Beach's approach isn't going to work because we get 10 million visitors a year. And if you only miss one in a thousand, let's still 10,000 important cases that then the states are out of community. Well, there's an element there where, where, okay, if you have a resurgence like that, a lot of cases in the states you mentioned, they can't stop it so easily. It has, it has an afterlife and that goes down logarithmically into the community. So once you, once you let go of this wild horse, you don't know where it's going to go. Well, you know, it's going to go up. This is a big problem. And so, so for them to say, oh, now we're going to, we're going to put the same social distancing rules back in place. The horse, she is out of the barn and you got to do more than that, right? Right. And we're seeing a problem here in the United States maybe in the rest of the world of this danger of complacency. We think it's the paradox of prevention. We think that because we prevented a bunch of deaths, we don't see the deaths that didn't happen. We just see that there aren't any deaths when these cases that are locked out. So we say, oh, you were lying. It's not that big a deal. The disaster didn't happen. So let's relax all the controls. Well, now the disaster will happen and people heads will roll or it will be blamed, but it's, it'll be too late. And the politicians have to make a decision. They should be honest with us. Either they're going to say, we're going to let people die. And we're going to sacrifice human lives for the economy. And we're going to make that trade that can be honest with us about that or they can be honest with us and say, we're going to, like Winston Churchill, Winston Churchill, he, when the Nazis were knocking on the door, getting ready to invade Britain, and he was at war and he knew his country was in peril. He didn't say, oh, it'll go away miraculously. Just go shop. He said, I have nothing to offer you but blood and toil and tears and sweat. And that galvanized the people to unite, get together, work together and get through it. I mean, it was four years of hell for Britain, for the world. But they toughed it out. We could do the same thing. This is a war. We need a leader who'll get up there and say, if we get together, work together, we'll suffer a few years of privation, a few years of hardship, we will get as many of us to the other side as possible. Well, the question is, what's in the kit bag? The question is, you know, your paper that you sent me was really wonderful. And the idea is you have to match these things. If you see mortality going up, cases and mortality going up, then you take more of those tools out of your kit bag and you turn the faucet one way or the other. So to diminish social distancing, I mean, to put more controls in place and maybe not reopen so quickly in order to reduce the number of cases. I mean, so what is the relationship that you have to be looking at? How do you find out what the risks are that way? And what's in the kit bag? Oh, well, of course, what's in the kit bag is, you know, wash your hands, social distancing, wear a mask. You know, there's been a lot of controversy about how hard it is to tell whether masking is effective because it's most places that require masking also require social distancing. So, well, the social distancing and the masking, but studies where they have people breathe on Petri dishes through masks, so that a mask can reduce what gets onto the Petri dish by 90%. That's not enough for a doctor who sees hundreds of patients a week, but a cloth mask is enough. 90% reduction in risk is enough to greatly reduce the community's risk when you're going shopping or something like that. So we need to keep requiring masking. They don't, the states that are seeing the worst spikes aren't requiring the masking and some of the guards say, oh, I have no plan to require masking and say, well, this is stupid. It's been in the countries that have effectively stopped this thing, Taiwan, Singapore, masking is what everybody does. Your mask protects me, my mask protects you. What else is the kit bag testing? I've had a COVID-19 test. It's not a lot of fun. I mean, the probe went up my nose and I felt like it wasn't coming out of my eye socket, but tested negative. Okay. And it only took a day and a half to get the results back. So I think the state's idea of requiring people who are from the mainland who want to come here to get a COVID-19 test or choose to be quarantined is a good idea. I mean, you can get the results back in a couple of days. They need on the airplane come here. While it is on the airplane, the Institute controls, you know, every middle seat empty, maybe with a plastic barrier, people wearing masks on the airplane. We have to do this safely. People can get here. What about tracking? Oh, well, yeah, contact tracing. Like I said, the West Virginia cases, they found that they traced to Myrtle Beach. They were able to trace them. If you don't test and you don't do follow-up contact tracing, you never figure out where the source infection is. And it stays seated in your community, causing more problems to pop up later on. So we could, we should ramp up contact tracing. That takes training people. You know, kind of people are nice. We like to talk to people. We're good at talking to people and eliciting information of who you've seen, who you've been with, where you've been, so that we can do the contact tracing. Want to do it in the least invasively possible, you know, because we are a free open society. We have rights. You can't say, you must tell us. Can you just please tell us? But we've got to talk into the contact tracing. So far, what you're talking about in the kit bag, there's a lot of complacency that has displaced any significant effort. A lot of people I can see even in Honolulu and maybe more on the mainland, they have set aside their masks. Where masks in such a way so the mask doesn't cover anything. I see so many people with masks dropped down on their chin and both their nose and their mouth are exposed. I don't know why they wear it at all. And then of course, I don't think that tracing has really been implemented in most of the country. It hasn't been implemented here. And so that's a huge item in the toolkit, the kit bag that isn't being used. And let's see, what were the other things you mentioned? Social distancing seems like people are going complacent on that too. I think what happened here is, you know, when the president announced we're back, we've licked this thing, which was not true and one of those many falsehoods, everybody took that as a message they can be complacent. Then we have complacency. Now you turn around, I don't think the federal government is doing check on this, but now you turn around and the states are saying, okay, it's time to get back to a more disciplined approach. People say, nah, we don't need to do that. That's old news. We're going to keep on being complacent. I think it's a public reaction thing, don't you? Yeah, I think it is. And well, leadership would help with that. I mean, if we had a leader like Churchill or Roosevelt who would say, you know, the only thing we have to fear is fear itself, or let's work together, let's get through this together. We don't have leaders uniting us in this war against this virus. We have leaders dividing us. And that's crazy. We're not going to be through this virus until there's a vaccine. And even today Anthony Apology says, look, we're talking end of 2021 before we can roll out a vaccine that's been shown to be safe and effective. He says he's not going to roll out one that's not safe. And which is good because we've already seen like hydroxychloroquine killed more people than, say, in the veterans creation and even in the bill. So we want a safe effective thing. We can't get a vaccine for at least a year, maybe a year and a half, optimistically. So we got to maintain controls for them. We may get treatment sooner. There's just a study and yesterday that came out of from the Harry Medical College that Dr. James Alcindor, he's done a lot of research on Zika. It turns out that the coronavirus has some similarities to Zika. He found a way to prevent 95% of Zika virus replication in humans. And so he's going to try a similar approach with coronavirus. The next step is to test on lab animals, make sure it's safe. But he could have a treatment that keeps you from dying of coronavirus in six months if it works. And there's a lot of other places working on treatments. So it's a treatment will be indicated back sometime before the end of this year, but don't rush. I mean, but yeah, so we know how many cases there are. I mean, aside from Donald Trump's remark, which I don't think was a joke at all. We've all seen him deliver that statement. It was not a joke where he said he was cutting back on testing because testing revealed too many cases. But putting that aside, we do have numbers pretty much on cases and mortality is that you can get that information. That's one side of the algorithm, I suppose. The other side of these things in this kit bag. The problem is that the two problems there is it's hard to quantify exactly what you're doing with the tools in the kit bag. How are you going to make an algorithm that connects cases and deaths to actually implementing what's in the kit bag? And the other thing is the kit bag requires leadership, as you say, requires cooperation, coordination, requires public acceptance, which that's social science. That's pretty vague. So what would you advise our government to do right now, based on the fact that we do have an upswing? Other states have even more pronounced upswing. What do you take out of the kit bag right now? Do you go back to the full lockdown? Is there a way to adjust the numbers of the tools in the kit bag? Well, okay, so what they have found in South Korea is opening up bars is dangerous. Okay, people don't want, when they get a little bit of liquor in them, they don't want to be socially distant. But in France, they found maybe opening restaurants is safer as you enforce social distancing and the waiters wear masks, the patrons wear masks, so they sit down in front of the food. Maybe you can open restaurants. You probably can't open a food court, but you can open unless you can do social distancing. So there's things that we're learning as we go along, learn from what other people's mistakes, you know, yeah, don't have a stadium full of people like the Adrian tour. Now, if the athletes come for a competition, don't let them party and dance at night together. You know, make them practice social distancing. We can't do the Honolulu marathon. There's just no way to do social distancing with 26,000 runners. For those other events, we might be able to do. You know, I can say maybe the Molokai to Oahu canoe race, they could get the athletes social distance and they're in the winter in the boat. Okay, there's only six of them in the boat together. So at least that group of socially distant know the boats. So maybe they could do those kinds of events. We're talking about factors. I mean, one factor is when you shout or speak, you're spreading virus. When you have a lot of people shouting and speaking in a small area, whether it be indoors or outdoors, but much worse indoors, you're leaving that the virus hanging in the air for who knows for quite some time. And I suppose, you know, we used to think it was only a few of virion particles that, you know, that did it. But no, it's an accumulation of virion particles. So if you're there for a long time and you pick up a lot of these particles, you're really going to be in trouble. And so all these factors work and you have to apply these factors, hopefully a numerical basis to all of human activity. And the masking is effective if it's done right. Now, saying that people don't wear the masks right there for we shouldn't bother with, that's like saying people don't wear their seatbelts right therefore we shouldn't bother with it. Statistically, seatbelts save lives, even though people are right. Okay, so if everybody is wearing a mask and a few people can't figure out how to wear them right, we still will save lives. So masking is the number one thing. I mean, they've even had anecdotal cases where like a hairdresser who had COVID and didn't know it, she was wearing a mask, her customers were wearing a mask, dozens of customers, none of them got sick. So that doesn't mean that, so some people say, well, it means the virus isn't that bad. No, no, no, it means that the masking worked in this case. And they've had other cases where the masking has been shown to, and at least in several anecdotes, help, you know, where other cases where people weren't masked from interacting like the Adria tour, pick up a basketball game, people got sick. So, or the choir practice in New Hampshire or was it Vermont? Vermont where everybody got sick because they were singing together, of course, spreading the virus out, nobody's wearing a mask, and like half the choir got sick. So, yeah, so, so what you say, you're right. It's this spreading of the virus particles, droplets, even finer particles, you know, down to nanometer scales, wearing a mask reduces that. And if it only reduces it 90%, that's not good enough for a doctor, but it is good enough for a community to greatly reduce the risk and the rate of transmission of this disease. And then we've got to let me assume for a minute that there's not going to be an easy therapeutic here at any, at any stage of the disease. And there's not going to be a vaccine until, well, optimistically sometime 2021. And it's not clear that a that will work as hoped, and be that it will be able to be delivered to the world and see that people will take it like that anti-vaxxer in Serbia. So the question is, you know, we hear about testing. We hear that there is better testing than putting a swab up and, you know, up way up your nose. And that instead of a day and a half, which is good against what it was a couple months ago, which is more like a week or 10 days, there are just talk about various competitive technologies that can test you in a less invasive way on a swab for your mouth, for example, and that can return results almost immediately in minutes. Now, wouldn't that be a great addition to the kit bag? Sure, sure would be. You need to make sure that those tests have a very low false negative rate. And the one up your nose is a negligible false false positive rate. So that's good. I mean, if false positive causes you to chase people to contact tracing and waste resources. So it's good. It needs to have a very low false positive rate and a very low false negative rate. So whatever they roll out. The other thing is we we need our leaders to be honest with us because if there is no vaccine, that doesn't come to come materialize in the next two years. And there's no therapeutic treatment that cures the disease. They need to tell us straight up. We're going to accept 13,000 casualties in Hawaii. We're going to let that we're just going to accept that. Here's the schedule. Here's the timeframe with which we're going to try to make that happen. So we can achieve herd immunity. And there's no guarantee that we will achieve herd immunity even because the virus may not provide permanent immunity. Hmm. Well, what about what about somebody like you and me? We're careful. Not wood. We don't get it. Okay. And then somebody somebody says something headline in the newspaper. Good news. We have we have achieved herd immunity 60 70% whatever of the population have actually had the disease and that by all scientific calculations we have achieved herd immunity. Does that does that headline help me? Does it help you? If you haven't had it, you could still have it. Does that herd immunity protect protect me? Well, so so then what they would have to do is keep tracking how many disease cases there are. So once you've achieved herd immunity, it means that if somebody gets the disease, even if they're out there interacting with people, less than one person will get it from them, which means that an outbreak will die out. So and it means that you're far less likely to run into somebody who has a disease therefore, but they need to keep tracking how many cases there are and publicize them so we can calculate what our risk is. Right now I don't know why it's like 100,000 that if you're a random stranger you run into there's only one in a thousand chance they have the disease. Thanks to the restrictions we put on here, especially restrictions on tourism. On the main line there's more like one in 100 and in some places it's way higher than half. If I'm interacting with the public, as a restaurant server and there's hundreds of customers coming through the day and there's a 1% chance that any one of them will have it, I'm like I'm going to meet a customer with the COVID. That'd be my luck. I'll meet the one. I hope you can get an advance for like one in a thousand chance that you're running into somebody. Almost out of time and I wanted to finish please finish. No I'm just I'm just amplifying what you're saying is that what's in the kit bag is if our leaders are honest about us with us telling us you know we're going to have to accept casualties, we're going to accept two deaths a day for the next four and a half years, which is what we talked about last show is what it would take to get to herd immunity. That takes political courage but they need to be honest with us so we can all pitch in and do what we have to do to keep it from getting worse than that because it could easily be much much worse that we could easily lose 30 people instead of 13,000 people. Funny that all the people who talk to us about this who have the ear of the press so to speak and have press conferences they are political people and they're therefore motivated not to panic us to keep the lid on things to make it look maybe a little rosier than it is and what you're saying is not is not rosy but it's scientific and it's the reality and you wrote you wrote this paper which impressed me so much and you know to me it's important that that paper and the policy points in that paper and the possibilities of policy points get to the policy makers we really need that to happen we don't we don't want an incomplete story here so what are you going to do what can we do to get these reality points to the people who can who can adjust our community to minimize cases and mortality. Yeah well certainly I can forward the you know the calculations to the policy makers so the legislature is back in session so presumably they're going to do something modern session it's not guaranteed of course the governor and the mayor you know making a lot of the right noises but there's they're not telling us how many casualties they expect nor the department of health but we need to get policy makers at least the information I can I can certainly forward them the paper I can't guarantee they'll read it that's that's the problem you know and it takes political courage to be honest with people to say either we're going to let the thing kill people and we're not going to treat the COVID people we're going to die we're going to get the economy back up and running as quickly as possible it takes courage to say that it also takes courage to say we're going to minimize the casualties as best we can by keeping the economy locked down for as long as feasible until there's either treatment or in or for four and a half whole four and a half years until we have herd immunity and that's scary and it's scary to say because that means you're going to accept casualties in the meantime and well we can never forget we're in a crisis yeah we never forget we're in a public health crisis and an economic crisis and that we have to we have to mediate between these two we have to spend the time and energy and resources to define our community to be better resilient so what that means is I hope you do circulate the paper I hope they read it and in any event we here on ThinkTech can present this in a completely honest way and so in a few weeks Mike I'd like to revisit this whole discussion see how it went see how it's going see what other thoughts what are the calculations what are the suggestions you know you are making there's a lot of science we can bring to bear on this and it's progressing quickly fortunately yeah so thank you Mike Mike DeWerth our chief scientist here at ThinkTech helping us understand the the true scope nature and prospects of of COVID and its effect on the economy thank you so much thank you jerry thank you hello