 Okay, we're back. We're live. I'm Jay Fardell. This is ThinkTech. And more specifically, it's ThinkTech Tech Talks. So we're going to talk a little tech today with our chief scientist, Mike DeWerck. In the past, we've talked about COVID and he's had some charts and graphs, but it all led us through this kind of balancing and see what science had to say, a scientific approach to balancing public health with reopening. This is a very valuable and interesting analysis. You will see what I mean. Welcome to the show, Mike. Nice to have you here. Aloha. It's good to be here, Jay. Thank you. So you looked at the data and you found some very interesting, surprising, if not counterintuitive data about the Great Depression. Can you talk about it? Yeah. I got a question in the last show. Will we kill more people with a lockdown than if we just let the disease run rampant? And we had, well, what other economic recessions can we look at? Well, it turns out the Great Depression is a good example. It's four years of really bad conditions, conditions that until now we hadn't seen. And there's some literature actually been done on it. Economists have studied this and they found some very interesting, perhaps puzzling results. So we go to the first set of graphs. Here's a paper called Entitled Life and Death during the Great Depression. And what they found was that during the four years of the Depression, 1930-1933, mortality rates actually went down. And that's just one fourth of the data they present in the paper. They went every five years from infancy to a very old age and looked at death rates. And I've highlighted and read the Great Depression and the recession of 38. And it turns out that for all age groups, the death rates in the Great Depression went down compared to the roaring 20s, the boom right before. And they tended to flatten out and they boom right after, and they go down again in the recession of 38. So that's showing that fewer people die during the Great Depression than die during the economic rooms before and after. You have a theory on why. Is there any indication, any kind of comparable data or factors that can explain this? Yeah. Well, this applies not just to the Great Depression but to economic recessions in general and rich countries. There's this well-known, huge literature in the economy, economics literature about fewer deaths during depressions. For every 1% increase in unemployment during the recession, the death rate goes down four tens of a percent, which is a pretty big effect. And suicides go up a little bit, but all of the causes we've gotten, including liver disease, influenza, pneumonia, you'd expect that people would stay home. They're not getting exposed to get the flu or pneumonia. So, okay, they won't die of that. There's fewer accidents because there's fewer people on the road. There's fewer industrial accidents because there's fewer people at work. Construction workers aren't getting crushed by equipment and stuff, things like that. So liver disease is a little bit of a puzzle that's clearly in the data, the lower liver disease. Maybe people just can't afford drinking. I don't know. But there's a lot of reasons why staying home would reduce mortality. And it reduces infant mortality as well. Maybe people are able to stay home, support the mother while she's pregnant, keep an eye on the infants and kids, and the mother has to sleep or is busy. So there's just, people are home together. They're not getting exposed to things. They're not getting put in at risk from accidents. There's a lot of reasons and the only cause of death that went up during the Great Depression is suicide. And it did not go up nearly enough to compensate for all of the decreases. So there's no place to like home? No place. Right when they said that. I think there was a song also. Okay, so you have another chart that that is with a similar result. Can you talk about that? The next slide it shows. So maybe people didn't die as much during the Great Depression, but maybe they got stressed out and they didn't live as long afterwards. Well, so on the next slide I show the same paper. They show life expectancy at birth. Since the 1930s, we've had enough time for enough people to die that we know what the median life expectancy was for all those years during the 1930s. And if you go to the next slide, oh, I don't see it on the screen. That's okay. So life expectancy at birth actually went up during the Great. We're looking at, okay, this is slide number two, right? Yeah. Right. So during the Great Depression, life expectancy at birth actually went up. And it's amazing. It's not a subtle effect. It went up quite a bit. Let's see. So the early 20s, economic expansion, you see this kind of up and down, up and down. But life expectancy during the Great Depression, steady up. So the more unemployment, the longer longevity of the people that were born in that era. And then it went back down again in the boom after the Depression. Then it goes up during the recession at 38 and the lead in the slowdown right before the recession at 38. So life expectancy at birth wasn't harmed either. So fewer people were dying and they were living longer. The ones that were born in that era. Can you explain the difference between life expectancy and mortality? It's not the same concept and the numbers that come from a different place. Well, mortality is how many people died here. So 100,000 people might die this year, but maybe the ones that are left behind are stronger and will live longer because of that. You could maybe make that hypothesis. So life expectancy at birth is how long you expect to live if you're born in 1930, as opposed to how many people died in 1930. Which because those people could have been old people that were going to die anyway. And now you've got, you know, some change that's made you able to live longer than the rest of the people that were living already at the time. So mortality means that people are already living. Life expectancy at birth is going to happen. So now it's a different set of factors because mortality, you know, means you lost your life somehow, whether from disease or accident or what have you. But expectancy means that, as you said, you're stronger. You're more resilient and your whole life and you're going to live a longer time because somehow being born in this period made you stronger. Can you give me some detail on that? I mean, how would that work? How would I be stronger because I was born in the 30s? For example, if during the 30s your mom was home, your dad was home, your grandma and grandpa were home, all taking care of each other. Watching mom, making sure she doesn't work too hard, doesn't put stress on her body. And then when you're born, your little infant, you have more family at home watching. That's a hypothesis. I don't know how to test it yet. Economists probably have tried to figure it out, but when you're little and there's more adults around to watch you because they're unemployed, then maybe you gain an advantage in terms of your vigor as a young person. You get a little bit stronger earlier and that should keep getting stronger later. Of course, the other things that have been going on since the 1930s is tuberculosis rates have gone down. They were going down then. Other things went down, but smoking went up. So despite that, the people born in the 30s live longer than the people born in the 20s and people born right after the Great Depression. And if you look at the next slide, there's this really interesting effect on minorities. Minorities gained the most in life expectancy during the Great Depression. So are you looking at the next slide yet? Yeah, we are. And what is the minority exactly for the purpose of this analysis? I think this is the difference. Anybody who's not white. So white people during the Great Depression gained about four years of life expectancy, both men and women, during the 1930s. Non-whites gained seven years of life expectancy. They closed the gap in longevity. During the roaring 20s, there was a big gap. It was narrowed during the Great Depression. Then it widened again during the economic expansion afterwards. Then it narrowed again during the recession of 38. So it's very clear in the data that full employment, a booming economy is hardest on the life expectancy of minorities because they're doing the toughest jobs, maybe. They're exposed to more risk factors. The caregivers have to go into the nursing homes and be exposed to the sick people or the bus drivers that are exposed to sick people all day, those kinds of things. And maybe it's just stress. This is mortality, not expectancy, right? This is life expectancy. Oh, this is life expectancy. Yeah, but I'm just life expectancy for minorities versus for whites from the paper, the same paper as the previous two slides. So people born in the 30s, minority people born in the, during the Great Depression gained seven years of life expectancy compared to what they had before. And white people born in the Great Depression gained four years of life expectancy. So those people live longer than if they'd been born in the roaring 20s or in economics after the Great Depression. So that goes back to the analysis we talked about before, is that during that period, if you're going to have a longer life expectancy, your life experience in that period would have made you more robust, more resilient, a stronger person in order to survive longer. That's very interesting. The interesting, yeah. Yeah. And so I know there's enough data for the war years and the economic depression that came by after World War II yet, but other depressions they've studied. And then the last slide I show the results of a different set of studies for a whole office of economic, the organized OECD countries, the economically developed countries. And for those 23 countries, which are all rich countries, you'll see the same trends through multiple recessions in the second half of the 21st, 20th century. Multiple recessions, the, if the unemployment rate goes up 1%, death rate goes down 4, 10, 7%. It's an astonishing correlation that the more the economy booms, the more people die. And that's just, that's the data. So it says to me is easing the lockdown, being in a hurry to ease the lockdown will cost more lives than it saves. That we can go, we should go slow on the easing of the lockdown and do it in a way that makes as much sense as possible. The most sensible thing would be for us to wait till there's a vaccine or an effective curative treatment, because then we don't have to incur the risk of people getting sick with COVID-19, as well as the other risks that they're going to face just in their jobs and the stressors of working, you know, in hard jobs. So how do we, this is a problem that we set ourselves. And it's a policy problem. Go ahead. I mean, I just think that's a fantastic analysis and a fantastic result. But it's very credible to say that if you have an economic recession or depression now, it effectively emulates what happened in the 30s. It falls right into that. Those charts you showed us. Yeah. And so you have, you have three factors. I mean, three results. One is mortality to be less in a depression or a serious recession. I think we're going to have a depression myself. Two is expectancy is going to be longer. Then three is disparity between whites and non-whites will be less. It's like everybody wins here by virtue of a depression. So therefore, you know, let's continue the lockdown. But what, you know, I mean, does anything militate against those conclusions? Well, you can say the conditions are different now, although in the second half of the 20th century, all those recessions they studied with the OECD countries, they doesn't seem to show a change in the second half of the 21st century, 20th century, rather. So I can say that I don't think there's a big change, except maybe socially. Maybe we are a less cohesive country than we were in the 30s. I don't know. There's a lot of fighting in the 30s. I mean, we had neo-Nazis, we had actual Nazi Nazis, you know, marching in the streets of the United States, wanted to support Germany and its horrible things that Hitler was doing at the time. So I think I wouldn't say that our social fragmentation is that much worse than it was in the 30s. We have demagogues here, like we had Father Codlin and Huey Lon back then, fragmenting the country. So I think that I don't think there's any reason to expect it to be different this time. You know, one thing that strikes me is bigger families in those days and the families, you know, maybe multiple generations in the families, one generation takes care of another. They're very physically close. They share in the food, they share in the, you know, in the daily life, they help each other. And it's that support mechanism that happened in a large, that used to happen more often, in a large family that may, that may be an operative factor here. Now we have small families, we have the nuclear family, or we have one person living alone. And the lockdown really doesn't allow, doesn't allow for a large family group to support itself. On the other hand, we are seeing millennials, young people standing at home with their parents a little longer. We might be seeing a return to those kinds of cohesive families because right now, during the lockdown, if you want to be out in a group of people, you have to live together to be, not want to follow the law in certain states, certain cities. So if you live with somebody, then you can be out with them and that works. And if you live with somebody and interact with them, you're less likely to go out and catch the disease somewhere else. So yeah, it could be a good, good, good things could come of a few years of lockdown. So speaking in terms of public policy, this conclusion, you know, when you test it, it sounds, it sounds pretty reasonable to me, is that if we could, if we could continue the lockdown or some version of the lockdown, we would, it would probably, it would probably increase your life expectancy and reduce mortality and reduce disparity. That's kind of an amazing result. But then that makes it pretty attractive to continue the lockdown. Well, as we provide the support that people will need, some people just will need support during the lockdown. And Congress did a good job with the stimulus payments. Well, the lockdown continues and the economy stays in the tank or goes worse in the tank, which might happen. That's, that's got to have a negative effect on all these charts, no? Well, great depression, four years, four years of economic depression. You know, the day we have a vaccine that's proven to be safe and effective, you'll see a boom like you've never seen before. Yeah, right. All the limitations have been gone. And you know, I suppose if you had a boom, such as a boom you've never seen before, you'll have more mortality, lower life expectancy and greater disparity is not necessarily a win-win-win. Yeah, we need to consider this an opportunity to head those consequences off or minimize the chance of those consequences. The danger I see is people just getting impatient. They want to make money. They want to go out and sell their homes, move, whatever. They want to have an economy. And the danger with the impatience is that the open economy too quickly, you will take casualties. We are in a war with this virus. You know, in New Zealand, they have a 1.3% mortality rate from this virus. Hawaii, we have a 2.6% mortality rate. We can get it down to the New Zealand rate and then we get a million people have a disease to achieve herd immunity before there's a vaccine. If you're impatient to achieve herd immunity before there's a vaccine, you've got to infect a million people in Hawaii. That means they'll take 13,000 deaths. It'll cost us 13,000 lives and much more disability to achieve herd immunity. And the policymakers have to say is how fast do we want to get there? I want to take all those casualties in one year or can we spread it over years? And in Hawaii, we can't take all those casualties in a year without collapsing a healthcare system. We only have 800 beds for COVID-19 patients. We can tolerate maybe 600 cases a day if the people that are too sick did not be in the hospital or in the hospital for 11 days each. We can tolerate 600 new cases a day. And we'll take two deaths a day. And it'll take us four and a half years. So that will take political courage for the politicians to say, yes, we're going to take casualties. Here is what we expect. We're going to try to reopen the economy at a rate that will only cost 600 cases a day and two deaths a day. Can you imagine a politician saying that? We're going to accept two dead people a day from this disease for the next four and a half years. And yet you can't imagine a politician saying we're going to leave the economy locked down for four and a half years until there's a vaccine. Either position takes political courage. Maybe the answer is in the middle, but I think the one point that is really important here is that if you continue the lockdown, you reduce the number of deaths by virtue of the disease. So you have greater life expectancy, less mortality, less disparity, and also you're knocking down the number of people dying from the disease. That's a pretty powerful position, isn't it? Yeah, I mean, it's a pretty good argument for waiting for the vaccine and waiting for the effective treatments. Because also not waiting is to let the disease run rampant and go through cycles of boom, lockdown, boom, lockdown, boom, lockdown. That's probably, yeah. So okay, so we can learn, we can extract from this analysis and what happened before some lessons about stress in your life and family and the risks of working or some kinds of jobs anyway. And I suppose it leaves us with the opportunity, Mike, you and me, to speculate on a better world going forward. If we were the policymakers driving off this discussion, we would want to create a better world where people lived longer, where they had less mortality, where there was less disparity between the races, and less immediate disease. How would we do that? How would we, in order to achieve this, we would have to make sure that all those factors that helped in the depression were present. We'd have to create a new world with, we were sure that those factors would help on all of these fronts. How, what kind of, how would that world look? Well, you know, like we had the works progress administration in the 30s, where we put people to work or unemployed. So our discuss subsidies, construction workers got to build things. We built some of our best bridges and dams and, you know, public works projects in the 30s. We need desperately to reinvigorate our infrastructure in the United States. We should be investing in that. We should be providing those jobs, rebuilding our bridges, rebuilding our dams. We should provide the jobs for the healthcare workers. We have a healthcare system that is a capitalist, just-in-time system that barely meets the needs to handle the cases they have now. There's no surge capacity. We need to build surge capacity in the healthcare system. We could, you know, provide better jobs for nurses, doctors, med techs, those people as well. We could be supporting those kinds of jobs and providing better pay for those people. I mean, when you got a home healthcare worker who's going to be facing sick people every day and she's getting $13 an hour in Hawaii, oh, that is just wrong. You know, that's just wrong. And we need to find a way to support those kinds of things that bring up the dignity of the working people and make us feel like we're in this together as a society, trying to work for a better future for everyone, everyone, not just the top 1%, or one tenth of a percent. No, so what I hear you saying is we have to change our way of looking at things, you know. I remember it was about traffic. It was in the 60s or the 70s and everybody was talking about making a four-day work week here. And the purpose was not about stress and strain. It was rather about keeping the cars off the roads because traffic was getting oppressive. But you could do that. You could say, look, you know, we're going to have a, the unions would like this. I think we're going to have a four-day work week. We're going to let you spend more time at home where we know it's safer for you, where you will have less mortality, higher expectancy, and less disparity. We're going to make it possible for you to stay at home. And we're also going to have this idea about let's not race for the magic buck here. Let's find, you know, a moral way to organize ourselves so we don't stress out every day. Am I in the right track with that? I think you're on the right track. And I'm not quite sure what it will take in terms of public policy, healthcare for all with health. I mean, they have a job tied to your health insurance just to be stressed. You know, people who might be in jobs that they're just badly suited for, they don't dare quit because they'll lose their health insurance. There are people who might want to start companies and, you know, be entrepreneurs. They can't take the risk of not having health insurance or having to pay an insorbent amount for health insurance because they're entrepreneurs. So that's a kind of, that's a start. And the other thing is better support for childcare. You know, we're, you know, we have a country now where we need two incomes to support family in most, most cities, certainly in Honolulu. And in Honolulu, two incomes isn't even enough. I mean, I know families that are working three full-time jobs between the two parents. One job should be enough. One job should be enough. Two jobs certainly should be enough. And this is, so we need to find a way to raise wages. And we either, I guess, have a more equitable tax system. Back in the 30s, the marginal tax rates on high incomes are much higher than they are now. In the postwar era during the session after World War II, marginal rates were like 60, 70% on the very highest incomes. We just eroded and eroded and eroded that distribution. You know, the people who have made the most of this economy, of this society, had the greatest obligation, you know, to support fellow humans because they didn't get there alone. They didn't build the roads. They didn't build the skyscrapers. You know, they didn't build universities. They, but they have been able to profit from it all in terms of their better education, their workers get to their offices, etc. We have a chance to rethink this whole thing. Now, I'm not a sociologist. Sociology is far harder than physics. It's far harder than that. No, but there are these two, the two disciplines have to intersect. And what I hear you saying is, you know, it's not just healthcare. It's the social safety net. It's making somebody feel that there's somebody out there going to take care of him or her. They don't have to worry about horrible things happening to you, either medically or socially or economically. And they have some of that in Europe, I think, you know, because of socialized medicine. And I think they're guaranteed in places in Europe. Andrew Yang, remember him, ran for president, $1,000 a month for everybody. There was a magic in that. And maybe that fits in this whole discussion, doesn't it? Universal basic income, maybe. Maybe. And when I say it's hard, physics is hard, well, the physicists are trying to help. Physicists have done a lot of work with network theory, trying to understand how clusters of, you know, gathered and hello. So with network theory. So in network theory, let you say, if a signal starts, say in this case, the COVID-19 case starts in one place, how does it spread through the whole network? And there's been a recent, you might see it in science news, that a group of physicists studied COVID-19, and they came with a model society, and they said that the optimal cluster size for limiting the transmission of diseases gatherings of 23 people. And I said, well, it's probably specific to the society you're in, and 23 is the magic number, but there is a magic number, and it's going to differ for Hawaii than other places. For example, here in Hawaii, we know we probably can't safely have the Honolulu Marathon. There's just too many people from too many parts of the world here coming into our state. But maybe we could safely do the Molokai to Oahu canoe race. But then we have to look at the clusters. So see the cluster of people participating in this event, how many of them are also active in their church? How many of them are active in their hula halas? How many of them are active in businesses? And how do those clusters interact? How does the disease transmit from a canoe race meet to your local church, and then to maybe a business? Understanding those dynamics is society-specific, and it's a big data problem, a hard big data problem. I mean, I hope somebody in the state's epidemiology office is working on it, because there's huge literature on it that willing to, if they need help, I'll be glad to try to help them out. But yeah, it's a hard problem, it's a big data problem, and it's a highly complex problem. If you say let's just do the whole million people in Hawaii, a million people will have a million connections, and so you're talking about a million million trillion possible data points you've got to track, but we're not going to do that. But maybe we can track each individual business, how likely it is to lead to connections, and then set criteria for what rate we open so we can ramp up to the rate that the politicians determine is the appropriate casualty rate we can accept. And it won't be zero casualties. I hope it's not in the whole 13,000 people. I hope we get to a vaccine before we have to incur that. See how science can do more than just tell us how the virus is contagious. I think we've been looking at epidemiology too narrowly. We have to look at science now not only as a way to flatten the curve, not only as a way to develop medicines, but also as a way to reinvent our society so that it will be able to deal with other viruses later. And science in conjunction with sociology and economics can actually find a better path for us. And that path would make a better life, a longer life for all of us. And I think that's what you've shown. And furthermore, if we reduce the amount of economic activity and still be efficient, we'll also reduce the effect on climate change. Wow. What a win, win, win, win, win. And reducing those greenhouse gas emissions and those sulfur emissions from fossil fuels will lengthen lives. It would lead to less death. It would lead less death than precisely the places where the poorest people live, people who live around oil refineries. People have to live in the coal fields. You know, all the down in Mississippi River, all the energy industry infrastructure is famous for the amount of pollution they put out. If we can reduce that, we'll save the lives of those people. And if we give them jobs in green energy, all the better. Wow, Mike, this is really important stuff. This is the biggest opportunity. It's being presented to us. It's painful, but we have to see it as an opportunity in which we can reimagine the human habitation of this planet. Thank you so much for coming down. Really appreciate it. Yeah, thank you, take care.