Scientific research on the coronavirus is being released in a torrent

Will that change how science is published?

EXPONENTIAL INCREASES are a hallmark of pandemics. The spread of SARS-CoV-2 around the world has followed such a curve inexorably. But so, too, has the research effort to understand and control the virus. More than 7,000 papers on the pandemic—covering everything from virology to epidemiology—have appeared in the past three months (see chart). A fifth of them have come out in the past week alone.

This is astonishingly fast. Researchers usually take years to design experiments, collect data and check results. Scientific journals, the self-appointed keepers of the gate between those researchers and the rest of the world, can easily take six months, often a year, to grind through the various steps of their procedure, including editing and the process of checking by anonymous outside experts, known as peer review.

The current public-health emergency has, however, turbocharged all this. With physicians, policymakers and prime ministers all needing the latest science in order to make immediate life-and-death decisions, speed has become paramount. Journals have responded to sharp rises in submissions by working overtime. In so doing they have squeezed their normal processes down to days or weeks.

Getting a move on

In the view of many, though, this is not enough. These people support a different way of disseminating scientific information—one that dethrones the journals by making journal publication an optional extra rather than a researcher’s primary goal. This model of scientific publishing relies on online repositories called preprint servers, on which papers can be posted swiftly and with only minimal formalities.

Mathematicians and physicists already use them widely. Biologists increasingly do so too.

Covid-19, however, has seen a step-change. Around half of the available scientific work on the pandemic has been released through preprint servers. The hope of preprinting’s supporters is that this will make the shift to using them irreversible.

Speed is good during a public-health emergency. The genome of SARS-CoV-2 was published by Chinese scientists on a public genome-data repository, a beast similar to a preprint server, just days after the virus was isolated. This permitted the rapid creation of tests to detect infections in people with suspicious symptoms. And the seriousness with which many parts of the world treated the new virus was aided by early reports which suggested that the fatality rates of the cases they looked at were much higher than those seen in influenza.

This increased speed shows that scientists have learned from their sluggish responses to previous outbreaks. In an analysis of research carried out during and after the Ebola outbreak of 2014-16 and the Zika outbreak of 2015-16, Marc Lipsitch, an epidemiologist at Harvard now working on covid-19, looked at just how sluggish those responses were. He found that, where preprints had been available, they appeared around 100 days before journal articles that had eventually been published on the same work. Unfortunately, less than 5% of all the journal articles published about the two outbreaks had been preprinted.

Dr Lipsitch recommended that preprints form a bigger part of a faster information “ecosystem” during future emergencies. And his wish, it appears, has been granted. The two biggest relevant preprint servers for covid-19 are bioRxiv, set up in 2013, and medRxiv, launched in 2019, both of which are run by Cold Spring Harbor Laboratory in New York state. (The “x” in the names represents the Greek letter “chi”, making them pronounceable as “bioarchive” and “medarchive”.)

BioRxiv is for general biological and related sciences. MedRxiv is focused on health and medicine. As The Economist went to press the two servers featured, between them, 2,853 articles about SARS-CoV-2 or covid-19. Another 789 had been posted on arXiv—at 29 years of age, the granddaddy of preprint servers—which belongs to Cornell University and specialises in maths and physical sciences.

Anyone can submit a manuscript to one of these servers and see it made available to the world within hours. Submissions are given a cursory check, to weed out opinion pieces and to ensure that they have the parts expected of a scientific paper—an abstract and sections describing methods and results. If the topic is controversial, the checkers may flag up outlandish claims.

But beyond this they do not attempt to review the scientific contents of the paper. Once a preprint is online, anyone with access to the internet can read it and, if they so wish, leave detailed comments.

Fast and loose?

This process—essentially a free-for-all version of peer review—can be brutal. But it often works. Conspiracy theories about SARS-CoV-2 being an artificial, laboratory creation were fuelled by a preprint posted to bioRxiv in January, by Indian scientists. This claimed “uncanny” similarities between the genetic sequences of SARS-CoV-2 and HIV, the cause of AIDS. The study was torn apart as soon as it appeared, though, by other researchers who weighed in and pointed out serious methodological flaws. As a consequence, the manuscript has now been withdrawn.

This incident does, however, highlight a repeated criticism of preprint posting, which is that dodgy material may be misused, either accidentally or deliberately, by overzealous patients, politicians, journalists or just plain troublemakers. It is certainly a risk. But in the opinion of many, that risk does not outweigh the advantage of the free and fast flow of information between researchers that preprints provide.

For those who question the quality of science contained in preprints, there is reassurance in a recent study by researchers in Brazil (itself posted as a preprint), in which the authors used a questionnaire to score the quality of preprints on bioRxiv, and also the subsequent peer-reviewed-journal versions of these papers. They found that the journal papers were indeed of higher quality. But the difference was, on average, only 5%.

In any case, peer review as organised by journals is not perfect. It will neither pick up all errors nor weed out all bad research. The distracting focus on hydroxychloroquine as a potential covid-19 treatment was, for example, partly stimulated by a peer-reviewed paper in the International Journal of Antimicrobial Agents that was published on March 20th by French scientists. That paper now has question-marks over its rigour and reliability.

Moreover, even when a peer-reviewed paper is withdrawn, the damage may already have been done. On March 9th the South China Morning Post, an English-language newspaper in Hong Kong, published an article about research reported in Practical Preventive Medicine, a peer-reviewed journal, with a headline that read “coronavirus can travel twice as far as official safe distance”.

This article has been shared more than 53,000 times on social media. Unfortunately, the study in question was retracted the day after the newspaper article was published. The Post reported the retraction immediately, but that report was shared less than 1,000 times.

The current pandemic highlights further limitations of the way peer review is typically organised. It works well when confined within a narrow group of specialists, but runs into problems when different fields rub up against each other. As Ivan Oransky, a founder of Retraction Watch, which catalogues bad practice in scientific research, observes, “if you were to do a study of the impact of social distancing, for example, and you only asked public health researchers to review that, there’s a reasonable chance that you would almost exclude or at least certainly not emphasise the economic disruption. Whereas if you only ask economists to look at it, you would almost certainly de-emphasise the health risks.”

Conventional journals might struggle to analyse the wide range of trade-offs from different angles in a situation like this. Preprints, says Dr Oransky, permit experts of different stripes to contribute, publicly and in parallel, to a wide-ranging criticism of a piece of research.

As Stuart Taylor, publishing director of the Royal Society, Britain’s top scientific academy, observes, moves towards more open science, preprints and faster dissemination of results were under way before the covid-19 pandemic. But these events will heighten those changes and probably make them permanent. Scholarly communication seems to be at an inflection point.

Like many other things until recently taken for granted, it may never return to the way it was before SARS-CoV-2 came along.

Italy is in more danger than the eurozone will acknowledge

It is hard to overstate the turn to Euroscepticism. It will not go away when lockdown ends

Wolfgang Münchau

A carabineri police officer talks to a woman wearing a face mask at the Gianicolo hill overlooking Rome, on Monday, April 13, 2020. The Italian government says beefed-up police patrols over Easter weekend have resulted in more than 12,500 people being sanctioned and 150 facing criminal charges for allegedly violating anti-coronavirus lockdown measures, which only allow people to move around for work, health reasons or some other necessity, such as grocery shopping or walking the dog. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death. (Cecilia Fabiano/LaPresse via AP)
Italians are beginning to blame the EU for everything that is going wrong © Cecilia Fabiano/LaPresse/AP

The spread between Italian and German bonds rose last week to around 2 percentage points.

Why should that be so?

Unlike in 2012, there is no looming threat of a liquidity crisis.

The European Central Bank’s Pandemic Emergency Purchase Programme will probably ensure that the Italian government is safe to issue whatever debt it needs this year. Rather, Italy’s problems are of a different nature.

As of the end of last year, Italy’s public sector debt was 136 per cent of gross domestic product.

Over the previous decade, it had increased by 30 percentage points. If you assume that what the IMF calls the Great Lockdown leaves Italian GDP 10 per cent lower than in 2019, and if outstanding debt increases by 20 per cent, then its debt-to-GDP ratio balloons to 180 per cent.

When debt rises and output falls at the same time, these ratios shoot up fast. So what should Italy do?

I see three courses of action.

My expectation for this week’s virtual meeting of EU leaders is a compromise on a restructuring fund. Once the applause fades and people look at the details, they will realise it will have no macroeconomic relevance.

This will leave the ECB, once again, as the only EU institution that matters.

Its pandemic programme will do the necessary this year. But what about afterwards?

The only available instrument left for the ECB to deploy is former president Mario Draghi’s “outright monetary transactions” — the never-launched programme that will forever be associated with his 2012 promise to “do whatever it takes” to save the eurozone.

This would allow the ECB to undertake unlimited purchases of Italian debt, but only if Italy applies to the European Stability Mechanism for an enhanced conditions credit line. This is like an overdraft facility with some mild conditionalities. It is not the facility itself that matters, but its link to an ECB programme.

Yet there does not appear to be a majority in the Italian parliament for ESM support. Nor is it clear that the ECB would agree to trigger OMT. The argument is that it is not intended to address looming insolvency.

Another course is for Italy to default, or seek a debt restructuring. This may be compatible with eurozone membership, but would need ECB involvement as otherwise Italian debt would lose its status. Domestic banks are another priority.

As they hold much of Italy’s sovereign debt, default could lead to bank failures. Still, as Irish economist Karl Whelan points out, Italy could “haircut” its bonds and win enough savings to nationalise and save them. Investors would be wiped out but deposits saved.

Finally, there is always the spectre of a eurozone exit. It is not a probable event.

But then again, nor was Brexit. As happened in the UK, Italians are beginning to blame the EU for everything that is going wrong.

I heard a story of someone blaming the Dutch for the delay in their unemployment payments.

This is an absurd accusation, of course. But the Five Star Movement, the senior partner in the ruling coalition, may see an opportunity to revive its flagging political support and play to rising anti-EU sentiment. It is hard to overstate Italy’s dramatic turn to Euroscepticism. It will not go away when lockdown ends.

Emmanuel Macron is right to warn about the unravelling of the EU.

I fear, however, that the French president will avoid a long-overdue confrontation with Germany, which remains sceptical about the idea of eurozone bonds. Unless he is willing to get such a bond under way with a smaller group of member states, his threat is cheap talk.

If Giuseppe Conte, Italian prime minister, acts in the spirit of his predecessors, he will agree to a foul compromise and discover later that the costs outweigh the benefits. Once that realisation sets in, there will not be many good options left.

When northern Europeans discuss eurobonds or similar instruments, they frame the debate in terms of solidarity and charity or, in the Dutch case, as a gift. They do not see it as risk insurance.

There is zero appreciation in Germany, and, I suppose, the Netherlands too, of a potentially catastrophic downside to their financial sectors and their economies were Italy to default.

Yet, default becomes increasingly probable if politics rules out alternatives.

If or when that happens, the eurozone will not be ready.


Relations between China and America are infected with coronavirus

China-bashing has become a bipartisan passion

FACED WITH the first great crisis of his presidency, Donald Trump fell back on his go-to tactic: blame China. His decision in January to bar non-American visitors from the country appears to have been his only prompt action against the coronavirus. After that failed to prevent it penetrating America’s borders, he has been insisting on China’s responsibility for the pathogen.

While the disease was concentrated in China, Mr Trump called it by its approved name, coronavirus. Since its arrival in America he has referred to it, in daily tweets and briefings, as the “China virus”. Others in his administration use “Wuhan virus”, including Mike Pompeo, the secretary of state. He is reported to have demanded the G7 group of industrial countries call it by that name. A White House staffer is said to prefer the phrase “kung flu”.

It is easy to see what Mr Trump is about. He wants to distract from his administration’s failure to contain the disease—such that America, despite having had months to prepare for it, will soon have more covid-19 cases than China.

He also sees in the issue an opportunity to own the libs. A note circulated by Mr Trump’s re-election campaign last week suggests that it plans to make the president’s fearlessness in uttering the phrase “China virus” a defining difference between him and his presumed Democratic opponent, Joe Biden. In 2016 Mr Trump portrayed Hillary Clinton’s aversion to the unhelpful phrase “radical Islamic terrorism” as weak; he has updated the tactic.

Yet what candidate Mr Trump said in 2016 and what America’s president says are different matters. China has responded angrily to his administration’s slurs. Where recent pandemics—including the 2014 west African Ebola outbreak—saw productive Sino-American co-operation, this one has taken the already-poor relations between Mr Trump and Xi Jinping to new lows.

And they are liable to worsen, despite efforts on both sides to rein in the rhetoric this week. Mr Trump appears set on a campaign of China-baiting which America’s looming recession and death toll will make more feverish, especially as the virus spreads to Republican-voting states. China-watchers warn of a rising risk of a “low probability, high consequence” upset. In the best case, one opines, the relationship with China will be “utterly broken”.
The best way to lower the tension would be if Mr Trump’s diversionary tactic failed. But this would require his supporters to denounce his handling of the virus, of which there is currently no sign. Republicans admire it. And even if their faith wobbled, Mr Trump’s China-bashing would be likelier to sustain his popularity on the right than to endanger it.

This reflects more than Republicans’ traditional hawkishness. Bashing China unites two of the Republicans’ main factions: national-security sorts, who dislike Mr Trump’s protectionism but like his belligerence, and economic populists, who are wary of militarism but love the tariffs. By extension, it is also one of the ways the Republican establishment, which dominates the former group, has made peace with Mr Trump.

No wonder ambitious Republicans, who try to keep a foot in both camps, sound especially hawkish. They include Mr Pompeo, who calls China’s ruling party “the central threat of our times”.

Discernible, too, amid the Republican mistrust of China is a fear of national decline that looks like an accompaniment to white conservatives’ dread of the socio-demographic currents that threaten the party. In a tweet this week, Newt Gingrich, a Trump loyalist and former presidential candidate, lamented that Huawei, a Chinese telecoms firm emblematic of state capitalism, was dispensing medical supplies while “our once great telecommunications companies have lost their entrepreneurial drive.”

This helps explain why Republicans find it easy to ignore the obvious expediency of Mr Trump’s latest China-bashing. It also explains why few appear to have registered that his antagonistic China policy has not achieved much.

His tariffs have been ruinous to American farmers and consumers and won no big concessions from China on any of the issues, such as intellectual-property theft, they were supposed to address. The need to confront China has been embraced by many Republicans as an ideological imperative, requiring no supporting evidence of its wisdom.

And yet the pandemic also points to other ways in which Mr Trump’s policy has backfired. In line with its general disregard for science and civilian expertise, the administration slashed the Centres for Disease Control’s China-based staff—the potential focal point for Sino-American pandemic co-operation—ahead of the outbreak.

Instead of rallying its allies in a global response to the pandemic, it has continued to alienate them. Mr Trump gave the Europeans no forewarning of his plan to bar non-American visitors from their countries this month. Instead of rising above China’s propagandists, he got into the mud with them.

Sino’ the times

Earlier this month Mr Trump was lambasted for having allegedly tried to buy a promising German coronavirus vaccine for America’s exclusive use. He would do better to reignite the liberal values and openness to talent upon which America’s economic dynamism is based. Last week Propublica, a news website, described how a Chinese scientist, Weihong Tan, was hounded from the University of Florida last year by federal restrictions on scientists with ties to China.

Now at Hunan University, he switched from cancer research and created a faster test for covid-19. And Mr Trump’s recent rhetoric, which has helped inspire a surge in hate crimes against Asian-Americans, cannot have tempted him to return.

Mr Trump’s effort to redefine relations with China as fundamentally competitive may prove to be his most enduring legacy. Contrary to his politicking, even Democrats now see the relationship in those terms.

His management of it, as the pandemic highlights, is a different story: it shows how America can lose.

Mexico’s Three Economic Fronts Face a Recession

By: Allison Fedirka

Mexico is bracing for a serious economic recession this year, much like the rest of the world.

But unlike many other countries, the Mexican government is not meeting the event with an abundance of bailouts, tax breaks or other fiscal measures.

Instead, Mexican President Andres Manuel Lopez Obrador (popularly known as AMLO) has opted to stay the course with his plans of austerity and social development funding, much to the chagrin of big business.

He has made it clear that his goal for combating the recession is to avoid sovereign debt and mitigate the impact felt by the country’s poor. Lopez Obrador is facing three fronts in his battle against a recession in Mexico: the country’s formal, informal and black market economies. And his decision to focus on propping up and reining in the informal economy through continued social development funding is more than just a continuation of adherence to political policy. It also reflects that the government is unable to effectively address the other two economies on its own.

The Three Economic Fronts

Lopez Obrador’s strategy to confront the economic recession preserves his big-picture plan to “transform” the Mexican economy and wrestles with the fact that the Mexican economy can be clearly divided into three distinct sub-economies, each playing by its own set of rules. The formal economy is characterized by services, finance and high-end manufacturing with intricate supply chains.

It generates 77.5 percent of the country’s gross domestic product and is concentrated in the central and northern parts of the country. The informal economy — a “gray zone” not taxed or regulated by the government but still legal — generates 22.5 percent of the country’s GDP and is characterized by precarious employment, basic manufacturing and low wages. It exists in much higher concentrations in the country’s south.

The black market economy, run by organized crime, is prevalent throughout the entire country. Its economic contribution is not clearly known given the illicit nature of its activities, but recent estimates put Mexican drug sales to the United States at $19 billion to $29 billion annually.

Despite its illegality, the black market injects a massive amount of capital into the economy, which generally speaking is a good thing. On the other hand, it also deters investment and infrastructure development and breeds extortion, corruption and violence. The result is a mixed bag of economic effects that is not easy to define or calculate.

AMLO’s proposed solution for dealing with the segmented nature of Mexico’s economy involves diminishing the economic and development disparities across the country through youth education and job training programs, labor-intensive infrastructure projects, support for small businesses, anti-corruption measures and government austerity.

In other words, he is attempting to reduce the informal economy and merge it with the formal economy.

His approach has been controversial and viewed by the opposition as contrary to the ultimate objectives of developing and growing Mexico’s economy. Indeed, the segmented nature of the country’s economy makes it extremely difficult to pursue a policy that helps one segment without hurting the other two.

But in the face of the recession, the government has opted to direct the few funds it has toward the informal sector, an approach that aligns with long-term goals and exists as the most viable short-term solution available.

The Formal Economy: Severe Limits

Mexico’s formal economy has a high degree of exposure to external forces and is therefore largely out of the government’s control. For starters, the Mexican economy is largely dependent on the health of the U.S. economy.

Mexican exports to the United States are equivalent to about 31 percent of the country’s GDP, and the United States is the leading supplier of foreign direct investment to Mexico. Remittances, which totaled $36.05 billion last year, are Mexico’s largest source of U.S. dollars, and 95 percent come from senders in the United States.

When the U.S. economy performs poorly (or restricts border crossings), the effects are often amplified in the Mexican economy. The International Monetary Fund expects the U.S. economy to contract 5.6 percent this year, and new unemployment claims in the country at the time of publication stand at 22 million.

For Mexico, this means that there are far fewer buyers of Mexican goods and that the country can’t trade its way out of the crisis, even considering the strong decline in the peso’s value relative to the dollar so far this year.

To escape its mild 2019 recession, Mexico had planned to turn to foreign direct investment in 2020. And even before a global recession became imminent, the government was struggling to attract foreign investment over concerns of regulations, crime and general doubts over management. Now, the United Nations estimates that foreign investment will drop by 30-40 percent globally this year.

For Mexico, this means investment will be difficult to come by and require fierce competition with others. Foreign investment is no longer a viable option to stimulate the economy. Lastly, other major financial sources, such as oil and tourism, not only remain out of Mexico’s control but have poor prospects this year.

Admittedly, state-owned oil company Pemex has been struggling for years, but even in the company’s best-case scenario, it can do little to address low oil prices, let alone change them.

As for tourism, travel restrictions and personal fears mean the cancellation of many summer trips.Mexican Foreign Direct Investment, 2006-2019

The Mexican government has offered little to mitigate the recession’s impact on the formal economy because the influence of external factors will outweigh much of what it can offer. The government says it only has about $10 billion available from various rainy day funds. This means the bailouts, tax breaks and fiscal stimulus called for by businesses in the formal sector cannot be executed on a scale that would have an impact on a $1.3 trillion economy.

Effectively stimulating an economy takes massive amounts of money, which often means taking on debt — and the concern over government debt in Mexico predates AMLO. The government currently does not have enough reserves to cover its debt in the event of an emergency, and incurring new debt would make matters only worse.

Additionally, spending money on the formal economy would largely put the two other major segments of the economy on the sidelines. The government’s financial authorities did loosen liquidity rules on banks, which they assert are well equipped to handle the pending economic crisis, but aside from that, it has taken a largely hands-off approach.

The Informal Economy: Opportunity for Impact

The Mexican government has directed its efforts toward the informal economy because its potential for impact is higher and the informal economy plays a critical role in the workforce. Mexico defines the informal economy as one that includes any economic activity that is legally produced and marketed but the production or distribution units are not formally registered.

It also includes all economic activities that operate from family resources, such as micro- and small businesses that are not constituted as companies. Because informal workers tend to have lower-quality jobs, lower wages and no insurance compared to those with formal-sector jobs, they are more vulnerable to recession.

And since the latest official figures from the end of 2019 show that Mexico’s informal sector employs 56.2 percent of all workers, a sizable portion of the country’s working population is highly vulnerable to recession.

The actions the Mexican government has taken to mitigate the impact of a recession on the country’s economy have focused on supporting the continued employment of informal workers.

Earlier this month, the government said it would provide a 25,000-peso ($1,000) credit for small and micro-companies that have retained employees and not reduced wages, offering low interest rates that increase slightly by company size.

The plan allows for a million total recipients, though an estimated 5 million will request access, and money will arrive in May and June.

This low-interest-rate credit will need to be paid back in three years, with payments starting after the fourth month. Lopez Obrador also announced additional credit for the creation of 2 million more formal jobs this year, but such a project was already in the works prior to the global recession.

One wild card that could impede the government’s task of easing the recession’s impact is remittances, which play a key role in many household incomes, particularly in poor segments of the economy.

BBVA estimates that, this year, remittances will decline by 17 percent to $29.9 billion due to the recession and mass unemployment in the United States. Nevertheless, from the government’s perspective, it’s still more cost-effective to support working programs now than deal with millions of people eventually out of work amid economic collapse.

The Black Market Economy: A Very Large Shadow

Though Mexico’s organized crime groups are not often considered in terms of their contribution to economic activity, they must also be factored in to efforts to combat the recession. For better or worse, the large scale and high value of their operations do create jobs and support economic activity at local levels.

The pervasive nature of organized crime means it touches the pocketbooks of hundreds of thousands of Mexicans. And these groups are not immune to the recession, though they are positioned better than most to confront it.

Like many multinational companies, organized crime groups in Mexico experienced supply chain disruptions with the slowing global economy, particularly with respect to the chemical precursors from China used to make fentanyl.

The disruptions hurt major fentanyl suppliers, such as the Sinaloa and Jalisco New Generation cartels.

Meanwhile, alternative revenue flows, including human trafficking, fuel robbing and extortion, are not currently available due to increased border restrictions, low oil prices and businesses going on hold for quarantine.

Of course, the addictive nature of drugs means that demand in that area remains. And that, in turn, has meant an increase in price due to supply chain shortages and stricter border measures.

AMLO’s government will have to face the threat of increased social and political encroachment by organized crime. The recession and health crisis have already presented organized crime groups with opportunities to intensify their presence in socioeconomic gaps in place of the government.

Big-name cartels like Golf, Jalisco New Generation and Sinaloa have also started community outreach and charity programs to provide locals with goods at a time when supplies and funds are scarce.

In this area, AMLO finds himself extremely limited in terms of what he can do to combat organized crime, particularly on the economic end; freezing assets will not reach a sum high enough to stop operations anytime soon.

This is one major reason that AMLO reiterated his plans to continue social development funding and welfare programs, which are intended (at least on paper, over time) to undermine the hold that organized crime has on local communities.

That said, the president knows this remains a weak point for the government because it cannot throw money around as easily as the cartels.

The Only Real Option

Lopez Obrador was forced to choose sides in preparation for mitigating the impact of Mexico’s deeper recession, and his outlier approach of rejecting stimulus measures reflects the reality of three very distinct economic segments, none of which overwhelmingly dominates the others.

He does not have the funds or enough control over the formal economy to risk stimulus; he does not have the reach or security ability to take on organized crime.

What remains is the country’s informal sector, where the bang for the buck (or punch for the peso) is larger, and where efforts generally align with longer-term goals of integrating the informal economy into the formal one, thereby improving economic standards for Mexico’s lower socioeconomic classes.

This may not be considered the ideal move by many, but it’s AMLO’s only decent option.

With New Hot Spots Emerging, No Sign of a Respite

While cities like New York have seen a hopeful drop in cases, upticks in other major cities and smaller communities have offset those decreases.

By Julie Bosman, Mitch Smith and Amy Harmon

A neighborhood in New York City, which has seen a drop in new cases of the coronavirus.Credit...Brittainy Newman/The New York Times

In New York City, the daily onslaught of death from the coronavirus has dropped to half of what it was. In Chicago, a makeshift hospital in a lakefront convention center is closing, deemed no longer needed. And in New Orleans, new cases have dwindled to a handful each day.

Yet across America, those signs of progress obscure a darker reality.

The country is still in the firm grip of a pandemic with little hope of release. For every indication of improvement in controlling the virus, new outbreaks have emerged elsewhere, leaving the nation stuck in a steady, unrelenting march of deaths and infections.

As states continue to lift restrictions meant to stop the virus, impatient Americans are freely returning to shopping, lingering in restaurants and gathering in parks. Regular new flare-ups and super-spreader events are expected to be close behind.

Any notion that the coronavirus threat is fading away appears to be magical thinking, at odds with what the latest numbers show.

Coronavirus in America now looks like this: More than a month has passed since there was a day with fewer than 1,000 deaths from the virus. Almost every day, at least 25,000 new coronavirus cases are identified, meaning that the total in the United States — which has the highest number of known cases in the world with more than a million — is expanding by between 2 and 4 percent daily.

Rural towns that one month ago were unscathed are suddenly hot spots for the virus. It is rampaging through nursing homes, meatpacking plants and prisons, killing the medically vulnerable and the poor, and new outbreaks keep emerging in grocery stores, Walmarts or factories, an ominous harbinger of what a full reopening of the economy will bring.
“If you include New York, it looks like a plateau moving down,” said Andrew Noymer, an associate professor of public health at the University of California, Irvine. “If you exclude New York, it’s a plateau slowly moving up.”

In early April, more than 5,000 new cases were regularly being added in New York City on a daily basis. Those numbers have dropped significantly over the past few weeks, but that progress has been largely offset by increases in other major cities.

Consider Chicago and Los Angeles, which have flattened their curves and avoided the explosive growth of New York City. Even so, coronavirus cases in their counties have more than doubled since April 18. Cook County, home to Chicago, is now sometimes adding more than 2,000 new cases in a day, and Los Angeles County has often been adding at least 1,000.

Dallas County in Texas has been adding about 100 more cases a day than it was a month ago, and the counties that include Boston and Indianapolis have also reported higher numbers.

It is not just the major cities. Smaller towns and rural counties in the Midwest and South have suddenly been hit hard, underscoring the capriciousness of the pandemic.

Dakota County, Neb., which has the third-most cases per capita in the country, had no known cases as recently as April 11. Now the county is a hot zone for the virus.

Dakota City is home to a major Tyson beef-processing plant, where cases have been reported. And the region, which spreads across the borders of both Iowa and South Dakota, is dotted with meat-processing plants that have been a major source of work for generations. The pattern has repeated all over: Federal authorities say that at least 4,900 meat and poultry processing workers have been infected across 19 states.

The Tyson plant in Dakota City has temporarily closed for deep cleaning. Now the workers wait, afraid to go back to work but fearful not to.

“They need money and they want to go back of course,” said Qudsia Hussein, whose husband is an imam helping counsel the families of workers who have been sickened or have died. With many businesses shuttered or suffering financially because of the pandemic, she said, “There’s no other place they can work.”

Trousdale County, Tenn., another rural area, suddenly finds itself with the nation’s highest per capita infection rate by far. A prison appears responsible for a huge spike in cases; in 10 days, this county of about 11,000 residents saw its known cases skyrocket to 1,344 from 27.

As of last week, more than half of the inmates and staff members tested at Trousdale Turner Correctional Center in Hartsville, Tenn., were positive for the virus, officials said.

“It’s been my worst nightmare since the beginning of this that this would happen,” said Dwight Jewell, chairman of the Trousdale County Commission. “I’ve been expecting this. You put that many people in a contained environment and all it takes is one.”

Everyone in town knows about the outbreak. But they are defiant: Businesses in the county are reopening this week. On Monday evening, county commissioners held an in-person meeting, with chairs spaced six feet apart. They have a budget to pass and other issues facing the county, Mr. Jewell said.

“We’ve got to get back to the business of the community,” he said.

Infectious-disease experts are troubled by perceptions that the United States has seen the worst of the virus, and have sought to caution against misplaced optimism.

“I don’t see why we expect large declines in daily case counts over the next month,” Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center who has studied the spread and evolution of the virus, wrote on Twitter. He added, “There may well be cities / counties that achieve suppression locally, but nationally I expect things to be messy with flare-ups in various geographies followed by responses to these flare-ups.”

The outbreak in the United States has already killed more than 70,000 people, and epidemiologists say the nation will not see fewer than 5,000 coronavirus-related deaths a week until after June 20, according to a survey conducted by researchers at the University of Massachusetts at Amherst. A federal projection, based on government modeling pulled together by the Federal Emergency Management Agency, forecasts a steady rise in deaths in the next several weeks, to a daily death toll of 3,000 on June 1.

Across the country, scientists tried to project the virus’s future course, and the results have been a range of shifting models. An aggregate of several models assembled by Nicholas Reich, a biostatistician at the University of Massachusetts, predicts there will be an average of 10,000 deaths per week for the next few weeks. That is fewer than in previous weeks, but it does not mean a peak has been passed, Dr. Reich said. In the seven-day period that ended on Sunday, about 12,700 deaths tied to the virus occurred across the country.

“There’s this idea that it’s going to go up and it’s going to come down in a symmetric curve,” Dr. Reich said. “It doesn’t have to do that. It could go up and we could have several thousand deaths per week for many weeks.”

The deaths have hit few places harder than America’s nursing homes and other long-term care facilities. More than a quarter of the deaths have been linked to those facilities, and more than 118,000 residents and staff members in at least 6,800 homes have contracted the virus.

There is no escaping some basic epidemic math.

In the absence of a vaccine, stopping the spread of the virus requires about two-thirds of the population to have been infected. And some experts have argued that before what is known as herd immunity kicks in, the number of people infected nationwide could reach a staggering 90 percent if social distancing is relaxed and transmission rates climb. (It is also not clear how long immunity will last among those who have been infected.)

As testing capacity has increased, so has the number of cases being counted. But many jurisdictions are still missing cases and undercounting deaths. Many epidemiologists assume that roughly 10 times as many people have been infected with the coronavirus than the number of known cases.

Because of the time it will take for infections to spread, incubate and cause people to die, the effects of reopening states may not be known until at least six weeks after the fact. One model used by the Centers for Disease Control and Prevention includes an assumption that the infection rate will increase up to 20 percent in states that reopen.

Under that model, by early August, the most likely outcome is 3,000 more deaths in Georgia than the state has right now, 10,000 more each in New York and New Jersey, and around 7,000 more each in Pennsylvania, Illinois and Massachusetts. Under the model’s most likely forecast, the nation will see about 100,000 additional deaths by Aug. 4.

“Even if we’re past the first peak, that doesn’t mean the worst is behind us,” said Youyang Gu, the data scientist who created the model. “It goes up quickly but it’s a slow decline down.”

Reporting was contributed by John Eligon, Robert Gebeloff, Danielle Ivory, Dionne Searcey, Timothy Williams and Karen Yourish.

China-U.S. Relations in the Era of COVID-19: What Lies Ahead?

The China-U.S. “Phase One” trade deal now feels like ancient history. How will the relationship between the world’s two most powerful countries change in the wake of the COVID-19 pandemic? In this opinion piece, Wharton dean Geoffrey Garrett offers predictions for 2020, 2021, 2022 and beyond.

It feels like ancient history now but it was only three months ago that China and the United States signed a “Phase One” trade deal and declared a cease fire to their 18-month trade war. Back then, this conflict was the biggest threat to the global economy.

Now, the new coronavirus is changing and challenging literally everything. The China-U.S. relationship — arguably the most important bilateral relationship in history between the world’s biggest and most powerful countries — is no exception.

Here are my predictions about those changes, from right now to how the world will look when we are on the other side of the crisis.

1.The Very Short Term (Now Through the Second Half of 2020) – Name calling, but no new crises.

Political leaders are under impossible pressures. Why didn’t they see the crisis coming?

Why didn’t they act sooner?

How are they going to mitigate its economic damage?

It is no surprise that some political leaders in China and the U.S. have engaged in mudslinging over the origins of the coronavirus. This is very regrettable since it cannot help — and only distracts from — the gargantuan challenge of responding to the combination of a once-in-a-century public health crisis coupled with the biggest hit to the global economy since the Great Depression.

But this mudslinging has not risen to the level of official foreign policy. The only exception is Donald Trump’s very public questioning of the World Health Organization’s activities in, and support for, China during the early stages of the crisis. The president then balanced his criticism of WHO with his respect for Xi Jinping.

Keeping a lid on the name calling — despite the domestic political incentives to escalate — is a good thing. And I expect it to continue, for one obvious reason: Neither China nor the U.S. can risk any further destabilization of their economies, which would surely be the consequence of any new diplomatic crisis between the two countries.

I suspect “no new crises” will extend through the remainder of 2020, above all because both China and the U.S. will do whatever they can to try to engineer something like a V-shaped recovery in the final quarter of the year.

2.Through the Phase One Timetable to December 31, 2021 – A much-reduced trade deficit, without China’s meeting its Phase One commitments.

The end of 2021 is the deadline for the most important provision of the Phase One trade deal:

China’s commitment to buy $200 billion additional goods and services focused on agriculture, energy and manufacturing. That is the next natural milepost in the evolution of China-U.S. relations.

The plain truth is that it will be essentially impossible for China to meet this commitment. It was always going to be extremely hard for the Chinese government to guarantee what amounted to a trebling of Chinese imports from the U.S. in two years.

Now the reality of an unprecedented economic slowdown in China — the IMF is estimates that the Chinese economy will grow by 1.2% in 2020, by far the worst performance since China’s “opening up” in 1978 — makes it almost fantastical to believe that Chinese domestic demand could absorb so much additional American production.

Source: World Bank World Development Indicators

But while it seems fanciful to expect China to meet its Phase One commitments, there is much better news on the Trump administration’s ultimate reason for the trade war — the mushrooming of the trade deficit the U.S. has run with China over the past two decades, topping $400 billion in 2018.

A stunning thing happened while all our attention was focused on the trade war: For the first time in 20 years, the trade deficit declined in 2019, by $74 billion. Note, however, that this was a product of the fact that China sold $87 billion less in goods and services into America in 2019 compared to 2018. Over the same 12 months, American exports to China (Trump’s hobbyhorse) actually declined, but by much less ($13 billion). This trend of much lower Chinese exports to the U.S. is bound to get even more pronounced with plummeting U.S. demand for the remainder of 2020.

“Neither China nor the U.S. can risk any further destabilization of their economies, which would surely be the consequence of any new diplomatic crisis between the two countries.”

If the U.S. government cares above all about the trade balance with China, the next two years are likely to be full of good news. But if the U.S. remains fixated on American exports to China, the road will be much rockier.

I hope cool heads prevail, because the U.S. will have every reason to understand why China won’t be able to meet its core Phase One commitment. This could open the possibility of new negotiations over a Phase Two deal with China, rebased post-COVID-19, and from a better position from the U.S. perspective (i.e., a smaller trade deficit).

3. 2022 and Beyond – A new “new normal”: decoupling, deglobalization and geopolitical instability.

I am not sure, however, that the broader climate of China-U.S. relations will accommodate something like a Phase Two trade deal. True, the China-U.S. trade imbalance will have narrowed greatly, something most will cheer. But I suspect this good news will be overwhelmed by a post-COVID-19 new normal in which the watch words will be “decoupling” and “deglobalization.”

The decoupling of the global supply chains entwining the American and Chinese economies has become an increasing priority for both countries in the past year, especially where there are national security considerations (e.g., high-tech firms like Huawei). Now with the coronavirus, everybody is already talking about the imperative to “shorten” and “strengthen” the healthcare supply chain. Far from slowing down decoupling, the virus will only accentuate efforts to disentangle the American and Chinese economies from each other.

Source: U.S. Census Bureau

The same story holds true for globalization more generally. The above graph makes two things clear.

First, the rise of China as a trading nation was perhaps the greatest driver for the unprecedented globalization we witnessed in the 30 years from 1980 to the financial crisis.

Second, 2008 was already standing out as “peak globalization,” with a dramatic decrease in China’s reliance on trade in the decade since then and a stagnation of both global and American trade at the same time.

Decoupling between China and the U.S. is looming now as the driver of even further deglobalization in the post-COVID-19 world.

As my colleague Mohamed El-Erian put it well in a lecture to Penn students recently, the globalization era was all about “efficiency.”

We are now entering a period that will be likely dominated by “resiliency,” and resilience requires sacrificing cost, quality, and choice in the name of security of supply.

That means deglobalization.

I fear the ultimate price of deglobalizing will be measured in terms of increased geopolitical instability and the greater chance of conflict between China and the U.S. above all.

It may feel a long way from the immediacy of the COVID-19 crisis.

But it is unfortunately all too easy to picture the path that might lead us there.

We can only hope that our political leaders in both countries are capable of managing down their conflicts in the name of peace and prosperity.

How Aging Societies Should Respond to Pandemics

Whereas just over 2.5% of the US population was over 70 in 1920, that share is now more than 10%. This shift has major implications for how the coronavirus spreads, how many people will die, and how we should respond to this and future pandemics.

Andrew Scott

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LONDON – The global fight against COVID-19 has triggered a surge of interest in the 1918-20 influenza pandemic that killed more than 50 million people around the world.

But while we can learn lessons from the past, we must recognize what is different this time and tailor our response accordingly.

Above all, society is aging. In 2018, for the first time in history, the world had more people aged over 65 than under five. Whereas just over 2.5% of the US population was over 70 in 1920, that share is now more than 10%. This shift has major implications for how the coronavirus spreads, how many people will die, and how we should respond to this and future pandemics.

Consider the number of expected COVID-19 fatalities in the United States. One recent high-profile study concluded that, absent policy changes in the US, the coronavirus would lead to 2.2 million deaths.

But if today’s US population was the same size, but with the (younger) age structure of 1920, that number is reduced to 740,000. That difference highlights the potential greater gains today from social-distancing measures to combat COVID-19, further justifying the approach even if it results in heavy economic losses.

When the US government evaluates environmental or public-transport safety measures, it uses the concept of the value of a statistical life (VSL) to gauge cost-effectiveness. Taking this approach, Michael Greenstone and Vishan Nigam of the University of Chicago calculate that social-distancing measures which save the lives of 1.7 million Americans are worth $7.9 trillion, or 37% of US GDP – outweighing even Great Depression-size declines in the economy.

These numbers reflect the aging of US society. Using the 1920 age distribution, the gains from social distancing would be less than half as large; so, any lockdown would be less than half as long.

Even using the US population’s age structure from 1970 would yield gains of only $5.7 trillion. From an economic perspective, therefore, the aging of society over the last 50 years warrants a 40% longer period of social distancing.

The issue is not just the growing elderly population, but also the fact that people are living longer. That makes it more valuable to save lives at all ages, because more people have more years ahead of them. The VSL for an American in their 60s has risen by $2 million compared to 1933 mortality rates, and by more than $1.25 million compared to 1970.

Even those in their 80s have experienced an increase in life expectancy over this period valued at more than $300,000 compared to 1933, and at more than $150,000 since 1970. These longevity gains further increase the benefits of social distancing and the acceptability of associated economic losses.

Moreover, these gains are set to increase further in the decades ahead. By 2050, more than 17% of the US population will be over 70 – boosting the economic value of social distancing to $9.5 trillion, or 44% of today’s US GDP.

Population aging also has important implications for who reaps the benefits of social distancing. Based on the 1920 US age structure, only 22% of the gains would flow to those over 70 years old.

Today, however, that share is just over one-third, and will rise to nearly one-half by 2050. And with labor-market layoffs disproportionately affecting the young, COVID-19 is starting to fuel a political debate pitting generations against one another.

But attempts to spark intergenerational conflict are exaggerated, for several reasons. For starters, the young and the old are part of the same families, and often the same households. Many of the countries that have been most severely hit by the pandemic, such as Italy, have been affected precisely because of their high levels of intergenerational mixing.

Furthermore, the young eventually become old. In fact, the chances of that happening are now much greater than ever before. Back in 1920, a 20-year-old in the US had only a 50% chance of living to 70, compared to an 80% chance today. Young people today should therefore be much more interested than their predecessors a century ago in how society looks after the health of the elderly during a once-in-50-years pandemic.

That doesn’t mean policymakers should ignore intergenerational issues. Ensuring targeted support for the young both now and after the pandemic is essential, especially in the case of college graduates entering the labor market.

One way to do this is by giving priority to younger workers as social-distancing measures are gradually eased. Given that more than ten million US workers are aged over 65, such a phased approach would minimize both the economic and public-health costs of such a policy.

As societies continue to age in the coming decades, we also need to invest in the future differently.

First, we must strengthen our medical capacity to fight pandemics by increasing the supply of intensive-care beds, ventilators, and other essential goods and equipment. As the costs of pandemics increase, so, too, should investment in medical mitigation.

Second, policymakers must focus more on improving how their countries’ populations grow older. While the COVID-19 mortality rate rises with age, it is not just chronological age that matters, but also underlying health conditions. Heart disease, cancer, obesity, and diabetes all increase the fatality risk, and their incidence tends to rise with age.

Focusing on public-health measures and research that slow the rate of biological aging is paramount if society is to exploit fully one of the greatest advances of the last century – the increase in healthy life expectancy. Such efforts will also be crucial to minimizing the costs of future pandemics that will occur over the course of these long lives.

Andrew Scott, Professor of Economics at the London Business School and a consulting scholar at the Stanford Center on Longevity, is the co-author (with Lynda Gratton) of The 100-Year Life: Living and Working in an Age of Longevity.