Julian Jamison is an economics professor at the University of Exeter and a Senior Research Affiliate at the Global Priorities Institute.
rootpi
Karma: 238
Thanks for this! A small point: as one of the coauthors of the Blattman et al Liberia CBT study, we didn’t use trained counselors either (they basically don’t exist in Liberia) so I think this helps somewhat with your legitimate concern about scaling. I wasn’t sure what you meant by job training in that context?
We are just finishing a ten-year follow-up of the same population, with encouraging results, which should be public soon.
Great question and great answers so far. I always liked Alexander Fleming (discoverer of penicillin, which has certainly saved millions of lives) but I suspect someone else would have found it relatively quickly if he hadn’t—although I’ve never looked into the details.
What about George Washington? He obviously wasn’t the intellectual leader of the early USA and its form of government (and should only get a fraction of the credit / blame for everything that followed), but my sense (?) is that he played a key political (leadership) and military role in the revolution. Perhaps more importantly, he voluntarily stepped down after two terms as president, when he was still very popular. This seems rare in history (before or after his time) and likely led to more stable governance since then not only in the USA but also around the world. Arguably the US is the world’s oldest continuous government and oldest democracy; the UK is tough to pin down, but I’d go with the Reform Act of 1832 if I had to pick a year when the House of Commons truly escaped from aristocratic influence.
Another point of agreement: the economics profession currently focuses too much on empirical work. Meanwhile my own personal view is that people like Esther and Chris B are slightly ‘too far’ in the pro-RCT camp, and that people like Lant (and you) are ‘too far’ in the anti-RCT camp. But I don’t see anyone in this discussion as being extreme (except possibly Lant...); healthy disagreement is to be expected and encouraged. Note that Esther and Abhijit’s most recent book tackles macro issues like migration, trade, climate change, and yes growth—using RCTs when possible / relevant but also plenty of other results (including lots of theory! Abhijit started life as a theorist, like I did). Meanwhile Chris has a forthcoming book on war and peace (macro level! no easy RCTs) for which he uses other approaches like machine learning. You can find all sorts of quotes, but the proof is in the pudding. Final point on this is that one can easily combine RCTs with admin data, ML, etc, and researchers (including me) are doing more and more of that, which imo is great—it’s not always one or the other.
As you say, the efficacy of deworming seems to be a point of disagreement between us. Again pulling back somewhat, you link to Eva’s paper as supporting your claim that RCTs have minimal external validity, but her paper is about all forms of impact evaluation (and she notes in the conclusion that the subset of RCTs aren’t special). So this would be extremely damning for economics if true, but her results don’t support your claim. For instance she notes that bednets and conditional cash transfers seem to do very well on this front. More relevantly, her point (as I read it) is to see how much of the nominal variation in effect sizes can be explained by other contextual variables, and she finds that typically a nontrivial amount of it can be. This is good news for external validity, since it means we can often explain / predict the differences even when they do arise.
I think I haven’t been very clear about ‘apples to oranges’ - I agree that these can & should absolutely be compared. I just felt like the way you were doing it glossed over an important difference. I can write a check to AMF and feel very confident that something will change in the world; we can then debate the expected magnitude of the impact of that change. But I can’t write a check to “growth reform in the developing world”, so even before we debate the relative benefits of changing immigration policy vs distributing bednets we have to calculate the probability that the desired policy will get implemented. I realize you’re fully aware of this, but that’s the part I keep coming back to because that’s the part where I’m pessimistic (partly having worked for the US government, although for a counterargument I liked this recent forum post) and suspect that our intuitions disagree, and mostly you keep talking about the benefits of more migration and of GDP growth (which are great!) and not so much about how we sit down and estimate the likelihoods of bringing those about. I’ll admit that the “pessimistic” estimate of 1% on ICRIER in the original post with Hauke really made me distrust everything afterward, since the pessimistic estimate in that case is a negative number and a plausible median estimate seems to be about 1 in a million.
On China I suppose my main point is still that I think it’s simply very very hard to quantitatively estimate most of this. Just because you (or I, or anyone) thinks that something is extremely conservative (when you admit you haven’t put in as much time on all this as you’d like, and indeed it’s not your job to do so) doesn’t make it so. In this specific case, if you forced me to take a stand, my best guess is to agree with you that economists have helped push policy in a better direction and that that made a big difference to global welfare. Even if I felt more confident about that, what is the counterfactual you are comparing to? Did some NGO or the WB cause that to happen on the margin, or would economists have tried to learn about the world and influence policy anyway? Are there similar opportunities going forward? The Taliban says they want economics expertise, so perhaps. But I don’t think we know the answers to these questions (yet), even within orders of magnitude, and whether or not this type of approach will beat RCT-type approaches depends entirely on those particular probabilities.
I’m going to try to step back first and speculate where we actually disagree, in hopes of getting at what you actually think should be happening differently, if anything. You seem to be arguing to some extent against things that do not exist, and in particular that neither I nor others are saying. I think we agree that (i) 1-5% of work in economics should be RCTs; (ii) RCTs are not the right approach for many, indeed most, questions in social science; (iii) there exists lots of policy-relevant and actionable information from non-RCT sources; (iv) intuitions can be a useful input, as long as one is transparent that that’s what they are; (v) the EA community should be spending resources studying policy interventions, including around growth but also imo health (e.g. lead paint, tobacco); and (vi) economists do more good than harm in the world.
Where I think we disagree is that your intuition is that with another three person-years of effort, the EA community will find growth policy funding opportunities (not based on RCTs...) that are far more effective than the current top GW charities, and my intuition is that we won’t (but that I still think we should look, as I’ve said many times, because the uncertainty is high and we might find them!). Neither of us knows for sure, as this hasn’t been done yet. Is it more than that?
You’re right that finding leads but not making recommendations could cause one to update upward, downward, or not at all (depending on one’s prior) so I shouldn’t have suggested that it was necessarily a bad signal. However I didn’t see anything quantitative (I did look at the appendices, but I believe the only quantitatively worked-out example was the incorrect and retrospective ICRIER one in the main text). This makes it very hard to meaningfully compare against current top interventions. I would love if you would be willing to go on the record, with as many caveats as you want, and pick one or two of the ones Hauke listed and put some back-of-the-envelope numbers behind them just to see how it plays out (you said that you “actually don’t think some of the GiveWell numbers are based on more evidence”—so where is your evidence?). Then we could have a substantive discussion. Or maybe I would be convinced once I saw the concrete reasoning.
To say that the net impact of historic policy economists has been positive (which I agree with) does not begin to tell us that it is “better than directly funding RCT-type stuff”: we need (prospective) numbers, or else we’re basing it on your intuition. I don’t reject your argument because it is based on intuition; I reject the claim that it is based on evidence, if it is based on intuition. No inconsistency from me, and certainly no claim that subjective assessments should all be rejected; indeed I have published those and am devoting a large portion of my current / upcoming research agenda to surveying people about their values in order to use those estimates in policy work. No RCTs whatsoever, except some light randomization around framing!
Thanks for checking—no you are not right. If I thought that philanthropists can never cause beneficial policy change, why would the very first sentence of the TL/DR in my very first reply have been “I 100% agree that we should be doing more research on effective ways to leverage broad policy initiatives”?? The issue is that while I can donate to AMF, I can’t donate to “San Francisco planning reform”. There’s an extra step involved in lobbying, which may be where our intuitions differ (I think it’s possible but low probability; I guess you think it’s higher but you never seem to talk about that part as much you do that GDP growth was really big). That’s the sense in which every time you compare a specific GW charity to ‘whatever it was that caused growth’ your claim is difficult to parse and evaluate from the perspective of a philanthropist.
If GW is saying to only consider RCTs, then I very much disagree with them (but see below). NB you’re the one who brought up the Cochrane review as support for your position on worms, even though exactly your own arguments about RCTs not being the holy grail—which I fully agree with—show that it is deeply flawed. I’m not sure who you’re arguing with here. Btw do you have any citations for the claim that “the external validity of all RCTs is pretty minimal”?
GW paid me some years ago specifically to do an informally bayesian analysis of the deworming results (i.e. what should our prior have been before Baird et al?), putting it in the context of everything we know about not just deworming (from RCTs and otherwise) but also the impact of early childhood interventions / shocks on adult outcomes, most of which was not from RCTs. So I honestly don’t know where you get the idea that there’s a group of people out there who only believe in RCTs (except that Lant and Angus D sometimes like to give that impression, so that they can argue against it). The fact that Lant can find one imperfect paper in one good-but-not-fantastic journal (if he had found something in a top-5 journal he would have used it instead, so clearly he didn’t) doesn’t prove much. Can you point to any randomista or organization saying that we should be agnostic before doing RCTs? I would be very surprised if so, because literally no one I know believes that. As far as Tanzanian macro policy, sorry if I gave the impression that you believed that particular example to be true. The difficulty is that you appear to be unwilling or unable to give any specific example whatsoever, so I had to make something up just to instantiate the point that we (as EAs) don’t implement policy; we fund organizations who indirectly influence policy (whereas we directly implement ‘RCT-type’ interventions). But I really didn’t mean to give the impression that you might have claimed that it was somehow always going to be a great approach, so apologies.
Thanks, and as I already wrote above I fully agree that prevalence in top-5 journals is [also] an important indicator—for the reasons you mention. Any new technique is going to be popular at first, both because it’s a shiny new toy (academia over-rewards novelty) and also because there will actually be a lot of useful low-hanging fruit that it can be used for at first (if it has any merits whatsoever, which RCTs certainly do). I suspect that over the next 5/10/20 years the proportion in top journals (which is much lower than 30% overall; that’s just for development) will go down; the proportion in other journals will first go up and then down; and it will settle at something like 10% for development and well under 5% for econ as a whole. This seems about right to me; maybe you think it’s still way too high?
Fair enough that not all of that time (much less all of Lant’s career) was spent trying to come up with a good example here. I still think that if after a nontrivial amount of cognitive resource spent on this by very smart people (e.g. Lant is in an excellent position to have run across something and at least mentioned it), no one has even come up with a single plausible example that’s worthy of further study, that’s discouraging in a bayesian sense. I fully agree it’s worth more research; I simply doubt that anything fantastic will appear after four years of work (or quite possibly ever).
I disagree with all of your (a)-(d), not least because economists and the WB/IMF have caused lots of bad things to happen in addition to lots of good things. However even if we accept those general lines of argument, the conclusion that despite there being only a small chance of success “the size of the rewards are so large that the expected benefits are very large, and must be larger than deworming” is entirely your intuition. I don’t share it, because I think the probability of success is very very small indeed. I could be wrong, and if you have a quantitative argument regarding the probability of any given high-quality campaign being successful a priori (not the actual ex post GDP change over decades) which isn’t based on your intuition, then we can discuss that.
This is indeed apples to oranges. A philanthropist can cause more deworming or bednets to be implemented. A philanthropist cannot privatize agriculture or legalize supermarkets or reduce tariffs. That’s the whole point. China in the 1950s/60s/70s was led by Mao, so how exactly would you (an external EA philanthropist) have convinced him to alter national policy?
External validity is certainly under-studied and -appreciated (at least by most economists, in part because of publication incentives), and I hope that GW takes it into account. The Poland paper I linked to is interesting in part because it reaches very different conclusions than earlier RCTs in the same domain, and I have published specifically on this problem. Criticism is also great, and the worm wars are evidence that Miguel & Kremer has received a lot of criticism! However none of this implies that we “expect the study finding to not be real”; if you have specific criticisms in this case, what are they? The Cochrane report you refer to is highly problematic, in part precisely because it only considers RCTs. For the interested reader, here are some non-RCT papers that all point in the same direction: one two three four
First you said RCTs were not possible in those cases (which I disputed and you seem to have walked back), now you say they are not necessarily useful. Neither I nor anyone else has ever claimed that an RCT is the right way to answer every question in economics, nor that we should be agnostic before any RCTs, so this is a strawman. I’m a theorist at heart (my PhD was on repeated games), and I fully agree with you that modern econ has gone on average too far toward “let the data speak for itself” (whether RCTs or otherwise), and that progress can sometimes be made from armchairs. I just don’t think theory is going to tell us whether in the real world funding an NGO to lobby for change to Tanzania’s macro policy is in expectation a better bet than funding deworming or bednets.
Your phrase was “a substantial chunk of the economics profession (>30%?)”, which I disputed (and linked to a source showing that it is less than 10% even for development). If your claim is instead that a nontrivial minority of the top development papers are RCTs, then I agree. And that’s an important indicator, although very different than the profession as a whole. What do you think the ‘right’ proportion would be in each case? I would also repeat myself that all of those authors value non-RCTs (and many of them also work on non-RCTs), and that both JPAL and GiveWell have become increasingly interested in broader policy work (as they ought to be, imo).
And thanks for your reply! I hope that you are now satisfied, since the issue is being discussed :) More seriously I really am glad you brought it to the fore again, because it deserves it, and I’m being [sincerely] critical only because I take it seriously and respect it.
Re the FP report: so did it find anything promising or not? My reading (could be wrong, obviously, so let me know) was that they/you didn’t in fact find anything to point to; that they/you believe such a thing does exist; but that it would take a lot of time and effort to find it. This is not especially encouraging, given that between them and the experts and you and Lant, at least one person-year has been spent on this already. If all you want is more discussion / research, as I said upfront I agree 100%. If you want to convince me that it is likely to succeed, you need to point to something more than intuition (in part because even the numbers you have thrown around are somewhat suspect).
There still seems to be an apples-to-oranges comparison here. You can criticize specific RCTs, sometimes validly and sometimes not (I’m happy to share the 10+ page report I wrote for GiveWell which on the whole validated the deworming results, and David Roodman’s extensive research came to a similar conclusion). But it’s not helpful to compare a single intervention (note that GiveWell has multiple charities with similarly high estimated ROIs) to “whatever it is that caused [those countries] to grow” which neither you nor the best macroeconomists seem to uncontroversially agree on even in retrospect. My claim is that if deworming had been added to their policy mix (and other aspects had adjusted however they adjusted), that would have been a good thing.
Sure you can run an RCT on allowing foreign investment: subsidize it in some regions and not others. Same for immigration: encourage it in some places (or times) and not others. Same for road pricing. These won’t pick up anything that is truly nationally systemic (and for that reason I agree full-scale tax reform is more difficult, although many taxes can be varied locally), but it doesn’t have to be perfect for us to learn a lot. It also doesn’t have to directly involve a “policy that you might enforce in the real world”—it just has to have useful implications for such policies. Some of these might be hard and take time and involve theory; so is figuring out what causes growth and how to make it happen.
The ICRIER case that you and Lant and FP point to is simply wrong. You suggested in the comments below that >30% of the economics profession is working in the RCT space; this is wrong for development econ (where it is less than 10%) and even further from the truth in other sub-fields. You say in your response to me that “EAs do not support a randomista approach to the rich world”—obviously I can’t speak for EAs in general, but I have worked on RCTs in the US (here and here and forthcoming here), RCTs in Europe (here and here), and for what it’s worth non-RCTs in the US (here and here and here) as well. Eva Vivalt, another EA-affiliated economist, is also working on randomized cash transfers in the US. David Reinstein is working on RCTs of charitable giving.
Purely anecdotally, I have found ‘randomistas’ to be highly practical, perhaps in part because they work more often in the field. I think most of them are happy to apply the technique anywhere it can help. I also think most of them admit that it isn’t always the best approach, whereas I rarely see Lant or Angus Deaton saying the same about RCTs (perhaps because they incorrectly believe the method can only be applied to second- or third-order domains? then again they are very smart people so I have some trouble accepting that explanation).
And finally back to the main question of this particular post. I’m personally not convinced that US policy work will necessarily get close to the GiveWell bar. Whether it does or not, I do think it’s nontrivially possible that developing-world policy wouldn’t beat it by an order of magnitude or more. As has been noted by others here I think, policy work often requires local contextual knowledge and connections, which for many poor countries would first have to be built up by the EA community. Most such work will be country specific, and most such countries (with some important exceptions, like Nigeria and India) have an order of magnitude lower population than the US. Most such countries have less stable governments, so any policy changes won’t last as long in expectation. Lots of factors come into play; it’s not so simple as saying 100x and that you personally don’t see how it couldn’t be true. Don’t get me wrong: it might be true! In fact I do suspect that policy work, like other interventions, will in general have a higher return in the global south. But it’s not a priori obvious.
I’ve been meaning to respond to the original post but never got around to it, so thank you for bringing it back up and encouraging more discussion. I’m not a ‘randomista’ per se, but I have published RCTs as well as non-RCTs, and I have worked in the US as well as many developing countries. FWIW, like Lant I have a PhD in econ from MIT (where I was one year ahead of Esther and TA’d for Abhijit), have taught at Harvard (and elsewhere), and used to work at the World Bank. We’re also fairly evenly matched at tennis, judging from an interesting doubles game many years ago. I was one of the ‘experts’ for the Founders Pledge work on this topic, which as you know didn’t suggest anything specific despite thinking hard about it for at least a little while.
TL/DR: I 100% agree that we should be doing more research on effective ways to leverage broad policy initiatives, including for growth (but also e.g. health). We know a lot about basically good macro policies (and imo very little beyond that; then again I’m a microeconomist) and it would be great to get countries to do more of those. This is hard, and no one seems to have particularly convincing concrete ideas about what to do differently (create another World Bank to compete with the first one??). The potential returns are high, but in expectation not necessarily any higher than for ‘RCT-led’ policies.
Detailed comments:
In a response here you say that no one would encourage Rwanda to do RCTs as growth policy—of course not: the RCT is not the policy, rather the evaluation. Research is not policy. In the original post you talk about NGO assistance (which you identify with small RCTs) vs govt policy (big impacts), but the point of many RCTs is to influence governments (and on the flipside the EA community is most likely to influence macro policy via NGO intermediaries as well).
More broadly I think you need to be careful to compare apples and apples. In the OP you say that you don’t think e.g. deworming is in the top 100 ways to increase growth. [As it happens I think deworming or bednets would have been a fantastic idea for most countries in say 1930; the fact that Denmark didn’t do it and still grew does not imply that it wouldn’t have been a better way for them to spend resources than most other policies they pursued.] Are you comparing to “institute macroeconomic stability” or to “fund a start-up that tries to convince Liberian officials to pay more attention to exchange rate fluctuations” ? It’s not well-defined as stated.
Also in the OP you say that no one argues that the huge welfare gains in e.g. China were due to interventions of “this [RCT] type”—well I do! There were huge gains in health, agriculture, urban migration, etc, all of which are regularly studied by RCTs. Also contra your claim in the comments here that none of immigration, housing reform, road pricing, ag subsidies, tax reform, etc can be evaluated with RCTs—of course they can be. NB I’m not claiming that RCTs led China to make those changes (which hadn’t happened yet).
You cited Weil (2014) as saying that health doesn’t have much effect on growth, but I noticed that he doesn’t reference either Hoddinott et al (Lancet 2008) or Baird et al (QJE 2016; working paper was public years earlier), both of which find that adult incomes are 10-15% higher after very low-cost childhood health interventions (a very high ROI!). You can call the latter work controversial if you want, but when I wrote a background piece on deworming for GiveWell there actually seemed to be a lot of evidence that ~10% income gains was pretty reasonable to expect.
Okay let’s talk about ICRIER, the example that Lant and you point to. He talks about an initial gift from Ford of $36mil (chosen to fit nicely with India’s additional $3.6trillion of GDP, but which Lant “strongly suspects” is the right order of magnitude). In fact I went back and read ICRIER’s entire 20th anniversary report, which thanked Ford for $250k. Their earliest annual report that I could find online (from 2002) shows an endowment of just over $2mil. Hence $36mil is wrong by a couple of orders of magnitude. If anything this would make your argument stronger of course: somehow Ford predicted ex ante (else this is not a useful example for us now) that donating a few hundred thousand had a nontrivial chance of increasing Indian GDP by trillions of dollars. Wow :)
On the other hand, you’d think that if ICRIER believed that their actions (quoting Lant) “increased by 10 percent the odds India adopted growth accelerating policies (my read of the situation is that it was higher)” they would have mentioned this somewhere in their celebratory 20th anniversary document? They don’t. Lant mentions the crisis of 1991; they don’t. Lant mentions the growth acceleration of 1993; they don’t. Closest seems to be the claim that a book by I.J. Ahluwalia (at one point an ICRIER affiliate), published by Oxford in 1985 after many years of work, may have influenced policy, although her wikipedia page doesn’t say anything along those lines and I couldn’t find any other evidence for it.
I love Lant and Michael Clemens’ work on immigration reform, and I think it’s hugely important. But to compare that or ICRIER to RCTs you need to make ad hoc back-of-the-envelope calculations about actually influencing policy. I can come up with similarly large numbers for RCTs (except based on much more evidence): GiveWell says we can save a [probabilistic] life for less than $5k, and the typical VSL is $5mil, so that’s an ROI of 1000 right there...
I liked the post (I have worked a lot on RCTs, and a little on NPIs, but not together alas!). Here’s another paper that I didn’t see mentioned (although maybe I missed it) which I think roughly falls into the category you’re considering?https://www.nber.org/system/files/working_papers/w27496/revisions/w27496.rev0.pdf
I feel like there are also some behavioral econ papers looking at e.g. social distancing in queues, but off the top of my head I’m not certain if there are actual randomized field experiments in that space...
-julian
Thanks for this great post. I’m closer to left-libertarian or classical liberal myself, but I have many friends and family (mostly in the US) who are more traditional progressives and much more sympathetic to typical social justice concerns than to EA. I agree with many of the issues identified here (including in the comments); my own experience has been that it is largely that they want to be able to “walk and chew gum at the same time”. As an economist, I’m imbued with notions like opportunity cost and only being able to optimize one goal at a time (potentially itself an aggregation of course), but this is very foreign and off-putting to them. Either they don’t understand the size of the actual disparities between issues, or… well actually I’m not sure, it’s hard for me to wrap my head around.
However I particularly wanted to mention an illuminating recent post by Matt Yglesias (who came up elsewhere in the comments) on his substack: https://www.slowboring.com/p/slate-star-codex
The main topic is distinct, but from “The radicalism of effective altruism” onward it is very relevant and informative. On the one hand Yglesias is criticizing the journalist’s progressive critique of EA, SSC, Silicon Valley, etc. On the other hand Yglesias (who is definitely on the left, and who likes evidence and reason a lot) doesn’t end up very sympathetic to EA himself. He thinks of it as purely consequentialist, extreme, etc. Even if it’s hard to attract some full-on progressives, someone like him should be exactly the type of person who supports EA. Something has gone wrong with the messaging if that isn’t the case, and we are missing out.
I agree with several of the previous responses, but just to add something I haven’t seen mentioned: it is a new / different experience ‘outside the convex hull’ of anything else. I selfishly enjoy that, because I like to experience new things (travel, changing research focus, ultra-running, etc), but I also believe that all of this gives me a more flexible and broader view of the world and how it can work and what it can contain, in a way that improves my perspective and my thinking. Imagination only goes so far, even for the most creative amongst us.
I consider myself ‘EA-adjacent’ for the past few years—very sympathetic and somewhat knowledgeable, although not fully invested for various reasons. However I think I was already broadly aware of all the IBCs you listed. So perhaps I am more invested than I thought! But my preferred interpretation is that most people who are sufficiently interested in EA and also sufficiently open to considering various causes will have already found most of these or will do so relatively quickly on their own. Obviously I could be wrong, and if you do a survey we will find out at least the first half.
[Note that I fully agree with you that it is very beneficial for people to be aware of these!]
Hi—I’m an American (although dual citizen with Canada) who worked in US government for six years (at the Fed and the CFPB) and am now an academic in the UK so happy to give my thoughts briefly; feel free to reach out if you’d like to discuss further.
I agree with the general premise, both because the US is so large and because (for better or worse, and despite everything) the US is still seen as a leader in many ways: whether or not they copy it (often not, often with good reason), almost everyone will at least consider doing anything the US does. The US system has more built-in checks & balances than the UK’s parliamentarian system, which can limit scope for progress, but that’s mostly at a high level (which is important, but not where most of us will have impact anyway). Similarly the federal system implies more decentralization in the US, which also limits the power of any one actor (federal or state or …). However in terms of the bureaucracy there is a lot of scope for action in the US, e.g. one of the few complaints about the CFPB that was actually true was that it had a lot of power (again for better or worse, but it did and to a lesser extent still does).
In terms of research (and non-profits, which I know a bit but not as well), you’re right that it doesn’t matter as much—except that the best research in many fields happens in the US, if only because it’s a coordinating device and had increasing returns to scale (once the best start coming, they all want to be there). This is certainly true in my field of economics and behavioral science, and I suspect (happy to be corrected) true in many relevant technical fields (climate change, AI, animal cognition) although perhaps less true in something like philosophy.
As others have noted fit and opportunity are probably more important than any of this, but on the margin yes I think there are good reasons to be in the US. [Why did I leave? Partly because my wife is European, and partly just because the senior academic job market is very thin and this was an offer at a good school in a nice location.] And yes, unfortunately I suspect that the Selective Service tickbox may stupidly cause problems; they certainly checked mine when I joined in a standard role. I had somewhat randomly done it when I turned 18 many many years ago and then completely forgotten about.
This is great—thanks. My belief certainly wouldn’t be that simply because of the age structure IFR is going to be lower in developing countries. I do think that will be protective, but I also think that poor health systems will (obviously) go the other way. Some risk factors (generally more stressed immune systems) may work against them; other risk factors (lower rates of hypertension & diabetes) may work in favor. Hopefully treatment regimens will improve over time in useful ways even for resource-poor settings, but it’s hard to predict. So I completely agree with your point in the google doc that current estimates are in some sense biased toward high-capacity countries, but it’s not clear (to me) whether that would make them too high or too low overall. As you say, places with good health info are also those with high life expectancies—which means healthier but also older.
i suppose my current guess is 0.5-1% for the headline number, which is a pretty broad range but there you go. Your analysis shifted this upward a bit!
Sorry for the slow reply! I had been working on some rough estimates for total (i.e. including medium- and long-run downstream impacts) costs and benefits of e.g. lockdown vs targeted social distancing, but even in high-income countries this is hard! This paper from Layard et al (using well-being adjusted life years) is perhaps the closest I’ve seen:
http://cep.lse.ac.uk/pubs/download/occasional/op049.pdf
See also this effort for LMICs from CGD:
https://www.cgdev.org/blog/scoping-indirect-health-effects-covid-19-open-call-resources
Happy to consider collaborating on something for developing countries, if only to get a sense for which dimensions are likely to be first order and hence worthy of further study, but I’m hesitant to believe even that would be feasible with confidence. Perhaps important enough to try in any case? Also not sure I am best placed for it, as a micro economist focusing on individual behavior...
Curious to hear what you think is the best existing evidence for IFR. Indeed 0.1% seems too low overall, but for under-60s my sense was that it is probably 0.1-0.2%, as in these papers:
https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30243-7.pdf
https://www.medrxiv.org/content/10.1101/2020.04.18.20070912v1
Of course the quality of health system resources will affect the IFR, but neither of the ones above (China, Italy) are from ideal situations either so I honestly don’t know how much worse it will be globally.
Thanks! and good question. I wasn’t being very precise, and partly that’s because I suppose I see it on a continuum. The extent to which lockdowns make sense will depend on the context and will be correlated (I believe) with GDP/capita, % formal economy, etc. I actually think a decent case could be made against lockdowns even in high-income countries, although I’m not sure the numbers would come out that way (and I realize that’s far more controversial). It’s true that they are “practical” in middle- and high-income countries, in the sense that they can be (roughly) enforced and won’t directly kill too many people, but they will still cause huge welfare losses (via stress, depression, financial insecurity, intimate partner violence, foregone education, foregone health care, etc, all of which can lead to premature mortality). They will also of course cause welfare gains (saving people from covid, including some indirect deaths, and from vehicle accidents, pollution, and so on). The trade-off isn’t obvious to me for HICs, but it looks pretty clear for LMICs. I fairly strongly believe that primary & middle schools shouldn’t be closed anywhere, except perhaps very temporarily in extreme hotspots.
Hi Richard—this all makes a lot of sense. Gustav Alexandrie and I have a model of ‘perspective-weighted utilitarianism’ which also puts intermediate weight on potential people and has some of the same motivations / implications. I presented it at the June GPI workshop and would be happy to discuss.
-Julian