by Lambert Strether
April 29, 2020
from NakedCapitalism Website
 

The Wall Street Journal (also at MSN website) produced an intriguing piece the other day, "The Secret Group of Scientists and Billionaires Pushing a Manhattan Project for Covid-19," which while picked up and signal-boosted by other venues,

• Business Insider

• Daily Mail

• Newsweek

• Beckers Hospital Review (the best),

...doesn't seem to have generated any additional reporting.

The scientists, billing themselves as "Scientists to Stop COVID-19," have produced an oddly untitled deliverable ^[1]

It's worth a read...!

(Two hours ago, news came that the administration has initiated "Project Warp Speed," which seems inspired by this project, but there's no reporting on personnel, and it's not clear they adopted the recommendations of the scientists.

 

I'm guessing that the issues I am about to raise for the deliverable of the "Secret Group" will also apply to Project Warp Speed). ^[2]

Given that "personnel is policy," I'll first reduce people mentioned in the Wall Street Journal story, and the scientists who signed the March-April deliverable to tabular form.

After that, I will take a quick look at the scientists' deliverable, focusing especially on issues of governance and restoring our economy.

The Manhattan Project cost $23 billion in US dollars and employed 130,000 people. I don't think anything of that scale is being proposed, unfortunately.

Now let's look at the billionaire and multimillionaire backers of… well, whatever the project is really called...

I'll call it, following the Wall Street Journal, the 'Secret Group'...

In addition to backers, there are also fixers, who connect the backers and the scientists to the administration, agencies, and other firms, primarily in Big Pharma.

I have ordered the backers and fixers, not alphabetically but by net worth.

Table I: The Backers (and Fixers)

In essence, the country would be betting on venture capitalists and private equity specialists to solve the COVID-19 epidemic; oligarchs, in other words.

I'm not entirely sure that's a good bet, even leaving aside debacles like Uber; private equity is, after all, responsible for a range of social ills, including surprise billing from practices in privatized emergency rooms, to our collective difficulties in getting a good night's sleep on a decent mattress.

The presence of fixers in the form of Trump's finance chair, in addition to Pence's gofer, is also interesting.

It is rational to develop connections to the current administration; however, the backers may well regard saving the Trump administration's bacon as the first priority - he has, after all, done very well for them - with the successful taming of SARS-COV-2 as a happy by-product, but a nice-to-have, not a have-to-have.

But perhaps I'm too cynical.

Now let us turn to the scientists. I have listed them in alphabetical order, but I removed all their degrees because they messed up the table.

Table II: The Scientists

This certainly is a list of the best and the brightest (If I had a column headed "Nobel," there would be two).

Nevertheless, in essence, the country would be betting a committee dominated by serial entrepreneurs in the biomedical field and by two institutions - the Broad Institute of MIT and Harvard, and the Howard Hughes Medical Institute - to come up with the correct recommendations to solve the pandemic.

That seems more than a little risky.

Where, for example, is Johns Hopkins?

 

And why there are no epidemiologists?

Having looked at personnel, I'm going to look at two policy recommendations.

(I'm skipping over the Committee prioritizing remdesivir; ^[2] my layperson's sense is that there are a lot of potential treatments out there, and it makes more sense to accelerate many rather than one. I also note that the stock market just had a massive pop based on a preliminary remdesivir result from Gilead, and I certainly hope that none of the backers were front-running it.)

First policy recommendation: Massive testing.

From the Taleb-adjacent New England Complex Systems Institute, Chen Shen and Yaneer Bar-Yam, "Massive testing can stop the coronavirus outbreak":

At this time in many places in the world, including the US, there are insufficient tests to achieve widespread testing. This limits our ability to use this approach.

 

Still, it is possible in principle for the test to be produced rapidly and cheaply and then applied massively to identify cases limiting the need to use other approaches such as lockdowns.

 

Once a large number of tests are available, massive specific testing can achieve the desired outcome of stopping the outbreak.

The scientists write on page 12 of 'Scientists to Stop COVID-19' (footnotes omitted):

All employees and students must certify (via smartphone app), before leaving home, that they are not experiencing enough of the following COVID-19 symptoms to exceed a calculated risk, weighted by symptom frequency, of being infected with SARS-CoV-2 (incidence frequency and standard error areshown, with data sources):

1. Fever (0.64±0.030)2–4

2. Sinus pain (0.50±0.18)4

3. Cough (0.46±0.032) 2–4

4. Reduced or altered sense of smell or taste (0.44±0.17)

5. Expectoration (0.32±0.036)

6. Stuffy nose (0.25±0.15)

7. Chills (0.18±.044)

8. Fatigue (0.18±0.025)

9. Sore throat (0.13±0.039)

10. Headache (0.13±0.037)2,4k. Difficulty breathing (0.11±0.034)2,4l. Joint or muscle pain(0.099±0.023)3,4m. Diarrhea (0.056±0.015)

11. Vomiting (0.026±0.018)

This certification should detect the vast majority of symptomatic cases, including mildly symptomatic ones, among those who accurately respond.

 

None of these individual symptoms are specific to COVID-19, but in aggregate they can be used to assess an individual's risk of being infected with SARS-CoV-2, and even if caused by other pathogens are a prudent basis for staying at home.

 

The acceptable level of calculated risk may differ among occupations (for example, nursing home caregivers could be subject to a very low risk threshold).

First, the Complex Systems Institute lists five approaches to mass testing:

Self-reporting and diagnosis, contact tracing, lockdown - geographic community identification, neighborhood generic symptomatic testing, massive specific testing, and targeted random sampling.

 

The scientists have opted for the first approach, but I would expect some discussion. Instead, they simply self-reporting and diagnosis via an app.

Second,

What on earth could "certify" possibly mean?

 

What is the "certifying authority"?

 

Local health agencies?

 

The State?

 

The Federal Government?

 

Facebook...?

 

What is the penalty for a false claim?

 

Or is this simply a "nudge theory" endeavor, with the certification performing the function of the "Close Door" button on an elevator that does not actually function?

Third,

What happens to the data, which includes a person's identity, their home - or, I suppose, wherever they slept last night - and medical data?

 

Given Peter Theil of Palantir's presence as a backer, one might suspect nothing good...

Fourth, only 81% of the United States population has a smart phone.

What about them?

 

Will there be a subsidy to buy them?

 

And what about people who prefer to use contract phones?

 

What happens if you lose your phone?

 

What happens if you lend your phone?

 

What happens if a whole family has one phone only?

Fifth,

Surely this depends on each individual having a unique identifier? That amounts to a national ID, which is, to say the least, controversial.

Sixth,

A mere "certification," in the absence of free testing and free treatment, is simply an incentive to game the system.

 

If people need to feed their families, certification will be a secondary consideration.

All in all, one might speculate that the backers and the scientists are both a little detached from the majority of the population.

'Second policy recommendation: An "empowered council', from page 10 of 'Scientists to Stop COVID-19':

We propose that the federal government appoint an empowered council that will work with U.S. and global stakeholders to coordinate the required development and investment actions in an efficient, time-sensitive, and non-partisan way.

 

The proposed centralized approach has proven effective in the past while responding to global emergencies.

 

A similar approach effectively accelerated the development of a polio vaccine in the 1950s.

 

In this celebrated case, the private National Foundation for Infantile Paralysis (later known as the March of Dimes) provided centralized funding and technical decision-making to ensure the development and availability of a vaccine for what was at the time a devastating infectious disease.

 

Such coordination requires centralized decision making to manage the activities across multiple individual promising approaches, and among the supporting functional and funding efforts - thus our recommendation to appoint an "empowered council".

 

A prospective agreement must be established primarily among the regulators, the key funders, and key global stakeholders to ensure that the empowered council has the authority to direct the overall enterprise.

 

The empowered council should have a strong technical/scientific background with direct experience in the previous development of infectious disease vaccines.

 

Such a central coordinating and decision mechanism can ensure alignment among regulatory requirements for clinical and pre-clinical evaluation of vaccine candidates and can effectively manage the large at-risk scale-up and manufacturing investments needed to ensure ready availability of a vaccine as soon as its safety and efficacy has been demonstrated.

 

It can also manage the complexities of the multiple parallel technical approaches that will be required.

They really do love that phrase, "empowered council," don't they?

(It reminds me of how, back in the day, affirmative debaters would propose "a magic board" to solve whatever problem the status quo had been unable to solve).

Note, however, that "the federal government" doesn't appoint anybody; the executive branch typically does, the legislative branch sometimes does, and I suppose the judicial branch might.

So already I think that the "empowered council" has stumbled coming out of the gate.

Anyhow, I have questions.

First, will the proceedings of the "empowered council' be open to the public? Will minutes be published? Will there be any democratic accountability at all?

 

Second, can the authors really believe that the March of Dimes is an appropriate precedent? It was legitimated by FDR and it was in existence for twenty years (not "warp speed"). It proposed that every child in the United States contribute a dime - that's why there's an FDR dime - for the eradication of polio. (Industrial production of the vaccine was also organized by - gasp - the Soviet Union, which led to testing in the United States). What's obvious about the March of Dimes is its deep small-d democratic roots, which I can only think would be very useful in vaccine compliance. The scientists propose nothing like that.

 

Third, who enforces the "prospective agreement" and what form does it take? Is it an international treaty?

 

Fourth, what on earth is a "global stakeholder"? What kind of document can Bill Gates, Giliead, the United States, and the Wellcome Foundation all put their names to, as if Bill Gates (say) were a sovereign, and the United States was a private person? Lawyers in the readership?

 

Fifth, what are the conflict of interest requirements?

 

Sixth, for vaccines and treatments developed under the aegis of the "empowered committee," what are the intellectual property rights? Will they be equivalent to the Salk and Sabine vaccines, given that the March of Dimes has been cited as a precendenty?

 

Seventh, how long can members of the "empowered committee" serve, and will the committee be sunsetted?

I must conclude, but I don't think I can say much more than I have already said. These matters seem to be moving very fast. It's not clear to me that "efficiency," as neoliberals understand it, should be the primary goal.

The Manhattan Project, after all, was very different institutional from this proposal, and had a very different social basis, as did the March of Dimes.

NOTES

1. Opening sentence: "We are a group of passionate citizen-scientists…." Ugh, "passionate." What is this, an intern's cover letter? As for "citizen scientists," please refer to Table I below.

    

2. Infection Control Today: "Those close to the project have requested to remain anonymous because it hasn't been officially unveiled to the American public." Oh. Another secret group? Or the same one?

    

3. The words "patent" and "intellectual property" do not appear in the scientists deliverable.

 

 

Table I: The Backer and Fixers