Monday, October 5, 2020

How King Uzziah became corrupt and was stricken with Covid and quarantined (II Chronicles 26)

Chronicles II chapter 26 describes how King Uzziah became corrupt and power hungry, so that the Lord infected him with the untranslatable disease that the Chronicler called "zaraath," which required him to be quarantined for the rest of his life.

Here it is, starting from verse 16.
 
And when he became strong, his heart became haughty until he became corrupt, and he trespassed against the Lord his God, and he came into the Temple of the Lord to burn incense on the altar of incense. טזוּכְחֶזְקָת֗וֹ גָּבַ֚הּ לִבּוֹ֙ עַד־לְהַשְׁחִ֔ית וַיִּמְעַ֖ל בַּֽיהֹוָ֣ה אֱלֹהָ֑יו וַיָּבֹא֙ אֶל־הֵיכַ֣ל יְהֹוָ֔ה לְהַקְטִ֖יר עַל־מִזְבַּ֥ח הַקְּטֹֽרֶת:
17And Azariah the priest came after him, and ,with him were priests of the Lord, eighty mighty men. יזוַיָּבֹ֥א אַֽחֲרָ֖יו עֲזַרְיָ֣הוּ הַכֹּהֵ֑ן וְעִמּ֞וֹ כֹּֽהֲנִ֧ים| לַֽיהֹוָ֛ה שְׁמוֹנִ֖ים בְּנֵי־חָֽיִל:
18And they stood beside Uzziah the king and said to him, "It is not for you, Uzziah, to burn incense to the Lord, but for the priests, sons of Aaron, who are consecrated to burn [incense]. Leave the Sanctuary, for you have trespassed, and it will not be glory for you from the Lord God." יחוַיַּֽעַמְד֞וּ עַל־עֻזִּיָּ֣הוּ הַמֶּ֗לֶךְ וַיֹּ֚אמְרוּ לוֹ֙ לֹֽא־לְךָ֣ עֻזִּיָּ֗הוּ לְהַקְטִיר֙ לַֽיהֹוָ֔ה כִּ֣י לַכֹּֽהֲנִ֧ים בְּנֵי־אַֽהֲרֹ֛ן הַֽמְקֻדָּשִׁ֖ים לְהַקְטִ֑יר צֵ֚א מִן־הַמִּקְדָּשׁ֙ כִּ֣י מָעַ֔לְתָּ וְלֹֽא־לְךָ֥ לְכָב֖וֹד מֵֽיְהֹוָ֥ה אֱלֹהִֽים:
19And Uzziah became furious, and in his hand was a censer to burn, and in his fury with the priests, the zaraath shone upon his forehead before the priests in the House of the Lord, over the altar of incense. יטוַיִּזְעַף֙ עֻזִּיָּ֔הוּ וּבְיָד֥וֹ מִקְטֶ֖רֶת לְהַקְטִ֑יר וּבְזַעְפּ֣וֹ עִם־הַכֹּֽהֲנִ֗ים וְ֠הַצָּרַעַת זָֽרְחָ֨ה בְמִצְח֜וֹ לִפְנֵ֚י הַכֹּֽהֲנִים֙ בְּבֵ֣ית יְהֹוָ֔ה מֵעַ֖ל לְמִזְבַּ֥ח הַקְּטֹֽרֶת:
20And Azariah, the chief priest, and all the priests, turned to him, and behold he was stricken with zaraath on his forehead; so they rushed him out of there, and he too hastened to leave, for the Lord had smitten him. כוַיִּ֣פֶן אֵלָ֡יו עֲזַרְיָהוּ֩ כֹהֵ֨ן הָרֹ֜אשׁ וְכָל־הַכֹּֽהֲנִ֗ים וְהִנֵּה־ה֚וּא מְצֹרָע֙ בְּמִצְח֔וֹ וַיַּבְהִל֖וּהוּ מִשָּׁ֑ם וְגַם־הוּא֙ נִדְחַ֣ף לָצֵ֔את כִּ֥י נִגְּע֖וֹ יְהֹוָֽה:
21And King Uzziah was stricken with zaraath until the day of his death, and he lived in a house of retirement, for it had been decreed from the House of the Lord,


HT: Aviya Kushner in the Forward

Sunday, October 4, 2020

Grocery supply chains: TNR reviews "The Secret Life of Groceries"

 The New Republic reviews The Secret Life of Groceries: The Dark Miracle of the American Supermarket, by Benjamin Lorr,  (It tells you more than you want to know about supply chains, from farmed shrimp in Thailand to American long haul trucking...)

There’s No Such Thing as Ethical Grocery Shopping--“The Secret Life of Groceries” exposes the dark secrets of America’s food supply. by Josephine Livingstone

Having read the review but not the book, it sounds like a broad based followup on this 2015 story from the Guardian:

Shrimp sold by global supermarkets is peeled by slave labourers in Thailand

by Associated Press: Margie Mason, Robin McDowell and Esther Htusan in Samut Sakhon and Martha Mendoza in Washington Mon 14 Dec 2015

Saturday, October 3, 2020

Convalescent plasma continues to be used for treatment of covid-19, but demand is flat

 The WSJ has the story:

Wanted in Covid-19 Fight: ‘Superdonors’ of Convalescent Plasma--Blood banks and researchers are mobilizing to find recovered Covid-19 patients who have high levels of antibodies and are willing to donate regularly   By Amy Dockser Marcus


"Blood banks and researchers are mobilizing to find recovered Covid-19 patients who could be blood plasma “superdonors,” people who have high levels of antibodies against the disease and are willing to donate regularly.

"The hunt has intensified in the past month, after the Food and Drug Administration authorized the use of convalescent plasma, derived from patients who have survived the virus, as a potential therapy for hospitalized patients.

...

"Right now, demand for plasma overall is flat, said Dr. Claudia Cohn, chief medical officer for AABB, a group representing the transfusion medicine and cellular therapy community. She said it could reflect reservations about the strength of existing data, the waning of the pandemic in certain areas of the country, or concerns that the authorization was issued under political pressure from the White House—a suggestion the FDA has pushed back on but that continues to generate debate.

"Doctors said an expected upturn in demand for convalescent plasma didn’t materialize after the authorization, although they are prepared for one should infections surge later this year."

Friday, October 2, 2020

Trading truthfulness for efficiency in the Israeli medical internship market, by Ariel Rosenfeld and Avinatan Hassidim


Too smart for their own good: Trading truthfulness for efficiency in the Israeli medical internship market, by Ariel Rosenfeld and Avinatan Hassidim, Judgment and Decision Making, Vol. 15, No. 5, September 2020

Abstract: The two most fundamental notions in mechanism design are truthfulness and efficiency. In many market settings, such as the classic one-sided matching/assignment setting, these two properties partially conflict, creating a trade-off which is rarely examined in the real-world. In this article, we investigate this trade-off through the high-stakes Israeli medical internship market. This market used to employ a standard truthful yet sub-optimal mechanism and it has recently transitioned to an “almost” truthful, more efficient mechanism. Through this in-the-field study, spanning over two years, we study the interns’ behavior using both official data and targeted surveys. We first identify that substantial strategic behaviors are exercised by the participants, virtually eliminating any efficiency gains from the transition. In order to mitigate the above, we performed an intervention in which conclusive evidence was provided showing that, for most of the interns, reporting truthfully was much better than what they actually did. Unfortunately, a re-examination of the market reveals that our intervention had only minor effects. These results combine to question the practical benefits of “almost” truthfulness in real-world market settings and shed new light on the typical truthfulness-efficiency trade-off."


Here's their description of the prior, inefficient random serial dictatorship rule:

"For about two and a half decades, until 2014, each intern was asked to submit her ranking of the hospitals relevant for her graduation class, and the assignment itself was decided by the RSD mechanism (with a few minor house rules aimed at providing special treatment for special intern groups such as PhD students and parents of young children), which has come to be known as the Internship Lottery. Up until a few years ago when the system was finally computerized, interns physically gathered in a large auditorium and ID numbers were drawn out of a hat. The RSDT mechanism has been deployed since 2014 in an attempt to increase efficiency (Bronfman et al., 2015) (see (Roth & Shorrer, 2015) for a review and discussion on the transition choice)."

And here (out of the sequence in the paper) is a quick description of the new, efficient mechanism.

"To mitigate the fact that the probability vectors induced by the RSD mechanism may be far from optimal, the RSDT mechanism was proposed: First, after each intern submits a ranked list of hospitals, a large number of RSD simulations is performed to approximate the true probability vector for each intern. Then, using a fitted utility function over probability vectors (learned through structured surveys), probabilities are automatically traded between the interns though a Linear Program (LP) which optimizes social welfare. The LP guarantees that each intern’s expected utility (given the utility function) is no-worse than what she had before the trade."

**************

Related post:

Thursday, March 26, 2015

Thursday, October 1, 2020

Becky Morton, RIP

 Becky Morton has passed away after a short illness. She was a pioneer in bringing experimental methods to political science, as an individual investigator, an editor and journal founder, textbook writer, and as an institution builder, who made NYU Abu Dhabi a center of experimental work.

Here's the announcement from NYU:

Mourning the Passing of Rebecca Morton September 27, 2020

"She was an extraordinary academic leader for the development of research and teaching in the social sciences at NYUAD, serving as Associate Dean of Faculty Affairs and Development, Program Head of Political Science, and Global Network Professor of Politics and Economics. Becky was the founding Director of the Social Science Experimental Laboratory at NYUAD, one of her proudest creations. Her unfailing commitment to nurturing early career scholars was epitomized in the postdoctoral program in the social science division, which she led as director until the beginning of fall. Becky’s intellectual engagement with colleagues, students, and our postdoctoral fellows helped forge a lively and successful research community in social science.

"Becky Morton was an outstanding scholar whose work ranged across economics and political science. Committed to interdisciplinary inquiry, she was the author and co-author of four books and numerous articles in prominent economics and political science journals, such as the American Economic Review, American Journal of Political Science, American Political Science Review, Journal of Law and Economics, Journal of Politics, and Review of Economic Studies."

*******

Here's one of her books:

Experimental Political Science and the Study of Causality: From Nature to the Lab"         By Rebecca B. Morton, Kenneth C. Williams


Here's her editor's introduction to the first issue of the Journal of Experimental Political Science, in 

Welcome to JEPS!,  Journal of Experimental Political Science,Volume 1, Issue 1, Spring 2014 , pp. 1-5, by Rebecca B. Morton  Joshua A. Tucker

In short, she was a force for experiments in political science, despite having a Ph.D. in Economics (and, as I recall, drinking Coke for breakfast).

Wednesday, September 30, 2020

A modest proposal for the design of presidential debates

 1. Turn off the microphone of whoever isn't supposed to be speaking.

Tuesday, September 29, 2020

Human infection challenge trial(s) for covid-19 vaccine likely to start in UK in January

 The Financial Times has the story:

UK to test vaccines on volunteers deliberately infected with Covid-19--‘Human challenge trials’ intended to accelerate vaccine development programmes   by  Clive Cookson.

"London is to host the world’s first Covid-19 human challenge trials — in which healthy volunteers are deliberately infected with coronavirus to assess the effectiveness of experimental vaccines.

"The UK government-funded studies are expected to begin in January ...

"The researchers, who did not want to comment publicly ahead of the launch, said the trials would play a vital role in narrowing the large field of promising Covid-19 vaccines likely to move into clinical testing early next year.

"Volunteers will be inoculated with a vaccine and a month or so later receive a “challenge” dose of Sars-Cov-2, the virus that causes Covid-19, under controlled conditions."

"About 2,000 potential volunteers have signed up for challenge studies in the UK through the US-based advocacy group 1Day Sooner, which campaigns for Covid-19 infection trials and has enlisted 37,000 people worldwide. Traditional clinical trials need tens of thousands of participants and researchers would struggle to attract enough for multiple vaccine studies."

Monday, September 28, 2020

Judicial clerkships in the time of coronavirus--uneven compliance with the pilot hiring plan, and post-clerkship connections

 An article in the UC Davis Law Review Online discusses the hiring of law clerks by U.S. judges, during the current pandemic,  with reference to the  Federal Law Clerk Hiring (Pilot) Plan which is in its second year this year. (The plan calls for judges to delay hiring second year law students until June, and to leave offers open for at least 48 hours.)

The Federal Law Clerk Hiring Pilot and the Coronavirus Pandemic  by Carl Tobias, UC Davis Law Review Online, 2020,54, 1-20.

The article says that compliance with the plan is uneven, but that "numerous jurists who support the nascent pilot are Democratic Presidents' confirmees ... while copious judges who seem to oppose the pilot  in turn are GOP chief executives' appointees..." (p9).

**********

An article in the NY Times talks about why clerkships are so valuable to clerks:

Law Firms Pay Supreme Court Clerks $400,000 Bonuses. What Are They Buying?   Inside information and influence with the clerks’ former bosses may figure in the transactions, a new study suggests     by Adam Liptak

"Supreme Court justices make $265,600 a year. The chief justice gets $277,700.

"Their law clerks do a lot better. After a year of service at the court, they are routinely offered signing bonuses of $400,000 from law firms, on top of healthy salaries of more than $200,000."

The article goes on to talk about the influence that clerks have later in their careers, when arguing cases before their former bosses. It's based on this article

The Influence of Personalized Knowledge at the Supreme Court: How (Some) Former Law Clerks Have the Inside Track by Ryan C. Black1 and Ryan J. Owens, Political Research Quarterly, 2020.

Abstract: When arguing at the U.S. Supreme Court, former High Court law clerks enjoy significant influence over their former justices. Our analysis of forty years of judicial votes reveals that an attorney who formerly clerked for a justice is 16 percent more likely to capture that justice’s vote than an otherwise identical attorney who never clerked. What is more, an attorney who formerly clerked for a justice is 14 to 16 percent more likely to capture that justice’s vote than an otherwise identical attorney who previously clerked for a different justice. Former clerk influence is substantial, targeted, and appears to come from clerks’ personalized information about their justices. These results answer an important empirical question about the role of attorneys while raising normative concerns over  fairness in litigation.

Sunday, September 27, 2020

Removing financial disincentives to living organ donation: HRSA publishes Final Rule

 The Health Resources and Services Administration (HRSA), Health and Human Services Department (HHS) has published its Final Rule in the Federal Register

Removing Financial Disincentives to Living Organ Donation--A Rule by the Health and Human Services Department on 09/22/2020

"SUMMARY: This final rule amends the regulations implementing the National Organ Transplant Act of 1984, as amended (NOTA), to remove financial barriers to organ donation by expanding the scope of reimbursable expenses incurred by living organ donors to include lost wages, and child-care and elder-care expenses incurred by a caregiver. HHS is committed to reducing the number of individuals on the organ transplant waiting list by increasing the number of organs available for transplant. This final rule is associated with Section 8 of the Executive Order (E.O.) 13879 titled “Advancing American Kidney Health,” issued on July 10, 2019, which directed HHS to propose a regulation allowing living organ donors to be reimbursed for related lost wages, child-care expenses, and elder-care expenses through the Reimbursement of Travel and Subsistence Expenses Incurred toward Living Organ Donation program authorized under section 377 of the Public Health Service (PHS) Act, as amended."

...

"The National Living Donor Assistance Center (NLDAC) [4] operates the living organ donor reimbursement program funded by HRSA's Reimbursement of Travel and Subsistence Expenses Incurred toward Living Organ Donation grants program. Under the authority provided under section 377 of the PHS Act, as amended, the program is operated via cooperative agreement. The program's purpose is to help remove financial disincentives for living organ donations. In adherence to the authority outlined in the PHS Act, the program's Eligibility Guidelines currently provide that “qualifying expenses” include those incurred by the donor and his/her accompanying person(s) as part of: (1) Donor evaluation, (2) hospitalization for the living donor surgical procedure, and/or (3) medical or surgical follow-up, clinic visits, or hospitalization within two calendar years following the living donation procedure.

...

"Through this final rule, the Secretary determines that reimbursement for lost wages, and child-care and elder-care expenses incurred by a caregiver, is appropriate for living organ donors who incur such expenses toward their organ donation."

*************

The final rule authorizes the National Living Donor Assistance Center (NLDAC) to expand the category of expenses that it can reimburse, for those who meet its income and other conditions.

I'm on NLDAC's Advisory Board, and at the present time I haven't heard that NLDAC's budget will be increased to fund the expanded expenses it is now permitted to reimburse.

Saturday, September 26, 2020

The unsharing economy: part time gig evicting people from their apartments

 Vice.com has the story:


Gig Economy Company Launches Uber, But for Evicting People--A company called Civvl says evicting people is the "FASTEST GROWING MONEY MAKING GIG DUE TO COVID-19."  By Ashwin Rodrigues

"In its Craigslist ads, posted across the country, Civvl explains the opportunity plainly: "There is plenty of work due to the dismal economy."

"Unemployment is at a record high and many cannot or simply are not paying rent and mortgages," the ads state. "We are being contracted by frustrated property owners and banks to secure foreclosed residential properties."

Civvl aims to marry the gig economy with the devastation of a pandemic, complete with signature gig startup language like "be your own boss," and "flexible hours," and "looking for self-motivated individuals with positive attitudes:" "FASTEST GROWING MONEY MAKING GIG DUE TO COVID-19," its website says. "Literally thousands of process servers are needed in the coming months due courts being backed up in judgements that needs to be served to defendants."

...

"The company, at first glance, appears to be some kind of _Nathan For You-_esque prank: siccing precarious gig jobs onto vulnerable people. But Civvl is connected to a larger—and real—gig economy company called OnQall, which describes itself as an app that provides "on-demand task services to non-urban communities beyond main city areas." OnQall is the developer behind other, more believable TaskRabbit-esque apps, like LawnFixr, CleanQwik, and MoveQwik. Given the fact that Civvl is advertising all over the country and that OnQall, though not popular, does exist, it seems as though Civvl actually is an attempt to simplify the process of evicting people who cannot pay their rent during a pandemic.

...

"There is a federal ban on evictions, declared by the CDC, but landlords are still attempting to press on. There is a penalty for violating the ban, which can include a combination of fines and jail time. Civvl did not respond to a question about how the company ensures evictions are legal, though based on the Terms of Service, it appears to pass all risk onto the companies using its platform, stating that it simply "provides lead generation to independent contractors," and does not actually carry out the work itself.  

HT: Sandro Ambuehl

Friday, September 25, 2020

The WHO proposal for allocating scarce vaccines: thinking of healthcare while dealing with politics by discussing ethics

From the Guardian:

'Landmark moment': 156 countries agree to Covid vaccine allocation deal--Covax plan will counter rising threat of ‘vaccine nationalism’, prioritising vulnerable healthcare systems and frontline workers  by Peter Beaumont

"A coalition of 156 countries has agreed a “landmark” deal to enable the rapid and equitable global distribution of any new coronavirus vaccines to 3% of participating countries’ populations, to protect vulnerable healthcare systems, frontline health workers and those in social care settings.

"The Covid-19 vaccine allocation plan – co-led by the World Health Organization and known as Covax – has been set up to ensure that the research, purchase and distribution of any new vaccine is shared equally between the world’s richest countries and those in the developing world.

"Sixty-four higher income economies have already joined Covax, which includes commitments from 35 economies as well as the European commission, which will procure doses on behalf of the 27 EU member states plus Norway and Iceland, with 38 more expected to join in the coming days.

...

"Recognising that the first useful vaccines to emerge may be in short supply, approved vaccines will initially be made available to a tightly targeted 3% of the population of participating countries, building over time to 20% of each country’s most vulnerable population.

...

"According to a document detailing the arrangement, under the scheme “all countries should gradually receive tranches [of vaccine] to cover each subset of their [initial] target groups … until they can cover 3% of the population”.


The document continues: “At this point of the pandemic, a reasonable scenario would be that, while the supply of Covid-19 vaccines remains very scarce, countries should focus initially on reducing mortality and protecting the health system.


“This … would enable, for example, the vaccination of frontline workers in health and social care settings in most countries … Additional tranches will follow gradually as more supply becomes available.”

**************

And this from the Washington Post:

World Health Organization unveils plan for distributing coronavirus vaccine, urges cooperation    By Emily Rauhala

"Under the plan, rich and poor countries pool money to provide manufacturers with volume guarantees for a slate of vaccine candidates. The idea is to discourage hoarding and focus on vaccinating high-risk people in every participating country first.

"So far, 64 higher-income countries have signed up, WHO officials said, but they added that 38 more are expected to do so in the coming days. Notably missing: Russia, China and the United States.

"China has not made an ann"ouncement either way. The White House said this month that the United States would not join, in part because the administration doesn’t want to work with the WHO, and will instead take a go-it-alone approach.

...

"The framework makes clear that each participating country can decide whom to vaccinate first, but it is based on the idea that doses for 3 percent of a country’s population could be used to vaccinate medical workers first and then other high-risk groups.

...

"“It seems like a compromise position,” said Thomas J. Bollyky, a senior fellow at the Council on Foreign Relations and the director of its global health program. “It’s not exactly what you would do if you were driven strictly by public health.”

"In a policy report this month for the journal Science, critics offered an alternate framework called the Fair Priority Model, which is critical of the country-based approach"

************

Here's the Science article:

An ethical framework for global vaccine allocation, by Ezekiel J. Emanuel1, Govind Persad2, Adam Kern3, Allen Buchanan4, Cécile Fabre5, Daniel Halliday6, Joseph Heath7, Lisa Herzog8, R. J. Leland9, Ephrem T. Lemango10, Florencia Luna11, Matthew S. McCoy1, Ole F. Norheim12, Trygve Ottersen13, G. Owen Schaefer14, Kok-Chor Tan15, Christopher Heath Wellman16, Jonathan Wolff17, Henry S. Richardson18

"The Fair Priority Model is primarily addressed to three groups. One is the COVAX facility—led by Gavi, the World Health Organization (WHO), and the Coalition for Epidemic Preparedness Innovations (CEPI)—which intends to purchase vaccines for fair distribution across countries (5). A second group is vaccine producers. Thankfully, many producers have publicly committed to a “broad and equitable” international distribution of vaccine (2). The last group is national governments, some of whom have also publicly committed to a fair distribution (1).

...

"The Fair Priority Model proceeds in three phases, preventing more urgent harms earlier (see the Table). Phase 1 aims at reducing premature deaths and other irreversible direct and indirect health impacts. Phase 2 continues to address enduring health harms but additionally aims at reducing serious economic and social deprivations such as the closure of nonessential businesses and schools. Restoring these activities will lower unemployment, reduce poverty, and improve health. Finally, phase 3 aims at reducing community transmission, which in turn reduces spread among countries and permits the restoration of prepandemic freedoms and economic and social activities."


Thursday, September 24, 2020

Unintended Consequences of Criminalizing Sex Work in East Java Indonesia, by Cameron, Seager, and Shah

 

Crimes Against Morality: Unintended Consequences of Criminalizing Sex Work

Lisa Cameron, Jennifer Seager, Manisha Shah

NBER Working Paper No. 27846 September 2020

 Abstract: We examine the impact of criminalizing sex work, exploiting an event in which local officials unexpectedly criminalized sex work in one district in East Java, Indonesia, but not in neighboring districts. We collect data from female sex workers and their clients before and after the change. We find that criminalization increases sexually transmitted infections among female sex workers by 58 percent, measured by biological tests. This is driven by decreased condom access and use. We also find evidence that criminalization decreases earnings among women who left sex work due to criminalization, and decreases their ability to meet their children's school expenses while increasing the likelihood that children begin working to supplement household income. While criminalization has the potential to improve population STI outcomes if the market shrinks permanently, we show that five years post-criminalization the market has rebounded and the probability of STI transmission within the general population is likely to have increased.


"Sex work is not directly addressed in Indonesian national law. As a result, sex work is widespread and largely tolerated throughout Indonesia, including East Java. However, a section of law titled “Crimes Against Morals” can be read to apply to sex work and has been used by local officials in some areas to close down sex worksites. On July 11, 2014, the Malang District government announced that on November 28, 2014, it would close all formal sex worksites within the district as a “birthday present” to Malang (Sukarelawati, 2014). The closures aligned with anniversary celebrations in Malang District and had religious overtones, being justified on the basis of sex work being banned by all religions (Tribunews.com, 2014).

Wednesday, September 23, 2020

Pandemic disruptions in the market for medical residents

 The coronavirus pandemic and associated lockdowns and limitations have stressed a number of labor markets, including the one for new physicians.  Here's an article from the Journal of Surgical Education that suggests that, in a world of online interviewing, the number of interviews might usefully be capped. They also recommend signalling...

The Case for Capping Residency Interviews

Helen Kang Morgan, MD,*,1 Abigail F. Winkel, MD,† Taylor Standiford, BS,‡ Rodrigo Muñoz, MD,§ Eric A. Strand, MD,║ David A. Marzano, MD,* Tony Ogburn, MD,¶ Carol A. Major, MD,# Susan Cox, MD,⁎⁎ and Maya M. Hammoud, MD, MBA

J Surg Educ. 2020 Sep 14, doi: 10.1016/j.jsurg.2020.08.033 [Epub ahead of print] PMCID: PMC7489264

"As a result of the COVID-19 pandemic, residency programs will make an abrupt shift to virtual interviews in the 2021 residency application cycle.1 ... Medical students, medical schools, and residency programs have needed to react to sudden developments such as cancelled clinical electives, delayed or cancelled United States Medical Licensing Exams (USMLE),2 significant limitations on visiting student elective and sub-internship rotations,3 and changes in Electronic Residency Application Service (ERAS) timelines.4 Given this context, applicants may opt to increase their total number of residency applications as well as interviews accepted and completed, especially since they will no longer be limited by travel and cost deterrents.5, 6, 7 Likewise, residency programs are no longer logistically restrained to configure an applicant's interview schedule on a single day, and will have the ability to schedule interviews throughout multiple days and during non-business hours. In-person interactions provided by traditional interview day experiences have historically weighed heavily in determining mutual compatibility8 , 9; thus, both stakeholder groups will be looking to raise their chances of finding a match, including potentially increasing the number of interviews.

This is particularly troublesome given the current state of residency application processes, "fraught with misaligned stakeholder incentives.10, 11, 12, 13, 14, 15 Although the ratio of positions per applicant is higher now than ever before, the number of applications per applicant have risen.16 , 17 These numbers have increased rapidly in certain specialties, with the mean number of applications per applicant in obstetrics and gynecology (OBGYN) rising from 28 in 2010 to 66 in 2019.18 The consequences of application inflation are numerous and include decreased abilities for residency programs to perform holistic review of applicants with increased reliance on metrics such as USMLE scores. Residency programs also need to devote significant faculty and administrative time for the interview processes.19 The consequence of application inflation that will be of crucial importance this application cycle is the growing awareness that a small percentage of applicants has been receiving a disproportionate percentage of interview offers.20 , 21 In the era of virtual interviews, if these applicants choose to schedule all of their interview offers, there is a real potential for detrimental downstream effects to other applicants. This may also lead to a greater number of unfilled residency spots, with a larger number of programs and applicants required to enter into the Supplemental Offer and Acceptance Program. Given the paucity of data to inform best practices, there is a pressing need to model the potential effects of current application processes and applicant strategies in this disrupted application cycle."
...
"All stakeholders urgently need equitable solutions that address both individual and systems-level problems for this coming application cycle and beyond.30 Capping the number of interviews that an applicant can schedule could remedy 1 pressing flaw in current application interview processes. Implementing caps at the interview scheduling stage is preferable to capping at the application stage given the multiple complexities that must be considered such as DO and IMG status, and overall competitiveness. In addition, exceptions may need to be made for individuals participating in the Couples Match. The potential legal implications of mandatory interview caps are in the infancy of exploration. Capping interviews would likely not violate anti-trust laws given that applicants would still have the choice of where they would like to interview, however these issues would need to be further investigated. New measures such as preference signaling mechanisms30, 31, 32 need to be urgently considered in order for programs to be able to prioritize whom to offer interviews. The use of “tokens” would enable applicants to be able to convey interest to a set number of programs; this has been well-described in graduate PhD economics education literature.33 It will be imperative for “fit” to not become a proxy for decisions guided by unconscious bias,34 but instead, for principles of equity and inclusion to guide change during this time of accelerated change."


HT: Marc Melcher

Tuesday, September 22, 2020

Filtering 'inappropriate' content is still a challenge for AI--human monitoring of YouTube

The Financial Times has the story:

YouTube reverts to human moderators in fight against misinformation--Video platform relied on machines after lockdown but found they over-censored borderline content

by Alex Barker and Hannah Murphy 

"Google’s YouTube has reverted to using more human moderators to vet harmful content after the machines it relied on during lockdown proved to be overzealous censors of its video platform.

"When some of YouTube’s 10,000-strong team filtering content were “put offline” by the pandemic, YouTube gave its machine systems greater autonomy to stop users seeing hate speech, violence or other forms of harmful content or misinformation.

"But Neal Mohan, YouTube’s chief product officer, told the Financial Times that one of the results of reducing human oversight was a jump in the number of videos removed, including a significant proportion that broke no rules." 

*****************

Wired Magazine has a good backgrounder on the AI attempt to alter the recommender engine:

YouTube’s Plot to Silence Conspiracy Theories--From flat-earthers to QAnon to Covid quackery, the video giant is awash in misinformation. Can AI keep the lunatic fringe from going viral?

by Clive Thompson

Monday, September 21, 2020

Auctions and Market Design Friday Seminar Series, organized by INFORMS (starting Oct 2)

 The auctions and market design section of INFORMS (the Operations Research and Management Science organization) is initiating a new seminar series,  every other week on Fridays, starting Oct 2.  I'll start the series off with a talk on contemporary kidney exchange, and there are talks scheduled through December, see below.

Auctions and Market Design Online Seminar Series

About the Seminar

The aim of this interdisciplinary seminar is to discuss pioneering and impactful work in the broad area of market design. Theoretical, computational, and experimental work as well as field studies will be featured. A wide range of applications, ranging from online advertising and labor markets to networks and platforms, will be presented. The seminar features research talks and expository talks to highlight trends in the field.

Organization

The seminar is organized by Ozan Candogan (Chicago Booth)Vahideh Manshadi (Yale), and Fanyin Zheng (Columbia).

The seminar will be bi-weekly on Fridays at 1-2 pm ET (10-11 am PT).

Email List

If this seminar interests you and you would like to be notified of upcoming speakers, you can join our email list.

Schedule

October 02 - Alvin Roth (Stanford University)

Title: Kidney Exchange: an Operations Perspective


October 16 - John Birge (University of Chicago)

Title: Increasing Efficiency in Electricity Market Auctions



October 30 - Jon Kleinberg (Cornell University)

November 13 - Winners of the Michael H. Rothkopf Junior Researcher Paper Prize

December 04 - Asuman Ozdaglar (MIT)

December 18 - Matthew Jackson (Stanford University)

Sunday, September 20, 2020

Deaccessioning art in the time of corona virus--

 Art museums have long frowned on selling art from their collections, and have been frowned upon when they do so. (It used to be not ok to sell art, except to buy different art, but not e.g. to fix the roof over the art...).  That's changing, "temporarily," in response to the financial crisis museums are facing during the coronavirus pandemic.  (It will be interesting to see if the old repugnance prohibitions can be restored later...)

Here's an April story from the Washington Post:

This is how bad things are for museums: They now have a green light to sell off their art

By Sebastian Smee

"To counter the constant temptation to regard art works as a way to get quick cash, the museum world heavily polices the sale of works from permanent collections — otherwise known as deaccessioning. The powerful Association of Art Museum Directors, made up of directors of museums in the United States, Mexico and Canada, has long frowned on any museum that sells off art for purposes other than acquiring new art.

"AAMD’s frowns have an effect. Museums that dare to ignore its guidelines — as the Berkshire Museum in Pittsfield, Mass., did in 2018, ultimately selling more than 20 works from its collection to raise money for a renovation — are censured, sanctioned and publicly shamed. For a renegade — or perhaps simply desperate — museum director, a decision to sell works from the collection, even if it’s to raise money deemed necessary for survival, might mean career death.

"However, in an unprecedented move, and as a direct result of the coronavirus pandemic, the AAMD has recently relaxed its guidelines. It’s too soon to gauge the effect, but it is already big news in the art world. Once unthinkable, the notion of selling off a Claude Monet or two to plug a budgetary hole — or to fend off a total financial meltdown — is suddenly something to contemplate.

"According to AAMD, museums may now “use the proceeds from deaccessioned works of art … to support the direct care” of their collection.

...

"AAMD says it recognizes “the extensive negative effects of the current crisis on the operations and balance sheets of many art museums.” It acknowledges, too, the impossibility of knowing when revenue streams might return to normal.

"The new guidelines are temporary, and are “not intended to incentivize … the sale of art.” But their effect may do just that."

***********

And, sure enough...:Here's the NY Times

Brooklyn Museum to Sell 12 Works as Pandemic Changes the Rules

Museums selling their art has long been frowned upon, but recent financial pressures have sent works to the auction block at Christie’s. The proceeds would pay for the care of the collection.

By Robin Pogrebin, Sept. 16, 2020


Saturday, September 19, 2020

Virtual conference on Zero/Minimal Intelligence Agents, October 22 – 24, 2020

 A remarkable 1993 JPE paper by Gode and Sunder showed that random bids and offers constrained only not to be money losing could converge in a sense to competitive equilibrium in double auction markets:

Allocative efficiency of markets with zero-intelligence traders: Market as a partial substitute for individual rationality

DK GodeS Sunder - Journal of political economy, 1993 - journals.uchicago.edu
We report market experiments in which human traders are replaced by" zero-intelligence" programs that submit random bids and offers. Imposing a budget constraint (ie, not permitting traders to sell below their costs or buy above their values) is sufficient to raise the allocative efficiency of these auctions close to 100 percent. Allocative efficiency of a double auction derives largely from its structure, independent of traders' motivation, intelligence, or
learning. Adam Smith's invisible hand may be more powerful than some may have thought; it can generate aggregate rationality not only from individual rationality but also from individual irrationality.


In October, there's a conference following up on the idea that some market institutions may have desirable properties that don't depend on the rationality of the agents.

The First Conference on Zero/Minimal Intelligence Agents October 22 – 24, 2020

"Zero-intelligence (ZI) and Minimal-intelligence (MI) agents have provided valuable insights into how rules of engagement and institutional structures affect outcomes. This virtual conference is for sharing insights, findings, theories, applications, and tools regarding ZI and MI agents..."  


PROGRAM

(Revised September 3, 2020)

THURSDAY OCTOBER 22, 2020 (DAY 1)

Session 1: Zeroing in on zero-intelligence: Externalism, automaticity and opaqueness

(October 22, 2020, 9:00-10:30 EDT New York, USA)

Moderator: Dave Cliff

a. Enrico Petracca: Zero-intelligence in ‘externalist’ new institutional economics

b. Shaun Gallagher: Zero-intelligence and human automaticity at two extremes

c. Antonio Mastrogiorgio: Opaqueness as a mark of minimal-intelligence

Session 2: Trading with Zero/Minimal Intelligence

(October 22, 2020, 11:00-12:30 EDT New York, USA)

Moderator: Daniel Ladley

a. Dave Cliff: Extending Zero and Minimal Intelligence Trader Agents to Exhibit Size-Impact

Effects

b. Barbara Ikica, Simon Jantschgi, Heinrich H. Nax, Diego G. Nuñez Duran, Bary S. R. Pradelski:

Trading in a Black Box: Zero Intelligence and Lack of Knowledge

c. Fan Gao and Daniel Ladley: Endogenous network in OTC markets

Session 3: Panel Discussion on Structural Rationality

(October 22, 2020, 13:00-15:00 EDT New York, USA):

Moderator: Shyam Sunder

Robert Axtell, Gerd Gigerenzer, Doyne Farmer, Charles R. Plott,

Larry Samuelson

FRIDAY OCTOBER 23, 2020 (DAY 2)

Session 4: Agent-based Computational Economics and ZI/MI

Agents (October 23, 2020, 9:00-10:30 EDT New York, USA)

Moderator: Friederike Wall

a. Shu-Heng Chen: Less is More: Minimal Intelligence in the History of Cognitive Science

b. Stephan Leitner and Friederike Wall: Micro- and Macro-Dynamics in Hidden-Action

Relationships with Limited Information

c. Friederike Wall: Hill-Climbers or Satisficers? On the Intelligence of Managerial Search in

Agent-based Models

Session 5: Uncertainty and Experiments

(October 23, 2020, 11:00-12:30 EDT New York, USA)

Moderator: Heinrich H. Nax

a. Barbara Ikica, Peiran Jiao, Aidas Masiliūnas, and Heinrich Nax: From Skinner Box

experiments to Black Box games: radical behaviorism for experimental game theory

b. Michael Maier, Karim Jamal, and Shyam Sunder: Aggregation of Diverse Information with

Double Auction Trading among Minimally-Intelligent Algorithmic Agents

c. Deborah Olukan, Jonathan Ward, Nicolas Malleson and Jiaqi Ge: Agent-Based

Computational Economics: Heterogeneous Expectation Formation

Session 6: Algorithms and Markets

(October 23, 2020, 13:00-14:30 EDT New York, USA)

Moderator: Aleksandra Aloric

a. Edgardo Bucciarelli, Andrea Oliva: Notes on algorithmic research, aggregations in economic

theory, and the unilateralism of the induction principle

b. Dave Cliff, Methodological Mess-ups in Modelling Markets with Minimal-Intelligence

Agents

c. Robin Nicole, Aleksandra Alorić , and Peter Sollich: Fragmentation in trader preferences

among multiple markets: Market coexistence versus single market dominance

SATURDAY OCTOBER 24, 2020 (DAY 3)

Session 7: Aggregation Theory and Evidence

(October 24, 2020, 9:00-10:30 EDT New York, USA)

Moderator: Dan Gode

a. Florian Artinger, Nikita Kozodoi and Julian Runge: Predicting Revenues with the Multiplier

Heuristic

b. Yuji Aruka, Yoshihiro Nakajima, and Naoki Mori: The Minimum Heterogeneous Agent

Configuration to Realize the Future Price Time Series Similar to Any Given Spot Price Time

Series in the AI Market Experiment

c. D. K. Gode: Does the Shape of Extramarginal Demand and Supply Matter?

Session 8: Dynamic Models and Beauty Contest

(October 24, 2020, 11:00-12:30 EDT New York, USA)

Moderator: Rosemarie Nagel

a. Kenneth Lomas and Dave Cliff: Exploring Narrative Economics: Integrating (Near-) ZeroIntelligence Trader-Agents with Opinion Dynamics Models

b. Jess Ben-Habib, John Duffy and Rosemarie Nagel, How to Protect against Zero Intelligence:

Idiosyncratic Signals in Beauty Contest Games

Session 9: Software Platforms for ZI/MI Simulations

(October 24, 2020, 13:00-14:30 EDT New York, USA)

Moderator: Shabnam Mousavi

a. Paul Brewer: Introduction and Overview of the Econ1.Net Robot Trading Laboratory:

b. Shabnam Mousavi and Shyam Sunder: Market Net Organization

Session 10: Properties of Market Institutions (Organized by Shabnam Mousavi, October 24,

2020, 15:00-16:30 EDT New York, USA)

Moderator: Elena Asprouhova

Friday, September 18, 2020

Market Design Working Group Meeting October 22-24, 2020

 The NBER market design conference in October now has a program:

Market Design Working Group Meeting October 22-24, 2020, via Zoom

Michael Ostrovsky and Parag A. Pathak, Organizers

Times are eastern daylight time


Thursday, October 22

12:00 pm

Susan Athey, Stanford University and NBER

Arthur Baker, Harvard University

Juan Camilo Castillo, University of Pennsylvania

Rachel Glennerster, DFID

Scott Duke Kominers, Harvard University

Michael Kremer, Harvard University and NBER

Jean Nahrae Lee, World Bank

Christopher Snyder, Dartmouth College and NBER

Alex Tabarrok, George Mason University

Brandon Tan, Harvard University

Accelerating a Covid-19 Vaccine

12:45 pm

Parag A. Pathak, Massachusetts Institute of Technology and NBER

Tayfun Sönmez, Boston College

M. Utku Ünver, Boston College

M. Bumin Yenmez, Boston College

Fair Allocation of Vaccines, Ventilators and Antiviral Treatments: Leaving No Ethical Value Behind in Health Care Rationing

1:30 pm

Open Discussions

2:00 pm

Xiang Han, Shanghai University of Finance and Economics

Onur Kesten, Carnegie Mellon University

M. Utku Ünver, Boston College

Blood Allocation with Replacement Donors

2:45 pm

Mohammad Akbarpour, Stanford University

Afshin Nikzad, University of Southern California

Michael A. Rees, University of Toledo Medical Center

Alvin E. Roth, Stanford University and NBER

Global Kidney Chains

3:30 pm

Open Discussions

4:00 pm

Adjourn

Friday, October 23

12:00 pm

Chiaki Moriguchi, Hitotsubashi University

Yusuke Narita, Yale University

Mari Tanaka, Hitotsubashi University

Meritocracy and Its Discontents: Long-Run Effects of Repeated School Admission Reforms

12:45 pm

Yan Chen, University of Michigan

Ming Jiang, Shanghai Jiao Tong University

Onur Kesten, Carnegie Mellon University

An Empirical Evaluation of Chinese College Admissions Reforms Through A Natural Experiment

1:30 pm

Open Discussions

2:00 pm

Adam Kapor, Princeton University and NBER

Mohit Karnani, Massachusetts Institute of Technology

Christopher Neilson, Princeton University and NBER

Aftermarket Frictions and the Cost of Off-Platform Options in Centralized Assignment Mechanisms

2:45 pm

David Delacretaz, University of Oxford

Processing Reserves Simultaneously

3:30 pm

Open Discussions

4:00 pm

Adjourn

Saturday, October 24

12:00 pm

Federico Echenique, California Institute of Technology

Antonio Miralles, Universita' degli Studi di Messina

Jun Zhang, Nanjing Audit University

Constrained Pseudo-Market Equilibrium

12:45 pm

Marzena Rostek, University of Wisconsin- Madison

Ji Hee Yoon, University College London

Exchange Design and Efficiency

1:30 pm

Open Discussions

2:00 pm

Martin Bichler, Technical University of Munich

Maximilian Fichtl, Technical University of Munich

Stefan Heidekrüger, Technical University of Munich

Nils Kohring, Technical University of Munich

Paul Sutterer, Technical University of Munich

Learning to Bid: Computing Bayesian Nash Equilibrium Strategies in Auctions via Neural Pseudogradient Ascent

2:45 pm

Mohammad Akbarpour, Stanford University

Scott Duke Kominers, Harvard University

Shengwu Li, Harvard University

Paul Milgrom, Stanford University

Investment Incentives in Near-Optimal Mechanisms

3:30 pm

Open Discussions

4:00 pm

Adjourn


Thursday, September 17, 2020

Job matching under constraints by Kojima, Sun, and Yu in the September AER

 From the September AER, the latest in a distinguished string of papers initially motivated by aspects of the clearinghouse for new doctors in Japan:

Kojima, Fuhito, Ning Sun, and Ning Neil Yu. 2020. "Job Matching under Constraints." American Economic Review, 110 (9): 2935-47.  DOI: 10.1257/aer.20190780

Abstract: Studying job matching in a Kelso-Crawford framework, we consider arbitrary constraints imposed on sets of doctors that a hospital can hire. We characterize all constraints that preserve the substitutes condition (for all revenue functions that satisfy the substitutes condition), a critical condition on hospitals' revenue functions for well-behaved competitive equilibria. A constraint preserves the substitutes condition if and only if it is a "generalized interval constraint," which specifies the minimum and maximum numbers of hired doctors, forces some hires, and forbids others. Additionally, "generalized polyhedral constraints" are precisely those that preserve the substitutes condition for all "group separable" revenue functions.

Here's the first paragraph:

"Hiring entities often face various types of constraints. In the United States, firms that receive favorable treatments from governments often promise to hire at least a certain number of workers (Byrnes, Marvel, and Sridhar 1999): floor constraints. In Chinese cities, the household registration system distributes quotas to employers for transferring  employees’ registrations from other places (Chan and Zhang 1999): type-specific ceiling constraints on hiring nonlocals. In rural India, a health subcenter is often required to be staffed by exactly one male and one female (Kapoor 2011): type-specific constraints with exact quotas. These are restrictions on the set of employees that an employer is allowed to hire. Inspired by a classical framework for studying job markets (Kelso and Crawford 1982), this paper studies how all possible restrictions of this type impact the substitutes condition on revenue functions of the employers, a condition known to be critical for the existence and certain regularity properties of competitive equilibria (Kelso and Crawford 1982; Gul and Stacchetti 1999; Milgrom 2000; Hatfield et al. 2019; Kojima, Sun, and Yu 2020a)"

and, from the Conclusions section:

"In a classical paper on the difficulty for rural hospitals in filling all of their positions in the National Resident Matching Program, Roth (1986) concludes that “this maldistribution seems unlikely to be changed by any system that does not involve some element of compulsion, or some change in the relative numbers of available positions and eligible students.” Our analysis suggests that in job matching with adjustable salaries, a compulsion in the form of floor or ceiling constraints may be a possible solution: one of the appealing properties of such a policy is that it preserves the substitutes condition and thus the existence of competitive equilibria under standard assumptions (Kojima, Sun, and Yu 2020a)."

Wednesday, September 16, 2020

On allocating scarce vaccines

 From the NBER working papers this week:

Do Black and Indigenous Communities Receive their Fair Share of Vaccines Under the 2018 CDC Guidelines?

Parag A. Pathak, Harald Schmidt, Adam Solomon, Edwin Song, Tayfun Sönmez, M. Utku Ünver

NBER Working Paper No. 27817   September 2020

Abstract: A major focus of debate about rationing guidelines for COVID-19 vaccines is whether and how to prioritize access for minority populations that have been particularly affected by the pandemic, and been the subject of historical and structural disadvantage, particularly Black and Indigenous individuals. We simulate the 2018 CDC Vaccine Allocation guidelines using data from the American Community Survey under different assumptions on total vaccine supply. Black and Indigenous individuals combined receive a higher share of vaccines compared to their population share for all assumptions on total vaccine supply. However, their vaccine share under the 2018 CDC guidelines is considerably lower than their share of COVID-19 deaths and age-adjusted deaths. We then simulate one method to incorporate disadvantage in vaccine allocation via a reserve system. In a reserve system, units are placed into categories and units reserved for a category give preferential treatment to individuals from that category. Using the Area Deprivation Index (ADI) as a proxy for disadvantage, we show that a 40% high-ADI reserve increases the number of vaccines allocated to Black or Indigenous individuals, with a share that approaches their COVID-19 death share when there are about 75 million units. Our findings illustrate that whether an allocation is equitable depends crucially on the benchmark and highlight the importance of considering the expected distribution of outcomes from implementing vaccine allocation guidelines.

Tuesday, September 15, 2020

Covid has slowed transplants in the UK

The Evening Standard has the story:

Organ transplant waiting list jumps to five-year high due to pandemic, new NHS figures show

by Naomi Ackerman 

"The number people waiting for an organ transplant has soared to five-year high as a result of the coronavirus pandemic, new NHS figures have shown.

"NHS Blood and Transplant (NHSBT) said this week that an estimated 6,700 people are currently in need of a transplant across the UK - up from 6,138 prior to the start of the pandemic.

"The health body has estimated that the increase in patients waiting - expected to be the highest since 2015-16 - comes after services were impacted by the effects of the pandemic.

...

"It is hoped that the waiting list can be shortened going forward following the introduction of a new law in May, making organ donation "opt-out" rather than an active choice.

...

"The law will see that families are still consulted before organ donation goes ahead - the reason is why health officials have implored people to make their wishes about donation known to their families.

"NHSBT has said that thousands of "transplant opportunities" have been missed in recent years. In 2018-19, it reported that 835 families declined to support organ donation - with many families saying they did not know what their relative would have wanted."

***********

HT: Alex Chan

Monday, September 14, 2020

Economies in the Time of Coronavirus (in English and Chinese)

 Here's a short essay I wrote for the Luhohan Academy in June, published on their web site in July in English, and the Chinese translation in the Caixin online magazine.

Economies in the Time of Coronavirus

by Alvin E. Roth

Here's the first paragraph:

"Years from now we will look back on the Covid-19 pandemic as a source of much new information, not just about epidemic disease and how to manage it, but about structural features of the world’s economies that were made clearer by the crisis and how it was handled, both well and badly.  In the meantime, we can begin to speculate about what we will have learned when the pandemic is history, and what we must still learn to prepare for dealing with its continuation, and with future pandemics."

...

here's another paragraph:

"Testing policies will have to keep in mind what economists know well, which is that there may be perverse incentives in play. Some people will be very eager to return to work, and might be willing to do so even when they risk spreading infection. Others may be happy to work from home (especially if there is risk of infection at work) and may not wish to return to work even when they themselves do not pose a risk to others. And if those who have been infected and have recovered  (e.g. who test positive for antibodies) are treated differently than others, some people may feel a need to expose themselves to infection in order to enter this privileged class. So who conducts the tests, and how they are reported and recorded, will be important."

and here it begins in Chinese (but gated):

阿尔文·罗思:新冠疫情时期的经济与政策 

2020年07月17日 10:59
T中
为应对疫情,我们要完成一些当下和短期目标,而为下一次大流行病做准备,我们面临一些更长期的任务

  文|阿尔文·罗思(Alvin E. Roth)

   

Sunday, September 13, 2020

A proposal for non-simultaneous kidney exchange in pairs and chains and with deceased donors...

 Here's an ambitious proposal, that may face  obstacles to implementation, but which provides some clarity about the inefficiencies of current practice.

Unpaired Kidney Exchange: Overcoming Double Coincidence of Wants without Money

Mohammad Akbarpour, Julien Combe, Yinghua He, Victor Hiller, Robert Shimer, Olivier Tercieux

NBER Working Paper No. 27765, September 2020, pdf

Abstract: For an incompatible patient-donor pair, kidney exchanges often forbid receipt-before-donation (the patient receives a kidney before the donor donates) and donation-before-receipt, causing a double-coincidence-of-wants problem. Our proposed algorithm, the Unpaired kidney exchange algorithm, uses “memory” as a medium of exchange to eliminate these timing constraints. In a dynamic matching model, we prove that Unpaired delivers a waiting time of patients close to optimal and substantially shorter than currently utilized state-of-the-art algorithms. Using a rich administrative dataset from France, we show that Unpaired achieves a match rate of 57 percent and an average waiting time of 440 days. The (infeasible) optimal algorithm is only slightly better (58 percent and 425 days); state-of-the-art algorithms deliver less than 34 percent and more than 695 days. We draw similar conclusions from the simulations of two large U.S. platforms. Lastly, we propose a range of solutions that can address the potential practical concerns of Unpaired.

Saturday, September 12, 2020

Politics and medicine, at Stanford and in Washington--an open letter from Stanford docs about corona virus policies

 Politics and medicine can combine poorly, particularly in a politicized pandemic.

Here's an open letter from over a hundred faculty at Stanford's Medical school, disowning the positions about pandemic policies taken by one of their former colleagues, now in Washington, by way of Fox News. (Here's the letter in full; to see the signatories click on the link...)

An Open Letter from Stanford Doctors [Update: the letter has been taken down from the Stanford medicine website, but here is another copy...]

"As infectious diseases physicians and researchers, microbiologists and immunologists, epidemiologists and health policy leaders, we stand united in efforts to develop and promote science-based solutions that advance human health and prevent suffering from the coronavirus pandemic. In this pursuit, we share a commitment to a basic principle derived from the Hippocratic Oath: Primum Non Nocere (First, Do No Harm).

"To prevent harm to the public’s health, we also have both a moral and an ethical responsibility to call attention to the falsehoods and misrepresentations of science recently fostered by Dr. Scott Atlas, a former Stanford Medical School colleague and current senior fellow at the Hoover Institute at Stanford University. Many of his opinions and statements run counter to established science and, by doing so, undermine public-health authorities and the credible science that guides effective public health policy. The preponderance of data, accrued from around the world, currently supports each of the following statements:

●  The use of face masks, social distancing, handwashing and hygiene have been shown to substantially reduce the spread of Covid-19. Crowded indoor spaces are settings that significantly increase the risk of community spread of SARS-CoV-2.

●  Transmission of SARS-CoV-2 frequently occurs from asymptomatic people, including children and young adults, to family members and others. Therefore, testing asymptomatic individuals, especially those with probable Covid-19 exposure is important to break the chain of ongoing transmission.

●  Children of all ages can be infected with SARS-CoV-2. While infection is less common in children than in adults, serious short-term and long-term consequences of Covid-19 are increasingly described in children and young people.

●  The pandemic will be controlled when a large proportion of a population has developed immunity (referred to as herd immunity) and that the safest path to herd immunity is through deployment of rigorously evaluated, effective vaccines that have been approved by regulatory agencies.

●  In contrast, encouraging herd immunity through unchecked community transmission is not a safe public health strategy. In fact, this approach would do the opposite, causing a significant increase in preventable cases, suffering and deaths, especially among vulnerable populations, such as older individuals and essential workers.

"Commitment to science-based decision-making is a fundamental obligation of public health policy. The rates of SARS-CoV-2 infection in the US, with consequent morbidity and mortality, are among the highest in the world. The policy response to this pandemic must reinforce the science, including that evidence-based prevention and the safe development, testing and delivery of efficacious therapies and preventive measures, including vaccines, represent the safest path forward. Failure to follow the science -- or deliberately misrepresenting the science – will lead to immense avoidable harm.

"We believe that social and economic activity can reopen safely, if we follow policies that are consistent with science. In fact, the countries that have reopened businesses and schools safely are those that have implemented the science-based strategies outlined above.

"As Stanford faculty with expertise in infectious diseases, epidemiology and health policy, our signatures support this statement with the hope that our voices affirm scientific, medical and public health approaches that promote the safety of our communities and nation."

*******

Here's a recent NY Times story on Dr. Atlas, a radiologist:

A New Coronavirus Adviser Roils the White House With Unorthodox Ideas

Dr. Scott Atlas arrived at the White House as a coronavirus contrarian, questioning controls like masks. He has angered top health officials while pushing a suite of disputed policy prescriptions.

By Noah Weiland, Sheryl Gay Stolberg, Michael D. Shear and Jim Tankersley,  Sept. 2, 2020

"Before joining the task force, Dr. Atlas pitched his ideas as a health commentator on Fox News, which is in part how he attracted Mr. Trump’s attention. His arrival at the White House has coincided with less visible roles for Dr. Birx and Dr. Fauci, the director of the National Institute for Allergy and Infectious Diseases."

**********

Of course, medicine isn't the only kind of science that has been caught up in Washington lately. (I write this from smoky California, where climate change seems quite real).

Nor is it the only part of medicine that has been caught up in politics around the world: I'm reminded of yesterday's post about the politics of global health care.  Science seems to be slowly gaining on politics there, and so I'm hopeful that's a general trend, although sometimes slow and uneven, with a high ratio of heat to light.