Thursday, August 26, 2021

Moral and Economic Reasons for Letting As Many Afghan Refugees As Possible into the United States

While the United States military was correct in withdrawing troops from Afghanistan this year, that still does not change the fact that Afghanistan is a bloody mess right now. Thousands are looking to leave the country. It is so bad that there were Afghan citizens swarming the airport, breaking through security to try to get on a plane. Some clung to military planes taking off and lamentably fell to their doom. Given the precarious situation in Afghanistan, an end to U.S. involvement was inevitable, as was the Taliban resurgence. The fate of thousands of Afghans, on the other hand, is not set in stone. 

President Ronald Reagan once called the United States a city on a shining hill. For many people seeking a better life, the United States has represented a land of freedom, opportunity, and a chance at a better life. As it says on the Statue of Liberty's pedestal, "Give me your poor, your huddled masses yearning to be free." Emma Lazarus' words have rung true over the decades as the United States has led the world in accepting refugees. While this has been an ideal set in the moral fabric of the United States, it has been less-than-ideal in practice. One of the reasons that President Franklin D. Roosevelt was one of the worst presidents is because he turned away refugees fleeing from Nazi persecution. More recently, President Donald Trump enacted a refugee ban as part of a litany of anti-immigrant regulations, whether it was for undocumented workers or those who "arrived here legally." 

In spite of this imperfect enactment of laws pertaining to refugees, at least we can take some solace that 81 percent of Americans are in favor of letting Afghan who helped the U.S. military throughout the War in Afghanistan into the United States (CBS-YouGov). Let's think about the moral arguments that would create such a majority opinion. For one, accepting refugees is truly an issue of a right to life, which should make pro-lifers happy. Two, it is something that has defined the American Dream since its inception, which should make those on the Right happy that we are continuing with this tradition. Not only does it help the downtrodden, but it also contributes to the diversity of the United States, which should make the Left happy. I could quote Exodus 22:20 and point out that the Bible details how the the text lays out an obligation to help out refugees, which should make the religious in the U.S. happy. We are helping those fleeing from literal tyranny to make a better life for themselves. 

The moral arguments should cover every major part of the political spectrum in the country, and yet there are some that are still against it. Some might be worried about the national security of the United States, so let's look at historical terrorism data (Nowrasteh, 2019). There have been three attacks or attempted attacks from Afghan-born individuals in the United States. Those attacks resulted in zero deaths and 30 injuries. Recent criminal data has a similar outcome. Afghan-born immigrants were incarcerated at a rate of 127 out of 100,000 individuals. As for native-born U.S. citizens? At a rate of 1,477 out of 100,000, which is to say that Afghan immigrants are 11.6 times less likely to commit crimes than native-born citizens. Furthermore, the Taliban doesn't have any ambitions beyond its own borders, which minimizes the likelihood of an attack on American soil. Also, let's keep in mind what happens on the next military endeavor (because odds are there will be one). If we abandon Afghans who helped the U.S. military during the War in Afghanistan, that tarnishes the United States' reputation. How likely would people be to help the U.S. military in future engagements knowing that translators and other supporters are hung out to dry?

Now that we have established that the threat from Afghan refugees to the American people is minimal, let's jump to the economic arguments. There are those on the Right, more specifically the anti-immigrant Right, that would like to portray refugees as an economic drain (e.g., Camarota, 2015). Some argue that greater welfare benefits are more likely to attract migrants. Earlier this month, political pundit Tucker Carlson blamed the housing crisis on refugees. He should be blaming land use regulations, but I digress. It might be politically convenient to blame refugees for being an economic burden, but refugees are in fact an economic boon. 

Let's start with the fact that refugees typically do not compete for the same jobs as native-born citizens (Mayda, 2017), a trend we see also see with immigrants. There is economic evidence showing that six years after arriving to their new country, refugees work at a higher rate than native citizens. This study also shows that the break-even point in terms of cost is around nine years. By the time the typical refugee has been in the United States for 20 years, that individual has paid $128,689 in taxes, which is $21,000 more paid in taxes than they received in benefits (Evans and Fitzgerald, 2017). Analysis from Western European data comes to a similar conclusion (D'Albis et al., 2018). Using a specific case study, Vietnamese refugees were able to become contributing members of society after so many fled Vietnam in the 1970s (Alperin and Batalova, 2018). You can read more from the Brookings Institution on the economic argument for accepting refugees (Bahar and Dooley, 2020).

This is not to say that taking in a large influx of refugees is not a huge undertaking because it is. At the same time, what I can say is this. It does not matter whether a migrant is leaving their country willingly (i.e., immigrant) or unwillingly (i.e., refugee). Much like with immigrants, refugees are a net positive contribution to the economy, especially in the long-term. Not only would it be good for the U.S. economy if we were to accept more refugees, it would be the morally right thing to do. It is my hope that the U.S. government expands the Special Immigrant Visa [SIV] program and raises the refugee cap to help alleviate the burgeoning humanitarian crisis in Afghanistan. 

Friday, August 20, 2021

It Is About Time the United States Withdraws Its Troops From Afghanistan

On August 15, the Taliban took over the Afghan capital of Kabul and the Afghan President fled. A day later, President Biden stood by his decision that he made on April 14 to withdraw troops from Afghanistan (here is a timeline for the Afghanistan withdrawal for more details on the events leading up to now). Since then, the news cycle has been going on nonstop about Afghanistan.  

The Right has been merciless in blaming Biden for a messy withdrawal. Biden's exit strategy is worth criticizing, especially with regards to evacuating American personnel, leaving military materiel behind and in the hands of the Taliban, and helping the Afghans that assisted the U.S. military. At the same time, the Afghanistan debacle started long Biden chose to withdraw troops from Afghanistan. Congress authorized the War in 2001 and President Bush led the charge on nation-building in Afghanistan. One could argue that Obama had inadequate resolve to fight in Afghanistan. We can blame Trump for entering peace talks with the Taliban or how he went about it. If you go through the Afghanistan Papers, which are assessments generated by a federal government project, there were also high-ranking officials who realized that the Afghanistan War was unwinnable while portraying the war with a rosy, Pollyannish view. There has been no shortage of imperfect actors in this war. 

That being said, criticizing Biden for how the troops were withdrawn does not mean the troops should not have been withdrawn. My criticism of the Afghanistan War dates back to 2009. U.S. involvement did not make sense in the 2000s, and it makes even less sense now. Afghanistan remains an exceptionally corrupt nation (Freedom House). The U.S. military still has not defeated the Taliban or reformed Afghan politics in a way where there is a democratic and stable government. What has been the cost of getting involved in another country's civil conflict? In terms of lives lost, there have been 65,000 Afghani soldiers, about 2,500 U.S. service members, over 3,800 U.S. contractors, and 47,245 civilians killed. The United States will probably have $2 trillion in war debts by 2030, which will creep up to $6 trillion by 2050 because of interest (Peltier, 2020). 

I am not going to hash out the entire history of the War in Afghanistan here, but I will assert the opinion that the war has been mismanaged. If you want a expert analysis on the matter, go with the the Special Inspector General for Afghanistan Reconstruction [SIGAR], which is the government's oversight authority for the country's reconstruction. In its August 2021 report, SIGAR detailed how the U.S. government "continuously struggled to develop and implement a coherent strategy for what it hoped to achieve." 

To continue quoting SIGAR: "The U.S. government consistently underestimated the amount of time required to rebuild Afghanistan, and created unrealistic timelines and expectations that prioritized spending quickly. These choices increased corruption and reduced the effectiveness of programs." Again, those are not my words, although I do concur. That is the conclusion of the oversight agency meant to monitor and evaluate how the U.S. military was performing in Afghanistan. In other words, the U.S. military had no long-term strategy on its military involvement in Afghanistan and had no exit strategy

Since the best military in the world is withdrawing, there is bound to be at least some effect on Afghanistan's internal affairs. At the same time, this was a civil war long before the U.S. entered Afghanistan for what was initially "a constrained counterterrorism operation in retaliation for the 9/11 attacks." The U.S. military went into Afghanistan to stop Al-Qaeda. As the think-tank Brookings Institution points out in its recent analysis, Al-Qaeda has a fraction of the power it had in 2001. At this point, terrorist groups from the Middle East and Africa are more of a threat to national security than Al-Qaeda, which diminishes the national security argument for staying in Afghanistan. 

Some situations are truly hopeless, much like Sisyphus pushing that boulder up the hill. Afghanistan is a country plagued with tribal bickering, parochialism, corruption, lack of sound institutions, and a lack of willpower for actual reform. Alexander the Great, Genghis Khan, and the Soviets had issues when they invaded Afghanistan. Given the history of volatility in that part of the world, not to mention the geopolitical, ethnic, and cultural complexities, it was inevitable that there would have been havoc and chaos when U.S. troops entered Afghanistan. However, the United States has been attempting nation-building for twenty years in Afghanistan without significant reform. As frustrating as it might be to put in so much effort so little reward, it is about time that the United States cuts its losses and withdraws from Afghanistan.

Thursday, August 12, 2021

We Do Not Need Mask Mandates to Fight the Delta Variant

We were making such progress with the pandemic in the United States. We got through the COVID peak in the winter. Since the vaccine rollout began in December, 71.3 percent of adults have received at least one dose as of August 11. Restrictions were getting lifted across the country. It looked like we were seeing the end of the tunnel with this pandemic. Then the Delta variant, a strain of COVID that is about twice as contagious as the Alpha variant (i.e., R0≈7), came along. In response to this variant, multiple cities have reinstated mask mandates, including Los Angeles, Phoenix, and Washington, D.C. 

There has been a partisan divide throughout this pandemic. Generally speaking, Democrats have taken the pandemic more seriously and have been more scared of coronavirus. Republicans, on the other hand, have not taken it as serious and are less afraid. Independents are somewhere in between. This trend has borne out by survey data. Republicans show a lower rate of vaccinations than other demographics (Kaiser Family Foundation). This divide is not confined to the vaccines. To quote Reason Magazine contributor Robby Soave, "In practice, people who don't want to get the vaccine are unlikely to follow the other, more annoying mitigation strategies. On the contrary, the places that are most likely to reintroduce the mask mandates and see widespread compliance are places where vaccination rates are high." According to a Morning Consult survey from August 4, both the unvaccinated and Republicans are less likely to wear masks going forward than the vaccinated and/or Democrats. Although the pandemic has been greatly politicized, we should not view it in those terms. The question is whether these mandates are going to help or if it is an exercise in futility. 

Before the Delta variant arrived, the question about mask efficacy has been in question. In the medical journal JAMA, they wrote in March 2020 that "face masks should not be worn by healthy individuals to protect themselves from acquiring respiratory infection because there is no evidence to suggest that face masks worn by healthy individuals are effective in preventing people from becoming ill (Desai and Mehrotra, 2020)." I looked at the question of face mask effectiveness twice last year (see here and here). At that time, I found inconsistent evidence, but was also mildly supportive of a temporary, indoor face mask mandate because a) they work under certain conditions (e.g., high compliance rate, more effective indoors and in larger crowds), b) they come with a lower cost (especially compared to lockdowns), c) surgical and N95 masks work much better than cloth masks, and d) there was an overriding public health concern. Looking at World Health Organization recommendations, I concluded that, at best, face masks would be but part of a more comprehensive strategy since their efficacy was lower than such a measure as social distancing. In December 2020, the WHO stated in its interim mask guidance (p. 8) that "there is only limited and inconsistent scientific evidence to support the effectiveness of masking healthy people."  That was the prominent WHO about a year into the pandemic, and that was the best they could say about masking healthy people. The American Institute for Economic Research released a piece on mask efficacy evidence that I found to be a good read. Needless to say, how I view the masks are that their efficiency is modest at best, and inconsistent and negligible at worst. 

In addition to asking whether the masks are effective, there is also a question about whether the mandates work. Lockdowns provide a good example and proxy of voluntary versus mandated behavior. Lockdowns were advocated for not based on evidence (because none existed at the time), but on modeling. The modeling made generous assumptions about the benefits of lockdowns while giving most, if not all, the credit, to lockdowns. The evidence is coming in with regards to lockdowns, and what we have been seeing is that lockdowns are ineffective. There are multiple reasons, but one of the big reasons was that people were social distancing without the lockdowns. People did not need a mandate. By and large, they voluntarily kept their distance. Do we see a similar phenomenon with masks? Were most people already masking before the mandates? Would people have worn masks regardless of the mandates? A recent study from the International Monetary Fund fails to make the distinction, which is why I ask these questions (Hansen and Mano, 2021). Were the mask mandates a primary cause in saving lives or were they simply incidental and correlational? 

We can look at multiple countries that implemented mask mandates and the number of cases still surged, especially last winter. I could also point out that Sweden has not had a mask mandate and its current COVID problem is all but nonexistent. I can show some earlier analysis from the Heritage Foundation, but I want to show a recent ecological study from the University of Louisville (Guerra and Guerra, 2021). The researchers found that although 80 percent of states mandated masks, the mandates "did not predict lower growth rates when community spread was low [minima] or high [maxima]." The conclusion thus inferred was that the mandates were unlikely to have affected COVID-19 case growth.


What makes all this discussion about how they have fared thus far is a case of "that was then, this is now." Two major changes have taken place in recent months. These changes do not make the previous discussion about masks pointless, but it does change the context. One such change is that the prominent strain of COVID [in the United States], the Delta variant, is significantly more contagious. You could make an argument that masks could be more effective against Delta. It is soon to tell since we do not have data to back up the assertion. The closest we have is previous research and inferences we can make. On the other hand, as I would argue, the rate of transmission is high enough that even if you go with the generous assumption of masks reducing transmission from 30 to 50 percent, there will still be high transmission in absolute terms. The second change is that the vaccination campaign is well under way. I discussed vaccine mandates a couple of weeks ago, and you can read an elaboration of the aforementioned changes here. What I will say is that while the idea of a more contagious disease sounds scary, it is not as simple or as catastrophic as "cases are surging" sounds.

Sir Andrew Pollard, who heads the Oxford Vaccine Group, said that while vaccinations slow the spread, they do not eliminate transmission. However, the odds of catching it as a vaccinated individual (i.e., a breakthrough case) is low. As the Kaiser Family Foundation points out in its research of state-level data earlier this month, the odds of a breakthrough case are less than one percent. More to the point, hospitalizations and deaths are really low for the vaccinated. Pollard also said that even if the vaccine-induced antibodies waned, odds are that our immune systems would remember enough to offer a degree of protection for decades. So why does transmission matter if actual harm has decreased? As infectious diseases expert Professor Paul Hunter brings up, we shouldn't frighten ourselves with high [confirmed case] numbers that do not translate into disease burden. 

Hospitalizations and deaths are much better indicators of disease burden than cases. What have we seen since the vaccines have taken hold? In most jurisdictions, there has not been a corresponding, comparable rise in hospitalizations and deaths. The areas getting heavily hit are those with low vaccination rates (although, to be fair, the places in the Southern U.S. are also dealing with hotter summer weather, which means they are indoors more often than the rest of the year). Looking at the American Hospital Associations Bed Occupancy Projection Tool, most parts of the U.S. are not above 70 percent. For context, the CDC calculated in 2015 that average bed occupancy was 65.5 percent. You can go through the data on hospitalizations and deaths yourself. When you do look at the numbers, I hope you see what I see, which is that the disease burden is not there to justify the mask mandates.

To summarize, our focus should not be on renewed mask mandates. Why? For one, mask mandates, as opposed to general mask-wearing, are shown to have been negligible at best. It has hardly been the silver bullet that proponents make it out to be. Two, the unvaccinated are less likely to wear masks than the vaccinated. Three, those who have been pushing for the mask mandates are the ones most likely to assume that we can get rid of COVID. Historically, we have only eradicated smallpox and rinderpest. A mask mandate distracts us from being able to accept that COVID is most likely to be endemic, i.e., it's not going anywhere. If endemicity is the future, then at best, masks would only delay the inevitable. Finally, one of the most prevailing features of those entering the hospitals for COVID are that they are not vaccinated. Fauci was right that this pandemic has become a pandemic of the unvaccinated. That being the case, mask mandates make little sense if the unvaccinated are the drivers of COVID at this stage. Vaccines are safe and effective. They have been shown to be especially effective against severe COVID cases and COVID deaths. Instead of spurious mask mandates or the CDC using mixed messaging about vaccines and face masks, what needs to happen is a solid vaccine campaign with unambiguous messaging so we can get our lives to as close to "pre-pandemic normal" as possible. 

Friday, August 6, 2021

The Swedish COVID Approach: A Case Study Pandemic Control Freaks and Lockdown Proponents Prefer to Ignore

Last year, Sweden was the target of derision on the Left, particularly those who were gung-ho about more pandemic restrictions. What did Sweden do that was so terrible? On the one hand, Sweden did recommend masks in certain scenarios (e.g., public transit), banned large gatherings, closed upper-secondary schools, and imposed travel bans. On the other hand, it didn't implement lockdowns, curfews, or mask mandates. This approach has been seen so lax by the pandemic control freaks that Sweden has been called a disastera catastrophea failure, an example of "how not to handle COVID", and has been accused of killing its own people

There was a model coming out of Sweden, one that was based on the infamous Imperial College model that got the United Kingdom to go into lockdown mode, that predicted that 96,000 Swedes would die by June 2020 if Sweden would not implement lockdowns, mask mandates, or other stringent measures (Gardner et al., 2020). Much like I asked last August, I would like to see how well Sweden has fared, even in spite of its seemingly lax approach.

Let's start with number of deaths. How close was Sweden to the predicted 96,000 deaths? According to the Swedish Health Ministry (Folkhälsomyndigheten), the number of dead in Sweden as of August 6, 2021 is 14,657. It has been about a year-and-a-half since the pandemic started, and Sweden has had less than a sixth of what the doom-and-gloom crowd predicted. Additionally, 9,771 of those deaths (or 66.7%) were of those who were 80 or older. The next argument I can anticipate is "well, maybe that is so, but it would have been better with lockdowns." Is that so? I took a look at the academic literature on lockdowns in June, and the data-driven evidence is showing that lockdowns were ineffective at its goal of saving lives. Not only that, it is likely that lockdowns have actually increased excess deaths.

Speaking of excess deaths, Sweden had a much lower excess death rate than many of its counterparts that locked down, including Spain and Belgium (Reuters; Eurostat). Deaths per 100,000 play out a similar finding (Johns Hopkins), mainly that other countries that locked down (e.g., Italy, France, Spain) fared worse than Sweden. Before mentioning Norway or Finland, it is worth mentioning that the Scandinavian counterparts ranked lower than Sweden in terms of restriction stringency on Oxford's COVID-19 Stringency Index during much of the pandemic.


How has the laxer approach working out for Sweden? Whether we look at Sweden's deaths (avildna), cases (sjukdomsfall), or intensive care admissions (nya intensivvĂĄrdade), what we see from the statistics from the Folkhälsomyndigheten [below] is that the pandemic seems to be subsiding in Sweden. While Sweden is looking at a denouement, other countries are looking to impose another round of restrictions. 

It is not that Sweden did nothing. What Sweden did was its best to truly follow the science, as opposed to being needlessly stringent under the guise of "following the science." In the meantime, those who want to continuously impose restrictions ignore the likes of Italy, Spain, or Peru, the latter of whom has the highest per capita death rate in spite of having locked down hard and early. While the Swedish case study is not definitive proof unto itself that excessive restrictions do not work, it adds to the growing evidence base that a less onerous and more laissez-faire approach rooted in science was the better way to handle the pandemic.