For all the folks arguing COVID-19 isn’t that bad...what they are missing is that most consumer experiences aren’t that good.

You're 55. Are you going to risk serious illness for a trip to the movie theater?

You're a libertarian? OK, one way of thinking about uncontrolled COVID-19 is a tax on every transaction.

Some of your customers are risk averse. So society's inability to control the virus means that all kinds of previously cheap transactions have now soared in price.

Think of COVID-19 as a health outage, like a power outage.

Our society is explicitly premised on the presence of electrical power. And implicitly premised on low risk of serious infectious disease.

When the health goes out, some businesses don't work. https://twitter.com/balajis/status/1256805815467425792

So this then gets to the question of: how bad is this thing really? What is the rational level of risk aversion, given the last few months of data?

Early reports from China put the median age of admitted patients at 47, with ~41% of severe cases under 50.
https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

The two largest Western studies I've seen on COVID-19 demographics are below.

1) US sample: 25% of hospitalizations were under age 50
https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm

2) UK sample: ~20% of hospitalizations under age 50 (from eyeballing top row of graph below)
https://www.medrxiv.org/content/10.1101/2020.04.23.20076042v1

So that's roughly 20-25% hospitalized in the UK/US under age 50, as compared to 41% of severe cases in China under age 50.

A big difference, but not 10X different. Maybe explained by poorer health in China or older societies in the West. Or some other factor.

Relatedly, there are a number of credible reports of long-lasting "mild" cases. We need quantitative studies of sublethal severity and long-term effects.

BBC
https://bbc.com/news/health-52548843

Guardian
https://theguardian.com/world/2020/may/01/lingering-and-painful-long-and-unclear-road-to-coronavirus-recovery-long-lasting-symptoms

BMJ
https://blogs.bmj.com/bmj/2020/05/05/paul-garner-people-who-have-a-more-protracted-illness-need-help-to-understand-and-cope-with-the-constantly-shifting-bizarre-symptoms/

Science
https://sciencemag.org/news/2020/05/finally-virus-got-me-scientist-who-fought-ebola-and-hiv-reflects-facing-death-covid-19

Finally, there's recent reports of strokes in young folks and Kawasaki-like illness in children in the US & UK.

The rate is up over previous years, BUT these are still small samples and the connection to COVID-19 is still being puzzled out. So this is
https://twitter.com/balajis/status/1253376567004127232

Putting that all together, here's current picture in US/UK:

- over-50s at highest risk
- but ~20-25% of hospitalizations are under-50s
- reports of "mild" cases that are weeks of illness
- published reports of elevated-but-still-rare serious conditions like strokes or Kawasaki

So that's the state of play.

Policy-wise, other countries have controlled corona. That may yield the best long run health *and* economic outcomes.

But the US isn't implementing ideal policy. It's reopening in highly variable ways.

What then? https://twitter.com/balajis/status/1257159480816488448

Every physical business that wants to reopen now has a set of problems. They must:

- pay for virus control (Purell, etc)
- compete with digital alternatives (theaters vs streaming)
- attract customers who suddenly have less disposable income

That's a huge set of new costs.

Essentially, the inability of the state to control COVID-19 has massively increased transaction costs for every physical business.

They need to buy masks, Purell, etc on top of disrupted supply chains, shifted consumer demand, and all the issues of cargo cult lockdown.

So, it's not as simple as "reopen and the economy comes back"

It's rational to be cautious given the data.

That caution translates into increased operational costs in many ways.

And many businesses (through no fault of their own) don't offer enough benefit to offset that cost.