AlleyCat
2021-08-28 18:58:36 UTC
America's Republicans Are Killing Their Voters
Jul 22, 2021
Jeffrey Frankel
Despite mounting evidence that vaccination leads to lower COVID-19
mortality rates, many in the US remain skeptical, if not downright
hostile. An analysis of the data that isolates the causal effect of
voting patterns clearly shows the heightened danger Republicans face.
CAMBRIDGE - On May 14, 1962, the agriculture commissioner of Montana,
Lowell Purdy, launched what would become one of the century's great
platitudes. "If we can put a man on the Moon," he declared, seven years
before the United States achieved President John F. Kennedy's goal, "we
surely are capable of seeing that our temporary surplus agricultural
products are placed in many hungry stomachs of the world."
Since then, the formula has become a clich - precisely because it often
makes a pretty good point. Today, for example, one might point out: "If
we can produce vaccines that drastically decrease the transmission and
severity of COVID-19, we surely are capable of ending the pandemic." And
yet, we have so far been unable to do so, largely because people simply
refuse to be vaccinated.To be sure, in some cases - especially in lower-
income countries - the primary impediment to large-scale immunization is
limited vaccine availability. But in a country like the US, the main
problem is vaccine hesitancy, even hostility. Although the Food and Drug
Administration has granted emergency approval to three vaccines - a
process that demands rigorous testing - many are convinced they are
still "experimental," and thus unsafe.As Anthony Fauci, the head of the
National Institute of Allergy and Infectious Diseases at the US National
Institutes of Health, put it, there are two Americas, and their
perceptions regarding vaccination are separated by a wall. For the
America that mistrusts vaccines, the expertise of remote authorities and
the logic of the scientific method are unconvincing.Perhaps more
tangible, real-world evidence can change their minds. It is certainly
piling up: recent data show a strong negative correlation between
vaccination rates and rates of infection, hospitalization, or death from
COVID-19 across the US. In the week that ended on June 22, counties
where 30% or fewer residents had been vaccinated suffered 5.6 new COVID
cases per 100,000 people, whereas counties where more than 60% of
residents had been vaccinated experienced just 2.1 new cases per
100,000.On updated data, a one percentage-point increase in the share of
adults (and teenagers) who were fully vaccinated in a given county as of
June 9 was associated with a significant decline in the COVID-19 death
rate - 0.06 per 100,000 inhabitants - over the subsequent 30 days (to
July 9). That represents 2% of the total monthly coronavirus-related
deaths. One could extrapolate from this that the statistical effect of
reaching 100% vaccination would be to bring COVID- related deaths close
to zero. SUBSCRIBE NOW
Enjoy unlimited access to the ideas and opinions of the world's leading
thinkers, including weekly long reads, book reviews, topical
collections, and interviews; The Year Ahead annual print magazine; the
complete PS archive; and more. Now less than $5 a month when you redeem
this offer.
SUBSCRIBE NOW
But, of course, correlation does not prove causality. The apparent
beneficial effect of vaccination could, one might argue, be the result
of some third factor, such as poverty. Low-income people are at higher
risk of becoming infected with and dying from COVID-19, owing to a range
of factors, from housing conditions to types of employment. If they are
also less likely to get vaccinated, it could create the illusion that
lack of immunization is the problem. Yet the beauty of econometrics is
that one can control for third factors, such as the poverty rate or
local temperature, to isolate statistically the effect of vaccination
rates. But this does not fully resolve the causality question. There is
also the possibility that the simple observed correlation between
vaccination and mortality understates the true impact of the vaccines.
After all, those living in a high-risk context - say, near a transport
hub - are more likely to know people who have suffered from the
coronavirus, and thus might be more likely to get vaccinated. This
"reverse causality" could lead to an apparent - and excessive - positive
correlation between vaccination and death rates.And, in fact, this could
partly explain why earlier studies, conducted as recently as the
beginning of June, did not find a clear negative correlation. But, as
the highly contagious Delta variant gains traction among the
unvaccinated, the correlation between immunization and lower COVID-19
infection and death rates is strengthening.Still, to have a chance of
convincing the vaccine skeptics, it is vital to disentangle causality
from correlation. The key is to look at variations in vaccination rates
that have nothing to do with where and how the coronavirus spreads -
indeed, have nothing to do with the coronavirus at all. In technical
parlance, we need an "exogenous instrument."Party affiliation or voting
patterns are an obvious choice. Throughout the pandemic, Republican
governors have been less likely than their Democratic counterparts to
support public-health measures, such as mask mandates. Not surprisingly,
Republican voters (45%) are less likely than independents (58%) and
Democrats (73%) to accept vaccines. In counties where then-President
Donald Trump won by a margin of 50 percentage points or more in the 2020
election, the vaccination rate was below 25%, as of April 17.
Sign up for our weekly newsletter, PS on Sunday
The "partisan gap" - which continues to widen - holds even after
accounting for income, race, and age, as well as population density and
the local infection and death rates. According to my calculations, when
controlling for the poverty rate and other relevant variables
(particularly age and temperature), a one percentage-point increase in
the share of a county's residents over age 12 who were fully vaccinated
as of June 9 is associated with a death rate that was 0.05 lower per
100,000 inhabitants during the subsequent 30 days.
To ensure that the results are not distorted by reverse causality, I
also performed another calculation, based on the same data. Accounting
for variation in the vaccination decision attributable solely to
partisan political affinity - and controlling for variables like poverty
- I found the difference in the COVID-19 death rate to be 0.04 per
100,000 inhabitants.I used voting patterns not to target any particular
group, but rather to provide a better estimate of vaccine effectiveness
on anyone. But I hope that at least some skeptics notice that members of
their political "in-group" are dying at a higher rate, and decide to
give vaccination a chance. As Rochelle Walensky, the director of the US
Centers for Disease Control and Prevention, recently observed, "This is
becoming a pandemic of the unvaccinated."
That IS great news!Jul 22, 2021
Jeffrey Frankel
Despite mounting evidence that vaccination leads to lower COVID-19
mortality rates, many in the US remain skeptical, if not downright
hostile. An analysis of the data that isolates the causal effect of
voting patterns clearly shows the heightened danger Republicans face.
CAMBRIDGE - On May 14, 1962, the agriculture commissioner of Montana,
Lowell Purdy, launched what would become one of the century's great
platitudes. "If we can put a man on the Moon," he declared, seven years
before the United States achieved President John F. Kennedy's goal, "we
surely are capable of seeing that our temporary surplus agricultural
products are placed in many hungry stomachs of the world."
Since then, the formula has become a clich - precisely because it often
makes a pretty good point. Today, for example, one might point out: "If
we can produce vaccines that drastically decrease the transmission and
severity of COVID-19, we surely are capable of ending the pandemic." And
yet, we have so far been unable to do so, largely because people simply
refuse to be vaccinated.To be sure, in some cases - especially in lower-
income countries - the primary impediment to large-scale immunization is
limited vaccine availability. But in a country like the US, the main
problem is vaccine hesitancy, even hostility. Although the Food and Drug
Administration has granted emergency approval to three vaccines - a
process that demands rigorous testing - many are convinced they are
still "experimental," and thus unsafe.As Anthony Fauci, the head of the
National Institute of Allergy and Infectious Diseases at the US National
Institutes of Health, put it, there are two Americas, and their
perceptions regarding vaccination are separated by a wall. For the
America that mistrusts vaccines, the expertise of remote authorities and
the logic of the scientific method are unconvincing.Perhaps more
tangible, real-world evidence can change their minds. It is certainly
piling up: recent data show a strong negative correlation between
vaccination rates and rates of infection, hospitalization, or death from
COVID-19 across the US. In the week that ended on June 22, counties
where 30% or fewer residents had been vaccinated suffered 5.6 new COVID
cases per 100,000 people, whereas counties where more than 60% of
residents had been vaccinated experienced just 2.1 new cases per
100,000.On updated data, a one percentage-point increase in the share of
adults (and teenagers) who were fully vaccinated in a given county as of
June 9 was associated with a significant decline in the COVID-19 death
rate - 0.06 per 100,000 inhabitants - over the subsequent 30 days (to
July 9). That represents 2% of the total monthly coronavirus-related
deaths. One could extrapolate from this that the statistical effect of
reaching 100% vaccination would be to bring COVID- related deaths close
to zero. SUBSCRIBE NOW
Enjoy unlimited access to the ideas and opinions of the world's leading
thinkers, including weekly long reads, book reviews, topical
collections, and interviews; The Year Ahead annual print magazine; the
complete PS archive; and more. Now less than $5 a month when you redeem
this offer.
SUBSCRIBE NOW
But, of course, correlation does not prove causality. The apparent
beneficial effect of vaccination could, one might argue, be the result
of some third factor, such as poverty. Low-income people are at higher
risk of becoming infected with and dying from COVID-19, owing to a range
of factors, from housing conditions to types of employment. If they are
also less likely to get vaccinated, it could create the illusion that
lack of immunization is the problem. Yet the beauty of econometrics is
that one can control for third factors, such as the poverty rate or
local temperature, to isolate statistically the effect of vaccination
rates. But this does not fully resolve the causality question. There is
also the possibility that the simple observed correlation between
vaccination and mortality understates the true impact of the vaccines.
After all, those living in a high-risk context - say, near a transport
hub - are more likely to know people who have suffered from the
coronavirus, and thus might be more likely to get vaccinated. This
"reverse causality" could lead to an apparent - and excessive - positive
correlation between vaccination and death rates.And, in fact, this could
partly explain why earlier studies, conducted as recently as the
beginning of June, did not find a clear negative correlation. But, as
the highly contagious Delta variant gains traction among the
unvaccinated, the correlation between immunization and lower COVID-19
infection and death rates is strengthening.Still, to have a chance of
convincing the vaccine skeptics, it is vital to disentangle causality
from correlation. The key is to look at variations in vaccination rates
that have nothing to do with where and how the coronavirus spreads -
indeed, have nothing to do with the coronavirus at all. In technical
parlance, we need an "exogenous instrument."Party affiliation or voting
patterns are an obvious choice. Throughout the pandemic, Republican
governors have been less likely than their Democratic counterparts to
support public-health measures, such as mask mandates. Not surprisingly,
Republican voters (45%) are less likely than independents (58%) and
Democrats (73%) to accept vaccines. In counties where then-President
Donald Trump won by a margin of 50 percentage points or more in the 2020
election, the vaccination rate was below 25%, as of April 17.
Sign up for our weekly newsletter, PS on Sunday
The "partisan gap" - which continues to widen - holds even after
accounting for income, race, and age, as well as population density and
the local infection and death rates. According to my calculations, when
controlling for the poverty rate and other relevant variables
(particularly age and temperature), a one percentage-point increase in
the share of a county's residents over age 12 who were fully vaccinated
as of June 9 is associated with a death rate that was 0.05 lower per
100,000 inhabitants during the subsequent 30 days.
To ensure that the results are not distorted by reverse causality, I
also performed another calculation, based on the same data. Accounting
for variation in the vaccination decision attributable solely to
partisan political affinity - and controlling for variables like poverty
- I found the difference in the COVID-19 death rate to be 0.04 per
100,000 inhabitants.I used voting patterns not to target any particular
group, but rather to provide a better estimate of vaccine effectiveness
on anyone. But I hope that at least some skeptics notice that members of
their political "in-group" are dying at a higher rate, and decide to
give vaccination a chance. As Rochelle Walensky, the director of the US
Centers for Disease Control and Prevention, recently observed, "This is
becoming a pandemic of the unvaccinated."