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This post unfortunately fails to honestly engage with its own counterarguments. Note to the author: you can't make a thinkpiece balanced by bringing up opposing
This post unfortunately fails to honestly engage with its own counterarguments. Note to the author: you can't make a thinkpiece balanced by bringing up opposing points if you're just going to dismiss them out-of-hand.
>Second, it should be the default that the status quo is a bad thing; instead of justifying why something should be done, the burden of proof should rest on those who believe things should remain the same.
This is ignorant of the cost of change. That cost is the main reason why society collectively assumes that "the system works". Arguments for change have to first attack that notion - as communists, fascists, and all other kinds of anti-conservatives do. None of them believe that change, in and of itself, is valuable.
Likewise, the author's talk of opportunity cost neglects the price of failure - in doing a retrospective analysis (like the one of vaccine development), it's easy to ignore the counterfactuals that never actually happened. But leaving them out means that your analysis is meaningless. Would the author be convinced to write the same article if the vaccine had been rolled out in January, and as a result the world suffered a second thalidomide scandal?
> Would the author be convinced to write the same article if the vaccine had been rolled out in January, and as a result the world suffered a second thalidomide scandal?
A better comparison would be the swine flu vaccine in 1976. According to Wikipedia [1], about 45 million people were vaccinated and 362 of them suffered Guillan-Barre syndrome. Only 1 person died of the actual swine flu.
But that comparison actually makes Ben's case stronger. What if all 330 million people in the US had been vaccinated against COVID, and 1 in 100,000 of them (about the same proportion as for the 1976 vaccine) had serious side effects? Even if all of those side effects were fatal (and they wouldn't be), that would still be only 3,300 deaths--less than 1 percent of the US COVID death count currently reported. And even leaving aside that not all side effects would be fatal, that death count is clearly an overestimate, since in the US people would be given the choice whether to be vaccinated, and not all Americans would take it.
[1] https://en.wikipedia.org/wiki/1976_swine_flu_outbreak https://en.wikipedia.org/wiki/1976_swine_flu_outbreak
That's assuming that we have already seen the worst-case outcome for a rushed vaccine - which I don't think is true. Human medicine is sufficiently complex that its negative consequences are extremely ripe for black swan events.
From that perspective, your argument falls in the same hole as Ben's: based on a retrospective view of bounded outcomes, you are trying to argue about unbounded future events. The real risk of a rushed vaccine rollout is not a repeat of the 1976 incident, but a medical disaster which is unpredictably and massively worse. Modern medical red tape exists precisely because of the risk of such disasters.
> That's assuming that we have already seen the worst-case outcome for a rushed vaccine
Why don't you think the swine flu vaccine, which was much more rushed than the current COVID vaccine, was reasonably close to a worst case outcome? Or at least close enough to serve as an upper bound estimate for side effects from the COVID vaccine?
> based on a retrospective view of bounded outcomes, you are trying to argue about unbounded future events
That's just as true of our actual response to COVID--none of the so-called "experts" ever really considered where we are now as a possibility back when doing so would have mattered.
> a medical disaster which is unpredictably and massively worse
You mean like what actually happened with COVID?
> Modern medical red tape exists precisely because of the risk of such disasters.
No, it doesn't. Modern medical red tape exists because our approach to risk is extremely one-sided; we punish regulators only when something bad happens that we think they could have prevented, not when something good fails to happen that they could have enabled. For example, the FDA took ten years longer than European regulators to approve beta blockers for people at risk for heart attacks. A rough estimate is that 100,000 heart attacks were suffered by Americans during those ten years that could have been prevented. But no regulator got punished for allowing those 100,000 deaths to happen.
>Why don't you think the swine flu vaccine, which was much more rushed than the current COVID vaccine, was reasonably close to a worst case outcome? Or at least close enough to serve as an upper bound estimate for side effects from the COVID vaccine?
Because
1. the negative side-effects of a vaccine are not a function of its rushed-ness - just like the injuries you get when a car runs you over are not proportional to how quickly you ran into the road without looking both ways.
2. I don't believe there is a sensible "upper bound" for medical side-effects, apart from the obvious one (everyone dies). Even if there was, you could not think to have safely established it through a single example.
>we punish regulators only when something bad happens that we think they could have prevented, not when something good fails to happen that they could have enabled.
This is also a very retrospective view. How would you establish when a regulator "failed to enable" new medicine? How could you decide that an entity had enough information in advance to make a decision that is obvious in retrospect? How would that entity then prove its historical ignorance in its own defense? Moreover, in the case of a disaster, how would it argue that its predictions were justified and the opportunity cost was too great to institute rigorous checks?
These questions don't exist for the current system. A regulator that fails to catch some medical issue is not questioned on its intentions, but instead punished for simply not being rigorous enough. That cures are slow to roll out is just the price of safe medicine.
> What if all 330 million people in the US had been vaccinated against COVID, and 1 in 100,000 of them (about the same proportion as for the 1976 vaccine) had serious side effects?
What your comment and the article both miss are the second order costs to safety failures: it's not only the immediate side effects that are a problem, but rather the change in behavior coming from the rest of the population.
If you think that 330 million people would have gotten a vaccine that had not gone through any safety trial, even though a large portion of the population is still unsure after the phase 3 trials, I think you're deluding yourself. If, on top of that, you had widely reported and exaggerated ("free speech" at work) reports of side effects, the percentage of willing volunteers falls dramatically. Vaccinating 5% of the population in January doesn't really help.
> it's not only the immediate side effects that are a problem, but rather the change in behavior coming from the rest of the population.
That's just as true of our actual responses to COVID.
> If you think that 330 million people would have gotten a vaccine
I explicitly said in my post that not all Americans would choose to take the vaccine. You are attacking a straw man. I was simply giving the highest possible upper bound to the expected number of deaths from vaccination.
> a large portion of the population is still unsure after the phase 3 trials
Yes, and why is that? Because despite all of our "respected" institutions saying that the vaccine is safe, many people don't believe them. Why not? Because they know that those same institutions lied to them, repeatedly--and not just in general, specifically during the whole COVID crisis. So why should people believe those institutions now?
In other words, we have a problem with the status quo.
> If, on top of that, you had widely reported and exaggerated ("free speech" at work) reports of side effects, the percentage of willing volunteers falls dramatically.
Who would be reporting and exaggerating the side effects in a way that everyone would hear about? The mainstream media. In other words, the problem you describe is the status quo right now. So the status quo in this respect obviously needs to change since it makes us as a society stupid, unable to even consider courses of action that, in hindsight, would have been obvious and dramatic improvements over what actually happened.
> That's just as true of our actual responses to COVID.
Please expand on that point to clarify. The second order negative outcomes of a botched vaccine rollout would be enormous, both for this particular pandemic and longer term.
> I explicitly said in my post that not all Americans would choose to take the vaccine. You are attacking a straw man. I was simply giving the highest possible upper bound to the expected number of deaths from vaccination.
This is a key point that you cannot elide though. If 30% of the population takes the rushed vaccine but 70% takes the tested slowly rolled out vaccine, the difference in the herd immunity outcome is large.
> Yes, and why is that? Because despite all of our "respected" institutions saying that the vaccine is safe, many people don't believe them. Why not? Because they know that those same institutions lied to them, repeatedly--and not just in general, specifically during the whole COVID crisis. So why should people believe those institutions now?
> In other words, we have a problem with the status quo.
The FDA never lied during the pandemic, that I know of. Broadly speaking people do trust them, and the tests and approval has a positive effect on vaccine acceptance. Also note that this isn't a binary choice "status quo"/"not status quo", you have to offer a realistic alternative to the status quo that we can measure the status quo against. Rushing the vaccine has more negatives than positives, in my opinion (both in hindsight and even more so with the information we had at the time).
> Who would be reporting and exaggerating the side effects in a way that everyone would hear about? The mainstream media.
No, mostly social media. But even if the mainstream media is responsible (whatever that term means, it encompasses local stations, cable news, NPR and newspapers like the NYT/WaPo, each of which have different propensities to exaggerate), you're not offering a solid alternative.
> Please expand on that point to clarify.
Our actual response to COVID has had huge second order negative effects, like killing the economy, for no real benefit. You need to include that in your analysis.
> The FDA never lied during the pandemic
I didn't say "the FDA", I said "institutions" in general. That includes both government organizations like the CDC and the WHO and the mainstream media. The FDA isn't the government organization that generally does direct public communication in a pandemic, so they didn't lie because they didn't really say anything at all. They did, however, botch development of tests and kept state and local health authorities from developing their own tests.
> mostly social media
You obviously have been living on a different planet from me for the past year.
> you're not offering a solid alternative
Oh, you want me to reinvent society from scratch?
You're right that I don't have a working alternative society in my back pocket, but our current society is clearly not working. The first thing to do if you're in a hole is to stop digging.
> Our actual response to COVID has had huge second order negative effects, like killing the economy, for no real benefit. You need to include that in your analysis.
There's strong evidence that the economy suffers whether or not governments institute lockdowns, mostly because people choose not to go out on their own. For example, take a look at the Swedish unemployment rate over the past year: https://www.statista.com/statistics/527418/sweden-monthly-unemployment-rate/ https://www.statista.com/statistics/527418/sweden-monthly-un...
> I didn't say "the FDA", I said "institutions" in general. That includes both government organizations like the CDC and the WHO and the mainstream media.
The CDC didn't lie either, AFAIK. The WHO is irrelevant in this case because they're not in charge of approving vaccines in the US.
> Oh, you want me to reinvent society from scratch?
> You're right that I don't have a working alternative society in my back pocket, but our current society is clearly not working. The first thing to do if you're in a hole is to stop digging.
There's no need to reinvent society from scratch, but if you criticize a situation harshly it's best to have your desired alternative in mind: what, exactly, do you want people to start or stop doing?
Maybe, but you could also have done something like opening up the trials to a much larger population or doing a sort of EEUA, basically making the risks very clear, having people sign a bunch of scary forms, but allowing people to take the vaccine if they wanted it, especially after Phase 2.
There would have been many people who would not want to take an unproven vaccine, but there might have been others that found the risk reasonable, assuming production could have been made available earlier.
What your comment and the article both miss are the second order costs to safety failures: it's not only the immediate side effects that are a problem, but rather the change in behavior coming from the rest of the population.
Yeah, it'd be a damn shame if a big chunk of the country had lunatic ideas about vaccinations.
> the economy suffers whether or not governments institute lockdowns, mostly because people choose not to go out on their own
Yes, in a free country many people will choose to curtail activities. But that's still a lot better than governments shutting down businesses without any real data or science to back up their decisions, including many businesses that (a) aren't linked by any real data to COVID transmission, (b) are taking precautions to protect their customers, and (c) still have plenty of customers who would like to go there. Not to mention (d) allowing "essential" businesses to stay open, but "essential" often means "has political connections" rather than really being essential, and (e) politicians notoriously violating the very lockdown rules they impose on everyone else. Which causes further secondary damage by further eroding people's trust in institutions.
> The CDC didn't lie either, AFAIK.
To be fair, the CDC hasn't done a lot of public communication either--most of that has been Fauci, who works for NIH, not CDC. But the NIH is a government institution too. And the things he said were trumpeted by the media, who I also included in "institutions":
Masks are bad--no wait, masks are good!
Lockdowns are bad--no wait, lockdowns are essential!
The herd immunity threshold is 60%--no wait, 65% to 70%--no wait, 70% to 80%, or is it 70% to 80% to 85%? Fauci admitted to the New York Times that he was just making up those numbers based on no actual science, just on what he thought would manipulate people into doing what he thought was a good idea.
> The WHO is irrelevant in this case because they're not in charge of approving vaccines in the US.
We're talking about second order effects. The WHO refused to even admit there was a pandemic until March 11, by which time Europe was already weeks into exponential growth and the US was not far behind. No wonder people in January and February 2020 weren't thinking in terms of a vaccine (or, for that matter, of shutting down international travel to stop the spread, which the WHO advised against).