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> Perhaps unpopular opinion, but the US vaccination system is about the worst when it comes to preventing spread. Instead, it seems to be attempting to prevent

> Perhaps unpopular opinion, but the US vaccination system is about the worst when it comes to preventing spread. Instead, it seems to be attempting to prevent death. This is by far the most common approach around the world - the same approach is taken in the UK, for example. It's in place for three reasons: 1. We worked out that about 90% of deaths in the first wave would have been prevented if we had been able to vaccinate the most vulnerable groups. This is A Good Thing, both in ite own terms, but also in terms of preventing healthcare systems being overwhelmed. 2. There was no evidence at the beginning that the vaccine prevented transmissibility - only that it prevented serious illness. So the preventing deaths strategy made sense. 3. It's simple to organise and roll-out at speed - and speed is of the essence. Doctors have people's ages and medical vulnerability on record, so you can very quickly draw up lists of who is eligible for vaccination in each cohort. Compare this with trying to arrange vaccination by (say) profession.

bagacrap 6y ago
I don't understand the relevance of #1, as we have no time machine. Regarding #2, I think no one seriously thinks the vaccine could fail to prevent spread (it surely is not 100% sterilizing, but everyone acts under the assumption it will vastly reduce spread). "There is no evidence for X" can be said for the vast majority of values of X, since most X are impossible and/or too time consuming to study. This includes, for example, X = "the best way to use the vaccine is to give a first round of second doses before a second round of first doses". But we often have to make decisions in the face of imperfect data. #3 is ridiculous because the logic appears to be, "the best rollout plan is the one that's easiest to enforce". By this logic, we should line up by height, like we did in elementary school when heading to the toilet.
- 8ytecoder 6y ago
  Preventing deaths and reducing the load on the medical system is absolutely necessary to move forward. If we have vaccinated a good chunk of the elderly and have guaranteed vaccine availability for them, we could open up the economy without fear of the medical system being overloaded. The main reason we shutdown was to prevent the load on hospitals. It has a cascading effect on anyone seeking care. (Personally know someone who’d have gotten a diagnosis and treatment earlier by at least a couple of months if not for Covid)

bagacrap 6y ago

I don't understand the relevance of #1, as we have no time machine. Regarding #2, I think no one seriously thinks the vaccine could fail to prevent spread (it surely is not 100% sterilizing, but everyone acts under the assumption it will vastly reduce spread). "There is no evidence for X" can be said for the vast majority of values of X, since most X are impossible and/or too time consuming to study. This includes, for example, X = "the best way to use the vaccine is to give a first round of second doses before a second round of first doses". But we often have to make decisions in the face of imperfect data. #3 is ridiculous because the logic appears to be, "the best rollout plan is the one that's easiest to enforce". By this logic, we should line up by height, like we did in elementary school when heading to the toilet.

8ytecoder 6y ago
Preventing deaths and reducing the load on the medical system is absolutely necessary to move forward. If we have vaccinated a good chunk of the elderly and have guaranteed vaccine availability for them, we could open up the economy without fear of the medical system being overloaded. The main reason we shutdown was to prevent the load on hospitals. It has a cascading effect on anyone seeking care. (Personally know someone who’d have gotten a diagnosis and treatment earlier by at least a couple of months if not for Covid)