(2021-08-19) ZviM Covid 8/19 Cracking The Booster

Zvi Mowshowitz Covid-19 8/19: Cracking the Booster. The news about Covid-19 is now essentially on a few distinct tracks: Vaccine effectiveness and booster shots, vaccination mandates, mandates for NPIs and other Covid-19 related crippling of the living of life, and the actual path of the pandemic.

The Numbers

Predictions

For next week, deaths should continue to rise with lagged cases, so I’m going with +45%. For cases, the slowdown in growth is presumably the new normal

Cases

Things aren’t quite stable yet let alone going in the right direction, but it seems more likely that the peak (at least for now) is relatively close and not too far above current levels.

Vaccinations

continue to show slow but steady progress.

Vaccine Mandates

You know how you convince a lot less than no people to get vaccinated or support your mandates?

it doesn’t feel like an accident, as if Fauci’s goal was to signal bad intent and further inflame tensions.

FiveThirtyEight has a breakdown of unvaccinated America

This is not a story about lack of access or time off of work. It’s a story of people who are scared of the vaccine, mostly for factually wrong reasons, and aren’t scared of Covid.

FiveThirtyEight attempts here to answer some of the justifications for vaccine hesitancy. It’s not perfect or complete, nor would I agree with every argument, but at least it seems likely to help rather than do further damage. A major theme of the objections addressed is the mindset that doesn’t differentiate 1% from 99% – the idea that if you could get infected after the vaccine, and you also might not get it without the vaccine, then the vaccine does nothing

San Francisco joins New York City in requiring vaccination for indoor dining.

The two sides are both trying to make the mandates look as obnoxious as possible, for different reasons.

the Texas Supreme Court has (for now) ruled that the executive mandate against mandates is mandatory, and therefore mask mandates are forbidden, although Biden is trying to use Federal coercion to change that

He’s also going to lay down the law on nursing homes, requiring vaccine mandates if they want to keep getting Medicare and Medicaid funding. I hate the tactic, but if there’s one place you really, really want a vaccine mandate, it would have to be nursing homes

Mask and Testing Mandates and Other NPIs

There is a golden middle where population-level NPIs (non-pharmaceutical interventions) are great, which is where you can stop Covid if and only if you use the NPIs for a limited amount of time.

If you can’t stop Covid that way, or you can only do so until you relax the controls, then all you’ve done is buy yourself some time that didn’t do you any good. The time needs to change things for the better, such as by getting people vaccinated.

NPIs can look good during the crucial two-week blame period, but then you’re in the same situation two weeks later, over and over again.

Delta Variant

The attributes of Delta are the biggest and most important unknowns.

What we find here is a comparison of the early numbers and reports, which had almost no breakthrough infections let alone deaths, and the new numbers that aren’t as insanely great.

I’m going to go ahead and say this is probably all hopelessly confounded. It’s all observational, they didn’t periodically test populations. The size of the difference between Pfizer and Moderna here is absurdly high. And, yeah, no.

if we’re not seeing anything like those results in general, then either we need to explain what’s going on somehow or claims of vaccine effectiveness this low are Obvious Nonsense. These are the first checks any reasonable person would run, and I’m confused why I’ve literally not seen anyone else do the calculation.

There remain large unknowns in all this, but my best guesses on the state of Delta have not changed much. Here’s my current model.

Can vaccinated people spread the virus if they catch it? Yes, of course they can, but less often than a similar unvaccinated person

How effective is the Pfizer vaccine against symptomatic Delta? Over my range of possible answers, mean 86%, median 89%.

How effective is the Pfizer vaccine against death from Delta? 99%+.

Booster Shot

Soon, you’ll be able to get a third shot eight months after your second shot.

Think of the Children

Periodic reminder: Whether mask mandates prevent Covid transmission in schools is one of those things that’s too important to know, because it would not be ‘ethical’ to study it properly even though some places already have mandates and some do not. Still, if you want to issue a study that says masks prevent Covid transmission in schools, it would be useful to actually compare schools where they wore masks to schools where they did not wear masks. Or else, one might say you have provided exactly zero evidence.

Periodic reminder: Air filters in schools were worthwhile before Covid anyway, estimated 0.15 SD impact on test scores, and also we shouldn’t need to cite test scores here, free our kids or at least let them breathe in the meantime.

Periodic reminder: Schools are what they are, and some kids hate them enough they prefer the dystopian nightmare that we refer to as ‘remote learning’ in order to be free of an even worse nightmare.

Scott Alexander has a post this week called “Kids Can Recover From Missing Even Quite a Lot of School” pointing out that losing out on a bunch of school seems to do surprisingly little, even measured in school test scores, as long as you don’t miss school during the month when they’re spending your life cramming for the test before you forget everything again.