I don’t want our analysis to lose sight of the fact that facing these tradeoffs is stupid and avoidable, and that almost every country could have done so much better. Avoiding outbreaks is so much cheaper and easier than dealing with them that the choice to do so should have been overdetermined. …
It’s much better to be careful instead of exponential growth than after it. The policy playbook we learn from COVID should be how and why to avoid such situations, not how to live with R0≈1 for extended periods.
You don’t need infeasible surge pricing for the-right-to-buy-groceries, and you don’ t need to fine-tune the number of people at live entertainment, if you competently follow a (any!) coherent cost-benefit model because you’ll keepR0≪1and there won’t be a pandemic in the first place.
Australia mostly did this. New Zealand did this. Taiwan did this. There’s no secret! It’s not even difficult!.
There’s a flu pandemic every year and we don’t seem to have good mechanisms to put that R0≪1 currently. Given that the OP talks about “all respiratory diseases, not just Covid” saying that there would have been a better solution for Covid isn’t enough.
It’s always looked to me like we mostly don’t care about the flu. If we wanted to slash flu cases we could very easily do so. Look at the 2020-2021 flu season vs. any other year. Thanks to Covid precautions, regular flu numbers went from hundreds of thousands to just hundreds of hospitalizations. I’d guess a 60% chance of those numbers returning to “normal” within 5 years, and 90% within 10, even though we know now that simply wearing masks and washing hands can reduce them by several orders of magnitude.
And I’ll bet that frustrates a lot of medical professionals!
I second that we don’t really care about the flu. Setting aside the question of how much of a mistake that is, I’d just point to that we simply haven’t tried to throw extra money at, and remove regulatory barriers from, using mRNA tech to make a better flu vaccine that can be rapidly updated without needing to predict what strains will be common, months in advance, and may be able to include a lot more strains at once. We still haven’t committed to doing that or even made any significant public noises about it, now that we have so much more data on how well mRNA vaccines work.
That said: I hear Moderna is hoping to combine an annual flu vaccine with a covid booster, which is a great idea, but I hope that won’t be the only option for either. I stopped getting the conventional flu vaccine after about 20 consecutive years where I was sick for about 10 days after doing so. Since then (and before that) I’ve gotten the flu and, for me at least, the actual flu’s symptoms tend to be less severe than that. Covid has not given me confidence in Moderna’s and Pfizer’s ability or interest in properly calibrating dosing to minimize unnecessary vaccine side effects.
Quoting myself last week:
You don’t need infeasible surge pricing for the-right-to-buy-groceries, and you don’ t need to fine-tune the number of people at live entertainment, if you competently follow a (any!) coherent cost-benefit model because you’ll keep R0≪1 and there won’t be a pandemic in the first place.
Australia mostly did this. New Zealand did this. Taiwan did this. There’s no secret! It’s not even difficult!.
There’s a flu pandemic every year and we don’t seem to have good mechanisms to put that R0≪1 currently. Given that the OP talks about “all respiratory diseases, not just Covid” saying that there would have been a better solution for Covid isn’t enough.
It’s always looked to me like we mostly don’t care about the flu. If we wanted to slash flu cases we could very easily do so. Look at the 2020-2021 flu season vs. any other year. Thanks to Covid precautions, regular flu numbers went from hundreds of thousands to just hundreds of hospitalizations. I’d guess a 60% chance of those numbers returning to “normal” within 5 years, and 90% within 10, even though we know now that simply wearing masks and washing hands can reduce them by several orders of magnitude.
And I’ll bet that frustrates a lot of medical professionals!
I second that we don’t really care about the flu. Setting aside the question of how much of a mistake that is, I’d just point to that we simply haven’t tried to throw extra money at, and remove regulatory barriers from, using mRNA tech to make a better flu vaccine that can be rapidly updated without needing to predict what strains will be common, months in advance, and may be able to include a lot more strains at once. We still haven’t committed to doing that or even made any significant public noises about it, now that we have so much more data on how well mRNA vaccines work.
That said: I hear Moderna is hoping to combine an annual flu vaccine with a covid booster, which is a great idea, but I hope that won’t be the only option for either. I stopped getting the conventional flu vaccine after about 20 consecutive years where I was sick for about 10 days after doing so. Since then (and before that) I’ve gotten the flu and, for me at least, the actual flu’s symptoms tend to be less severe than that. Covid has not given me confidence in Moderna’s and Pfizer’s ability or interest in properly calibrating dosing to minimize unnecessary vaccine side effects.
I’m somewhat optimistic that we could see a combined flu/covid/RSV/hMPV shot in 2022.
Thank you!