Covid 4/1: Vaccine Passports

Zvi1 Apr 2021 12:10 UTC

50 points

Writer’s Note: This is being posted on April 1, which is April Fools Day. To avoid all ‘is this the fake out?’ issues, this post does not contain any April Fools material. The fools contained herein are the usual, regularly scheduled fools we talk about every week. The official April Fool this year is whoever accidentally ruined 15 million doses of the Johnson & Johnson vaccine by mixing in the wrong ingredients.

This week started a big debate over vaccine passports. States including New York are deploying systems that let people prove they have been vaccinated, or document recent negative tests. Naturally, lots of people are outraged by this attempt to create a public record and provide information that helps people make better decisions. Thus, the long middle section where I go over all the objections I can come up with against this proposal. Some of them are legitimate.

Meanwhile, the overall arc remains the same. Things are getting worse again, and it’s a race to see how long it will take vaccinations to catch up to the problem and get us headed in the right direction again.

Let’s run the numbers.

The Numbers

Predictions

Last week’s prediction: Positivity rate of 4.9% (up 0.3%) and deaths fall by 7%.

Result:

Deaths only falling 0.4% is rather scary, and seems like strong evidence that the new strains are deadlier if it isn’t a data artifact. The data from Wikipedia suggests that it is indeed a data artifact, and deaths dropped at roughly the rate predicted, but there’s reason to suspect that result is a data artifact given what’s happening in the West. It’s all rather worrisome, and strong evidence that the new strains are sufficiently deadlier to make up for an increasingly youthful set of people being infected.

We also need to mention that the positivity rate went from 4.6% to 4.9%, while the same data source is claiming 11.8% fewer tests but 12.1% more cases, which really, really does not compute. Those three facts can’t all be true at once.

Johns Hopkins has a 4.8% positivity rate at the moment, so I’m going to assume that the positivity rate is accurate and the number of cases or tests has some error or data artifact in it that’s being corrected for the positivity rate calculation. In particular, I’m going to assume tests didn’t actually fall another 11.8% last week.

Prediction for next week: Positivity rate of 5.3% (up 0.4%) and deaths are unchanged.

Also, I really miss the Covid Tracking Project, and I’m sad that no one found a way to step up and keep it from ending. The next time something this important is about to go away, I’ll make a more explicit call to see if it can be saved.

Deaths

Date	WEST	MIDWEST	SOUTH	NORTHEAST	TOTAL
Feb 11-Feb 17	3837	2221	5239	2700	13997
Feb 18-Feb 24	3652	2433	4782	2427	13294
Feb 25-Mar 3	3834	1669	5610	1958	13071
Mar 4-Mar 10	2595	1775	3714	1539	9623
Mar 11-Mar 17	1492	1010	3217	1402	7121
Mar 18-Mar 24	1823	957	2895	1294	6969
Mar 25-Mar 31	1445	976	2564	1262	6247

I don’t see a big glaring ‘this is a timeshifted number’ sign anywhere in the data in the West, but going up this much then right back down again isn’t a thing that actually happens, so at least some of that isn’t real, and the Midwest and Northeast see no declines in cases. Those are also the currently hardest hit areas, where cases are rising, so it does make sense to believe some amount of progress in the West and South, for an overall small improvement in deaths for now.

Cases

Date	WEST	MIDWEST	SOUTH	NORTHEAST
Feb 11-Feb 17	97,894	73,713	185,765	125,773
Feb 18-Feb 24	80,625	64,857	150,493	110,339
Feb 25-Mar 3	66,151	58,295	151,253	115,426
Mar 4-Mar 10	62,935	57,262	114,830	109,916
Mar 11-Mar 17	49,696	59,881	109,141	115,893
Mar 18-Mar 24	47,921	72,810	99,568	127,421
Mar 25-Mar 31	49,669	93,690	102,134	145,933

Sharp increases in the Northeast and Midwest, and small increases in the West and South. The fourth wave is here, the question is whether it will be small or it will be large. These are big weekly increases and there’s zero sign of any new restrictions happening, so the strategy seems to be waiting on vaccinations to get us out of this. That will work, but the tide won’t turn that way alone for at least a few weeks.

European Union comparison graph:

Again, for readability reasons I encourage you to go to Our World In Data to check out other countries of interest to you. The fourth wave might not be that bad in the United States, but in Europe where vaccine efforts are lagging far behind ours things do not look good.

Vaccinations

Occasional dips and spikes aside, this continues to look almost exactly like a linear increase in doses available per day over the course of several months. Hopefully we get a big boost to that soon from Pfizer and Moderna, but losing 15 million J&J doses to a manufacturing error is a rather large setback on the J&J front.

Here’s the current availability timeline map:

Almost all gaps have been filled in, and there are far fewer remaining delays. A lot of the country has full eligibility already, and by a week from now it will be a lot more. By April 15, most restrictions will be lifted.

Availability for those who make an effort seems remarkably good based on anecdotal evidence. Most of my Magic friends have been able to find slots quickly now that they are eligible, often finding next day availability. There is certainly a traffic jam right after eligibility restrictions loosen in a given state, but that does seem to clear up before too long. If you’re not finding anything, I encourage you to keep trying.

Vaccine Passport Hype

It seems the next big battle is going to be about vaccine passports.

For an entire year, we’ve failed to provide immunity passports, due primarily to our determination to refuse to in any way acknowledge that people who got Covid-19 were then immune to reinfection, or that someone’s actual physical risk of getting Covid-19 should be considered when deciding what actions to take. There were also a whole array of other arbitrary nonsense concerns that are used as part of the war against anyone ever doing anything potentially helpful, such as ‘equity’ and ‘privacy’ and ‘if we tell them the true situation they might change their behavior’ concerns.

With a large and increasing portion of the population getting vaccinated, widespread eagerness to let life return to some semblance of normal, and messaging leading to a widespread belief that vaccines don’t actually let one change one’s behavior leading to lots of unnecessary vaccine hesitancy, there is a strong obvious need to be able to tell who is and is not vaccinated.

Thus, the concept of a vaccine passport. You download a QR code on your phone, anyone can scan it and see that you’re vaccinated, or notice you can’t produce one and exclude you from risky activities.

This allows life for those who are vaccinated to return to normal, by ensuring that gatherings that would otherwise be risky exclude the unvaccinated until we’ve suppressed the virus, and it provides strong incentive to the unvaccinated to get vaccinated.

One thing to watch for is the distinction between those who support passports because it allows for valuable activity to take place safely, and those who support it because it allows people to ‘follow the CDC guidelines.’ That’s the distinction between caring about the physical world and caring about fulfilling symbolic requirements, and it’s important to retain that distinction.

Sounds great, and also obviously the right thing to do. Yet there are objections. It’s worth dealing with them. The first job is to list all the distinct objections I’ve seen or that I can think of, and I managed to get to 12 (with some overlap):

Privacy concerns – from ‘this will create a new database’ to yelling ‘mark of the beast’
Equity concerns – some people aren’t vaccinated, some don’t have phones, etc
Coercion concerns – this is effectively a vaccine mandate at pain of exile from life
Fraud concerns – I haven’t heard this objection yet, but won’t it be easy to fake?
Fear concerns – If we give the impression vaccinated people are safe, they’ll take risks!
Culture war concerns – Some people won’t take kindly to this, and that’s terrible.
Practical concerns – This will be a government program so they’ll mess it up a lot.
Norm concerns – If people see the vaccinated living life, the unvaccinated will too.
Motive concerns – If I support this helpful thing, my loyalties will be in doubt.
Vague concerns – Fear, uncertainty and doubt around anything new, ever.
Vibe concerns – This feels like a thing we should hate so we hate it.
Anti Elite concerns – Elite people like this, so we hate it on principle.
Approval concerns – This is only in Emergency Use Authorization, you can’t punish people for waiting until full approval.

Some of these seem purely hostile and/or stupid. Others are legitimate concerns.

Privacy Concerns

Privacy is a legitimate concern, and the most common and forceful objection that I have observed. Hence this poll represents a common framing.

There are multiple different privacy concerns, regarding different actors getting access to different information. Some are unavoidable, others are a choice. It’s important to track them separately.

The big distinction I would draw is between the information on who has been vaccinated and the information of who has been where and done what other things.

If the privacy concern is ‘people will know my vaccination status’ then I notice I am confused as to why this is a problem. To me this seems like the exact opposite of a problem. The whole point is to make sure people can know your vaccination status, so everyone can take appropriate action in response to this information!

If there is physical information about the world that would change the consequences of actions in ways that would change your behavior, that’s information you need to know. I’ve been asked about my vaccination status often, and I’ve asked many others about theirs, and at no point did anyone involved think privacy concerns were an issue here.

Yet there are people calling this the ‘mark of the beast’ or even invoking Godwin’s Law directly off the bat by comparing it to the Nazis forcing Jews to wear a yellow star, which fall into some combination of ‘anything scary sounding is good when signaling that everyone should be scared and making no sense is actively helpful in clarifying what you’re up to’ and ‘pattern matching systems in the brain aren’t using much logic and this feels like it might sound good so go with it.’

In short, I think the concern ‘people will respond to me based on how likely I am to have Covid-19’ is a stupid objection, to the extent it isn’t one of the other objections in disguise (e.g. it could actually be objecting that this is helpful, or that this is coercive, or about equity, etc.)

The other privacy concern is that this risks tracking us more generally, or opening the door to such tracking, and that’s a completely legitimate objection.

I was listening to the Brian Lehrer show and they were interviewing someone advocating for the New York State vaccine passport app. When asked about privacy concerns, he responded that the current version did allow people to be tracked, as each QR scan would identify who they were and that they were at a particular place and time, but that future versions would fix that real soon now and privacy would be dealt with.

I am skeptical. Government programs that collect information about private citizens tend not to view that as a bug to be fixed, but rather a feature to be preserved. Corporations that get to gather similar information aren’t going to be lining up to object to this either. It’s entirely possible this will get fixed, but unless sufficient pressure is brought to the issue, chances are that it won’t be fixed.

It would be quite bad, in my view, if the government had records of who was where at what time for many everyday activities. It is very reasonable to not want any part of such a system. It is also very reasonable to worry that once such a system is in place, the powers that be would find a way to make the system permanent, in order to keep collecting the data, or use the program as precedent to then collect the data in other ways.

Can anyone think of an example of where such information was created, and the government was respectful of our rights and didn’t check it whenever they felt like it? Anyone?

The good news is that this is avoidable. There are plenty of privacy experts out there that can design a version of the system where you can’t be tracked. The system can see if you’re vaccinated, but it can’t tell who ‘you’ are while doing so, except to verify that the claim is legitimate. I’m sure plenty of crypto people can help us out on this one and would be happy to do so free of charge.

Equity Concerns

There are two potential inequalities.

There is the concern that some people don’t have smartphone access, and thus wouldn’t be able to provide the QR code, and would be shut out of the system.

That’s an important concern to point out, for the purpose of fixing it. The good news is that there’s no reason for this to be an issue. A QR code can be placed upon a piece of paper, and those without a phone can carry the piece of paper, the same way we can carry the vaccination card now except with a less trivial duplication/fraud problem. It’s not a meaningful objection.

The real concern is that this is punishing people for not getting the vaccine, combined with the concern that some groups and communities aren’t getting equal access to the vaccine, and those same people are already worse off in general and worse off for the lack of vaccine access. Aren’t we punishing those communities and people even more?

One could argue that those are activities people shouldn’t be doing unvaccinated under those circumstances, and one would be right, but such arguments rarely sway equity advocates. You can’t answer an equity concern with an efficiency argument, equity advocates don’t consider that a valid response.

We can separate this concern into the period where vaccines have limited availability and it’s hard to get an appointment, which for now is still everywhere, and the period in the future where vaccines are freely available at your local pharmacy to anyone who walks in or at most signs up a day in advance.

During the period where vaccines have been widely available for long enough for everyone to get them, I consider equity concerns solved. The stab is quick, the stab is free, and there are real consequences to not getting the stab. If anything, there’s an equity concern not using vaccine passports, because that would lead to the undervaccinated communities having more Covid and people getting sick or dying more often, by letting people engage in risky activities without being vaccinated, taking risk and also not having the additional incentive to get vaccinated.

Before vaccines are easy to acquire, the argument is stronger. In particular, a reasonable concern would be if major life activities ended up gated by passports before those passports could reasonably be acquired, and activities that would be reasonable to do unvaccinated and are important for people to access become impossible to do without a passport. If it’s all ballparks and concerts, I’m not sympathetic at all, and if it’s about indoor dining I’m still not sympathetic because life goes on and it’ll all be over soon enough anyway, but if it stops people from grocery shopping or getting a job, yeah there’s a concern there.

The obvious solution there is to not allow vaccine passports to be used as gateways to essential life activities until such time as vaccine availability is complete, except insofar as there’s sufficient risks involved in the activity that it makes sense to require the passport anyway.

I don’t think this needs to be a government requirement. There would be both direct loss of business (and/or good employees) and a lot of blowback for requiring vaccine passports in places like grocery stores, or firing people who aren’t vaccinated before they have the opportunity to get a shot.

Looking for new employment or new housing, or seeking travel on mass transit including airplanes, seem like the places most likely to create a real issue. These are already places where there are especially strong anti-discrimination provisions, where people making decisions are told they are not allowed to consider information (that they’d often consider quite useful) when making those decisions. For frontline jobs, I’m willing to bite the bullet and say, yes, absolutely we should allow a vaccination requirement, the physical need here is too important, and I’d prefer requiring it by law to using law to prevent there being an employer-mandated requirement.

For travel, there’s big real costs imposed by not being vaccinated. If you can’t check who is vaccinated, you’d need to impose those costs for all passengers – everyone would have to distance like no one (else) was vaccinated, often cutting capacity in half or worse. Reserving at least some capacity for vaccinated people only makes everyone’s trip cheaper and easier and safer. It’s important to make sure the unvaccinated can travel at all, and in some reasonable fashion, but ignoring the issue seems super expensive. Despite this, I don’t expect those involved to get their acts together fast enough on these matters to cause issues before vaccination access is widespread.

For those worried this is effectively class discriminiation, this will soon become the easiest class marker there is to fake. All you have to do is get vaccinated. If this becomes a central method of those who are attempting to discriminate by class, that’s great news in the medium-term.

In short: I’d sympathize with this worry (to the extent that equity concerns ever deserve any response other than ‘transfer payments’) if we were looking at an extended period of widespread passport use for essential life activities without vaccine access, but that seems highly implausible. Anyone who wants an appointment by the end of August (to be super conservative) will be able to get one without being savvy, and it’s already April and these things take time to get adopted.

Coercion Concerns and Approval Concerns

Is this us forcing people to get the vaccine?

Mu. It’s not us forcing you to get vaccinated, but it’s not not forcing it, either. It’s a rather strong nudge, a punishment for being unvaccinated slash a reward for being vaccinated.

The extent to which this is coercion versus bribery, and the extent to which that effect is central versus incidental, depends on one’s point of view.

One can look at ‘require passport for activity’ as coercion by punishing the unvaccinated. One can also look at it as coercion by bribing the vaccinated. In this context, the two are basically the same, even if they are clearly meaningfully different in the ‘free glazed Krispy Kreme donut’ scenario. The power to tax is the power to destroy, and the power to bribe is the power to tax.

If you don’t have a deep suspicion of anyone who wants to force or coerce others into their preferred patterns of behavior, you need to get more deeply suspicious.

The sirens can be overcome. They don’t mean we should never force anyone to do anything. It certainly doesn’t mean we should never prevent anyone from doing anything, and it most definitely doesn’t mean we should never provide an incentive to do one thing over another thing.

For example, it definitely doesn’t mean we shouldn’t coerce people into vaccinations. We should and do require people to get vaccinations! You can’t go to school, or get many jobs, without proof of vaccinations. The externality argument, and the ‘this is an overwhelmingly worthwhile thing to do’ argument, are both extremely strong. A vaccine is exactly the place where we should be least suspicious of coercion.

The approval concern is that it’s not reasonable to apply this coercion if the FDA isn’t even willing to fully approve the vaccine. There are several responses to this, but the main one is that if the FDA is playing bureaucratic games with its labeling and timing in ways that have killed hundreds of thousands of Americans, that’s on the FDA, and we should not take such labels either seriously or literally. The vaccines are safe, and even if the FDA hasn’t officially fully approved them yet, most of our most important people are vaccinated, we now have given hundreds of millions of shots and we damn well know they’re safe, so I do not want to hear it.

To the extent that this is a messaging issue, it sounds like the worry is that we’re providing a nudge against getting the vaccine and this should make us not want to push people in the other direction to fix it, which I find confusing.

To the extent that these effects are contained to vaccinations, the coercion effect is a bug rather than a feature. We want to provide strong incentives to get vaccinated. There is a real worry that this helps establish a pattern and/or method of coercion in general, that is used on other things. In this context I am not too worried about that, but I am open to that lack of worry being a mistake.

I don’t consider ‘vaccination required’ that different, in a world where vaccinations are free and widely available and the passport software protects your privacy, from ‘mask required’ or from ‘no shirt, no shoes, no service.’ We want people to wear masks and shirts and shoes, and also get vaccinated, and the lack thereof has practical real costs for all of them.

Fraud Concerns and Practical Concerns

Can’t people who want one simply fake a QR code that will represent that they are vaccinated? Especially if the system is meant to protect their privacy?

There’s a clear trade-off involved. The easiest ways to preserve privacy involve making the signal easy to fake. Verifying that it isn’t fake requires verifying identity, which is a threat to privacy.

As I noted earlier, I expect crypto people to have good answers to these problems, as they have been hard at work dealing with similar issues for a while with large amounts of money at stake.

If not, then how are we to feel about a system where it’s not that hard to fake being vaccinated?

Presumably we should feel a similar way to how we feel about people showing ID to buy alcohol.

We have a thing people want to do (buy and consume alcohol) that we have decided some people mostly shouldn’t do until they meet the requirement to do it at lower risk (be older). Thus, we ask them for proof that they are older, in the form of ID. In response to this and other ID requirements, a huge portion of young people historically get fake IDs.

This clearly does have a big impact on the amount of alcohol consumed by minors, who spend considerable effort acquiring booze and often fail to do so, or get lower-quality booze at higher prices or in less enjoyable ways.

In exchange, we initiate our young into a culture of fraud and lying, where in order to participate in ordinary human activity (again, buying and consuming alcohol) they have to lie and commit fraud, and those who facilitate such frauds and lying, in various forms, become heroes with high status, look cool and get laid, and often also make money.

On top of that, what alcohol is still consumed is often in secret, and hidden from those who could help deal with problems when they arise, and thus is often consumed in relatively dangerous ways. The harm mainly falls on those consuming alcohol, but also on others, and also they often harm each other.

The parallel here seems obvious. If we require vaccine passports that are not that difficult to fake, then a bunch of people will respect that, but a bunch of other people will fake them and then act even less responsibly, since acting like they were unvaccinated would be suspicious, and also they’ll cultivate the anti-virtues of lying and fraud.

Given how easy it is to commit fraud and lie in order to get vaccinated earlier, my assumption is it also probably won’t be that difficult to fake the passport, so that’s the deal we’re facing here. The same way I think it would be better if the laws against minors consuming alcohol were less strict but were more strictly enforced, it would be best if we used the passports only when necessary, but ensured that it was difficult and/or risky to fake them.

Thus, the practical concerns involve privacy and fraud. They also involve error. Multiple people who called into the radio show I listened to complained or asked about issues getting the passport. One lady got her first shot in Florida, and the system didn’t know how to handle that. The response was a hand wave. Another had the concern about not having a smartphone, which again shouldn’t be an issue in theory but in practice the solution wasn’t obvious or forthcoming. And Cuomo shows us exactly how stupid a government program like this can be...

What happens when a substantial number of vaccinated people are more than 90 days out from their second dose, which will be true soon? What happens when people see this and think vaccination only works for 90 days, and thus don’t bother getting vaccinated, or start going back to pre-vaccination behaviors, or request a third dose as a booster shot?

My wife signed up for Excelsior, and she doesn’t even get to keep it until 90 days after the second dose, because it seems it has to at least be renewed every 30 days for some reason.

So, yeah. Government running the system is a real concern here.

Fear and Norm Concerns

Whenever anyone suggests letting people who are vaccinated do things that are now safe, others respond that this would be terrible because unvaccinated people would then respond to those actions by treating the pandemic as over slash adjusting their norms and taking more risk, and also that the vaccinated people are still at some risk and any additional risk anyone takes is terrible, or something like that.

At least one person I follow on Twitter (who I won’t link to or quote here) blamed the recent uptick on cases on the CDC issuing guidance that unvaccinated people could meet together, on the theory that of course this inevitably had been misinterpreted as giving permission to others to not wear masks or not distance, and of course that was the direct cause of the uptick. Which is obvious nonsense, since the uptick was already predicted and baked in, and also I see no evidence of people making that kind of adjustment to the CDC guidelines.

Vibe and Anti-Elite and Vague Concerns

When I talk about anti-elite concerns or vibe concerns, I mean arguments kind of like this:

One could interpret this as saying that bad people are supporting vaccine passports for bad reasons, thus we should oppose them. One could call that an uncharitable interpretation, but it’s not, because that’s both the real argument here and also not a crazy argument. If there are bad reasons people are supporting policy X, then policy X is likely to get enacted in worlds where it’s net harmful due to that support, and if we collectively push back against X a similar amount, we can correct this imbalance. That’s especially true when the motives are selfish, and some special interest wants to take from the public treasury, or otherwise get private benefit at public cost (e.g. make us all continuously show passports in order to let them feel superior).

It is a useful exercise to total up all the bad reasons people are for or against something, where bad in context means considerations you don’t value rather than a moral judgement, and then pushing back to correct this imbalance. It’s important to correct both bias and incentive on every level at all times, even if that doesn’t look like the locally ‘rational’ thing to do. Someday I hope to explore such issues in more detail.

Here, these arguments very much run both ways. There are people who are opposing this for zero-sum reasons, and people supporting it for zero-sum reasons, and it’s not obvious which effect is going to dominate. One could even say we’ll know which one dominated when we see which side won.

When I talk about vague concerns on the concern list, I’m pointing to a general Suspicion of Authority that is pervasive in America, and with good reason, and a general suspicion of anything new like this, again with good reason, but not to any particular good reason. I do think that a vague uncomfortableness is appropriate for various reasons (again, there are 13 concerns listed) and this represents a threshold effect that needs to be overcome.

Culture War and Motive Concerns

Masks became a culture war issue, despite there being no privacy issue with masks, despite a Republican president, and with no real concerns of any kind other than ‘how dare you tell me what to wear’ and ‘this mask is mildly annoying.’ Vaccines are also already an issue. Vaccine passports dial this up even further, and raise the specter of ‘red tribe members are being systematically censored and excluded already, and now we’re going to accelerate this process and lock them out of major life activities’ with the new administration leading the way. I can totally see this perspective. I don’t think it’s right or that we should let it stop us or anything, but I do get it.

There’s thus both the concern that this is part of a broader culture war push from the left, whether or not it’s being sold or even explicitly contemplated that way, and the instinctive and automatic ‘the other side wants thing so we oppose that thing’ dynamic going on as well.

That leads into an argument from some lawmakers that goes something like this: You want to do this useful thing. However, there are lots of people that have been convinced to oppose this thing, and if you tried to do this thing anyway, they’d be mad and this would cause trouble for you, and this would be ‘combative’ and ‘divisive’ and we’d be forced to make your life miserable and job harder, so Mr. President, please don’t do this or we can’t be held responsible for the consequences. That’s not a completely illegitimate concern, even if it’s largely disingenuous and those same people saying this isn’t going over well are mostly working hard to ensure that it doesn’t go over well. Resistance is a real issue here, as is upping the general distrust factor and level of conflict and paranoia. It’s a concern.

Finally there’s the Motive Ambiguity concern. If you’re for the passports, you’re presumably for them so that people can get back to living their lives and stay safe. Those sound suspiciously like better things that you prefer to worse things. Can’t have that. Whereas if you oppose it, you can signal your loyalty to almost any group via your choice of symbolic concern, and even plausibly claim loyalty to all of them at once. Neat trick.

One could argue that there are also some plausible bad reasons to support the passports, and this could be used as a defense here. You might be supporting good things over bad things, but maybe you like inequality and discrimination, or you like punishing the outgroup for defying your preferred shibboleths, or you hate privacy. There are several good choices here that lend plausible deniability to supporters. I don’t think that fully works, because when it’s this obvious which side has the physical benefits on its side there will always be suspicion that those concerns mattered, but it does help.

Summary on Vaccination Passport Arguments

I still find the case for vaccine passports overwhelming, as there’s no realistic path to doing things safely without them other than waiting for full suppression, and giving people incentive to get vaccinated once we have unlimited supply is super important. Yet the concerns here are real, and worth worrying about.

I am especially concerned about privacy, and it is important to find and push for a technological solution that doesn’t allow the tracking of who had their QR code scanned where and when. I would also be concerned if we were to start screening off essential aspects of life within the next few months, while access to the vaccine remained an issue, and we do need to protect housing, transportation and jobs against actions that shut people out too broadly and quickly, even if there are some efficiency losses involved.

What is especially troubling are those who seem determined to ban, boycott or punish those who attempt to run a private business in a safe fashion. The exact worst thing one could do right now would be to ban people from asking about others’ vaccination status when trying to figure out what would be safe or unsafe actions, and that’s exactly what a number of states including Florida seem to be doing in order to score political points.

Asking The Best Question

Nate Silver gets major points for asking what is arguably the best question about Covid that is rarely asked, and asking it correctly, and to which I’m not super confident in the answer:

I think I’ve talked about this a few times, where there are two possible worlds. In world one, each exposure if 95% less likely to infect you, so any given action isn’t too risky but if you take lots of risky actions continuously you will eventually get Covid-19. In the other world, degree of effectiveness varies from person to person, so 95% of people can do whatever and never be infected, while 5% are at the same risk they would have been without vaccination.

You could also have a hybrid world between the two, which seems highly plausible; it gives varying degrees of additional protection to different people, that combine for 95% protection.

My prior has been that it’s mostly the second world. Most people are immune, and no realistic exposure is going to change that, and if they did get exposed a bunch it would act like a booster shot long before anything bad happened. A few people’s shots get botched or contaminated, or they have compromised immune systems, or something randomly goes wrong, and they’re still varying degrees of vulnerable, but often with substantial partial protection.

Thus, mostly this answer:

Here’s a more complete take:

I’m willing to go with that explanation.

What that means in practice is that once you’re vaccinated, there’s an effective cap on how much risk you can take. It still makes sense to defend against the bigger risks when the cost of doing so is reasonable. It could also be reasonable, if circumstances broke correctly, to actually not care at all and accept the full ‘if the vaccine didn’t work I’m going to catch this’ failure rate, since it caps out around 5% for infection and the death rate per case is much lower on top of that. Doing this likely only shortens life expectancy no more than a few days.

I still plan on taking the easy precautions, but part of that is I don’t have a way to usefully take a lot of risk. There isn’t that much to do in this town.

Vaccines Still Work

The latest reproduction of this result is a new study of health care workers.

The headline numbers are drops in infection of 80% and 90% after the first and second doses respectively, starting fourteen days after the first dose for the date of the test, and they reflect actual behaviors of people who know they’ve been vaccinated.

There isn’t much more to the study than that. Once again, it’s clear that protection against all infection is somewhat weaker than the 95% protection against symptomatic infection, and that the first dose gets you far more than halfway to being protected.

On a related note, I did go back and look at the data about the timing of protection from the first dose, and I’ve concluded that it’s potentially slower than we thought, based on the timing of the real world data. You still have a lot of protection by day 10, but I wouldn’t get excited on day 7, and waiting until day 14 isn’t crazy. After that, we’re still talking 80%+ protection from one dose from infection alone, higher than that for symptomatic infection, higher still than that for hospitalization and death.

There is no clean way to do a study on the exact infectiousness level of the vaccinated, but I continue to view the probability that they aren’t at least roughly as much less infectious as they are less likely to test positive on a PCR test to be quite small. A bigger decline would surprise me less than a smaller decline, since those who get worse cases tend to be more infectious.

This study is commonly referred to as ‘good news.’ On reflection I agree with that assessment, but almost entirely in the sense that we now have stronger evidence to overcome vaccine hesitancy, rather than this being a positive update on effectiveness. For this to be good news on effectiveness it has to move our estimates substantially upwards, which this doesn’t. That’s a sign of good calibration.

This study also makes it very clear that first doses first would have been the correct approach, but that horse is quite dead and I see no reason to beat it further.

Also, in case there was any doubt, yes the vaccines work in children.

Hopefully this isn’t used as a ‘wait until the kids are vaccinated’ excuse.

Vaccines don’t work, unfortunately, if you ruin them during the manufacturing process. Which seems to have happened to 15 million doses (!) of Johnson & Johnson.

The argument that ‘money’ is not effectively the limiting factor on vaccine production now has to explain why people for whom ‘it was no secret that [they] did not have a deep bench of pharmaceutical manufacturing experts’ were put in charge of one of the major vaccine production sites. Either there was a supply limit that was binding, in which case perhaps that supply should have gone somewhere that had a deep bench of manufacturing experts, who would be less likely to do things like mix ingredients for two different vaccines together and thereby ruin 15 million doses. Due to a single ‘human error.’ Or, alternatively, if there wasn’t a supply limit, why aren’t there more factories?

This is from the-source-I-will-not-link-to via Twitter:

Participants are Heroes, Go Team Yeah

Not Covid related, but it looks like I made it onto someone’s fantasy intellectual team, going 106th in the draft. It’s quite the honor to be taken at all in such a thing, especially considering some of the giants that went only slightly before I did. Of course, the scoring system is super generous to me, with bets (B) being one of three categories, and a second (S) being steelmanning. In theory I even have some meme (M) game, especially with Eliezer Yudkowsky, Julia Galef, Robin Hanson, Robert Wiblin and Scott Alexander all counting as one of the three uses necessary for a term to count. One big advantage my team will have is that I am aware of the competition, and as always, it’s good to have fantasy players who care even a tiny bit about their fantasy scores. My understanding is there are 9 teams, and the only team member I know about is Robert Wiblin, so it’s hard to judge whether the team is well-rounded or generally seems strong. But if I keep writing at this pace, I should be a monster in the (B) category, and I do expect to keep writing for a while, so before seeing the rest of the team I’d give my team a 30% chance of winning that category outright (if you think I’m wrong please say so, but I really don’t recommend betting against me on this for an amount I’d care about, in either direction, for obvious reasons), and maybe a 20% chance to win overall out of 9 teams because I think picking me also reflects well on their likely other picks by showing they’re more likely to be thinking carefully about the points system. I wouldn’t underestimate how much the pick order was determined by whose content you wanted to monitor the whole time! You take Joe Rogan first and you’re committing to a lot of hours of listening, and I mean a lot. That’s the only way to get that kind of value. A lot of this competition will be an effort play – who will be willing to tally all the probabilistic predictions and check lots of writing everywhere against a list of potential memes? Steelmanning is easier, since it’s much harder to miss so long as you read your team’s stuff at all.

After I wrote that, the teams were posted. I’m on the Null Hypothesis, which is an excellent team name, plus you get to be on the Kling-approved Null Hypothesis Watch while looking for points. We got the number one pick at #4 (Scott Alexander), which I suspected was reasonably likely given he fell to 4th (it’s possible we had Tyler Cowen, but even that seemed highly unlikely, and several later in the round also seemed implausible), and also is great. This definitely feels like someone took people they knew and were happy to follow closely, which makes sense as a strategy. Hence both Weinsteins, and the package of myself, Alexander and Yudkowsky both make sense, and also play into finding M point triggers within the team. I’m guessing I’ll end up providing the first point for a lot of Ms from both of them. Tabarrok is similarly a free action and was a steal at #42, and Taleb is basically a giant M-point hunt – he’s never scored an S point in his life, and when asked for a probability he’ll either have a formula or tell you it’s impossible to know the probability and also there’s a 100% probability that you’re an idiot, but you’re sure to pick up Black Swan, Antifragile, Skin in the Game and so on. Collison and Thompson also feel like people such a reader would be happy to keep tabs on. Overall, there’s a lot to like, and good reason to think the team will be well-monitored, but I do think there are some potential blank spots. I definitely like our chances to win (B), which I’d bump to 35%, and I’d keep our winning chances around 20%. Tim the Enchanter’s team looks strong too. Clan Graham seems strong in very memes but not well-rounded elsewhere. I’m not sure what to make of the teams that are mostly people I don’t recognize – presumably it’s right to be skeptical there.

In Other News

Very Serious People are back in charge of policy, so we can neither move at nor call any operation Warp Speed.

FDA approves three rapid tests for home use, two without a prescription. Better late and crippled than never.

The Biden Administration has noticed that the massive government vaccination sites tend not to be as useful as the existing infrastructure of pharmacies. So far so good, but then the implied intervention is to do less rather than do more. I will never understand why ‘costly’ gets to be an adjective in such descriptions given the benefits at stake.

There’s a take on the whole AstraZeneca announcement mess last week that it was about AZ not properly respecting the authority of the DSMB, and thereby doing things ‘the wrong way,’ rather than any substantive disagreement (e.g. 76% vs. 79% is a small disagreement anyway), and they got called out because the people calling them out were disrespected. I don’t buy it, and while it would be somewhat mitigating it doesn’t make AZ’s actions not supremely stupid, because it’s playing with fire where you can’t accomplish anything with it:

It still seemed necessary to share the alternate hypothesis.

Washington Post notices that sometimes people lie to get life-saving medicine earlier, especially when there’s zero probability they would ever be caught, and frames this as something that is ‘damaging friendships.’

Quarantine procedures to countries that aren’t doing suppression are not about preventing Covid-19 (official link). Two week quarantine for fully vaccinated people.

Zeynep piece in The Atlantic laying out our situation, solid presentation, nothing especially new, the race between vaccinations and the fourth wave coming from a new deadlier and more infectious strain, and all that. I do think this leans a little hard into the ‘if we move fast we win if we move slow we lose’ thing, especially given the late hour and how little variance is actually in play at this point, but mostly that seems fine.

She also links to one of several calls for a ‘vaccine surge.’ The logical idea is that if there are some places with high infection rates, especially when dominated by newer and deadlier strains, we should direct our vaccine supply to those areas first, because it will have a higher impact there. As a first best policy this would obviously be correct, but opening up the floodgates of which states are ‘most deserving’ would be such a disaster I don’t even want to consider it. Allocation by population rather than politics and power, even if there are real needs not being met, as the lesser of two disasters.

I too strongly endorse the strategy of yelling “Fix It.” Rather than issue rules and attempt micromanagement, if there’s something that needs to get done and isn’t getting done, because there are a bunch of veto points stopping it for reasons that obviously aren’t any good, it makes sense to try activating everyone’s blame-avoidance programming, and trigger them into physical-world mode, by yelling “FIX IT!” as loudly as possible. Pick an outcome, pick a date:

While I’m linking to that post, I’ll give my reaction to its first section as well, where he points out that there’s no correlation between the minimum age requirement and what percentage of the elderly are vaccinated, and respond that the places doing better or expecting to do better with vaccinating the elderly were then in a better position to expand eligibility. So I agree that singling out states and obvious problems isn’t useful, I don’t think this particular non-finding says what he thinks it says.

Cuomo finally joins the crowd and sets a date for full eligibility:

The one week delay for the 16-29 year olds is quite smart. Every time you make a lot of people eligible at once, you reliably cause a system overload and make it super hard to get an appointment that’s at all reasonable. By giving the 30-49 year olds a week’s head start, Cuomo gives them the chance to book as far out as they want, then the kids can get in line behind them. I heartily approve, and I think not doing this in other states was a missed opportunity. If anything, I would suggest going to 40 before (or instead of) 30, but this still does most of the work that needs doing.

This is not a coincidence because nothing is ever a coincidence, even though it’s definitely a coincidence, or is it:

You think your attitude on social media can’t save lives? Behold:

Reverse the associations of potential minor social awkwardness and vague blameworthiness, and those five doses get used. The source article from Guardian is mainly about the ‘controversy’ around providers turning to whoever is around to ensure doses aren’t wasted.

It then ends by pointing out that the UK is at a point where it needs to loosen eligibility requirements, as proven by inability to fill appointments, yet the requirements aren’t changing:

Potentially good advice, making lemonade edition:

Finally, I got to go back to New York City this week to get my second shot of Pfizer. I have a small amount of soreness in my arm and spent a day not feeling quite 100%, but it definitely wasn’t the whammy that I’ve heard others experienced, and I’ve been able to work and write this column in its aftermath with little trouble. I decided not to try and see people because waiting two weeks allows me to not worry about conditions at all, and I’ve found that such worries distract from my ability to enjoy seeing people, so better to use the trip as a more solitary one this time, and connect with people mid-April. If you’re in New York City and would like to see me next time I’m there, please do drop me a line.