Given the generalized lack of competency, understanding of reality, interest in any sort of nuance whatsoever, and so on, since the pandemic began… do you really believe any of the relevant institutions could or would choose to (and would successfully) implement any of the solutions you propose to those objections you believe are reasonable? I, for one, very much do not. And I don’t just mean government institutions either. The failure of infectious disease experts at major universities to speak out in favor of saner policies, the shortsightedness of business and other groups pushing for premature (and selective) re-openings, those all play a role too, and I’m skeptical of them implementing their own policies requiring vaccination by employees or customers.
Granted, overcoming that objection of mine would be very easy. All it would take is for the CDC, FDA, and whichever governor or state legislature is proposing a vaccine passport rule to come forward with a (even partial) self-assessment listing what they got right, and what they got wrong, based on the information they had at the time, since last January, and a commitment to a timeline to produce a detailed plan for how they will do better in the future. I won’t hold my breath. For example:
“We should have admitted from the beginning, that yes, obviously in any given situation masks don’t increase your risk of getting sick and could reduce it, so people should wear one for anything they would do in public indoors anyway, but making it a policy requirement without any plan in place based on when and why it makes sense, like requiring masks outdoors in any place less crowded than a city center, is not likely going to be helpful.”
“We should have discussed, from the beginning, the importance of ventilation indoors, and encouraged more open windows, HVAC system improvements, and spending as much time outdoors as feasible.”
“We should have stated clearly, from the beginning, that we were going to make the best recommendations we could at any given moment, and that some of that will definitely change as we get more data, but until we get that data we won’t know which ones.”
“We should have initially recommended people disinfect things coming into their house or business as a possible transmission vector, and then updated when we found out that fomites weren’t a major component of the pandemic beyond very high touch surfaces.”
“We should have actually bothered to do even basic cost-benefit analyses when making decisions.”
“We should have recommended everyone who can do so to take vitamin D, since the potential risks are so much lower than the potential rewards. Actually, we should have been doing that for a lot more people, for a long time, in most of the US.”
’We should have approved OTC/at-home/prescriptionless tests, including new types like maybe that MIT over-the-phone AI tool, with way lower thresholds for accuracy and specificity, as soon as possible. False positives just lead to more caution/less risk-taking, and false negatives are no worse than no test. We can require stricter test modalities for more critical use cases, which can help in making sure capacity is more available for those.”
“We should have committed 10x more funding to vaccine development right away, and done human trials as soon as possible.”
“As soon as we had any indication what handful of vaccine initiatives were likely to succeed, we should have asked Congress to approve funding to pay companies to ramp up the necessary production capacity well in advance of their expected timeline for FDA approval, since it would cost dramatically less than we were spending on relief bills or losing from the restrictions in place.”
Also: at this point we have a pretty good idea how long it’ll take for everyone who wants a vaccine to have had ample opportunity to get one. Those people who do, will not die of covid once a few more weeks have passed. At that point it’s not unreasonable to let others take their chances if they want to, if they judge their personal risk to be low enough, because they’re no longer endangering anyone who didn’t choose to be so endangered. So, a vaccine passport policy may make sense for… what, until late May at most? Is it really worth it to fight this battle on passports instead of focusing on campaigns to encourage people by touting all the positive benefits of these vaccines (and vaccines in general)?
I, for one, would like to come out of this pandemic into a world where people are generally impressed with how incredible the impact and potential of mRNA vaccines will be in the future. Not one where they’re mostly associated in the public consciousness with polarizing political battles.
“Government incompetence” is a fully-general objection to almost anything. I wish it weren’t so often a CORRECT objection.
And vaccine passports are exactly the sort of topic which we should expect such incompetence. It’s unclear what problems are being solved by them, what measurements can be used to adjust or kill the program if it’s not working, or what the incentives are of any players involved.
I don’t have a good inside-view model of the large numbers of people going maskless in crowds without the vaccine, but my outside-view model of them makes it seem VERY likely that they’ll just ignore it for most things, and forge or otherwise bypass it if actively enforced.
Really, the blend of arguments adds up to “why bother?”
Fully agreed on all counts. And the thing is, there are many things that government does competently (enough for the purposes I care about). Sometimes, when it isn’t, I look at what happens and say, oh yeah, that’s a train wreck, but I see how the decisions that lead to it made sense to the people involved even if they were competent and had the best of intentions. Other times, not so much.
Even if we made fakes easy to spot, and the gatekeepers were able to spot them and report them every time—it’s worth considering that the first link in the chain of events leading to the death of George Floyd involved somebody spotting and reporting a forgery. Is this REALLY the path we want to go down?
Mostly meta, mostly with the motivation of explaining a vote in case it would otherwise seem like an attack:
I believe you that you’re pointing this out because you want to avoid very unjust and harmful outcomes that might not be easily anticipated just by looking at the first step. And that’s good!
But you’re also leaning hard on a highly-publicized, highly-emotionally-charged single incident in a discussion about broad public policy. And that’s bad. Not only can it raise others’ emotions in ways that impede truthseeking, but it’s easy to make serious errors extrapolating that way in the first place.
I have downvoted this comment for that reason—but I want to contrast that your other comments have been quite good. In particular, you brought up the same issue in a more nuanced and explained way in another comment; that comment also included a lot of other useful perspective, and got an upvote from me.
I also think it’s very possible that you have further information we don’t (possibly intuitive, experiential information that is hard to unpack or transmit; and in fact you have already pointed at much of this in the other comment!) that does point in the direction of, say, “‘vaccine passports’ deployed in certain ways would cause people to forge them, and then cause enforcers to detect this and escalate the situation in such a way as to cause violent disasters” (or something similar—don’t anchor on that if you have a better idea!). If so, I would encourage you to keep trying to reify that connection if you can (though certainly don’t think you have to keep sinking energy into it regardless of anything), but also to try not to be too impulsive if people start picking it apart or depicting worlds in which not all the links hold up.
[Some edits and corrections shortly after posting.]
I appreciate the explanation of the downvote (no harm no foul) and I’ll try to tweak it if I get a chance. I probably do have experiential information that’s hard to unpack (without starting to break confidentiality, based on my line of work—which is annoying, because I absolutely never wanted to play the “I could tell you, but then I’d have to wipe your memory tomorrow” card, but here we are).
I do think the potential for escalation of conflict is a real concern; and that’s another reason for keeping the implementation as discreet as possible. For a restaurant, I could imagine a combined vaccine status/capacity logging/contact tracing app that has the same look and feel to everyone involved as a handy way of making reservations in 30 minute increments once the capacity reaches a certain level. This would involve giving everyone a QR code, and I believe this would probably be easier to enforce because it’s a lot easier to catch “two people being in the same place at the same time”
My main “meta-points” in all of this are:
a) Keeping the code open source, like Jeffrey Zients suggests, is incredibly important. b) We should try to come up with a set of guidelines of what it would mean for vaccine passports to be a failure (e.g., no measurable effect on case rates, evidence of rampant forgery, etc)
I realize this is going to be different for different people and in different places, but if you’re in a place where mask compliance is high already, and rules are actually enforced, this isn’t likely to be a thing. I mean, obviously it is to some degree, people get a negative test result (sometimes, too soon after exposure for it to even mean anything) and then see friends and family unmasked. But I don’t think it’s anywhere near significant enough to change my conclusion.
If that were likely to be a major problem, I’d think we should already be seeing large numbers of people who’ve recovered from covid refusing to wear masks in public. After all, that’s much stronger evidence of not having covid, and not being able to catch it, than a negative test result is. Also, better messaging could help mitigate that, “Sometimes tests are wrong, so you can’t treat a negative test as a guarantee, but even if you could, a mask helps protect both you and others, so you should wear one to help you stay negative.”
Still: I don’t mean for my list to be definitive. I was making examples based on my own assessments of the kind of reflection I’d need to see from major public health figures and institutions before I start trusting them to implement any policy that requires delicacy, nuance, precision, and care, to avoid causing significant harmful side effects.
If you’re not concerned about enforcement why bother with the security theater? Might as well just trust people when they say they’re vaccinated. The marginal benefits of the apps is negligible, compared to the cards. Anyone with the chutzpah and resources to forge a CDC card isn’t going to have a hard time forging a QR code and a driver’s license.
I agree. I’m not sure if I said otherwise anywhere, but if I did, it was a mistake. I do not support enforcing any kind of vaccine passport. I might, if the vaccine rollout were much slower than it currently is and there were an institution I trusted enough to roll out and enforce one thoughtfully enough. But as things are in the US, we’re approaching the point where anyone who wants a vaccine is allowed to get one. To me that means that within a month or two, it mostly stops being a valid argument that the unvaccinated-by-choice are putting anyone but themselves at risk, unless they’re working directly with vulnerable and un-vaccinatable populations.
Given the generalized lack of competency, understanding of reality, interest in any sort of nuance whatsoever, and so on, since the pandemic began… do you really believe any of the relevant institutions could or would choose to (and would successfully) implement any of the solutions you propose to those objections you believe are reasonable? I, for one, very much do not. And I don’t just mean government institutions either. The failure of infectious disease experts at major universities to speak out in favor of saner policies, the shortsightedness of business and other groups pushing for premature (and selective) re-openings, those all play a role too, and I’m skeptical of them implementing their own policies requiring vaccination by employees or customers.
Granted, overcoming that objection of mine would be very easy. All it would take is for the CDC, FDA, and whichever governor or state legislature is proposing a vaccine passport rule to come forward with a (even partial) self-assessment listing what they got right, and what they got wrong, based on the information they had at the time, since last January, and a commitment to a timeline to produce a detailed plan for how they will do better in the future. I won’t hold my breath. For example:
“We should have admitted from the beginning, that yes, obviously in any given situation masks don’t increase your risk of getting sick and could reduce it, so people should wear one for anything they would do in public indoors anyway, but making it a policy requirement without any plan in place based on when and why it makes sense, like requiring masks outdoors in any place less crowded than a city center, is not likely going to be helpful.”
“We should have discussed, from the beginning, the importance of ventilation indoors, and encouraged more open windows, HVAC system improvements, and spending as much time outdoors as feasible.”
“We should have stated clearly, from the beginning, that we were going to make the best recommendations we could at any given moment, and that some of that will definitely change as we get more data, but until we get that data we won’t know which ones.”
“We should have initially recommended people disinfect things coming into their house or business as a possible transmission vector, and then updated when we found out that fomites weren’t a major component of the pandemic beyond very high touch surfaces.”
“We should have actually bothered to do even basic cost-benefit analyses when making decisions.”
“We should have recommended everyone who can do so to take vitamin D, since the potential risks are so much lower than the potential rewards. Actually, we should have been doing that for a lot more people, for a long time, in most of the US.”
’We should have approved OTC/at-home/prescriptionless tests, including new types like maybe that MIT over-the-phone AI tool, with way lower thresholds for accuracy and specificity, as soon as possible. False positives just lead to more caution/less risk-taking, and false negatives are no worse than no test. We can require stricter test modalities for more critical use cases, which can help in making sure capacity is more available for those.”
“We should have committed 10x more funding to vaccine development right away, and done human trials as soon as possible.”
“As soon as we had any indication what handful of vaccine initiatives were likely to succeed, we should have asked Congress to approve funding to pay companies to ramp up the necessary production capacity well in advance of their expected timeline for FDA approval, since it would cost dramatically less than we were spending on relief bills or losing from the restrictions in place.”
Also: at this point we have a pretty good idea how long it’ll take for everyone who wants a vaccine to have had ample opportunity to get one. Those people who do, will not die of covid once a few more weeks have passed. At that point it’s not unreasonable to let others take their chances if they want to, if they judge their personal risk to be low enough, because they’re no longer endangering anyone who didn’t choose to be so endangered. So, a vaccine passport policy may make sense for… what, until late May at most? Is it really worth it to fight this battle on passports instead of focusing on campaigns to encourage people by touting all the positive benefits of these vaccines (and vaccines in general)?
I, for one, would like to come out of this pandemic into a world where people are generally impressed with how incredible the impact and potential of mRNA vaccines will be in the future. Not one where they’re mostly associated in the public consciousness with polarizing political battles.
“Government incompetence” is a fully-general objection to almost anything. I wish it weren’t so often a CORRECT objection.
And vaccine passports are exactly the sort of topic which we should expect such incompetence. It’s unclear what problems are being solved by them, what measurements can be used to adjust or kill the program if it’s not working, or what the incentives are of any players involved.
I don’t have a good inside-view model of the large numbers of people going maskless in crowds without the vaccine, but my outside-view model of them makes it seem VERY likely that they’ll just ignore it for most things, and forge or otherwise bypass it if actively enforced.
Really, the blend of arguments adds up to “why bother?”
Fully agreed on all counts. And the thing is, there are many things that government does competently (enough for the purposes I care about). Sometimes, when it isn’t, I look at what happens and say, oh yeah, that’s a train wreck, but I see how the decisions that lead to it made sense to the people involved even if they were competent and had the best of intentions. Other times, not so much.
Even if we made fakes easy to spot, and the gatekeepers were able to spot them and report them every time—it’s worth considering that the first link in the chain of events leading to the death of George Floyd involved somebody spotting and reporting a forgery. Is this REALLY the path we want to go down?
Mostly meta, mostly with the motivation of explaining a vote in case it would otherwise seem like an attack:
I believe you that you’re pointing this out because you want to avoid very unjust and harmful outcomes that might not be easily anticipated just by looking at the first step. And that’s good!
But you’re also leaning hard on a highly-publicized, highly-emotionally-charged single incident in a discussion about broad public policy. And that’s bad. Not only can it raise others’ emotions in ways that impede truthseeking, but it’s easy to make serious errors extrapolating that way in the first place.
I have downvoted this comment for that reason—but I want to contrast that your other comments have been quite good. In particular, you brought up the same issue in a more nuanced and explained way in another comment; that comment also included a lot of other useful perspective, and got an upvote from me.
I also think it’s very possible that you have further information we don’t (possibly intuitive, experiential information that is hard to unpack or transmit; and in fact you have already pointed at much of this in the other comment!) that does point in the direction of, say, “‘vaccine passports’ deployed in certain ways would cause people to forge them, and then cause enforcers to detect this and escalate the situation in such a way as to cause violent disasters” (or something similar—don’t anchor on that if you have a better idea!). If so, I would encourage you to keep trying to reify that connection if you can (though certainly don’t think you have to keep sinking energy into it regardless of anything), but also to try not to be too impulsive if people start picking it apart or depicting worlds in which not all the links hold up.
[Some edits and corrections shortly after posting.]
I appreciate the explanation of the downvote (no harm no foul) and I’ll try to tweak it if I get a chance. I probably do have experiential information that’s hard to unpack (without starting to break confidentiality, based on my line of work—which is annoying, because I absolutely never wanted to play the “I could tell you, but then I’d have to wipe your memory tomorrow” card, but here we are).
I do think the potential for escalation of conflict is a real concern; and that’s another reason for keeping the implementation as discreet as possible. For a restaurant, I could imagine a combined vaccine status/capacity logging/contact tracing app that has the same look and feel to everyone involved as a handy way of making reservations in 30 minute increments once the capacity reaches a certain level. This would involve giving everyone a QR code, and I believe this would probably be easier to enforce because it’s a lot easier to catch “two people being in the same place at the same time”
My main “meta-points” in all of this are:
a) Keeping the code open source, like Jeffrey Zients suggests, is incredibly important.
b) We should try to come up with a set of guidelines of what it would mean for vaccine passports to be a failure (e.g., no measurable effect on case rates, evidence of rampant forgery, etc)
False negative is worse than no test at all. It gives a person additional incentive to ignore mask rules.
I realize this is going to be different for different people and in different places, but if you’re in a place where mask compliance is high already, and rules are actually enforced, this isn’t likely to be a thing. I mean, obviously it is to some degree, people get a negative test result (sometimes, too soon after exposure for it to even mean anything) and then see friends and family unmasked. But I don’t think it’s anywhere near significant enough to change my conclusion.
If that were likely to be a major problem, I’d think we should already be seeing large numbers of people who’ve recovered from covid refusing to wear masks in public. After all, that’s much stronger evidence of not having covid, and not being able to catch it, than a negative test result is. Also, better messaging could help mitigate that, “Sometimes tests are wrong, so you can’t treat a negative test as a guarantee, but even if you could, a mask helps protect both you and others, so you should wear one to help you stay negative.”
Still: I don’t mean for my list to be definitive. I was making examples based on my own assessments of the kind of reflection I’d need to see from major public health figures and institutions before I start trusting them to implement any policy that requires delicacy, nuance, precision, and care, to avoid causing significant harmful side effects.
If you’re not concerned about enforcement why bother with the security theater? Might as well just trust people when they say they’re vaccinated. The marginal benefits of the apps is negligible, compared to the cards. Anyone with the chutzpah and resources to forge a CDC card isn’t going to have a hard time forging a QR code and a driver’s license.
I agree. I’m not sure if I said otherwise anywhere, but if I did, it was a mistake. I do not support enforcing any kind of vaccine passport. I might, if the vaccine rollout were much slower than it currently is and there were an institution I trusted enough to roll out and enforce one thoughtfully enough. But as things are in the US, we’re approaching the point where anyone who wants a vaccine is allowed to get one. To me that means that within a month or two, it mostly stops being a valid argument that the unvaccinated-by-choice are putting anyone but themselves at risk, unless they’re working directly with vulnerable and un-vaccinatable populations.