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Scott briefly observes, "The only thing about COVID nobody talks about anymore is the 1.2 million deaths.
A better comparison for 1.2 million Americans dying would be the Spanish Flu: An estimated 675,000 Americans died, while the total population was estimated to be round 106,000,000. (The 2020 estimated population was around 331,500,000.)
One problem I have with the online debates about covid policy is there's no clear counterfactual: 2021 deaths were higher than 2020 deaths, which is bad for arguments that containment policies were only protecting the most vulnerable at the expense of the general population, because the most vulnerable had disproportionately died in 2020 and management had improved. It's possible that a different set of policies would have resulted in disproportionately more QALYs lost by lower-risk demographics, due to the non-linear dynamics of disease transmission (don't forget rates of mutation). I don't really care to defend any policy, since there were a lot of avoidable mistakes, but I think the criticism should be more specific and measured.
(Edit: Scott's Lockdown Effectiveness: Much More Than You Wanted To Know, published July 1, 2021 - anyone know if there's been much change in the understanding of NPI effectiveness?)
The thing that gets me--and I will admit my loss of facts over the years-- is there's no counterfactual for how effective the vaccines were. I presume the peak numbers would have come down a little, but vs. what? Overall, it doesn't seem to me there's much evidence that the vaccines did anything as the course of the covid outbreak followed every other pandemic just at a different scale. All I get is, "Of course they worked, it's obvious. You're stupid."
They kept track of death rates among the unvaccinated vs vaccinated (vs boosted, etc.), and it definitely looked like you wanted to be in the group whose first exposure to Covid spikes was of the artificial, non-exponentially-reproducing variety. Vaccine effectivity dropped off with time fast enough that there was no way to stop the disease from spreading, but at least we might have somewhat reduced the fatality rate from more of those first virgin exposures.
The obvious problem with those numbers is that this was anything but a Randomized Controlled Trial, and who knows what other differences those population groups had. IIRC I could find the data age-adjusted, but not controlled for anything else. There's a paradox where, if you tell everybody that e.g. square dancers live longer, you may soon find that square dancers really do live longer, not because it's better than other forms of exercise or whatever, but because now all the people who are doing a lot of other things to take care of their health have started square dancing too. Perhaps people who resisted taking a Covid vaccine are more oppositional toward other sorts of public health recommendations too, either with regard to Covid (letting themselves be exposed more easily) or to other contributing factors (obesity, smoking, "toughing out" serious infections, whatever).
The more subtle problem is that it's hard to tell how Covid-19 would have evolved in the presence of a more universally vaccinated population. Death rates fell way off with the Omicron variant, but would the virus inevitably have evolved in the same way at the same speed?
Ask if they think the FDA should have allowed the vaccine to be freely distributed and/or sold after it was first invented, in March 2020, without spending the next several months waiting on slow-but-legally-mandated testing methods and FDA approval before they could ramp up production. It's a little hard to get up on a "not trusting the system and taking the vaccine makes you a stupid anti-vaxxer" high horse when nearly half of the US deaths came during a time period when the system would have jailed anyone who gave you the vaccine.
What we needed were expedited Challenge Trials. The first thing I thought was ridiculous is how the virus was dangerous enough that it made sense to shut down everything, but not so important that we could do challenge trials for treatments on volunteers. I know many people who would have willingly been exposed to the virus to test out a treatment/vaccine.
A challenge trail would have shut down a lot of this vaccine effectiveness debate. Isolate a group of 400 people, vaccinate half, expose half of each group to the virus, and record the data. Hard to argue with that, fast results, save a million lives.
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