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Truth takes time to uncover

alexberenson.substack.com

I am not a big fan of Alex Berenson. I don't like journalists because they don't understand population statistics. They are interested mostly in anecdotal cases and their duty is to write about them in an interesting and viral way. And yet, that is an important service to identify targets that are worth of deeper analysis.

In Alex case while he missed many times, he also hit some good targets.

  1. vaccine effectiveness against infection is lost withing 3-4 months

  2. prior infection provides stronger immunity than vaccination

The second was always suspected but the evidence was always lacking. Now it turns out that twitter supressed tweets that announced the first real evidence (even if not very strong) that it is the case. I believe that this suppression likely extended wider than just twitter and ultimately influenced the US policy to not recognise immunity from infection when vaccine mandates were put in place. In contrast, most European countries with mandates recognised immunity from prior infection in one way or another as inferior or equal to immunity from vaccination.

There might be some practical considerations – vaccination is easy to register and provide proof. Prior infection is more nebulous, requires expensive testing, some tests are less reliable. The whole idea casts shadow how reasonable vaccine mandates are in the first place. Some would worry that the recognition of immunity from prior infection could also encourage vaccine hesitant to seek getting infected.

Such policies however are very risky because they are conditional on us never finding out the truth. It was always more likely that prior infection confers stronger immunity than vaccination. It was stupid to try to supress the evidence at any time. Eventually it surfaced (as it was bound to) and made those attempts to control narrative look evil.

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I trusted that rationalist community will be better than general public with regards to understanding medical evidence. I no longer have these illusions. One example was that we don't really have much evidence about Paxlovid use in vaccinated. For this reason the UK do not recommend it for healthy, vaccinated people with low risk. The same applies to Tamiflu. Even if they were beneficial to some degree, they are not cost effective. And yet rationalists on these forums often claim the opposite, with general statements that the scientific recommendations are due to incompetence.

People often make the case that if we can shorten the cold period of feeling terrible even a couple of days it is worth it. It may be but somehow I think people underestimate the impact of mental health. People in depression don't feel terrible for couple of days, they feel terrible for months, even years. It was the issue why I objected to lockdowns because the harm from covid for young people was low and in most cases it was just feeling terrible for a few days. While getting into financial difficulties, social problems, depression, drug and alcohol use can have much longer lasting periods of feeling terrible and also long lasting negative effects. And for many children losing schooling can have life-time consequences.

It is important to understand that it is trivial to cure COVID since day 1, the rationalist diaspora, like the medical diaspora are simply extremely illiterate in pharmacology. In retrospect, it seems people litterate in pharmacology are extremely rare.

You can either solve age induced immunosuppression/thymus involution via thymalin OR potently block viroporins OR potently downregulate/block ACE2 receptors OR block/downregulate any other related necessary component in the virus reproduction/action chain.

As a bonus you can also block the toxicity including cytokine storm.

That's 3 independently sufficent class of action mechanisms which all have existing pharmaceuticals.

trivial to cure COVID since day 1

I am going to file it with "cancer is trivially treatable, evil medical companies are suppressing news about herbal remedies"

To be honest, I don't know how to classify your message. Scott has written a long article that media rarely lies. I believe that this is also not a lie. However, thinking that the whole medical establishment just haven't used this wonderful treatment method out of ignorance is too far fetched. It took time to realize that overactive immune system is killing covid patients but by now we have several approved monoclonal antibodies to treat exactly that. It helps in some cases but overall it is not only about the effectiveness of the drug but diagnosing that it is exactly the case of overactive immune system causing damage in particular cases and the timing etc. Medicine is very complex.

Just because you criticized rationalist community now will not get you any points from me. Rationalists may be sometimes misguided but they are not that bad to believe any story like this without more evidence.

Intuitively, paxlovid should work in those who are vaccinated, just mechanically. 200 seconds on google scholar gives me this,

Overall, 180,351 eligible were included, of them only 4,737 (2.6%) were treated with Paxlovid, and 135,482 (75.1%) had adequate COVID-19 vaccination status. Both Paxlovid and adequate COVID- 19 vaccination status were associated with significant decrease in the rate of severe COVID-19 or mortality with adjusted HR 0.54 (95% CI, 0.39-0.75) and 0.20 (95% CI, 0.17-0.22), respectively. Paxlovid appears to be more effective in older patients, immunosuppressed patients, and patients with underlying neurological or cardiovascular disease (interaction p-value <0.05 for all). No significant interaction was detected between Paxlovid treatment and COVID-19 vaccination status

It's not cost effective in young, healthy people who don't already have severe disease ... of course? Were rationalists claiming otherwise?

Yes, it was highly demanded to relax the rules so that everyone can get it regardless of risk status by many rationalists here and elsewhere (e.g., Zvi).