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PaperclipPerfector  10mo ago (text post)   31928 thread views

Culture War Roundup for the week of July 17, 2023

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They were developed very quickly--I believe the first ones in January of 2020. They were approved "quickly" in the sense that a new medicine getting approved in less than a year would be unheard of in normal situations. They were not approved quickly in the sense that quickly by FDA standards is still glacially slow by any reasonable person standards. Also, the testing process was delayed--they were allowed to do phase 2 and phase 3 trials at the same time, IIRC, but those trials took a lot of time because most people weren't getting covid in the course of a month and you need a lot of people in the control group to get COVID in order to have enough data. This could have been worked around with challenge trials, which people even volunteered for, but we can't have that. People might get hurt!

Edit: Since I'm being sarcastic, I should say that manufacturing might have slowed down the process of getting vaccines out anyway. But even with a small number of doses you could prevent a lot of deaths by vaccinating old people and other at-risk groups, which is what we did, so I would guess challenge trials still end up saving lives on net.

Counter-argument: if you roll out a vaccine to the entire population without waiting long enough to see if there are delayed side effects, you could do a LOT of damage.

Probably not as much damage as, you know, the COVID pandemic. The null action also costs millions of lives and trillions of dollars!

We roll out the vaccine to 95% of the population. Six months later, turns out it makes people infertile. Whoops. Civilisational collapse.

Any attempt to roll out a new type of medicine at a civilisational scale should be done extremely carefully. Coronaviruses are to some extent a known factor and are very unlikely to have that level of effect - the mRNA vaccines were very likely to be safe (and mostly were) but it was an entirely new mechanism for messing with the immune system and in my opinion you shouldn't do that for 95% of the population without being very very sure what happens.

Six months later, turns out it makes people infertile.

That's still a good deal for over-65s! You could have rolled it out to all of them and still nearly eliminated the pandemic death toll. That's my whole point - sure, it wasn't worth rolling out an experimental vaccine to everyone at once, but it was obviously worth it for the most vulnerable.

Oh, I agree completely! I argued the same thing elsewhere on the thread.

Covid might also have delayed unknown side effects, so by the exact same logic delaying them could do a lot of damage.

It could. But when I say “a LOT of damage”, I mean the very small chance of rolling out thalidomide to 95% of the population. Covid was, fundamentally, a really bad influenza virus - in my opinion the space of worst-case side effects was much more constrained than that of bad medicine.

(What I would actually have done is a very accelerated rollout for the very elderly who had most to lose and then a more delayed rollout for everyone else.)

What I would actually have done is a very accelerated rollout for the very elderly who had most to lose and then a more delayed rollout for everyone else.

The thing is, if you don't imagine that anything permissible must be mandatory, then you don't have to worry about making those decisions! Instead, you can put the information out there, including the appropriate statements about risk/uncertainty, then you can make it permissible, and your job here is done! People who have the most to lose, be it because they're elderly or because their livelihood depends on not being locked down, or any number of reasons that you haven't even thought of, can just make their own choice about how worth the risk it is! You don't even have to worry yourself to try to come up with a list of reasons why someone might choose to take it or not take it. They'll come up with that list for you, in a beautiful, distributed fashion!

Will some people make the "wrong" choice? Probably! But in the case where you're the one making the choices for everyone, will you sometimes make the "wrong" choice for some people? Probably! Why should society think that your choices for them are better than their own?

if you don't imagine that anything permissible must be mandatory, then you don't have to worry about making those decisions!

It’s a good point, although you’re attributing opinions to me that I don’t hold. I was never in favour of mandatory vaccination, at least not for the new Covid vaccines. There’s a spectrum of action roughly along the lines of:

  • Putting the information out there
  • Advertising heavily
  • An opt-out vaccination program
  • A mandatory vaccination program

Realistically a lot of old people are pretty out of touch (I had a family member of the appropriate age at the time) and I don’t think there’s anything wrong with having a doctor come and say, “I would like to give you this vaccine, are you okay with that.” Which is probably what I would have done in this case.

Sure, you can do some encouraging for like old people and such. Whatever. But why not make it available to people who might have a reason to take it, but who aren't in your narrow category of people you know have reason to take it (i.e., old people)? Let them know the risks/uncertainties. They know their own circumstances.

Limited supply and risk of side effects, since part of the scenario is that we’re rolling this out with minimal testing.

Concerning risk of side effects, I still don't think you've answered the question. A variety of people may have different reasons to be tolerant of the risk of side effects. Some might be old, at higher risk, have fewer years to live. Others might have some other condition that bends their personal risk curve in favor of taking it. Others, like I mentioned, may have incredible amounts of their livelihood at stake. And there are other situations that we can't even think of. Why not just let them know the risks/uncertainties, trust that they know their own circumstances, and not make their decision for them?

Concerning limited supply, that's generally what the price mechanism is good at. Rather than having category upon category decreed by the government, when such politicized categories scarcely have anything to do with value, just let people buy it. Sure, you could buy some for some specific category where you know there is a need (like poor old people), but then just let people buy the rest of it. The price will help distribute it to people who have the most reason to get it (e.g., someone whose livelihood depends on it is likely to pay a higher price than someone who can work from home and is just a little inconvenienced by lockdowns). If the price starts out kind of high from limited supply, it also encourages people to pay significant attention to the risks involved, because if they're going to spend that money, they want to be pretty confident they know what they're getting for their money.

I would conclude from your points, limited supply and risk of side effects, that we should mostly just let people buy it, choosing on their own, from their own circumstances. Why do you think those points cut in the other direction? Why do you think they make it more likely that you're going to make a better decision for other people than they would make for themselves?

Again, I don't see why any argument that is fundamentally based on uncertainty would favor delaying the vaccine. Yes, it's a bad flu for many healthy people in the short term, but that doesn't mean it doesn't have long-term effects. Getting the vaccine was, at worst, 1 day of flu symptoms for most people, too, but you don't seem to think that means that covid has some unknown long-term risk. There are viruses (like rabies) which hang out in people for a long time with no apparent symptoms but are extremely dangerous. And the whole point of a vaccine is to be similar to the disease it prevents.

(Also, I feel like I should point out that thalidomide is a very important medicine which is only really bad if you give it to pregnant women, which means that you could give it to well over 95% of the population and not have many big problems).

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