Updated Thoughts on COVID19: December 2021 Version

The Omicron outbreak is upon us. The vaccine efficacy against serious illness and death appears to be holding. But it’s not stopping the spread. It’s a scenario that allows nearly everyone to confirm their prior biases on whether or not the vaccine was a good idea. Whether or worked, or didn’t. Both are in fact true, depending on which variable you care about. If saving lives and turning COVID19 into the flu is the goal (it’s mine) than it appears to be working. If destroying the disease by locking down spread was the goal, than it didn’t. We’re now completely free for the pandemic response to tumble into the political lexicon where beliefs matter more than solutions. And nothing ever gets solved. It’s worth spending some time on the shape of the problem we’ve got now before we nail the plank down permanently into our party platforms.

So here goes…

40% of COVID19 cases appear asymptomatic. That number jumps significantly for younger people to well over 50%. It’s a mixed blessing because it makes it so there’s loads of people wandering around shedding a potentially deadly pathogen completely unaware that they’re doing it. But it also means that for the overwhelming majority of people a COVID19 infection doesn’t end up giving them significant health problems. For our elderly, sick and obese, COVID19 harms or kills them at an unacceptably high rate though. COVID19 introduces the civic case study that has asked us for the last two years now to keep the vulnerable among us safe by asking the less vulnerable to sacrifice. It’s something we’re not that great at in America. And it’s showed.

We added a variable into the mix here that is one of the greatest scientific accomplishments of my lifetime too. An MRNA vaccine that greatly lowers the impact of the disease on even those at high risk. You are 11 times (ELEVEN TIMES) less likely to die of COVID19 if you are vaccinated. It also slows, but not nearly as much as we’d hoped for new variants, the spread of the disease. And so now we’ve got to grapple with the problematic question of exactly what we can force people to do to their own bodies during a pandemic.

Can we force a shot into someone’s arm? No. Do active duty military people have the same agency over their bodies as private citizens? No (I’ve got stories). Can governments, employers, businesses and private citizens treat people differently based on their vaccination decisions? Yes. Is everyone going to like that? No. Should we keep mandates the same if the vaccine is less effective against containment than it is at reducing severe illness…? That’s a good one. I don’t know.

Political debates like to conflate what we can do and what we should do. And so it’s important to realize that way more of this discussion lives in the domain of should do vs can do.

If by now, we’ve not learned our lessons on moralizing, we should have. From the three weeks to flatten the curve to the stay the fuck home crowd to the didn’t get the vax and now is dead gloating, anyone who has decided to climb a righteous hill and look down at the world’s poor decisions as if they were in possession of the only real truth has learned pretty tough lessons lately. I certainly did. We couldn’t stop the disease from spreading. Many of the answers we thought we had turned out not to be answers. So moralizing isn’t really a great idea here because you’re pretty likely to be on the other side of it if you give it a few weeks.

Not moralizing is not abandoning the facts though. Don’t forget that we closed the beaches in California in the summer of 2020 and did other absurdly stupid things. We did them because we had no data. We have more data now. And so our decisions should get better and better. And we should feel comfortable now that there are more things here that simply aren’t as subjective as they once were.

For example….

The data on the vaccine efficacy is unambiguous (11 times less likely to die! Not 11%…11 X!). Countries that have gotten to the 90% vaccination threshold are having a very different experience than ones like America that have not. America is about 60% vaccinated. There are two times more unvaccinated Americans in America than there are Germans in Germany. As a result, hundreds to thousands of Americans are going to keep dying a day more than if more of us got vaccinated. That is an undeniably bad thing brought about by irrational forces that have no upside. The third shot also appears to deliver substantial protection from contagion and severe illness. It’s free. And there’s not any great reason not to get it for nearly everyone. We’re not going to get to 90% in America and the reason is pretty clear though.

People had legitimate concerns over getting an emergency vaccine. They’re not crazy for being skeptical, at least initially. The massive swaths of data have proven though, as much as anything is ever going to be proved, that the risk from getting a vaccine is astronomically low. But it’s not zero. It’s also not perfect protection. And if it’s not zero risk and not perfect protection than there’s a market to make both the risk and the gaps in protection the story. This market exists in politics and in media distribution. Podcast hosts are going to podcast host. Politicians are going to equate liberty with a resistance to any collective efforts. The former will gain voice. The latter will gain power. And we’ll just hang out at 60% vaccination rate and more people will die than should have.

It’s helpful to remember that professional contrarians and politicians (of any sort) have no responsibility to solve problems. So consume the information they distribute with that in mind. Their goal is to have the biggest bonfire to dance around. Listen to the people trying to solve the problem differently than you listen to people trying to grow an audience. For some things there are not smart contrarian views. And if you’re building an audience on the brand of contrarian, you have to stay away from certain topics or force yourself to find a quack to talk about it. No one can stay away from the topic of COVID19 today. So we should expect some quacks.

Say what you will about Fauci and others in the medical field but 100 years from now people will remember them based on one thing: the outcomes of this pandemic. People will remember podcast contrarians because of the size of their audience and politicians on whether they win elections. Neither have incentives to solve any of my problems or answer hard questions.

One of those hard questions is if there’s ever going to be a reality where any institution larger than a small mom and pop business is going to be fine with people with a confirmed COVID19 diagnosis working in their places of business. You can come to work with a cold. You can come to work with the flu. I don’t know when or if this ever happens with COVID19. If it doesn’t what are the sorts of things we’re just going to have to deal with? More people missing work? More or continued remote work? Canceled events? Travel disruptions? School closings? My assumption is that, over time, a lack of symptoms and vaccination status will play a role in drastically reducing “time away” requirements. We’re not there yet for reasons Tyler Cowen outlines well here.

I think the place that will force the shift to more lenient away time rules eventually is schools. If we made people vaccinate their kids with a brand new vaccine and those vaccines work and we still end up closing down schools, I think we’re going to see people lose their collective minds like we haven’t quite yet. The open question is whether governing bodies of our school systems are quite smart and agile enough to lead the change. If so, it will be a shift from past performance.

Which leads to one more closing thoughts. We should all be hopping mad at the state of American COVID19 testing. We should view it as a failure of government infrastructure. Omicron was new. But the idea of a winter wave wasn’t. It sounds like hundreds of millions of tests are going to roll out in January. And it won’t matter. And that’s a brutal failure…all the way to the top.

Good luck and God speed over the coming weeks. The only undefeated advice so far is that there are some things that make you safer and others around you safer and you should do them. And over time you’ll have to do them less. But that time isn’t quite yet. The bond market actually thinks its sooner now with Omicron. We’ll see…