Covid-19 Politics

A few things I've seen: Data came back and shows that not only is delta more transmissible it's associated with double the risk of hospitalization as Alpha in unvaccinated people.

I've also noticed that Ivermectin has now completely replaced Hydroxychloroquine as the science denier's ineffective pharmaceutical of choice against covid. It also seems to be causing unvaccinated people to place a certain amount of faith in it that if they get covid it will save them. Instead, its users are buying it from veterinary medicine outlets and poisoning themselves with it, but also dying from covid which it doesn't treat. I wonder what kind of mania could cause a person to turn down a clinically test, safe and effective vaccine for a medicine that is toxic when used improperly and has not been proven effective for covid?

It seems nearly every day a new "right-wing radio host" or Republican official or outspoken opponent of the covid vaccine is being intubated or dying of covid. There even seems to be a widening partisan split in infection rates though unvaccinated people jeopardize the health of the vaccinated too.

It’s no longer about science, masks, vaccines, politics nor issues. The Trumpizoids are a tribe. Their identity is at stake. To make a turn-around on any of the ridiculous stands they have taken is to deny whom they have fundamentally become and reject the sacred ties with the tribe they have joined.

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Originally Posted by broncofan

I've also noticed that Ivermectin has now completely replaced Hydroxychloroquine as the science denier's ineffective pharmaceutical of choice against covid. It also seems to be causing unvaccinated people to place a certain amount of faith in it that if they get covid it will save them. Instead, its users are buying it from veterinary medicine outlets and poisoning themselves with it, but also dying from covid which it doesn't treat. I wonder what kind of mania could cause a person to turn down a clinically test, safe and effective vaccine for a medicine that is toxic when used improperly and has not been proven effective for covid?

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It's bizarre that the same people who claim that the vaccines are unproven risky technology are happy to embrace unproven alternative cures. The only consistency is opposing whatever the medical establishment advises.

The psychological roots of this mania seem to be a sort of mass euphoria about being liberated from the constraints of evidence, logic, morality or even law. Trump and the right-wing media bubble have given them free reign to indulge their instinctive impulses, and if they stop pandering to them they will be rejected as well. They are like children freed from any adult constraints, as in Lord of the Flies. The id is in control and the ego and super-ego have been sidelined.

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Originally Posted by filghy2

They are like children freed from any adult constraints, as in Lord of the Flies. The id is in control and the ego and super-ego have been sidelined.

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Side topic but what a book that was. It was one of those books that American kids were "forced" to read for class because its lessons were rendered clear enough that teachers could let Golding do the teaching. But it also scared the crap out of me because I had seen the movie when I was 10 and was sure I would have been outcast and hunted by those little fuckers (I'm sure that's common tho).

But back to what you and Trish are saying. They are impervious to evidence based reasoning, completely unable to apply rules and laws in neutral, fair ways, and are showing their willingness to die for their fantasies while denying the cause of their deaths. Social media helps amplify this because it allows for very misleading pieces of information to be broadly distributed and no real chance for response or correction.

As you have pointed out their radicalization has taken place over time but to me Trump represented the idea that once you normalize a sociopath there can really be no call for any restraint or limit any more. Respecting the norms and traditions of democracy means you can't treat him like an outcast, you have to work with him at times. In working with him you come into contact with the fantasist, the narcissist, and the sociopath and his supporters have no choice but to venerate that behavior or abandon him. They decided that fantasies served their interests better than reality.

The studies on Ivermectin make it tough to believe any good faith actor could believe it's effective given the (unsuccessful) struggle to separate its effects from placebo. Could you imagine if the results of clinical trials for vaccines were close to the margin of error for the sample?

A recent analysis of Israeli data showed that on average immunity from infection conferred better protection than pfizer's vaccine. Someone said this means vaccines are irrelevant and a scientist piped up and said "if we had clinical trials for an equally effective vaccine whose side effects caused 650,000 deaths in the American public should it get approved?" We're so blessed to have access to vaccines and cursed that not enough people are taking advantage of them.

I'll conclude by saying, Delta was a bad break. Yes variants were and are inevitable, but delta changed the course of the pandemic for sure.

https://www.ft.com/content/66adc278-...c-b33e915d4631

I'm not knowledgeable about ip rights but initially I thought people who wanted waivers of patent rights were being unreasonable. At the time I didn't know Pfizer would make 33 billion dollars from its vaccine. Now I support waiving patent rights because I don't see how it would be much disincentive to create vaccines given the windfall companies are making from their shots. If a billion more doses of the mrna vaccines can be made by waiving patent rights I'm for it. Pfizer and Moderna would still be making enormous profits that far exceed r and d costs. The article talks about production capacity in South Korea.

Edit: the article says pfizer and moderna are being asked to waive ip rights by granting licensing deals. So it is likely they would be compensated for the vaccines South Korea makes, in addition to the shots they produce at their own plants that there is still ample demand for.

your on Point Broncofan

check these threads out
http://www.hungangels.com/vboard/sho...ing-like-flies

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Originally Posted by broncofan

A few things I've seen: Data came back and shows that not only is delta more transmissible it's associated with double the risk of hospitalization as Alpha in unvaccinated people.

I've also noticed that Ivermectin has now completely replaced Hydroxychloroquine as the science denier's ineffective pharmaceutical of choice against covid. It also seems to be causing unvaccinated people to place a certain amount of faith in it that if they get covid it will save them. Instead, its users are buying it from veterinary medicine outlets and poisoning themselves with it, but also dying from covid which it doesn't treat. I wonder what kind of mania could cause a person to turn down a clinically test, safe and effective vaccine for a medicine that is toxic when used improperly and has not been proven effective for covid?

It seems nearly every day a new "right-wing radio host" or Republican official or outspoken opponent of the covid vaccine is being intubated or dying of covid. There even seems to be a widening partisan split in infection rates though unvaccinated people jeopardize the health of the vaccinated too.

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Originally Posted by broncofan

I'll conclude by saying, Delta was a bad break. Yes variants were and are inevitable, but delta changed the course of the pandemic for sure.

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A bad break, but a foreseeable one, just as the original virus was foreseeable. Once again, we've been caught out by complacency and the desire to declare victory prematurely. With a high reproduction rate the penalty for failing to act early is huge.
It's only the vaccines that are keeping this manageable at all. And now we have reports of a new variant in South Africa that may be even more infectious and more vaccine-resistant.
Delta also encourages a sort of perverse logic that if nothing we do is fully effective then why try. Some people struggle to think in terms of counterfactuals.

I recommend this article by Larry Brilliant and others. It offers a delineation of the virus and goes further into the political realm. It argues that on the one hand, there has been a lamentable failure by politicians to co-ordinate a global- in some cases even a national- response to the pandemic, while on the other hand science has been able to map the genome sequence of the virus and produce an effective vaccine, albeit one that has not been distributed equally. Telling comparisons are made between Covid-19 and the global campaigns against Smallpox and Polio.

in addition, the science suggests we must learn to live with Covid-19 and it’s astonishing ability to mutate (see page 83 for their scary description), to the extent that variants may become the permanent challenge, for while most mutations may not have a devastating or any effect on people, some have such a potential. The assumption is that the science can deal with the variants, but that it is the politics that is weak.

https://www.foreignaffairs.com/artic...-forever-virus

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Originally Posted by broncofan

As you have pointed out their radicalization has taken place over time but to me Trump represented the idea that once you normalize a sociopath there can really be no call for any restraint or limit any more.

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It was building for a long time, but it went over the edge remarkably quickly once certain tipping points were passed. As you suggest, the Trump takeover and the sidelining of the adults in the Republican room was the critical trigger in normalising what was previously unthinkable. Fox News and social media then provided the feedback loop.

This is a classic example of how a system that appears to be stable over a long period can quickly turn unstable when the right triggers interact with pre-existing conditions. This happens a lot in the natural world but also in human societies, because peoples' attitudes are so influenced by the leaders of the group they identify with and by other members of the group. The internet and the siloisation of the media have turbocharged this process.

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Originally Posted by filghy2

Delta also encourages a sort of perverse logic that if nothing we do is fully effective then why try. Some people struggle to think in terms of counterfactuals.

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This is a common theme among right wing demagogues. One shmuck said "lambda variant is easier than saying vaccines don't work." The thing is vaccines have "worked" for every variant so far, but slightly less effectively which makes sense. You may have already posted an article about the effectiveness against delta, but one reason breakthrough transmission is taking place is because antibodies neutralize it less efficiently so waning levels matter more. The protection against hospitalization and death erodes more slowly and is probably more resistant to variants.

I'm rather tired of this argument that if something doesn't completely eliminate a problem it is ineffective. If the unvaccinated are still more than 10 times more likely to die that SHOULD make the argument by itself.

Nobody is wearing masks indoors where I live (except me and a few others). It doesn't really make much sense. 6 months out pfizer may only be 50% effective against symptomatic disease, plenty of people aren't vaccinated, and the disease numbers are obviously climbing here. Also, it's so fucking easy to wear a mask while getting a starbucks. These people want to get back to normal but you don't get there by playing pretend.

I was all for scrapping the mask for vaccinated people before delta when numbers of cases were cratering. That's not been the case for months really. People are probably going to get boosters with the current shots but one scientist lamented the fact that the boosts aren't taking place with mrna vaccines adapted for delta.

Disagreement With WH Over Booster Shots Prompt Senior FDA Directors to Step Down

ttps://www.newsweek.com/disagreement...p-down-1624750


Covid-19 Booster-Shot Access May Be More Limited, CDC Committee Signals


https://www.barrons.com/articles/cov...ss-51630413273

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Originally Posted by broncofan

Nobody is wearing masks indoors where I live (except me and a few others). It doesn't really make much sense. 6 months out pfizer may only be 50% effective against symptomatic disease, plenty of people aren't vaccinated, and the disease numbers are obviously climbing here. Also, it's so fucking easy to wear a mask while getting a starbucks. These people want to get back to normal but you don't get there by playing pretend.

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It's probably mainly complacency, but there are arguments out there that say masks are ineffective. I haven't looked at it closely, but it sounds like another example of the "if it's only partially effective it's useless" fallacy. For something that is low cost the effectiveness threshold for it to be worth doing is not high. Even if masks reduce transmission by only 10-20 per cent that is still probably worthwhile in combination with other measures. The absurd implication of this argument is that if we had 10 measures that each reduced a problem by 10% we should not do any of them.

This argument also implies that the medical establishment has been engaged in some conspiracy to force people to wear masks for no apparent reason. It's a conspiracy without any clear motive.

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Originally Posted by filghy2

The absurd implication of this argument is that if we had 10 measures that each reduced a problem by 10% we should not do any of them.

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And yet even among those who aren't acting in bad faith it is difficult to get people to adopt multiple levels of protection against a risk. So I do think that in addition to people being disingenuous jackasses there is some baseline inability to understand risk.

I realize it's probably difficult to study mask effectiveness empirically but there are theoretical reasons why even a porous mask worn by one person could protect them. It's because the number of virions someone breathes in sets a probability they get infected (if infectious dose is the average "viral dose" needed for someone to get infected). The infectious dose may be so low in unvaccinated people that a mask that blocks 50% of the particles does not make a difference most of the time. But people who have been vaccinated have circulating antibodies that wane over time. The reason circulating antibodies are considered the most important proxy for protection from symptomatic disease is that the other parts of the immune system that are primed by a vaccine (memory b cells and t cells) tend to take at least a few days to mobilize and as such are considered more relevant to prevent severe disease.

There is also an unresolved issue of whether viral dose correlates with disease severity. It's been proven to be the case for many viruses. It's unknown whether it is for sars-cov-2 and animal models did not yield any obvious correlation but it's still possible.

Ultimately, the issue is that we have incomplete information and as you say we know mask wearing is a pretty low cost measure. The fact that it might work means it makes sense to adopt when cases are spiraling out of control.

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Originally Posted by blackchubby38

Disagreement With WH Over Booster Shots Prompt Senior FDA Directors to Step Down

ttps://www.newsweek.com/disagreement...p-down-1624750

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I haven't read the newsweek article yet but will later. If the world shared vaccines and they were mobilized in ways that were likely to end the pandemic or save the most lives it would be more efficient to give the shots to people who are not yet vaccinated.

The US has purchased and is keeping a large enough store of vaccines to be able to give two shots to every eligible American. We know there are at least about 40% of people who for one reason or another are not getting their shots. We could give the vaccines to countries that need them more, but we can't use them for people who don't want the vaccine.

The data from Israel shows that effectiveness of Pfizer against symptomatic disease wanes pretty significantly after 6 months (moderna does a bit better). The protection against severe disease and death lasts longer than that. But protection against symptomatic disease does have the potential to help control the pandemic and slow spread. For immunocompromised people the booster shot makes a lot of sense and if we are not going to give away our stockpiles the booster makes sense for everyone else.

The data coming in from Israel shows that the booster does restore efficacy pretty well, even when comparing people with three shots to people who have gotten two shots. I'd say these are my preferences: 1. give vaccines away; 2. give boosters ; 3. let them sit there in the hopes people decide to get vaccinated and risk expiration of the vaccines.

Here's a link to an article from the US Food And Drug Administration on why people should not use Ivermectin to treat or prevent COVID-19. https://www.fda.gov/consumers/consum...event-covid-19

Here is a link to the official (Phase One) report from the joint WHO/China team on the origins of SARS-CoV-2 including the 'lab leak' hypothesis.
Includes some interesting subtilties at the intersection of science and politics but overall the team performed admirably ,in my humble opinion.
https://www.nature.com/articles/d41586-021-02263-6

The New York Times reports that various officials of the GOP are protesting Biden's vaccine mandates, and Mike Wallace confronted the Governor of Nebraska-

"Interviewing Ricketts on Fox News Sunday, Wallace asked the governor why he was fighting the administration’s new COVID-19 rules, especially since Ricketts insisted that he’s been encouraging vaccines and believes they work in combatting the pandemic. The Nebraska governor, meanwhile, said he felt the government shouldn’t be mandating vaccinations.
“I've talked to a number of people,” Rickets declared. “They've told me, if they make me take the vaccine, I'm just going to be fired.”

Wallace retorted that Nebraska’s school system actually requires students to be vaccinated against a series of diseases, wondering aloud why Ricketts appeared to be fine with those requirements but not a mandate for the COVID-19 shots."
https://www.thedailybeast.com/chris-...ccine-mandates

Meanwhile in the UK, the Government, for now, has ditched the idea of creating 'Covid Passports' to show when entering various establishments....so I guess they will abolish driving licences too...? Oh, and in the US agan, Voter ID?

So are we getting a booster shot or not:

Tensions mount between CDC and Biden health team over boosters

http://www.politico.com/news/2021/09...oosters-511529

Departing FDA regulators pan Covid boosters in paper

https://www.politico.com/news/2021/0...h-paper-511638

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Originally Posted by blackchubby38

So are we getting a booster shot or not:

Tensions mount between CDC and Biden health team over boosters

http://www.politico.com/news/2021/09...oosters-511529

Departing FDA regulators pan Covid boosters in paper

https://www.politico.com/news/2021/0...h-paper-511638

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Agree. And not surprised at all that there's tension mounting between the CDC and President Biden's Health Team over booster shots,and the infighting between them sure isn't helping with getting important information to the american people .

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Originally Posted by Stavros

“I've talked to a number of people,” Rickets declared. “They've told me, if they make me take the vaccine, I'm just going to be fired.”

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I'm sure some of these claims are fake bravado, but you have to wonder about the mentality of someone who not only refuses to get a potentially life-saving vaccine, but is also prepared to lose their job over it. When it came to restrictions they weren't prepared to sacrifice any income to reduce the risks of Covid. When it comes to vaccines they are actually prepared to sacrifice income to increase the risks of Covid and/or to avoid some grossly inflated risks from vaccination.

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Originally Posted by blackchubby38

So are we getting a booster shot or not:

Tensions mount between CDC and Biden health team over boosters

http://www.politico.com/news/2021/09...oosters-511529

Departing FDA regulators pan Covid boosters in paper

https://www.politico.com/news/2021/0...h-paper-511638

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I thnk the CDC is still reeling from the assaults of the ignorant, savage and seditious Trump Presidency, but to me a lot of the problems here are mostly political, rather than science-based, and that is true for most countries not just the US. In the 1990s I used the CDC's database a lot and it remains a major source of information, so it is tragic to see how bad politics has disrupted what ought to be one of the most reliable US institutions of learning and research.

The question of boosters is a diffcult one -Boris Johnson is to confirm that Boosters will be available to over-50s from December, just as the existing Covid vaccines are to be made available for 12-15 year olds -the December date reflects the anxiety in the UK Government that the coming winter months will see an increase in infections. Also, your second link doesn't, to me, suggest there is a medical/scientific problem with boosters, thus-

""Even in populations with fairly high vaccination rates the unvaccinated are still the major drivers of transmission and are themselves at the highest risk of serious disease," wrote the authors, which also include World Health Organization scientists.

Even if booster shots were shown to lower the risk of serious disease, they said, existing supplies would be better off deployed to unvaccinated corners of the world, rather than boosting vaccinated populations, to head off the development of more variants."

That said, Boris Johnson has no grip on policy -we were going to have Vaccine Passports, now they have been 'delayed', his plan to reform social care turns out to be anything but, linking social care to NHS funding and limiting the overhaul at a time when the 'Winter is Coming' fear seems to be as ominous as it was in Game of Thrones.

If I am offered a boost I will take it, though I would prefer to see existing vaccines and resources extended to those who don't have it, with surplus supplies given free to countries that need it. I don't know what to do about the militants who reject basic, elementary science -to me this is not based on any knowledge of medical science but a fetish for the politics that rejects Government as if it were a sinister organiation determined to take over people's lives, which right now is as likely to be found in Texas as Afghanistan, contradicting the fears expressed by loopy fanatics ike Lin Wood. As for vaccine passports, people need a licence to drive a car, is that an infringement of their liberty?

All round, sober reflection on what is needed, but as noted so many times in the last 18 months, co-ordinated leadership and organization of the kind that seems to be lacking.

Right now it is not the politicians to admire, but the continuing dedication and hard work of health care workers dealing with the reality on the ground 24/7, without whom some of us would not be here.

Here's some more info on the Israeli data that is behind the push for booster shots. https://www.politico.com/news/2021/0...fficacy-511777

I think the media often overplay these stories about disagreement in official circles. A certain amount of disagreement is a normal, healthy part of the process of moving knowledge forward. There has to be a balance between this and avoiding unnecessary confusion, but too much enforced consensus can be counterproductive because it feeds a perception that alternative views are being suppressed. We should actually be more worried if officials never disagree, because that is a sign of group-think which leads to poor decisions.

FDA scientists skeptical of COVID-19 booster evidence ahead of key meeting

hehill.com/policy/healthcare/572436-fda-scientists-skeptical-of-covid-booster-evidence-ahead-of-key-meeting

Is disagreement and positive discourse in official circles good for a democratic government, Yes. But there is also the issue of who should have the final say in approving a drug and when it shall be administered. From the article I just posted:

"The FDA's independent panel of experts on Friday will review the evidence from Pfizer and will likely vote on whether there's enough evidence to show boosters are necessary.

The FDA does not have to follow the agency's advice, but if the agency breaks with the panel's recommendation it would likely stoke public confusion and raise major questions about political interference."

Then there is this:

"In an unusual move last month, President Biden and top health officials publicly announced a booster shot program would begin the week of Sept. 20, well before the FDA and CDC examined the evidence.

While officials have been careful to say the booster program is contingent on the FDA and CDC giving the green light, they have been criticized by some public health experts for speaking as if the approval was a given."

Its up to the CDC to devise public health guidelines, the FDA to approve the necessary treatments to to combat the disease, and the government to take everything into consideration and then implement those guidelines and treatments in order to fight the pandemic.

But with the booster shots, it seems like the Biden administration jumped the gun on the plan and now its up to the FDA and the CDC to try to make it work. Even if the evidence doesn't wind up supporting it.

Another thing, why are we just getting Pfizer's evidence tomorrow and not Moderna's as well.

Moderna releases new data on Covid breakthrough cases it says supports need for booster shots

http://www.cnbc.com/2021/09/15/covid...ird-doses.html

"The group, called the agency’s Vaccines and Related Biological Products Advisory Committee, is scheduled to debate administering third doses of Pfizer and BioNTech’s vaccine as federal health regulators say they need more time to review Moderna’s application for extra doses."

So if the third booster shot for Pfizer is approved, those who got the Moderna one have to wait to get their booster shot. Even if there is a good chance that their efficacy is waning. Because from what I understand, you can't mix vaccines.

I think Pfizer had better data simply because Israel only used Pfizer and had kept pretty careful records of its effects over time. I'm sure Moderna is tracking the use of its drug as well but the Israeli data was the first to indicate a need for boosters.

We'll see what the FDA and CDC say. Immunocompromised people, such as organ transplant recipients and people on immunosuppressant drugs have already been given access to boosters. I've seen some data indicating a benefit for older people, not just from symptoms but also serious disease. If our stockpiles are just sitting there and more people will not get the vaccine, even a benefit against mild disease can help slow the spread and provide benefits to us.

Even effective boosters will never provide the value that using the shots for unvaccinated people has. The question is how much benefit, for whom, and whether we can as an alternative convince new people to get shots or give them away.

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Originally Posted by blackchubby38

Because from what I understand, you can't mix vaccines.

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This is trickier. It's likely you can mix vaccines and get good benefits but unless there are studies showing that nobody will recommend an unregulated use. People who got the Johnson and Johnson shot were encouraged to get boosters with an mrna vaccine after delta appeared. On the other hand, going from an mrna vaccine to az or Johnson & Johnson is seen as less effective. But there is likely a lot of compatibility between Moderna and Pfizer and probably an effective boost but data awaits.

A good example of the hesitancy is that many countries were reluctant to recommend scheduling the second shot 8 weeks after the first shot so that there would be more coverage before people finished their two shot regimen. It turns out waiting longer between shots probably causes a better response to the second shot but because they were tested in 3 or 4 week intervals many scientists advised against it. I'll see if I can find anything on the mix and match boosting.

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Originally Posted by blackchubby38

Because from what I understand, you can't mix vaccines.

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Sorry. If what you meant is that regulators probably won't let people, you might be right. I was vaccinated with pfizer and if I had the option for a third shot with moderna when it's indicated to be effective I would probably prefer that to waiting. But maybe regulators won't allow it.

I received my 3rd Pfizer vaccination last week because I was directed to do so by my physician . I was instructed to get the same brand as my first 2 injections and they stamped my Vaccination card with the date of the 3rd shot.

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Originally Posted by blackchubby38

The FDA does not have to follow the agency's advice, but if the agency breaks with the panel's recommendation it would likely stoke public confusion and raise major questions about political interference."

Its up to the CDC to devise public health guidelines, the FDA to approve the necessary treatments to to combat the disease, and the government to take everything into consideration and then implement those guidelines and treatments in order to fight the pandemic.

But with the booster shots, it seems like the Biden administration jumped the gun on the plan and now its up to the FDA and the CDC to try to make it work. Even if the evidence doesn't wind up supporting it.

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Your concern suggests the relationship between science and politics is not as secure as it could be owing to the view I think politicians have that results are not just medical, but political. We have a similar disconnect in the UK where the Johnson Govt is keen to 'move on' from Covid through a sweeping relaxation of rules, travel arrangements, and so on, even as the scentific advisors it has have recommend caution. Johnson's impatience is part of his character, famously uninterested in detail, he chases headlines with more zeal than a corrupt lawyer chasing ambulances.

Is Biden an old man in a hurry? Is there an impatience to his policy-making that is creating risks for the US as well as its people? I am quite relaxed about the Boosters, and am not too concerned about mixing vaccines either, but in a febrile atmosphere, notably in the US where anti-vaccination ignorance and hysteria is in some places destroying lives, I think the President needs to show more balance, or he risks leaving people behind, or confused, and that is not good for the desired outcome.

I suspect that if the States that adore Trump had not decided they no longer respect the Presidency, Congress, the Constitution, the Rule of Law, and elementary indeed, advanced science produced by the USA's once proud institutions, you would not be so anxious. Trump now claims that, in effect, if he is not re-elected President in 2024, it will mean the end of the USA, even as he did more than most to hasten that demise, on the basis that L'état, c'est moi, as anti-scentific as you can get, and lethal to democracy.

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Originally Posted by broncofan

Sorry. If what you meant is that regulators probably won't let people, you might be right. I was vaccinated with pfizer and if I had the option for a third shot with moderna when it's indicated to be effective I would probably prefer that to waiting. But maybe regulators won't allow it.

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I was under the impression that the scientists/doctors weren't going to let people mix with vaccines. But if we are allowed to, like you I want my third shot to be with Moderna.

The FDA panel has decided to recommend booster shots at this stage only for 65+ and other high risk groups. https://www.yahoo.com/entertainment/...203847937.html

It sounds like expert opinion is somewhat divided on the case for booster shots, and maybe also on the mixing of vaccines. That is not surprising because it involves weighing the risks of giving approval when there may be incomplete information against the potential benefits in combating the pandemic. Even with the same clinical information, different experts might come to different judgements on that balance. "Following the science" doesn't always give a clear-cut answer.

I understand that it is generally desirable for the regulators to be able to make decisions without political pressure, although a degree of pressure is unavoidable because of the consequences. The FDA were under a lot of political pressure to give early approval to vaccines last year. Maybe that was undesirable, but if there had been no pressure would they have been as willing to give emergency approval as early as they did?

My sense is that regulators are generally inclined to err on the side of caution because the consequences are asymmetric. If they approve and there are problems they get the blame, but if they don't approve then nobody sees the counterfactual. Sometimes this can cause problems.

For example, the advisory panel in Australia contributed to vaccine hesitancy earlier this year through their advice on AstraZeneca, which was then the only widely available vaccine here. The problem was that their advice seemed to focus too narrowly on the very low risk of blood clots from AZ, and not enough on the broader risks of Covid. As a result, we've struggled to deal with the Delta outbreak over the past 2-3 months because the initial vaccination rate was low.

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Originally Posted by filghy2

That is not surprising because it involves weighing the risks of giving approval when there may be incomplete information against the potential benefits in combating the pandemic. Even with the same clinical information, different experts might come to different judgements on that balance. "Following the science" doesn't always give a clear-cut answer.

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Doctors in clinical practice frequently prescribe drugs off-label based on their judgment as to risks and benefits and can use the existing evidence as a guidepost without rigid mandates. In a pandemic it's understandable that regulators want to be more careful about decision-making without a strong evidence base. A bunch of scientists saying they don't think there should be a problem boosting with a different vaccine is not as compelling as a study showing it. Scientists saying using half the dose of moderna might be almost as effective and save vaccine isn't as good as data. I can see why caution is taken when an error can cause systematic harm and loss of confidence in vaccines.

There's also the fact that the booster decision isn't a "pure" medical decision. It's one dealing with the scarcity of supply and best allocation given that constraint. There's also the different goals that we have for vaccine use. One being to stem transmission and another to prevent hospitalization and death. Both are valid of course but it's a complex issue. I doubt we're going to be transparent about the fact that our regulators are probably thinking in completely nationalistic terms and the only opportunity cost is vaccinating unvaccinated Americans.

To be clear, I'm not saying that the recommendation is wrong; it may well be the right balance of different considerations at this time. I was getting at the more general issues around what "following the science" means and how much authority a democracy should cede to unelected experts. Like all three-word slogans, it raises as many issues as it resolves.

I've been thinking about this lately because Australian governments have ceded more authority to medical officials in this pandemic than almost any other country, and consequently we've had about the most restrictive regime of any democracy. This worked fairly well until recently, because we were able to eliminate community transmission so that most of the country had only limited periods of lockdown.

It's not working so well with the delta variant, with much of the country now in seemingly never-ending lockdowns that have limited the rise in cases but haven't been able to suppress the virus. The current plan is that restrictions will be eased once they reach the 70% vaccination target, which is expected around the end of October. However, some outside experts claim that even this is too risky, and restrictions may be reimposed if cases start to rise too rapidly. State governments are also taking different approaches, so interstate travel restrictions are likely to continue for longer.

This raises issues about democratic legitimacy and whether officials are making decisions that extend beyond their area of expertise. Medical advisors are experts is assessing the risks associated with the virus under different scenarios. It's not clear that this makes them experts in balancing these risks against the negative impacts of lockdowns and other restrictions. That is the de facto situation when governments say they must defer to medical advice.

It is true that this delegation of authority is being made by elected governments who can be defeated at the next election if voters are unhappy with the outcomes. However, the longer that extraordinary emergency powers are extended the more we seem take on some of the attributes of technocratic dictatorship.

I understand all of your points and agree with them. Follow the science is a useless slogan when public policy decisions don't just depend on descriptions of what is but also what people value and want. Sometimes in regulation the description of what is leads very clearly to a response which is probably the only place where following the science is straight-forward. But at least part of the decisions elected officials make with respect to policy involve social sciences and are always normative anyway.

I also understand both the problems with legitimacy when it comes to experts who were not elected and people's unreasonable expectation that the policy preferences of experts are deferred to in all cases. This is particularly the case when there's so much pressure for them to be lock-step with scientists that they are accused of denying reality if they choose an alternative.

Just to offer an off-hand opinion I don't think lockdowns make a lot of sense at this point simply because we know it's very unlikely delta is going to disappear unless the world gets a lucky break (a less deadly variant people get more durable immunity to). Maybe they would make sense if hospitals were overrun. Wearing masks and getting vaccinated is probably going to be the way forward until things change, as they have many times.

Damn those pesky experts...! If the people no longer trust science because they choose to believe Climate Change science is at least not proven, or total rubbish; if people no longer trust the Generals who say the invasion of Iraq is 'doable' (Dick Cheney's word) but don't plan for the aftermath, and get their 'invasion lite' wrong anyway; and if people no longer trust the bankers who lend and borrow more than they earn, why trust the scientists when it comes to Covid-19?

I think, in general terms, the logic of face masks and vaccinations as antidotes to Covid-19 is irresistible, and that only cranks and those with an extreme anti-Government agenda oppose the science. But as frustration grows at the length of time it is taking to 'get back to normal' then even rational people begin to query the extent which science is shaping policy.

I am a bit of a Priest on this, and take the faith as well as the medicine, but I cannot officiate on other people's behalf, and can only plea for more time and obedience. Or the hallowed ground of normal life will take even longer to return, though I am confident it will happen before the return of Jesus, and no, that's not the Mexican taxi-driver who never showed up to return me to my LA hotel all those years ago.

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Originally Posted by broncofan

Just to offer an off-hand opinion I don't think lockdowns make a lot of sense at this point simply because we know it's very unlikely delta is going to disappear unless the world gets a lucky break (a less deadly variant people get more durable immunity to). Maybe they would make sense if hospitals were overrun. Wearing masks and getting vaccinated is probably going to be the way forward until things change, as they have many times.

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The best argument for lockdowns (combined with border controls) is that going early and hard could allow the virus to be eliminated until vaccines became widely disseminated. This way you could limit the death toll while also limiting the economic disruption over time. Australia was able to achieve this previously, but it's much harder with the more infectious delta strain, which must change the benefit-cost calculus. Compliance with restrictions also declines when people can't see an end in sight.

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Originally Posted by Stavros

But as frustration grows at the length of time it is taking to 'get back to normal' then even rational people begin to query the extent which science is shaping policy.

I am a bit of a Priest on this, and take the faith as well as the medicine, but I cannot officiate on other people's behalf, and can only plea for more time and obedience.

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The issue is that the right approach is not just a question of science, but also involves consideration of economics, ethics and human psychology. Medical scientists will always focus on the question of how to limit the health impacts below a certain level, because that is what they are trained to do. But we also have to consider what must be sacrificed to achieve this outcome, as well as peoples' willingness to accept restrictions, given their effectiveness depends on a high degree of voluntary compliance.

I would make a distinction between policy decisions being informed by scientific advice and policy decisions being based purely on scientific advice. It is not anti-science to say that scientific advice sometimes needs to be balanced against other considerations. The right balance between freedom and risk is ultimately a social/political question rather than a technocratic question.

Now the question becomes do I go ahead and just get the 3rd Pfizer shot or wait for the CDC and the FDA to make up its mind about mix and matching:


CDC 'starting to see mix-and-match data' for COVID-19 vaccines: Director

finance.yahoo.com/news/cdc-starting-to-see-mix-and-match-data-for-covid-19-vaccines-director-131034795.html

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Originally Posted by blackchubby38

Now the question becomes do I go ahead and just get the 3rd Pfizer shot or wait for the CDC and the FDA to make up its mind about mix and matching:


CDC 'starting to see mix-and-match data' for COVID-19 vaccines: Director

finance.yahoo.com/news/cdc-starting-to-see-mix-and-match-data-for-covid-19-vaccines-director-131034795.html

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Yes , get your Pfizer booster, I did.
Or , for the hands down best antibody response, catch Covid ,get your Moderna or Pfizer #1 and #2 ,than throw in a mixed booster. Oh ,and don't forget your flu shot!

Sukumvit I am sure will be interested in this since he spoke of new antivirals at the beginning of the pandemic.

Merck developed a new antiviral drug called molnupiravir and the phase iii trials show significant reduction in hospitalization and death. In fact, the results of the study were so strong that the study was stopped on recommendations of regulators. I assume this means there were enough signs of efficacy that it would be considered unethical to continue giving the control group placebo.

The article also said that the pill is likely to work against new and old covid variants with similar effectiveness.

https://www.reuters.com/business/hea...dy-2021-10-01/