COVID-19: Chapter 9 - OMGicron

Is it really true that the amplitude of the wave is particularly important in highly vaccinated communities? The delta wave tore through some vaccinated communities with lots of infections but death and serious illnesses weren’t nearly as high as in previous waves. Obviously the amplitude of the wave is more important in communities that don’t mask and vaccinate at high rates, which is an unfortunate irony. But they’re doing that to themselves.

This sounds not great:

According to Cornell’s COVID dashboard, positive tests rose 5x from Dec. 6 to Dec. 8, then another 4x from Dec. 8 to Dec. 11.

But that seems more extreme than the graph does:

I think so. For a variety of reasons. Not overwhelming the healthcare system, protecting the vulnerable, minimizing mutations, people travel from highly vaccinated communities to less vaccinated places etc.

That’s fair, you’re actually talking about reasonable policy proposals. Testing, ventilation, effective and targeted masking. How effective is the government at moving these constructive policy proposals forward? Not very, and they’re actively harming the testing piece of it by limiting over the counter tests to two different brands. In Europe apparently OTC tests are ten times cheaper and widely available.

I don’t think there is really any good data on how long vaccine plus infection will provide good protection. I don’t even think there’s particularly good evidence on how long the vaccines alone, unboosted by another dose or an infection, will provide good enough protection against death or serious illness. So I think that my risk is quite low from covid now. The risk of a booster is low as well obviously, but I’m just being conservative as I think that there’s a pretty good chance that once this becomes endemic we won’t really need any booster injections at all, we’ll just get boosted every few years by an infection.

Why would not get a booster, go get boosterized, y’all.

I think I explained why, but again: my risk of death or serious illness from covid is probably quite low.

My odds of crashing my car on the drive to work are low but I still wear a seatbelt.

  1. That’s not the only thing that vaccines protect you from
  2. The cost of getting boosted is exceedingly low
  3. Risks on the order of 1/10000 are still worth a little trouble to further reduce by another order of magnitude or more.

That analogy only works if there was a baseline chance of death or serious injury from wearing a seat belt while not being in a car crash. There’s risk in getting the booster as well, it’s low but not zero. Inaction in the face of two difficult to quantify but very low risks seems reasonable.

If you’re suggesting the odds of dying from the vaccine are greater than the odds of dying from COVID, it’s pretty easy to see that’s wrong, but I’m pretty sure you’re either rationalizing or keeding.

This is why I have a problem with attributing this failure to “liberal elites”. Using the concept “liberal elites” in the first place implicitly assigns to these underdefined actors some kind of influence or power. Who cares what “liberal elites” yell about in their individual personal lives? The “liberal elites”, when exercising (or not exercising) their actual power are in reality bending over backward to avoid any direct forceful confrontation with antivaxxers. I have heard plenty futile appeals from “liberal elites” begging antivaxxers to do the right thing and be responsible and get vaccinated for the greater good. With predictable outcomes. It’s just all silly conservative framing to think that “liberal elites yelling at antivaxxers” is a big part of the problem here. Being nice to the antivaxxers is a problem, accepting a world with mandatory drivers licenses but not mandatory vaccination for made up reasons is a problem, the solution is to, yes, tell the antivaxxers to sit down and shut the fuck up and get your vaccination if you want to participate in daily life outside your home and on our streets. Political cowardice is bad enough, political cowardice combined with slurping up conservative lies that all their bad behavior is our fault for being mean to them is even worse.

Yelling at anti-vaxxers doesn’t accomplish much, but it’s fun.

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It probably is low. That said, Id argue that the studies on antibody levels/waning, potential reinfection severity/long-COVID, and the unknown of Omicrom argue for boosting even if there are unknowns about exact risk levels. Still care more about the unvaxxed vaxxing than boosters, but think both help the community and are beneficial for the individual. Hope you give the studies another look.

Agreed both the FDA and Biden administration have been bad on testing, in part for the reasons mentioned.

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I’m saying that there’s no way anyone knows if the risk of someone in my exact situation dying from the vaccine booster is greater than dying from covid. There’s no studies at all from what I’ve seen that address the risk that breakthrough infections have from covid. But it seems quite probable that a breakthrough infection will act as a booster of sorts and might provide good protection for quite a while. There’s no way that anyone can compare my miniscule risk of death or hospitalization with the miniscule risk of getting a booster and say which is greater. It’s all totally unknowable at this point.

I’m basically assuming that my infection will effectively be a booster so if (ok, when) they start talking about fourth shots I’ll probably talk to my doctor about if I should get one. Added benefit there is they might have designed a booster against the latest strain.

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We’ve gone from ‘he’s right about people not caring about the pandemic’ to ‘there’s no way anyone knows if the risk of someone in my exact situation dying from the vaccine booster is greater than dying from covid.’

Well sure then.

Ive seen infections as boosters theorized (although less so with Omicron), and have seen work suggesting that infections can make you more vulnerable to severe outcomes in future infections. Still TBD. Safety data from boosters seems super good though.

You’re trying to have it both ways here. Is exposure to COVID inevitable or not?

Here you say mitigation doesn’t matter because you can’t stop waves of infection going through the country. This is a reasonable point of view, but it’s incompatible with the argument you’re making about getting boosted. If you’re a virtual certainty to be exposed to COVID, you should want to be boosted as it’s very clear that the risks of getting a booster are tiny compared to the amount by which it protects you in the event of an infection. OTOH, if your reply to this is “well what if I don’t get COVID”, then you’re saying not getting COVID at least for a period of years is a reasonable possibility, which is incompatible with this “oh well we’re all going to get it” fatalism in the quote above.

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Exposure to covid is inevitable, yes. I don’t see the contradiction. I’m not getting the booster because I think that someone in my exact situation (vaccinated with breakthrough infection four months ago) has a miniscule covid risk and that getting a booster probably doesn’t lower that risk all that much and has nonzero risks itself. I’m not anti booster and not saying that others shouldn’t get a booster.

Of course I’m not saying that boosters don’t work. I’m saying that it seems reasonable to assume that a breakthrough infection will have a similar effect to a booster.