Category: Medicine
The mental health benefits of vaccines
We estimate that COVID-19 vaccination reduces anxiety and depression symptoms by nearly 30%. Nearly all the benefits are private benefits, and we find little evidence of spillover effects, that is, increases in community vaccination rates are not associated with improved anxiety or depression symptoms among the unvaccinated. We find that COVID-19 vaccination is associated with larger reductions in anxiety or depression symptoms among individuals with lower education levels, who rent their housing, who are not able to telework, and who have children in their household. The economic benefit of reductions in anxiety and depression are approximately $350 billion. Our results highlight an important, but understudied, secondary benefit of COVID-19 vaccinations.
Here is the NBER working paper by Virat Agrawal, Jonathan H. Cantor, Jeeraj Sood, and Christopher M. Whaley.
NBA fact of the day
As the omicron variant rips through NBA players and coaches, it has reached a season-high among game officials: 36% of the league’s referees are in COVID-19 protocols, sources told ESPN on Thursday.
Here is the full ESPN story. Unlike most Americans, NBA refs are tested on a regular basis.
Some simple game theory of Omicron
Let’s say that everyone is totally reckless, and they go to Christmas Eve “Omicron parties.” A week or two from now the virus has cleared their systems and I, who stay at home and blog, can then go out and frolic. Even if they stay sick, or if they die, they are removed as sources of potential infections for others (see below for new variants, possibly from the immunocompromised).
If I know that is happening, I find it easy to stay at home for a week. I look forward to my pending freedom. In other words, right now my behavior becomes safer. I engage in intertemporal substitution.
Alternately, let’s say that quite a few people decide to behave more safely. They stay at home and avoid the Omicron parties, and furthermore they go about with a mask in Whole Foods and don’t go to bars at all. The Omicron pandemic, instead of being over in two weeks, can run on for months, depending on the exact numbers of course. There is a ready stock of “not yet infected with Omicron” potential victims to keep the virus circulating. And that means ongoing risk for me.
Returning to my decision calculus, I can wait a week but I cannot stay at home for a month or two. So I know I am going to go out, and I expect I am going to get Omicron. So I might as well go out now. My behavior becomes riskier.
Get the picture? If one set of people behave more safely, another set takes more risks. And vice versa.
This is one reason why moral exhortation, or for that matter policy interventions, may be less than effective in our current moment.
It is also a reason why telling people “don’t worry about it!” doesn’t fully translate at the collective level either.
Of course you can modify these scenarios with reinfection risk, new variants, and other factors.
The real conspiracy theory
Read it here. No, this was not a conspiracy in the strictest, most intentional sense (it didn’t need to be!), but it did kill thousands of people and manipulate our politics…
C’mon, people, let’s not be afraid to admit this one.
ProPublica on the FDA and Rapid Tests
Lydia DePillis has written the best piece on the FDA that I have ever read in a mainstream news publication. It gets everything right and yes it frankly verifies everything that I have been saying about the FDA and rapid tests for the last year and a half. I wish it had been written earlier but I suppose that illustrates how difficult it is to radically change people’s mindset from the FDA as protector to the FDA as threat. The sub head is:
Irene Bosch developed a quick, inexpensive COVID-19 test in early 2020. The Harvard-trained scientist already had a factory set up. But she was stymied by an FDA process experts say made no sense.
The piece recounts how cheap, rapid tests could have been approved in March of 2020! Here’s the opening bit:
When COVID-19 started sweeping across America in the spring of 2020, Irene Bosch knew she was in a unique position to help.
The Harvard-trained scientist had just developed quick, inexpensive tests for several tropical diseases, and her method could be adapted for the novel coronavirus. So Bosch and the company she had co-founded two years earlier seemed well-suited to address an enormous testing shortage.
E25Bio — named after the massive red brick building at MIT that houses the lab where Bosch worked — already had support from the National Institutes of Health, along with a consortium of investors led by MIT.
Within a few weeks, Bosch and her colleagues had a test that would detect coronavirus in 15 minutes and produce a red line on a little chemical strip. The factory where they were planning to make tests for dengue fever could quickly retool to produce at least 100,000 COVID-19 tests per week, she said, priced at less than $10 apiece, or cheaper at a higher scale.
“We are excited about what E25Bio is capable of shipping in a short amount of time: a test that is significantly cheaper, more affordable, and available at-home,” said firm founder Vinod Khosla. (Disclosure: Khosla’s daughter Anu Khosla is on ProPublica’s board.)
On March 21 — when the U.S. had recorded only a few hundred COVID-19 deaths — Bosch submitted the test for emergency authorization, a process the Food and Drug Administration uses to expedite tests and treatments.
You know how the story ends but really READ the WHOLE THING.
The Slow Rollout of Rapid Tests
I thought the Biden administration would at least make original pandemic errors. But no, its been making all the same errors. Slow on vaccines, slow on rapid testing and slow on new drugs, and far too little investment. Still after a year and half of shouting it from the rooftops we are getting some rapid tests. Josh Gans has an interesting reminder focusing on Canada that this has been an example of expert failure not just US failure.
Rapid test advocates such as myself have suddenly moved from fringe crazies who were told they didn’t understand the science to we need them and we need them now.
Several cases in point:
- The CDC now says that unvaccinated students exposed to Covid can “test to stay.” That is, rather than sending all the students in a class (or a school!) home when one tests positive for Covid, they test the students instead and so long as they are negative, they stay.
- The US Government is going to order 500 million rapid tests and distribute them free to the public … by mail!
It is hard to appreciate what a sea change this is in terms of attitude. A year ago, when we tried to roll out rapid tests — that had already been purchased and were sitting in their millions in warehouses in Canada — to Canadian workplaces, we were told that those tests had to be administered by health care professionals in PPE in secure and sanitised environments with all manner of precautions taken that really took the “rapid” out of rapid testing let alone exploding the costs to businesses who wanted to keep their workers safe. This was because they required those long-swabs etc. Eventually, short swabs were permitted. Then self-swabbing supervised in the workplace. Then swabbing at home while on a virtual call with a professional for that supervision with the swabs being picked up and then taken for safe disposal. Finally, we got to self-administered, at-home screening without supervision and you could pop your negative swan in the bin. A year after we had been told that you needed a full-court medical professional press to do this, our kids in Ontario were sent home with 5 rapid tests to use over the holidays. Only a couple of weeks ago, the Ontario government’s advisory board, the Ontario Science Table, finally endorsed the use of rapid tests in this way.
Freddie on worry porn
Bogost’s piece is an absolute classic, maybe the classic, in a particularly strange form of worry porn that progressives have become addicted to in the past half-decade. It’s this thing where they insist that they don’t want something to happen, but they describe it so lustily, imagine it so vividly, fixate on it so relentlessly, that it’s abundantly clear that a deep part of them wants it to happen. This was a constant experience in the Trump era – liberals would imagine that Trump was about to dissolve Congress and declare himself emperor, they’d ostensibly be opposed to such a thing, but they were so immensely invested in the seriousness and accuracy of such predictions that they’d clearly prefer for it to happen. I wrote about Chris Hayes and his bitter yearning for Trump last week, and he’s a good example, someone who ruminates on Trump and the dystopian future he might bring about with such palpable emotional pathology that it’s clear that, on some level, he needs it to happen, so that he can say “I was right.” And so with Bogost here; that level of anxious catastrophizing always carries with it the quiet, throbbing need for the bad dream to come true. Covid is already bad, very bad. I am always so confused that so many people seem desperately to want it to be worse.
Here is the full essay.
Zvi’s Omicron post #7
But the main uncertainty that I’m now wondering about, that feels central, is how we will react.
What will happen when the rice grains on the chessboard suddenly get fully out of hand, stuff hits the fan and the hospitals overflow? Not if. When. How will governments react? How will the people react?
Do read the whole thing, recommended.
Earlier data on Texas abortion restrictions
Between 2011 and 2014, Texas enacted three pieces of legislation that significantly reduced funding for family planning services and increased restrictions on abortion clinic operations. Together this legislation creates cross-county variation in access to abortion and family planning services, which we leverage to understand the impact of family planning and abortion clinic access on abortions, births, and contraceptive purchases. In response to these policies, abortions to Texas residents fell 20.5%and births rose 2.6% in counties that no longer had an abortion provider within 50 miles. Changes in the family planning market induced a 1.5% increase in births for counties that no longer had a publicly funded family planning clinic within 25 miles. Meanwhile, responses of retail purchases of condoms and emergency contraceptives to both abortion and family planning service changes were minimal.
That is an NBER paper from 2017 by Stefanie Fischer and Corey White.
Will this Australian polity prove sustainable?
And what would Lysander Spooner say?:
South Australian Premier Steven Marshall said the two-week rule for vaccinated close contacts was under constant review.
And:
When Shaun Ferguson was browsing the plants at a local nursery last Tuesday afternoon, he never thought it would land him in two weeks quarantine in a medi-hotel.
That night he received the text message that no one wants to receive.
“At about 11.30 that night I got a text message from SA Health saying that I’d been to a potential exposure site for the Omicron strain,” Mr Ferguson said…
There were three other people on the bus with him, including a woman who had also visited the pet and plant shop in Glengowrie.
“She said, ‘I never go anywhere, I’m fully vaccinated … I just decided I’d go there and get this cat brush and now look what happens. I’m in quarantine,'” Mr Ferguson said.
There is much more to the story, and for the pointer I thank A.
How Many Lives has Vaccination Saved?
The U.S. vaccination program campaign has profoundly altered the trajectory of the COVID-19 pandemic, preventing nearly 1.1 million deaths. Even with only about 60 percent of Americans vaccinated to date, the nation has dodged a massive wave of COVID-19 deaths that would have started as the Delta variant took hold in August 2021. Because of Delta’s rapid and nationwide spread, deaths due to COVID-19 would have far exceeded all previous peaks.
Our estimates suggest that in 2021 alone, the vaccination program prevented a potentially catastrophic flood of patients requiring hospitalization. It is difficult to imagine how hospitals would have coped had they been faced with 10 million people sick enough to require admission. The U.S. has 919,000 licensed hospital beds and typically accommodates about 36 million hospitalizations each year.3 Even the 2.6 million COVID-related hospitalizations that occurred during 2021 placed an enormous strain on hospitals, with many staff lost not only to the virus but also to exhaustion and burnout. Faced with such unprecedented demand, U.S. hospitals operating under crisis standards of care would likely have had no choice but to turn away tens of thousands or even hundreds of thousands of individuals.
The methodology is somewhat unclear so take this with a grain of salt–many future studies will look at this question–but one million lives saved is not outside the realm of the possible. One million lives saved at a $7 million value of statistical life is a 7 trillion dollar savings. Keep this number in mind when evaluating pandemic investment.
Photo Credit: Lindsay Bonanno
Who is protected against Omicron?
The vaccine made by Sinovac Biotech Ltd., one of the most widely used in the world, doesn’t provide sufficient antibodies in two doses to neutralize the omicron variant and boosters will likely be needed to improve protection, initial lab findings showed.
While the first two studies to be released on the Chinese shot and omicron diverged on how much the vaccine’s immune response is degraded, they both indicated the standard two-dose course would not be enough, raising uncertainty over a shot relied on by millions of people in China and the developing world to protect against Covid-19.
Among a group of 25 people vaccinated with two Coronavac doses, none showed sufficient antibodies in their blood serum to neutralize the omicron variant, said a statement from a team of researchers at the University of Hong Kong released late Tuesday night.
Here is more from Bloomberg.
Will China ever get Pfizer?
As Covid-19 started spreading in Wuhan early last year, Chinese billionaire Guo Guangchang’s drugmaker appeared to have scored a big win: A partnership with Germany’s BioNTech SE, which went on to produce with Pfizer Inc. one of the world’s most successful vaccines against the coronavirus.
Yet almost a year later, the shot is yet to be approved in mainland China, and in recent weeks Beijing has thrown its heft behind a homegrown mRNA vaccine, allowing China’s Walvax Biotechnology Co. to test its own experimental shot as a booster. The developments are raising new questions about whether the U.S.-German vaccine, licensed for the potentially lucrative Greater China region by Guo’s Shanghai Fosun Pharmaceutical Group Co., will ever be used on the mainland, where President Xi Jinping’s administration has backed a nationalist agenda on all fronts, including in the fight against the virus.
Here is more from Bloomberg. And will China ever get Omicron? Yes. Pfizer, maybe not.
Omicron in China
China’s efforts to keep the new coronavirus strain out of its borders have failed, with the country reporting its first case of the Omicron variant in the coastal city of Tianjin on Monday (Dec. 13).
The timing and location of the new case are not ideal for China’s leadership. Tianjin is right next door to Beijing, which is due to hold the Winter Olympics in a matter of weeks.
The news coincides with an expanding cluster of cases of the Delta variant in another coastal province, Zhejiang. The outbreak has seen at least a dozen publicly traded companies immediately suspend production in the province, according to a Guardian report.
Here is the full story. Casualties issues aside (which remain unclear), this development may also be of considerable import to the political economy of China, a country that has promised near-zero Covid to its citizens, and derived legitimacy from its degree of success so far. Yet China has low levels of natural immunity, and the effectiveness of its vaccine investments to date remains uncertain against Omicron, or for that matter against Delta. And here is The Zvi’s update on Omicron more generally.
Those new vaccine service sector jobs MIE
A man in New Zealand who reportedly received up to 10 Covid vaccines in a day on behalf of others is under investigation by the country’s Ministry of Health, Newsweek reported.
Reports indicate that the unnamed man was paid by multiple individuals to pretend to be them while obtaining a vaccine, in an effort to avoid vaccination requirements.
Here is the full story, via Air Genius Gary Leff. Not long ago I was wondering how many vaccines you could take in a day and still survive…this is data!