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Herd Immunity is Herd Immunity

Some assorted thoughts:

In the big picture, the efficacious of a vaccine doesn’t matter per se what matters is getting to herd immunity. If you have a less efficacious vaccine you need to vaccinate more people but herd immunity is herd immunity, i.e. vaccines mostly protect people not because they are efficacious but because we reach herd immunity. I’ve never had measles mostly because I have probably never been challenged with measles not because I have been challenged but due to a vaccine I fought it off. The AZ vaccine at 70% efficacious will work just fine. (One potential issue, as Josh Gans notes, we don’t yet have data on transmission reduction which could vary by vaccine.)

As I mentioned in The Vaccine Works Fast, the first shot of the Pfizer vaccine seems to work well enough so that one *might* consider delaying the second dose a few weeks to get the first dose out more widely. In fact, the accidental low-dose, standard-dose regime for the AZ vaccine had people getting the second dose 7 to 8 weeks after the first dose and that was the 90% efficacious regime. We don’t have full-information but the exact timing of the second-dose does not seem critical, although everyone should get a second dose.

A related point is that we could mix and match vaccines. The UK will run a trial on this question. Mix and matching has two potentially good properties. First, mix and matching could make the immune system response stronger than either vaccine alone because different vaccines stimulate the immune system in different ways. Second, it could help with distribution. It’s going to be easier to scale up the AZ vaccine than the mRNA vaccines, so if we can use both widely we can get more bang for our shot. (As Tyler has noted the British have really stepped up on rational trial design.)

The mRNA vaccines are getting the press but for the world as a whole the AZ, Chinese, Russian and similar more traditional vaccines are going to be the big players because facilities exist for scaling them up around the world.

Addendum: Countries in the world that now have a vaccine: the UK, Canada, Bahrain, China, Russia. One country without a vaccine: the United States. The US FDA advisory committee is meeting today. You can watch here.

From the comments, on HCTs

The box most bioethicists are in is so small their thinking can’t extend beyond a few target people. In this case, the control group in a vaccine trial.

The subjects could be paid for the risk, which is what we do for jobs all the time. Those risk/reward amounts for risky jobs are used to make estimates for the value of human life. Life insurance would allow high-risk people (us geezers) to join the trials.

Their box doesn’t even consider human challenge trials (HCT) that give you very rapid and accurate data on efficacy even with pay and insurance to cover the risk. The lives saved by a month faster approval is in the 10’s of thousands more than offsetting and risk to a few people. Tracking the first million doses for side effects would provide the side effect data that is usually within days of injection.

Outside their mental box, 1000 people per day are dying for each day they study the issue and delay a decision, but those lives are not included in their thinking and analysis.

That is from Dallas.  I would stress there are higher costs yet from delay, noting the hundreds of millions of people in developing nations who are falling back into poverty while the pandemic continues to rage.  Some of them are dying too.

The Agorics era at Mercatus and GMU

This started in the late 1980s, and was led by GMU economist Don Lavoie, who earlier had been a computer programmer.  Here is one bit from Don’s extensive essay, co-authored with Howard Baetjer and William Tulloh:

The market for scholarly ideas is now badly compartmentalized, due to the nature of our institutions for dispersing information. One important aspect of the limitations on information dispersal is the one-way nature of references in scholarly literature. Suppose Professor Mistaken writes a persuasive but deeply flawed article. Suppose few see the flaws, while so many are persuaded that a large supportive literature results. Anyone encountering a part of this literature will see references to Mistaken’s original article. References thus go upstream towards original articles. But it may be that Mistaken’s article also provokes a devastating refutation by Professor Clearsighted. This refutation may be of great interest to those who read Mistaken’s original article, but with our present technology of publishing ideas on paper, there is no way for Mistaken’s readers to be alerted to the debunking provided by Clearsighted. The supportive literature following Mistaken will cite Mistaken but either ignore Professor Clearsighted or minimize her refutations.

In a hypertext system such as that being developed at Xanadu, original work may be linked downstream to subsequent articles and comments. In our example, for instance, Professor Clearsighted can link her comments directly to Mistaken’s original article, so that readers of Mistaken’s article may learn of the existence of the refutation, and be able, at the touch of a button, to see it or an abstract of it. The refutation by Clearsighted may similarly and easily be linked to Mistaken’s rejoinder, and indeed to the whole literature consequent on his original article. Scholars investigating this area of thought in a hypertext system would in the first place know that a controversy exists, and in the second place be able to see both (or more) sides of it with ease. The improved cross-referencing of, and access to, all sides of an issue should foster an improved evolution of knowledge.

A potential problem with this system of multidirectional linking is that the user may get buried underneath worthless “refutations” by crackpots. The Xanadu system will include provisions for filtering systems whereby users may choose their own criteria for the kinds of cross-references to be brought to their attention. These devices would seem to overcome the possible problem of having charlatans clutter the system with nonsense. In the first place, one would have to pay a fee for each item published on the system. In the second place, most users would choose to filter out comments that others had adjudged valueless and comments by individuals with poor reputations. In other words, though anyone could publish at will on a hypertext system, if one develops a bad reputation, very few will ever see his work.

And this:

Miller and Drexler envision the evolution of what they call agoric open systems–extensive networks of computer resources interacting according to market signals. Within vast computational networks, the complexity of resource allocation problems would grow without limit. Not only would a price system be indispensible to the efficient allocation of resources within such networks, but it would also facilitate the discovery of new knowledge and the development of new resources. Such open systems, free of the encumbrances of central planners, would most likely evolve swiftly and in unexpected ways. Given secure property rights and price information to indicate profit opportunities, entrepreneurs could be expected to develop and market new software and information services quite rapidly.

Secure property rights are essential. Owners of computational resources, such as agents containing algorithms, need to be able to sell the services of their agents without having the algorithm itself be copyable. The challenge here is to develop secure operating systems. Suppose, for example, that a researcher at George Mason University wanted to purchase the use of a proprietary data set from Alpha Data Corporation and massage that data with proprietary algorithms marketed by Beta Statistical Services, on a superfast computer owned by Gamma Processing Services. The operating system needs to assure that Alpha cannot steal Beta’s algorithms, that Beta cannot steal Alpha’s data set, and that neither Gamma or the George Mason researcher can steal either. These firms would thus under-produce their services if they feared that their products could be easily copied by any who used them.

In their articles, Miller and Drexler propose a number of ways in which this problem might be overcome. In independent work, part of the problem apparently has already been overcome. Norm Hardy, senior scientist of Key Logic Corporation, whom we met at Xanadu, has developed an operating system caned KeyKOS which accomplishes what many suspected to be impossible: it assures by some technical means (itself an important patented invention) the integrity of computational resources in an open, interconnected system. To return to the above example, the system in effect would create a virtual black box in Gamma’s computer, in which Alpha’s data and Beta’s algorithms are combined. The box is inaccessible to anyone, and it self-destructs once the desired results have been forwarded to the George Mason researcher.

There is really quite a bit more at the link, noting that at the time Don had assembled a group of about ten people working on these ideas.  As for the hyperlinks, I recall thinking at the time something like: “People don’t value reading so much, so making reading better with hyperlinks won’t have a huge marginal value!”

Cases vs. deaths in the Covid debates

Once upon a time, there were some herd immunity theorists.  They claimed that once a certain percentage of the population had been infected, the R for Covid would fall below one and the disease would become far less common and less significant.  Since these analysts were especially aware of heterogeneity issues (though common in the broader scholarly literature), these same herd immunity theorists tended to be less pessimistic than many of the mainstream forecasts.

To be clear, everyone knew that herd immunity was a general and universally accepted concept in the literature.  But these particular herd immunity theorists were the ones saying it really would matter, and they did so in the bold and fearless manner.  As I mentioned earlier, the NYT didn’t really start covering this issue until this August, a kind of unbelievable (and appalling) communications failure from public health experts who didn’t want to say anything that might be construed as minimizing expected risk.

Now, I don’t recall many of those theorists early on making a prediction about a specific number required for the herd immunity threshold to be reached.  Nonetheless, when deaths and hospitalizations collapsed in Sweden, London, and New York at about 20 percent seroprevalence, obviously it seemed that might be the critical level for herd immunity to kick in. (Higher measured levels of seroprevalence, such as for the slums of Mumbai might just come from the speed of ripping through a very dense and exposed community.)  And a lot of the observed later waves were in fact coming in other parts of these countries or regions, such as Barcelona following Madrid, or Arizona following New York.

These herd immunity theorists were correct in predicting an “earlier than the mainstream is telling you” collapse in deaths and hospitalizations in the hard hit regions.  And that is very much to their credit.

You will note that part of their prediction or implied prediction was that past the herd immunity point cases should fall, not just deaths.  Transmission just would not be very effective or speedy any more, so cases should be low whether or not people die in the hospitals or the hospitals can save them.  I’ll be coming back to this.

Then things started to go askew in the last few weeks.  First, it seems like a bad second wave came to an already fairly hard hit Madrid.  OK, you could say Madrid was never had 20% seroprevalence to begin with.  And then what appears to be a second wave has started coming to Israel, with rising hospitalizations.  Finally, it is believed that in Britian R equals about 1.7, and that a second wave of cases is on the verge of hitting London and Southeast England.  That hasn’t quite happened yet, but the informed authorities greatly fear it, and the numbers so far seem to indicate that as the trend.

Added all up, those data points are not decisive in rejecting the claims of these herd immunity theorists.  But they do make the herd immunity theorists look less correct than they did say three weeks ago.  Those “partial second waves,” or whatever they turn out to be, seem more active than one might have expected.  Again, though, the story is still unfolding and we should not rush to final conclusions.  But in the meantime we should update!

In response, many of the herd immunity theorists strike back and ask “where are the deaths“?  But that is not the right question for testing herd immunity claims.  Those claims were about transmission slowing down, and those claims should be true about Covid-19 cases whether or not more people are surviving in the hospital.  (Imagine for instance a perfect antiviral that saved everybody — would that mean herd immunity was true a priori?  Nope.)

Another claim from some of the less careful herd immunity theorists is that cases are rising again because testing is rising.  That doesn’t seem to explain observed patterns in Israel, Spain, or England, where in all instances actual Covid cases are rising above and beyond what is going on with testing policy, and by some considerable margin.  It probably does explain some parts of America, however.

It is very likely that death rates will be much lower this time around, because of better procedures, younger victims, lower doses, and possible (speculative!) variolation through mask use over time, exposing people to lower doses repeatedly and boosting their immune responses.

There is a temptation to say “few deaths, we don’t need lockdowns!”  Indeed, the more partisan of the herd immunity theorists are obsessed with the lockdown issue.  Lockdowns are important questions, but don’t let your lockdown views skew your interpretation of the numbers, and furthermore there are many other important Covid questions of interest, for instance:

1. How much more should we invest in better hospital procedures?  Better biomedical fixes?  And how much should we hurry?  If transmission is mostly over, you can relax much more, but ongoing cases both will bring some long-term damages (short of death) and also some ongoing panic, whether rational or not.

2. How do we deal with the fact that case numbers per se will scare people for a long time to come?  Again, if transmission is winding down, you don’t need as big a long-term plan here.

3. Should you let large swarms of tourists into your currently semi-protected region, say it is Venice, Italy or the less infested parts of Hawaii?

4. To the extent there is current herd immunity or semi-herd immunity as I call it, how fragile is that arrangement with respect to a possible rotation of potential super-spreaders?  And what might set off those fragilities?

For those questions, and indeed many others, it matters a great deal whether the original herd immunity prediction about “permanently low cases past the herd immunity threshold” is correct, or not.  Whether the death rate is high or low.  You really do need to understand about the cases in their own right, once you see this broader spectrum of issues at stake.

The more partisan herd immunity theorists wish to debate “how terrible will this be and will that justify a lockdown?”, and then they seek to talk you into a mood of not being so terrified, because frequently they are lockdown skeptics.  Again, that is a super-important question.  But don’t let it distract you from the other important questions at hand.

And for those other questions, as I’ve already stated above, the trajectory caseload predictions of the herd immunity theorists are looking worse than they did a few weeks ago.

Of course I will be giving you updates on this matter as time passes.  But this is the very latest, namely that some of the herd immunity theorists are on the precipice of being dogmatically wrong about matters of real import, just as were some of the most pessimistic mainstream predictions from March and April.

From the comments, on alien visitation

…it looks like Avi Loeb (Harvard astronomer) is writing a book that will argue that we have been visited by aliens.

Harvard’s top astronomer lays out his controversial theory that our solar system was recently visited by advanced alien technology from a distant star.

In late 2017, scientists at a Hawaiian observatory glimpsed an object soaring through our inner solar system, moving so quickly that it could only have come from another star. Avi Loeb, Harvard’s top astronomer, showed it was not an asteroid; it was moving too fast along a strange orbit, and left no trail of gas or debris in its wake. There was only one conceivable explanation: the object was a piece of advanced technology created by a distant alien civilization.

https://www.hmhbooks.com/shop/books/Extraterrestrial/9780358278146

That is from Josh P.  And here is the Amazon link.

From the comments, on coronaviruses

I am still waiting for the new conventional wisdom about what is happening to emerge, and I believe it will be as follows.

A particular ancestral betacoronavirus emerged in bats several decades ago with a special superpower, different from but conceptually not too distinct from HIV’s ability to rapidly mutate. This virus had the ability to easily spread out among many animal species and evolve among them through a standard slow process of mutation subject to selection pressures, but then to occasionally co-infect a single host and recombine to create a radically different variant (a “chimera,” although I think it’s better thought of as an “offspring.”). These offspring would occasionally be very deadly because they combined well-developed abilities that had evolved in separate lineages from the original ancestor evolving in separate species.

Eventually I think we will categorize all the recent betacoronavirus outbreaks (Sars-1, Sars-2, MERS) as part of this broader process, and require a vaccination strategy that can be quickly deployed against new recombinations from this original ancestral betacoronavirus as they randomly emerge from the primordial stew across many animal species, including ours. The evidence thus far points to recombinations resulting in the emergence of a distinct dangerous variant with some regularity.

This story also explains the existence of some preexisting immunity in much of the population to Sars-Cov-2, but substantial variation in what feature of Sars-Cov-2’s genetic code the immune system reacts to depending on whether the individual is known to have had SARS, MERS, or neither. In all likelihood, possibly many relatively nonlethal or even asymptomatic variants of the same betacoronavirus ancestor have been circulating undetected among human populations during this same 10-20 years, resulting in people people who have been exposed to different random bits of genetic material present in Sars-Cov-2.

Here is the link.  By the way, it turns out that smallpox is much older than we had thought (NYT).  Betting on origins being longer and deeper than other people expect is often the bet to make.

Will the coronavirus and the poor response doom Trump’s reelection chances?

Ross Douthat wonders maybe so (NYT), Arnold Kling says probably not:

Closing the border is his signature issue, and the Democrats have staked out a position as the “resistance” to that. I know that they think they can benefit from this crisis, but I would be surprised if they do.

My earlier Feb.3rd Bloomberg column suggested it would help Trump.  I won’t repeat the core claims of my column (some summarized here), but I am still sticking with that earlier call for a few reasons:

1. Few Americans will know/understand that some foreign governments did a better job than we did, and indeed that is already the case in many other policy areas.  “Foreign country did this better than us” is never an argument that works in American politics.

2. The literature on political business cycles suggests that absolute performance is not what matters, but rather whether the economy is gaining momentum.  So if the coronavirus situation is improving in the months leading up to November, Trump will receive some credit for that, no matter how poor the initial response.  And I think that plausibly will be the case.  Even if you believe in a second winter wave, it may take longer to materialize.

3. The literature on disaster spending suggests politicians are rewarded electorally for their response to disasters, not for preparation.  Enough of the American public still is oblivious to this issue that a major Trump action still could be marketed as timely and indeed pro-active.

4. For my hypothesis to be true, Trump at some point needs to make a “big push” kind of response, but I consider that highly likely, even if the push is ill-considered in its details.

Screening Human Embryos for Polygenic Traits Has Limited Utility

By Ehud Karavani, et.al., possibly an important piece:

The increasing proportion of variance in human complex traits explained by polygenic scores, along with progress in preimplantation genetic diagnosis, suggests the possibility of screening embryos for traits such as height or cognitive ability. However, the expected outcomes of embryo screening are unclear, which undermines discussion of associated ethical concerns. Here, we use theory, simulations, and real data to evaluate the potential gain of embryo screening, defined as the difference in trait value between the top-scoring embryo and the average embryo. The gain increases very slowly with the number of embryos but more rapidly with the variance explained by the score. Given current technology, the average gain due to screening would be ≈2.5 cm for height and ≈2.5 IQ points for cognitive ability. These mean values are accompanied by wide prediction intervals, and indeed, in large nuclear families, the majority of children top-scoring for height are not the tallest.

Here is the link, and for the pointer I thank the excellent Kevin Lewis.

From the comments, on the Coase theorem

#1 on prefiguring of the so-called Coase theorem, consider also p. 396-7 of W.H. Hutt, “Co-ordination and the Size of the Firm,” South African Journal of Economics 2(4), December 1934:

“Now, under one ownership, their relations would, given competitive institutions, be exactly the same, provided that both methods were equally efficient from the social standpoint. There is no reason why the spreading of the lines of responsibility back to several sources should lead to less effective planning than subordinacy to an authority emanating from one source, given the equal availability of relevant knowledge to the managers who devise the plans…The most important significant difference between the two cases is that, in practice, in the one case there may not be the availability of relevant knowledge that there is in the other.”

That is from Daniel B. Klein.  And:

For a still earlier ‘discovery’ with transaction costs and all see my former colleague Yehoshua Liebermann’s “The Coase Theorem in Jewish Law,” Journal of Legal Studies, Vol. 10, No. 2 (Jun., 1981), pp. 293-303

That is from Moshe Syrquin, link for both here.

From the comments, on work hours and spousal distribution

#3) If working long hours is bad, “overworked” in the author’s language, then why would the author say that women are often “stuck” in limited roles or take a “back seat” to their husbands. Why not say that husbands most often bear the burden of overworking so that their wives can have a better work-life balance, even in cases where the wife has sufficient education to bear more overwork burdens? Conversely, if wives really are taking a “back seat” to their husbands, then it must be the case that workers *welcome the opportunity* to earn premiums by working longer hours. So, which is it, are husbands sacrificing home life for the benefit of their wives or do couples actually view higher “overwork” premiums as a welcome benefit?

Here is a logically coherent, self-consistent way of describing things: The percentage of women with advanced education has been steadily increasing. That liberalization, along with economic liberalization, has contributed to economic growth, especially for highly educated couples. Such couples are well enough off that, in many cases, both spouses don’t even have to work full time to generate sufficient income. Many affluent wives prioritize work-life balance over pure financial returns. With such a large fraction of highly educated workers prioritizing work-life balance, firms find it necessary to increase “overwork” premiums to attract workers to fill the most time-demanding roles. The tax wedge between taxed office work and untaxed home production (own childcare and enjoyment of spending time with one’s family) may also contribute to workers’ prioritization of work-life balance over pure financial compensation.

That is from BC.

Peter Thiel on medicine and longevity

Or is it that there’s something wrong with culture, with the funding?  Almost no grants go to younger scientists.  When it’s scientists under age 40 that make […] of the most big discoveries, 2% of NIH grants go to scientists under age 40.  That seems a little bit off.  You have a peer-review process where anything heterodox can’t get funded.  You have sort of a publish or perish dynamic where you have to do small, incremental things to publish lots of articles that don’t add up to anything ever…

And again, my sort of libertarian cut on what happened would be the history of was that we had a healthy, scientific world that was non-governmental.  It was decentralized.  It was idiosyncratic.  Different people were doing different kinds of things.  And in the 1930s, 1940s, it got centralized accelerated.  The Manhattan Project…there was actually a way you could accelerate science temporarily by adding tons of money and centralizing…

So the centralization worked.  But to use an ecological metaphor, it worked by creating a monoculture.  And we’re now two generations in to where that monoculture has been just catastrophic.

That is from this taped dialogue between Peter and Bill Hurlbut, previously linked on MR.

On hitchhiking, circa 1969, from the comments

I hitchhiked across the U.S. twice in 1969. Here’s what my 18-year-old white, male, hippie self learned:
1. Expect to get picked up and propositioned by homosexuals.
2. Everybody is really interested in drugs and wants to get their hands on some.
3. Drugs quickly went from being the pastime of a small, hip elite, to becoming the obsession of trashy, low-class types.
4. Cowboys or anyone who identified with them wants to kill hippies.
5. Mexicans want to kill hippies.
6. It’s possible to sleep in an empty lot in Seattle or Portland, but in L.A., you will be harassed.
6. Panhandling is the world’s most humiliating activity.
7. Day labor is shockingly arduous.
8. America’s roadsides are a continuous scroll of accidental beauty, dramatic vignettes, and surreal occurrences.
9. Even a single night in a small town jail is awful enough to dissuade any sane person from ever committing or coming close to committing an imprisonable offense.
10. Jesus communes and Hare Krishna people will take you in and feed you when no one else will. But they have their own problems.
11. Iowa is surprisingly beautiful.
12. We thought because we all had long hair, we were all on the same wavelength – we weren’t.
12. There are lots of smart, interesting normal people out there, and from them you learn that the best thing in life is to follow the straight and narrow, observe social conventions, work a steady job, and avoid extremes.

That is from Faze.

Was the Colombian peace deal so wonderful?

It seems to be increasingly unpopular with the Colombian electorate, and now there is this report:

Hundreds of Colombian farmers, activists, and community organisers have been killed over the past 18 months, despite the landmark peace deal that supposedly ended 52 years of war. For them, and for local leaders in the former conflict zones, the war – which left an estimated 220,000 dead and seven million displaced over five decades – didn’t end: it only became worse.

“Whenever we hear talk of peace, we worry,” says Anadelia Trochez, 43, president of the community council in El Ceral, a village in the Cauca Valley, the most productive coca-growing area in the country. “Out here, that usually means more trouble.”

Of course that is not the final word, but the evidence increasingly suggests it is a perspective to be taken seriously.  I recall how many outsiders swooned when the initial Colombian peace deal was first announced, and how tragic they considered it when the Colombian electorate rejected the first version of the deal.  Critics of the deal were considered warmongers.  Those are classic signs of mood affiliation.

The pointer is from Tom Murphy.