Covid 9/1/22: Meet the New Booster

We will soon have a new, updated booster shot only eight or so months behind schedule. Given only 30% of America is boosted even once, not many people will accept this kind and generous (if rather late) offer. It won’t make much difference even to those who take advantage of it at this point, but better to update than not update, the usual various objections aside. Hopefully this makes the next update easier.

Other things were mostly as one would expect.

This week I also wrote a long analysis of the student loan forgiveness situation.

Executive Summary

  1. Booster update available soon.
  2. Student loan forgiveness bigger than most realize.
  3. Monkeypox situation looking better.

Let’s run the numbers.

The Numbers

Predictions

North Carolina reported almost 500 deaths, which is obviously a backlog, so I adjusted that number to the still-rather-higher-than-reality 150.

Prediction from last week: 542k cases (-5%) and 3,030 deaths (-5%)

Results: 523k cases (-9%) and 3,183 deaths (-1%).

Prediction for next week (HOLIDAY): 420k deaths (-20%) and 2,550 deaths (-20%).

Labor Day is going to mess with reporting a bunch, so noting that this does not represent a predicted real decline in either cases or deaths.

Deaths

Cases

Moderna Sues Pfizer

Moderna is charging Pfizer with patent infringement.

Vaccine maker Moderna announced Friday that it’s suing rival drugmakers Pfizer and BioNtech for patent infringement. The lawsuit alleges the two companies used certain key features of technology Moderna developed to make their COVID-19 vaccine. It argues that Pfizer and BioNtech’s vaccine infringes patents Moderna filed between 2010 and 2016 for its messenger RNA or mRNA technology.

In October 2020, Moderna pledged not to enforce its COVID-19 related patents while the pandemic was ongoing, according to a statement from the company. In March this year, it said it will stick to its commitment not to enforce its COVID-19 related patents in low and middle-income countries, but expects rival companies like Pfizer to respect its intellectual property.

Moderna is not seeking to remove the Pfizer and BioNTech vaccine from the market, but is seeking monetary damages.

On the one hand, this is horrible, it was a pandemic, you use what tools you have. Moderna pledged not to enforce the patent during the pandemic.

On the other hand, fair. Moderna developed key real innovations that were foundational for the Pfizer vaccine. Pfizer should pay a license fee for that, which is all Moderna is asking for. It would not be reasonable to expect Moderna to waive this forever.

My solution would be that they agree on a reasonable fee, ideally going forward only, and that the United States happily cover the costs involved by letting Pfizer raise the price to match. Moderna deserves to be paid, and Pfizer shouldn’t have to pay, and we got orders of magnitude more benefit than all of this costs. A little bonus payment seems quite reasonable to me.

Meet the New Booster

Bivariant boosters (aka ‘updated boosters’) have been FDA approved. That only took (checks date) about 8 months longer than necessary. Weekend Reading has the write-up from a very straightforward meeting.

Should you get the new booster shot? Certainly you should get the new rather than the old, if you are getting boosted. Getting boosted is a better deal than it was prior to this authorization, once the new doses have shipped.

I do not intend to get an additional booster at this time. I consider it a reasonable decision and small mistake either way, with the note that if you are going to get boosted within the next year or so, now seems like the right time to do so.

There are standard calls for what the public ‘deserves to know’ and I would direct everyone to how we deal with flu vaccine updates. And standard ‘may’ verses ‘should’ as if people listened to that much (only 30% of America is boosted). And concerns about ‘what about the 12 year olds, you didn’t test in them specifically’ as if there was any scientific reason to need to do that.

And that’s it. No other issues here whatsoever. Finally, FDA does something right.

You didn’t think it was going to be that easy, did you?

You know, for a second there? I kinda did.

Then, of course, the inevitable.

Yes. Of course. Why would I ever doubt it? All right, what is it this time?

Oh. Right. That.

Once again, I’d direct everyone to the flu vaccine updates for the ‘never tested in humans’ objections. It is good that we have grandfathered in a bunch of very sensible procedures you could make such statements about, to go with all the horribly stupid other procedures we are also stuck with.

The part where the FDA withdrew approval for the old booster makes logistical sense. If both boosters were running around you’d have people running around going ‘give me the old booster’ and then they’d be told ‘we don’t have that because you’re being stupid and they spoil and we don’t keep both versions around.’ Except mostly no, the people who are not trusting the new booster weren’t about to go trust the old booster.

Except there’s the college students who might be forced to get a booster, and somehow managed not to get one until September anyway. In which case, yes, I agree that the mandate there is super dumb, although I don’t think it matters or anything. If you’re going to mandate the new booster in young people, while 70% of adults have no booster at all and the young people are at minimal underlying risk, you are not doing a reasonable or responsible thing.

Others disagree.

Always so much to unpack in such statements. What makes a mandate for those who least need to do the thing ‘equitable’ exactly? Why do colleges uniquely need to ‘protect surrounding communities’ that are not going to be ‘well-protected’ either way and have mostly declined their own boosters. Which, to me, does not sound all that equitable. The implication that any number of lives saved justifies such an action.

Physical World Modeling

What does this man think we should do, exactly? And what value to him a school?

Presumably he thinks most schools should close, right now, until we can renovate the buildings. Wouldn’t take that many years, right? Schools are entirely symbolic anyhow.

Jill Biden has a rebound case of Covid, I have resolved my market on this accordingly. We should update in favor of this being more common, but the market already had it as pretty likely. She was no doubt tested frequently. How many get ‘rebounds’ and do not even notice? She has no symptoms, and I notice that when I saw the headline I did not consider that her health might be at risk.

Can’t quite tell if joking.

The case that rebounds are a big deal.

The FDA is forcing Pfizer to test the effects of a second course of Paxlovid (Bloomberg, and it’s really odd that they say ‘US regulators’ here rather than the FDA).

Agreed that we should know the frequency of rebound cases, both with and without Paxlovid, so we can plan accordingly. And agreed that being sick, even low level sick, sucks on many levels, although most rebound cases seem to be nominal rebounds without substantial symptoms. I notice that mostly the value lost is due to the additional need to isolate rather than being unable to go about one’s day.

Thus I think the more understudied question is how infectious people are during the rebound period. That’s the study we need most, because I think there is a reasonably large chance that the answer is ‘not enough to matter, you should maybe wear a mask but mostly go about your day.’

American Academy of Pediatrics lies to us once again.

This is a textbook case of the Law of No Evidence. Or it would be, if there wasn’t any Proper Scientific Evidence.

The claim that masks do not harm children’s language development is Obvious Nonsense. You know what I’ve recently noticed my six-month-old baby pays very very close attention to when I talk to him? Exactly how I am making the sounds, and then he tries to imitate them. This isn’t some bizarre hypothesis.

Then, of course, when the masks do cause delays? ‘Talk to your pediatrician.’

The stuff about how masks are ‘may be needed to keep kids safe’ is also lying. Kids do not need masks to be kept safe from Covid-19. You can argue that they might keep others safe, but that is not the claim here.

And yes, there is constant gaslighting about how no one would ever have insisted on masks in a given situation.

Image

Remember, the American Academy of Pediatrics is talking about ‘the first few years’ of a child’s life in the thread above.

Bob Wachter once again crunching the numbers on risk his way. One interesting note is he expects a rapid decline in case numbers within the next 1-2 months absent a new variant. It’s unclear to what extent this is driving his continued extreme caution.

Work on universal coronavirus vaccines is not going so well. Funding is tight, but it is also about lack of other types of support.

“We want to start clinical trials tomorrow, but there are lots of barriers to getting there,” says Yale University immunologist Akiko Iwasaki, a panelist at the White House summit who has a vaccine candidate that’s administered as a nasal spray. For starters, funding remains far tighter than in the Warp Speed days: The Coalition for Epidemic Preparedness Innovations (CEPI) has invested a more modest $200 million in 11 efforts run by small companies and academics, and the U.S. National Institute of Allergy and Infectious Diseases (NIAID) has committed just $43 million in four pancoronavirus vaccine programs. And efforts also face a dearth of materials needed to make vaccines, a shortage of nonhuman primates on which to test candidates, and uncertainty about how to assess new products in populations that already have immune response to SARS-CoV-2.

Among other issues, did you know there is a shortage of monkeys for medical research? This is, of course, on top of not allowing challenge trials in humans. You would think the market would solve this one and breed more monkeys. It’s not obvious why this is not happening, but the obvious presumption is some combination of price controls and animal activists messing things up. Also plausible that it takes a while for supply to adjust to newly higher demand, but it does not seem like we are using price mechanisms to allocate what monkeys we do have to the most valuable projects. Until then, the monkeys won’t do.

In Other News

Head of FDA fails to notice the call is coming from inside the house (Science article).

If he is curious how, as head of the FDA, he might encourage more translational effort into effective treatments, I am happy to advise him any time free of charge. Call me.

The Lockdown Files, about the early history of locking down the UK. The consequences of doing so seem to not have been well-considered. Then again, my inside source says, alas, that this is not the most reliable source. Still, there are some choice quotes.

This was the crux: no one really did. A cost-benefit calculation – a basic requirement for pretty much every public health intervention – was never made. ‘I wasn’t allowed to talk about the trade-off,’ says Sunak. Ministers were briefed by No. 10 on how to handle questions about the side-effects of lockdown. ‘The script was not to ever acknowledge them. The script was: oh, there’s no trade-off, because doing this for our health is good for the economy.’

If frank discussion was being suppressed externally, Sunak thought it all the more important that it took place internally. But that was not his experience. ‘I felt like no one talked,’ he says. ‘We didn’t talk at all about missed [doctor’s] appointments, or the backlog building in the NHS in a massive way. That was never part of it.’

There’s also this gem:

His Eat Out to Help Out campaign was designed to be an optimistic counter-narrative. ‘The survey data across Europe showed that our country was far and away the least likely to get back to normal. All the evidence was that everyone was too scared to go and do things again. We have a consumption-driven economy, so that would be very bad.’

How was policy set? No one knew, but it was by ‘SCIENCE(tm)’:

No. 10 wanted to present it as ‘following the science’ rather than a political decision, and this had implications for the wiring of government decision-making. It meant elevating Sage, a sprawling group of scientific advisers, into a committee that had the power to decide whether the country would lock down or not. There was no socioeconomic equivalent to Sage; no forum where other questions would be asked.

So whoever wrote the minutes for the Sage meetings – condensing its discussions into guidance for government – would set the policy of the nation. No one, not even cabinet members, would know how these decisions were reached.

Well, science slightly edited.

In the early days, Sunak had an advantage. ‘The Sage people didn’t realise for a very long time that there was a Treasury person on all their calls. A lovely lady. She was great because it meant that she was sitting there, listening to their discussions.’

It meant he was alerted early to the fact that these all-important minutes of Sage meetings often edited out dissenting voices. His mole, he says, would tell him: ‘“Well, actually, it turns out that lots of people disagreed with that conclusion”, or “Here are the reasons that they were not sure about it.” So at least I would be able to go into these meetings better armed.’

But his victories were few and far between.

Post on Canada’s decision to ban travel for the unvaccinated. I highlight this piece because it is illustrative of the ‘complain about everything no matter what’ style of recrimination, which doesn’t hunt. Post complains that there was no ‘scientific basis.’ That a political decision was about politics, a popular thing done before a snap election. Did the author want a study for ‘punish people who don’t do what we want means more people will do what we want?’ An exact point estimate of the reduced spread from movement restricting the unvaccinated? It complains that there were no public health experts on the team making the decision, as if that would have been helpful. Then it complains that they ended the ban and tried to stop a lawsuit against the government. And that government officials ‘shouldn’t hide behind a cloud of secrecy’ which taken this broadly is Obvious Nonsense, of course officials need to be able to have private discussions and use them to make decisions. Meanwhile, such posts somehow are still mad about the treatment of the Great Barrington Declaration, and think it will help their cause to keep harping on that, which it very clearly won’t.

Djokovic still not allowed to play the US Open due to not being vaccinated. Rather rediculous.

Monkeypox

Monkeypox has peaked, or at least reached a plateau, because the MSM community adjusted its behavior.

This behavior change is not long term sustainable but it does not need to be because we can put vaccine shots into the arms in question.

Of course, same as it ever was with the public health goals.

Metaculus seems a little late to the party on this one.

Each day, developments were mostly as expected, and CDC did not move to change its recommendations. Thus, each day, the probability of the recommendation should have declined slightly, rather than the bottom falling out all at once. This would be a more important bias to notice if there was real money to be won, but if there was real money to be won the bias would probably have been corrected faster. As it is, if you see a static prediction like this, ask whether that is a reasonable delta.

Should your kids be worried about monkeypox, asks latest Celine thread? No, no, no, seriously, no, stop it, not unless they are MSM with multiple partners.

USA spending $11 million to support making more monkeypox vaccines. Good. Also this being million with an M should tell you how big this problem really is.

Not Covid

Difference in people’s perspectives we need to fix: Is it more of a BS job if you only do a small amount of real work but otherwise don’t have to do BS work, or is it more of a BS job if you then fill the rest of your day with BS?

Not in bad news section because it isn’t news: Baby formula shortage crisis continues. FDA continues to deny all applications from abroad to sell baby formula. The plant at the heart of this may be starting up in several additional weeks, and may keep producing once it starts. Hope springs eternal.

From Feb 2021 on magical thinking. Endorsed.

Keeping Up With the Jones Act

There is a vigorous debate on the Jones Act.

  1. Is it so transparently awful that we should use it to show industrial policy in general is terrible?
  2. Or is the use of the Jones Act to prove the terribleness of industrial policy why we have such a transparently awful law still on the books?

Both sides make good points.

I think Matthew Yglesias is closer to my model. I would go even farther.

The Jones Act has not been repealed because it is the avatar of bad industrial policy and highly destructive rent seeking.

If we repeal the Jones Act, it would encourage us bastards who do not want your particular highly inefficient rents to continue to be paid. You know what’s so much more dangerous than the ultimate example of stupid industrial policy? The example of the repeal of the ultimate example of stupid industrial policy. You embolden the ‘general good things’ alliance against their enemies. Who knows what other rules and carve outs might get targeted next?

Can’t have that. The line must be drawn here.

You broke your little ships.

Bad News

Life expectancy continues to drop, effects seem primarily due to overdose deaths and general increased use of addictive substances rather than directly from Covid.

Technically news, but in no way a surprise: Millions in Covid aid went to retrain veterans. Only 397 landed jobs (WaPo). Patrick McKenzie explains: They’ll ~never work and ~never stop being approved because working not strictly required.

Trigger warnings are the goggles. They do nothing.

Not news but came to my attention this week: If your pilot has a mental health problem, you can rest assured they are not getting treatment for it.

New York City moves to make construction substantially more expensive.

Times Square to be made uglier via ‘gun free zone’ signs. In case you were wondering where to take your gun, or what officially counts as ‘Times Square,’ either way you’ll want to stay outside this box:

California legislature passes law to dictate fast food wages. So, more robots, then.

California senate also passes AB 2273, which age verification providers assure us won’t be that big a deal, we probably can avoid giving websites your personal information by scanning your face.

Whole thing seems blatantly unconstitutional, but if it’s not, then California is on the verge of kind of banning huge portions of the internet and otherwise causing a sufficiently large cluster**** that I am going to need more popcorn. Here’s a take from Eric Goldman saying it will ‘break the internet.’ Here is his deep dive. I am not following this too carefully but given all the requirements involved there are a lot of websites where the only legally reasonable response seems to be ‘IP block California.’

The debate between ‘things are so bad now’ and ‘it has always been thus’ continues. Matt Yglesias weighs in on part of it: Getting better policy debates is extremely difficult, they used to be even worse.

I don’t think polarization has anything to do with it because I’ve read news coverage of policy debates in the 1980s and 1990s, and it was much worse.

I really do think there’s just a kind of entrenched fandom aspect to American political culture. The bulk of the coverage centers on concepts like “X is a win for Joe Biden” or “Y is a setback for Biden” rather than trying to describe what’s happening or what the real arguments about it are. And I don’t think that’s just because the reporters are bad or the media is bad, it’s genuinely what people mostly want.

Twitch streamers experience a lot of burnout, NPR notices. This is because the incentives are strongly to stream for long periods of time, without breaks, constantly. You can’t succeed at the job by halves. This turns what would be a great job into a terrible one.

New paper from Anthropic: AI training technique that works by teaching AI to lie in order to tell people what they want to hear proves best at telling people what they want to hear. Thinks this counts as safety.

Good News, Everyone

Fear of failure is good, actually? At least in terms of results on MasterChef. What confuses me is why the conventional wisdom goes the other way. One possibility is that outcomes being bounded and comparative changes the answers here.

Excellent news indeed (direct White House link).

Today, the White House Office of Science and Technology Policy (OSTP) updated U.S. policy guidance to make the results of taxpayer-supported research immediately available to the American public at no cost. In a memorandum to federal departments and agencies, Dr. Alondra Nelson, the head of OSTP, delivered guidance for agencies to update their public access policies as soon as possible to make publications and research funded by taxpayers publicly accessible, without an embargo or cost. All agencies will fully implement updated policies, including ending the optional 12-month embargo, no later than December 31, 2025.

Counterpoint:

And more explanatory counterpoint that SciHub exists.

Tyler Cowen is skeptical that this will be of much benefit. As I understand it, the problem is that the new rule does not require the journal version to be open access, only that an open access version exists. Whereas if it did require the journal version be open access, it might put the journal out of business.

I heartily agree. Let’s do that other version. Put the journals out of business.

New York one step closer to congestion pricing for cars below 60th Street (as much as $23), Bloomberg post originally titled ‘Congestion Pricing Is Going To Be The Death of Lower Manhattan.’

If for-hire vehicles are required to pay additional tolls under New York City’s proposed congestion pricing plan, “thousands of drivers will lose their life savings,” Aziz Bah, the organizing director of the guild that represents over 80,000 drivers in the city, said Thursday night during the Metropolitan Transportation Authority’s first public hearing on the plan.

I notice that this is not how ‘supply and demand’ works. Does this person think the taxi/Uber/Lyft drivers won’t raise prices to compensate? Is it retroactive for decades, since I can’t think of another way anyone could ‘lose their life savings’?

According to the assessment, traffic in the district could drop by as much as 9% and use across the entire public transit systems could potentially increase by as much as 2%. 

Sounds like demand to be in the area is rather inelastic.

California passes, with overwhelming support, housing bills AB 2011 and SB 6. If you want to be allowed to build housing where there once were stores, you now have a choice. You can either make some units artificially cheap or you can pay union wages, much better than not having a choice, and both seem feasible. As long as someone in the coalition gets paid, you’re good. One bill even gets around environmental review requirements. Here is a technical thread on AB 2011. It’s quite the legislature they’ve got over there.

Court rules that New Orleans restricting short-term rentals to city residents unconstitutionally restricts interstate commerce.

EAs are, Will McAskill claims, always thinking on the margin. This makes the neglect of general economic prosperity as a cause area that much more frustrating. How is it that there was a major macroeconomic policy push by OP that wasn’t NGDPLT?

Talking to strangers is more enjoyable than people think. Update accordingly. Notice that if you already know about how much people enjoy talking to strangers, but not how much they expect to enjoy it, then this new information becomes bad news, but I presume it is instead good news. Does this mean it is ‘that easy’? No, but it’s also not that hard.

Paul Graham agrees with me that the new GMail design is horrible. The good news is this thread made me sufficiently non-blind to find that I figured out how to switch back. It’s in the quick settings, not the full settings. Did not see that coming.

New Conboy lab paper confirms that repeated plasma dilution has lasting age-reversal effects in humans. Is it happening?

Washington Post reporters sensibly hold less zoom meetings on Fridays.

New York MTA workers hourly wages aren’t low but seem reasonable. As is usually the case, the problem isn’t the hourly pay, it’s what they don’t do in that hour.

Colleges cutting down on cafeteria perks in response to food inflation (Bloomberg).

We are safe from Scott Lincicome’s hot sauce due to overregulation. But, for how long?

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20 Responses to Covid 9/1/22: Meet the New Booster

  1. Radu Floricica says:

    Strongly suggest trying out Superhuman. It’s basically a modern, fast UX over gmail. Can’t ever imagine going back.

  2. Agreed that we should know the frequency of rebound cases, both with and without Paxlovid, so we can plan accordingly. And agreed that being sick, even low level sick, sucks on many levels, although most rebound cases seem to be nominal rebounds without substantial symptoms. I notice that mostly the value lost is due to the additional need to isolate rather than being unable to go about one’s day.

    A personal anecdote, and some meta-analysis of study data on rebound with & without paxlovid:

    I got COVID-19 at the end of July. I blogged the experience, starting here and going on for 13 posts, initially daily and then less frequently.

    The healthcare system worked for me, largely because I knew which buttons to push and how hard. (Also: nurse practitioners rule!) So I tested positive at 8am, and was swallowing the first dose of paxlovid by 3pm the same day. It’s possible to get the system to move faster, but most of those scenarios involve bleeding out in an ER (which is suboptimal in other ways). So, best-case result for me personally.

    Unfortunately, I got a rebound infection. Ironically, on the day I tested positive with rebound, I was posting a tiny little meta-analysis of 2 papers on rebound probability with & without paxlovid.

    Resulting calculations of rebound probabilities (and 95% confidence limits):

    (1) With paxlovid: 0.83% (CL: 0.26% – 2.26%).

    (2) Without paxlovid:: 1.15% (CL: 0.20% – 4.55%).

    (3) Statistical significance: Given the overlap of the 95% confidence limits, you’d probably guess that’s not statistically significant. A test of proportion agrees, with a near-100% p-value.

    Conclusion: We should call it COVID-19 rebound, not paxlovid rebound, because it seems to have little to do with paxlovid.

    Still, rebound was awful for me personally in terms of fatigue, lassitude, and brain fog. The brain fog still hasn’t lifted completely. Basically, COVID-19 didn’t hospitalize me or kill me, but it cost me about a month of my life (likely due to age). A second course of paxlovid would have avoided a lot of that, but my doc fell back on the “CDC says there’s no evidence” and would not be dislodged.

    So I’m glad the FDA pushed Pfizer into a clinical trial for a second course of paxlovid, though I wish it had happened sooner for me personally. And, of course, it would be nice if they’d just test something simpler: start (almost) everybody with COVID-19 on 10 days of paxlovid and be done with it. Too many ways for the wrong decision to get made if you wait for a rebound to decide: patient doesn’t test, patient doesn’t report, doc not available, doc doesn’t want to write a second scrip, insurance says no, etc.

  3. On Moderna suing Pfizer:

    Yes, it’s objectively bad. But… it’s also more or less traditional in these matters. Everybody sues everybody else about everything within reach until the courts tell them to shut up and who pays whom how much.

    Awesome medchem-blogger Derek Lowe has an explainer from a couple days ago, in which he points this out. As well as the fact that Moderna is itself being sued by others who allege patent infringement, in keeping with the traditions of the tribe.

    “A pox on both your houses” from Romeo and Juliet would be my usual response, except that we just now have an actual pox problem, so maybe not the best metaphor.

  4. On using flu vaccine update regulations to process COVID-19 vaccine updates:

    It is good that we have grandfathered in a bunch of very sensible procedures you could make such statements about, to go with all the horribly stupid other procedures we are also stuck with.

    Harsh, but fair.

    Understanding when to adhere to tradition, and when to violate it is surprisingly nuanced. At least, to me.

  5. TK says:

    Why do you think it’s better to get the new booster now versus timing it with a possible winter wave? Would it matter if someone had an infection at some point this year?

  6. Anonymous-backtick says:

    “You can either make some units artificially cheap or you can pay union wages, much better than not having a choice, and both seem feasible. As long as someone in the coalition gets paid, you’re good. One bill even gets around environmental review requirements.”

    Hooray, option select graft!

  7. Bivariant boosters (aka ‘updated boosters’) have been FDA approved. That only took (checks date) about 8 months longer than necessary. Weekend Reading has the write-up from a very straightforward meeting.

    I updated the post on the bivalent booster, so that it now includes the CDC ACIP meeting.

    Helen Branswell of STAT News live-tweeted the whole affair, so I followed along with her (62 tweets!).

    Lots of good stuff:

    – Epidemiology of unvaccinated vs vaccinated (the former are kinda sitting ducks),

    – Rate of waning of vaccine efficacy vs symptomatic infection by age group (disappointingly fast, though more robust vs hospitalization or death),

    – No interesting safety signals (not even myocarditis),

    – Comparable abs vs old strains with the classic vaccine, but superior abs vs Omicron with the new vaccine (so as good against the old, better against the new),

    – CDC proposes to simplify the recommended sequence of vaccinations (2 primers + 1 bivalent booster),

    – Antigenic original sin doesn’t seem to be happening (good!),

    – Surveys of likely public acceptance are better than for the old boosters (no idea why, but worth exploiting to get bivalent vaccine in arms),

    – Lives saved and medical costs averted look to be ginormous (100 – 160k lives, 62-100 billion dollars in direct medical costs averted),

    – Advocating giving annual flu shot at same time as booster (sensible to increase flu shot uptake),

    – Enormous confusion about vial labelling, colors, instructions and injection volumes (which almost seem to have been done to maximize medical errors like getting the old vaccine instead of the new or vice versa),

    In the end, they approved 13-1 (with one member absent), and with reasonable-looking (at least to me) practice guidelines for both vaccines. But not until after a lot of apparently pointless worrying about human trials even though they do that for flu vaccines yearly.

    • And as of about 7:30pm EDT tonight, CDC Director Walensky has approved the committee decision. So this is now A Done Deal.

      I say “about”, since her statement apparently isn’t up on the CDC site yet. However, Branswell, Herper, and colleagues have the approval up already over at STAT News. They’re faster than the CDC at reporting even the CDC’s own statements, which is in itself kind of a statement.

  8. Bobbo says:

    Zvi, you don’t mind a mostly out-of-thread comment… probably my last one on the topic.

    Now that emotions have cooled around the Canadian Convoy, I wanted to post one last update. And my blog hasn’t found it’s audience yet, and this was the only place I commented on it that got treated seriously.

    Originally, I thought a majority of Canadians supported the Convoy, and if you look at Elon Musk’s tweet of thousands (tens of thousands) of Canadians protesting down Wellington street (in minus 30 degree temperature even), it makes sense. But people came out so quickly against the Convoy after the first few days, I didn’t publicly support it anymore, for fear of being cancelled or what have you. Once tempers cooled though, months later, I ‘came out’ to friends that I was protestor (only talking to friends who hadn’t expressed an opinion one way or the other), all of the male ones supported the convoy and none of the female ones (minus my wife). Well, my one friend’s wife I’d put as on the fence I suppose.

    I largely feel cowardly now I didn’t public support it more after seeing this, because I think a lot of people were afraid of social backlash, and perhaps more public posts could have tipped the tide. I now think there was a vocal minority who were stridently opposed to the Convoy, with what seemed to be like a sudden majority opposing the Convoy.

    As well, my employer dropped their whole policy of, “anyone who publicly supports the Convoy is immediately fired and then we’ll include how he had an inappropriate sign that said “Mandate Freedom” on his lawn in our company-wide newsletter.” So now it is safer to mention my support. And then I got a new job, not because of this, but I did think about it.

    I actually just got back from Atlanta, one big attraction being the Civil Rights museum. Of particular interest to me was the tactics protestors used. I wondered how protestors at that time would have fared if the government had been able to freeze bank accounts without warrants.

    My faith in the government of Canada has been shaken, but I do take solace that at least Trudeau is very unpopular, and I think our courts will find that freezing the bank account of someone who sings “O Canada” at the war memorial was government overreach. Or that trampling an Indigenous protestor with a horse is just another in a long list of indignities the government has made the Indigenous suffer in this country.

    When I see the “scandals” that bring down leaders of other countries, I am amazed at what Trudeau can get away with. WE was not bad enough?

  9. Will says:

    Hi Zvi, thanks as always for these posts. Did you share anywhere your reasoning for not getting a new booster? Have you already gotten a second booster/fourth shot?

    If Zvi hasn’t/doesn’t plan to share his reasons, can anyone else point to some sane/reasonable guidance or analysis of the booster situation.

    I got my third shot last December, and I had always kind of assumed that I would end up having another booster this fall. Just because I get a flu shot every year, so it seemed reasonable I would end up getting a COVID shot every year too. But I never really did any research/analysis into this, so wondering if Zvi not getting a shot is an indication I should think about it a bit more.

    • TheZvi says:

      I’ve had one booster. I don’t see the cost of the second booster (in terms of short-term sickness plus logistical hassle) as worth the benefits for me in reduced illness (which I do think are positive) given my age and good health. I do think it is a small mistake either way. I’d likely get the new booster if I was substantially older.

  10. An index to the (semi-)daily blog posts on the experience of getting, and recovering from, COVID-19 in my household.

    Summary: One month in, and we’re still not back to normal. A couple papers cited say the median time to full return of cognitive function in cases like ours is 6-9 months.

    It was not a trivial cost for us, despite vaccinations and paxlovid.

  11. David W says:

    I can’t figure out if my local sources have the bivalent booster or the original version. I’ve been waiting for the update to get boosted, it didn’t seem to pass the cost-benefit ratio for me until now. I very much don’t want the original one at this point, since it not only would be lower cost/benefit but also prevent me from getting the bivalent booster for at least 2 months.

    But when I go to their websites, I keep running into ‘last updated July’ or ‘last updated May’.

    Any suggestions for figuring this out? Should I just wait a couple weeks and assume the pipeline of old boosters will run out by then?

  12. Pingback: Covid 9/8/22: Booster Boosting | Don't Worry About the Vase

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