Thread by @delong

braddelong.substack.com/p/briefly-note…

First: We are a half-vaxxed country. And a country that looks like it is going to stay half-vaxxed: there is just too much money to be made by media grifters and too much political hay to be made by right-wing politicians seeking to win the Trump... 1/

...base for vaccination rates in the country as a whole to get above 50% before the Delta Variant sweeps through.

This is a catastrophe.

While hiking in Claremont Canyon earlier last week, I found myself to Andy Slavitt’s podcast. Andy had been one of the most positive... 2/

...influences on the rolling what-to-do-about-coronavirus debate. Yet I found it extremely disappointing to listen to:

On one of the podcasts I listened to he had as his guest Trump FDA Commissioner Scott Gotlieb. Gotlief had been one of the best of the Trump political... 3/

...appointees. (And, yes, I realize how incredibly low a bar that is, and how brutal is this damnation-with-faint-praise.) As I hiked down from Panoramic Ridge back to the house, I found myself depressed and let down.

The first reason I was let down was what seemed to... 4/

...be a constant mantra repeated over and over again by Slavitt and his guests alike: if you are vaccinated, resume your normal life without masks and without social distancing—you can do everything except go into a moist, crowded, hot batcave and sing for hours. And maybe... 5/

...you can do even that.

But that seems to me to completely ignore the fact that we are a half-vaccinated country. If you do get the Delta Variant in a breakthrough case, since we are a half vaccinated country and the Delta Variant’s R[0] is between 4 and 8, you will... 6/

...give the disease to between 2 and 4 people—say 3. And in two weeks, they will each give it to 3 people—now we are at 12. After two months your downstream chain of infections will have given the disease to about 363 people. And odds are that 4 of them will die.

If you... 7/

...mask up, and maintain social distancing, so that you don’t give your breakthrough case to anyone during the three days after which you are infectious before you realize you have symptoms, you save four lives. Now you can say that a breakthrough case is a low-probability... 8/

...event, and it is. You can say that it is no worse than drunk driving at night. Yes, you can say that.

Or you can say that the antivaxxers are immovable, and that each of them will catch the Delta Variant sooner or later, so all your giving the disease to them would do... 9/

...is move their death date forward in time by six months to a year: they had their chance to get vaxxed, they rejected it, so their deaths from drowning in their own mucus are none of their concern. Yes, you can say that.

The second reason I was let down was what seemed... 10/

...to be a constant mantra repeated over and over again by Slavitt and his guests: risk to you, risk to YOU, RISK to YOU, risk to YOU, risk to you, risk to you. Very rarely—in fact, if I counted correctly, more mentions from the snippets of recorded person-on-the-street... 11/

...than from Slavitt and his guests—was there any talk about the risks to *****US****.

On September 26, 2020, now-Supreme Court Justice Amy Coney Barrett allowed the Trump White House to host a crowded party for her. 30 people. Risks to her from having this nomination... 12/

...party were not that large. But, approximately, caught COVID-19 at that party. With a fourteen-day infection cycle, those 30 then gave it to 50 in mid-October, who then gave it to 80 in early November, who then gave it to 150 at the end of November, who then gave it to... 13/

...200 more in mid-December, 200 in early-January, and 200 in mid-January. Then it drops off—another 620 between then and now. A total of 1530 people. And that’s if the guests at Amy Coney Barrett’s party and their contacts behaved like normal Americans. They may not have... 14/

...—it might be much, much more. Or it might be much less: some fraction of that 1530 would have rejected immunization, and we know that with the Delta and other variances eventually more than 90% of Americans will acquire immunity either through vaccination or through... 15/

...getting a strong enough case of COVID-19 to trigger an immune response.

Odds are that, of those people, 15 are now dead. 15 people who would now be alive had Supreme Court Justice Amy Coney Barrett said “I don’t think that’s a great idea” when having a big party for... 16/

...her was mooted. Maybe it is more—maybe the chains of infection went to elderly Trumpists. Maybe it is less—maybe a good many of those who got infected would have gotten the disease anyway in the winter or the future, and that for many of the 15 it just cut their life... 17/

...short by 4 months or so. I can’t tell.

But 15 is the number to keep in your head. Amy Coney Barrett, I guarantee, does not think of herself as some ca. 1450 Mexica priestess watching her hench-priests sacrifice 15 people with obsidian knives on one of the pyramids of... 18/

...Tenochtitlan to celebrate her ascendancy to power. She does not light fifteen candles every Sunday, and pray on her knees that if any of those fifteen died unshriven that their sins descend upon her rather than upon them.

But maybe she should?

Slavitt and his guests’... 19/

...—all of their risk to you, risk to YOU, risk to you, risk to you—greatly discourages in his listeners the kind of systemic equilibrium thinking that we economists and you epidemiologists do as a matter of course. And we very badly need Americans to think that way:... 20/

...“vaccination is of very little risk to me, and may do a lot of good for others” is the way the thinking should go. And Slavitt’s vibe… discourages that.

I do not know why his podcast is doing this. Has the elite public health community decided that the best way to get... 21/

...as many people vaccinated as possible is to say that the reward for getting vaxxed is that you get to resume your normal life, and that whatever spread to the unvaxxed is produced by the vaxxed who do not social distance is outweighed by the reduction in spread because... 22/

...that carrot will induce more vaccination?

If so, show me the arithmetic.

If not, what are Slavitt and company thinking?

And there was a third reason I was let down. Scott Gotlieb was all about “Let’s not point fingers at Trump and his enablers! Let’s talk about the... 23/

...systemic bureaucratic defects that have also led to this… total clusterfuck!”

If every Scott Gotlieb who wants to preserve his standing among professional Republicans by “moving on” from Trump and his enablers would actually, you know, act like somebody with real... 24/

...ovaries, the country would be in a much better position than it is. And Slavitt did not challenge him, at all.

Sick, in an almost Cultural-Revolution sense…

braddelong.substack.com/p/briefly-note…

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