(2022-12-22) ZviM Covid 12/22/22 Reevaluating Past Options

Zvi Mowshowitz: Covid-19 12/22/22: Reevaluating Past Options. Here in America, things are quiet. It seems like it was a good week to look back, as MR did, upon our options regarding focused protection, and what we can take away from that.

The Numbers

Physical World Modeling

CDC recommendations have always been the ultimate motte and bailey. Now a judge has made this fact text, allowing any (California) public health department to mandate any recommendation of the CDC without the ability to challenge it.

Bob Wachter thread attempts to explain the nuances of the effectiveness of masks, vaccinations, boosters and home tests. In all three cases, the issue he’s trying to fix seems to have been made worse due to authorities talking often in terms of things ‘working’ versus ‘not working’ and oversold benefits, which leads to people thinking that if the benefits are lesser or conditional, than they ‘don’t work.’ Also that regular people don’t have much ability to understand ‘works somewhat’ to begin with, so we weren’t starting from a great spot, either

What should the Biden administration have spent their money on? Did it make sense to spend what little was left on free tests? Jerome Adams suggests spending it on free masks

I would focus on longer term interventions and on vaccinations

Reevaluating Focused Protection: Alex Tabarrok asks whether focused protection along the lines of the Great Barrington Plan would have worked. His method is to ask, did better nursing homes do better?

The Centers for Medicare and Medicaid Services (CMS) has a Five-Star Rating system for nursing homes. The ratings are pre-pandemic ratings. Thus, the question to ask is whether higher-quality homes had better Covid-19 outcomes? The answer? No.

What the US did was focused protection and lockdowns and masking and we still we had a tremendous death toll in the nursing homes.

I interpret this partly as saying ‘the things that worked for Covid are orthogonal to the things that worked to get high overall ratings pre-Covid.’

I do think the core assertion here, that focused protection of those in nursing homes was not in practice a realistic option, is still mostly correct.

as Alex also points out, earlier vaccinations would have definitely worked. We clearly had odds to vaccinate nursing home residents months earlier, even if we couldn’t have speeded things along in general.

Tyler also gets into the act

here are some of the effective measures in protecting the vulnerable, or they would have been more effective, had we done them better:

1. Vaccines, including speedy approval of same.

2. Prepping hospitals in January

here are three actions that endangered the vulnerable rather than protecting them:
6. Publishing papers suggesting a very, very low Covid-19 mortality rate, and then sticking with those results in media appearances after said results appeared extremely unlikely to be true.

Also, if you were so big on protecting the vulnerable now, they are still vulnerable to a wide variety of non-Covid problems as well as Covid. We do a lot of horrible things to our elderly nursing home residents and I see very little in the way of caring about it.