Hi there,
I’m breaking my online writing hiatus for an emergency broadcast about the state of the pandemic.
Our collective sense-making mechanisms are all broken, and the mainstream news articles on the vaccines and the pandemic are laughably bad. If you’d like to kill a few brain cells all while heightening your anxiety, just turn on your favorite news channel.
Where we Stand
Vaccines are our ticket out of the pandemic. The war against COVID-19 was always going to be won through scientific innovation and not political levers. I said the same thing back in July of 2020.
With over 100M Americans vaccinated with at least 1 dose, and over 100M Americans infected and recovered from COVID-19, we have a rapidly declining pandemic in most of the US states. Better yet, hospitalizations and fatalities are plummeting as a large majority of the most vulnerable population has now received a dose of the vaccine. The virus is simply running out of the vulnerable people it could infect and kill. At this rate, the US will be back to normal by May-June, albeit with some caution.
The Vaccines
Our current vaccine discourse is dizzying. How many do we need? Do they protect only against hospitalizations and sickness? Can I still transmit the disease after being fully vaccinated? Allow me to share my mental model of the vaccines.
Much confusion about vaccines arises from us losing sight of the first-principles of immunology. Our body’s immune system is extremely complex. Textbooks on immunology are often thick and heavy enough to give doctors a workout. We likely still don’t know everything about the immune system and will continue to learn more. What we do know is that it has protected us from pathogens all around us for millions of years.
That being said, vaccines work by training our immune system to produce antibodies for a given pathogen. The idea is remarkably simple, yet tremendously powerful. Introduce weakened version of a virus to the body, let it produce antibodies against it, and the immune system will store the memory of how to fight it the next time.
Remember the above basic principle and most of the vaccine confusion resolves itself. For example, could you still transmit the virus after being vaccinated? No1. You can’t spread it because the virus never gets the hold of your body. It can enter it, but your immune system will defeat it. The virus never gets to replicate in the body, and without replication, you can’t be a vector.
The Dose Question
Most flu vaccines are single dose, and they are about ~60-70% effective. Then why is the COVID vaccine regimen two-dose? Because the second dose acts as a booster. It can help us develop a stronger and more durable immune response against the virus.
Now, it helps to keep things in perspective. Just how much does the second dose help us? I think the current answer is – only a little bit more. The more data we gather, the more we are learning that the first dose generates as much as 90% of the protection. Yes, the second dose may get us to 95%, but that is a marginal difference, unlikely to matter in the grand scheme of things. What is currently not fully understood is whether the second dose really makes the immunity last longer, and if so, by how much. My prediction here is that the difference again won’t matter much.
If you have the opportunity to do so, I’d still recommend getting the second dose. It will probably help, and the reports of side-effects seem overblown so far. But, know that you are *pretty much* fully protected just after the first vaccine.
Post-vaccine guidance
There are two post-vaccine questions we are faced with. First is the individual question – what can *I* do once I am vaccinated? CDC released their guidance on this and said that it should be okay to gather indoors with 1 other unvaccinated household *without masks*. This is a huge indicator of the power of vaccines. Keep in mind that the CDC will always be the last institution to say that the pandemic is over. It’s their job now. They are and will be overly restrictive. I think individuals will make their own risk assessment and behave accordingly, and it’s hard to give a blanket answer.
Second is the societal question: where will we be as a society after vaccinations? This question is much easier to answer – the USA is opening back up. It was the red states first, but the blue states are closely following the suit. California is set to reopen Disneyland to visitors, for example. It’s clear that the vaccines are leading to a rapid collapse in hospitalizations and fatalities, and we now have a path to normal closer to us than we ever anticipated.
Public Health Messaging
I have made some claims above that run counter to the mainstream public health messaging. There’s a good reason for that.
First, I think public health messaging in the US is a complete failure. This is to be expected from large stagnant bureaucratic organizations. From the WHO backing China’s false claims that there is no human to human spread, or that the virus wasn’t airborne, to the CDC advising everyone to not wear masks, only to do a full 180 degree switch on it a few weeks later, mainstream public health messaging in the US is a total failure.
Second, public health experts have an agenda. They are not in the business of conveying raw facts to people, but to push policy levers that *they think* are the best. Since I know better than to blindly trust their judgement, I am forming my own opinions based on the information publicly available. This shouldn’t be a surprise, after all, another MIT student created the best pandemic models and predictions, consistently beating CDC’s predictions (full story here)
Finally, there is always the financial motive to consider. Companies like Pfizer and Moderna have soared beyond expectations during this pandemic, and they will want to maximize their profits. There’s already talks of “price hikes” and “yearly booster shots” from Pfizer execs (story here). Just as your barber will always tell you to get a haircut, Pfizer will always sell you the vaccine. It remains to be seen whether the booster doses provide any non-trivial additional benefit at all, but I would be a little cautious to keep pumping our bodies with an mRNA cocktail every year just because it’s good for Pfizer’s bottom line.
Variants
A word on variants. They’re not what they’re cracked up to be. Countries/states where we know variants are prevalent have continued to show decline in cases, hospitalizations, and fatalities. The vaccines are increasingly shown to work against several variants, with the possibility to quickly develop booster shots when we need them. The virus cannot physically evolve to arbitrary spike protein configurations as it has a finite number of moves available to it, and our immune system is well equipped to deal with them. However, none of this is going to stop the mainstream media from writing doomsaying articles about the variants. It’s the perfect story for them - “something bad may happen in the future and therefore you need to keep watching my news channel and never go outside”. Only thing we can do is to ignore the noise.
—
Ayush
Note that in life, *extremely unlikely* is as good as a No. There is no zero-risk scenario except when you’re already dead.