05 January 2021

Shtetl-Optimized: “My vaccine crackpottery: a confession”

I think that, in a well-run civilization, the first covid vaccines would’ve been tested and approved by around March or April 2020, while mass-manufacturing simultaneously ramped up with trillions of dollars’ investment. I think almost everyone on earth could have, and should have, already been vaccinated by now. I think a faster, “WWII-style” approach would’ve saved millions of lives, prevented economic destruction, and carried negligible risks compared to its benefits. I think this will be clear to future generations, who’ll write PhD theses exploring how it was possible that we invented multiple effective covid vaccines in mere days or weeks, but then simply sat on those vaccines for a year, ticking off boxes called “Phase I”, “Phase II”, etc. while civilization hung in the balance.

What could’ve been done faster? For starters, as I said back in March, we could’ve had human challenge trials with willing volunteers, of whom there were tens of thousands. We could’ve started mass-manufacturing months earlier, with funding commensurate with the problem’s scale (think trillions, not billions). Today, we could give as many people as possible the first doses (which apparently already provide something like ~80% protection) before circling back to give the second doses (which boost the protection as high as ~95%). We could distribute the vaccines that are now sitting in warehouses, spoiling, while people in the distribution chain take off for the holidays—but that’s such low-hanging fruit that it feels unsporting even to mention it.

Scott Aaronson

An argument that has been circulating online from the beginning of the pandemic, repeated again and again by people who understand next to nothing about vaccination and why this particular system is in place. It’s almost like the first reaction of tech people encountering regulations is to think: ‘I don’t know why this rule is in place, therefore I will ignore it’. Basically Facebook’s ‘move fast and break things’ mantra applied to public health – and we already know how much damage this approach has caused in society. A medicine or a vaccine is not software, where you can roll out products with bugs and fix them on the fly; you cannot release a patch if a poorly tested vaccine distributed to millions of people starts showing side-effects.

The risky way to speed up a coronavirus vaccine

To some of the points in the article:

  • in March and April 2020 there were dozens of vaccine candidates in clinical trials, and most of them have not advanced to the next stage – only three made it past Phase III trials until the end of 2020. To start manufacturing and distributing that many doses of ineffective vaccines would be a massive waste.
  • Human challenge trials are controversial both because the results are skewed towards young healthy people who are more willing to become volunteers (the results would not be relevant for a disease that primarily affects older people), and because we have no cure for COVID-19 (if someone develops complications, he or she might die because of the challenge trial) – the video above does a good job of explaining at length.
  • As for weighting the risks against the massive numbers of infections and deaths… There are simple, clear measures people can take to protect themselves and their close ones from the virus (physical distancing, wearing masks, more thorough personal hygiene, better ventilation), but many are refusing to take this advice. The same people will likely refuse to vaccinate, no matter how safe the trials were, or how fast vaccines would be made available.

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