Friday, April 16, 2021

The Public Health Establishment Is In Disagreement Over Vacccines

Buried deep in a CNN story about the Michigan COVID surge, I found this:

Though the virus appears to be spreading unchecked in those under age 59, those with a few months of vaccine eligibility (age 60 and up) have an impressively stable (and low) infection rate. This makes Gov. Gretchen Whitmer's plea to President Joe Biden for more vaccines all the more logical though, as the administration pointed out when they rejected Whitmer's request, giving more vaccines to Michigan will mean fewer for the surrounding (and other) states.

This bears out the view expressed by the LA County health department that the vaccines are in fact highly effective. But if, as the story says, Michigan has vaccinated in the neighborhood of 25% of its population, roughly the same as other states, this raises the question of whether Michgan has been vaccinating the right people. California for the first several months of vaccine distribution specifically targeted those most likely to become infected, which showed immediate effects. If Michigan is vaccinating a lot of people -- affluent suburbanites, for instance -- who aren't likely to get sick, it's wasting time and vaccine.

Beyond that is this story at MSN:

The political dynamics have changed markedly in recent weeks as vaccination rates have grown, warmer weather has returned, and the public and business owners have become increasingly vocal about reopening schools and loosening restrictions around social gatherings.

“I think we have a real compliance issue if we try to go back to the sort of restrictions that were in place in March and April of last year,” said Pennsylvania state Rep. Mike Zabel, a Democrat who had supported previous shutdown orders by Gov. Tom Wolf, a fellow Democrat. “I don’t think there’s any appetite for that in Pennsylvania at all.”

. . . Other governors also are staying on course to reopen society as they simultaneously expand vaccine eligibility, potentially complicating President Joe Biden's efforts to conquer the pandemic.

Thus it isn't just states like Texas and Florida that are ignoring the CDC, it's states with continuing surges like Michigan and Pennsylvania. They're becoming more aware, I think, of continuing legal and electoral challenges to strict orders that seem less and less effective.

But this raises another issue, whether the CDC is actually working against solving the problem. There's no question that Drs Walensky and Fauci advocate indefinite masking and social distance, no matter how effective the vaccines prove. A tweet thread by Dr Vinay Prasad of the University of California at San Francisco outlines the problem:

CDC messaging on restrictions post vax has been a mess

The q is not: is there 0% change of spread after vax (ans: almost surely no)

The Q is: do precautions have a reasonable ARR (w/ real compliance) post vac? (ans, also almost surely no)

My sense is that the effectiveness of vaccines, properly targeted, crept up on the CDC in particular. I think it's significant that nobody (UPDATE: Yahoo News finally noticed) has mentioned the case of California, which as far as I can see has been unique in specifically targeting the most vulnerable populations, indeed with incentives to meet quotas in the poorest areas. Doing this in the first months of vaccine distribution had spectacular results.

On the other hand, before the vaccines became available in mid December 2020, even though California had something like 98% compliance with masks and distancing, those measures clearly had no effect on the late 2020 surge there -- as they had no effect anywhere else.

Nor would I rule out the CDC deciding to "pause" all the vaccines, putatively to avoid inevitable bad reactions, but actually to extend the crisis. But I don't think they'd have supprt even among their colleagues.

I think the lack of a united front among the CDC, blue governors, and other health authorities suggests the panic is slowly waning, and the public is losing patience with efforts to extend it. Things will improve when Drs Walensky and Fauci begin to recognize their 15 minutes of fame has expired. Michigan