I have one correction on the obesity/overweight numbers, unless I misunderstood the claim being made. In most contexts, including the NCHS numbers cited above, the cutoff for overweight is a BMI of 25, not 30. The cutoff for the vaccine is a BMI of 30, so only ~40% of people qualify, not ~70%.
I’m curious if someone more knowledgeable can help me understand how to think about a vaccine that is 80% effective. Is the idea that each person will have a high chance of being essentially immune, and a low chance of having minimal protection? Alternatively, does it offer approximately 80% protection to everyone, the way that masks and social distancing would?
If it’s the latter, it seems like risk compensation could largely undo the effects of an 80% effective vaccine. If I see my family once a week without a mask, and I start going back to the gym, I could easily increase my risk by a factor of 4-5x.
Fair enough; thanks for the advice!
Interesting; I will give that a try. Any particular type or brand that you recommend?
How long did it take you to adapt to the CPAP? I have mild sleep apnea and tried to use a CPAP for a bit, but I absolutely could not sleep with the mask on.
Are nasal strips useful for something other than preventing snoring? I already use earplugs, and I’m always on the lookout for more improvements to sleep quality.
At the moment, the poor person and the rich person are both buying things. If the rich person buys more vaccine, that means they will buy less of the other things, so the poor person will be able to have more of them. So the question is about the ratios of how much the two guys care about the vaccine and how much they care about the other thing… and the answer is the rich guy will pay up for the vaccine when his vaccine:other ratio is higher than the other guys.
This is only true if the rich person is already spending as much money as possible, so an increase in spending on Item A must cause a decrease in spending on Item B. For someone like Jeff Bezos, an increase in spending on Item A probably just results in slightly less money spent by his great-grandchildren in 100 years.
It might be the case that it is separately desirable to redistribute wealth from the rich guy to the poor guy. This would indeed allow the poor guy to buy more things. But, conditional on a certain wealth distribution, it is best to allow market forces to allocate goods within that distribution.
I don’t see why this has to be true in all scenarios. If we want to make sure that the starving guy gets some of the food, can’t we just allocate the food to him directly, rather than having to give him enough money to win a bidding war with Jeff Bezos? Perhaps we desire a system where, in general, Jeff Bezos can use his money to do whatever he wants, but we have safeguards in place to prevent him from outbidding a starving guy on the food he needs to survive. I recognize that this may not be efficient in monetary terms, but it could be efficient in terms of overall human utility.
Agreed on all points, except for about how clear the author was being about the use of the word “value”. Although he does make the reference to willingness to pay, his rhetorical point largely depends on people interpreting value in the colloquial sense. He writes, in the previous post:
If we’re not careful, next thing you know we’ll have an entire economy full of producing useful things and allocating them where they are valued most and can produce the most value. That would be the worst.
Imagine if you alter the phrasing to this, which is roughly equivalent under the “value = willingness + ability to pay” paradigm:
If we’re not careful, next thing you know we’ll have an entire economy full of producing useful things and allocating them to people who can pay the most money for them and where they can generate the most wealth for those people. That would be the worst.
Many people might reasonably object to that scenario, even though it sounds silly when we phrase their objection as “I think we should allocate resources to people who value them less”. My own feelings are probably closer to the author’s than those of the hypothetical objectors, but I’d prefer it if we could avoid these kind of rhetorical techniques.
I said it last week, people righteously said that things are not worth to the customer what the customer will pay for them because poor people have less money than rich people, and no, sorry, that’s not how this works, that’s not how any of this works.
It seems easy to construct a scenario where this is untrue, or at least conflicts with an intuitive definition of “value”. If I’m trying to auction off a rare food item in a room with Jeff Bezos and a starving person with no money, Bezos can easily win the auction if he has the slightest desire for the food. A tiny rounding error on his fortune is more than the starving person’s entire life is worth (in a monetary sense). Bezos clearly puts a higher monetary value on the food, but it seems absurd to suggest that this is an example of the food being allocated to the person who values it the most. To use a more realistic example, it’s hard for me to agree that a billionaire values their tenth vacation home more than a homeless person who is in danger of freezing in the winter.
I’m generally in favor of free markets, and maybe allowing Jeff Bezos to do whatever he wants produces an overall better world than the alternative. However, it seems disingenuous to say that his vast fortune means that he can value an item of trivial importance more than other people value anything at all.
I apologize; I made an error in my original comment. I was actually referring to high blood pressure rather than diabetes. 15 out of the 26 people in the control group had high blood pressure, which is greater than the number of people who needed ICU care. Using your (maximally generous) assumptions, we would have zero non-hypertensive patients from either group needing ICU care.
Firstly, two risk factors were more common among the treatment groups: <60 years of age, immunosuppressed & transplanted.
Absolutely true, but the overall risk factor prevalence was still significantly higher in the control group. Furthermore, I’m not sure if all risk factors are created equal. Regardless, the overall point is that the two groups had significant differences in important characteristics.
*In order to achieve a p<.05 the lack of blinding/fuzziness would must have failed to send 16 of the 46 treatment group members to the ICU.* That is still not likely without deliberate fraud.
I think it’s more likely that they sent a few of the control group members to the ICU unnecessarily. If you figure that the difference in risk factors between the two groups accounts for a couple of the extra ICU cases, the placebo effect accounts for another couple, and unnecessary ICU admission accounts for another couple, it brings the P-value up pretty dramatically. I’m not statistically literate enough to know how to properly adjust for those factors and get an exact number, but it doesn’t seem to require deliberate fraud.
Just to be clear, I still think that there is probably at least some sort of real effect here. I’m just advocating caution in interpreting the results of a tiny study with clear flaws. I don’t really understand why there was no placebo control or double blinding, and that makes me more suspicious that there are other flaws that I’m not educated enough to notice. For example, the way that they describe the ICU admission criteria suggests that the presence of a comorbidity is itself a factor for ICU admission. If that’s the case, the differences in the risk factor numbers become even more important.
Regarding the Vitamin D study, it doesn’t seem like it was placebo controlled. Given the lack of placebo control, I’m not sure how it could be double blind. There were also a number of risk factors where the treatment and control groups had significant differences, most notably diabetes (present in 2.5x as many patients in the control group). If you combine the differences in the characteristics of the groups with the lack of placebo control and blinding and the “fuzziness” of ICU admission criteria, that could start to explain the effect without any deliberate fraud.
Of course, it’s still an impressive enough result that we absolutely need to be doing further research. I just think we should be cautious about how much weight we put on a single tiny study with unclear controls and blinding.