Some unpleasant pandemic arithmetic

A lot of discussion around “living with Covid” starts from the premise that, as long as vaccination rates are high (say 80 per cent of the population), we don’t need to worry about high case numbers. That’s because vaccinated people are less likely to suffer bad outcomes (hospitalization and death). The problem with this claim is that, because the primary function of vaccines is to protect against infection, unvaccinated people will be over-represented among cases. Let’s try some simple arithmetic.

Suppose the vaccination rate is x%, and that vaccination gives y% reduction in infection risk and z% reduction in bad outcomes (hospitalization and death) conditional on infection. Denote the percentage of bad outcomes for unvaxed by b %. Assume all unvaccinated will be infected if exposed.

Then, for each 100 people exposed, (100-x) unvaccinated and x*(100-y)/ 100 vaccinated will be infected. Example, if x = y = 80%, there will be 20 unvaccinated and 16 vaccinated. That is, even though unvaccinated people are only 20 % of the population, they will account for more than half the cases.

The number of outcomes will be

b* = (100-x)*b⁄ 100 + x *(100-y)*(100-z)*b⁄ (100*100 )

Say b = 5%, z = 80%, Then we get 1.16 bad outcomes, compared to 5 in the absence of vaccination. So the good news is vaccination works,

But as a proportion of cases, things don’t look nearly so good. In the absence of vaccination b=5 % of cases have bad outcomes, but with vaccination b*=1.16/36 = 3.2 per cent, which is only marginally lowe.

So, the idea that we don’t need to worry about high case numbers if vaccination rates are high doesn’t really stand up. We have to keep case numbers down. Taking the vaccination rate as given, that can only be done with measures like mask mandates, social distancing and vaccine passports.

33 thoughts on “Some unpleasant pandemic arithmetic”

1. paul walter says:

Haven’t we done this fool’s paradise number concerning lockdown cessation a few times before?
We’ll see in a few weeks. Meanwhile, the politicians have found an enabler involving the non vaxxed, who will now be scorned when numbers go up. but all the folk in the malls. barbers, gyms etc, better not be unvaxxed, or the kiddies.

It is easy to see why even Andrews capitulated, when the figures comparing vaccinated against the rest turned up, given the heat the man himself had been put under, but I find the criminal disregard for hospital workers vile. It is reminiscent of the callousness shown firefighters during the bushfires last year by the very same claque of maniacs at the very top.

Ute Culture’s finest hour!

2. Duke the lost engine says:

Correct me if I’m wrong, but I think you are failing to account that as vaccination rates get higher, the unvaccinated, as a group, are getting younger and younger, so effectively b is getting lower and lower rather than being fixed.

3. Andrew says:

John it is beyond obvious to say that your analysis is rather sensitive to the relative risk reduction between the 2 cohorts (excluding other composition effects such as age). And I dont get where you get your risk ratios. All the evidence from the UK and US suggest the magnitude of risk reduction is much greater than you suggest. And clearly if the baseline absolute risk of mortality is already low, then the absolute difference is going to appear low.

https://www.bmj.com/content/374/bmj.n2282
Suggests the difference is not a 20% reduction in absolute risk but 10fold.

And then obviously we need to net the expected number of deaths out against the expected increase in deaths from late diagnoses in oncology and other health related opportunities it’s costs that the pandemics and responses to it have incurred

4. Geoff Miell says:

Westmead Institute for Medical Research Clinical Professor Graeme Stewart says for best estimates for herd immunity requires at least 85% of Australia’s total population to be vaccinated. That means 99% of eligible Australians (12 years and older) need to be fully vaccinated.
https://johnquiggin.com/2021/09/21/australias-covid-plan-was-designed-before-we-knew-how-delta-would-hit-us/comment-page-1/#comment-245925

Per the Australian Government COVID-19 Vaccination Rollout, for eligible population aged 12
years and older, for at least ONE DOSE, as at Oct 22:
National: _ _ 86.4%
ACT: _ _ _ _ 95+%
NSW: _ _ _ _93.0%
Victoria: _ _ 90.2%
Tasmania: _ 86.6%
SA: _ _ _ _ _ 78.6%
NT: _ _ _ _ _ 73.3%
Queensland: 74.6%
WA: _ _ _ _ _75.7%

Given the data above, I’d suggest none of the Australian state/territory jurisdictions have yet reached so-called ‘herd immunity’ levels, per Professor Stewart.

Andrew Freedman, a reader in infectious disease at Cardiff University School of Medicine, told CNBC recently on why COVID cases are rising when millions have been vaccinated in the UK:

“The delta variant is highly contagious and this accounts for the continuing high number of cases now that we are mixing much more freely since most restrictions were eased.”

“Those catching Covid now are a mixture of unvaccinated, partially vaccinated and double vaccinated people. A large proportion of new infection are in (unvaccinated) children and adolescents.”

“We know that the vaccines are only partially effective at preventing people from catching the delta variant, but are much more effective at protecting against severe disease, hospitalisation and death. Fully vaccinated individuals are mostly getting only mild symptoms if they do catch it, although a small minority, especially older and more frail people, are still getting more severe illness.”

IMO, measures like mask mandates, social distancing and vaccine passports are still required.

I’d suggest the added complication now is waning protection for those people who received full vaccination more than six months ago.

5. Svante says:

The problem with this claim is that, because the primary function of vaccines is to protect against infection,

JQ, could this be expressed better and as succinctly? I believe I know what you mean, but I believe that the expression above, and as has also been seen widely expressed in similar terms, has caused much confusion in the wider population and vaccine hesitancy, and continues to still be a FUD type gift to the antivaxxer cause.

Perhaps “the primary function of vaccines is to protect against disease” would do?

My understanding is that the immune system, naturally and/or due to prior vaccination, is mobilised by an infection upon detection and works as best it may then to resist infection spread within the body, and to reduce infection and disease severity caused by the infection. Most vaccinations in most people greatly enhance the immune system response, so much so that for SARS-Cov-2 most vaccinees won’t even know or will hardly be aware of ever having become infected with the particular pathogen a vaccine targets. They are not diseased, and even though infected and infectious to varying extent are likely rather at ease with regard to their state of health. The main issue is that the severity of disease is varied but mostly much reduced in that small minority of vaccinees who may actually suffer disease post infection.

6. Ikonoclast says:

We should have contained and eradicated COVID-19 disease in the first place. By “we” I mean China firstly, then the West and then the world. The fact that we have failed to date says a lot about our poliitical-economic system(s) and nothing about our technical ability to eradicate the virus: be the strain as contagious as the initial Wuhan strain or as contagious as the later Delta strain. We had the technical capacity, even before the invention of vaccines, to eradicate this disease. The public health technical capacity lay in test, trace, isolate, mask, distance and quarantine. The capacity was always there. But we (the world) refused to use it. The countries that did use it mostly succeeded, even before vaccines, in suppressing it and even moving (with some difficulty) towards complete eradication. They had better economies as a result. That was our position until certain governments (NSW and Federal), business interests and some citizen groups (criminals, rednecks, denialists and anti-vaxxers) sabotaged us.

Eradication in one country or in a few become far more difficult when the pandemic was permitted to spread rapidly around the globe. The governments and significant citizen sub-groups of leading Western countries and groupings, USA, EU and UK. for example. behaved like rank idiots with not the least idea of how to implement epidemic control in their jurisdictions or to behave with consideration for vulnerable others. We let this happen and it did not need to happen.

Even now, we should not dismiss the possibility of eradicating COVID-19:

“We should not dismiss the possibility of eradicating COVID-19: comparisons with smallpox and polio.”

https://gh.bmj.com/content/6/8/e006810

I wonder if vaccines, hoped for and then delivered, were a bad thing in one sense. Without vaccines, we would know we had to follow the other measures of test, trace, isolate, mask, distance and quarantine. With vaccines people think they are invulnerable like NFL players running around with helmets on. Actually, the helmets make them less safe precisely because they imagine themselves invulnerable in helmets and take greater risks then ever. Vaccines could operate in the same manner, causing people to imagine themselves invulnerable and actually increasing their danger by encouraging reckless behaviors. Certainly our governments here in Australia are now acting recklessly and encouraging people to do so as well.

Given our current messed up position, we of course do need vaccines now. We also need all the other measures possible and dropping them all, or in part, will lead to very serious epidemic outbreaks o waves in 2022 in Australia. It could be our worse year yet by far.

7. James Wimberley says:

There’s another issue I’ve not seen discussed. The best vaccines are 92% effective against serious illness, which I take (perhaps wrongly) to mean hospitalization or previous death. That means 8% are not protected. Assume, realistically, that all will be exposed sooner or later, and a death rate among the hospitalized of 17%. That gives a total death rate of 1.4% of vaccinated adults.

Take the UK as a representative high-case country. Total population fully vaccinated is 45.5m, almost all adults. The UK can then expect another 62,000 deaths sooner or later among the vaccinated.

You can tinker with my assumptions, particularly around children, and get slightly different estimates. The takeaway however is that a large number of deaths among the vaccinated are unavoidable under a “live with it” strategy. It’s worth aiming for eradication.

8. Harry Clarke says:

John, I think I get your reasoning but not sure about the conclusion you draw on the basis of your “simple arithmetic”. Of course I agree with that conclusion itself – I am doubly vaccinated but will still be taking every means to prevent infection and not throwing caution to the wind!

Your arithmetic suggests we will get many fewer cases of the infection with high levels of vaccination and many fewer bad cases. But your problem is that the ratio of reduced bad cases to reduced total infections doesn’t fall much. You say this is because if we have very high infection levels (which we won’t according to your arithmetic) we will still have many bad cases. It seems to me, rather, that most infections will occur among the unvaccinated and the same proportion of those develop severe cases as prior to the use of vaccines.

Maybe I am missing something obvious here but I don’t quite get it. The problem with the 4th wave in the UK at present seems to be that the effectiveness of vaccines is wearing out. The suggestion is that booster shots perhaps should be given after 5 not 6 months and that the term “fully vaccinated” should refer to those who have had 3 vaccine shots rather than 2.

9. James Wimberley says:

harry Clarke. “the effectiveness of vaccines is wearing out.” Any evidence for this? The evolutionary pressure on the virus is to get more and more contagious, not more and more severe – the nasty South African variant that beats vaccines hasn’t had a chance to go global in the face of super-contagious Delta. Occam supports my vaccine unprotection theory. Also antivax holdouts – daily vaccinations in the UK have slowed to 60,000 or so a day, so the limit may be 95% or so of adults vaccinated.

10. hix says:

That gives a total death rate of 1.4% of vaccinated adults.

Only if the numbers refers to absolute protection, albeit, my hope would be that the numbers refer to relative protection compared to the non vaccinated. Most non vaccinated don´t end up in the ICU either. That is the number given would suggest x% less likely than the unvaccinated, so we would end up with something like 1,4%*probability of the unvaccinated to die.
18 till 59 year above 60 years
sympthomatic disease 85% 83%
hospital 96% 95%
ICU 97% 95%
death 100% 92%
(own translation, premilary data, real outcomes are expected to be somewhat worse due to underreporting of vaccination rates among the hospitaliced)
https://www.n-tv.de/wissen/Impfung-verhindert-fast-alle-schweren-Verlaeufe-article22810018.html

11. hix says:

Sry, i´m stupid, the standard numbers are not relative, they are simply according to the formula in the op. That still gives us one more factor 1,4%. That is: the 1,4% would still refer only tho those who do get the diseases (hopefully to those who get it sympthomatic), which might still be as low as 13% (basis RKI study). So 1,4% * 0,13= 0,182%. Gah.

12. hix says:

Sorry, fourth, maybe my first version was right. Either way, there is a factor missing that deminuishes those 1,4% by a lot. Also note that among the dead with vaccination, many do not enter a hospital before they die, which gives us another distortion. Not going to work it out anymore today if ever.

13. James Wimberley says:

Hix: Many thanks for the correction, As you say, vaccine efficacy is defined as the proportional reduction in the metric of interest compared to a control population of the unvaccinated. If we plug in a guess of 10% as the share of the latter who end up in hospital, my scary total of UK deaths among the vaccinated goes down I think to 6,800, plus another 30,000 or so who will survive a nasty and expensive time in hospital This is still significant enough to weigh on public policy.

I see no reason to change my assumption that all the unvaccinated will get infected sometime. Delta has put paid to indirect herd immunity.

14. Ikonoclast says:

On the policies currently planned for Australia, EVERYONE will get infected with SARS-CoV-2, sooner or later. More to the point, they will get infected multiple times over the next decade or two. A person who is 45 today will be 65 in two decades, obviously. A person who is 65 today will be 85 in two decades, obviously. Such persons will likely catch COVID-19 about every second year, or ten times in 20 years, vaccinated or not, if the disease remains endemic. Each one of these infections will carry a risk, rising as the person’s age rises. Notwithstanding vaccination, they will succumb sooner or later. The risks will prove additive and perhaps even multiplicative, as each infection does pulmonary, organ and general vascular damage. The overall nature of COVID-19 disease is as a whole-of-body vascular disease. This has serious implications for ageing people.

“The sequelae and complications of coronavirus disease 2019 infection have continued to emerge during this pandemic era. Although the long-term effects are continually being monitored and studied, we have been seeing more acute and subacute medical complications requiring a thorough discussion and, sometimes, adjustment of our standard of care and intervention.

Coronavirus disease 2019 (COVID-19) has rapidly become a pandemic of unexpected proportions. As our knowledge of the virus rapidly progresses, we are learning the sequelae of the disease course. Significant information has been collected and learned regarding the more obvious respiratory and intestinal symptoms associated with the disease. We have been, however, noting an increase in the incidence of inflammatory sequelae affecting multiple organ systems in patients who have acquired and/or recovered from the disease, especially the cardiovascular system.” – “Development of symptomatic inflammatory aneurysm treated with endovascular repair in coronavirus disease 2019–infected patient” – Christopher J. Riley, MD∗ and Pedro Teixeira, MD.

This suggests a picture of multiple infections of COVID-19 progressively becoming more serious and more damaging as persons age. It suggests successive and accumulating damage. Add in the serious likelihood of the evolution of more dangerous strains and the situation long term looks dire. With the disease remaining endemic around the world and international travel being permitted continuously (as is the current plan) new, even more highly dangerous variants will almost certainly evolve and be spread around the world. Delta plus variant is not the end of SARS-CoV-2 evolution.

I find it darkly amusing that virtually all the people with the real money and political power in our system, and who are pushing for opening up without adequate controls, are over 50. They seem to be clever with political, power and money levers, though even there it has to be be said many of them are people who have “failed upwards” [1], like Boris Johnston. They are very stupid with respect to the real powers and forces in this world, which are of course natural (physical, chemical and biological) forces. They have no idea what they have unleashed.

Note 1. Failing upwards is a when a series of failures is good for a person’s career. Both bureaucratic and corporate structures seem to promote “failing upwards” usually via cronyism, nepotism and spin. Others always pay for the mistakes of people who fail upwards.

15. Malcolm says:

BMJ this week published a risk model using UK data. You can try it out here: https://bmjsept2021.qcovid.org/

As a 50-year-old fully vaccinated male with no risk factors, it estimates my chance of death after a positive COVID test as about 1 in 2000.

And based on the current rate of spread in the UK, it estimates my risk of death in the next 90 days as 1 in 125,000

16. Duke the lost engine is correct. The calculation should be done by age group, and it’s the vax rate for the 65+ group that matters most.

17. Ikonoclast says:

Malcolm,

But then you (and I and everyone else over 50) need to factor in multiple episodes of catching COVID-19 over the next x years until each one of us passes away from COVID-19 or something else. This is on current indications of COVID-19 remaining endemic, re-contractable multiple times, with immunity and vaccines waning but being boosted and also not even making any assumptions for more dangerous variants which could arise.

So, assuming one catches it once every 2 years, the risk is much greater than .0005. It is even much greater than .0005 x 10 = .005 or 0.5% over 20 years. With ongoing damage from multiple episodes we can possibly assume the cumulative or additive risk of catching the disease each two years until 70 from 50 and dying at some point is at least an order of magnitude greater than that again. That gives a 5% or 1 in 20 chance that today’s healthiest 50 year olds who otherwise maintain good health will die of COVID-19 before or by age 70. Add that to all their other chances of dying before or by age 70.

This might not come to pass but I think it’s a genuine risk as a plausible bad case scenario. Why won’t people catch it multiple times? Why won’t it do accumulating damage (like long-covid) to people and worsen their chances of fighting it off each “next” time? The onus of proof is really to prove why this won’t happen. All the current signs are for multiple reinfection possibilities and for an accumulation of damage from probably all but completely asymptomatic infections. A high percentage of old people will end up with long-covid. Neither they nor the medical / aged care system will cope. It will be a disaster. That is my prediction anyway.

18. Malcolm says:

Iko,

The 1 in 2000 is conditional on a positive test and is based on actual testing data in the UK. If you are vaccinated and exposed to COVID your chance of testing and returning positive is less than 100%.

I think a better basis for extrapolation would be the 1 in 125,000 figure. Very roughly, over 20 years this gives a risk of death of 0.05%.

19. Ernestine Gross says:

Some terminology issues I am aware of (and I would expect there are a lot more, which I am not aware of):

The Covid-19 vaccines (BioNtech-Pfizer, Moderna, Astra-Zenica) provide protection against symptomatic infections (NOT infections per se). Transmission of the virus, Sars-Cov-2, by people (vaccinated or otherwise), who do not show symptoms, is therefore possible.

People who have recovered from the Covid-19 sickness also have immunity in this sense (there is a lot more of this type of protection in the UK than in Australia). Hence working only with vaccination rates when comparing data across countries has serious limitations.

The effectiveness of this protection is measured using laboratory (test) methods and field data. The efficacy measures are relative measures, as stated by hix (and very clearly explained by Prof Karl Lauterbach, epidemiologist and public health expert, who happens to be the Social Democrats’ health expert in the Federal Government in Germany).

As mentioned in an earlier comment, the effectiveness of vaccines various a lot across age cohorts.

Symptomatic infections may be classified as mild, moderate or severe and possibly deadly. This complicates any discussion of ‘protection’ even more in so far as the efficacy may differ for these 4 categories as well as for the variant of the virus. In addition various health agency (eg US vs EU) may use different criteria for all categories except death. What is a ‘bad outcome’ (death ultimately) depends on medical treatments and hospital facilities. It quickly gets very technical.

From a public health perspective, the crucial condition is a capacity constraint. That is the demand for hospital and associated medical services must not exceed the constraint. This is the responsibility of health ministries and health departments.

But from an economic perspective, the medical supply constraint is not the only factor of interest. Both, from an individual agent’s perspective as well as from the perspective of ‘the economy as a whole’ (society), mild or moderate symptomatic infections still reduce productive capacity (isolation for x days, tests, GP consultation, temporary school closures with associated implications for working parents, cancellation of an allowed meeting with friends, etc ) even though there is no demand for hospital services. This factor is now a big problem in the UK, given the persistently very high case numbers.

Incentive compatibility. It seems to me every individual agent could have an incentive to wear a P2 (N95 in the US, FFP2 in the EU) mask in public closed spaces (eg public transport, shopping centres, hairdressing shops, ….) because they reduce their personal risk of losing a few days of their otherwise normal life due to a mild or moderate infection, if this simple insight would be explained often enough. As an aside, there would be a little encouragement for supporting the local (Australian) manufacturers of P2 masks. This is all I could say from the perspective of economics, leaving the epidemiological stuff to the relevant experts.

20. Harry Clarke says:

James Wimberley, My phrase “the effectiveness of vaccines is wearing out” simply meant that the effects of the vaccines were dissipating with time. A lot of the new UK infections among vaccinated were those vaccinated 5+ months ago.

21. Ikonoclast says:

The pandemic arithmetic just gets worse and worse.

“Vaccination reduces the risk of delta variant infection and accelerates viral clearance. Nonetheless, fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings, including to fully vaccinated contacts. Host–virus interactions early in infection may shape the entire viral trajectory.” – The Lancet.

https://www.bbc.com/news/health-59077036

Also, protection effectiveness wanes in 6 months to about 74% (Pfizer) and 67% (AstraZeneca). That is to say, if you are fully vaccinated your chances of serious illness or death are then 1/4 (Pfizer) or 1/3 (AstraZeneca) of the unvaccinated rate for your cohort and medical condition status. For example, if your chance of serious illness or death was 1.2% unvaccinated then six months after being fully vaccinated with Pfizer it would still be reduced to 0.3% and with AstraZeneca reduced to 0.4%. These actually are not particularly comforting numbers.

Assuming a “re-normalised” lifestyle, assuming everyone in the household catches COVID-19 every year “like a cold” and assuming a slight increase in variant virulence (quite likely) then just 3 to 4 years under this regime elevates your risk back to the equivalent of unprotected status in the face of a one-off infection. Unless something changes to amend this picture we face an almost unmitigated public health disaster within the next 5 years.

Opening up to the world and abandoning suppression and eradication of COVID-19 in Australia could well prove a massive disaster. The benefits of opening up are dubious. [1] The risks are serious and very likely to generate an ongoing public health disaster in Australia which greatly exceeds our medical and life-care capacities. The (neoliberal) authorities have no idea where this pandemic is going and no understanding of the serious risks they are running by intentionally infecting everyone, notwithstanding vaccination.

The capacity of the SARS-CoV-2 virus to mutate to more and more dangerous variants is far from exhausted. The chances that far more dangerous variants will yet arise in the world are very high, perhaps even certain.

“Immunologist Professor Doctor Sai Reddy, of the federal technology institute ETH Zurich, believes a combination of existing strains could result in a new and more dangerous phase of the pandemic.

He warned: “Covid-22 could be even worse than what we are experiencing now.”

As a result, multiple vaccinations will need to be prepared over the next few years as the world continues to fight the evolving threat, “maybe for the rest of our lives”. – ‘New super variant ‘Covid-22′ could be more dangerous, expert’ – ByRoss Millen, Ryan Merrifield.

This is the most likely outcome. Opening up before the mutations are anywhere near played out is an extremely risky strategy. Australia throws away its greatest asset, its isolation. Isolation now becomes an asset which is hard, nay impossible, for doctrinaire neoliberal economists to understand. People who can’t change their thinking when critical facts change are placing themselves on the critically endangered list. The year 2022 will be disastrous for Australia unless we change our policies.The year 2022 will be disastrous for the rest of the world, except possibly for China. The world has doubled down on deliberately infecting itself with the most dangerous pathogenic global pandemic since the Black Death. The stupidity is mind-boggling. Neoliberal economics ushers in a new dark age. They don’t care about climate change either but that’s another story.

Note 1. The world has little that Australia needs except for elaborate manufactures and these can still be imported at low risk if transport crews are kept away from the population.

22. Ikonoclast says:

Now, the anti-antisemitism is on florid display along with all the other lunacy. J.Q. needs to delete all of Terraforming Earth’s comments which I am sure he will do as soon as he notices them.

23. Ikonoclast says:

24. UGH! Sorry for letting that slip through. From now on, I will auto-moderate new commenters.

25. mrkenfabian says:

Penguinunearthed’s link/site was worth the visit. The role of Actuaries seems crucial to evaluating risks and responses to problems like Covid and Climate Change and it is good to see visible signs that they are. I think it is everyone apart from the fringe activists or pollies or commentariat that need to drive the responses forward.

26. KT2 says:

+1 for mrkenfabian liking “Penguinunearthed’s link/site was worth the visit. The role of Actuaries…”

Now. Actuaries. They are even smater than the Dr Engineers I used to work with. Actuaries were the only group who they would ask for clarification from, as they are the only species who could out evaluate them. Stats – nah. It was a question of ” is the bridge going to collapse at what fist benefit and therefore can we ge INSURANCE or trigger the winning legal clause.

As none of them had skin in the game and plenty of potential skin free upside, I came to regard both actuaries and “consulting engineers engineers” as simply guns for hire.

The big 4 are PR machines with guns – ‘studies & audits’.

Apologies to all you engineers and actuaries. When did you last to a pro bono for family violence, political polarisation, Co2 future costs, gender equality etc etc.

Happy to hear good examples.
Worley ex + Parsons took over the group I worked with. So…
“~25,000 current projects
48,000 people
49 countries”
https://www.worley.com/
Brains as big as mountains, biridges dont fall down, while societies aound them are falling. Which is basically my point – theae 48,000 peoole know there is better long term stuff to do but don’t.

At least most bridges and buildings stay up.

27. Ikonoclast says:

While the COVID-19 virus continues to mutate we can still hope for further innovations in vaccines, including not just boosters but possibly “universal vaccines”. These are vaccines which will stop a variant not yet seen at the time of production of the universal vaccine. So while I am a doomster most of the time, I can find some hope if I look hard enough. Big advances are being made in gene and vaccine technology.

https://qz.com/2054159/a-universal-covid-vaccine-is-needed-in-fight-against-new-variants/

At the same time, our economic system remains of serious concern. It is not interested in prevention. We all recall the old saying “Prevention is better than cure,” [1] and it is true. Unfortunately, in our economic system: “There’s no money in prevention.” Our system prioritizes, develops, sells and distributes only that in which there are prospects of early money profit. In true prevention nothing happens. No production, no profit. There is no circuit for profits. There is a bit of an exaggeration of course. Some things do happen but they are not forms of production which are prime sources of private profit. They mainly revolve around necessarily statist actions (precisely because there’s no private profit opportunities) or in researching, developing and stockpiling against rare contingencies. Again, the private profit system has no intrinsic incentives to research, develop, or stockpile against rare but highly damaging contingencies.

“Pharmaceutical companies, likewise, have a perverse incentive. Healthy people make them no money, neither do dead people; sick people though, they’re a goldmine.” [1]

Pharmaceutical companies are now vitally interested in COVID-19 prevention, since their research was underwritten by massive government grants and they were further gifted their monopolies on production. Overall, our system is not one which prevents disasters. Climate change is another case in point. Our system generates disasters and then a select plutocratic sub-group profits off the disasters.

It’s nothing new to point this out. “Disaster capitalism is a term that refers to the generation of profits based on the occurrence of some type of disaster. That term was first coined by Naomi Klein in her work The Shock Doctrine.” – Wikipedia. Well before Naomi Klein, Thorstein Veblen pointed out that the capitalist system was a system of strategic and tactical sabotage of the potentials inherent in technology, industry and industriousness itself. Disaster capitalism and sabotage capitalism or two sides of one coin, the capitalist coin. Sabotage leads to disaster. Capitalist sabotage creates the disasters we face.

Capitalism is not merely purblind in its greed. It is premeditated, deliberate and deliberately destructive. The sabotage of human potentials is intentional and pre-planned. The sabotage of human safety is also intentional and pre-planned. The object is the profit but the collateral damage to people is knowable and known in advance. This has been clear right from the denial of cigarettes causing cancer to the denial of CO2 causing climate change and on to the modern denial that placing factory farming and international travel above the needs for pandemic control will cause, has caused to deaths of 5 million people and counting.

For sure we have to use science. Equally as sure, we have to move beyond capitalism or it will destroy us by its use of science only for response and cure and its refusal to act to prevent the predictable consequences which require so much in response and cure. While we remain capitalist we remain on the path to complete disaster, civlizational collapse and very likely human extinction.

“Shallow all the actions
Of the children of men,
Fogged was their vision
Since the ages began.” – Marc Bolan, “Monolith”.

Note 1. The Economics of Disease Treatment and Prevention – Guest Blogger Dan Rose on February 20, 2012, ‘Sociological Images’.

28. Stockingrate says:

The term “vaccine passport” should be dropped, it is too readily understood or misunderstood to promise what it cannot deliver, that is negligible risk of transmission (and that before considering fraud, or other variants). Border controls (country and state primarily) on numbers and purpose built quarantine are required, together with vaccines, masks, test, track and trace and isolate, and the will to compare infection rates to Japan, China, Taiwan, even NZ and to go to Zero. We won’t though and many deaths and much long covid will likely follow. There is plenty to be positive about – boosters, possible nasal vaccines, therapeutics, possible nasal prophylactics- all the more reason to not open up to covid now.

The economic mismanagement of opening up to covid seems to be largely forgotten.

29. Ikonoclast says:

History is forgotten as Stockingrate notes above, and it is forgotten within months.

In addition, denialism connects the dots of events in precisely the wrong way. When a very imperfect early response leads to preventable deaths (COVID-19 is the example here), the preventable deaths are blamed on the eventual response itself, not on the very imperfect and dilatory nature of the response. This move by denialists requires that they forget most details of the history. Cause and effect also have to be inverted. In this mode of thinking, vaccinations cause the deaths even though scientific evidence and the history of the events show the contrary, except for the tiny proportion of adverse reactions.

This is an example of the fallacy of reverse causation. A heightened level of death causes a response (vaccinations in this case). But for while deaths climb while vaccinations climb, until vaccinations and other measure bring the death rate under control. The period where deaths and vaccinations rise together is misinterpreted. It’s something one might call “point in time cherry picking”. Only by analyzing the entire time series can the correct conclusion be drawn. It’s not possible to analyze time series if one forgets history.