# 49

The moment’s here. My people are all the people. It is time to let my people go.

While case counts in many places remain high, we are on the way back down the mountain. The hospitals will hold. People can choose, based on their preferences and situation and the local conditions, whether they want to go now or wait a few more weeks before going. That is their call. It needs to be their call.

One could argue, as Tyler Cowen did in this excellent talk this week at Yale, that the moment is not quite here yet, on the theory that in a month cases will be an order of magnitude lower and thus it will be politically and socially easier to make the transition. There would be less opposition then, so better to wait, the price for doing so is small.

Would I take that deal? Absolutely I would take that deal, if we agreed on an end date or on explicit end conditions. A few more weeks is a small price in the grand scheme, and getting these things to happen takes time, so ‘a few weeks from now’ is the second best time to end pandemic restrictions.

But there’s no need for that. The best time is right now.

Remember that the case counts are seven-day averages and there is a several-day delay between infection and positive test, so we are living continuously living, for better and for worse, ‘in the future.’

Today I go back to the excellent Da Umberto, to celebrate (barring another variant, and ignoring the writing of posts and the pro forma wearing of masks and showing vaccination cards) the end of my pandemic.

## Executive Summary

1. Cases now declining most places.
2. Restrictions mostly remain in place.
3. Let my people go.

Let’s run the numbers.

## Week-Over-Week Predictions

Prediction from last week: 4.4mm cases (-10%) and 14,500 deaths (+15%).

Results: 4.05mm cases (-17%) and 15,964 deaths (+26%).

Prediction for next week: 2.85mm cases (-30%) and 20,000 deaths (+25%).

Overall it seems we peaked faster and more in unison than I expected, while other places did the opposite, and had softer declines than I expected. Based on those smaller declines elsewhere, I still expect the decline to accelerate as the West turns the corner, but I don’t expect a crash as quick as the rise up. A much faster decline is possible, but it would make our observations elsewhere quite weird.

The most confusing and surprising place of all right now is India. Cases are somehow flat there, and have been for a week, without hitting levels where that much adjustment makes sense, and I will freely admit that I don’t understand it at all, although I haven’t had time to look in detail and there are no related news stories that naturally have entered my feeds.

I interpret the death count here as saying that last week’s count was indeed artificially low rather than that this was a true 26% rise, and this in turn means this week’s is a bit higher than its true level. Deaths should continue to rise due to their lag behind cases, and I wouldn’t be that surprised by up to about a +40% number here, but after 1-2 more weeks after that we should see declines there as well.

## Deaths

Looking at the details makes it clear that last week had a more serious disruption to death reporting than we realized. Perhaps this week was thus slightly higher than its true level, on the order of a few percent. The large jumps across the board are mostly real, but that they weren’t far worse puts a cap on how bad things are going to get.

Worse plausible case, which still seems very unlikely, is something like +50% this coming week, +25% the week after, then +10% three weeks from now followed by a peak anyway, anything substantially worse than that would be very surprising. That’s a lot of death, but nothing like what we feared as recently as a month ago.

## Cases

Reminder from Bob Watcher that our case averages are reports from a week in the past, so on the way up our case counts underestimate cases, and on the way down after the peak they reliably overestimate cases.

He also notes that graphs seem much less like fast-up/fast-down than one would have predicted. The UK in particular has been bizarrely stable rather than continuing to decline. My best explanation for the slow decline is that different sub-regions peak at different times combined with behavioral modifications, but this is not sufficient to explain what we are seeing.

## Vaccines

Then comes the other part people are talking about.

‘Fades faster than natural infection’ isn’t obviously that bad, since it’s a kind of arbitrary baseline, although obviously we’d prefer if it wasn’t true.

I strongly agree that boosters every five months is not a strategy. And yet, some people think this, like hope, is indeed a strategy.

No, really, asking for a booster every six months that knocks a lot of people on their ass for a day or two? Yeah, that’s kind of a huge ask. The short term side effects are sufficiently costly that most people will correctly decide that it’s not worth it even if there’s lots of Covid out there. If this is the world we live in, the booster will be eventual mild reinfection. Those terms will need to be acceptable, because ‘better vaccines’ seem highly unlikely. These were pretty awesome vaccines.

Quebec is mandating that if an unvaccinated shopper is going into a big-box store, an employee must follow them around at all times to ensure they don’t sneak off and buy something that is not food or medicine. We would not want such folks exchanging money for goods, that’s how you get the Covid, you see. Having someone follow around and stay in close proximity to the unvaccinated person seems like the opposite of how you stop the spread. Also, isn’t there a step where you have to pay for your goods? Couldn’t you check vaccination status at checkout instead of on entry and avoid this? You could, but then you wouldn’t be able to publicly humiliate the unvaccinated, and the cruelty is (quite literally) the point.

## NPIs Including Mask and Testing Mandates

Netherlands lets our people go, ending all Covid restrictions.

Denmark lets our people go.

A proposal to skip PCR tests entirely and switch to relying on antigen tests, because the speed premium exceeds the accuracy premium. Seems mostly right to me.

Two years later, everything has changed, also nothing has changed? University of Washington develops Covid-19 test that is fast, cheap and accurate, combining strengths of rapid tests and PCRs.

Researchers at the University of Washington have developed a new test for COVID-19 that combines the speed of over-the-counter antigen tests with the accuracy of PCR tests that are processed in medical labs and hospitals.

The accuracy of COVID-19 tests has been a pressing matter throughout the pandemic. Many at-home antigen kits for COVID-19, which detect pieces of the proteins the virus creates instead of its genetic material, are 80-85% accurate, though accuracy may drop with the omicron variant, which harbors a relatively high number of mutations not found in other strains. PCR tests are generally 95% accurate or better — a key FDA benchmark — but require expensive equipment and a long wait for results.

Initial results reported in the paper show that the Harmony kit is 97% accurate for nasal swabs. The Harmony kit detects three different regions of the virus’ genome. If a new variant has many mutations in one region, the new test can still detect the other two. It can, for example, detect the omicron variant, which has dozens of mutations in the region of the genome that encodes the so-called spike protein.

And of course, since that’s the only mention of the FDA, we can assume that the University of Washington’s vastly superior new test kits are not legal for use. Nothing ever changes.

NFL decides to be true to itself, put the best product on the field for the playoffs, and screen for symptoms instead of testing players daily. No reason to be looking for the asymptomatic cases at this point, the show must go on. It definitely worked. Wow did they deliver their best product on the field for the divisional round.

Bari Weiss giving the audio version on Real Time of why she’s done with Covid. Also Kerry’s memory of being repeatedly told that everything was fine, all our prevention made sense and specifically to watch Tiger King. And yeah, it’s time to stop all this, but also if you still haven’t watched the original season of Tiger King you should totally do that, it’s almost as crazy as our Covid policies.

On that note, Hong Kong residents are paying up to $26k to fly their hamsters out on private jets to save them from the government’s cull. A feature of the world is that when people famously take extreme positions like the one from the Great Barrington Declaration, sometimes they are doing it because they think very differently than most others and have some strange models. Other times they are doing it because they wrote the conclusion at the bottom of the page and worked their way back up the same way everyone else did except they wrote down a different conclusion. In either case, usually they do not stop there. The Great Barrington Declaration was an extreme position, but it was easy to understand why, if the physical world worked in the right ways and you had the right values, it could be the right thing to do. There was an actual physical model and cost benefit calculation behind it. You could argue it was right or wrong. This, on the other hand, is The Chewbacca Defense. It does not make sense. I have gone over this a few times trying to find a way to make it make any sense. No success. If you have constant reinfections, you don’t have herd immunity. If you have herd immunity, you don’t have constant reinfections. Either more people get infected, or less people get infected. This is using the phrase ‘herd immunity’ like a talisman that can protect people without thinking about what the phrase actually means, the same way that those calling for more precautions have their own meaningless talismans and Sacrifices to the Gods. A judge threw out New York State’s indoor mask mandate, calling it unenforceable and unlawful, but that order was stayed on appeal, so the mandate remains in place. Presumably by the time the final ruling comes out the point will be moot. Thread explaining why we should all be ‘done with Covid’ shortly. For others, can you be too safe from the Covid monster? For those of you who doubt the reality of Covid Derangement Syndrome – the syndrome that drives people to believe that every further reduction, no matter how small, in the risk of encountering the SARS-CoV-2 virus is worth whatever the cost of this reduction, no matter how large – take a look at this photo of a traveler at the Charlotte airport. (HT Gary Leff and Todd Zywicki) If you think about Covid precautions as things one does in order to satisfy power and prevent social awkwardness, this strategy is obvious nonsense, since it is worse at both tasks while being more annoying. However, if your goal is to prevent Covid-19 for real, then it’s more efficient to go all-out and use technology that is mildly socially awkward and annoying, but that actually works. It’s the middle position, of crippling one’s life without getting the job done properly, that doesn’t add up. Where are all these free tests coming from? One data point, from the comments, suggests the obvious. My test supplier is claiming the feds are seizing most shipments of tests for their 4-free-tests program. Utah Governor, seen here saying ‘now hear me out,’ suggests that if you have symptoms you should stay home and isolate to avoid getting others sick because you’re sick but not worry about getting a test. That got a bit of mocking, but isn’t that exactly what you should do if you’re sick with something else too? If you have Covid you should stay home, take some time off, rest up and not get others sick. If you have the flu, or a cold, or other minor illness, yes, you should stay home, take some time off, rest up and not get others sick. So if you test, it doesn’t much matter what result you get, so it makes sense to consider not testing. No value of information, unless it impacts what you do once you’ve recovered in terms of risk management. Reminder that different areas continue to react to the pandemic very differently, and it does not seem to impact case counts all that much. I expect to be back to my baseline restaurant use rate going forward, after a month of going back to delivery. ## Think of the Children Let my people go. Let my people stay. University of Florida used to provide ‘isolation housing’ for students with Covid. Then they stopped doing that and instead started telling kids they had to leave campus, as in ‘serious consequences if not gone by 5pm,’ so as an example of what happens next, a student who was positive decided to go home and boarded a flight. Also it seems many places don’t let anyone under twenty-one book hotel rooms, which seems crazy? For almost two years children have been unable to see the faces of those around them. It was pointed out that maybe this was a problem, and that was widely dismissed as crazy talk by all the Very Serious People. Now that it’s time to take masks off, this position has been reversed with the only new evidence being ‘children aren’t learning’ and ‘well obviously I mean come on’ so it’s time for the rewriting of history. Remember. This is the WaPo article. A reply to the post above that was an emoji plus a link to the article was hidden by Twitter as potentially offensive content, which reminds me of this. When I follow the links in the quoted paragraph, I find evidence that the children are not learning, but no attempt to link it to masks. I do think the masks contribute, but we also closed schools and did insanely terrible remote learning so it’s not like ‘test scores are down’ is strong evidence that something else is terribly wrong. This is a Just So story that happens to obviously be true, but it was also obviously true a year ago. Suddenly torturing children is bad? As parents of school-aged children, we have also noticed a disturbing pattern, especially during the omicron surge: punitive mask culture. This can take many forms. Some older children, for example, have been given detentions and even suspensions due to “mask slippage” or improper mask-wearing. Younger children have also been subjected to harsh rules to minimize the spread of covid-19 during lunch hours, often their only mask-free time during the school day. Some must eat in total silence during mealtimes. Others have “expedited” lunch or are instructed to pull their mask down to take a bite and pull it back up to chew. Activities intended to relieve stress, including recess and gym, have been curtailed because of the danger of “increased exhalation.” And not torturing students is good, the kids might actually smile? Hopkinton High School in Massachusetts, in a region which boasts a 98 percent vaccination rate, offers a glimpse of what happens when students are given the opportunity to move from mandatory to optional masking. During their brief masking-optional pilot, the school reported that “smiling is more contagious than covid-19,” and a survey of students found that 70 percent said the policy improved their experience, including their ability to learn. Earlier in the linked thread are claims that masks don’t compromise children’s breathing (uh huh) and that they are vital to keeping kids safe (which they aren’t because kids are safe regardless) and it ends with saying masks are not forever (unless, of course, they and those like them have their way). Here is their link’s argument that masks aren’t a problem. A key part of learning to communicate for a child is watching the faces, mouths, and expressions of the people closest to them. Babies and young children study faces intently, so the concern about solid masks covering the face is understandable. However, there are no known studies that use of a face mask negatively impacts a child’s speech and language development. And consider this: visually impaired children develop speech and language skills at the same rate as their peers. In fact, when one sense is taken away, the others may be heightened. Young children will use other clues provided to them to understand and learn language. They will watch gestures, hear changes in tone of voice, see eyes convey emotions, and listen to words. So we start off with a classic No Evidence, then proceed to quite the Proves Too Much. I mean who uses visual aids to help with language? My son’s speech therapists, for one. Whenever they talk to him, they put their hands by their mouths and use highly exaggerated facial expressions, every time. I wonder if a face mask might interfere with this process of improving one’s speech? They even agree, within the same document, saying that speech therapists are going virtual in order to avoid masks or using clear masks so children can see their lips move. This, in many cases, is too much to ask. And here, right below their claim that there’s no problem, is their advice on what to do to mitigate the problem that they just claimed didn’t exist. Those are good ideas. Totally do those things. They work for adults, too. But if you need to get attention, reduce noise and distractions, speak slower and louder and use other body parts to ‘add information to speech’ then there can be zero doubt that this is a substantial reduction in communication ability and bandwidth. Which you then claim doesn’t matter. This is lying, but it’s more than that. It’s gaslighting. Now we’re being told that such messages were never sent and such claims were never made. Same as it ever was. I agree that one can’t trust such organizations in similar future situations. One can still have some amount of trust once you control for the political considerations. Often there are no political considerations, or they are in an obvious direction so one can adjust for them. You do also have to control for their level of understanding of logical reasoning. ## In Other News The Florida Man (and Governor) Ron DeSantis spent this week demanding a continued supply of monoclonal antibodies whose emergency use authorization was withdrawn by the FDA because of the whole ‘they don’t work against Omicron’ issue, along with the fact that almost all cases are now Omicron. They are instead being sent what treatments we have that do work, but that is not good enough for Ron DeSantis. He instead demands that Biden overturn the FDA’s decision as if that is a thing Biden is capable of doing. I would suggest to DeSantis that if he thinks that those who think treatments are worth using should be free to use those treatments even when the FDA does not approve of them (and even in cases where they do not work), he should generalize this insight into something like “FDA Delenda Est.” Meanwhile, here’s his surgeon general nominee deciding it would not be safe and effective to answer the question of whether vaccines work. Japan’s successful Covid strategy relied heavily on sharing information and less than other places mandates. Cultural factors were likely the central reason for Japan’s success, but was that in addition to the lack of severe behavioral mandates and the unusually free flowing of information, rather than in spite of those differences. My friend Will Eden’s child has Covid, despite generally extreme precautions. Even extreme precautions sometimes fail, and sometimes a complete lack of precautions still succeeds. Feels bad to trip up at the very end like this after all the sacrifices, but that’s sunk cost fallacy and not the right way to think about it. Thread of people saying we should eradicate Covid-19, without saying how to do this impossible task. Risk, what it both is and is not. It is a ‘risky’ decision not to impose restrictions. It is also a ‘risky’ decision to impose them, as this comes with very large costs. When one is viewed as risky and the other as safe, the wrong decisions get made on the margin, and sometimes rather far from the margin. Biden administration opposes strengthening the WHO, which is great news especially given that Biden previously rejoined the WHO. The WHO is trying to use its track record of active interference throughout the pandemic on behalf of the virus (and occasionally on behalf of China) as evidence that it should get more power and money in order to interfere in the future. BRUSSELS, Jan 21 (Reuters) – The United States, the World Health Organization’s top donor, is resisting proposals to make the agency more independent, four officials involved in the talks said, raising doubts about the Biden administration’s long-term support for the U.N. agency. The proposal, made by the WHO’s working group on sustainable financing, would increase each member state’s standing annual contribution, according to a WHO document published online and dated Jan. 4. The plan is part of a wider reform process galvanized by the COVID-19 pandemic, which has highlighted the limitations of the WHO’s power to intervene early in a crisis. But the U.S. government is opposing the reform because it has concerns about the WHO’s ability to confront future threats, including from China, U.S. officials told Reuters. Paper calculates the costs of various Covid treatments, finds many including fluvoxamine don’t on net save money compared to Medicare estimated hospital costs. I notice I am confused why this is the comparison point, since Medicare pays artificially low prices subsidized by non-Medicare patients and also I hear it’s better for people to not need to go to the hospital even when they’re not under stress. Still, it’s good to keep in mind when considering early treatment that the NNT is going to be high because most patients were always going to get better on their own. Did CDC director Walensky actually not know that vaccinated people could transmit Covid-19 until that deeply flawed Provincetown study? Wow. I mean, wow. Other than mumbling CDC Delenda Est I have no idea what to say to that. Sarah Palin has made it very clear she has no intention of getting vaccinated. This past week, she was in New York City to take part in her defamation lawsuit (which I admit is a bit on the nose), and she took time out to illegally indoor dine at a fancy city restaurant and test positive for Covid-19. While known to be Covid-positive she decided to move to dining outdoors instead. I’m going to go ahead and say that’s a good time to get delivery. Her lawsuit against the New York Times has been postponed. ## Other Prediction Updates This is being carried over from the final Omicron post. China keeps daily cases under 50 per million through 2022: 30% → 40%. It’s a long game. A week has passed without incident, which is good news, and the containment in India makes me think the task might be more realistic than I thought, so bumping this up. Day of the case-average peak: January 15 → January 16 (resolves to the 16th) Turns out my final guess was slightly optimistic, my guesses before that moderately pessimistic. Good to have this behind us. Will There Be a Federal Mask Requirement on Domestic Flights as of November 8, 2022? 44% → 35%. Polymarket is back at 44% but we have a bunch of new information. All restrictions have been lifted in both Denmark and The Netherlands, and more than that the tide is clearly turning against restrictions, faster than I would have anticipated. It seems much less likely now that we’ll sustain these kinds of restrictions the whole year. Chance that Omicron is vastly (75%+ in the same person) less virulent than Delta: 40% → 35% Deaths exceeded my projections, so I should adjust this accordingly. Chance we will be getting boosters modified for Omicron within 6 months of our previous booster shot: 15% → 20%. The move to a five month cycle over a six month cycle makes this seem more likely to accidentally end up happening in a way that’s different from the intended question that was being asked, so bumping it up. I’d be very surprised if we get that much voluntary uptake, and even more surprised than that by actual requirements with teeth barring a new scary variant, but I interpret this question as it being what officials are telling us to do rather than what most people actually do. Polymarket on When We’ll Be Below 100k daily cases: Here are (1) market’s estimates on January 17, then my estimates on January 17, and the third number is current market prices, then my current values. February 15: 8% / 15% / 9% / 10% March 1: 24% / 55% / 25% / 35% March 15: 48% / 70% / 36% / 55% April 1: 74% / 78% / 58% / 65% April 15: 84% / 82% / 82% / 70% Mary 1: 89% / 84% / 90% / 73% To get there, we’ll need to cut cases in half close to three times from here. Whether or not that happens by March 1 depends on whether cases level off like they did in the UK, or whether they decline more like the way they went up or how they are declining in the Northeast. We’ve seen enough leveling off in other places that it seems unlikely that we will make it by March 1, but I still do expect to get there by about March 15. If we don’t get there by soon after that, I think a lot of that is because either there’s a new variant or cases stabilized at a higher level than 100k/day, so I don’t think there’s that much chance of it happening quickly after that if it hadn’t happened already. Standard warning: I’m not thinking about these numbers as carefully as I would if I were considering making a trade, so think carefully before trading and this is of course not investment advice. That’s also why I’m not going to be looking at the other currently available markets – it’s a state change to go focus on such questions, and it’s not worth doing that many state changes every week. Instead, my plan is to choose a sampling of one or more each week, based on what is interesting, and also to allow comments that suggest things that look like they might be out of whack. ## Not Covid Public pre-K once again found to be actively harmful to children’s educations. Also didn’t help behaviorally, so presumably this was all-around net harmful, despite the help this gave to parents. Yet somehow the conclusion by Freddie here is ‘yes using child care like this is harmful to kids but we should offer universal free child care instead of giving parents money anyway, thus economically coercing parents to use it even if they’d rather stay home with their kids.’ I am confused why the conclusion isn’t ‘seems like we should try to help families in need and help them avoid using such services unless they need them, so do the default obviously right thing and give them money.’ Peterson’s statement to open Rogan that ‘climate is everything therefore your models are useless’ as a fully general argument against anyone ever knowing anything. Hopefully when it’s from this direction people who use it in other directions can better recognize it. Also, Neil Young’s catalog was pulled from Spotify because he said it was him or Rogan, and Spotify can do math. Innovate UK application for startup working to increase diversity in clinical trials turned down in part because ‘negative impact of automation may lead to job loss in industry.’ # 49 New Comment 24 comments, sorted by Click to highlight new comments since: Netherlands lets our people go, ending all Covid restrictions. Well, not all. Night clubs are closed, you can't drink past 10 PM, there are restrictions on number of people at events. Plus masks stay mandatory in a lot of places. Indeed, it's more like going back to roughly what the immediate neighbors are doing (except Denmark) than a frank "Let it Go". They could not hold the hard line any longer, especially as before the recent election, Netherlands was in the Laissez-faire camp in Europe. Going from laissez-faire to one of the hardest line in Europe, jut when the first credible signs of the pandemy resolving emerged, was a strange move. A loosing bet by Mark Rutte (the prime minister) imho. That being said, I do not think there will be an unforced "Let it Go" in most European countries. It will likely happen under street pressure, fueled by the few countries really relaxing (because they are conviced they should, or for political reasons) first (UK, Denmark, Scandinavian countries, Ireland), all with a lot of attempt at saving face. And I guess that for the countries not correctly evaluating the street pressure and doing it too slow, it may turn sour with governments falling. Correction: I hope rather than guess. Guessing what will happen politically has become really hard here. Quebec is mandating that if an unvaccinated shopper is going into a big-box store, an employee must follow them around at all times to ensure they don’t sneak off and buy something that is not food or medicine. This makes me feel like we're moving away from an Orwell-inspired dystopia to a Kafka-inspired one. It also increases my prediction bet that we will see governments, from state to local, try and tighten restrictions despite most people desiring to loosen them, leading to a few months of increase conflict despite the situation improving on simulacrum level 1. Peterson’s statement to open Rogan that ‘climate is everything therefore your models are useless’ as a fully general argument against anyone ever knowing anything. I appreciate you drawing attention to this. It does fall pretty flat the moment you start to think about it. It's trivially easy to imagine a very poor model of climate and then imagine small tweaks to make it better, and then iteratively improve this overtime. Like we would all imagine and be familiar with. It is a very anti-Bayesian statement from someone who should know better. It is a very anti-Bayesian statement from someone who should know better. As a Bayesian, shouldn't you update against the being the case, given this evidence? Update against Peterson, you mean? If so, yes, to an extent. In a similar way to how I would update against Linus Pauling or Timothy Leary, weighted more towards the later part of their lives (or in Peterson’s case the recent part). In an older Joe Rogan podcast he said something like “I’ve found a way to monetize SJWs.” Which is maybe the moment that he jumped the shark. Whereas at one point he organically stumbled on to ideas that he thought were worthwhile but also happened to goad an opposition in to engaging with him and amplifying him, now he’s trying to deliberately engineer narratives that will goad an opposition in to engaging with him and amplifying him. It’s not that what he’s saying can’t be true anymore, but rather that he (ironically) is optimizing for virality rather than truth… but that’s also basically everyone trying to be an influencer now. So he’s probably not uniquely evil as much as he’s a good person in a lucrative prison of perverse incentives. During their brief masking-optional pilot, the school reported that “smiling is more contagious than covid-19,” and a survey of students found that 70 percent said the policy improved their experience, including their ability to learn. That only 70% of kids said that getting rid of an annoying thing was good from their point of view is to me surprisingly low, and an update in the opposite direction vs what was seemingly intended by those who shared that result. Then again, none of these statistics ever mean much at all without looking at the survey instrument and such. I would be interested, using the same methodology, what percentage of students would report that the sky is blue. Or green. Regarding India's flat case curve, is it possible that it's an artifact of the known issue with PCR's picking up dead virus long after an infection has cleared? So really these could be cases that began weeks ago and they're being erroneously considered "new" Maybe the UK's case curve has flattened after the end of the spike due to the asymptomatic people that are getting tested for whatever reasons and turn positive for the reason you state? It doesn't feel likely (perhaps it's just the other omicron subvariant giving it a push? or just the "control system" of people relaxing?). The hospital admissions continued to go down as one would expect if this was the case, though the data at ourworldindata is a few days behind. I was talking to my therapist earlier today about this. Aside from a small scare last week where I appear to have misinterpreted a test strip, I'm done. Most of my coworkers have either had Omicron and recovered (including the vaccine hesitant coworker I had a tussle with back in early November) or everyone in their household except them has had it (which makes their baseline risk similar to mine, as someone who lives alone). I feel like there's going to be an inevitable awkward period where a lot of us will be able to say, quite accurately, that we're done. I wore N95's and hunkered down exactly when it was necessary; I'm back to cloth masks now - I haven't seen anything to suggest that they're not adequate for source control. The issue seems to be largely a matter of taste and etiquette. It's proper that some of us get to be "done". The etiquette issue comes with the fact that there are two very different reasons that one could be done - either (a) you and/or everyone else in your household has recently recovered (b) you're boosted and cases have already plummeted. It's the second category that's socially awkward. If you're in that category, you can be done at your discretion, but you should probably keep it under your hat. Regarding your friend's child who caught it despite extreme precautions, something I've been tossing around in my head for a few days: if a whole bunch of people spread out a million "microcovids" over the same period of time, only about 63% of them (1-(1/e)) will actually get it. I'm calling this number the Universal Unfairness Constant. Regarding your friend's child who caught it despite extreme precautions, something I've been tossing around in my head for a few days: if a whole bunch of people spread out a million "microcovids" over the same period of time, only about 63% of them (1-(1/e)) will actually get it. I'm calling this number the Universal Unfairness Constant. Can you explain the math behind this? Sure! tends to as tends to infinity. That's the probability of remaining Covid-free (think of it as the probability of never rolling a 19 when rolling a million sided die a million times). Thus the probability of getting Covid during that period is Hm. I can see that being a lower bound, for people getting covid, but I don't think the 1/n and the power of n are suitably connected for it to be a very accurate estimate. Though overtime, the number of times to get exposed is going up, and viewing the risk of getting it as going down (as we learn how to mitigate covid risks better) seems to paint a picture with very broad strokes that's somewhat accurate overall. If a bunch of people spread out a million microcovids over a year, about 63% will get covid. People assume "wouldn't they all get it by then?" But to get over 99% it would actually take about 4.6 million microcovids! In my model, it made sense take precautions to buy time to get vaccines and treatments. We have those now, so the cost-benefit calculation changes. Further wearing a mask is not going to help people avail themselves of them, or encourage institutions to approve existing treatments or accelerate new ones. I'm grappling with the NNT numbers mentioned above. It's very much worth it to me to pay$10 for fluvoxamine to say cut the duration of omicron (and perhaps probability of long covid, however small it is) by, say,  ~30% (that's my estimate). It's even worth it for me at that price to buy enough to not have to watch friends and family suffer longer if they choose to avail themselves.

> No, really, asking for a booster every six months that knocks a lot of people on their ass for a day or two? Yeah, that’s kind of a huge ask. The short term side effects are sufficiently costly that most people will correctly decide that it’s not worth it even if there’s lots of Covid out there.

I am not convinced that this assessment is necessarily correct. It seems to be ignoring the possibility of being 'knocked on your ass' for maybe several days with COVID.

If the issue is that immunity is waning, then you might effectively be left with a choice of a certain exposure to vaccine with a possible (or even probable, depending on prevalence) exposure to the virus. Hand-waving away the risks of any more serious outcomes from infection, a calculation of the trade-off would want to include the probability of side effects of each (vaccine vs. virus) and duration of each.

My prior is that if you let your immunity wane for, say, 12 months, and then catch COVID, but are otherwise relatively young and healthy, there's a pretty high chance that you'd have symptoms in the region of 'knocked on your ass for several days'.

It would also be good to think about what changes we expect to see over time. Immunity might fade more slowly (or fade to a higher remaining level) as your total number of doses (or virus exposures) increases, which might mean that boosters could be every 12 months rather than every 5-6 months. (The seasonality stuff that ACX has touched upon has left me feeling that annual seems more like a  longer-run default than 6-monthly.) I guess there might also be a change in likelihood and duration of vaccine side effects with increasing numbers of boosters, though I don't have much of an intuition of what that might look like.

The Covid you get will be a reinfection (or at least, every time after the first will be), plus you'll have been vaccinated. So mostly it will be asymptomatic. And over the long run, how many infections would you be preventing per booster? I have a hard time thinking it's more than one every three or four boosters.

Every 12 months, if you can update to 'this year's' like the flu and get it in time, might plausibly prevent e.g. 0.5 Covid infections in expectation at equilibrium and be worth it, but every 5-6 months is NGMI.

I had to look up "NGMI". Full disclosure, I snuck in a 4th Pfizer in mid-November in order not to punch a vaccine hesitant co-worker. My antibodies are still over 2500u/mL, and she's since gotten infected and recovered (and she infected zero people). Now that I'm convinced that I have fairly durable antibodies, most of my future boosts will come from frequent exposure.

Probably will depend on how many tricks Covid has up its sleeve (it's far from infinite - convergent evolution is real) and how much affinity maturation we get from the first few boosts. My guess is we're all going to require a fair number of immunizing events at first, but it will settle down.

if you have symptoms you should stay home and isolate to avoid getting others sick because you’re sick but not worry about getting a test

That was the original UK government advice (before home testing was widely available).

Yeah, let the people go.

Seriously. My childhood was hellish largely to the "education" and the extreme control and supervision that free-range kids blogs often talk about. I was thinking of signing up for cryonics and had actually started filling out the paperwork, but seeing these forcibly done to adults too even after the vaccine came out changed my mind.