Ruby

Member of the LessWrong 2.0 team. I've been a member of the rationalist/EA communities since 2012. I have particular rationality interests in planning and emotions.

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Wedding Ceremony
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Novum Organum

Comments

The Case for Extreme Vaccine Effectiveness

That makes sense, and now you mention it, I heard the same about injectable monoclonal antibodies. At first they thought a few hours at room temperature would destroy them, turned out that's probably false.

LessWrong FAQ

Ah, my bad! I will correct this shortly.

Quick examination of miles per micromort for US drivers, with adjustments for safety-increasing behavior

Nothing fancy. In the Bay Area it's lots of people's choice:

  • Rail (BART) usually won't take you the last mile or two.
  • Car ownership is expensive (just having somewhere to park is either expensive or your car is likely to get broken into), plus many people never learned to drive, and parking when you go places is a pain.
  • The buses are awful.
  • Uber/Lyft aren't that expensive in this area, or weren't when pooling with other random people.
  • People are too lazy to cycle. :P (also bikes getting stolen all the time)
     
The Case for Extreme Vaccine Effectiveness

Thanks for this detailed comment. I do think the conclusions of the OP apply for now and one should act on them only so long as a vaccine-evading variant hasn't become prominent enough to affect overall vaccine protection, and one should be on the lookout for it happening. (I may soon create a mailing list for people to get updates.)

After a few hours of hunting, I ended up finding that GISAID seems to be the central place for getting data on variant data. I couldn't get access since I don't have an institutional account, however outbreak.info both has an open-access API and pretty good dashboards for tracking variants.

I'll have more of a look at them today.

I think now is a bit more like a [potentially brief] Spring and people ought to enjoy the weather before things get frosty again. Though I might update upon looking at the data.

The Case for Extreme Vaccine Effectiveness

Updates / Changelog

2021/5/13
I've now had a chance to look into variants. Based on: (1) the result from this large study from Qatar,  (2) the current prevalences of variants in the US, and (3) the assumption that other variants of concern are no more vaccine-resistant than B.1.351, (4) the current prevalence of variants in the US as per outbreak.info, I conclude that vaccine effective I believe that vaccine effectiveness against getting Covid at all is reduced by a factor of 0.95; however, vaccine-effectiveness against severe disease and death is probably not reduced.

In conclusion, within the United States, I believe that the results of this overall still hold. Huzzah!

2021/4/24
I've now spent some time looking into variants and how they might affect vaccine effectiveness. Currently, it seems clear that: (1) certain variants are already pretty widespread and gaining in prevalence in quickly, (2) some of those variants have lab/in- vitro evidence of decreased effectiveness. What is unclear is the real-world clinical significance. I don't know enough immunology and haven't read enough to know.

In my current poor epistemic state of ignorance, I would currently guess that vaccines offer somewhat less than 99% effectiveness (for young people against symptomatic), but probably still pretty high, say upwards of 80% or even 90%. And effectiveness against more severe cases is probably still higher. But everything lower confidence than when I wrote this post.

If I can get the chance, I'll look into this more and provide more updates. For those interested, outbreak.info is an utterly amazing source of data on variants and mutations–both dashboards and collections of relevant papers.

2021/4/22

I removed a short section discussing different false-positive rates among different levels of severity that I now think was confused, following the exchange in this thread.

2021/4/17

I added a subsection in the Objections section discussing how the vaccine and control groups in the big Israeli study might be different, and how this should widen confidence intervals.

The Case for Extreme Vaccine Effectiveness

I thought about this for a while, and I think the entailment you point out is correct and we can't be sure the numbers turn out as in my example.

But also, I think I got myself confused when writing the originally cited passage. I was thinking about how there will be a smaller absolute number of false-positive deaths than the absolute number of false-positive symptomatic cases, because there are fewer death generally.  That doesn't require the false-positive rates to be different to be true.

Also thinking about it, the mechanisms by which the false-positive rate would be lower on severe outcomes that I'd been thinking of don't obviously hold. It's probably more like if someone had a false-positive test and then had pneumonia symptoms, it'd be mistaken for Covid, and the rate of that happening is only dependent on the regular Covid test false-positive rate.

 

Quick examination of miles per micromort for US drivers, with adjustments for safety-increasing behavior

The quick examination didn't get into this in the final numbers, but I feel confident that time of day (day vs night) is a big deal. Deaths during the nighttime were roughly the same as daytime deaths, but I'd assume most of the driving happens during the day, and disproportionately deaths are at night, both for visibility or sleepiness reasons.

I would advise people against driving through the middle of the night. Even if you don't feel tired, it's not good to go against your circadian rhythms. 

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