Ghost_of_Li_Wenliang

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COVID: How did we do? How can we know?

Agreed - and I agree that "naive" is the right word for it.

I think the main thing I would change about the post (besides the info from Chi which greatly weakens one of the 4 main planks) is better emphasising that it sketches an ideal ceiling which we should expect to sink as details are added. A relatively realistic ideal, but not strong warrant for righteous rage.

Signing off now; thanks to everyone.

COVID: How did we do? How can we know?

Not mostly happy, I think. China apparently needed a new factory, but other places didn't (to the tune of 3bn wasteful doses or ~12bn real ones). 

Also fast approval was only one prong of the fix, along with 2) an order of magnitude more investment, 3) invested much earlier, as pre-Phase I pre-purchases, 4) HCTs, and 5) pivoting away from 80%+ waste as soon as we realise we're doing that.

(HCTs are still relevant here because some of the vaccines have a shelf life < 6 months, and HCTs could thus allow May-June 2020 production to dampen the second or third waves.)

Half a trillion dollars should really make some dent in the known and unknown bottlenecks. Not sure how to shrink my estimate to account for the immovable remainder.

COVID: How did we do? How can we know?

Datum about process over speed in the civil service and civil society (and also about OWID being far more savvy about optics than Cummings):

“Someone please ensure that they have the 530k within 24 hours from now and report back to me it’s been sent,” Cummings wrote to the chief executive of NHSX. “No procurement, no lawyers, no meetings, no delay please – just send immediately,” he continued. The funding request had the backing of the health secretary, Matt Hancock, who was copied in on the email chain at this point...

After a flurry of communication between top civil servants, money for Our World in Data was approved within days and put on NHSX’s budget, the Guardian understands.

... the grant was not even wanted by the not-for-profit in the form being offered... The group chose to follow its own due process and later applied formally to DHSC and was awarded a grant.

“What a waste of time when we were at that position in the pandemic. I think it was unethical, immoral, and an abuse of power,”

COVID: How did we do? How can we know?

August 28, 2020: "Production has started at a new plant in Beijing with an annual capacity of roughly 300 million doses. Sinovac has agreed to supply 40 million doses to Bio Farma, an Indonesian state-owned company, between November and March. Sinovac started building the factory in late March and finished the project in July."

So this is in fact a little piece of the happy timeline.

COVID: How did we do? How can we know?

One last guess:

My ideology-of-all-public-officials guess is pretty weak compared to an obvious alternative: simple public-choice herding at the executive level. (200 units instead of a million.)

If governments were each minimising their own reputation loss by (correctly) predicting that they wouldn't be punished for doing what everyone was doing, this could be enough to prevent ~all innovation. As much as you want safety in numbers, you doubly don't want to be the first to risk and lose. No entrainment needed, let alone intentional coordination.

(What could explain Israel's contract being redacted? The dodgy data-sharing agreement? No, that came out. The reputational risk of being seen to have rushed something out in [Autumn 2020]? No: it worked, so why not unredact now?)

COVID: How did we do? How can we know?

I am also very confused. The incentives for politicians to move as fast as they could were so vast.

Besides just vaguely accusing them of lacking courage: Another possibility is a profound entrainment of world elite opinion. One globalised and very narrow Overton window for public professionals. University is the obvious place for this to propagate, but I don't really know. What is its content? "Don't be hasty"? Could a philosophical accommodation really prevent every defection? 

(There were some - Hungary vs EU on vaccines, Israel. I actually just tried to find out the date of Israel's Pfizer contract - and it's redacted!)

I think this is currently the strongest objection to the ideal timeline, even if it just points to the space where a concrete objection might well be.

COVID: How did we do? How can we know?

You should go for a Connemara; so good natured, unlike some other breeds.

COVID: How did we do? How can we know?

You seem to be mistaking this for a white paper, or a piece of legislation, or an itemized purchase order for one different timeline please. It is not that. It is instead a thing to measure our situation against, to short-circuit the useless shrugging described in the opening section.

It would be difficult for more seriousness, more money, more personal and institutional courage to not help. I struggle to understand why you are so sure it wouldn't, or, if you do, why you're pointing out that unexpected things happen, on occasion.

In fact the genome was released by one person, and the government didn't say anything [against the genome]. He could have done it a week earlier still.

COVID: How did we do? How can we know?

The estimate undersells long COVID because we don't know how many years of 3.2m QALYs to add, but yes that's roughly it. And yes, I only claim that it was a decent deal, particularly since the funding for it couldn't really have gone on something else.

I freely admit that it could be off by a large factor (see my final paragraph). I would love for someone to come and do a proper Bayesian interval version, which would foreground the uncertainty.

I continue to challenge calling it "unrealistic", on priors, just because it's very uncertain. Last January, a historical baseline would have called it unrealistic to expect completion of vaccine R&D, trials, approvals, and distribution in 11 months. But here we are. I would have you be less sure about what's not possible, or not realistic.

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