Have the Democrats Risked Ruin by Increasing Vaccine Hesitancy in the Electorate?

By Lambert Strether of Corrente.

A failure of Covid vaccine uptake threatens the United States with ruin. Therefore, Nassim Nicholas Taleb’s Precautionary Principle applies. Liberal Democrat election tactics have violated the Precautionary Principle by turning Trump into a demonic figure. In so doing, they may well have created “the horn effect” (the opposite of the halo effect) around the Administration’s vaccine development effort, Operation Warp Speed, thereby increasing vaccine hesitancy in the public, and risking vaccine uptake failure. That is the Abstract, now let us move on to the Discussion, starting with Taleb (and I hope I don’t cut myself juggling those sharp tools)[1].

In Taleb, et al, “The Precautionary Principle (with Application to the Genetic Modification of Organisms)” (PDF) we find the following discussion of harm (i.e., the sort of thing that a policy maker might be thought to take into account):

Two kinds of potential harm must be considered when determining an appropriate approach to the role of risk in decision-making: 1) localized nonspreading impacts and 2) propagating impacts resulting in irreversible and widespread damage.

Traditional decision-making strategies focus on the case where harm is localized and risk is easy to calculate from past data. Under these circumstances, cost-benefit analyses and mitigation techniques are appropriate. The potential harm from miscalculation is bounded. On the other hand, the possibility of irreversible and widespread damage raises different questions about the nature of decision making and what risks can be reasonably taken. This is the domain of the [Precautionary Principle (PP)].

Vaccines do not themselves risk ruin:

Our position is that while one may argue that vaccination is risky, or risky under some circumstances, it does not fall under PP owing to the lack of systemic risk.

However, causing a vaccine to fail, thereby bringing us back to square one when fighting a pandemic, does. From Joseph Norman, Yaneer Bar-Yam, and Nassim Nicholas Taleb, “Systemic risk of pandemic via novel pathogens – Coronavirus: A note,” New England Complex Systems Institute (January 26, 2020)”

These are ruin problems where, over time, exposure to tail events leads to a certain eventual extinction. While there is a very high probability for humanity surviving a single such event, over time, there is eventually zero probability of surviving repeated exposures to such events. While repeated risks can be taken by individuals with a limited life expectancy, ruin exposures must never be taken at the systemic and collective level.

The Trump Administration’s vaccine plan is called Operation Warp Speed; I have written about it here. The program design is clever: The Federal governement pays vaccine makers to work in parallel, developing vaccines and taking them all the way to the manufacturing stage without knowing they’ll work, in the hopes that one or more will pan out; that’s wasteful, to be sure, but not nearly as wasteful as ruin. (Similarly, given the PP, “goo goopearl-clutching about contracts and contractors is not relevant. I wish we didn’t have to rely on Big Pharma to do all this, but that’s where we are as a society so there’s no point fussing.) Authority figures like Dr. Anthony Fauci have said that Operation Warp speed should deliver at least one safe and effective vaccine in a few months. Good news, right? Well, that’s not how the Democrats are acting.

To understand the oddities of the Democrat position, let’s look at the debates. First this exchange from Trump v. Biden:

BIDEN: In terms of the whole notion of a vaccine, we’re for a vaccine, but I don’t trust him at all. Nor do you. I know you don’t. What we trust is a scientist.

TRUMP: You don’t trust Johnson & Johnson, Pfizer?

Trump is correct, and a more disciplined debater would have pointed out — and more on-the-ball moderator followed up on — that Biden’s own platform “trust[s] Johnson & Johnson, Pfizer.” Here is the Biden platform on the technical aspects of vaccines:

  • Invest $25 billion in a vaccine manufacturing and distribution plan that will guarantee it gets to every American, cost-free.

Remarkably, Biden’s platform says nothing about developing or testing vaccines, implying by omission that Johnson & Johnson will have done their jobs. In other words, he assumes Operation Warp speed will succeed in producing a safe and effective vaccine.

However, Biden is committed to different narrative: Turning Trump into a demon figure. From further on in the transcript we have this really rather astonishing exchange:

WALLACE: I want to pick up on this question though. You say the public can trust the scientists, but they can’t trust President Trump. In fact, you said that again tonight. Your running mate, Senator Harris, goes further, saying that public health experts quote, “Will be muzzled, will be suppressed.” Given the fact that polls already show that people are concerned about the vaccine and are reluctant to take it, are you and your running mate, Senator Harris, contributing to that fear?

BIDEN: No more than the question you just asked him. You pointed out he puts pressure and disagrees with his own scientists.

WALLACE: But you’re saying you can’t-

BIDEN: Everybody knows-

WALLACE: Or Senator Harris is saying you can’t trust the scientist.

BIDEN: Well, no, no. You can trust the scientist. She didn’t say that. You can trust the-

WALLACE: She said that public health experts quote, “Will be muzzled, will be suppressed.”

BIDEN: Yes. Well, that’s what he’s going to try to do, but there’s thousands of scientists out there, like here at this great hospital that don’t work for him. Their job doesn’t depend on him. They’re the people… And by the way-

TRUMP: We spoke to the scientists that are in charge-

BIDEN By the way-

TRUMP… they will have the vaccine very soon.

WALLACE: Let him finish.

BIDEN: Do you believe for a moment what he’s telling you in light of all the lies he’s told you about the whole issue relating to COVID?

Rereading this after listening to it: Biden silently accepts (see, again, his platform) that the scientists at Johnson & Johnson and Pfizer are trustworthy. Other scientists are trustworthy too, except the ones who have been muzzled by Trump (demonizing) who’s a liar anyhow (demonizing again). But what does Trump need to lie about, since Johnson & Johnson and Pfizer will have produced a successful vaccine?

Before going further, it might be best to address the “muzzling issue” with a real-life example. From (you guessed it) Jonathan Chait, New York Magazine, “Trump Determined to Get Vaccine Before Election, Reportedly Overrules FDA Guidelines.” Second paragraph:

Trump has spent weeks hinting that he would like a vaccine to be announced before the election, and that he also distrusts his scientific advisers. Now his administration has overruled the Food and Drug Administration’s proposed vaccine guidelines, according to a report from the New York Times. It is abundantly clear that Trump’s political team is overruling its scientists in order to rush through the approval of a vaccine before the election.

And now, at the end of the article, the Update:

Update: The administration has relented, and the FDA has now published the vaccine guidelines Trump tried to prevent.

In other words, all we had here was a normal power-move inside the Beltway. But that was a “muzzling” for the ages, wasn’t it?

Now let’s take a step back from the debate and try to put ourselves in the shoes of an ordinary voter who’s just tuning in. There’s an old adage in the advertising business that you don’t knock your competitors product. If you’re “Joe’s Ford Dealership,” you don’t run ads saying “Bob’s Chevrolet” is run by crooks, and Bob doesn’t run ads saying “Walt’s Honda” is run by thieves. Why? Because the general public concludes that they’re all crooks, and nobody goes to the Auto Mile to buy cars!

There’s evidence showing that something like this is happening with vaccines:

That’s quite a drop. This is ruin staring us in the face. From the New England Journal of Medicine, “Ensuring Uptake of Vaccines against SARS-CoV-2“:

Covid-19 continues to exact a heavy toll, development of a vaccine appears the most promising means of restoring normalcy to civil life. Perhaps no scientific breakthrough is more eagerly anticipated. But bringing a vaccine to market is only half the challenge; also critical is ensuring a high enough vaccination rate to achieve herd immunity. Concerningly, a recent poll found that only 49% of Americans planned to get vaccinated against SARS-CoV-2.

Since Operation Warp Speed received virtually no publicity until recently, the reality of vaccine development has nothing do with the drop. Here is the Harris poll:

Now, of course a Democrat loyalist could say “This is all because Trump was putting pressure on the scientists and lying!” But they don’t call it “the two-party system” for nothing. Trump is a free agent; but the Democrats are free agents, too. Instead of panicking, as Chait did, and painting Trump as an all-powerful demon figure, why could not the Democrat messaging have been “Our institutions are so strong that Trump can’t work his will on them?” Or simply “We trust the scientists at the pharmaceutical companies, no matter what Trump says”?[2] Would the increase in vaccine hesitancy that Gallup found, and the decrease in trust that Harris found, have been avoided if the Democrats had taken that tack? I think it would have. (Instead, as with my Auto Mile parable, the voters may well have concluded that they’re all crooks and lost trust in the entire effort.)

But the Democrats — I grant, not without reason — are deeply committed to the narrative that you should not “believe for a moment what he’s telling you in light of all the lies he’s told you.” The difficulty with that could come from what’s called “the Horn Effect” (as in the horns of a Demon). From (sorry) WikiPedia:

The horn effect, closely related to the halo effect, is a form of cognitive bias that causes one’s perception of another to be unduly influenced by a single negative trait….

It is a phenomenon in which an observer’s judgment of a person is adversely affected by the presence of (for the observer) an unfavorable aspect of this person. The Guardian wrote of the devil effect in relation to Hugo Chavez: “Some leaders can become so demonized that it’s impossible to assess their achievements and failures in a balanced way.

And so with Trump, the Democrats having demonized him successfully for many, many voters: Whatever he says about the vaccine, and whatever he says about Operation Warp Speed, will get turned into a negative by the Horn Effect, creating vaccine hesitancy by a second path and worse, negatively impacting any institution or effect associated with Trump, even the ones Democrats nominally support.

In short, to avoid ruin by applying the Precautionary Principle to the poltiics of Covid vaccine development, the Democrats would have had to abandon two narratives that demonized Trump: The narrative that he is brutalizing helpless scientists, and the narrative that he is a liar. Understandably, from a nuts-and-bolts campaign perspective, they would have found this difficult to do. (Do note, however, that even if your opponent is a liar, that doesn’t mean you have to call them one; the object is to win, the larger object should be to avoid ruin, and neither is aided by moralizing[3].) Of course, the liberals could have avoided all this by running on a platform of providing universal concrete material benefits like #MedicareForAll, especially for the working class, but if not demonizing Trump was hard for them, that — as we now see, sadly — would have been impossible. So here we are!

NOTES

[1] Caveat that this is not the post I thought I was going to write — it happens — and so I may assert claims more than usual, rather than backing them up and citing to evidence. Liberal Democrats have also employed at least two tactics that will make it harder for the body politic to dodge ruin as it approaches: Fetishizing “the science” (instead of encouraging critical thinking about science); and (deeply ironic for a party of their name) urging that vaccine decision-making be removed from the political realm (instead of appealing to “our better angels,” to appropriate Biden’s appropriation of Lincoln).

[2] It’s all the more remarkable that the Biden campaign didn’t do this, since they’re really raking in the bucks from pharma.

[3] Trump has, for example, pressured the EPA very successfully. That’s not because he’s demonic; it’s because he’s a normal Republican.

Print Friendly, PDF & Email
This entry was posted in Guest Post, Health care, Pandemic, Politics on by .

About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

91 comments

  1. J

    Kamala said she would be first in line to take a vaccine should Dr. Fauci recommend it. Why does she get this privilege? /s

    Reply
    1. drumlin woodchuckles

      She may not have been stating an expectation of actually getting it first. She may just have been playing brave and trusting, hypothetically speaking, if a vaccine gets Fauci’s approval.

      Reply
      1. ambrit

        Right. Performative politics, like Obama and the water in Flint Michigan.
        Even if she does get a shot, publically and well publicized, what are the odds that it might be a placebo formula?

        Reply
        1. drumlin woodchuckles

          Interesting. I hadn’t thought of that angle. Maybe they could give her a vaccinnation, secretly tell her that its a placebo, and double-secretly make it from some of that Flint LeadWater.

          Reply
    2. Lambert Strether Post author

      > first in line to take a vaccine

      I have suggested several times that all Federal electeds (Congressional and Executive branch) and all political appointees go first, as a trust-building exercise, including Harris, who is still a Senator.

      The general principle:

      Reply
    3. lordkoos

      It may not be a privilege — in China public officials such as mayors, regional leaders, party members, etc are getting the vaccine first in order to show the public that it is safe.

      I don’t see how Democrats can be blamed for people’s reluctance to take the vaccine when Donald Trump’s history of endless lies would make any thinking person pause before taking a treatment that is promoting. Remember the bleach?

      Reply
  2. drumlin woodchuckles

    If that is what the Democrats have achieved, they had co-equal help from Trump. Trump’s obvious fakery and his efforts to get his political commissars to get the departments they head to issue strictly Trumpolitical reports and findings have self-discredited as possibly fake and dangerous any vaccines which emerge through such a fake political process.

    So the Democrats had help here.

    And if the vaccines are all full of time-delay cancer-triggers, then non-uptake means disaster-avoidance. And that’s where Donald’s Trumpery leaves ME with relation to any vaccine which emerges through the Trumpolitical process.

    Reply
    1. Lambert Strether Post author

      > If that is what the Democrats have achieved, they had co-equal help from Trump.

      “Say a dog bite me in the ham: must I bite him again i’ the same part?” –Brandoch Daha, The Worm Ourborous. There’s no particular reason the Democrats have to repay Trump in the same coin. If you read the post, you’ll see I wrote “Instead of panicking, as Chait did, and painting Trump as an all-powerful demon figure, why could not the Democrat messaging have been “Our institutions are so strong that Trump can’t work his will on them?” Don’t make Trump look big; make him look small. That’s what the calmer players are doing: See Slaoui, Kaiser, the NIH, and the FDA itself are doing. Of course, the Democrats can’t do that because they’ve been committed to a strategy of demonization since 2016, but that’s a problem they themselves created (and to be fair, they couldn’t have predicted it would have proven destructive to vaccine takeup in a pandemic).

      It’s also worth noting that other countries understand that the Covid pandemic is a multiplicative process, and that speed is of the essence:

      As the battle against the coronavirus pandemic intensifies, with infections and deaths still rising, Canada’s health ministry said it had received its first submission for authorisation for the vaccine on Thursday.

      The aim of a rolling review is to accelerate the process and last month, Canada’s health minister Patty Hajdu signed an order allowing companies developing vaccines to submit safety and efficacy data and information as they become available.

      The European Union’s health regulator on Thursday also started a rolling review of the first batch of data for the potential vaccine being worked on by AstraZeneca.

      > the Trumpolitical process

      Congratulations! Your comment ignores that the Biden campaign itself admits that a vaccine produced by operation Warp Speed will be safe and effective, that Fauci agrees, and that FDA guidance puts the likely approval date for any such vaccine after the election. It isn’t a Trumpolitical process because there are many players involved, and Trump is not an all-powerful demon figure. Your comment shows the Horns Effect in action, so thank you.

      Reply
  3. Carolinian

    Well why should we trust Big Pharma? Haven’t they done a pretty good job of discrediting themselves?

    In any case the election will be over in a month and, assuming Biden wins, let’s see what he says then and whether anyone believes him. If Trump wins it will of course be another four years of bickering and the dilemma that you describe. But I see no reason to trust Trump, Biden or Pharma. Such is the world we now live in.

    Reply
    1. notabanker

      I trust the Europeans and Aussie’s infinitely more than the US. There is no way I’m in line to get a vaccine until there is global recognition on it’s effectiveness.

      Also, I think the play here is there is no vaccine and there won’t be. Instead it will be access to treatment that minimizes it, with the emphasis on access. Maybe even affordable too.

      Reply
    2. albrt

      Yeah, I don’t see the problem here. The democrat party is engaging in an appropriate level of cynicism for the situation, given the givens. One of the givens is that they themselves are totally untrustworthy.

      So I wouldn’t trust a vaccine approved by Trump, Biden, Pfizer, Johnson & Johnson, Boris Johnson, or anyone else who’s offering to approve a vaccine. And that’s not caused by a single negative trait, it’s a broad constellation of negative traits displayed consistently by everybody who is in a position of power in our system.

      I can get N95 masks now and I don’t mind wearing them. So good luck everybody. I need to light my lamp now and get back to searching for an honest man.

      Reply
          1. furies

            I find it interesting that some people here who are all for ‘herd immunity’ but are now quailing over a ‘rushed’ vaccine.

            Precautionary Principle inconsistencies are making my head spin…

            Reply
    3. Maritimer

      “Well why should we trust Big Pharma? Haven’t they done a pretty good job of discrediting themselves?”

      Maybe Nassim Taleb can check in on that one with his detailed analysis. I have posted here before that Pfizer, AstraZeneca and Johnson and Johnson, major vaccine developers, are all criminal organizations. Check here:
      https://www.corp-research.org/pfizer
      One would think that anyone doing reliable analysis would consider that vaccine developers are criminals. In addition, this fact is never reported in the media which wishes to be considered “trusted”.

      And “The Federal government pays vaccine makers to work in parallel, developing vaccines and taking them all the way to the manufacturing stage without knowing they’ll work, in the hopes that one or more will pan out; that’s wasteful, to be sure, but not nearly as wasteful as ruin. ”

      If “ruin” is pending, which is not proven, then why are other alternatives not also being funded.? Why are all the eggs put into the Big Pharma basket? Those with alternatives are not funded and some are censored. This is science?

      Lastly, in any vaccination scenario, I would expect to see what the uptake will be among medical professionals. In my jurisdiction, despite intimidation, the uptake on a flu vaccine among medical professionals runs about 60 percent. Cause for due hesitancy. I expect the media will not be reporting the uptake for medical professionals.

      Reply
      1. Lambert Strether Post author

        > Big Pharma criminals

        It doesn’t matter. I myself would greatly prefer a Manhattan Project-style project, run entirely by the government. But I don’t think that’s on offer in the United States, and I’m not sure we have the operational capability to do that anymore. (Granted, it would be a priority for a party that wanted to govern to rebuild those capabilities, but that’s not where we are now.) Big Pharma is the only game in town, and if we want a vaccine, we have to play at their table. (One could make the argument that we should wait for another country to come up with one, but I’m not sure that makes sense geopolitically or even ethically.)

        > If “ruin” is pending, which is not proven

        Ruin is the outcome of an unchecked multiplying process. Are you saying Covid-19 is not a pandemic?

        > I would expect to see what the uptake will be among medical professionals.

        That assumes that professionals are apolitical (“following the science,” as we say). In fact, the PMC, being the Democrat base, is not only deeply politicized, it’s subject to The Horns Effect. I think looking at the data, and carefully curating the professionals evaluating it, would be a far better method than relying on the aggregated views of the professional class.)

        Reply
    4. Ignacio

      Well that is the sad consequence of making it a political weapon. From my distance, having heard opinions from US and UK experts involved in vaccine development (plus others) and in the process of vaccine evaluation I feel confident that whenever a vaccine is approved for general use in the US it will be on the basis of strong medical and scientific grounds (whether it is a suboptimal decision there could be discussion as there are many candidates and I don’t believe we should run to a frontrunner without watching closely what is in the pipeline). Political noises apart, the process will almost certainly go through well thought guidelines and a long experience in vaccine development.

      It is a pity that Trump has been given too much credibility knowing his awful record on Covid 19 as if his word could be automatically translated into policies. His announcements have been based on desperation, trying to win something through political noises. It is true, as Lambert states that Democrats, focusing in Trump haven’t helped to reassure their fellow citizens that US institutions are much stronger than Trump’s craziness.

      I believe that any Covid vaccine will be subjected to a public scrutiny and transparency without precedents and we will have very good idea of what benefits and what limits will have any candidate that is approved. I don’t give much importance to current polls in vaccine acceptance which are indeed heavily influenced by politics and would change in a dramatic way when the process of approval ends. Of course, there will always be the religious antivaxxers but I don’t believe this idiotic elite will have that big impact on vaccine deployment.

      Reply
    5. Lambert Strether Post author

      > Well why should we trust Big Pharma?

      The Biden campaign says that the test data should be released, and they’re right. (I don’t know the rules and regulations well enough to know whether this is the normal process or not; I suspect not because of intellectual property issues.)

      That said, vaccines are not a hugely profitable line of business for Big Pharma. I suspect their motivation — beyond Operation Warp Speed’s money — is the same as Andy Slavitt of US of Care. Slavitt has been a really good aggregator and disseminator of Covid information. I suspect he will leverage the resulting trust and credibility he has built up to prevent or cripple #MedicareForAll (which is what US of Care is designed to do). Similarly, the corporation that delivers a safe and effective vaccine will reap an enormous and long-lasting public relations reward, especially valuable in its policy impact. So they have a lot of incentive to do what is, in this context, the right thing.

      Reply
  4. Kwark

    Blaming the messenger (Democrats?, an arguable assertion in it’s own right) in this situation is pointless. It seems highly unlikely that the US populace would be substantially more accepting of a vaccine, particularly one that might appear to be rushed into service, if Democrats (as if ONLY Democrats were critical) had simply stood by and not said anything. Given the extreme anti-science, anti-expert, anti-education atmosphere promulgated by the Trump administration and, indeed, pushed by the entire Republican party (for at least a generation) why would one expect the public to be enthusiastic about a vaccine?

    Reply
    1. Lambert Strether Post author

      > It seems highly unlikely that the US populace would be substantially more accepting of a vaccine, particularly one that might appear to be rushed into service, if Democrats (as if ONLY Democrats were critical) had simply stood by and not said anything.

      Try reading the post, and then try not straw-manning.

      1) In fact, the post cites polling that shows support for vaccines has decreased and gives reasons why. (That means that the country faces ruin, but never mind that).

      2) I did not recommend that the Democrats “simply stand by” and not say “anything.” I suggested several things they could say and do. It’s really not my problem that the Democrats committed to a strategy of demonizing Trump that has (as drumlin woodchuckles’ comment helpfully shows) created a Horns Effect, such that even reasonable approaches to Covid are rejected.

      Note that a constructive defense of Democrat behavior would be to show their post-election plan for avoiding ruin by preventing likely vaccine takeup decline, indeed increasing it. The plan may be “Get rid of Trump” (perhaps because that’s the only plan). I think the public relations challenge will be greater than that.

      Reply
  5. Shiloh1

    Like the ‘stimulus’, vaccine rumors by this company or that one have been good for gunning the stock market for the past several months. Buy the rumor, sell the news.

    Reply
  6. dcblogger

    It is unfair to blame Democrats. Directly Trump talked about dropping regulations to speed development, that there would be a vaccine before the election, that is when I lost confidence in whatever vaccine was developed here in the USA. A vaccine that was developed in another country, by a rational process based on science, that vaccine I would take, but it was Trump who trashed the reputation of American medicine.

    Reply
    1. ambrit

      Alas, I posit that it was American Medical Science that ‘trashed’ it’s own reputation. Once large medical establishments and universities became beholden to commercial interests, the inexorable march of a Medical Gresham’s Law was inevitable.
      As much of a bog standard Republican as Trump is, I can see a logic behind the ‘Warp Speed’ process. Straight ahead all out experimental efforts are pretty standard for “war” time conditions. I’ll give Trump the benefit of the doubt somewhat here because the Dreaded Pathogen is indeed acting like an aggressor.
      Medical crises on a social scale have generally been treated as quasi-political events. An example is Reagan’s dealing with the HIV/AIDS scourge.

      Reply
    2. Lambert Strether Post author

      > A vaccine that was developed in another country, by a rational process based on science, that vaccine I would take,

      Unfortunately, science-loving Democrat Nancy Pelosi nixed that possibility: US should not approve vaccine based on UK trials, says Pelosi Financial Times:

      “We need to be very careful about what happens in the UK. We have very stringent rules in terms of the Food and Drug Administration here, about the number of clinical trials, the timing, the number of people and all the rest,” Ms Pelosi told reporters in Washington.

      Which apparently Trump, albeit an all-powerful demon figure in other contexts, is not able to over-ride in this context. More:

      “My concern is that the UK’s system for that kind of judgment is not on a par with ours in the United States.”

      She added: “My concern is that the UK’s system for that kind of judgment is not on a par with ours in the United States. So if [prime minister] Boris Johnson decides he is going to approve a drug and this president embraces that, that is a concern that I have.”

      I am very dubious that’s how the British approval system works. See, of all people, Zeke Emmanuel. Deck: “The U.S. could learn a lot from Britain.” Thailand just signed a licensing and distribution deal with the Oxford’s AstraZeneca. Thailand has a great track record on Covid, and it’s extremely unlikely they would do such a thing if the UK had an inferior regulatory regime. So I don’t know what Pelosi’s on about here, but whatever it is, is not based on, well, the science.

      > A vaccine that was developed in another country, by a rational process based on science

      Another demonstration of the Horns Effect (and a fine case of question begging, too). See the above quote on other countries, like Canada, “speeding development,” because with a multiplicative process like a pandemic, speeding developing is the rational thing to do to avoid ruin.

      Reply
      1. TroyIA

        Nancy must not have heard that regulators around the world met in June to standardize vaccine trials to provide an apples to apples comparison of various vaccines. So the trial design is the same in the U.K., U.S., Brazil, China etc.

        ICMRA SARS-CoV-2 Vaccines Workshop #2 – Summary

        Participants agreed that stringent success criteria to ensure that SARS-CoV-2 vaccines have adequate efficacy should be specified in initial clinical efficacy trials. These should include efficacy point estimates that reflect the desired vaccine efficacy and specification of the lower bound of appropriately alpha-adjusted confidence interval around the primary efficacy endpoint point estimate. These should also apply to interim and final efficacy analyses. There was agreement that the studies should be adequately powered to estimate vaccine efficacy as robustly as possible, generally favoring more conservative stances on the success criteria that would rule out licensure of weakly effective vaccines that could do more harm than good. However, a specific numeric value to be used for the lower bound and vaccine efficacy point estimate was not agreed upon at this stage It was also reflected that efficacy estimates crossing a certain pre-specified lower bound for efficacy, due to factors such as epidemiological evolution of the pandemic, would not preclude the possibility of a positive benefit risk conclusion if there also were other data supportive of efficacy.

        Reply
      2. Jeremy Grimm

        I would take a vaccine developed in another country by a rational process based on standard science, that demonstrated its efficacy and safety in a large segment of the population in that other country as verified by a rational process based on standard science and as demonstrated over a period of a few months or more. [And assuming the same quality and purity of vaccine would be used in the U.S.]

        Reply
  7. Cuibono

    i think we all agree that there needs to be careful evaluation by independent parties of any proposed vaccine and that this process, if rushed, or politically influenced might be less than optimal.

    Reply
    1. Lambert Strether Post author

      (Here are some links on the approval process, which is complex, and ideas for how to evaluate it. I don’t know what “independent parties” might mean; if I read the approval process correctly, the ultimate judgment resides with the Executive Branch. Which is how everyone would want a democracy to work, right?)

      Let me address the hidden assumptions in that word “rush,” which I think is doing more work than it should. As discussed in the first part of the post — and I’m underlining it here because everybody seems to be ignoring it — a pandemic, being a multiplicative process, can have ruinous consequences, as in entirely destroying the system in which it is developing, Black Death-style. It is entirely appropriate to accelerate, hasten, expedite, quicken, spur, or “add oil” to a vaccine development process to prevent a pandemic, for exactly the same reason it was wrong for Cuomo and Diblasio to dither about closing the schools: Days count. Canada (and other countries) understand this, which is why they are doing it.

      Reply
      1. Brian

        I just don’t see how you can propose that the Covid pandemic poses a risk of ruin to, let’s say, the US. The most dangerous aspect of the pandemic is the distortion it is causing to societal self-image. (i.e. the sky actually is falling.).

        There’s no doubt that if it continues unabated for a time it will be an ongoing catastrophe. But the coronavirus will run out of victims that will be susceptible to its worst effects (the elderly). This will have the effect of lowering average life expectancy, and contributing to tragic loss of loved ones. But I don’t see how this would fundamentally risk ‘ruin’ for the Americans.

        Life expectancy was vastly worse through the vast majority of recorded history, and all of pre-history. Why would such a reduction in life expectancy that would still (likely) be very high in historical terms be ruinous?

        Even if a vaccine is not totally successful, it will still help. There almost certainly be continued development in treatment for Covid. And transmission can be controlled by increasing adoption of mask wearing and some systems restructuring for group activities.

        I mean, I suppose the coronavirus could mutate and turn into a ‘black swan’ event, but their are many other conditions on earth that seem far more ruinous than coronavirus given the still expanding human population and environmental degradation.

        Reply
      2. Jeremy Grimm

        I think the word “rush” does less work than kindness to a ‘Warp-Speed’ vaccine development process in our present climate of politics and economics. Corona is not the Black-Death. It does not warrant rushing the vaccine development process — here “rush” is intended to suggest corner cutting and less than careful work. If vaccines took years to develop in the past how are we suddenly able to come up with a vaccine in a relatively short time? Multiple contractors each bathed in money might discover candidates for a vaccine faster … but how do multiple contractors speed the test process? Were there flaws in the old test process? Why weren’t they addressed before now?

        I believe the root cause for the need-for-speed in coming out with a Corona vaccine is the timing of the Presidential election. I believe there were flaws and deliberate delays built into the vaccine testing process by the FDA to create a barrier protecting Big Pharma from competition. I also believe a basic test protocol — cut down to exactly what is necessary — is still a long relatively slow process that all the four-star MBA management techniques in the world cannot change.

        Reply
        1. Lambert Strether Post author

          > If vaccines took years to develop in the past how are we suddenly able to come up with a vaccine in a relatively short time?

          Please read the post:

          The Federal government pays vaccine makers to work in parallel, developing vaccines and taking them all the way to the manufacturing stage without knowing they’ll work

          There are other optimizations to process as well.

          Reply
          1. Jeremy Grimm

            I have noted in other comments to this post the use of multiple contractors to speed discovery. Some testing processes simply take a certain amount of time and must flow in serial. Working those processes in parallel does not speed their best case execution. Identifying long-term side effects and assessing the longevity of a vaccine’s effectiveness simply take time. I doubt these are the only steps in the unstreamlined vaccine testing and approval that take a certain fixed time to execute. While I can believe that there are steps in vaccine discovery and testing that are unnecessarily drawn out by FDA procedures I also believe there are steps in approving a vaccine that can only be ‘streamlined’ by cutting corners and taking undue risks.

            Reply
  8. Samuel Conner

    Thankfully, the ruin that we are facing in this instance is simply the ruin of US. I don’t mean that to be snarky; it’s just how low my expectations have fallen in recent years.

    Reply
    1. Lambert Strether Post author

      There is that. But there’s also a lot of good in the United States. It would be a shame if we became a walled garden, cut off from the world, with everything inside decaying. Not good for the world, either.

      Reply
  9. Steve

    It appears there is no limit to DNC duplicity to gain power. They supported operations trashing the FISA court process and integrity of the FBI and CIA with commercial media co-conspirators. Now they are trashing public health in a pandemic, spoiling the work of brilliant dedicated chemists, geneticists and biologists. How can they be trusted to run the country?

    Reply
    1. Lambert Strether Post author

      > How can they be trusted to run the country?

      I don’t think a party faction that opposes #MedicareForAll in the midst of a pandemic has standing to opine on health care policy. Or science (although perhaps on the latter my own Horns Effect is kicking in.)

      I do think there’s a “just politics” aspect to all this; even with the caveat above, I certainly don’t advocate that the Democrats should not push back on anything that Trump does. My beef is with the kind of politics the Democrats are doing; they have succeeded in poisoning the well that they, and inportantly we, will have to drink from in the future.

      Reply
  10. Jeremy Grimm

    If a safe and effective vaccine is found for the Corona virus I would not hesitate to get my shot. I already got this year’s flu shot. Regardless of what the democrats or Trump or Big Pharma say about how safe and effective or not so safe and effective the Warp-Speed-Developed-and-Tested vaccine may be — I believe the precautionary principle suggests caution to see how safe and how effective the vaccine proves to be over a few months time. I am able and quite willing to remain holed-up until the dust settles before I creep out to get my safe and effective free vaccine. Some things take time to properly develop and test. Some side effects take time to develop and might only affect a small part of the population — but a part of the population missed in the Warp-Speed testing.

    The practice of dumping money on several contractors to come up with a solution to a problem is a very old and sometimes effective DoD practice. I agree with Lambert. Besides — after blowing trillions on the stock market I don’t see why anyone should fuss about Uncle dumping a billion here or a billion there on Big Pharma to come up with a vaccine.

    I believe there are risks associated with a new vaccine no matter how safe and effective it is advertised to be. I think the precautionary principle is not the only consideration to be weighed. Each individual needs to weigh the risks against the benefits of getting some of the first round(s) of vaccine. These notions become ‘sticky’ of course because of the risks an unvaccinated flu spreader places on others. To my mind that implies keeping people who have not been vaccinated home and it means having some way to verify that people who work together have all been vaccinated. And though testing for Corona is not a panacea, it would seem an important part of verifying the efficacy of the vaccine while minimizing the risks to those trusting to that efficacy.

    Reply
    1. drumlin woodchuckles

      Given the current untrustworthiness of all the actors in every aspect of the American ( and possibly British) side of the vaccine effort, don’t be surprised if millions of people decide to wait for years to see what the vaccine does to its willing beta testers over the five to ten years following its rollout.

      Expect efforts to extort acceptance through forced stay-at-home orders against those people who will not accept an “extorted” vaccination in violation of Nuremberg Medical Ethics laws ( no forced medication . . . as I understand it) to be met with extreme violence on the part of heavily armed people who have zero reason of any kind to regard “government” as any friend of theirs.

      Trust destroyed ( as it has been destroyed in this country) will take a generation or more to earn back and regrow.

      Reply
    2. Lambert Strether Post author

      > Each individual needs to weigh the risks against the benefits of getting some of the first round(s) of vaccine.

      Taleb writes:

      Our concern is with public policy. While an individual may be advised to not “bet the farm,” whether or not he does so is generally a matter of individual preferences. Policy makers have a responsibility to avoid catastrophic harm for society as a whole; the focus is on the aggregate, not at the level of single individuals, and on globalsystemic, not idiosyncratic, harm. This is the domain of collective “ruin” problems.

      Reply
      1. Jeremy Grimm

        Taleb’s public policy involves the application of ‘Warp-Speed’ to existing protocols for vaccine development. Has there been some breakthrough in our understanding of disease and vaccine development that enables and justifies this speedup? Are the protocols developed over many decades overly conservative for reasons unrelated to developing effective vaccines? I am not aware of evidence for either case. However I do see evidence of a policy decision made for reasons of political expediency. Similar policy and decisions brought the U.S. to its present situation.

        I am in a risk age group but situated such that I have little need to be in the vicinity of other persons. I can and will remain isolated until the vaccine is proven. The cost and risk of my staying home is low for me. The risk of taking a vaccine developed at ‘Warp-Speed’ and touted by the policy makers who have mishandled dealing with the Corona pandemic both in matters of public health policy and economic policy is far greater. This is the context for my statement: “Each individual needs to weigh the risks against the benefits of getting some of the first round(s) of vaccine.” I believe individuals have a responsibility to act for their own welfare and a responsibility to act for the Common Good. Where those two come into conflict the Common Good takes precedent. I see no conflict between them in my great aversion to being a first adopter of the Corona vaccine. Besides there are plenty of other people who are compelled to risk exposure to the Corona virus. For them the costs and benefits of a new vaccine are different.

        This suggests a new issue. Many of those most exposed to the risk of getting the Corona virus are the hospital staff, nurses, and doctors who are working to treat the Corona virus. What kind of aggregate or globalsystemic risk might be incurred by pressing hospital staff, nurses, and doctors into receiving a new Corona vaccine developed at ‘Warp-Speed’ by a Government and public health agency which has already made many flawed policy decisions? I believe that Government and its public health agency bears a considerable burden of proof as to the efficacy and safety of their ‘Warp-Speed’ vaccine.

        In my view the Government and public health agency of the U.S. have so badly handled the Corona pandemic — I believe my idiosyncratic decision for when to get the ‘Warp-Speed’ vaccine based on my own careful study and assessment of the available research data is better for both my own good and the Common Good, since I see little evidence that the Government and public health agency of the U.S. care for either.

        It would be quite wonderful if a new method for discovering and testing vaccines has been discovered. However I am extremely skeptical. Some kinds of testing simply take time. There is no mythical man-month, and no wondrous one month baby produced by nine woman working as a ‘team’. Once the efficacy and safety of the ‘Warp-Speed’ vaccine has been proven following more standard protocols — or if evidence can be provided for the new techniques for discovering and testing vaccines, making the old protocols obsolete — I believe the Government and public health agency can rightly mandate that all members of the public receive the vaccine … or remain apart from the rest of Society.

        Reply
  11. VietnamVet

    It is inevitable in the Western Corporate Plutocracy that the rulers funded the development of a number of for-profit vaccines. If animal tests were skimped to get into phase III trials early, I can’t think of a better reason to delay for months getting a coronavirus vaccine to see if there are adverse effects. The real problem with this scheme is that the oligarchs and their purchased political parties deep-sixed the restoration of the federal public health system – the only sure way to control the virus like China and New Zealand. Up to a million Americans could die due to this decision. The US economy will not recover as long as there is a pandemic. Together with climate change destruction of towns in the Gulf Coast and the West, it is simply impossible for the current unequal and unjust economic system to survive.

    Reply
    1. Lambert Strether Post author

      > If animal tests were skimped to get into phase III trials early, I can’t think of a better reason to delay for months getting a coronavirus vaccine to see if there are adverse effects.

      I think “skimped” is doing a lot of work, there. First — and if I’m wrong on this, I’d very much like to be argued out of it — a pandemic is a multiplicative process that will ruin the system in which it is spreading. (That’s real systemic reason it’s not “like the flu.”) It follows that speed is important, because with a multiplicative process every day counts. Second, other countries (Canada et al.) understand this, and are also doing what’s necessary to “accelerate the process.” Third, even if in fact animal trials are going to be skipped, and we’re going straight to human trials, I would like to understand why that’s an issue; humans are, after all, the animals who will ultimately use the vaccine, no?

      Reply
      1. vlade

        Flu also has pandemics, and is a multiplicative problem (Spanish flu was a flu, and still is, in terms of mortality, worse than CV).

        The difference is that we understnad flu virus better after all those years so are able to deal with it, most of the time (now and then we still have a nasty year with massive infections and excess mortality).

        With CV we still don’t entirely understand not just the virus itself, but the spreading – i.e. whether it’s sort of linear like the flu, or whether it’s driven by super-spreader clusters (which of course at some time become linear, because the system is oversaturated by the clusters).

        Reply
      2. Jeremy Grimm

        Exactly how have the protocols for testing a Corona vaccine been skimped on? Skipping over animal testing raises that question in my mind. How is it that we can suddenly shave months or years off the vaccine development process? Is the Government and public health developing a beta-test version of the Corona vaccine for rapid deployment?

        Need for speed in dealing with the Corona pandemic is a result of past failures by the Government and public health. Need for speed is a result of short-sighted economic policies in dealing with the Corona pandemic as well as the long-term deconstruction of our economy and its underpinnings resulting from years of short-sighted decision making. There is an old saying: “Fools rush in ….”

        Reply
  12. Clive

    This gets straight to the Achilles Heel of the Precautionary Principle — it inserts a gatekeeper between human thought and human action. But there’s no agreement whatsoever on who can act in the role of the gatekeeper. Nor are there any criteria for establishing who is qualified to hold that role, how they should be identified and who should appoint them (lest we end up with self-appointed gatekeepers). Or how biases, groupthink and limited knowledge can be nullified. It is a dead-end.

    So we’re inevitably back to the same solutions and the same choices which have rumbled on for two thousand years or more: democracy (you have to pick from limited political groups and it’s a package deal) or technocracy (you trust in “experts” and hope they really are experts and not merely just as flawed actors as the politicians in a different wrapper).

    For this specific question, we’re back to the same conundrum which has characterised COVID-19 — some people wanting complete freedom of choice even if it imposes risk on others, some people wanting complete absence of risk even if it limits the choices of others. Neither extreme is going to get everything they want.

    Reply
    1. David

      The other problem with the Precautionary Principle is that it assumes a single threat to take precautions against, or at least a set of threats that are essentially independent of each other. It can’t really cope with a situation where applying the PP in one area could lead to massive, and potentially unbounded, problems and losses in other areas, and where, applying the PP from the other end, one would have acted differently.
      I think this is Taleb’s weakness: he’s good at things he understands from personal experience, mainly the financial markets, but much less good (as we all are) on things he’s only read about.

      Reply
      1. ShamanicFallout

        +100. Who could have ever thought that there could be major fallout from trying to hive off one “problem” (or potential problem) from all other constituents? I do see one problem: taking one’s cues for action from Taleb

        Reply
      2. Lambert Strether Post author

        > The other problem with the Precautionary Principle is that it assumes a single threat to take precautions against, or at least a set of threats that are essentially independent of each other.

        I think this makes sense. I don’t know if anybody has an account of how to decide stacked crises. More research needed (ha ha).

        On the other hand, faced with a multiplicative process like a pandemic, is it truly the best course of action to do nothing because we don’t know what the knock-on effects might be? How do we decide.

        Reply
    2. Lambert Strether Post author

      > This gets straight to the Achilles Heel of the Precautionary Principle — it inserts a gatekeeper between human thought and human action.

      I don’t understand your point. It’s a political process. Do you think there is some Archimedean place to stand where politics do not enter? The entire “give it to the PMC to decide because the technocracy is apolitical” is about as political as it gets!

      The point of the Precautionary Principle as best I can summarize it is that risks are different in multiplicative vs. additive systems; if I understand Taleb’s business model, he’s made a good deal of money on the idea. I don’t see what that has to do with gatekeeping.

      Reply
      1. Clive

        It is political but it elevates the role of the arbiter of what satisfies the Precautionary Principle (or doesn’t) from being just another interest group chipping in with its views — and there’s nothing wrong with chipping in your views either to the politicians or the people or both — to one which doesn’t merely express its views but has an implied veto on policy.

        If Trump or Biden or anyone else wants to enact or promote a policy (be it in receipt of an approval from public opinion or in spite of what the public says it wants), say to champion vaccination or to dissuade against it, that is their right by virtue of the position they’ve been elected to. It is a matter which is between them and the voters.

        And if they are not to be precluded from enacting a policy because it is deemed to fall foul of the Precautionary Principle (and if the determiners of what does or doesn’t fall foul of the Precautionary Principle don’t have power in the process, they’re merely demoted to another hobby lobby yapping away, so who cares what they think), the whole notion of the Precautionary Principle is rendered either irrelevant or no more relevant than anything else so we can safely forget about it in terms of any meaningful impact on government.

        However, if the determiners of what does or doesn’t fall foul of the Precautionary Principle do have power in the process, who gave them that power — or how did they acquire it? If they inserted themselves, unbidden and with no constitutional underpinning and no democratic event, into the process, that’s not politics, that’s a Palace Coup. Or an attempted one, anyway.

        Lurking in the application of the Precautionary Principle is an inevitable invisible hand, somewhere — assessing policy responses and decreeing them either “safe” or “risky”. And this is the trick it’s trying to pull off, of course. If you could get yourself into a position where you can be that invisible hand — and you may even make yourself visible once you’ve accomplished it — then virtually limitless power is yours. This is the trick which is being pulled, it’s very good, but once you can see how the trick is being worked, it’s just another attempted PMC power grab, is it not?

        I’ll conclude with another observation. View it from a different angle, and the Precautionary Principle is itself conveying the horn effect on elected officials. By throwing shade on them — concluding that a political manifesto or policy (such as public health) isn’t merely a transaction between the voter and the voted-for but rather requires sense-checking and risk-assessments to be applied to it — the Precautionary Principle delegitimises the political process and its outcomes. They could — horror of horrors — result in policy frameworks which are “too risky” to be “allowed”.

        Which is where we came in, wasn’t it, with doubt being cast on the ability of politicians to act in their electorate’s best interests if left to their own auspices. This is then an example of how, if the Precautionary Principle is applied, it has a tendency to cannibalise itself in the process of its own application.

        Reply
        1. Ignacio

          I really feel lost in this discussion, it may have entered too abstract territory and passed my English skills. Is this a discussion on whether a vaccine candidate should be deployed or not according to the PP? Or about enforcing a vaccination program? Because the laws regarding the rights and obligations for vaccine deployment are already there. In Spain vaccination is voluntary by default. Yet, according to the Constitution, the Government can declare emergency in case of an epidemic and enforce vaccination programs (not voluntary any more). In this case the competent authority would be the one in charge of health issues (the corresponding Ministry I guess). So far this has been considered an extreme measure but…

          Reply
          1. Clive

            Yes, there’s the merits (or demerits) of the Precautionary Principle as an abstract concept — which is one thing.

            Then there’s the application (or not) of the Precautionary Principle to a specific, namely vaccination — which is another thing, but naturally a related one.

            Both these have been discussed in this nested thread and also elsewhere in other comments so I won’t dwell further on them here to avoid repetition. But I will add my own opinion.

            Which is: forced medical treatment is a long-established human rights red line and rightly so. The UK government too does (if I recall rightly) reserve the right to in effect force treatment because it can incarcerate you in a “quarantine facility” (umm, yeah, okay…) indefinitely until such time as you relent and have “treatment”. I will never never never be okay with that. Some Rubicons must stay uncrossed. If, conversely, we’re talking about volitional medical treatment (like a vaccination) then I don’t see what on earth the Precautionary Principle has to do with any of this and what it brings to a decision — either my own personal decision or the UK government’s. I and I alone will decide what is best for me based on the facts and the implications on society which prevail at the time the decision is needed and the UK government has the same right and the same responsibility that goes with it.

            I have made such decisions in the past on equally weighty and impactful quandaries (whether to have children or not, whether to enrich myself yet further through iniquity, whether the support older people for whom they don’t really have much choice other than me to care for them — and much else besides). I trust my own judgement on those issues and I trust the judgements of everyone, everywhere who makes up our shared body of humanity to do the same. I will not impose my will on them and I certainly won’t have Taleb claim some special wisdom or other to bestow which enables him to make his decisions (or another Precautionary Principle-inspired malarkey) on me.

            As for a vaccine itself, as I say, I’ll review what’s put in front of me as a proposition, but as a fundamental principle, I’m minded to accept any and every medical intervention going (you name it, when it’s been indicated for me in terms of medicines, medical devices or medical procedures in the past, I’ve gone for it unhesitatingly) and have a high risk tolerance for these things — the potential benefits to society is another shove to prod me in that direction, too, not that I really need much shoving. That said, if there’s any hanky-panky with testing or legitimate question marks hanging over safety and efficacy, I do reserve the right to say “thanks, but no thanks”.

            But as I say, when it comes to medical treatment, I will respect everyone’s right to choose and will not judge at all other individuals’ choices — whichever way they decide to jump.

            Reply
              1. Clive

                I’m not sure how 87 pages of medical ethicists discussions can be boiled down into a comment, but here’s a short — and therefore possibly trite — snapshot:

                A key ethical question about mandatory treatment is, thus, how great the threat to others (and public health in general) would need to be in order for mandatory treatment to be justified.It is noteworthy that TB is relatively exceptional—i.e., there are not many other cases of infectious diseases for which treatment is routinely required.

                So, it depends.

                And one of the things it depends upon is visibly of good quality data untainted by vested interests or even merely zealotry to aid decision making.

                Another is the presence, or absence, of a fear-driven messaging agenda designed to “bounce” people into particular choices. Such attempts are frequently counterproductive anyway.

                Reply
            1. Ignacio

              I am almost certain the personal choices will be respected in the US and elsewhere and no democratic government will try to enforce vaccine deployment beyond voluntary acceptance except in special cases (you have to navigate the legislation about this but there are specific instances when some groups can be forced to vaccination, for instance let’s say workers in nursing homes could be a case). That is why I was surprised by the discussion in the very beginning. In fact I believe that during the first phase the vaccine will only be recommended to the population at risk (elder and other compounding risks) and a large portion of this segment of the population will happily run for the vaccine + others not at risk but wanting the protection the vaccine provides. No vaccine will be approved that does not provide protection.

              In contrast with previous vaccination programs the info made available to the public about the benefits and risks of the selected candidate (at least the risks that can be detected in the ongoing trials) will be widely discussed, acknowledged and known for anyone wanting to know. It will be the most transparent process ever. The amount of info that is publicly available regarding the development of vaccines is already enormous and the protocols for vaccine development are publicly available.

              Some if not most trials have been designed as to analyse the efficacy of the vaccines in the age cohorts at risk and in some of these is where the candidates will show the best results in terms of efficacy and risks. A good job explaining what are the risks associated and their expected frequency will have to be done.

              Reply
              1. Clive

                I agree. If Nancy Pelosi badmouths vaccinations for COVID-19 and people listen to her and believe her and refuse to be vaccinated then that’s their choice and she’s doing her job, as a politician. I think that she is talking rubbish because nothing she has said seems to be substantiate-able. But if that’s what she really thinks then she’s entitled to say it and if it’s not what she thinks, but she believes there’s some political capital to be made by being disingenuous, then that’s between her and the electorate.

                What escapes me entirely is how some application of the Precautionary Principle (and even how it should be applied or whether it should be applied to a particular situation seems a point about which there is no consensus) should somehow preclude Pelosi from political actions in her role as a political actor or vitiate any decisions voters come to about what she has said to them.

                Nothing that Pelosi says or doesn’t say has any bearing on the requirement for a vaccine to be safe and effective. If there are limitations to the safety and/or effectiveness (and/or there have been any variations to the usual testing protocol to establish safety and effectiveness) these can and should be set before the people and the people can make their own decisions about the risks and benefits of opting to have the vaccine. If there is insufficient voluntary take-up of the vaccine, governments have the power to enforce vaccination but this is a profound step for them to take with profound implications. Not least that it may result in non-compliances. In such an eventuality, anyone be they pundits or governments who merely parrot something about the Precautionary Principle are not going to convince anybody simply by an incantation of those words.

                So what function is it serving here?

                Reply
                1. Ignacio

                  I guess some common sense, rather than the PP should apply in Pelosi’s case given we cannot ask for the same in Trump’s case. Worse examples of political struggle that ignore the PP can be seen where i live, to the point that WHO representatives have called to stop this non sense in Madrid.

                  But all this raises questions about how free should be the political speech if at some point they only help to increase societal risks. Trump has put the bar quite high by pretending he could force vaccine approval too soon while Pelosi just showed ignorance or stupidity adding more chaos to Trump’s chaos. If anything this shows the political discourses, posturing and messaging have been very much degraded thanks to the epidemic. The political class in the US and many other countries including mine has been shown to be quite vulnerable to an emergency like this.

                  At some point I am not sure if legal actions should be taken against the free discourse of politicians. Here I am thinking on Ayuso currently governing in Madrid.

                  Reply
          2. Lambert Strether Post author

            > Is this a discussion on whether a vaccine candidate should be deployed or not according to the PP?

            Yes. The surveys cited talk about willingness to be vaccinated, and point to the drop in the numbers of people willing to be vaccinated voluntarily; Now, in an article I couldn’t get to, the NEJM, “Ensuring Uptake of Vaccines against SARS-CoV-2,” has this in its second paragraph:

            One option for increasing vaccine uptake is to require it. Mandatory vaccination has proven effective in ensuring high childhood immunization rates in many high-income countries. However, except for influenza vaccination of health care workers, mandates have not been widely used for adults.

            So, in the worst case scenario, a consequence of the Horns Effect that the Democrats’ strategy of demonization has created around the Administration’s vaccine development program* will lead to a legal requirement to be vaccinated. The moral issues Clive raises aside, I would not expect that to go well, at all, in the current political climate.

            NOTE * I keep characterizing Operation Warp Speed as developing vaccines, but it also develops treatments, although to a lesser degree (for example, Regeneron, the drug given to Trump).

            Reply
        2. Lambert Strether Post author

          > It is political but it elevates the role of the arbiter of what satisfies the Precautionary Principle (or doesn’t) from being just another interest group chipping in with its views — and there’s nothing wrong with chipping in your views either to the politicians or the people or both — to one which doesn’t merely express its views but has an implied veto on policy.

          I don’t accept that for a minute. The PP is just that: A principle. It can be applied by any political actor, and democratically as well. I think the notion of an “arbiter” is a classic case of question begging.

          Reply
          1. Clive

            That’s okay then. It’s just a credentialed version of “my mother-in-law says”. We (both as individuals and politicians) need assign no more weight to it than we would any other interest group’s pleadings, the Precautionary Principle being merely opinion and judgment rather than science or law. You can take it, or leave it.

            Reply
      2. vlade

        Taleb made his first lots of money when he was a trader at a bank and bought a lot of cheap options at a very right time. IMO, got lucky (in his older writings I believe he even admited to it).

        His second business array, where he tried to replicate it in a hedge fund ended in tears – but it’s something he doesn’t like to talk about.

        Only his last business array, where he teamed up with others, seems to have worked. I don’t know the details, but I’d guess that they are not running entierely on PP.

        Otherwise, I agree with Clive. Unless the risks are objective – which, with human activities they extremely rarely are – who and how decides what is PP and how to apply it? When you have a massively complex system, like a climate, who decides what is the right lever to pull and into what position? It will be always someone’s decision, and I’d argue that “someone’s decision” is always political.

        The good metaphor is actually the US Supreme Court. In theory, they should be above politics, making sure the law is applied. But that’s never above politics, because the individual judges have political views, which inform how they believe the law should be applied.

        The problem we humans always run into is that we’d like to have something superior, that would, unambiguously, tell us what is right and what is wrong.

        Unfortunately, our society operates more like a computer program than a universe. I use this as a very loose analogy, not as a determinism, but as a system that has ground rules (natural laws), but using it you can create systems that are not bound and enforced by those rules (i.e. you can create a program that creates a “universe” where the natural laws governing the platform the program runs on don’t apply, where you can do stuff “because the author says so”).

        So one has to be careful with PP, lest it becomes another deus-ex-machina.

        Reply
        1. Lambert Strether Post author

          > Otherwise, I agree with Clive. Unless the risks are objective – which, with human activities they extremely rarely are – who and how decides what is PP and how to apply it?

          My understanding is that processes have statistical properties. In the ordinary course of business, this is well understood and uncontroversial (Deming). Taleb, if I am using his sharp tools correctly, urges that we can sort processes into multiplicative and additive buckets (pandemics v. giving birth (??)). Multiplicative have properties that yield ruin. So far as I can tell, assuming my summary is half-way correct, this is uncontroversial.

          For the rest, I don’t see what the issue is. “Who decides” applies to any decision whatever, regardless of the decision-making tools (e.g., PP) used to assist. I can’t why PP can’t be used across the political spectrum.

          Reply
          1. David

            It can. It’s less a question of the political spectrum than the spectrum of decisions. Most decisions taken according to the PP are uncontroversial in the sense that they represent choices made within recognised limits, even if you disagree with them. Here we seem to be in State of Exception territory (see my comment below). Either a completely new and violently controversial policy will be tried (forced vaccination for example) or the usual processes of government will be short-circuited, or both. In each case, PP will be the justification. Either will be a qualitatively different situation from the mundane use of PP in decision making, and the question of who gets to decide what is obviously fundamental. If a country’s Chief Scientist says that compulsory vaccination is essential if a catastrophe is to be avoided, but the legislature refuses to make the necessary laws, would the PP require the government to rule by decree ? And supposing the scientific advice is wrong?

            Reply
      3. David

        I essentially agree with Clive. It reminds me of the argument of Carl Schmitt, that to understand who the Sovereign was, you needed to see who had the power to declare a State of Exception, and so overturn the accepted constitutional order. What Clive calls the Gatekeeper is the equivalent of the Sovereign.
        Two alternatives are possible. Either the elected government has the right to invoke the Precautionary Principle here, as it often does in more mundane cases (eg cancellation of organised school trips in case something goes wrong and parents take the government to court), in which case it’s just a heuristic to guide decision-making. Or, it’s an independent principle, whose invocation is not in the hands of the government (even if they ultimately have to approve it) but in the hands of technical “experts”. Then the question naturally arises, who chose these experts? What status do they have? Supposing they disagree etc? Lambert’s right that all these decisions are political (“with a small p” as they say) because they have to do with power, decisions and consequences, even if they are not necessarily Political (“with a capital P”) ie they don’t necessarily emerge from the standard political party interactions.

        Reply
        1. Lambert Strether Post author

          I think the issue of the PP as a tool for decision-making, and the political process using it as a tool, as completely orthogonal. The one has nothing to do with the other.

          Now, I’m sensitive to the idea that politics can be engineered into tools, so “a tool for decision-making” may be doing more work than it should be asked to. But I don’t see why thats true in this case.

          Reply
  13. cocomaan

    It’s just amusing to me that, after complaining about Jenny McCarthy and other vaccine skeptics for years, even decades, Democrats and other progressives are now vaccine skeptics too.

    Reply
    1. Jeremy Grimm

      There is some difference. The vaccines Jenny McCarthy and other vaccine skeptics refuse have been proven effective and safe. Whatever ‘Warp-Speed’ vaccine the Government and public health agencies come up with to deal with the Corona pandemic is not quite the same. I believe there is good reason to be skeptical of a vaccine if it has not been tested following standard techniques developed over decades.

      Reply
      1. Lambert Strether Post author

        > I believe there is good reason to be skeptical of a vaccine if it has not been tested following standard techniques developed over decades.

        Do we have any concrete information that’s not happening? Again, “tested following standard techniques” is doing a lot of work; there are lab techniques, and there are regulations. Canada, as I have shown, is changing its regulations because of the speed requirement.

        Reply
        1. Jeremy Grimm

          I have argued in other comments how some processes cannot be parallelized to increase ‘efficiency’ and get faster results. The most common counter example is the one month baby. I have no concrete information that standard techniques developed over decades are not being used … nor do I have ‘concrete’ information or evidence that they are being used. But I do not accept the burden of proof in this argument. I believe that burden falls on the Government or its advocate.

          However that may be:
          — We have a process that in the past took years and now through the magic of dumping money on Big Pharma and the wonders of parallelism we can expect that process to deliver a safe and effective vaccine in time for the Presidential elections.
          — The CARES Act contains a section devoted to easing the FDA regulations for developing and approving remedies for Corona infections. Is it a great leap to think some similar easing of standard techniques and procedures for testing and approving a vaccine have not also been a part of the ‘Warp-Drive’ development of a Corona vaccine? Could the CARES Act verbiage be interpreted — by a friendly court — to allow such easing of standards for a Corona vaccine?

          Reply
  14. Larry Y

    One other principle applies here – skin in the game.

    If the scientists and doctors who developed and tested the vaccine get it, along with their families… and also the regulators and decision makers, up to Trump, his administration, Dr. Fauci, and they also recommend it to their families.

    Reply
    1. vlade

      I hate the skin-in-the-game stuff Taleb talks about.

      He’d know better himself, because SitG principle is directly contradictory to Precautionary Principle, because there’s no-one who can be correct 100% of the time. If you’re correct even 99% of the time (which still, no-one really is), you’re even to get a decision wrong if you’d do 70 decisions.

      Which, with skin-in-the-game could very well ruin you. Hence a status-quo decision is the only safe one, because no-one can run a counterfactual.

      Skin-in-the-game would encourage status-quo in a massive way.

      Reply
      1. Lambert Strether Post author

        > I hate the skin-in-the-game stuff

        I think it works for the kind of life that Taleb wants to lead. I don’t think it scales to public policy.* (Do we really want civil servants to have skin in the game? Is another phrase for that “tea money”?)

        I’m not sure why SitG has to contradict PP, though. Can you expand on that?

        NOTE * Now I see I could be contradicting myself. I’ve advocated that Federal electeds and political appointees be the first to be vaccinated. I’ve though of that as a measure to build public confidence, not as something they would take into account in policy making. But since they know the test is approaching, perhaps they do have SitG. Hmmm.

        Reply
  15. Brooklin Bridge

    Republican and Democrat politicians alike will be waiting, like the rest of us, to see if the winner concoction works. This business of attributing blame to one Mafia family over another is tricky at best. The name of the soup is Capitalism, the flavor is greed, the ingredients are too well blended to pick apart in any meaningful way. There is something slightly icky about the author’s premise that Democrats should be more careful about the image of vaccine development their characterization of Trump/Republicans is creating.

    Granting that this particular case (development of a vaccine to combat a deadly pandemic) may be somewhat of an exception, the system of Capitalism is nevertheless poorly suited for it. Absolute transparency – both the good and the bad – would go a long way to solving the issue at hand, though problematically real tranparency might well mean the opposite of quick acceptance of a vaccine, but you would have to remove the profit motive altogether (such as burnishing ones rep to facilitate future kills) before you could easily pick apart one responsible party over another as far as the message goes. Anything else is simply trying to get the mixture juuuust right so as to better attract/dupe the customer.

    It’s interesting that so many people basically know this truth, in this case that there will be considerable risk involved with early vaccination (my understanding is no other vaccine has ever been developed and tested anywhere near so quickly yet television ads are replete with advertisements for law firms offering assistance for the harm caused because this or that drug was developed for profit over health -by one or another big pharma player- at the expense of the consumer), but still, in large numbers, gravitate to one party or another’s ideology (way of making the same poison more palatable) with such blind tenacity.

    Reply
    1. Brooklin Bridge

      the author’s premise should be changed to simply […]the premise.

      I was thinking about the “author” of the horn effect.

      Reply
  16. Darthbobber

    For what it’s worth, I get the impression that the Biden-Trump exchange, and Harris’s comments, probably produced no effect at all on the electorate. The shitshow aspect of the presidential show eclipsed any focus what so ever on such policy presentations as there were. And Harris’s got slightly more coverage but had faded into the background of white noise ephemera within a day and a half.

    Reply
  17. Alex Cox

    The vaccine, we are told, only needs to be 50% effective. This means it may not work for half of its recipients.

    We are also told that two shots will be necessary, just to reach that half-assed goal.

    Anecdotally I don’t have a single peer who intends to get the first dose right away. We are all 60+, and people to whom I’ve spoken are inclined to wait and see how it shakes out…

    Reply
    1. Jeremy Grimm

      I too am 60+ and have good reasons to get a vaccine — even if it is only 50% effective and assuming it has a very low incidence of serious side effects. I will let others take the risk of getting a brand new vaccine. I too will wait. I plan to wear a face mask in public even after the Corona is gone, and I have always washed my hands often since I was child.

      Reply
  18. HotFlash

    Are Democrats, or at least the Dem nomenklatura, poisoning the well? Could be, but I would look at the people who would believe them. We have been lied to by both parties, all presidents in my memory, many ‘scientists’, ‘journalists’, a myriad of govt officials elected and unelected. Anyone who trusts any member of the PMC blindly is a candidate for the Darwin Awards. We have seen fudging of pharmaceutical testing (eg, cherry-picked reports submitted to the FDA), provision of deadly drugs for enormous profit (eg Sackler), fake peer reviews and other chicanery in ‘reputable’ journals (eg Lancet and JAMA), doctored statistics (eg FL) and a ton of conflicting reports about what Covid is or isn’t, does or doesn’t. Who to believe?

    In a democracy, or representative democracy, which is what the US is, the people are supposed to chose their representatives, who then are and/or direct the policymakers. I agree that the Dems are being inconsistent, but this is not news. I think the takeaway on this is that the talking points reveal that they (once again) have no particular concern for society as a whole but rather with their own power, money, and ultimately, that of the donor class, which is the crystalization of late-stage capitalism. It’s all been smoke and mirrors for decades.

    As Lambert notes, quoting Taleb: Our concern is with public policy. While an individual may be advised to not “bet the farm,” whether or not he does so is generally a matter of individual preferences. Policy makers have a responsibility to avoid catastrophic harm for society as a whole (italics by HotFlash); the focus is on the aggregate, not at the level of single individuals, and on globalsystemic, not idiosyncratic, harm. This is the domain of collective “ruin” problems.

    And that, gentle readers, is where our problem lies. Our public policy is directed for profit, while our our media and education system conspire (yes, conspire) to destroy our critical thinking skills in order to engineer consent, while we are left to educate our ‘individual preferences’ as best we may. We the people have lost control of the helm, we can only save ourselves. (Note: reading NC is my go-to for that.)

    As for the vaccine? I would hesitate. The process reminds me of a TV ‘reality’ show (“You’re off the island!” or “You’re fired!”). I would like to see results in a year, both for intended effects (how often would boosters be required?) and long-term side-effects. I am particularly concerned about the late-manifesting effects of Covid, esp stroke and the neurological effects, which might be possible side effects of a vaccine also. Short-term trials won’t reveal those. I am old, don’t really have a long term left, but I would prefer not to be paralyzed if I can avoid it. I would weight differently for a child where heart, cognitive, and, perhaps, developmental problems would last a much longer lifetime.

    TLDR: looks like we are on our own, folks, as usual.

    Reply
  19. gc54

    I believe that the day after a Biden/Harris victory is finalized MSM will propagandize “our long national nightmare has ended” and that all govt entities are on a path to liberation so that rationality, scientific integrity, truth, honesty, and the American Way (TM) will flourish “like before” by (say) Feb 1. Trumpian scapegoats will be identified and replaced by ghastly Obamanites and Hillbots (so no improvement in “competence” except in regime change), and USians who won’t line up for their $hot(s) will be denigrated as “anti-vaxing idiots” and suffer workplace ostracization at least and dismissal potentially “to protect the vulnerable”, sure to ensure compliance. \s

    But I’m also in a situation where I can sit this out until I’m convinced that rewards exceed risks.

    Reply
  20. Jeremy Grimm

    It struck me that all this discussion about a Corona vaccine leaves unchallenged the notion that all will be well once we have a vaccine, much as all will be well once we have wider testing and better contact tracing. I am left with the impression the Government and public health agencies still have no coherent plan for how to get the Corona pandemic under control in the U.S. I am left with the impression that concerns other than public health have precedence over Public Health.

    Will everything be fine once we have Corona vaccine? Suppose a truly effective and safe vaccine becomes available early in November. Will that mean everything can go back to “normal”? Will the vaccine be as effective as the vaccines for smallpox and measles or will it be as effective as the vaccines we get every year for the flu? I suspect the latter case is more likely based on the little evidence available. In either case should wearing face masks stop in a world where the Corona virus is just an early warning for what could be lurking in wait for a new pandemic?

    Reply
  21. Jeremy Grimm

    Thank you Lambert for engaging with us all. I enjoyed exercising my little gray-cells and greatly appreciate the extra effort you undertook to help us all think more clearly. Nothing sharpens the wit better than fencing with a master. I notice you left many of us with the last word. I take that to mean — not agreement or concession — merely an acknowledgment that you had to leave our education to attend to your many many more pressing duties. I sincerely thank you for the time you could give us. Thank you.

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *