By Lambert Strether of Corrente.
I’ve loathed Andy Slavitt and his progress up the greasy pole — Penn/Wharton > Harvard MBA > Goldman Sachs > McKinsey > UnitedHealth > CMS > Obama and Biden administrations (various) — for some time, because as Founder of the so-called United States of Care (NC here and here) Slavitt worked hard to help achieve the liberal Democrats’ #1 policy goal: Shoring up the the private health insurance “industry” and making sure Medicare for All “never, ever” came to pass. (Since Medicare for All would, according to The Lancet, save 68,000 lives and $450 billion a year, it’s hard to see Slavitt’s actions as anything other than sociopathic servility to whoever’s pocketing those billions. And sure, 68,000 lives a year might not seem like much in these days of a pandemic, but over a decade or so, those little numbers can really add up!)
Recently, Slavitt tweeted out a thread that most likely indicates the future preferred policy path for the Covid pandemic, as determined by the Penn/Wharton-Harvard-Goldman-McKinsey-UnitedHealth-CMS-Democrat hive mind currently dominant at the Federal level and in Coastal states. I’m not going to quote the whole thread, because I might stroke out. Instead, I’m going to quote and comment on the central tweet. Slavitt’s thread begins:
COVID Update: I’ve had dozens of people ask me with Delta here, what is the COVID end game.
Because I don’t know, I interviewed 6 experts on various elements— variants, vaccines, global, policy, ev biology & historical precedence.
Will break it down here. 1/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) August 14, 2021
And here is Slavitt’s central tweet:
2- Given Delta’s contagiousness & the fitness of future mutations in order to beat it, this means SARS-CoV-2 will be contagious enough that everyone will get the virus.
The aim is simply that more people get it be vaccinated when they do so fewer get COVID. 5/
— Andy Slavitt ??? (@ASlavitt) August 14, 2021
So, (1) “Everyone will get the virus,” (the “Let ‘er rip” part) but (2) vaccinate as many as possible (the 2.0 part). Well… The public mind doesn’t seem prepared for the former. And the fact that the vaccines we have today are not sterilizing means some will come down Covid (the disease), even if not as many as catch SARS-Cov-2 (the virus). I’m not sure the public mind is prepared for that either. So I asked alert reader GM to do some back-of-the-envelope math on what Slavitt’s modest proposal would mean for the population as a whole, in practice. Here is GM’s response:
If we have a vaccine that needs to be taken annually and is over the period of that one year on average 95% efficient against symptoms, that means one symptomatic infection every 20 years. Or 3 such infections by the time one is 60. Assuming a Poisson distribution, 17% of people will get it 4 times, 10% 5 times, etc.
, for 10% of people it is >=9 infections.
If the vaccine is 80% efficient, we have on average 12 infections by age 60.
This is all simplified, of course, in reality vaccines are waning and it is not a linear function of time, so I am not sure whether it even makes sense to be talking about an average efficiency over a year, a lot depends on when one was vaccinated relative to the timing of whatever waves the population is subjected to.
Also, this assumes no future evolution towards worse — 10% breakthrough on Wuhan-2019 is different from 10% breakthrough on current B.1.617.2, which in turn is very different from 10% breakthrough for 2003 SARS-1 and any hypothetical future SARS-CoV-2 evolution products that might be much more lethal that the present strains.
In terms of damage, it is easy to think about the cumulative cell damage — you get bad COVID once, you lose, say, 30% of your lungs, next time you lose another 30%, and you are now extremely vulnerable to any subsequent infections because there is not much left. Same for kidney failure, etc.
But then there is the immune system damage aspect which is much more murky, but could be potentially even more serious. The virus has a super-antigen, and we have actually never dealt with a virus that reinfects and has a super-antigen. This means a potential downwards spiral of T-cell exhaustion with each subsequent reinfection, which in turn means increased susceptibility to other pathogens, high rates of any autoimmune issue you can think of, and all sorts of other very bad things. In fact SARS-1, even though it did not have a super-antigen, still wrecked people’s immune systems even on the first infection — many of the survivors were hit hard repeatedly after that by otherwise minor to regular people infections.
We will see whether the people who are worried about this will turn out to be correct (there are very good reasons to fear it), the problem is that whether they are correct will only become apparent in the rearview mirror. And by then the frog will not only have been boiled, but the water in the pot will have boiled off too and the frog’s carcass will have been charred on the bottom of it.
So I guess the #ZeroCovid people have a point. Slavitt’s policy recommendations:
But there is something we can decide not to tolerate:
100 people die every day from the flu in a bad season, mostly elderly & kids. We should not accept this. And we should not accept even more from COVID. 21/
— Andy Slavitt 🇺🇸💉 (@ASlavitt) August 14, 2021
Refusing to accept “preventable deaths” is rather rich, coming from a high-level political operative whose goal is to keep pumping $450 billion a year into the private health insurance industry while — so that? — 68,000 people die. More central, however, Slavitt is pushing a modified version of the conservative line: That Covid is just like the flu, albeit a bad flu. So, yes, “Let ‘er rip!” Get vaccinated, however, and you’ll only catch this flu 3-12 times a year before the age of 60. A sophisticated, PMC-style “Let ‘er rip”!
But as GM points out, this is a flu that could rip out 30% of your lung capacity each time you catch it. That’s a pretty bad flu. Is a public that avoids medical treatment because our health care system is so horrific going to “lead their lives” like this? Has the public mind been prepared for “everyone will get the virus”? Will yet more noble lies be told?
 I do not wish to imply that the PMC hive mind is principled or consistent in any way; just that Slavitt, by virtue of his position, is a good indicator of where the PMC is today.
 BoJo thought herd immunity was a thing.
 GM notes: “The calculations assume 100% attack rates under conditions of completely unmitigated epidemics. This has not been the case so far but that is because people have been cautious even without formal restrictions. But it is a reasonable assumption under a full “return to normal”. It is what happens with regular coronaviruses, against which seropositivity is 95-100% at any given moment and people serorevert within 18 months. And those are not in the same league as B.1.617.2 in terms of contagiousness.”
 On super-antigens, see e.g. PNAS, “Superantigenic character of an insert unique to SARS-CoV-2 spike supported by skewed TCR repertoire in patients with hyperinflammation“: “A hyperinflammatory syndrome reminiscent of toxic shock syndrome (TSS) is observed in severe COVID-19 patients, including children with Multisystem Inflammatory Syndrome in Children (MIS-C). TSS is typically caused by pathogenic superantigens stimulating excessive activation of the adaptive immune system. We show that SARS-CoV-2 spike contains sequence and structure motifs highly similar to those of a bacterial superantigen and may directly bind T cell receptors. We further report a skewed T cell receptor repertoire in COVID-19 patients with severe hyperinflammation, in support of such a superantigenic effect. Notably, the superantigen-like motif is not present in other SARS family coronaviruses, which may explain the unique potential for SARS-CoV-2 to cause both MIS-C and the cytokine storm observed in adult COVID-19.”
 How do these people sleep at night?
 Go long oxygen tanks.