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Comment by JoeAltmaier | Hacker News Reader

From the article:

   "...the middle of a Pandemic is not the time to be cutting corners"

I wonder when is the time

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In reality an emergency is of course exactly the time to take more risks.

I'm no anti-vaxxer, but I cannot tell what's worse: a little known virus that hit us like an unexpectedly motile wall of bricks, or a rushed vaccine. I'd rather be exposed to neither, so I'll keep on keeping away from people until this thing blows over.

There are some risks wroth taking and some that are not. The problem with risks in an emergency is they can make things worse. Emergency officers are often killed when they choose to risk going faster than the speed limit - even though they have sirens on to warn everyone they are taking extra risk for an emergency.

Part of the definition of risk is that it can make things worse!

My point is that in emergencies, stakes are higher, so the potential benefit from taking a risk is higher.

I thought airline pilots and marines trained specifically to avoid taking unnecessary risks in an emergency. They rely on playbooks, checklists, training.

There are also other tools left in the Arsenal before throwing Hail Mary passes — like, everyone could wear masks.

> I wonder when is the time

Wartime would be such time - scarcity of resources in combination with lack of alternative measures.

As long as simple measures like wearing masks, keeping your distance and minimising risky activities are sufficient, there is no rush.

It's also not as if COVID-19 is a zombie apocalypse or some primarily airborne and highly infectious variant of Ebola that threatens to wipe out huge parts of the population within weeks or months.

In this instance, cutting corners is equivalent to not gathering data, and acting on the premise that what you want to be true is true.

Which is another way of saying: when there are massive consequences, is not the time to proceed on wishful thinking.

Because, as TFA pointed out: if you give people an ineffective vaccine, they will act as though they have an effective vaccine, and likely increase spread.

If you give someone a vaccine that has more antibody-mediated enhancement than protective effect (or at least, just a significant proportion of), you may do more harm than good as well.

And once you've deployed the vaccine to the general population, you've significantly impaired your ability to resolve questions about the above.

When stakes matter, and consequences are large and long-lasting, isn't the time to make blind leaps of faith.

Overstating it? Folks are not all behaving responsibly as it is, so nothing new there. Deploying in larger numbers, then measuring the result is gathering data too. There are massive consequences to the plague as it is.

This same person says "the difference between doing things correctly and not doing things correctly is a matter of a few months".

First, this is not a matter of "correct", it's a matter of "allowing people to voluntarily take additional risk on a vaccine similar to a phase III trial which we let people do already".

Second, A "few months" is huge. Like a vaccine working a few months earlier would be the biggest global event of 2020. He must be in quite the nice position if the pandemic going an extra "few months" is no big deal.

Let’s say a vaccine is safe — you still have to know if it’s actually effective. That’s one of the things measured in these trials. We can’t just say, whoops, and mail a new dose to everyone. So, the risk isn’t just the safety. It’s about not squandering the precious resources that have been pulled together to manufacture distribute untold numbers of doses of a vaccine.

That stood out to me as well. There's a real opportunity cost to not moving more deliberately: those few extra months represent several hundred thousand lives lost. Could a vaccine be worse than that? Of course if the answer is yes, then that would be horrific -- you wouldn't want to vaccinate hundreds of millions of people and then discover that you've unintentionally shipped Thalidomide 2.0. But at the same time, the probability of such risks should be balanced against the certainties of what will happen without a vaccine.

Anybody who says that this is a simple or easy calculation frankly has no idea what they're talking about.

COVID has leapt from the realm of science and reason into fear and hysteria.

If we 'saved' 1 million elderly people from dying of COVID, and they instead died over a period of time from vaccine side effects, those effects would be impossible to quantify via a binary PCR test and so would be ignored.

Additionally if people were vaccinated, but still died, we could at least say 'oh well, we tried'.

Rushing out a vaccine and giving it to people near the end of their natural lives is a completely legitimate decision to end this hysteria and get back to normal life.

Elderly does not imply "near the end of their natural lives." Consider folks who are about to retire. They're certainly at risk but they still have a whole phase of their lives ahead of them.

Agreed. Here it means, older than 50. Which is still running marathons, still having children, still working, still riding century rides for some.

If it's a vaccine that does anything other than exactly what it's supposed to is going to erode public trust in any future vaccines that might actually work.

Unfortunately these kind of calculations clash with ethics. You can’t take actions that cause people to die, even if they prevent more other people from dying.

I’m not an expert on this, but my guess would be: it’s logistically very difficult to produce the required number of doses. They’ve been gearing up all over the world to get ready. So, I would think that you really don’t want to spend those resources on a vaccine that’s either 1) not safe, or 2) not as effective as you thought it was.

When the risks of cutting these corners are significantly outweighed by the risks of getting to a vaccine slower.

With due respect to the many losses from Covid-19 - the numbers are not huge. 0.012% of the world's population has died from Covid over a period of about half a year. The annual death rate of all other causes in the world is 0.77%, or (normalizing to half a year) about 33 times as high.

So, Covid is a serious pandemic but not terrible enough to risk significant corner-cutting in vaxine development - as I see it.

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