My Vaccine Crackpottery: A Confession

If you're a computer scientist or a physicist and you want to criticize biomedicine, please go work in the field for a couple of decades. It gives a wonderful perspective.

After two decades of working in biomedicine, I returned to pure software engineering/computer science because biomedicine (especially the US, but everywhere, really) is so messed up structurally, it will never recover. It will only get more expensive and less effective.

I've been seeing a lot of very negative takes similar to this one on how poorly we have been doing with vaccine distribution (not to mention, well, everything we did before the vaccine). Upon thinking about a lot of the people that I read content from, I noticed something in common with those saying this: they are all extremely ambitious people. Most of them are (serial) startup founders, a few are hardworking prolific academics, but it's safe to say they know what having high expectations and moving quickly is like.

That is to say that there exists a large contrast with what they believe can and should be achieved with what the average politician or government worker has grown to expect: A paradigm of milquetoast results and mediocre enthusiasm paired with general social gestalt that now expects bureaucratic and institutional failures to occur throughout the systems that we need so badly to help us.

Many have strong personal opinions on how we would start to improve this situation, but I think proper incentives, higher expectations, and skin in the game would be a good start.

Great post, but even he underestimates how obvious an approval decision it was. Vaccines have a strong safety and efficacy history.

I think if you replace the words "not approved" with "banned", the insanity of the vaccine ban is clear. Even though Congress has multiple times given.the FDA commissioner broad powers to approve during a pandemic, they opted to not do it. There needs to be legislation to ensure the next one goes better. Effectively, they need to remove the discretion part from the FDA. My favorite ideas are: (1) automatic EUAs for any vaccine candidates when a disease has over 1 in 1,000 chance of killing a group and the vaccine candidate is from a company who has had a drug approved in the last 10 years. (2) allowing people during pandemic to pay to be in a vaccine trial. I know many people who would have loved to be in a trial, but were not able. (This was the FDA doesn't have to say something is "authorized" so it seems more organizationally feasible.) (3) allowing human challenge studies to happen. (4) 1 gradual rolling study instead of separate studies. Gradually increase the number of people who can be tested, and stop of the safety profile looks bad, but watch all for efficacy outcomes. So vaccinate 10 in week 1, 100 in week 2, 1,000 in week 3, 10,000 in week 4, etc. There has only been 1 ever long term side effect reported (from a polio love virus vaccination of an immunocompromised person), so you really want to see short term effects. (5) also just increase the level of ambition. Trump should have proposed bills in congress to lift the vaccine ban. Biden's goal in his first 100 days is to vaccinate 100M (given that we are supposed to have about 240M doses delivered by then with already approved vaccines. This is a low bar, sort of like saying "I hope we don't just accidentally throw away most of the vaccine". His goal should be 50% vaccinated in the first 30 days or something.

I wish folk would move away from the world war two nostalgia, it's debilitating and wasn't at all hard and fast, even if a 90 minute movie cut leads you to believe that.

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> The solution, I’d say, is not to put toddlers in charge of the government! As should be obvious by now—indeed, as should’ve been obvious back in 2016—that solution has some exceedingly severe downsides. The solution, rather, is to work for a world where experts are unafraid to speak bluntly, so that it never falls to a mental toddler to say what the experts can’t say without jeopardizing their careers.

Well, yes. But what if the public want to be run by an angry toddler because he confirms their prejudice? What if they've spent years listening to Angry Toddler Radio filling their heads with those prejudices?

> I think that, in a well-run civilization, the first covid vaccines would’ve been tested and approved by around March or April 2020, while mass-manufacturing simultaneously ramped up with trillions of dollars’ investment.

We have 60 clinical vaccines[1]. Which ones? All of them? The first one? The first dozen? You're going to see a bunch more of these types of arguments from hindsight in the coming months. The choice wasn't to approve or deny and then manufacture the vaccines we have today. It was to find the signal in the noise.

[1] https://www.who.int/publications/m/item/draft-landscape-of-c...

the whole covid thing could have been easily stopped if the whole world would just lockdown together for 1 month eh?

why did we even need a vaccine?

A lot of interesting content. But I wanted to just point out this:

> in West Virginia, they mistakenly gave antibody treatments instead of vaccines

If you're vaccinating entire population, there will definitely be mistakes. Go ahead, mention that someone managed to notice them and notify the right people. Don't put them in the same sentence as someone spoiling vaccines on purpose. We can't afford people being afraid to report mistakes.

I can’t find much to disagree with in the post. And I expect to be downvoted for saying so unqualified. So in anticipation of that, I hope whoever is annoyed by what’s in it is keeping in mind the author’s repeated insistence that he’s not an expert and expects his lay perspective to be wrong.

Interesting read.

My personal ideal world Covid crack-pottery confession is that prevention is better than cure:

Food merchants should have been practicing utmost care with contamination to the order of handling plutonium for nuclear weapons.

People should have been practicing healthy eating habits and exercise routines such that their immunity to virus would be of multiple order of magnitude more than what it currently is. So much so that the virus would barely a blip in the global consciousness radar.