Comment by program_whiz | Hacker News Reader

Comment by program_whiz | Hacker News Reader

Hey I'm all for the vaccine, but lets be real about it. Humans struggle with productization. Games, phones, cars, and everything else we make have problems initially (and frequently after any small changes) because we have to come up with a repeatable and robust process for producing, packaging, shipping, delivery, etc, which may have totally different requirements from prototyping and development. Furthermore, these processes have a myriad of unknown unknowns -- with failure points we don't anticipate until they happen (complex systems).

This is another (very very) complex system with a relatively untested technology in an extremely noisy deployment environment. Every user is running a different OS basically, and every deployment corrupts the deployment image to some degree (RNA breakdown). Problems were bound to occur, and yes, the extent of those challenges are likely being downplayed to avoid panic and to get people to take the vaccine.

On the question of motivation: global pandemic, billions in R&D spent, pressure from people on politicians, etc. The usual set of unavoidable human reasons to release products before they are 100% tested (since 100% testing can only really happen in the wild anyway). Combine that with politicization of every topic, and the inability of the public at large to handle any nuance (e.g. "there may be some problems in production, but we believe overall it is worth the risks and won't pose a major problem because of X, Y, and Z.")

You can never test "100%", especially if you don't define what it means. But you've set it up to be an unsatisfiable expectation anyway, saying that "100%" means "testing in the wild". Which means releasing it. So you provide a definition that is always true: you can't adequately test a product before release, because you can only test it adequately after the release.

That's not that much different from the self deceiving mind trick those say who claim this is a "human experiment". Which is, of course it is! I mean the process for testing and certifying a medication has to include a phase where we experiment on humans.

And the whole process is designed with this in mind: increasing number of participants during phase 1-2-3 trials and then it gets released, without being tested "100%", if you will, and it enters phase 4, that is basically tracking it while being "out in the wild". Though you could argue that phase 3 is just as much out in the wild.

I think what you can see from how these vaccines are being tested and released is that these are the most rigorously tested products out there.

Another way to skin the same cat: Safety is not a binary variable even though we have this mental model of safe/unsafe. In fact safety is continuous ranging from high risk (unsafe) to low risk (safe).

With more information (more trials/subjects) we get a better estimate (with less uncertainty) of the associated risk. The properties (safety/risk) of the vaccine don't change. What changes is the uncertainty around our estimations.

This is still a simplification (e.g. there could be unknown unkowns) but I find it a better heuristic than safe/unsafe.

I agree on the simplification. No such thing as "safe", only "safe enough" which assumes every one's scale of safety is the same. That seems presumptuous.

Humans have relatively little genetic variation, you overstate things with the weird analogy to operating systems.

And you are under appreciating the myriad ways differences can express themselves in nature. We share 50% of the same DNA as a banana, and we're 98.8% the same as a chimpanzee.

Spurious examples aside, the pandemic has highlighted ethnic differences in reactions to both pathogen and vaccine.

And from personal experience in the field, seemingly "random" confounding factors can have drastic effects - supposedly safe gadolinium based contrast agents caused NSF if you happened to have bad kidneys.

Aggregation occludes all nuance, essentially by definition.

Decisions that are correct for the aggregate can often be wrong for the individual.

But I guess that kind of thinking is why the pandemic has been such a crapshoot in the first place.

My point is that in the terms of the weird analogy, we are pretty much running the same operating system as the chimp. For instance, they studied the immune response to the mRNA vaccines in primates.

> "We share 50% of the same DNA as a banana"

This is a widely repeated "internet fact" but it's not true. For one thing, a banana has only about 520 million base pairs of DNA, while the Human genome has 3.1 billion.

In reality, depending on the search method used, at most about 24% of human genes have orthologous genes in the banana genome:

https://lab.dessimoz.org/blog/2020/12/08/human-banana-orthol...

I agree that there is so much variation in people’s reaction to the vaccine. My 99 year old Dad had very little negative reaction. I felt shitty for one day after my second vaccination. My Dentist has been missing about 1/3 of work days, periodically feeling very poorly for a few days. Most of my friends and family had just mild reactions.

I am in general skeptical about some vaccines, especially loading infants up on many vaccines all at once. However, with COVID-19, I think the general risk is worth keeping the global economy from complete collapse (if that is even possible).

My understanding is that this "reaction" is just immune response, and since you likely have a strong immune system than your father you saw a stronger reaction, both of which would likely be less deleterious than if your father contracted COVID directly.

Keep in mind that a runaway immune response is also what kills covid patients.

> However, with COVID-19, I think the general risk is worth keeping the global economy from complete collapse (if that is even possible).

We could simply reopen the economy at any point. There are more than enough counterexamples around to demonstrate that lockdowns do not eliminate Covid-19, and that a lack of lockdowns does not lead to endless piles of dead bodies in the streets. Lack of sufficient vaccination is not what is keeping the economy closed -- its usefulness in driving forward certain agendas is. The vaccines aren't even promising anything close to 100% effectiveness, particularly not among the highest risk groups (who were excluded from the clinical trials).

"We can go back to normal soon if everyone just does this one thing" has been the carrot dangled in front of people's noses to get them agreeing to measures of dubious effectiveness since the start of the pandemic. If the virus mutates in the fall and winter and boosters have to be rolled out again, we'll either "have to" shut the economy back down until everyone gets shots in their arms again (in which case these vaccines are a poor preventative against economic damage) or we'll accept the need to live with some amount of endemic Covid spread (in which case it was certainly not lack of vaccines keeping us from reopening).

> There are more than enough counterexamples around

Citation needed.

Lockdowns do not eliminate Covid-19: UK, California, New York, France, hell even Japan. Also pretty much the entirety of pre-Covid epidemiological science.

Lack of lockdowns does not lead to mass death: Sweden, Florida, South Dakota, vast portions of the Global South.

I guess it depends on your definition of "mass deaths"

The US has 500k deaths so far, I consider that pretty massive.

Lockdown _did_ eliminate covid in New Zealand, so there are examples both ways.

It's pretty clear that there's a spectrum of lockdowns and their effectiveness. Personally I would rather you all stayed home for 2 weeks rather than sacrifice my grandparents for the economy.

The lockdowns in much of the western world were pretty weak overall. So many caveats and exceptions. It was "lockdown except for that which is _too_ inconvenient for my voting base"

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... found "Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people.". https://www.frontiersin.org/articles/10.3389/fpubh.2020.6043... found "Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate."

The lockdowns didn't help your grandparents at all, all they did was destroy the lives of many young people and business owners, and plunge over a hundred million people worldwide into extreme poverty: https://apnews.com/article/lifestyle-health-ap-top-news-addi....

> Personally I would rather you all stayed home for 2 weeks rather than sacrifice my grandparents for the economy.

If you think the life of your grandparents is worth more than a hundred million people in poor countries being able to put food on their table, you're incredibly selfish.

The US didn't have a lockdown and the economy wasn't ruined by shelter in place. It was ruined because nobody wants to go to a restaurant if they might get sick - this would've happened even without public health restrictions.

Luckily, CARES aid was so effective it actually reduced poverty.

California effectively did not lock down; both state and county public health orders Constitutionally rely on enforcement by county sheriffs, most of whom did not (and many of whom very publicly announced they would not) enforce the (therefore, purely notional) orders.

Of course, never a true Scotsman nor a true lockdown. The worst spread and the highest seroprevalence are all in California's urban areas which locked down most stringently.

> The worst spread and the highest seroprevalence are all in California’s urban areas which locked down most stringently.

LA, Sacramento, and every Bay Area County Sheriff publicly announced a focus on “education and voluntary compliance”; virtually all the urban Southern California Sheriffs aside from LA County publicly annouced outright non-enforcement policies (some asserting that the orders were unconstitutional), as did the Sheriffs the counties with the major San Joaquin County cities.

The “most stringent lockdowns” weren’t anything like lockdowns.

Aside from the components that were directly within state or other non-sheriff’s authority to enforce (like the alcohol service components which could be enforced directly by state Alcoholic Beverage Control), there was no enforced lockdown essentially anywhere in the State, and this was publicly announced and widely reported in the media, so people were aware of the nonenforcement.

Minor late correction: “San Joaquin County” should have been “San Joaquin Valley”. (Or, since Sacramento was addressed elsewhere, it could have been in broader context “counties with the other significant Central Valley cities.”)

None of those places had lockdowns of the style Italy did.

Travel restrictions are working for AU/NZ/Japan/Korea along with restricting indoor gatherings when necessary. They didn't work for NYC because they didn't restrict European travel.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5... found "Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people.". https://www.frontiersin.org/articles/10.3389/fpubh.2020.6043... found "Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate." https://www.medrxiv.org/content/10.1101/2020.06.11.20128520v... found that social distancing mattered, but lockdowns had little effect.

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