Plague Update


Another non-regular update on the history of the plague.

Again, I’m not much concerned with whatever today’s popular debates are, more in how the last year will look from the point of view of history.

The interesting stuff lately was Dominic Cummings’ 100-tweet account of, particularly, March 2020 in number 10.

It appears my understanding of what was going on was fairly close. The initial plan was to allow the spread with minimal intervention to achieve natural herd immunity, and that plan was changed mid-March due to the expected impact on hospitals.

Where I was wrong was that internally they were explicitly talking about intermittent lockdowns long-term until vaccination was available, which was not what they were saying out loud. From my point of view at the time they did not appear to have any long-term plan.

To me the government actually comes out of the account quite well — they did have a long-term plan, though they appeared not to, and the long-term plan did more or less work.

Obviously the actual choice was between letting everyone get infected or acting to reduce infections, and, if acting, the optimum is to act as quickly and strongly as possible, to reduce the overall pain. Therefore any dithering or half-measures were not optimal. However, given the structures in place, some amount of dithering and half-measures were inevitable, and it could have been a lot worse.

Cummings’ focus is of course the particular ways in which the structures and personnel of HMG fucked up various things. That isn’t a major interest of mine. I was only ever mildly interested in his project to inject some rationality into government, because I saw very little possibility of it succeeding, and after the Sabisky affair I basically wrote it off and forgot about it.

The plague situation today as I see it is that we are expecting it to be around for ever, but with reduced impact because of vaccination and people acquiring some immunity by being infected when young enough to mostly not be too badly affected. Basically (and ironically) it is going to become just like the flu, but probably 2-10 times worse. It will make a noticeable impact on life expectancy but not one that changes society or the way we live.

That’s what it looks like, but it’s not certain. I would be a bit surprised if either we got a new wave of hospital-flooding epidemic, or if it effectively died out — but I’ve been surprised before.

Short term, the winter 2021-22 in Britain looks a bit touch-and-go : it is spreading fast through the younger generation, so we are going to get a huge spike of cases, and a lot of people seriously ill, both the small proportion of the large number of young infectees, and a larger fraction of those who catch it from children and who aren’t protected by vaccination. I would selfishly prefer we just muddle through it, but it’s looking like there’s quite a good case for trying to pinch it down again somewhere about now.

One change the endemic scenario does make is it changes the arithmetic of the health risks of obesity. Where previously it significantly increased your chance of dying prematurely, now it’s going to massively increase it. I expect the existing debates over diet, low-carb vs low-fat, seed oils vs saturated fats, etc. to seriously blow up as the stakes become much higher.

The vaccine controversies worry me. Vaccination is clearly the vital part of handling this, and I got myself done as soon as I could. However, there are sensible people seriously saying that the safety of vaccines cannot and must not be questioned, and in the long run that is an invitation to catastrophe. Even today, giving hundreds of millions of people a vaccine that was rushed through approval is a significant risk — in my view one very much worth taking, but that’s a conclusion that can only be reached by considering all the possibilities. Succeed in making vaccines unquestionable, and you are guaranteeing that within decades unsafe vaccines will be widely used.

As with the details of No. 10 policy-making, I have a strong “not my problem” perspective. The two facts are that popular opinion influences policy, and much of the public has spectacularly wrong opinions. As a result some very smart people are taking the view that the public’s opinion must at all costs be forced to be correct. For me, the answer is that popular opinion should be ignored and not allowed to influence policy. If there’s one lesson from the whole debacle of 2020-21, it’s that it is not possible for democratic governments to loudly lie to the population while continuing to believe the truth themselves. “You might not want a vaccine but that’s tough, you’re fucking getting one” is less bad than “vaccines are always safe and anyone that claims otherwise will be silenced”.

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