" Instead, this is a comparison versus completely unvaccinated "

This sort of thing has been going on long enough that if I weren't just metaphorically banging my head on the wall over it, I'd have been hospitalized by now. There are so many important questions out there research studies are being designed to avoid generating the answers to, that I find it hard to avoid the conclusion that at least the people funding the research actively don't want those answers.

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The “community transmission” stuff is just infuriating.

As you note, “low” and “high” transmission don’t have objective thresholds. But it’s worse than that — the CDC’s thresholds for community transmission are set so low hat they provide hardly any information at all.

By my count, in 2022 the US *as a whole* has spent 223 days in the “high” transmission band and 104 days in the “moderate” band. Not a single day below “moderate,” which was the threshold that the CDC announced for its renewed masking recommendations back in summer 2021.

Is that really what these nitwits think — that the United States as a whole had been in a “surge” since mid-July 2021, the last time the country’s overall case rate was in the “moderate” range? What kind of useful information is this scale supposed to impart?

Put another way, if we had ~17 million cases in a year we’d be *averaging* “high” transmission over the course of the year. That’s about 5% of the country — i.e., people would end up as a Covid case once every *20 years* on average. That’s not a risk that’s even worth thinking about, but the CDC’s scale is there screaming red-alert, “high” transmission. It’s useless.

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On loss of institutional trust: some while back, I remember getting mailers from the CDC advertising a survey they were conducting regarding Public Health Communication Effectiveness. Seemed like an exciting opportunity to register a Delenda Est datapoint with The Man! ...but my household didn't make it past the demographic screening stage. Which strongly implied they were only looking for respondents who have minor children -> pediatric vaxx or covid school guidance. A bunch of unrelated adults? Who cares what they think...

That figure for "is tangentially/unaware of Meet The New Booster" is interesting. ~Everyone I meet in day-to-day life knows about it here, but as per the other graph, most intend to get it sometime between Real Soon Now and Eventually. (Usually because of worries about side effects/inconvenience outweighing efficacy...there are holidays to be done now!) SF got really high uptake for the previous three shots, as well as what few monkeypox vaxx doses made it out here, but for this latest one...it's kinda a collective shrug. All the PSAs I see on subway, etc. are still aimed at getting people vaxxed __at all__, for the first 1...3, with no mention of new booster. Probably aiming for that last tiny slice of At Risk Marginalized Communities, who knows? (Local politicians' newsletters stopped mentioning covid entirely some months ago. They know what their voters actually care about.)

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"Is it possible that three years from now we are all using some other service that looks exactly like Twitter, or (far worse outcome) some set of five different ones? Yes, if things go badly enough that outcome is possible, although I’d consider it an underdog (~25% maybe) even with all the absurd social pressure trying to make Twitter die out of spite. Is it going to be Mastodon? No."

I notice that I am surprised - with Zatko's statements about how borderline Twitter's servers are at the best of times, in conjunction with the massive drop in engineer count, I would have placed the odds of catastrophic failure as substantially higher.

Although I agree Mastodon being the long-term successor is unlikely.

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I feel like the low effectiveness of the bivalent booster has vindicated people like Paul Offit and Vinay Prasad, who asked for real trials instead of rushing forward with antibody measurements only. They argued that it’s very difficult to know a priori what particular formulation would be best, because we don’t have a sufficient understanding of the immune system. We are stuck relying on RCTs and can’t just assume an updated vaccine will be better than the original.

You criticized their humility at the time (and still do), but I think you need to acknowledge that they were at least partially correct.

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I've deactivated Twitter because it proved useless for promoting my Substack and my brain cannot process more information than I already receive from sources elsewhere that I trust to provide it in good faith.

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A covid question unrelated to this post; have you done an estimate of what happens when covid gets loose in China? (maybe best case and worse case. What's the best way to let a known virus spread through your country?)

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