Covid 2/23/23: Your Best Possible Situation

No news is (often) good news.

At old Magic: The Gathering tournaments, judge Tony Parodi would often tell us, ‘if your opponent did not show up, that is your best possible situation.’

Every week, when I set out to write the Covid update, I held out the hope that at some point, perhaps soon, you would never read one of these again. There would be nothing to report. That the reports would no longer help anyone. I could go think about and write about something else.

Today is that day. I had to go see about… well, to start off, the possibility of AI destroying all value in the universe. Not my desired first pick. Once again, I much prefer the worlds where over the next weeks, months and years I get to deep dive into other very different aspects of the world instead.

It is still a joyous day. After three years, the weekly Covid posts are over.

From this point forward, I am no longer going to actively seek out Covid information. I am not going to check my Covid Twitter list.

I will continue to compile what Covid and related information I come still across, although with a much higher bar for inclusion going forward. If it seems worth its own post from time to time, I’ll do that. If not, I won’t. Unless something changes a lot, that will be a lot less common than weekly.

We have normality. Cherish it.

You’ll miss it when it’s gone.

Executive Summary

1. This will be the last weekly Covid post unless things change radically.

2. We have normality. I repeat, we have normality.

3. Anything you still can’t cope with is therefore your own problem.

Let's run the numbers.

The Numbers

Predictions

Predictions from Last Week: 210k cases (-6%) and 2,625 deaths (-7%).

Results: 210k cases (-6%) and 2,396 deaths (-15%)

Predictions for Next Week: No more formal predictions. Expect continued slow declines in underlying numbers for a while.

Arizona reported 23k cases, which has to be a backlog dump, so I cut them down to a high but plausible 4k. Colorado reported negative deaths, so I changed that to zero.

I entirely forgot about Presidents Day, which makes the case number here unexpectedly high, and largely accounts for the deaths result. Overall slightly disappointing given the holiday.

Deaths

Cases

Physical World Modeling

I was alerted to quite the case of modeling: Metaculus has been successfully working with the Virginia state government to help them make better decisions. They are currently running the Keep Virginia Safe II contest with a $20k prize pool, which where the link goes. I have been informed that such information is actually listed to and used in real decision making, which makes it exciting to consider participating. Perhaps this will even spread to additional jurisdictions. You never know.

Bloom Lab goes over the long term history of pandemics, especially flu, and speculates on what to expect from Covid going forward - most of the thread is from January but seems fitting for the final update. The last note is new, suggesting that Omicron might not actually be less virulent after all, with the difference in outcomes being due to immunity - older adults with no prior infection and no vaccination were found to have similar mortality rates. China would presumably tell us a lot, if we had any data we could rely upon.

Metastudy confirms that yes, Covid infections are protective against future Covid protections even under Omicron.

In Other Covid News

State Senator in Idaho introduces a bill that makes providing or administering any mRNA vaccine a crime. I have learned not to be all that concerned by ‘politician introduces terrible bill,’ almost none of them go anywhere. Still, wow.

A fun note: Bret Stephen says in his column that the conclusions of new study on the efficacy of masks were unambiguous. The study says ‘relatively low adherence… hampers drawing firm conclusions’ and ‘there is uncertainty about the effects of face masks.’ Same as it ever was.

Remember the Vaccine

Vaccines saved lives, in one chart.

This is all-cause mortality. The zero point is actually zero.

Once you are vaccinated, there is no noticeable correlation between times where was a lot of Covid and unvaccinated people had substantially higher death rates, like December 2021 and January 2022, and all-cause mortality among the vaccinated.

In terms of death, once you were vaccinated, Covid was irrelevant.

Now there has been convergence between death rates for the Covid and non-Covid groups, and when there was a recent modest surge of cases, neither line responded. This suggests that Covid simply isn’t a substantial risk of death anymore, even for the unvaccinated.

Going forward, Covid is one more disease in your life. Infectious diseases are bad for your day, for your week, for your health. Sometimes people have persistent issues afterwards. We should cure them, prevent them, vaccinate against them, treat them.

Will we learn that lesson more generally? No, of course that. Oh well.

Is vaccination still worthwhile going forward? Yes, I believe that it is. The benefits continue to exceed the costs. What I would not do is boost on a regular basis, or apply the kind of pressure that causes a drop in willingness to get vaccinated for other things, where the benefits, both to the individual and to society, are much larger.

Other Medical and Research News

I am starting to think the thing these people hate is attempting to be effective.

Vaccine-stockpiling agency does a structural reorganization in light of lessons learned. Better than nothing I suppose. Does not seem likely to address any of the reasons why, when we need vaccines, we won’t have them until too late.

H5N1 sentences that are not as comforting as they seem to have been intended:

#H5N1 #birdflu is garnering headlines galore. I'm not here to tell you H5 isn't a dangerous virus. But how likely it is to ever be able to spread easily among people isn't currently knowable. Few people alive know more about H5 than @CDCgov's Tim Uyeki.

When there is a dangerous virus, saying the risk of a pandemic ‘isn’t currently knowable’ is not a but. It is an and. I would very much prefer it if we did know the chances. Also, the post linked to says that no, mink-to-mink transmission would not change the assessment of the risk to human health, which is somewhere between Law of No Evidence and Obvious Nonsense.

Scott Alexander offers Declining Sperm Count: Much More Than You Wanted to Know. Doesn’t relate it to testosterone. Overall made me less worried rather than more worried.

Some observations from Scott Sumner on obesity. He notes that income and obesity are correlated for women - the more income, the less likely to be obese - but not for men.

Another hint at what might be happening can be found in this primer on the concept of ‘food neutrality,’ which I found via an NPR profile.

Food neutrality is the understanding that no single food holds superior nutritional or moral value over another.

This idea often receives pushback in a world of diet culture, a system which advocates for foods that change the body weight, shape or size.

Practicing food neutrality is achieved through:

• identifying and dismissing food rules

• developing a relationship of trust with our bodies.

• dismissing rules about moderation

• identifying and exposing ourselves to fear foods to decrease anxiety around specific foods

• purchasing, prepping, and enjoying all types of foods

If anything, this is worse than my extrapolation from basic concept, because it includes ‘dismissing rules about moderation’ and literally ‘there is no such thing as unhealthy food.’

This doesn’t answer the question of how we have reached the point where people can advocate for such things with a straight face. Such attitudes do go a long way towards explaining why one might have a large obesity problem.

Do I often choose to eat foods that are, shall we say, less than maximally healthy, because I enjoy them more? Yes, absolutely. It would be a sad world if one didn’t. What I don’t do is fool myself about what I am doing.

I hope you stick around as I explore other, non-Covid topics that I believe will have higher value going forward. There are always infinite things out there. Let’s go exploring.