One Size fits All

Lauchie Reid: Hyacinths and Thistles. All images courtesy of the artist.

I got into a Twitter fight last night with a person – I think female but can’t tell for sure – who tweeted that she did not want to be in crowded indoor spaces with the unvaccinated and that they should stay outside like smokers.

I suspect we will hear a lot of this sort of thing over the next few months as COVID wanes and the vaccinated become a majority because it is not enough to be “protected”, the vaccinated seem to need to be isolated from the unvaccinated. Thus the call for vaccine passports and vaccinated only events.

The logic of this seems to rest on the idea that the “vaccine” is not 100% effective in preventing infection or transmission of COVID. What it does confer, apparently, is a reduction in the severity of the symptoms of COVID in the event that the vaccinated person is unlucky enough to catch the virus. You can see the problem, essentially a vaccinated person may be at the same risk for infection as an unvaccinated person and at the same risk of transmitting the bug as an unvaccinated person.

Now, frankly, I don’t think we have enough data one way or another on the vaccine’s efficacy in preventing infection or transmission – the early data seem pretty encouraging on the vaccine’s reducing the severity of the COVID symptoms and the mortality numbers are falling encouragingly. But separating the vaccinated from the unvaccinated is not at all obvious based on what we know so far.

My Twitter gal did not like that position at all and was eventually reduced to calling me “selfish” for not a) getting jabbed, b) for suggesting that there was no logic in separating people who could be infected and who could transmit the virus but who had the prospect of a better outcome if they did from people who could be infected and who could transmit the virus and only had a 99.9% chance of full recovery.

The COVID conversation usually comes down to people’s perception of the risk COVID presents. The vast majority of people who contract COVID feel badly for a few days and are done. Death from COVID is largely confined to people over 80 with one or more co-morbidities. At a clinical level doctors are becoming much, much better at treating the symptoms of COVID. This is not contested information. The daily statistics show much better outcomes for hospitalized patients. Even the “variants of concern” do not seem to have increased the lethality of COVID.

So a risk calculus with respect to the vaccine needs to begin with assessing an individual’s likelihood of a fatal outcome if he or she were to contract COVID. A 99.9 percent survival rate if you are under 80 and are not significantly compromised is a reassuring place to start. Does it make sense to take a new and untested vaccine to improve those odds? (And before we get into the weeds on testing, the vaccines all are being used based on an Emergency Use Approval which is not at all the same as the full testing which drugs typically undergo. That testing is ongoing and will be completed in late 2022 or early 2023.)

As I have consistently written about COVID, you have to manage your own situation which means being aware of and assessing what your life holds by way of risk. First off, do you live in an area with high rates of infection? Do you interact with strangers on a regular and continuous basis? What is your general health status? Do you get outdoor exercise? Individuals can assess these factors for themselves.

Against your personal risk profile when you are looking at “the jab” you would normally take the advice of the medical community which, in turn, would rely on the peer reviewed results of the drug testing the jab is undergoing. But those results are not yet available. Even the mid-term effects of mRNA based vaccines are more a matter of conjecture than evidence.

So the calculation is not so straightforward. As I happily say when asked, “Not yet, I’m in the control group.”

Which brings us back to “selfish”. I assess my personal risk of contracting – much less dying from – COVID as very close to zero which has meant I have been in no hurry to get jabbed. But my Twitter pal seems to think that is selfish. Somehow, my not being jabbed is going to…what? Make her jab less effective? Nope. Destroy herd immunity? No, at worse it may reduce herd immunity infinitesimally but there is very little evidence either way. Prevent her from feeling confident in enclosed crowded spaces? Maybe, but not at all my problem. Prevent the great re-opening? Possibly. The re-opening is a political decision and various politicians have come up with various metrics – case numbers, outbreaks, hospitalizations, first jab percentages, full jab percentages – to give the appearance of science to a purely political decision. Again, not my problem and not part of any rational, personal, risk calculation.

I suspect that the woman on Twitter was, in fact, driven by the very basic human tendency to want others to do what you are doing. When people are terrified, and COVID and the mass media have scared the Hell out of people, they want the security of the group. When the politicians, media and public health officers all say, “Everybody needs to get the jab,” it is much easier to go along with the crowd. Part of going along with the crowd is trying to herd dissenters into the ranks of the righteous. If they won’t be herded then, well, they’ll have to be ostracized.

The good news is that, as COVID fades, so will the zealous. As the threat recedes the urgency of the group think will diminish. As normal returns, attempts to separate the vaccinated sheep from the unvaccinated goats will lose their moral force.

My Twitter friend will have to find something else to be indignant about.