monkeypizza

Right. I'm not saying eval(their net behavior)>0; I'm saying that if your response function is always negative, you lose the ability to influence their response.

Have you heard the one about the country with the death penalty for all crime? It just leads criminals to maximally try not to get caught, without regard to damage done [i.e. removing all witnesses to even the smallest crimes]. This isn't what you want; even within "negative" relationships both sides lose when you don't have a gradient of responses.

Watch out not to condemn them no matter what they do. Sure, they messed up in the past, but given the situation they found themselves in when they saw this report, this response is still good.

You risk making discourse difficult when you continue punishing people who are attempting to do the right after doing wrong for a while.

I'd be curious what you think of "Ghettoside" - a book from the left that examines the claims implied by your linked comic about the nature of the suffering we are trying to prevent: https://www.vox.com/2016/8/26/12631962/ghettoside-jill-leovy...

If you define away neutrality, there is no neutrality, yes. But does everyone agree with your definition?

This seems more like a "you're with us or against us" trick.

"I care about protecting all children" is still neutral, right? But if someone popularized "ICAPBC", by your argument "ICAPAC" would innately become a shibboleth? Something doesn't seem right here, where neutral positions automatically get converted to dog-whistles without any proof.

right - and this all started when someone who said "hey, let's stop people from shutting down discussion" was accused of being intolerant. When in fact for the existence of tolerance to continue, some self-defense is necessary.

Yeah, this debate has two instances of it from opposite sides: The original story claimed to feature people who were (voluntarily) not accepting speech from someone they suggested was subtly intolerant. Then someone said "we shouldn't restrict people like that, and we should restrict (or resist) people who try it".

It's hard to make self-modifying systems stable! I simultaneously want to preserve open debate, but also do want to reduce prevalence of views proposing easier rules to shut down debate (by defeating them in debate, not by law).

Right. The original comment suggested that any prohibitions made by an allegedly tolerant society invalidate their claim.

I don't think that is a very useful definition of tolerance. The only stable system here, if there is one, might be something like hardcoded self-defense actions, plus otherwise general tolerance. Not saying it's logically or morally consistent.

I was just bringing it up to get an admission that "there is a line". Everything else is about debating where that line is. The old ACLU set it really far into the "freedom" zone - recently people want to restrict it more, by for example talking about classifying relatively generic/common/vague speech as violence, when previously only direct incitement to violence was considered beyond the line.

My main point was that the GGP's concept of tolerance, as something which can have no line at all, has never been the case in the US, and doesn't seem advisable, since his argument that any resistance is invalidation of tolerance would lead it to be easily destroyed.

In your definition of tolerant, is it required to tolerate even attempts to destroy the tolerant person? i.e. is there a line beyond which tolerance doesn't apply? Where do laws fit in here? I honestly thought that tolerance already included this concept - it actually means tolerant of difference of opinion, except for attempts to overthrow and replace the system of tolerance itself.

Yes, this is a coherent, stable proposal. For a tolerant society to adopt complete tolerance, even of things designed to destroy their society, is unstable.

https://en.wikipedia.org/wiki/Paradox_of_tolerance

Abstract:

  When vaccines are in limited supply, expanding the number of people who receive some vaccine can reduce disease and mortality compared to concentrating vaccines in a subset of the population. A corollary of such dose-sparing strategies is that vaccinated individuals may have less protective immunity. Concerns have been raised that expanding the fraction of the population with partial immunity to SARS-CoV-2 could increase selection for vaccine escape variants, ultimately undermining vaccine effectiveness. We argue that although this is possible, preliminary evidence instead suggests such strategies should slow the rate of vaccine or immune escape. As long as vaccination provides some protection against escape variants, the corresponding reduction in prevalence and incidence should reduce the rate at which new variants are generated and the speed of adaptation. Because there is little evidence for efficient immune selection of SARS-CoV-2 during typical infections, these population-level effects are likely to dominate vaccine-induced evolution.

Conclusion:

  We propose that dose-sparing strategies, which could have large public health benefits, not be dismissed out of concern that they might promote immune escape in SARS-CoV-2. In fact, multiple lines of evidence suggest that expanded vaccination coverage could reduce the rate of immune escape, providing an additional benefit of dose sparing beyond its immediate impact on disease. These beneficial effects hinge on the assumption that vaccination provides some protection against variants of SARS-CoV-2, or in other words, that vaccine effectiveness against the variants is not zero under dose sparing. Another requirement is that other fitness-enhancing mutations not be exclusively linked to vaccine escape mutations. Both of these assumptions appear currently met. We encourage research to refine understanding of vaccine effectiveness, immune pressure, and the evolutionary dynamics of SARS-CoV-2, and to investigate this problem more thoroughly.

Author Affiliation

  Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
  Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
  BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
  Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
  Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

Your question is addressed here: https://dash.harvard.edu/bitstream/handle/1/37366988/Dose_sp...

  When vaccines are in limited supply, expanding the number of people who receive some vaccine can reduce disease and mortality compared to concentrating vaccines in a subset of the population. A corollary of such dose-sparing strategies is that vaccinated individuals may have less protective immunity. Concerns have been raised that expanding the fraction of the population with partial immunity to SARS-CoV-2 could increase selection for vaccine escape variants, ultimately undermining vaccine effectiveness. We argue that although this is possible, preliminary evidence instead suggests such strategies should slow the rate of vaccine or immune escape. As long as vaccination provides some protection against escape variants, the corresponding reduction in prevalence and incidence should reduce the rate at which new variants are generated and the speed of adaptation. Because there is little evidence for efficient immune selection of SARS-CoV-2 during typical infections, these population-level effects are likely to dominate vaccine-induced evolution.

Would combining two people's double doses all into one person, raising their resistance even more while leaving three people uncovered be beneficial in not setting up situations that would select for vaccine-immune strains? This is implied by your argument in favor of maximizing concentrated immunity rather than maximizing total population immunity.

i.e. if you think 1x0%, 1x95% is better than 2x85%, do you not also think that 3x0%, 1x99% is better?

Is there something in NACI's analysis that you disagree with specifically?

Their argument seems to be that we have 2 months of evidence that hospitalizations & negative effects are strongly reduced even by single doses, and we can reduce world-wide virus numbers by getting more 2x single dose resistances rather than single person double doses.

In this view, the risk of resistant strains would actually be less with 2 people at ~85% resistance, than one person with 95%. This is because if everyone had 85% resistance the virus reproduction rate would be <1, and it would completely die out, so wouldn't have an opportunity to evolve stronger strains - which it currently does have due to being prevalent all over the world.

Canada came out with support for first doses first: https://www.canada.ca/en/public-health/services/immunization...

The summary:

    While studies have not yet collected four months of data on vaccine effectiveness after the first dose, the first two months of real world effectiveness are showing sustained high levels of protection. ...
   
   Short term sustained protection is consistent with immunological principles and vaccine science where it is not expected to see rapid waning of a highly effective vaccine in adults over a relatively short period of time. Extending the interval between doses was shown to be a good strategy through modelling, even in scenarios considering a six month interval and in theoretical scenarios where waning protection was considered.
   
    NACI recommends that in the context of limited COVID-19 vaccine supply, jurisdictions should maximize the number of individuals benefiting from the first dose of vaccine by extending the interval for the second dose of vaccine to four months.

So basically, it makes theoretical sense, looks beneficial in total, so let's consciously adjust the vaccine administration regime we studied.

1. China has prior restraint on everything associated with working in the media - purchase of materials required for publication of newspapers, licenses to publish media, licenses for journalists, all requiring heavy inspection of political views.

2. The US doesn't.

Your other points stand, but this core difference still matters.

https://en.wikipedia.org/wiki/Prior_restraint

Sure, Alex should update his criticism, but it's still valid to look back at why it took this long; First Doses First has been out for a while - it's been 2 months since, for example, Tony Blair publicly advocated for it.

I think the gains we would get from even a single day earlier application of First Doses First probably outweighs the pain caused to the FDA by Alex criticizing them.

https://www.businessinsider.com/blair-one-covid-19-vaccine-s...

> There’s no need to experiment.

People who haven't caught coronavirus yet are still likely to catch it and be at risk. That is, new people are still being infected and are likely to be for a few more months yet.

What calculation are you running to say that changes to policy which might increase first-dose protection are not worth making to protect them?

What is the relationship of his credentials to his logical argument? By arguing from credentials you implicitly take the side of the status quo in history; you'd have been arguing against every overturning of conventional wisdom.

I'm not saying all rejection of convention is correct, obviously - but if you look at the specifics of the argument, not the status or credentials of the arguer, it seems more likely to come to a correct judgement.

Good point. I'd imagine we could leave it voluntary, and just start the "delayed 2nd dose" policy later.

> It's not appropriate to start experimenting on the general population based on a hunch.

By varying the parameters of the situation, could you be induced to change your view? i.e. vary CFR up to 1%, 10%, 50% - given that you acknowledge that the natural experiments we are observing from single-dose administration suggest most of the immunity granted by a vaccine is in the first dose - at what point do you budge?

If you admit that for a 50% CFR, you would not insist on following the established standard of care, then the question is where is the border for you, where your recommendation flips, and you consider early end to quarantine, reduced life loss, to be worth moral hazard of ad-hoc decisions, or not following the standard of care would bring?

The comparison was between

    giving 2 doses to one person over 65, and nothing to another other person over 65
    giving one dose each to two 65+ people

We have evidence that total harm prevention under the second case is higher than the first case, and it also makes perfect logical sense, and there are public health officials confirming this.

On the other hand we have tradition, custom, specific tests.

Say vaccines were tested based on administration in a blue room, but weren't tested in a room painted red. Why are you able to assert without tests that the room color is irrelevant, but are asking for proof that giving two people 85% resistance is better than one person with 95%, when all the evidence supports it? What is leading to wanting to strictly adhere to the exact tested procedure? How do you square your disagreement with the public health officials actively investigating this issue in the linked posts?

from an earlier post in the series:

Michael Osterholm, Regents Professor, McKnight Presidential Endowed Chair in Public Health, the director of the Center for Infectious Disease Research and Policy (CIDRAP) and state epidemiologist for the Minnesota Department of Health:

    …Imagine you are setting across the table from two people both of whom are 65 or older, both with underlying health conditions. You have two doses of vaccine, one in each hand. And you say to them I can give two doses to you or to you but then the other person gets nothing. Or I can give one dose to both of you. And this is what I know. At the very least, one dose is likely to prevent serious illness, hospitalization and death. Two doses will probably even prevent clinical disease with B.1.1.7. But the other one of you; if you get infected with this virus, which I think substantial numbers of Americans will, things are not looking good for you. What do you want me to do?

    If that is your Mom or Dad. Your Grandpa or Grandma. What would you do?

    This is where the rubber meets the road. I think if the data bears it out we can save so many lives in the upcoming weeks and we are missing that opportunity.

    I have already made my choice. I am postponing my second dose. I want my second dose. But I am confident that I can wait. And I can only hope that my second dose, which I have just deferred, will go to someone who it will save their life. It will make a totally different world for that family.

    You know some could argue that this could be the end of my career. But I could not sleep with myself at night if I didn’t do this. I just know in my heart of hearts that this is something we must do if we are going to save lives.

https://marginalrevolution.com/marginalrevolution/2021/02/os...

Other related posts including quotes from supporting experts: https://marginalrevolution.com/?s=first+doses+first

This is more about looking at the ability of our systems to change their response in emergencies; why are obvious things so hard to do, when they both fully make sense, and are supported by an interested group of experts, against a larger but less interested group of conventional, rule-following experts?

Right. So continue your reasoning: you are arguing that if we pay the minimum required to produce an item, from that point onwards, more money doesn't unlock additional production? I agree you need to be able to charge enough to cover costs; the question is what happens after that. Why does it require proof to suggest that paying someone slightly more than the absolute minimum they'd ask to do something will increase their willingness and ability to do it?

At 20/dose, companies could produce N. At 30/dose they could probably find a way to produce more (perhaps by spending money to retrofit an old machine, which at 20/dose wouldn't have been worth it). And at 100/dose they can afford to fly the device manufacturer out to personally oversee sped-up installation.

So many people in the comments are just certain that more money wouldn't have made any difference to vaccine production, and that economic considerations had nothing to do with it. The arguments they make fail to simple comparison tests:

"If we paid Tesla 2x as much per car, could they really not produce more cars?"

They also fail to privileging the status quo - "If we paid Tesla half as much money, would they produce fewer cars?"

Obviously, they would. Money influences how easily they can produce cars. At the margin there must be decisions related to turning money into efficiency every day. And the same thing must apply for vaccines. The best vaccine expert in the world asked for a yearly sabbatical - 200k wasn't enough to keep them. Double that to 400k? Oh actually it can wait til next year.

The question for people who deny money's ability to produce more vaccines is: why do you admit that any lower price for a vaccine would reduce supply - but you deny that any higher price would increase supply. What magic is this?

The OP doesn't actually propose giving the money as profit. An alternative interpretation of his proposal to "let people pay more" would be for the government to offer a prize to companies for producing X number of additional vaccines by a certain day, offering to buy them from the company for say 3x the current price - then selling a portion of those at 5x and giving the rest away for free to need people, to balance out the cost.

This would be a truer test of "Do companies really, really not have any extra capacity? Or are they just allocating resources according to profit maximization, not to maximum effort?"

This is what normal markets ARE - companies take risks and investments for a chance at profit. The government could fake the system by offering high rewards... or we could just let companies do reasonable things like sell 20% of their output at market price.

This reminds me of the CCP in the 1950s where most private land was socialized... and farmers ended up putting all their effort into their private plots, because that was the only work they could do that they'd actually get to keep.