welcome to the nonlinear library, where we use text-to-speech software to convert the best writing from the rationalist and ea communities into audio.
this is: COVID: How did we do? How can we know?, published by Ghost_of_Li_Wenliang on the effective altruism forum.
Obviously it was a triumph: the fastest vaccine development, approval, and rollout in history (by a factor of 5). We're up to 2.5bn doses in arms, out of say 12bn. And we got several good ones! Huzzah!
Obviously it was a catastrophe: through dumb inaction and a comedy of errors, we squandered the chance to suppress the virus. 4 million people are confirmed to have died of (or with) COVID - and given unbelievable underreporting that might be actually 12 million - and given Delta's momentum 20 million by the end is not unlikely. This is despite this virus being easy mode: unlike 1918, very few of the deaths were among the young frontline workers keeping the healthcare and delivery systems working; unlike SARS 1, post-viral disability is relatively rare. This is just the present pandemic and doesn't count future deaths from letting the thing become a permanent fixture.
How did we do? How can we even answer that question?
When I talk about whether a given country's response to COVID was a success or a failure, smart friends reply "governments had to balance the tradeoffs, so what looks like failure is really just compromise between multiple objectives (like economic activity)", "it's easy to say the optimal response in hindsight", that "it's difficult to compare different countries because of the different distances from China, wealth, state capacity".
For instance, they think the UK did ok. They can think this because they choose to compare to the average actual response (never mind that the UK is top 20 in deaths per capita). But what would the best possible response look like? What did our institutions stop us from getting?
Vax
Any self-respecting COVID rant must foreground vaccination. It is the solution, where other policies just buy time, or else consume old or disabled people.
We underinvested, and prevented market investment.
The EU paid $14 per Pfizer dose. What was it really worth? The current black market price for Pfizer is about $500. But that's a gross underestimate of the shadow price, since you get almost zero quality assurance or liability from darknet dealers. (You might still get the travel passport, depending on how weak your country's infosec is.) One proper estimate of the per-vaccine social benefit is $6000.
So we should have spent trillions in massive pre-purchase, on every credible vaccine. (The much-praised Operation Warp Speed and its equivalents elsewhere only pre-purchased about 2bn out of the necessary 12-14bn, and did so shockingly late, in August 2020.)
$3000 x 14 bn doses pays for a lot of overtime on microlipid machine assembly (which was the bottleneck on mRNA vaccine supply last year).
(That's assuming that you continue to ban vaccine markets, believing, as you apparently do, that fairness is worth the early death of millions. Another way to fund supply expansion for the global south is to just not get in our own way.)
The rich world defected, duh
16% of the world bought 70% of the vaccines. What force on earth could stop them? None, so we needed the massive supply increases, which were effectively banned.
This was not even good selfishness: it guaranteed the emergence of new strains in the global south.
This is the real evil of the EU procurement. They want to harm their own by delaying 4 weeks, to look strong? Well, that's one thing. But had they done a pre-purchase in March 2020, then global supply could have scaled up, so that the inevitable snatch away from the global south was completely balanced out by expanded supply
What did we do? Overall, about 2bn doses ordered by August 2020, i.e. 5 times too little, 5 months too late.
The strange death of human challenge trials
Probably the biggest mistake was not intentionally infec...
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