November 21, 2022 from Vinay Prasad's Observations and Thoughts

STAT— a Boston Globe Subsidiary— recently ran a poll asking 34 "ID experts” what they are doing about COVID. The poll is embarrassing— first, it is not science. They asked a convenience sample of 34 people who are just as neurotic and irrational as they are to fill out the survey. They didn’t ask for political views, but I suspect that all 34 voted for Biden, all 34 voted for Dems in midterms, most do Yoga or meditate, nearly all have net worth >1 million dollars, and probably all are mad at Elon Musk. It’s fine to be friends with a group of like-minded people. It’s not fine to pass that off as a survey of ‘experts’. Bad journalism.

Their answers are demented, betray a deep ignorance about COVID19, and more generally show that they are incapable of judging risk. Sars-cov-2 will circulate for 10,000 years. All you can do is lower your risk of bad outcomes before you get it the first time. The only thing proven to lower that risk is vaccination. After you get vaccinated and/or after you get COVID19, you have only one decision to make: how do you want to live the rest of your life? Not this winter, or this year, but the REST OF YOUR LIFE— cuz covid ain’t going anywhere. For 99.99999% of Americans that should be totally normal.

Kids face such low risks from current variants AND have such high rates of sero-prevalance AND have never had data supporting the efficacy of restrictions, ERGO they should never, ever face restrictions again. Yet, some respondents still mask their kids. That’s a lamentable choice. Not only unproven, but pointless. Others limit playdates citing RSV. That’s cruel and stupid. You never would have limited playdates in 2014 (unless someone actively ill) because of RSV. Your risk/benefit calculator is broken. Kids need to play with other kids. Humans are social creatures. Cold, flu and RSV are risks that it is on balance ok to accept, given the benefits of socialization.

Some adults who have had multiple boosters wear masks to concerts. Why? You will get COVID anyway later. One in 4 won’t eat at a restaurant. I am deeply concerned these people need counseling.

One ‘expert immunologist’ wears masks only during take off and landing. I prefer to pray to Lord Boeing, blink my eyes three times, and pinch myself— an equally valid anti-covid strategy. How is this different from someone with a compulsion who checks their door-locks 4 times before going to bed? It is a mental habit that disrupts life.

Others take their mask off to eat. This is all crazy. You will definitely get breakthrough COVID. It is too contagious to stop. Why all this theater only to get it anyway? Why not live normally and get it when you get it? There is no evidence that overthinking it—hyper-rationalizing your choices— delays infection, and frankly I (and most Americans) think it is insane to waste mental energy on these contortions.

All have gotten or want to get bivalent vaccines. That just tells you they are not good at judging risk/ benefit. There are no data that anyone benefits clinically (i.e. lives longer or better) from these vaccines and it is UNLIKELY that they will benefit someone who HAD COVID. It is UNLIKELY they will provide net benefit to a young healthy person. If Gruber and Krause worked at FDA, they would not even receive EUA for people <65.

Some report they want to reduce their risk of spreading the virus. That’s arrogance and narcissism. You are one tiny person in a sea of 8 billion people with 100 billion more to come in the next 2000 years. The virus will replicate and spread to all people trillions of times and your greatest actions are like spitting in Lake Mead, and thinking you solved the drought. I cannot imagine wasting my energy thinking about this while there are real problems in the world like poverty, war, violence, famine. Delusions of grandeur.

One expert avoids shaking hands. Good, I don’t want to know you. Two carry CO2 monitors. What a deranged choice. Randomize 1000 people to carry the monitor and 1000 to not, and I promise the time till COVID will be identical in both groups. Don’t like that study. Do a run in period. Give the monitor to 10,000 people and then the 100 who report they use it, will be randomized to continue or discontinue. Watch the time to COVID be identical in both groups. What’s crazy is that these ‘experts’ are happy to do this without the study. They are no better than people who buy amulets to ward off covid— they just have a different mechanistic theory that they worship, but neither needs evidence.

Half of experts surveyed won’t let unvaccinated loved ones attend their gatherings. Frankly, this is the hallmark of a deranged individual and a failing culture. Most cultures value relatives, treasure loved ones even when they make choices you would not. Not being vaccinated is a choice that ONLY AFFECTS THEM— they will get COVID, and so will you— imagine being so intolerant as to exclude loved ones in this way. It is a mental sickness.

Some want to use rapid tests to make the gathering safer. Consider this: we randomize 10000 gatherings to using rapid tests vs not. I bet there would be nearly equal number of COVID cases in both groups in the weeks to follow. These ‘experts’ have not done this validation study. Again, they are in love with mechanism and theory, but no better than the anti-science fools they look down on. Both have such a superficial understanding of science that they change their lives in the absence of validation studies.

What a sad bunch of “experts”. Continuing to inflict restrictions on children. Leaping to get unproven boosters, and engaging in a plethora of actions with nearly no evidence that they improve any long term outcome. It reminds me of the old BF Skinner experiment. Give a pigeon a pellet at random, and it learns a bizarre dance. Here that pellet is a twitter ‘like’ or ‘RT’, and these are the dances that emerge.

These experts think they are so wise, understand the virus so well, that with a Co2 meter on an airplane, a rapid test in their pocket, and a kf94 with gaping holes around the nose, they can avoid the inevitable. They will just make themselves sad, lonely, and crazy, and in 2 years they will throw in the towel. And when they die, years from now, they will have had COVID just as often as the rest of America— who are no longer doing jack shit because they actually have basic, common sense.

The headline should have read: STAT: we asked 34 people as irrational as we are to validate our delusions and they didn’t disappoint.


Appendix: The Right Answer

There is only one right answer in fall 2022.

Children should not be subject to any restrictions ever, including masking, and should live normal lives. There is no need to encourage nor discourage vaccination among kids who have not had covid.

Adults who have not have COVID should get between 1 and 3 doses, depending on age and risk factors, and resume normal life.

(Almost) Everyone should lose weight and improve their medical problems.

Anyone who has had COVID should never think about about it again, and continue living normally.

The logic here is simple: once you have had covid, no one has proven that doing anything will lower the risk of actual bad outcomes (forget antibody titers)

Once you have had vaccination, no one has shown that delaying infection will offer any long term benefit.

Vaccination can lower the risk of severe disease among the un-immune, but that absolute risk reduction is proportionate to baseline risk, and it really only makes sense to target the elderly, un-immune.

And, you have to love your loved ones even if that is slightly risky to you. You definitely have to love your loved ones when it comes as no risk to you. Otherwise, you are a bad person.

Here is the survey for the curious

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https://vinayprasadmdmph.substack.com/p/stats-id-experts-are-not-good-thinkers
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