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Fully agree with this -- though I'm not optimistic that hospitals will allow much of it.
This sounds like serious confounding. In all likelihood, prison docs had X doses and triaged, and then repeated.
I will say though -- I do still think Moderna primary was likely better, but I've (since writing) found out that the booster is half the dose of the primary dose -- so I doubt Moderna's increased efficacy translates to the booster.
Adding in post: Omicron both increases short term value of booster and may increase risk of hitting any lifetime cap (its further evidence for more future variants that will warrant boosting)
On somewhat further investigation (really limited here -- lets not lean too much on it) -- the Moderna boosters are half the dose of the Moderna primaries. If you believe, as I do, that the primary reason for increased Moderna efficacy in trials was due to dosing, then the reduced booster dose means that the reason I give above (higher efficacy) is no longer a relevant factor.
I do think @npostavs is right that this study is likely quite confounded. Though I do still believe Moderna primary doses had reasonably better efficacy against OG covid, and in all likelihood against delta and now omicron.
I'm in basically the same boat as you, 30ish adult, Pfizer regime completed in April. I too have been lazy and uninterested in side effects (knocked out for a day after second dose). And I too am exceptionally interested in hearing discussion of "should I" as well as timing/choice thoughts. So -- just throwing out my thoughts. (Caveats: I'm an econ/stat type, my last bio-ish class was in high school and I remember none of it).
Should we get boosters?
I think my basic answer is "yes". The longer answer is:
- if it will allow you to reduce other precautions: yes. Free, very low risk of complications and reduces risk of covid -- allowing precautions to relax.
- if you got covid, and have been vaxxed: don't bother.
- if you don't/can't risk compensate (have already relaxed all precautions, or will never), haven't had covid: yes, but YMMV in terms of benefits.
I haven't given any consideration to "lifetime mRNA vax limits" until your mention, I have no idea how plausible that is -- but my current belief is "20% chance that's a real issue down the line".
So take everything below as being "conditional on getting a booster at all."
Timing
I plan to try to get a booster in a few weeks. The holidays are subsequently anything in January/feb are likely to be high risk for everyone. It doesn't seem unlikely to me that in terms of picomorts or QALY risk (etc) this winter -- where we still face reasonable case counts, but effective treatment regimes are still being rolled out and assessed (for now) -- is probably the highest risk period (for covid-19) remaining. Waiting until after winter thus makes little sense to me. If it going to happen in the next 6 months, it should probably be in the next month.
Choice
I have a mild preference for a Moderna booster over a Pfizer booster. Moderna efficacy seems to have been consistently a smidge higher for everything -- likely because its a larger dose (ETA: looks like booster dose is smaller so this factor may be ignorable). This + the benefits of some variation in vaccine regime makes it seem preferable. Two points on this however:
- This is a small risk change -- not worth it if it forces you to change plans or to do something "risky" without a booster. Given the choice I would choose Moderna -- I'm not sure its worth much to search it out.
- These benefits come with some risks. I've had two doses of Pfizer, and no reactions that warranted hospitalization or the like. No guarantees here -- but switching it up does add some risk. (so does just another round of pfizer).
- "Larger moderna dose" may be a negative if you are worried about some "lifetime limit on mRNA doses".
ETA:
Wrapup
Would genuinely like to hear more debate on "should", "timing", and "choice". "Should" seems likely it will be well covered by media shortly. But "timing" and "choice" are things I doubt I'll see outside of this venue.
Look at their photos. If you like them, they know their subject (though perhaps not how to teach it). If you don't like them, find a new instructor. Rinse and repeat. Most tutorial people put their photos online to some extent, so this shouldn't be hard -- and unlike many domains (e.g. woodworking) -- looking at the photo on your screen should be enough to judge it pretty well.
If you can't tell if you like them, I suspect that your first step should be to try to develop your "taste". Start by just looking at tons of pictures. I recommend one of the photo-apps that isn't instagram, though instagram can work. Flickr used to serve this role. For a while I think 500px did. Not sure where to go now -- but I would try those at first. Look at pictures. Rate them in your head -- based on your opinion. Once you're confident looking at a photo and judging it -- start trying to figure out what about them you like and dislike. "Thats too high contrast" or "I love the black and white", or "I love the aerial perspectives". Then go and try to change the pictures you take in that manner and/or return to YouTube to find someone who's pictures are like that.
Honestly I think the celebrations stopped being "valued" by the people who could organize them.
A big celebration involves a lot of planning effort and a fair bit of cash. And it can easily wind up looking like there was substantial corruption in choice of vendors, etc.
On top of that, for cash strapped local govs, the Q "can this money be better spent elsewhere" is real and all consuming.
I think this is right here, though I'd push it forwards a little. 7 days incubation +a few days to detect for some people etc, and you're probably looking at reasonable protection even on t+1 and t+2. I think basically the "dose+ 14 days" is coming down to the fact that it takes us up to 14 days to detect. Otherwise, those two numbers (and pieces of guidance) are suprisingly similar.
The big caveat to all this is that the NEJM figure (based on Pfizer's EUA submission) is focused on OG covid, not covid 2.0.
But the math I did back when I got my shot (based on that figure + an incubation period), was that within 2 days I was at like 70% efficacy.
I think a large factor for people making decisions around covid risk is not just the risk they are posing to themselves, but also the risk they are imposing on others. Insofar as "risk I impose on others" enters my utility function, this is going to change a lot of your conclusions pretty quickly. The reason being that "risk imposed on others" is growing super-linearly in most activities.
E.g. If I go to a restaurant and then meet a friend, I've incurred much more risk to the friend than if I didn't go to the restaurant. If I then meet a third friend separately, the risk to that friend is increased by each of the prior interactions, and so forth. Each additional activity poses additional risk to all the people involved in later activities. This is classic exponential growth type stuff, but all we need is super-linear growth in risk.
Once you have something (bad) growing super-linearly like that, it should be pretty straightforward to see that even if the net utility from each of two different actions is positive, the utility from doing both actions may be less than the utility of doing just one. Insofar as the thing that is growing super-linearly is about 'micro-covids', it makes sense that some things are better and worse on that scale (eating inside a restaurant vs going on a walk with a friend), and so accounting for that differential cost makes sense. And now we're firmly in 'budget' territory -- different costs for different activities all of which i like, but with some kind of max on how much I can reasonably spend.
This (US export ban) is news to me. Can you link to a source for that?
I think korin43 has it right.
Notably, the article you quote cites the US as doing more poorly than the UK, one of the only large countries to outperform the US in both your rankings. I agree that I've seen a number of articles in that vein, but none of them seem to compare the US to countries other than Israel and the UK.
In comparison with the EU however, US vaccine procurement looks incredible. I'll cite a relatively neutral google news search (https://www.google.com/search?q=EU+vaccine+procurement&hl=en&source=lnms&tbm=nws). For future readers: at the moment this shows many news sources saying things like "why has EU procurement been so bad".
I think that Siderea's section 2 is actually very important. While it is possible that the monetary costs of the boots are structured such that buying good boots once is a better use of money than buying cheap ones every year, it is certainly the case that the time-costs of avoiding that big upfront expenditure are huge. The same is true for many of your examples. Being money-poor forces you to work up to your constraints on other dimensions (time, stress, etc) to survive without money -- which in turn prevents you from using slack in those dimensions to stop being poor.
I will commend your notice of financial products being cheaper for the rich. This is, I think underrated as a source of inequality. It takes $3k to invest in the top tier of vanguard funds. It takes $1mil to become an accredited investor (possibly changing?). This incentivizes more savings behavior by the wealthy, it is literally cheaper/better. Those incentives can create a self reinforcing system. This is probably why we see lots of people giving advice along the lines of "fight every inch for the first $100k of net worth" (see e.g. charlie munger rule).
I think the reason the second fact gets less attention has to do with the focus rapidly shifting to markets and prices as the mechanism by which the exchange rate is set, rather than 1-on-1 negotiation.
Not to say that the second fact is irrelevant. OPs examples of relevance of fact 1 include things like household chore splits between partners, as well as career choice -- applications where fact 2 is clearly very relevant.
But in econ 101, there is a lot of ground to cover. comparative advantage is a natural jumping off point for supply & demand Qs which are pretty much required content, whereas negotiation, game theory, bilateral decisions are usually treated as somewhat supplementary.
Really well written and thought out.
Indeed, if both Alice and Omega know that Alice's decision-making will tell her to use the 1-boxer strategy, then Alice will know she will gain $1M
and
In both cases, her counterfactual optimization urged her to be a 2-boxer
feel like the crux to me.
If Alice was such a person to listen to the counterfactual optimization, then both Alice and Omega would not know she would 1box. There is a contradiction being buried in there.
Excellent post. I have a small complaint on the Coase section though. Quoting for reference:
Suppose that, in a particular case, the pollution does $100,000 a year worth of damage and can be eliminated at a cost of only $80,000 a year (from here on, all costs are per year). Further assume that the cost of shifting all of the land down wind to a new use unaffected by the pollution—growing timber instead of renting out summer resorts, say—is only $50,000. If we impose an emission fee of a hundred thousand dollars a year, the steel mill stops polluting and the damage is eliminated—at a cost of $80,000. If we impose no emission fee the mill keeps polluting, the owners of the land stop advertising for tenants and plant trees instead, and the problem is again solved—at a cost of $50,000. In this case the result without Pigouvian taxes is efficient—the problem is eliminated at the lowest possible cost—and the result with Pigouvian taxes in inefficient.
With the numbers laid out, (and presuming the mill is more than $100k profitable), I agree that the "efficient" outcome is for the resort to convert to timber. However, the result with Pigouvian taxes is still efficient. This is because Friedman arrives at the wrong equilibrium result with taxes. It is possible this is because he has structured his taxes incorrectly -- they aren't properly taxing damages, but rather an intermediary which can cause damages.
I think the result that Coase would advocate is that in the presence of a tax on damages, the mill pays the resort owner $50k+1 to convert to timber. At that point, the damages are $0, and no Pigouvian tax is paid. This is central to Coase's realization. Conditional on the pre-existing endowments, we should arrive at the min-cost solution -- the question is who bears the cost. In this case, imposing a Pigouvian tax transfers the burden from the resort owner to the mill owner.
I believe not. The point was that even if a referenda gains a majority of 1% of the population, it is still a successful referenda. Thus 0.51% when turnout is 1% is adequate to change law.
This. I think Mistake theorists would frequently question whether the game is actually zero-sum. This divergence in opinions about the nature of the game feels important to me.
I think the reason not to worry too much about the passive revolution is that as long as there are money-making opportunities from active trading -- people will be incentivized to do it. The end state "everyone is passive -- there is no price signal" is not one we can reach from where we are, and it is not a stable equilibrium. If we ever did cross over into "too few hedge funds", there would such a strong incentive for more, that I don't think it would last long. But perhaps I misunderstand this critique.
Really excellent discussion of the EMH. Love your description of it as some kind of demon-god creature.
I'll jump in on a minor point.
"And yet, and yet…even when criminals have advance access to earnings reports, they still don’t do all that well, which is evidence for the very strongest form of the EMH (the one that no-one, including me, believes can possibly be true)."
This might instead be evidence that there is a lot more insider trading than we think -- making it so that those we know of were competing for gains against other insider traders.
Could certainly go either way. I was trying to emphasize that the productivity loss has an externality associated with it though. I wholeheartedly agree that individuals may be better off -- they are optimizing, but with more information. At most, their predictions about locational preferences have changed but reality hasn't (outside the next couple of years at least). But if that reduces aggregate productivity growth, people alive in 100 years may be suffering -- their utility isn't being accounted for by individual decisions.
A secondary effect, which I failed to mention I thought you should add (I don't think you have it) -- is that I suspect people will move closer to family. I've been comfortably living a 12 hour drive from any family for 5 years now -- and I was happy to fly to see them frequently -- but flight is not a robust transport method -- and going forwards I'll be thinking about locales within more like 4 hours of them.
Whether that is good or bad, I don't know. Closer family bonds, which are good for many reasons. but the models around people moving towards work involve largish productivity growth again.
De-urbanization is something you list several times as being important and beneficial. I don't think I agree.
In the short term at least de-urbanization is diametrically opposed to __climate progress__ -- and that may be true in the medium to long term. See for instance, stats about NYC
In the long term, urban areas have been highly productive historically -- and while it is possible that tele-everything can undermine that effect, I doubt it can fully counter the productivity benefits of cities. Insofar as productivity has been critical for human welfare over longer time spans, I worry that reducing productivity by deurbanizing could have long term consequences. I suppose you could have a complicated model where partial telework allows some de-urbanizing of work, which lowers urban prices, which allows greater concentration/productivity? But at minimum it isn't __obvious__ to me that this is a benefit.
More broadly though -- I really like your list and the general thesis. Good writeup too.