What cheeses me off

Why aren't there benefits beyond protection to being vaccinated?

Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here.

When I was growing up in Australia, there was a Saturday morning TV show called Hey, Hey, It’s Saturday. It is hard to explain but it was hosted by a guy and a puppet ostrich. (Of course, everyone wondered why an ostrich and not an emu but that was the way of things.) It is hard to describe the show but it was kind of a variety show that last three hours a week. It was made for kids until they worked out adults were watching and moved it to Saturday night. It lasted decades.

One of the regular segments on the show was “What cheeses me off” where people wrote in about things that annoyed them. I always loved that and it doesn’t take knowing too much about me to understand why. In my mind, I write into that show several times a day. I’d embed some examples but I couldn’t find one that wasn’t horrifically offensive. But if you must there is an example here from the adult version of the show and another from the kids. Don’t say I didn’t warn you.

Anyhow, that all was front and centre today when I processed news regarding vaccine rollouts pretty much everywhere. Suffice it to say, what cheeses me off? The whole thing really. But it was really neatly summarised by economist Miles Kimball. He calls the problem “pandemic perfectionism.” I think even that is kind but here is how he defines it:

Some of the caution about evidence, accuracy, efficacy and side-effects would make sense if we were facing a lesser disease. But when people are dying all around, getting the job done is what counts, even if you get the job done by imperfect means. The way the reproduction ratio works, combining a set of several very imperfects means that pushed the reproduction ratio below the critical value of 1 could crush the spread of the coronavirus.

For a while, the Union’s top general in the Civil War was a perfectionist: George McClellan. George McClellan kept looking for the perfect opportunity to engage the forces of the Confederacy in battle. He accomplished little. Ulysses Grant and William Tecumseh Sherman got the job done by their willingness to use imperfect methods.

There are numerous examples from masks to test efficacy to the now adopted first doses first debate. Here is one that resonated:

Despite evidence that having had Covid-19 confers decent immunity, there is little push to conserve currently scarce vaccine doses by strongly discouraging those who have had Covid-19 from getting vaccinated until supplies of the vaccine are more abundant. I think using scarce vaccine doses on those who have already had the disease is motivated by the idea that the immunity of those who have had the disease is probably imperfect, which no doubt is true, because nothing is ever perfect.

Yes. We can call it pandemic perfectionism. But it really cheeses me off? Surely, if you have already had Covid-19, before giving you a priority vaccine dose, how about a serological test first to see if you have anti-bodies? At the very least, it may turn out you need one rather than two doses. To be sure, I can imagine people lying about such things — something that wouldn’t be a problem if we had decent health records — but to not even try seems just plain crazy.

There is, however, a broader theme. Public health officials are of the belief that simple directives are required because people can’t handle any nuance. I still don’t see that there is any “science” behind that belief and there are plenty of examples where failing to have nuance has led to a backlash with worse consequences. It seems to me that the default should be the unvarnished truth.

This is happening regarding a brewing issue: if you are vaccinated, can you do more ‘normal’ things? Logic tells you ‘yes’ but the advice is currently ‘no.’ Here is Daniel Leonhardt:

Right now, public discussion of the vaccines is full of warnings about their limitations: They’re not 100 percent effective. Even vaccinated people may be able to spread the virus. And people shouldn’t change their behavior once they get their shots.

These warnings have a basis in truth, just as it’s true that masks are imperfect. But the sum total of the warnings is misleading, as I heard from multiple doctors and epidemiologists last week.

As Emily Oster explains, the basis for these recommendations comes from the fact that we don’t KNOW that vaccinated people cannot spread the virus and so we don’t want vaccinated people partying just in case. But this is translated into continued mask mandates, no easing of travel restrictions and no seeing of your elderly grandparents. Right now, maybe that will hold. But what happens as case numbers fall. In that case, as Oster argues, the fact that it is HIGHLY LIKELY that the vaccine prevents spreading will become apparent and people will be really cheesed off. In the meantime, the vaccine is being under-sold which could have obvious problematic effects.

It is hard to parse all of this. When I wrote my book back in March last year, I thought the big challenge with vaccination would be that people would be free to live life normally and that would provide an incentive for people who had not been vaccinated to pretend they were. This would give rise to immunity passports to provide that proof. But right now, there is no value to being vaccinated (well, except for the obvious one that you aren’t going to get Covid-19 which is pretty important). The point is that there is no additional value. How crazy is that when vaccinations have a positive externality meaning that getting them has social benefits that exceed private benefits? In that case, you want to push up the private benefits as much as possible.

What is more, if you keep people who are vaccinated locked up, you will never actually find out whether they are spreaders or not!

What is crazy about all this is how universal it is. No country I am aware of has opted to let vaccinated people be a little freer. What happens if we do find out too late that vaccines aren’t as effective as we think? In that case, we are going to want to change people’s behaviour. But if you kept them locked up over the summer because not everyone is vaccinated and they realise that was too much, then how likely are they to comply quickly with calls to social distance again if, say, immunity wained?

This entire matter continues to cheese me off and it should cheese you off too.

What did I miss?