Proof of booster

[shpalman]

Are you suggesting leaving the venues open and not requiring passes, or closing the venues?

[lpm]

Obviously venues have to close. We need to embrace lockdownism again.

Voluntary action is hurting the nightclubs etc already, though. There will be a lot of empty seats at panto and a lot of cancelled Christmas parties. Voluntary action works quite well.

[shpalman]

Well it would stop them complaining about having to employ more staff to deal with the fewer people showing up

[Herainestold]

Sorry to go all Herainestoldish, but - if the early indications of its behaviour are true - the majority are going to get Omicron in the next few months and that's how it'll end this variant's outbreak. You simply can't beat R=3.5. All you have to play for is to spread a Jan/Feb peak into a Jan to June peak to reduce NHS overload - and use the time to pump vaccines into unprotected morons as fast as you can.

Hear me now, or I will tell you later.

[Millennie Al]

I guess it depends on what the real purpose of Covid passes is. Is it to (a) meaningfully reduce the risk to you, the punter entering the venue right now,

That would be bad as it is for each person to guard their own interests by acting according to their personal appetite for risk and evaluation of costs and benefits. If you take that choice away from people how are you going to handle the responsility when you make the wrong choice?

or (b) reduce the risk that you pose to the other punters already in the venue,

This would be a very worthy reason, except for the lack of evidence that it makes a big difference to the risk. Specifically, if it halves the risk, but multiple infectious people are present, it does no good to exclude other infectious people.

or is it (c) to generally make your life more awkward until you get vaccinated, because that has an overall benefit for society, ... mostly because you are 10x less likely to block an ICU bed for a fortnight?

I would agree that this seems the most plausible reason, though I'm not sure the authorities in various places have thought it through to this point. The main problem with this is that it is an example of the corrupting effect of public healthcare, which is that you give a group of people subsidised healthcare and then use that as grounds to impose rules on them.

[shpalman]

I guess it depends on what the real purpose of Covid passes is. Is it to (a) meaningfully reduce the risk to you, the punter entering the venue right now,

That would be bad as it is for each person to guard their own interests by acting according to their personal appetite for risk and evaluation of costs and benefits. If you take that choice away from people how are you going to handle the responsility when you make the wrong choice?

The responsibility when they make the wrong choice like "but the government said it was safe" or like before he died, John told the doctor treating him how much he regretted not getting the vaccine kind of responsibility?

Still I'm sure I'm just cherry picking and there are plenty of people who got seriously ill or died of covid who totally owned their choices.

[shpalman]

or (b) reduce the risk that you pose to the other punters already in the venue,

This would be a very worthy reason, except for the lack of evidence that it makes a big difference to the risk. Specifically, if it halves the risk, but multiple infectious people are present...

Halves the risk or what compared to what? How many is "multiple" and how is that "specific"?

(Is it like when one of our regional administrators said that an R of 0.5 meant that he'd need to meet two infected people in order to catch covid?)

The figures from my bit of Italy suggested that there's a factor of 5 between vaccinated and unvaccinated people catching covid, and the other data suggests that the viral load in a vaccinated person drops off sharply after 2-3 days rather than decaying more slowly, so I as a vaccinated person am less likely to be infected and/or if I did get infected recently it's more likely that my viral load has already dropped. Since in the venue there are now only other vaccinated people, they're less likely to detectably catch it from me even if, and much less likely to have a bad outcome from it.

Until recently it was also possible to enter a venue with proof of a recent negative test (PCR or antigen but can't be a self test) which would also reduce the risk that the person posed to the other punters already in the venue while not protecting the person themselves at all.

[shpalman]

or is it (c) to generally make your life more awkward until you get vaccinated, because that has an overall benefit for society, ... mostly because you are 10x less likely to block an ICU bed for a fortnight?

I would agree that this seems the most plausible reason, though I'm not sure the authorities in various places have thought it through to this point. The main problem with this is that it is an example of the corrupting effect of public healthcare, which is that you give a group of people subsidised healthcare and then use that as grounds to impose rules on them.

The thing is that they give you access to the subsidized health care anyway, even if your health problems could have been avoided or mitigated by better choices. Well, maybe not in Singapore.

[lpm]

or (b) reduce the risk that you pose to the other punters already in the venue,

This would be a very worthy reason, except for the lack of evidence that it makes a big difference to the risk. Specifically, if it halves the risk, but multiple infectious people are present...

Halves the risk or what compared to what? How many is "multiple" and how is that "specific"?

(Is it like when one of our regional administrators said that an R of 0.5 meant that he'd need to meet two infected people in order to catch covid?)

The figures from my bit of Italy suggested that there's a factor of 5 between vaccinated and unvaccinated people catching covid, and the other data suggests that the viral load in a vaccinated person drops off sharply after 2-3 days rather than decaying more slowly, so I as a vaccinated person am less likely to be infected and/or if I did get infected recently it's more likely that my viral load has already dropped. Since in the venue there are now only other vaccinated people, they're less likely to detectably catch it from me even if, and much less likely to have a bad outcome from it.

Until recently it was also possible to enter a venue with proof of a recent negative test (PCR or antigen but can't be a self test) which would also reduce the risk that the person posed to the other punters already in the venue while not protecting the person themselves at all.

The link provided by Woodchopper estimated Omicron halves this benefit - 40-60% reduction in vaccine effectiveness against symptomatic infection. Obviously there's no way Omi can be doing so well if all it's got to feed on are the unvaccinated. It must be doing pretty nicely against the vaccinated as well.

A venue of only vaccinated people is still better, obviously. But against Delta vaccine efficacy against transmission was something like 85% for fairly recent vaccinations, perhaps waning to 67% after 6 or 9 months. Against Omicron it might be 43% to 33%. An unboostered person with second dose 5 months and 29 days ago can't be particularly reassured when they enter a vaccine-only venue.

At the new level of risk I'd go with shutting down indoor venues like cinemas rather than passports, but at a guess venues of boostered people only would be back to the old Delta efficacy so booster-passports could work. Everything points to precautionary principle right now.

[Woodchopper]

This would be a very worthy reason, except for the lack of evidence that it makes a big difference to the risk. Specifically, if it halves the risk, but multiple infectious people are present...

Halves the risk or what compared to what? How many is "multiple" and how is that "specific"?

(Is it like when one of our regional administrators said that an R of 0.5 meant that he'd need to meet two infected people in order to catch covid?)

The figures from my bit of Italy suggested that there's a factor of 5 between vaccinated and unvaccinated people catching covid, and the other data suggests that the viral load in a vaccinated person drops off sharply after 2-3 days rather than decaying more slowly, so I as a vaccinated person am less likely to be infected and/or if I did get infected recently it's more likely that my viral load has already dropped. Since in the venue there are now only other vaccinated people, they're less likely to detectably catch it from me even if, and much less likely to have a bad outcome from it.

Until recently it was also possible to enter a venue with proof of a recent negative test (PCR or antigen but can't be a self test) which would also reduce the risk that the person posed to the other punters already in the venue while not protecting the person themselves at all.

The link provided by Woodchopper estimated Omicron halves this benefit - 40-60% reduction in vaccine effectiveness against symptomatic infection. Obviously there's no way Omi can be doing so well if all it's got to feed on are the unvaccinated. It must be doing pretty nicely against the vaccinated as well.

A venue of only vaccinated people is still better, obviously. But against Delta vaccine efficacy against transmission was something like 85% for fairly recent vaccinations, perhaps waning to 67% after 6 or 9 months. Against Omicron it might be 43% to 33%. An unboostered person with second dose 5 months and 29 days ago can't be particularly reassured when they enter a vaccine-only venue.

That looks about right. In the Norwegian superspreader event at a restaurant 140 people were infected and they'd all been double vaccinated.

One other issue is the length of time people are in the a venue. No time to look up the link but as far as I remember being double vaccinated didn't protect against household transmission of Delta. Basically, spend hours every day in the same rooms and vaccinated people are going to get infected. So IMHO there's a big difference between, say, someone who is in a cafe for 20 minutes, and someone who is in a venue all day, for example at a conference.

So I'd see vaccine passports being more useful in places where there isn't prolonged contact between people, and less point if they are going to spend a long time in each other's company.

[Millennie Al]

it is for each person to guard their own interests by acting according to their personal appetite for risk and evaluation of costs and benefits. If you take that choice away from people how are you going to handle the responsility when you make the wrong choice?

The responsibility when they make the wrong choice like "but the government said it was safe"

Those are cases where the government said things, but people could largely choose to believe or not. Obviously the government must sometimes give advice, and even strongly worded advice, but people should choose for themselves whether or not to take it.

or like before he died, John told the doctor treating him how much he regretted not getting the vaccine kind of responsibility?

That is what I am getting at. It's much better for John to regret not getting the vaccine than for his doctor to regret not letting hime have it or for the governement to make it too difficult to get it. Equally, if the story was John had a rare adverse reaction and died from it, it would be much better for it to have been as a result of John's choice to get vaccinated rather than him getting it under duress (with respect to the effect on his health - it's legitimate to go further when his vaccination makes a big difference to other people's health).

[Millennie Al]

or (b) reduce the risk that you pose to the other punters already in the venue,

This would be a very worthy reason, except for the lack of evidence that it makes a big difference to the risk. Specifically, if it halves the risk, but multiple infectious people are present...

Halves the risk or what compared to what? How many is "multiple" and how is that "specific"?

It's specific as in it's intended as a hypothetical example figure.

The figures from my bit of Italy suggested that there's a factor of 5 between vaccinated and unvaccinated people catching covid, and the other data suggests that the viral load in a vaccinated person drops off sharply after 2-3 days rather than decaying more slowly, so I as a vaccinated person am less likely to be infected and/or if I did get infected recently it's more likely that my viral load has already dropped. Since in the venue there are now only other vaccinated people, they're less likely to detectably catch it from me even if, and much less likely to have a bad outcome from it.

That all may be true and still not justify excluding the unvaccinated for the sake of the vaccinated. It is plausible that excluding the unvaccinated gives people sufficintly greater confidence that they gather more frequently and in greater numbers so that there is overall no protection. The problem with dealing with people is that the are very complex and rules have lots of unintended effects.

[Millennie Al]

that it is an example of the corrupting effect of public healthcare, which is that you give a group of people subsidised healthcare and then use that as grounds to impose rules on them.

The thing is that they give you access to the subsidized health care anyway, even if your health problems could have been avoided or mitigated by better choices.

That does not matter. To give a different example, suppose I provided your car insurance free (i.e. I pay for claims as if I were an insurance company - not that I pay premiums to someone else). Then I might demand you only drive some models of car on the grounds that the others are too likely to cause me expense. And then demand that you only drive in certain places, as some roads are more dangerous than others. And then demand that you adjust your speed, acceleration, braking etc to make you a safer drivers. And then demand that you not drive when the Met office says you should only make essential journeys. And so on. The provision of a benefit can have a corrupting influence whereby it becomes and end in itself and so a reason for lots of restrictions. With Covid, this is almost explicit in "Stay home. Protect the NHS. Save lives". Are there any places where the Covid slogan tells people to protect private healthcare? A few are listed at https://order-order.com/2020/05/14/glob ... -compared/ and none seem to have an equivalent to "Protect the NHS". You also see the same influence when things like obesity are mentioned and someone refers to it being a burden on the NHS. It hasn't quite turned corrupting yet, as we don't refer to elderly people as being a burden, but it seems quite close.

[bjn]

The implication in "Protect the NHS" is that you are stopping it collapsing under the weight of COVID cases and so allowing it to deliver medical treatment to real people for whatever reason. It is not some some reified aim independent of actually delivering healthcare in the real world.

Or is that just me? Because if the NHS had collapsed at any point over the last 10 months my family would have been in an world of absolute despair and pain.

[bjn]

And private healthcare doesn't impose rules on it's users?

[shpalman]

it is for each person to guard their own interests by acting according to their personal appetite for risk and evaluation of costs and benefits. If you take that choice away from people how are you going to handle the responsility when you make the wrong choice?

The responsibility when they make the wrong choice like "but the government said it was safe"

Those are cases where the government said things, but people could largely choose to believe or not. Obviously the government must sometimes give advice, and even strongly worded advice, but people should choose for themselves whether or not to take it.

or like before he died, John told the doctor treating him how much he regretted not getting the vaccine kind of responsibility?

That is what I am getting at. It's much better for John to regret not getting the vaccine than for his doctor to regret not letting hime have it or for the governement to make it too difficult to get it. Equally, if the story was John had a rare adverse reaction and died from it, it would be much better for it to have been as a result of John's choice to get vaccinated rather than him getting it under duress (with respect to the effect on his health - it's legitimate to go further when his vaccination makes a big difference to other people's health).

The number of people expressing regret at not getting the vaccine as they lie in hospital dying of covid seems to have been higher than the number of people expressing regret at getting the vaccine as they lie in hospital dying of an adverse effect directly caused by it.

If everyone were able to evaluate the risk/benefit ratio objectively following correct professional medical advice there'd be no anti-vaxxers.

[shpalman]

This would be a very worthy reason, except for the lack of evidence that it makes a big difference to the risk. Specifically, if it halves the risk, but multiple infectious people are present...

Halves the risk or what compared to what? How many is "multiple" and how is that "specific"?

It's specific as in it's intended as a hypothetical example figure.

But it's not helpful to quantify that and leave everything else as some/many/lots.

The figures from my bit of Italy suggested that there's a factor of 5 between vaccinated and unvaccinated people catching covid, and the other data suggests that the viral load in a vaccinated person drops off sharply after 2-3 days rather than decaying more slowly, so I as a vaccinated person am less likely to be infected and/or if I did get infected recently it's more likely that my viral load has already dropped. Since in the venue there are now only other vaccinated people, they're less likely to detectably catch it from me even if, and much less likely to have a bad outcome from it.

That all may be true and still not justify excluding the unvaccinated for the sake of the vaccinated. It is plausible that excluding the unvaccinated gives people sufficintly greater confidence that they gather more frequently and in greater numbers so that there is overall no protection. The problem with dealing with people is that the are very complex and rules have lots of unintended effects.

What about excluding the unvaccinated for the sake of themselves or the other unvaccinated?

And I'm not going to join in second-guessing unintended effects without any evidence for them because you can really invent anything there. The UK immediately had outbreaks linked to nightclubs, Italy didn't.

[headshot]

Obviously venues have to close. We need to embrace lockdownism again.

Voluntary action is hurting the nightclubs etc already, though. There will be a lot of empty seats at panto and a lot of cancelled Christmas parties. Voluntary action works quite well.

Citation need on Panto etc. The people I know have been playing to full houses. That may change as we get closer to Christmas…I’ll check in with them and report back.

[Millennie Al]

That all may be true and still not justify excluding the unvaccinated for the sake of the vaccinated. It is plausible that excluding the unvaccinated gives people sufficintly greater confidence that they gather more frequently and in greater numbers so that there is overall no protection. The problem with dealing with people is that the are very complex and rules have lots of unintended effects.

What about excluding the unvaccinated for the sake of themselves or the other unvaccinated?

That's considered in a separate post. We split them into benefit to a) self, b) others c) society and I was only considering a) in this one.

And I'm not going to join in second-guessing unintended effects without any evidence for them because you can really invent anything there. The UK immediately had outbreaks linked to nightclubs, Italy didn't.

All the more reason to urgently research the effects. When government actions are expensive and intrusive they really must be justified on the grounds that they are worthwhile. We can have an exception for when urgent action is needed, but even if it's just one-off, that should be checked, but here it's ongoing.

[Millennie Al]

If everyone were able to evaluate the risk/benefit ratio objectively following correct professional medical advice there'd be no anti-vaxxers.

And if every govenment were able to do that, then there'd be no pandemic.

[Millennie Al]

And private healthcare doesn't impose rules on it's users?

Not like "Protect the NHS". Insurance based healthcare may have limits of coverage, but healthcare not based in insurance doesn't. For example, if you buy glasses entirely privately, and a week later break them, the optician doesn't care as another sale is just a sale. You could break a pair every week and keep coming back and, while you may get advice from an optician who is trying to help you, you'll never get turned away. If there was a huge increase in people breaking their glasses, the extra profit from the extra sales would fund more opticians to meet the demand.

With insurance-based provision, the insurer may start to impose limits on claims or increase premiums.

With public healthcare what should happen is that increased demand leads to increased funding to meet the demand, but this means links from healthcase to funding to government policy to taxes to pay for the funding. Since the voters paying the extra taxes may not think they'll benefit from the extra provision, coping may be slow and difficult. "Protect the NHS" should really be "Fund the NHS" except for short term emergencies. And that does not mean repeatedly having the same emergency. That needs the NHS to be expanded so that it has the capacity to cope. Fantastically large sums of monet have been spent in the course of this pandemic. It's not like the money isn't there. And with regard to capacity, note that the last few cases of smallpox were dealt with by Catherine-de-Barnes Isolation Hospital, which had been kept on standby for years with no patients just so it would be ready.

[shpalman]

That all may be true and still not justify excluding the unvaccinated for the sake of the vaccinated. It is plausible that excluding the unvaccinated gives people sufficintly greater confidence that they gather more frequently and in greater numbers so that there is overall no protection. The problem with dealing with people is that the are very complex and rules have lots of unintended effects.

What about excluding the unvaccinated for the sake of themselves or the other unvaccinated?

That's considered in a separate post. We split them into benefit to a) self, b) others c) society and I was only considering a) in this one.

Ok, then this is (a) excluding the unvaccinated for the sake of themselves, because the consequences for an unvaccinated person catching covid from a vaccinated person are worse than for a vaccinated person catching covid from a vaccinated person. Vaccinated people can of course still catch covid and still be infectious, even if the probabilities of these are reduced by the vaccine.

And I'm not going to join in second-guessing unintended effects without any evidence for them because you can really invent anything there. The UK immediately had outbreaks linked to nightclubs, Italy didn't.

All the more reason to urgently research the effects. When government actions are expensive and intrusive they really must be justified on the grounds that they are worthwhile. We can have an exception for when urgent action is needed, but even if it's just one-off, that should be checked, but here it's ongoing.

How would you propose to check, and what should we do in the meantime? It seems like the UK suddenly needs urgent action again.

[headshot]

Looks like the Govt are going to shift to proof of being “fully vaccinated”, for Covid passes etc, to include the booster doses too.

Two doses won’t cut it.

To tackle the spread of the Omicron coronavirus variant, Javid announced in parliament on Monday that to qualify for a Covid pass, people would need proof of a recent negative test result or three jabs, rather than two. He said the change would come into force “once all adults have had a reasonable chance to get their booster jab”.

https://www.theguardian.com/politics/20 ... d-measures

[discovolante]

Looks like the Govt are going to shift to proof of being “fully vaccinated”, for Covid passes etc, to include the booster doses too.

Two doses won’t cut it.

To tackle the spread of the Omicron coronavirus variant, Javid announced in parliament on Monday that to qualify for a Covid pass, people would need proof of a recent negative test result or three jabs, rather than two. He said the change would come into force “once all adults have had a reasonable chance to get their booster jab”.

https://www.theguardian.com/politics/20 ... d-measures

Ooh, 'reasonable chance' eh? *rubs hands together*

[headshot]

Looks like the Govt are going to shift to proof of being “fully vaccinated”, for Covid passes etc, to include the booster doses too.

Two doses won’t cut it.

To tackle the spread of the Omicron coronavirus variant, Javid announced in parliament on Monday that to qualify for a Covid pass, people would need proof of a recent negative test result or three jabs, rather than two. He said the change would come into force “once all adults have had a reasonable chance to get their booster jab”.

https://www.theguardian.com/politics/20 ... d-measures

Ooh, 'reasonable chance' eh? *rubs hands together*

I look forward to them implementing this by Christmas 2026.