The risk of dying for the 70+ crowd is significant and much, much higher than for regular influenza. The risk of dying for the below 50 crowd is negligible and on par with regular influenza.
Prioritizing the elderly literally saves lives.
Jumping the queue if you belong to a group that is not at risk is incredibly selfish and immoral. You can wait a couple of months, it won't kill you.
I have seen this stated before. What is your source please? This is false: SARS-CoV-2 is significantly more lethal than seasonal influenza for all ages past puberty. In fact, at 50 it is almost 15 times more lethal.
https://github.com/mbevand/covid19-age-stratified-ifr
If you are below 50, risk factors play a significant role in determining your actual IFR, while if you're above 70, your age is the primary risk factor.
I don't think your graph adjusts for that, and I think the difference in IFR between covid and the flu for healthy people under 50 is smaller. We're already at pretty small risks for those ages, and even if the difference is still 10x, it is - to use a highly scientific term - whatevs.
So if you are healthy and under 50, you won't die from covid, and you shouldn't jump the queue. Better?
Sure, but that doesn't change the argument. I napkin-mathed the QALY difference between vaccinating a 30yo compared to a 70yo elsewhere in the thread, feel free to continue that by adding long covid into the mix.
If anything, I bet it will strengthen my case, because older people are more likely to get sick from the virus, and therefore more likely to develop long covid than younger people, which means the "QALY utility" of vaccinating an older person becomes even greater, which makes GP an even bigger immoral asshole for skipping the line.
You're moving the goal posts. I'm not saying it's okay to jump the queue, but it's not "old people", it's "old people and people with other health issues that are risk factors".
Of course with a highly transmissible virus the opportunity cost between vaccinating an isolated 70+ person and a young person who comes in contact with many 70+ people is tricky to ascertain. That said, I don’t think here in CA the tiering system is attempting to minimize deaths by accounting for expected transmissions.
a) Age is just a confounding variable. Covid seems to be a "cardiovascular" viral disease rather than a "respiratory" one. For the vast majority of people Covid is unpleasant but not at all dangerous. Figuring out the real factors that make Covid dangerous should have been top priority, but unfortunately it isn't.
b) Flu and "common cold" is, in fact, very dangerous and deadly. We just classify those deaths differently, e.g., as deaths from stroke even though strokes can be caused directly by the "common cold".
> “Prioritizing the elderly literally saves lives.”
that’s true, but a bit naive. the utility function shouldn’t simply be a function of age, as that would ignore important other factors, like transmissibility, that affect overall population-level outcomes. QALYs[0], while not impervious to critique, would be a better target for maximization.
but the problem with that, again, is political, not technological or even psycho-social. that prioritization metric would be perceived as too complicated (harder for most politicians to explain without potentially exposing their own ignorance), but moreover, doesn’t serve the interests of the largest political donors.
Wouldn't you also have to add in the second-order effects of the long-term impact on society of that 30yo being able to return to the workforce in a more full capacity? I have no dog in this fight and don't really care who gets vaccinated soon. Just trying to sharpen up your analysis.
that may (or may not) be true, but it likely doesn't matter. you're thinking of the system as essentially static, so you're only solving for a portion of the problem (the naive solution). dynamic systems like pandemics have intertwined higher-order effects, which can often drown out the more obvious direct effects in unintuitive ways.
for instance, you're ignoring the limited flow rate of vaccine production and the significant friction of wide distribution, which at least means there's an inflection point before which it makes more sense to target "superspreaders" first.
the optimal answer to a dynamic system is rarely the static one.
> Jumping the queue if you belong to a group that is not at risk is incredibly selfish and immoral. You can wait a couple of months, it won't kill you.
Per the NYTimes, medical ethicists disagree with this viewpoint.
1. People often are bad at measuring their risk level.
2. If you turn down the chance to get vaccinated, someone even less at risk than you might get it instead.
3. Active folks who are out and about might spread the disease to hundreds of people, many of them at high risk. As we now know that the vaccines do in fact influence spread, prioritizing vaccinations to active individuals can and will save many lives.
4. I care for you and hope you and your loved ones can get vaccinated soon.
"If You’re Offered a Vaccine, Take It", from the NYTimes:
> If you turn down a vaccination based on the belief that you’re not particularly high risk, you might also be fooling yourself. It’s difficult for people to accurately measure their own risk level; research has shown that people underestimate their risk in all kinds of situations. These optimistic biases, as they are called, often lead people to perceive, wrongly, that public health campaigns are more relevant to others than to themselves.
> In other words, the notion that other people need vaccination more than you do may simply be a product of irrationally optimistic thinking. After all, the science on Covid-19 is not yet fully understood, and it is evolving rapidly, especially given the emergence of variants of the virus.
> When you get a vaccination, you’re not the only person who benefits, either. Scientists aren’t yet sure how much vaccination thwarts the transmission of Covid-19, but preliminary data suggests that it reduces spread to a degree. When you get the shot, then, you’re not only protecting your own health; you’re also likely slowing the spread of infection in your community and reducing the chance of overwhelming hospitals. In addition, if you are inoculated and friends or family members fall ill with Covid-19, you are better able to care for them, since you probably won’t get sick.
> Still, people may yell at you for getting a shot when you’re eligible if they feel you don’t deserve it as much as they or their loved ones do. And you may not be able to appease them with rational answers. Deep down, individuals who are angry about unfair vaccine allocation are upset at the system, and understandably so. In that situation, you’re just an easy scapegoat. “I think the best thing to do in a situation like that would be to say that you care for that person and hope they get the chance soon, too,” Dr. Ferguson said.
Getting a retail job or getting a thawed vaccine about to be thrown out does neither of those things
Save that copypasta for something you understand
The state handles the prioritization and they already prioritize the elderly. When their infrastructure fails at making appointments, a vaccine dose will be destroyed so there is greater utility for someone outside of the queue to use it at that point
> the risk of dying for the below 50 crowd is negligible and on par with regular influenza.
This is indeed a fact yet, many people I know that pride themselves in being informed and progressiv act like they're going to die immediately if they come into contact with the virus. Imagine if these people knew how many viruses and bacteria are all around them, even inside them. People can be really dumb when they are needlessly afraid.
My anecdote is that at my local grocery store the main people not wearing masks are the older folks and teenagers.
I know people who are in their 30s with no pre existing conditions who have already been vaccinated because:
* they work for a hospital system (in IT)
* they work at a university (doing research)
* their family member has a pre existing condition (but somehow that family member is not the only one to get a vaccine)
In addition to this, smokers and those /who have already recovered from covid/ are lined up to get first /and second/ doses before I get a single dose. I think it's fair to think of the system the politicians have decided on as flawed; to use your rhetoric, it literally ends lives to waste 2 doses on those who have already recovered from the illness. If gp wishes to apply his own sense of rationality to the process, I don't blame him.
You've fallen for the fallacy of believing that sick/vulnerable people are less deserving, and also failed to understand that preventing these people from being sick in hospitals make hospitals more available to you and your family if you should need them, for urgent or non-urgent care. The priority is to prevent system collapse first, then prevent deaths, then disability, and finally overall risk reduction.
Also, people who work in IT in hospitals have significantly higher risk just because if their workplace, and reducing the likelihood of them being carriers protects other patients (some of whom cannot be vaccinated) and their staff. The same applies for family members of vulnerable people.
I agree that the priority system is screwed up in many places and that as a result a lot of people were vaccinated who really shouldn't have been at this stage.
But that's the moral choice of the people who designed those systems, and the people who didn't decline even though that was the right choice.
But two wrongs don't make a right. It's still wrong for you to jump the queue, regardless of what everyone else is doing.
> Go ahead, find an approach to morality that leads to a healthy 30yo getting vaccinated while a 70+ does not
If the 30 year old is employed in a position with many unavoidable close contacts, the expected number of lives, life-years, or QALYs saved by vaccinating them can be much higher than the 70 year old, if the latter has few unavoidable close contacts.
Generously assuming people live to 90, saving a 30yo who would have died of covid saves 60 life-years, while saving a 70yo saves 20 life-years, i.e. 3x more.
But the risk of dying is around 50x higher[1] for a 70yo compared to a 30y, which means you have to vaccinate ~15x as many 30yos as 70yos to save the same amount of life-years.
So vaccinating the elderly first both saves lives and more life-years.
> Generously assuming people live to 90, saving a 30yo who would have died of covid saves 60 life-years, while saving a 70yo saves 20 life-years, i.e. 3x more.
This makes the fallacious assumption that if life expectance at age X is n years, life expectancy at age X+k is n-k years.
...which is still a factor of ~3x, which means my napkin math wasn't too shabby, which means this tangent was completely irrelevant, because my main point is unchanged.
But you're giving equal weight to a year lived in the prime of someone's life vs. a year lived in a care home, which might not be a reasonable way to calculate it.
Please don't break the site guidelines like this, regardless of how wrong another commenter is or you feel they are. We're trying to avoid the deeper circles of internet hell on this site.
Only if they will save more lives by being vaccinated than if the 70 year old was. We should be focusing on people who are higher risk of being transmission vectors, such as grocery store employees etc, at the same time as vaccinating the weak.
This is less clear-cut than it seems because nearly everyone that's highest risk is retired and doesn't really need to leave the house. Is it better to tell a dozen pensioners that leave the house once a week for grocies to stay home so younger people can get vaccinated and go back to work? Possibly, depending on who you're asking.
Younger people are far more mobile and so contribute greatly to the spread of the virus. The old and sick don't go out much so aren't the ones spreading the virus.
Is it more important to stop the spread as quickly as possible or directly vaccine the more vulnerable? It's hard to know, and it probably depends on how much vaccine you have. Countries like the US with lots of vaccine may be better off vaccinating the most mobile members of society first to drop total infections ASAP. Countries with less are better off focusing on the vulnerable because they're a long way from herd immunity.
If you have enough vaccine supply you will minimize deaths by eliminating transmission quickest which implies vaccinating the most exposed, not the most vulnerable.
Throwing more variables at a question we already have an answer to is a waste of time.
We know that older people get it more, die more, and are more at risk under all circumstances.
It is also infinitely easier to find old people than it is to find uninfected super-spreaders, we'll have vaccinated all the elderly long before anyone could develop a system to find the biggest potential spreaders.
Also, with vaccine production ramping up, a lot of countries project that they'll have vaccinated everyone by summer. Who cares if there's a better model? Elderly + frontline healthcare workers is a good enough model, go go go!
Less of them may die if we can get R0 under 1.0 faster by vaccinating those spreading the virus. It's absolutely still an open question IMO.
You are wrong about the first part. There are way more under 65 infected than over. And I've seen some preliminary studies that they do 80%+ of the viral spreading.
Prioritizing the elderly literally saves lives.
Jumping the queue if you belong to a group that is not at risk is incredibly selfish and immoral. You can wait a couple of months, it won't kill you.