This analysis is missing an important effect in the other direction — vaccination reduces community transmission, including reducing the risk that unvaccinated people get infected. I know there’s been enormous arguments about how large the reduction in infections is, but it’s not zero, and uninfected people don’t transmit to anyone else. Accounting for this would *increase* the estimate of lives saved.
Yes, this is true of course. And it's quite likely that during especially the first hald of 2021, when the bulk of lives were saved, this was a large effect, even if it was then much diminished as Omicron got going.
The issue I have is the counterfactual. It can't just be that we let the transmission skyrocket without doing anything (we had spent the previous 12 months doing the opposite, after all!) If we hadn't had any vaccines in early 2021, then we would have had to control infection even more than we did in the actual case (because we wouldn't have had the vaccine-induced reduction in serious illness and death). And this - presumably - would mean that we wouldn't have opened up restrictions during 2021 and onwards (at least not to the same extent), and so some of the infections, hospitalisations and deaths in a "let it rip" case would not have happened.
More people would have died overall, no doubt, but to understand what we would have done in that counterfactual situation is darn near impossible. Perhaps even, with no hope of vaccines on the horizon, far more countries would have adopted a suppression approach?
This is what I was trying to get at with the footnote 3, but I think I didn't put it very well. Given your comment, I may edit a bit more to clarify. You are right that it has been ignored.
I can’t imagine we would have continued virtual school, shutdown of public events, etc, much longer than we actually did, even without a vaccine. People were clearly losing patience, come what may.
On the other hand, without the vaccine would we have been forced to take indoor air quality and masking more seriously than we actually did? Maybe? I wish we still would.
This analysis is missing an important effect in the other direction — vaccination reduces community transmission, including reducing the risk that unvaccinated people get infected. I know there’s been enormous arguments about how large the reduction in infections is, but it’s not zero, and uninfected people don’t transmit to anyone else. Accounting for this would *increase* the estimate of lives saved.
Yes, this is true of course. And it's quite likely that during especially the first hald of 2021, when the bulk of lives were saved, this was a large effect, even if it was then much diminished as Omicron got going.
The issue I have is the counterfactual. It can't just be that we let the transmission skyrocket without doing anything (we had spent the previous 12 months doing the opposite, after all!) If we hadn't had any vaccines in early 2021, then we would have had to control infection even more than we did in the actual case (because we wouldn't have had the vaccine-induced reduction in serious illness and death). And this - presumably - would mean that we wouldn't have opened up restrictions during 2021 and onwards (at least not to the same extent), and so some of the infections, hospitalisations and deaths in a "let it rip" case would not have happened.
More people would have died overall, no doubt, but to understand what we would have done in that counterfactual situation is darn near impossible. Perhaps even, with no hope of vaccines on the horizon, far more countries would have adopted a suppression approach?
This is what I was trying to get at with the footnote 3, but I think I didn't put it very well. Given your comment, I may edit a bit more to clarify. You are right that it has been ignored.
I can’t imagine we would have continued virtual school, shutdown of public events, etc, much longer than we actually did, even without a vaccine. People were clearly losing patience, come what may.
On the other hand, without the vaccine would we have been forced to take indoor air quality and masking more seriously than we actually did? Maybe? I wish we still would.
This is gay
V good! And sorry about the anti-vaxxers. They’re quite... motivated...