What's the ACTUAL Science on Covid?
An interview with Dr. Dan Wilson.
“The best thing to do is to always bring everything back to the evidence—we want to keep policies evidence-based and avoid the various efforts to politicize the pandemic.”
Dr. Dan Wilson is a molecular biologist and science communicator who got his PhD in Biological Sciences from Carnegie Mellon University—his YouTube channel “Debunk the Funk” debunks misinformation about Covid, vaccines, and other topics in biology.
Dr. Wilson gave me tons of helpful scientific information on Covid—it was a breath of fresh air to be able to ask him all about Covid, and I’m excited to share Dr. Wilson’s incredible knowledge with readers.
I hope that this piece will help to inspire better science communication—something is really broken in our society when it comes to the way that scientific information flows from scientists to the public.
I was honored/thrilled to interview Dr. Wilson. See below my interview with him, which I edited for flow, organized by topic, and added hyperlinks to—this was a highly collaborative document, and Dr. Wilson provided most of the hyperlinks.
Science Communication
1) What are the best sources for Covid information where people can get the information that they need and want?
I do my best to keep up with the scientific literature and databases.
But if you can’t do that, I recommend the virologist- and immunologist-run podcast This Week in Virology that will give you detailed and up-to-date information and then some. Our World in Data is another good resource for raw data.
I also like science-based news websites like Science Magazine and Nature. And there are several great science communicators who directly address misinformation: Alison Campbell, Virology Down Under, Integral World, and Vaxopedia.
However you decide to get your information, it’s important to:
(1) listen to multiple sources if you really care about an answer to a question you have
(2) remember that science can change as we collect new data
2) What do you think about “Your Local Epidemiologist”? She seems to me like an extremely good information source.
She seems like a good source, so I’ll follow her Substack going forward—it’s also great that she posts so often.
3) What’s the purpose of your YouTube channel “Debunk the Funk with Dr. Wilson”?
I was almost done my PhD, and I thought that debunking would be a great way to teach science, so I started the channel in January 2020 as a way to satisfy my passion for science communication. I’d been a conspiracy theorist in high school many years ago, so I was familiar with anti-vaxxer arguments and leaders. My ultimate goal was to talk to anti-vaxxers and start them on a journey of changing their mind just like I changed my mind—my more reasonable goal was just to help people who were on the fence and unsure about vaccines.
Then Covid hit and there was a whole new tsunami of misinformation, so now I mostly focus mostly on Covid misinformation, but my general goals remain the same.
4) Since Covid emerged, how good has America’s science communication been on the topic of Covid?
My opinion is that it’s been pretty bad—there’s been so much bad reporting and confusing messaging and inadequate explanation, and all of that’s allowed conspiracy groups to absolutely explode, so from masks to ivermectin the communication has left a lot to be desired.
But as I write this, about 67% of Americans have received their first Covid vaccine, which is simultaneously encouraging and unacceptable—encouraging because it shows that misinformation isn’t dominant, and unacceptable because that number should be higher in a country with America’s resources.
5) When it comes to Covid, to what extent have Americans been able to get the information that they need and want?
American science reporting and science literacy weren’t great even before Covid—the mainstream media seriously needs to improve on science reporting, and in my opinion science communicators need to get better at squashing conspiracy theories.
But the information is all there for anyone to see, so people just need to be exposed to it and have it explained to them properly.
And you can at least point to the fact that most people are getting vaccinated as a sign that most Americans are getting the information they need.
6) What do you think about the comparison between science communication on the topics of Covid and climate? Both these issues require real sacrifices from citizens, but on climate I can get comprehensive answers within minutes to anything that I want to know, whereas on Covid I’ve been completely stonewalled.
I think your frustration is justified—we’ve seen information change extremely quickly due to the rapid stream of new data about this new virus. I’ve been wrong about things during this pandemic, as have the scientists who inform policy—these mistakes often aren’t properly explained or justified in the general media outlets, and Covid skeptics worsen the situation when they quickly jump on these mistakes and quickly capitalize on them.
I’d be curious to hear more about how you’ve felt stonewalled.
7) On stonewalling, all of the various experts I contacted told me they were too busy or didn’t respond at all, and I was also unable to get answers on various internet forums, and so I had to eventually abandon a massive list of lockdown-related questions that my anti-lockdown friend had helped me make.
Yeah, this isn’t surprising—academic scientists have a ton on their plates. Most have to teach, run their lab, meet faculty responsibilities, review papers, write grants, and the list goes on—it’s tough, and it’s even tougher to take time away from that to address misinformation that some scientists might think is so blatantly wrong that it doesn’t need addressing.
8) Do science communicators like Dr. Anthony Fauci consciously choose to not cite sources and not show citizens scientific papers and not do thoroughly sourced and impressively visualized PowerPoint presentations? Whenever I watch Dr. Fauci or others, I wish that they’d do these things, and yet I published a piece about why science communicators might consciously choose to avoid these things.
I don’t know what the reasoning here is—I agree that this is an area where science communication can greatly improve.
I think that scientists like Fauci try to strike a balance between informing people and not depending too much on data, but it’s tough to explain science and data clearly for a lay audience, and you have to remember that scientists might struggle with this even when talking to their own department.
9) How good a scientist is Fauci, and how good a science communicator is Fauci? Why not find a charismatic and cool and sexy person to communicate the science to people? And why not replace Fauci, since Fauci’s brand has been damaged to such an extraordinary degree?
Fauci has been NIAID’s director for about 40 years—he’s been involved in research on several infectious diseases including HIV and Ebola. He’s a good scientist and a good science communicator.
He’s made mistakes, and he’s been wrong about certain predictions and speculations, but a different scientist in his position would’ve also made mistakes. And it’s important to remember that Fauci has had to deal with a lot of hate and pressure and BS and vilification.
It’s true that he’s not the most charismatic or cool or sexy, but it would be hard to justify putting anyone else in his position—he’s been addressing the public about infectious disease for 40 years, and he’s also been advising presidents on infectious disease for 40 years, and he’s a pretty good public speaker.
Given the vilification and the way that he’s become a political bogeyman, it might make sense to some to have a fresh face communicating the science to the public.
But the core problem is that there’s enormous distrust of Dr. Fauci due to misinformation—in my opinion, science communicators need to make a concerted effort to actually explain why this misinformation is wrong, since proper explanation might increase trust in public figures like Fauci.
10) What do you think about Fauci’s actions early on in the pandemic and Fauci’s comments on 29 February 2020?
It’s easy to say in hindsight that Fauci was wrong that the risk was low, but previous outbreaks of SARS and MERS had fizzled and flopped and hadn’t caused any devastating pandemic, so it wasn’t unreasonable to try to keep the public calm and say that the risk was low. I said similar things to friends and family in February of 2020, since I thought that this would be like previous coronavirus outbreaks, but I knew that it was important for the WHO and CDC to be on high alert—I was wrong in my own feelings about how this would turn out, and I was also wrong to think that the WHO and CDC would have it under control.
It’s true that China had locked a city down. But China had also reacted strongly to SARS, and SARS didn’t affect the rest of the world too much, so it wasn’t clear that this time around would be different:
Learning from SARS: Preparing for the Next Disease Outbreak: Workshop Summary (2004)
“Controlling SARS: a review on China’s response compared with other SARS‐affected countries” (2009)
Fauci made mistakes that I think science communicators can learn from. He should’ve been more explicit about the dangers and uncertainties and he should’ve been less concerned about freaking people out—it’s better to overreact and scare people than to fail to communicate the dangers and uncertainties to people.
Covid’s Severity
1) How can one illustrate how severe this pandemic is relative to other diseases?
Looking at excess deaths is by far the easiest way to visualize this pandemic’s severity—excess deaths by country are measured relative to a 5-year baseline:
“Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset” (30 June 2021)
“Mortality: A comprehensive look at the COVID-19 pandemic death toll” (12 August 2021)
The huge global increases in these figures paint a grim picture. And we can then compare this number to other diseases—for example, we can see that Covid has killed more people in the US in about a year and a half than the previous 10 flu seasons combined, and that’s just confirmed deaths.
2) How would you respond to the argument that a truly severe pandemic wouldn’t require any government intervention because people would be scared enough to change their behavior on their own?
I would say that history tells us otherwise—we’ve had anti-vaxxers and science deniers throughout every pandemic and outbreak we’ve experienced, whether you look at the 1918 flu pandemic or the HIV/AIDS pandemic or smallpox outbreaks or polio outbreaks or whatever else.
Covid is the biggest pandemic that we’ve experienced since the 1918 flu—millions of people have died from Covid despite lockdowns and masking, and you can imagine that the death toll would’ve been far higher if no action had been taken and it had been allowed to burn through the global population unchecked.
3) What are the best metrics that can give one a sense of how severe this pandemic is, and what is the magnitude of each of these metrics for Covid? I would imagine that the infection fatality rate is also a crucial metric. And I would imagine that hospitalizations are a crucial metric because that tells you the burden on the stressed-out doctors, and the burden on the stressed-out nurses, and the burden on the healthcare system.
Excess mortality is the best metric—see the papers linked above. An infection fatality rate doesn’t tell the whole story—viruses like Ebola and SARS and MERS all have much higher infection fatality rates than Covid, but none of these viruses spread efficiently and so they can only kill hundreds or thousands of people, whereas Covid spreads much more efficiently and can kill millions of people.
4) How would you respond to this October 2020 paper? The paper looks at “61 studies (74 estimates) and eight preliminary national estimates” and concludes as follows:
The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients and other factors. The inferred infection fatality rates tended to be much lower than estimates made earlier in the pandemic.
Covid skeptics commonly share this paper. And they often comment that John Ioannidis is the most cited scientist of all time, but that’s misleading—Ioannidis’s 2005 opinion piece “Why Most Published Research Findings Are False” got the most downloads of any “scientific” article due to its flashy title, but suffice to say that Ioannidis is not a very well-respected scientist and that the 2005 piece’s title is inaccurate and misleading.
It’s important to remember that infection fatality rate is subject to very large charges during an ongoing pandemic—the IFR can fluctuate over time and several factors can influence how much the IFR changes and in what direction it changes.
This particular paper about infection fatality rate that you quote from is based on a very incomplete dataset—the paper says “I searched PubMed and preprint servers for COVID-19 seroprevalence studies with a sample size ≥ 500 as of 9 September 2020”, but there was no way anyone by September 2020 would’ve had an accurate estimate for several different areas of death count or of total infections. And at that point several deadly waves of Covid had yet to hit the world. So Ioannidis’s analysis is extremely outdated and inaccurate at best and intentionally misleading at worst.
5) Waves of Covid crank up infections and therefore crank up deaths, but why do waves of Covid crank up the IFR?
During a wave of Covid, the IFR will shift due to various factors like healthcare infrastructure and the age of the people infected and vaccination coverage. During a wave, fewer and fewer people have access to quality care as hospitals get overwhelmed—some patients might be forced to go home when they need to stay in the hospital and other patients might be too afraid to seek care. And during a wave, more spread also means more risk for more vulnerable groups.
6) Ioannidis’s paper is from October 2020, so isn’t it OK that the paper uses old data?
Scholars should know better than to publish such conclusions with so little data and so early in the pandemic—his statistics are premature and his conclusions are wrong.
But as far as I know, he hasn’t made any attempt to update his analysis or to correct himself—that comes off to me as intentional.
7) To what extent does this analysis confirm Ioannides’s findings? Here’s the conclusion from the analysis:
The development of estimated effective IFR and observed CFR reflects the changing age distribution of infections over the course of the COVID-19 pandemic in Germany. Further research is warranted to obtain timely age-stratified IFR estimates, particularly in light of new variants of the virus.
I don’t think this analysis does confirm Ioannidis’s findings—Ioannidis offered a fixed IFR based on limited data, but this analysis breaks the IFR down by age and acknowledges the fluidity of the data, especially in relation to Delta.
8) Why exactly is the IFR subject to very large changes during an ongoing pandemic?
These numbers shift as infection spreads and as we learn more about infections and deaths—Ioannidis made his calculations before the large winter surges, before the larger seroprevalence studies, and before the death counts were properly understood. And it’s also important to remember that Ioannadis’s analysis used a geographically limited dataset, even though other data were available.
9) What is the infection fatality rate for different age brackets if you’re healthy and in great shape?
Actually, it depends—this paper is the best estimate of different regions’ infection fatality rate for different ages:
“Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications” (8 December 2020)
10) What is the hospitalization rate for different age brackets if you’re healthy and in great shape?
Again, it depends—we don’t have hard numbers for this yet.
11) How did India and Brazil avoid total devastation, given the horrors—see this 27 March 2021 piece on Brazil and see this 25 May 2021 article on India—that those two countries faced at one point and given how terrifyingly far from significant vaccination those two countries were back when they were in the headlines?
In terms of confirmed deaths, Brazil ranks second and India ranks third—Brazil has consistently had a tough time with Covid, and India had one of the worst Covid waves that we’ve seen during this entire pandemic, and those two countries have a lot of deaths over and above the confirmed deaths.
We have excess deaths data for Brazil and it’s significant:
“Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset” (30 June 2021)
We also know that there have been mass graves in both India and Brazil:
“AP PHOTOS: Mass funeral pyres reflect India’s COVID crisis” (26 April 2020)
12) What is the IFR for those below 60, and how does it make sense to implement drastic policies if that IFR is extremely low (like 0.01% or whatever)?
The IFR for younger people appears to vary by country and likely reflects each specific country’s case burden and public health infrastructure. And a high number of infections can still lead to a lot of deaths, even if countries like the US have a low IFR for younger people.
Locking down makes sense because lots of infections means lots of death—even a small IFR of 0.5% would mean 1.5 million dead people if 300 million people got infected, so you can get out a calculator and multiply numbers by the rate and see how many people would die.
You can see in this article some data on deaths among younger people:
“All-Cause Excess Mortality and COVID-19–Related Mortality Among US Adults Aged 25-44 Years, March-July 2020” (16 December 2020)
13) How much do comorbidities—diabetes, heart disease, cancer, obesity, and so on—affect the IFR and why isn’t there more government and media attention to how important comorbidities are when it comes to the IFR?
Comorbidities can significantly worsen a Covid patient’s outcome—see Table 3 here for data on that:
But during an active pandemic, you need an immediate response, so you can’t focus on long-term problems like obesity and diabetes. The government has been trying for decades to get the population to eat healthier and exercise and so on, but you can’t mandate that the population eat certain diets or spend X amount of time each day exercising—I highly doubt that the people who have problems with vaccine mandates would be happy with the government telling them what to eat and how much to exercise each day.
14) If Covid is so deadly, why is the average age of death around 80 everywhere in the world?
I don’t understand why Covid would be considered less dangerous just because some of society’s most vulnerable members make up most of the deaths—does age somehow lessen the significance of an untimely death?
The facts are that Covid has been the deadliest pandemic in a century and that Covid has caused a lot of excess deaths—and has overwhelmed hospitals—wherever it’s been allowed to run rampant.
15) What about the point that the statistics—that are used to find excess deaths—aren’t proportional to death rates?
This author seems to expect excess deaths in a modern pandemic to rival total deaths per capita a century ago—this is a strange assumption to make. It’s better to compare any given year’s excess deaths to the most recent 5-year baseline than to do a comparison to total deaths per capita 100 years ago—our standards have increased over the last 100 years, and excess deaths during Covid are extremely high by today’s standards.
16) What about this analysis? Look at this quote:
The comparison is more striking when years of life lost (YLL) is the measure used. Goldstein and Lee (11) estimate that the mean loss of life years for a person dying from COVID-19 in the United States is 11.7 y. Multiplying 377,000 decedents by 11.7 y lost per decedent gives a total of 4.41 M years of life lost to COVID-19 in 2020, only a third of the 13.02 million life years lost to excess mortality in the United States in 2017 (Table 1). The reason that the comparison is so much sharper for YLL than for excess deaths is that COVID-19 deaths in 2020 occurred at much older ages, on average, than the excess deaths of 2017.
Manipulating the numbers to emphasize age doesn’t change the fact that total excess deaths have gone way up in the US during the Covid pandemic—see the eLife papers that I referenced previously, and see also this letter that responds to the analysis that you quote from:
“The COVID-19 pandemic adds another 200,000 deaths (50%) to the annual toll of excess mortality in the United States” (7 September 2021)
Lockdowns
1) Which scientific papers and scientific data were underpinning Covid lockdowns at every stage of the pandemic from the start of the pandemic to today?
You can find precedence—for measures like lockdowns—in several pandemic preparedness guidelines that had been established pre-Covid. Here’s an example:
Then several studies throughout the pandemic demonstrated that things like lockdowns and social distancing and mask wearing were effective against Covid specifically—here are some examples:
“The Efficacy of Lockdown Against COVID‑19: A Cross‑Country Panel Analysis” (3 June 2020)
“Trends in COVID-19 Incidence After Implementation of Mitigation Measures — Arizona, January 22–August 7, 2020” (9 October 2020)
“Ranking the effectiveness of worldwide COVID-19 government interventions” (16 November 2020)
“Airborne transmission of respiratory viruses” (27 August 2021)
2) Were the available lockdown-relevant scientific papers and scientific data properly presented to the public at every stage of the pandemic from the start of the pandemic to today? Lockdowns were a massive political firestorm.
I didn’t keep up with the pandemic through news or press conferences, so I don’t know what was said, but I doubt that the science was properly communicated—whatever was said evidently wasn’t good enough to stop vocal anti-lockdown groups from spreading misinformation.
3) What do you think about this 28 April 2021 piece in The Lancet? Here’s a quote: “There is also increasing consensus that elimination is preferable to mitigation in relation to a country’s economic performance.” But you might point out that the countries that did “elimination” are all island countries—South Korea is effectively an island because no one crosses its border with the DPRK.
I think it’s correct that the better long-term Covid strategy was to swiftly implement and aggressively enforce drastic actions for a short period of time in order to try to eliminate Covid, rather than to delay and then implement a half-assed approach for months on end.
Covid traveled easily from China and sparked an outbreak in NYC, so focusing on the fact that these countries are island nations misses the fact that our world is extremely globalized—South Korea and Japan are hotspots for international travel, yet they kept Covid numbers relatively low thanks to proactive public health policies that most citizens cooperated with.
4) Why is it OK to invoke hypothetical non-lockdown scenarios in order to say how many deaths lockdown measures have prevented? One might respond that we live in the real world, and so hypotheticals aren’t useful to consider.
We know that lockdown measures are effective in quickly slowing down the spread of an out-of-control virus so that other more sustainable solutions can be properly installed—see the papers that I referenced previously.
The alternative is that we simply allow the virus to spread and allow the pandemic’s devastating ripple effects to continue—that’s not OK, and it’s not hypothetical. And by now we’ve seen what happens when the virus is allowed to ravage countries that refuse to take sufficient action—ironically, we (the US) are one of those countries.
5) What about the argument that lockdowns must be ineffective because a lot of the US states with the worst death rates had implemented harsh lockdown measures and because a lot of the US states with the least bad death rates had implemented virtually no lockdown measures? See these statistics.
The US never really locked down—it was a free-for-all of states doing different things, and there was no real coordinated effort, and it shows. The US as a whole lost during this pandemic—trying to see which state did better or worse is just ranking the losers, so to speak.
But you can look at county-level analyses that measure reductions in Covid spread due to policies like masking and restaurant restrictions—here’s one analysis:
6) How would you respond to these articles that challenge the conventional view on lockdowns? First, “The Case against Lockdowns”. Second, “Death and Lockdowns”. Third, “Lockdown: a deadly, failed experiment”. Fourth, “The Masked Ball of Cowardice”.
These articles contain the same misinformation that I’ve been hearing for months now.
We have lots of data to demonstrate that lockdowns work—governments have certainly misused lockdowns and planned poorly, and that’s certainly harmed public trust regarding lockdowns, but that doesn’t change the fact that lockdowns do reduce cases quite effectively:
“Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset” (30 June 2021)
“Mortality: A comprehensive look at the COVID-19 pandemic death toll” (12 August 2021)
The first article denies that lockdowns work and uses Sweden as an example, but Sweden’s excess death figures are not good and Sweden is absolutely not a model of success.
The second article mentions excess deaths, but the author seems to think that lockdowns cause many of these excess deaths, and that’s a wildly incorrect interpretation of the data—see the two eLife papers that I just referenced.
The third article claims that lockdowns are deadly and that Covid death counts are inflated, but countries that successfully locked down and prevented Covid’s spread saw normal or decreased levels of excess death—see again the two eLife papers that I just referenced.
The fourth article starts off with the claim that the CCP spawned the idea of lockdowns. This is just wrong—health authorities suggested locking down as a radical solution to a situation that was quickly turning dire, and there wasn’t any influence on these health authorities from any CCP propaganda campaign, and it’s completely bogus to think that CCP propaganda somehow swayed expert advisers all over the world.
7) What about the enormous collateral damage that lockdowns have created? You can look at mental health, suicides, and all sorts of things.
Lockdowns aren’t supposed to be long-term solutions—or actions that you have to enforce again every couple of months—and your goal should strictly be to use the time that the lockdown buys you to enact more sustainable solutions. So ideally lockdowns won’t last long and won’t compromise mental health, but in many places lockdowns weren’t used appropriately.
Lockdowns are definitely difficult for people and lockdowns have many serious effects on people, even if the data appear to not point toward any increase in suicides:
“What has been the effect of the pandemic on the suicide rate of the U.S. population?” (21 June 2021)
8) How would you respond to the notion that we didn’t respond to previous pandemics in the same way that we’re responding to Covid? See the following quote from the 16 June 2020 piece “How Have We Responded to Previous Pandemics?” (the link in the quote below was dead so I replaced it with a link that works):
So why the rush to lock down citizens across the world in response to coronavirus? It’s all the more surprising when you bear in mind that the World Health Organisation (WHO) specifically recommended against quarantining as a strategy for managing the outbreak of a flu-like pandemic in a report it published in 2019. This was drawn to my attention by a reader with a background in epidemiology and public health who says she’s been horrified by the unquestioning acceptance of the Covid response measures by her colleagues whom she expected to be more capable of critical thought. The WHO report even stopped short of recommending the quarantining of exposed individuals. No doubt some people will point out that COVID-19 isn’t a flu-like illness, so more drastic measures are called for. But the WHO report says that quarantining wouldn’t have done any good as a way to mitigate the impact of Spanish flu, a much more deadly virus than SARS-CoV-2.
These recommendations were made regarding flu viruses—Covid is very biologically different from flu viruses.
And Covid spreads asymptomatically and presymptomatically much better than the flu does, which means that we don’t necessarily know who’s infectious at any point in time—this means that we have to take measures like trying to get people to self-isolate after a confirmed exposure to Covid, since a person can spread the virus to many people before any symptoms show up.
It’s also important to remember that lockdown measures are not the same as quarantining—quarantining is when you physically isolate people and monitor them during their infectious period to see if they develop symptoms, whereas lockdown measures are supposed to reduce exposures and cases.
9) Why doesn’t this 2006 paper lend support to skeptical views about our reaction to Covid? See this quote:
Reports from many countries indicate that mandatory case reporting and isolating patients during the influenza pandemic of 1918 did not stop virus transmission and were impractical. In Canada, the medical officer of health for the province of Alberta concluded that forced home isolation of patients, posting signs on houses, and “quarantine” (details unspecified) captured only ≈60% of patients in the community because of diagnostic difficulties involving mild cases and failure to notify cases to authorities. As the medical officer noted, “many citizens regarded the placard [sign outside the quarantined person’s house] as an injustice, either because they did not believe the diagnosis justified, or because their neighbors were alleged by them to be avoiding quarantine by concealment or evasion…Charges of discrimination were frequently made against the health department” (6).
Contact tracing is only as good as your detection methods—it’s crucial to be able to identify an infection and quickly trace its path in order to catch contacts before they expose more and more people. We’re much better at detecting cases now than we were in 1918—that paper even discusses the specific improvements in these kinds of policies that would make these policies more useful and less disruptive:
Research is also needed to identify ways to make quarantine and other restrictions more focused and less burdensome for individual persons and societies and to assess how “leaky” restrictions can be and still be effective. Improved methods are also needed to communicate with essential partners and the public. Finally, improved informatics capabilities would allow outbreaks to be monitored and interventions to be assessed in real time to meet the needs of all who will help control future pandemics.
Covid’s Origins
1) How strong is the consensus among relevant scientists about Covid’s origins? I assume that it’s hard to assess the consensus’s strength, since it’s not like there was a massive survey where every relevant scientist staked out a position on the matter.
The consensus is extremely strong that the origins are natural—only a few loud scientists have a dissenting opinion, and these scientists get a lot of attention from the media.
And there are lots of dissenting nonexperts who contribute to the spread of misinformation.
2) What evidence underpins that consensus?
There’s a lot, but here are my two favorite papers that summarize the evidence:
“The origins of SARS-CoV-2: A critical review” (16 September 2021)
“Coronaviruses with a SARS-CoV-2-like receptor-binding domain allowing ACE2-mediated entry into human cells isolated from bats of Indochinese peninsula” (17 September 2021)
3) What would adequate investigation into Covid’s origins look like?
We’d ideally be able to look for evidence of Covid antibodies in blood bank data in order to get an idea of when and where Covid began to circulate. And it would also be ideal to thoroughly search the animals at each farm that supplied the Huanan Seafood Market with meat and/or live animals—you could take blood samples from these animals and you could also sample these animals with nasal swabs and anal swabs.
It’s unfortunate that tensions and accusations are preventing these things from happening.
4) How can we achieve adequate investigation, given that Beijing will try to interfere with any efforts to investigate?
That’s a question for diplomats at this point, not scientists—we know what data and what kind of investigations we need, and it’s just a matter of governments getting along, and it’s a real shame that governments can’t cooperate.
5) What things should the world do to prevent future pandemics, and if the consensus is correct about Covid’s origins then how does that affect how we should prioritize these things?
I think other scientists would be more useful to listen to than me on this. But my understanding is that it’s key to have a clear and well-prepared plan of action. And behind that plan we should monitor for any new signs of pandemic pathogens that might emerge so that we can act quickly if they emerge. And we also need to be conscious about how we increase the risk of spillover events when we interact with wildlife and disrupt natural habitats.
To help facilitate these actions, we need to acknowledge Covid’s natural origins—accusations about lab origins distract from these solutions. And accusations about lab origins also demonize essential research, mislabel essential research as “gain of function”, and force us to take steps backwards.
6) How would you respond to this clip where Joe Rogan talks to Sanjay Gupta about Covid’s origins?
The first half was frustrating to listen to—the second half only a little less so.
First and foremost, the “Fauci emails” release adds nothing new—all that can be said is that people were acting “suspicious”, which is debatable. But even if there were something suspicious in those emails, it’s useless to project secret motives and concoct elaborate conspiracies and speculate about what certain comments meant. And it’s especially useless to do these things when we have evidence about Covid’s natural origins—why waste time speculating about this stuff when we have evidence?
With that said, I don’t see Peter Daszak’s words as being suspicious. He’s the president of EcoHealth Alliance, and he knew that his company was going to face accusations, so it’s perfectly reasonable to me that he would publicly discount the idea of a lab leak origin and then privately ask his colleagues questions about the idea—why wouldn’t he discuss with some really smart colleagues various ideas that he knew he’d have to address?
I think Gupta did a better job in addressing Rogan’s questions about “gain of function”, but my simpler response would be that the Wuhan Institute of Virology performed research that’s better described as “characterization research”—they would find viral sequences in the wild and paste pieces of those wild sequences into a backbone in order to learn something about how those wild sequences function. So if this is “gain of function” research, most molecular genetics research would have to be classified as such, and calling this type of research “dangerous” would basically imply that we should never study viruses at all.
7) What do you make of this 22 October 2021 article about the NIH?
I think that this a terribly misleading headline that’s meant to grab clicks—this headline refers to the kind of work that I described before, which is characterization research.
8) How would you respond to this 12 October 2021 piece? The piece says that Chinese scientists tested “80,000 animals from 209 species” and that “not a single animal infected with SARS-CoV-2 was found”. And see here:
In SARS-1 the coronavirus underwent a few mutations in the horseshoe bat to accommodate to the civet cat; in the civet there were several more mutations to make it human-adoptable; once it became “humanized” it underwent still more mutations to make it virulent. How do we know that? Every one of those mutations has been identified. In SARS-2 not a single intermediary mutation can be found despite what has likely been an exhaustive effort to find such a scapegoat.
The coronavirus is characterized by a crown of spikes (RNA proteins). For the virus to become activated, the spikes have to be cleaved or split. The enzyme that causes the cleavage derives from the host cell. The virus needs the host to cooperate, but the host does a better job if the cleavage site is made up of a certain arrangement of amino acids: proline-arginine-arginine-alanine. That array in SARS-2 is unique, not seen in other coronaviruses, suggesting it may have been “man-made” or retroengineered. This variant also has quite a low affinity for horseshoe bat cells. One can be pretty sure that this virus has never seen the inside of a bat. That only leaves a single viable source of origin.
80,000 animals isn’t a lot when you consider that the Chinese exotic animal trade is an $80 billion industry that’s bigger than America’s entire meat industry. And this paper points out that the sampled animals don’t represent very well the animals known to carry coronaviruses of the lineage that Covid comes from:
“The origins of SARS-CoV-2: A critical review” (16 September 2021)
When the outbreak was detected, the Huanan Seafood Market was shut down and all of the animals that were in the market at the time were culled and weren’t sampled, so it’s important to remember that we never got to sample those animals.
And it makes total sense that Covid’s path will be much harder to track down than SARS’s path—Covid (unlike SARS) spreads asymptomatically and presymptocally, and Covid doesn’t cause severe symptoms as much as SARS does.
9) And how would you respond to this 5 May 2021 piece about Covid’s origin?
I see this as another speculative click-grabbing article that doesn’t understand the science—for example, the article discusses the fact that the Covid spike binds to ACE2 really well, but this fact never indicated that Covid had been engineered.
And this fact no longer has a place in the lab leak theory—a group of coronaviruses referred to as BANAL were recently found in Laos, and the spike proteins on these coronaviruses behave almost identically to Covid’s spike protein:
“Coronaviruses with a SARS-CoV-2-like receptor-binding domain allowing ACE2-mediated entry into human cells isolated from bats of Indochinese peninsula” (17 September 2021)
10) To what extent is it a suspicious coincidence that Covid originated in the place that just happened to have a lab that was studying ways to infect humans faster through bat coronaviruses?
It’s not a coincidence that the lab was located there—Wuhan is the 10th most populated city in China, and it’s reasonably close to coronavirus hotspots, and it’s an attractive place for talented researchers to live.
It would be more coincidental if the lab was the outbreak’s actual epicenter and the first Covid infections had actually been lab employees and their family members and their close contacts. But instead the outbreak’s actual epicenter was a wet market that sold live animals known to carry coronaviruses, which is exactly where we would expect a coronavirus outbreak to start, so anyone who wants to focus on the lab’s proximity to the outbreak’s epicenter should also consider the wet market’s much closer proximity to the outbreak’s epicenter.
11) What about the known safety problems at the Wuhan lab?
The cables discussed in this article allege that there was a lack of trained staff, but the cables don’t ever explain the actual reasons behind this allegation, so the details are unclear.
Audits and inspections of any lab will find problems and issues, so that on its own isn’t alarming, but what I find interesting in the article is the following:
“Most importantly,” the cable states, “the researchers also showed that various SARS-like coronaviruses can interact with ACE2, the human receptor identified for SARS-coronavirus. This finding strongly suggests that SARS-like coronaviruses from bats can be transmitted to humans to cause SARS-like diseases. From a public health perspective, this makes the continued surveillance of SARS-like coronaviruses in bats and study of the animal-human interface critical to future emerging coronavirus outbreak prediction and prevention.”
The people sending the cables called this research “critical” and didn’t call for the research to stop. So the article seems to be a click-grabber that’s sensationalizing a story.
12) What about this 22 September 2021 article about the Wuhan lab?
This discusses the DARPA grant that wasn’t funded. People who support the lab leak theory will point out that the grant’s authors proposed inserting a furin cleavage site into wild coronaviruses’ spike proteins—the furin cleavage site in Covid’s genome stands out as being very different from the one in SARS or MERS.
But this kind of experiment would be done using the backbone of another virus that’s been dubbed “WIV1” that’s used specifically for these kinds of experiments—Covid clearly wasn’t made from this backbone and doesn’t show any obvious signs of manipulation. So this is more speculation, nothing more.
13) What about the fact that Fauci and others were warned that the virus looked like it was engineered?
This article refers to Kristian Anderson’s email to Fauci where he said that “parts of the virus look engineered”.
People who report on this often leave out the next part where he says that he should know more after his lab’s upcoming lab meeting—after that lab meeting, the group wrote their paper about Covid’s origins:
“The proximal origin of SARS-CoV-2” (17 March 2020)
As a scientist, none of this is surprising or suspicious to me—these are two senior scientists speculating about ideas that they’d come up with based on glancing at the genome. And after the lab meeting, the postdocs in Anderson’s lab (who likely did the hard work of analyzing the genome) convinced Anderson that his initial suspicions weren’t correct and that the parts that he thought “looked engineered” are actually common in coronaviruses. So this is more misrepresentation and more sensationalized media.
Vaccine-Resistant Strains
1) There are moral reasons to vaccinate the world ASAP, but how would you respond to the worry that some people have about vaccine-resistant strains? Dean Baker wrote in his 4 August 2021 piece “If a Vaccine Resistant Strain Develops in Africa, Will Dr. Fauci Lose His Job?” that we “certainly can’t take for granted that a vaccine resistant strain will not develop” and that “if that happens, and we face the horror story of having to go through a whole new round of infections and shutdowns, the question is whether anyone will be held accountable”.
Vaccines teach your immune system to fight the virus, so the virus really has to develop resistance to your immune system, and that requires the virus to drastically mutate all at once in order to evade all of the immune system’s antibodies and T cells. But that drastic mutation doesn’t happen all at once, and that’s why we haven’t seen the emergence of vaccine-resistant strains of measles, polio, or smallpox.
We can’t at the moment calculate the likelihood that a vaccine-resistant strain will emerge, but it’s very unlikely because thanks to how our immune system works the virus would have to spread through a vulnerable population for a long time and replicate a lot and mutate a lot:
“Negligible impact of SARS-CoV-2 variants on CD4+ and CD8+ T cell reactivity in COVID-19 exposed donors and vaccinees” (1 March 2021)
“mRNA vaccines induce durable immune memory to SARS-CoV-2 and variants of concern” (14 October 2021)
“BNT162b2 vaccination induces durable SARS-CoV-2 specific T cells with a stem cell memory phenotype” (2 November 2021)
We can reduce the risk of this happening if we continue to raise vaccination levels—vaccination slows Covid’s spread, and less spread means less mutation, and less mutation means less chance for significant mutations that could be disastrous for us.
2) Is Baker correct about the dynamics of mutation when he writes in the piece that the “more the virus spreads, the more it has opportunities to mutate”?
Yes, that statement is correct—viruses that spread and replicate more will acquire more mutations within their population.
The good news is that vaccines reduce viral spread within a population and also reduce viral replication within an infected individual—here’s some information on faster clearance of the virus (less replication in the individual):
“Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine-breakthrough infections: a multi-center cohort study” (31 July 2021)
And here’s some information on reduced transmission within a population:
3) What does the following quote from this 1 June 2021 article in Nature mean?
The extent to which mutations affecting the antigenic phenotype of SARS-CoV-2 will enable variants to circumvent immunity conferred by natural infection or vaccination remains to be determined. However, there is growing evidence that mutations that change the antigenic phenotype of SARS-CoV-2 are circulating and affect immune recognition to a degree that requires immediate attention.
This quote tells me that some Covid variants can already evade some vaccine- and infected-granted immunity and that it’s important to monitor this trend. And this is consistent with the data—for example, the Delta variant is better than previous variants at infecting both vaccinated and unvaccinated people:
“Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence” (8 August 2021)
“Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant” (12 August 2021)
But vaccination still remains ~90% effective in preventing severe disease—hospitalization, ICU admission, and death—against Delta, which is really what matters at the end of the day, since having a lot of infections obviously isn’t a crisis if people aren’t getting hospitalized.
4) How would you respond to the idea that vaccines cause variants to occur?
I would ask people who are concerned about that to answer the following question: Does natural immunity cause variants to occur?
The reality is the opposite—vaccines make new variants less likely to emerge. Viral evolution requires a lot of replication and time, and vaccines that reduce viral spread between individuals—and reduce viral replication within an individual’s body—essentially restrict the virus’s freedom to continue to acquire mutations and evolve.
Vaccine Effectiveness
1) What can one read that quantifies as a percentage how much the vaccine reduces spread when it comes to Delta?
Covid vaccines reduce transmission, but the main thing that Covid vaccines do is prevent severe disease, and that’s crucial to remember—we don’t have any crisis if we have a lot of cases and no hospitalizations, do we?
The preliminary data point toward a significant reduction in Delta transmission, but we don’t yet have hard numbers on this. This preprint reports a very significant 63% reduction in Delta transmission in addition to the reduced risk of being infected in the first place:
Vaccine effectiveness against SARS-CoV-2 transmission to household contacts during dominance of Delta variant (B.1.617.2), August-September 2021, the Netherlands (14 October 2021)
Vaccines have been found to reduce transmission of previous variants by ~70%:
2) By what exact mechanism does the vaccine reduce—when it comes to Delta—spread, infection, illness, and hospitalization? When it comes to spread, is the mechanism simply that people are sick for a shorter period of time and therefore they have less time to infect others?
The vaccine trains your immune system to fight the virus—the vaccine essentially primes your body to fight the infection before it progresses to severe disease, so when the virus shows up your body will quickly mount a response and quickly ramp up antibody production and quickly mobilize immune cells, and all of this will happen much more quickly than it happens in an unvaccinated person who hasn’t had Covid. This quick response quickly inhibits viral replication—and quickly clears the infection—before too many virus particles are shed and before these virus particles can cause severe disease to you.
This ability to mount a faster immune response reduces risk of infection; risk of disease if you do get infected; and risk of hospitalization if you do experience disease. And this ability to mount a faster immune response also reduces risk of transmission, since immune memory allows you to mount a faster immune response that clears the virus before the virus reaches the replication threshold that’s necessary for efficient transmission.
3) How would you respond to this information? Here’s a quote:
The research impresses Nussenzweig and other scientists who have reviewed a preprint of the results, posted yesterday on medRxiv. “It’s a textbook example of how natural immunity is really better than vaccination,” says Charlotte Thålin, a physician and immunology researcher at Danderyd Hospital and the Karolinska Institute who studies the immune responses to SARS-CoV-2. “To my knowledge, it’s the first time [this] has really been shown in the context of COVID-19.”
The numbers in that preprint don’t stand up:
But putting aside whether the numbers even stand up, I would ask those making comments about natural immunity being “better” than getting vaccinated to define “better”—if you want more antibodies then it’s better, but does that difference in antibodies actually matter when it comes to protecting you? Probably not—just look at what I referenced earlier:
“mRNA Vaccination Induces Durable Immune Memory to SARS-CoV-2 with Continued Evolution to Variants of Concern” (23 August 2021)
So there’s no—or very little—functional difference between natural and vaccine-granted immunity.
In my opinion, what you quoted here is poor messaging and science communication because this sends the wrong message to too many people—some people might see this and think that they don’t need to get vaccinated or that they should intentionally get infected in order to get natural immunity.
And note that there are CDC data that suggest that vaccination gives you more protection against Delta infection than natural immunity does:
“New CDC Study: Vaccination Offers Higher Protection than Previous COVID-19 Infection” (29 October 2021)
4) To what extent does Manaus’s experience demonstrate natural immunity’s effectiveness? This study apparently shows that there were almost zero re-infections when Manuas experienced its second wave—here’s the study’s abstract:
Manaus, a city of 2.2 million population, the capital of Amazonas state of Brazil was hit badly by two waves of COVID-19 with more than 10,000 severe acute respiratory syndrome deaths by the end of February 2021. It was estimated that the first wave infected over three quarters of the population in Manaus based on routine blood donor data, and the second wave was largely due to reinfection with a new variant named P1 strain. In this work, we revisit these claims, and discuss biological constraints. In particular, we model the two waves with a two-strain model without a significant proportion of reinfections.
What you’re quoting from is a modeling study that simulated a hypothetical scenario.
This paper shows that significant natural immunity in Manaus wasn’t sufficient to protect the people there against another devastating wave of Covid:
“Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence” (27 January 2021)
5) How would you respond to this evidence regarding vaccination? The 30 September 2021 paper is titled: “Increases in COVID-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States”.
This paper is not an excuse to not vaccinate—vaccines are doing their job, which is to prevent severe disease and keep people out of the hospital.
You would only expect to see a consistent overall downturn in Covid cases after achieving herd immunity, and it’s not clear where the threshold for herd immunity is for Covid, but it’s safe to say that most places haven’t reached that threshold—until you achieve herd immunity, Covid will still be able to spread, especially among unvaccinated people.
6) What do you think about the fact that some countries are experiencing their worst Covid rates ever despite high vaccination rates?
Consistently, countries have started to vaccinate and then relaxed restrictions too soon in response to ~40–60% of eligible people being vaccinated—when you have no restrictions and a significant portion of the population unvaccinated, Delta comes in and finds the unvaccinated people and manages to spread efficiently. And you have to remember that kids remain mostly unvaccinated and that schools are resuming in most countries. And it’s important for people to understand the scale of how many unvaccinated people there are in America—right now over 150 million Americans are unvaccinated, and if you imagine that Delta is a fire then that’s a lot of dry tinder.
I’ve looked at the data for each country, and the details do vary, but the general scenario is always what I described. But as I explained before, the rates for severe disease—hospitalization, ICU admission, and death—remain low in these countries.
7) What do you think about the fact that the vaccine effectiveness wanes drastically after 6 months? This fact apparently explains why cases and hospitalizations are spiking in highly vaccinated countries.
I’d say that this statement is false—the immune memory response remains very durable and robust, which is why hospitalizations among the vaccinated remain very low. It’s true that effectiveness against infection wanes, as always happens with every vaccine and with every infectious disease, but the memory response of B- and T-cells has been measured and it’s very good:
“mRNA vaccines induce durable immune memory to SARS-CoV-2 and variants of concern” (14 October 2021)
“BNT162b2 vaccination induces durable SARS-CoV-2 specific T cells with a stem cell memory phenotype” (2 November 2011)
8) Why do they only count you as “vaccinated” if 14 days have passed since you were vaccinated? I think that some people regard this as somehow suspicious—this “14 day” issue is supposed to undermine the statistics that show that unvaccinated people are almost exclusively the ones clogging up the hospitals.
Vaccines don’t immediately give you functional immunity against real infection—you have to wait for your immune system to mount a sufficient response to the vaccine, and that wait is about 14 days for almost every immune response to almost every pathogen:
So this isn’t a suspicious fudge factor—the data show that you have to wait about 14 days.
9) What do you think about this 23 October 2021 piece? Here’s a quote:
A recent study found that vaccinated people infected with the delta variant are 63 per cent less likely to infect people who are unvaccinated.
This is only slightly lower than with the alpha variant, says Brechje de Gier at the National Institute for Public Health and the Environment in the Netherlands, who led the study. Her team had previously found that vaccinated people infected with alpha were 73 per cent less likely to infect unvaccinated people.
What is important to realise, de Gier says, is that the full effect of vaccines on reducing transmission is even higher than 63 per cent, because most vaccinated people don’t become infected in the first place.
De Gier and her team used data from the Netherlands’ contact tracing system to work out the so-called secondary attack rate—the proportion of contacts infected by positive cases. They then worked out how much this was reduced by vaccination, adjusting for factors such as age.
De Gier says they cannot calculate the full reduction in transmission due to vaccination, because they don’t know exactly how much vaccination reduces the risk of infection. But even assuming vaccination only halves the risk of infection, this would still imply that vaccines reduce transmission by more than 80 per cent overall.
Others have worked out the full effect. Earlier this year, Ottavia Prunas at Yale University applied two different models to data from Israel, where the Pfizer vaccine was used. Her team’s conclusion was that the overall vaccine effectiveness against transmission was 89 per cent.
I cited the de Gier research group elsewhere in this document, and I agree with this piece. Vaccines first reduce the risk of infection. And if you do get infected, vaccines reduce the risk of severe disease and also the risk of transmission. So vaccines provide a multi-layered benefit—vaccines work!
10) To what extent do we need vaccines when we have stuff like Paxlovid?
This drug looks like it could really help to save lives in the case of immune-compromised people. Prevention is the best medicine, so we still very much need vaccination—constant medication doesn’t make sense as a replacement for vaccination, and also gives a lot more money to Big Pharma than vaccination does.
Post-Covid Vaccination
1) What can one read on whether you should still get a shot if you’ve already had Covid?
These papers explain the surprisingly significant boost that your immune system receives when you get vaccinated post-Covid:
“mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection” (25 June 2021)
“mRNA Vaccination Induces Durable Immune Memory to SARS-CoV-2 with Continued Evolution to Variants of Concern” (23 August 2021)
I’m not sure why anybody wouldn’t want that boost—natural immunity doesn’t somehow guarantee that you won’t get infected again, and post-Covid vaccination enormously boosts immunity in people who already have natural immunity, so this enormous extra boost is definitely worth a quick trip to the pharmacy.
2) But isn’t post-Covid vaccination a low priority, since those people have as much immunity as vaccinated people do?
Maybe, but why wouldn’t these people want to improve their immunity and reduce risk even further?
And vaccination has some advantages—you get a higher antibody titer after infection, but there’s evidence that vaccination gives you “better” antibodies:
As to why vaccination gives you “better” antibodies, we don’t have a great mechanistic understanding of the observation yet, but it’s probably due to certain mutations—that were added to the vaccines’ spike proteins—that help to focus and improve the immune response.
3) How many unvaccinated Americans have natural immunity, how can we quantify the extent to which vaccination would improve these Americans’ immunity, and how can we best communicate to these Americans?
We can estimate how many unvaccinated Americans have natural immunity, but we can’t really know the number.
I think that this article effectively sums up the benefit of vaccination following infection:
“Hybrid immunity” (25 June 2021)
If having natural immunity is like having an airbag in your car, adding vaccination is like adding a seat belt, automatic brake system, crumple zone, and new set of tires—it really adds so much extra protection, which really matters in a community setting.
4) What do you think about this 10 August 2021 piece from “Your Local Epidemiologist”? The piece says: “If you’ve recovered from COVID19, you still need to get the vaccine.”
I agree with that statement—you don’t know how high-quality your natural immunity is, and you gain what immunologists would consider a superpower if you get vaccinated post-Covid, and your superpower will help to stop transmission chains. So you should definitely get vaccinated post-Covid in order to protect yourself, protect those around you, and protect your community.
Vaccine Mandates
1) To what extent is the vaccine mandate in the US based on the idea of spread reduction? This interesting 30 September 2021 piece says that there’s no single vaccine mandate in the US and that “mandates have not been instituted solely because vaccination reduces the spread of the virus”. And the piece also says this:
The Delta variant is more transmissible than prior ones. It is transmissible even by those who are vaccinated, but that doesn’t mean vaccination isn’t reducing spread. Some studies have shown that people who are vaccinated have ‘high’ viral loads for less time than people who are unvaccinated; they are contagious for a shorter period of time. And other research shows that people who are vaccinated have lower viral loads than people who aren’t, particularly when we include people who are asymptomatic (of which 40-60 percent of infections are thought to be). And if you are a glass-half-full type of person, there’s evidence from the Netherlands that vaccination reduces the likelihood that a person infected with the virus transmits it to another person from about one-third to one-tenth.
The science tells us that vaccine mandates will reduce Covid’s spread.
But it’s also crucial to point out that vaccines keep people out of the hospital, and that’s the whole point—we don’t really have a crippling pandemic if very few people are being hospitalized or dying, even if lots of cases are happening.
2) What do you think about this 25 September 2021 article? Here’s a quote: “The argument that natural immunity against COVID-19 is an alternative to vaccination is emerging as a potential legal challenge to federally mandated vaccination policies.”
Natural immunity is generally comparable to vaccine-granted immunity, but the problem with the policy of making natural immunity an acceptable substitute for vaccination is that people will have Covid parties in order to intentionally get Covid in order to get around a vaccine mandate—that would be terrible for everyone involved, so it’s better to just require vaccination.
And it’s also much simpler to just require vaccination.
3) Does it make sense to mandate that people with exemptions or people with natural immunity get vaccinated, and how many of the remaining 33% of Americans who aren’t vaccinated either have exemptions—including religious exemptions—or have natural immunity?
Exemptions are pretty rare for these vaccines—no contraindications were found for people with autoimmune conditions and severe allergies and so on, and the only exemption that I’m aware of happens if you have an anaphylactic reaction to the first dose.
Natural immunity is generally very good, although it can be inconsistent. But a policy that allows natural immunity to substitute for vaccination will encourage people to go out and get Covid in order to avoid vaccination.
And those who have already had Covid still stand to gain immensely from vaccination—vaccination will significantly boost a recovered person’s immunity, which has implications for that individual and also for that individual’s community.
4) How would you respond to the evidence presented in this 2 November 2021 video to support the case that vaccine mandates aren’t good policy?
Overall, only a small percentage of workers are getting laid off—or calling in sick—due to vaccine mandates. For example, less than 2% of healthcare workers were fired in most hospitals.
Mandates aren’t an ideal approach—the mandates have clearly created tension and fueled more conspiracy theories. The ideal is that people will reject misinformation, understand the science, and get vaccinated—that’s unfortunately not what we have, so we have to resort to mandates.
5) Why ban anti-vaxxers from public places where masks are never removed? How can Covid carriers infect others in public places if those public places force everyone to wear a mask? What is the probability of a Covid carrier infecting others through their mask?
The risk of transmission in a public place could be very low if everyone wore a mask and also did it correctly, but it would depend on how many people are there and how long they stay around and how well-ventilated the place is.
Surgical and cloth masks are too loose-fitting to protect you much from inhaling other people’s infected droplets and aerosols, but these masks are very good at stopping you from contributing infected droplets and aerosols to the air around you that other people are breathing, so these masks are much more about protecting others than about protecting yourself.
Good Science
1) To what extent is it a problem if an analysis is based on very early data and/or has an extremely small sample size?
It would be a significant problem—scientists need to stay on top of dozens of publications in their field every month or even every week, and one analysis is never the end-all-be-all, and good conclusions will always be based on a strong foundation of consistent data across several studies.
2) How do you know that the Covid-related science that you reference is good science? See this 28 April 2020 piece that discusses the problems with Covid-related science—here’s a quote from the piece:
Good science requires time. Peer review. Replication. But in the past few months, the scientific process for all things related to COVID-19 has been fast-tracked. While that is, of course, understandable on some level—thousands are dying worldwide every day, after all—it’s not necessarily safe. What was once a marathon has been compressed to a 400-meter dash: Researchers race to deliver results, academic journals race to publish, and the media races to bring new information to a scared and eager public. And, at the same time, unverified opinions circulate widely on social media and on TV from so-called experts, which makes understanding the situation all the more difficult.
Bad science—or at the very least incomplete science—is simply slipping through the cracks.
The phenomenon described in this quote is true and has definitely contributed to misinformation and bad science.
I know that the science that I’ve referenced to you is good because the data are consistent and high-quality—it takes practice to navigate scientific literature, but it’s doable, and with each paper I ask these questions:
(1) What experiments did they do?
(2) What experiments did they not do?
(3) What was their sample size?
(4) What do other research groups find when other research groups ask similar questions?
3) Throughout this pandemic, how often have we seen genuine errors from scientists? I assume that something isn’t a genuine error if the evidence changes.
During this pandemic, I think most genuine errors have come from people trying to determine which drugs are effective against Covid—there was a large shift where a lot of labs that didn’t usually study things like Covid started to study Covid, and these labs posted a lot of low-quality preprints, and those preprints ultimately made it harder for researchers to do good research.
For example, the whole debacle with ivermectin and hydroxychloroquine made it harder for researchers to actually test these drugs, since people started to take these drugs and that made it harder to get proper controls for studies. Neither of those drugs turned out to be effective once we tested them, but testing these drugs took a long time because scientists had to sift through and discard poor data that had emerged due in part to politicization, and scientists’ mistakes were partly responsible for that mess.
Media Coverage
1) How would you describe media coverage in the US when it comes to Covid? One can look at the coverage from CNN, or from the NYT, or from other sources.
Pretty bad.
2) What are the biggest problems with media coverage in the US when it comes to Covid?
The reporters don’t understand science—even when they interview scientists they don’t ask the right questions or give proper airtime to Covid-related scientific issues.
And it’s not realistic to expect to get good science communication from soundbites—it takes time and patience to discuss issues, answer questions, clearly display data, and clearly explain data.
3) How can those problems be solved?
We need more good science journalists—I’m not aware of any quick and easy solution.
4) What do you think about the idea that scary anecdotes—the scary interviews with doctors and nurses, or the scary interviews with people who’ve lost loved ones, or scary coverage like this video—should always as a matter of principle be paired with graphs (like those big “roller-coaster graphs”) that can contextualize the short-term trends against the the entire pandemic’s long-term backdrop? For one thing, the big graphs allow you to see where hospitalizations currently are relative to the past—see this example, but an ideal graph would show hospitalizations throughout the entire pandemic:
There’s a constant dilemma with science communication because you don’t want to manipulate people with personal stories, but you also don’t want to ignore personal stories. And studies show that personal stories are more compelling than data to most people and that personal stories make a bigger impression than data even when paired with data.
5) Without that statistical context, don’t you have sheer anecdote and sheer “fear porn”?
Absolutely—there should be a balance. But it’s easier said than done.
6) To what extent does the media engage in partisan cherry-picking? There’s a perception among conservatives that the media will pick GOP-controlled states with surging cases, ignore Democratic-controlled states experiencing similar surges, demonize and blame unvaccinated people in those GOP-controlled states and act like the sky is falling, ignore those GOP-controlled states once the case/hospital/death statistics in those states inevitable decline due to the virus’s cyclical nature, and then rinse and repeat.
I don’t watch the news, but I get the impression that they try to land partisan punches at every opportunity—in my opinion, the focus during a pandemic should be on which policies are leading to which outcomes, so it shouldn’t be such a big story when a Democratic- or Republican-controlled state experiences this or that outcome.
The best thing to do is to always bring everything back to the evidence—we want to keep policies evidence-based and avoid the various efforts to politicize the pandemic.
Reaching Unvaccinated People
1) What do you think about the quote below from this 1 November 2021 piece?
And while booster momentum is great, it’s not going to get us out of this pandemic. We really need to be focused on the unvaccinated. According to the Kaiser Family Foundation, more than 2/3 of unvaccinated adults are under the age of 50. Among unvaccinated, 6/10 identify as Republican or lean Republican. Almost half of unvaccinated adults have a high school education or less (45%). Thirty percent of unvaccinated change their minds because of conversations with their family and friends. If you need some guidance on where to start, go to my previous post here.
I agree that vaccinating unvaccinated people is more valuable than boosters—a shot in the arm of an unvaccinated person helps the community much more than someone getting their third shot.
I don’t know the best way to reach the unvaccinated, but I feel strongly that education that specifically addresses misinformation has to be part of the solution.
2) What do you think about this 21 July 2021 piece that discusses strategies for reaching unvaccinated people?
I agree with a lot of those sentiments! It’s important to listen to and talk earnestly and respectfully with people who believe misinformation—it’s something I’m trying hard to do more of on my YouTube channel.
3) How would you respond to the notion that life is already back to normal and that therefore it makes no sense to appeal to unvaccinated people on the grounds that getting vaccinated will help to return things to normalcy more quickly?
I think it’s short-sighted to say that things are “back to normal”, especially with such a large portion of the population unvaccinated, since we could still see resurgences.
And with each surge we’ll see more viral evolution—we can’t necessarily predict that viral evolution’s path, but it could be a deadly mistake to get too comfortable too soon, so why should we risk it? So let’s get vaccinated and continue to be careful—for each other’s sake.
4) How would you characterize the extent to which we’re “out of the woods” now when it comes to Covid?
I think that with vaccination rates rising we’re getting closer to “out of the woods”.
But we won’t be there until a significant portion of the world is vaccinated—unfortunately we don’t know the threshold for herd immunity when it comes to Covid. We need vaccines to reach developing countries, but that isn’t expected to happen until 2023. I can only hope that the worst is behind us—I hope I’m right.
HI Andrew, I've got another thought for you following on from Office Hours.
I've scanned this interview and it's full of useful information that somebody might need. Yes, it's too long for many people to sit down and read, but it's not too long for someone who needs to answer some of the questions you've asked. There are people out there who are having conversations with their hesitant relatives who will find this useful.
How about writing a concise interview on some really important points (keeping it under a 10 minute read), then having a second version with the full interview. You could space out the posting so the longer version came out a few days later. That way people who enjoyed reading a shorter interview would get something, and people who liked the more detailed one would get something too.
Also I hadn't come across Dr Dan before. I love watching great science communicators work.