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Patrick Watson of Mauldin Economics suggests that a one-off tax levy on the unvaccinated would both motivate vaccinations and recover some of the costs the unvaccinated are forcing on everyone else

Patrick Watson of Mauldin Economics suggests that a one-off tax levy on the unvaccinated would both motivate vaccinations and recover some of the costs the unvaccinated are forcing on everyone else

By Patrick Watson*

Remember when COVID-19 vaccines were going to bring “herd immunity?” Good times.

In early 2021, many smart people said the pandemic would end as soon as this summer, by which point 70% of the US population would be vaccinated. Deprived of hosts, the virus would then disappear.

Well, “this summer” is here. The virus is still spreading because…

  • Far fewer people than expected got their vaccines, and
  • The faster-spreading Delta variant raised the herd immunity threshold, while
  • Many people stopped wearing masks and taking other precautions.

This is quickly becoming both a short-term and long-term problem.

The immediate challenge is rapidly rising hospitalizations, mainly unvaccinated people. Capacity is already stretched in some areas. In past outbreaks, hospital demand didn’t fall until a few weeks after cases started dropping, which hasn’t yet happened. So this will certainly get worse.

The long-term problem: Every new case is a chance for the virus to mutate into something worse. Math says more cases make that more likely.

Nor is this just a US problem. Even if we could magically vaccinate all Americans tomorrow, most of the world is still vulnerable, and will remain so for months or even years.

Wealthy nations should be doing more to help the developing world, out of sheer self-interest if nothing else. That’s not happening fast enough.

On the other hand, the US can’t help other countries unless we solve our own problems. So let’s start there.

I have an idea to get more Americans vaccinated. Trigger warning: Some readers will really, really hate it.


Source: Wikimedia Commons

Tax Incentives

The roughly one-third of eligible Americans who remain voluntarily unvaccinated (i.e., don’t have other health issues that prevent it) all have their reasons.

Some want the shots but have practical barriers, like child care or transportation. Local governments and community groups are working on this. (If you know such a person, please consider offering help.)

A larger number believe the vaccines are unproven and/or risky, or that COVID-19 won’t hurt them. John Mauldin recently explained why those ideas are incorrect.

The responses John got demonstrate that few of these people are likely to change their minds.

While the Supreme Court ruled long ago that states can legally require vaccines, it would be ugly—and maybe unnecessary if unvaccinated people had to bear the significant and growing costs of their choice.

Here’s my idea to boost vaccinations. It has two parts. Both are necessary.

  • First, Congress passes a one-time $5,000 “COVID Tax” on every US resident over age 12. It would be added to the 2021 income tax liability. No exceptions, no deductions.
  • Second, Congress grants a one-time $5,000 tax credit to every fully vaccinated American over age 12.

The net effect: Vaccinated people would pay $0 and the unvaccinated pay $5,000. It would both motivate vaccinations and recover some of the costs the unvaccinated are forcing on everyone else. (For reference, the average COVID hospitalization costs about $73,000.)

This plan would have several other advantages.

  • It’s a national solution to a national problem, negating the reckless governors who are letting the virus spread to other states.
  • The present tax system could administer it. There would be an issue with low-income people who otherwise wouldn’t file tax returns, but the IRS recently dealt with that in distributing stimulus payments. As an added incentive, we could even make the credit a bit larger than the tax below certain income levels, giving those people refunds.
  • It’s enforceable under existing law. Lying to the IRS is a criminal offense. People who don’t mind flashing a fake vaccine card might think twice about prison time.
  • It would help the economy. An almost fully vaccinated population would reduce the need for business-stifling restrictions. We might even be able to ditch our masks more often.

If $5,000 seems high, remember the Obamacare tax penalty was capped at $695 and didn’t accomplish its goal. People paid it rather than get health insurance. I would consider a lower amount if it’s enough to get people’s attention. Ideally, no one would have to pay anything because they would all be vaccinated.

One problem: Some would cite religious or medical reasons they can’t be vaccinated. We would need a fair way to evaluate those claims. But here again, there’s precedent. We once had local draft boards make similar decisions. It could be done.

Even with all that, some people still wouldn’t get their shots. Fine. They could pay the tax. Hopefully it would be a very small number—small enough to finally get the virus under control. 

I don’t especially like using the tax system this way. I wish everyone would cooperate voluntarily. But many are not, and the rest of the country is entitled to protect itself.


Source: Wikimedia Commons

Real Liberty

Some will call this tax an assault on their freedom. That’s not the right way to look at it.

Here’s US Supreme Court Justice John M. Harlan writing in that 1905 case I cited above. The issue was whether requiring the smallpox vaccine infringed on individual freedom.

[T]he liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good. On any other basis, organized society could not exist with safety to its members.

Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy. Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.

In other words, your freedom ends at someone else’s face. Others shouldn’t have to share air into which you may be exhaling a harmful virus, or pay for your hospitalization, when you have an easy way to significantly reduce those risks. You’re infringing on their freedom.

Whether the government requires vaccination (as it did with smallpox) or strongly incentivizes it (via my tax idea), it isn’t attacking your liberty. It is defending liberty for everyone else.

Freedom isn’t free. If staying unvaccinated is your idea of freedom, you shouldn’t mind paying for it.


*Patrick Watson is senior economic analyst at Mauldin Economics. This article is from a regular Mauldin Economics series called Connecting the Dots.  It first appeared here, and is used by interest.co.nz with permission.

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88 Comments

I strongly recommend everyone that reads this article, to go over to where it was originally published, and read all of the comments there.

https://www.mauldineconomics.com/connecting-the-dots/how-to-vaccinate-a…

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Great comments

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They guy that posted this lancet journal in those comments really summed it up well.

https://doi.org/10.1016/S2666-5247(21)00069-0

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Good call on the comments. hopefully people are beginning to catch on.
The guys an idiot. The problem is not that there aren't enough vaccinated. The problem is that the vaccine is non sterilising, it just stops you getting really sick, it doesn't stop you getting infected. Or, if Israel is anything to go on, spreading the virus.
Israels on third jab, one of the most highly vaccinated countries in the world and the virus is exploding there. Although who really knows what's going on if they are using the PCR test.
There was always a strong risk this would happen with a non sterilising vaccine.
Who would have guessed that a cure to the common cold would not just pop out of big pharmas arse after just 6 months and a super speedy slogan from Trump. At least they are making lots of money though.
Ultimately this is perfect for big pharma, they can keep manufacturing vaccines that just reduces symptoms and never deal with the underlying problem. And governments will fall over themselves to buy them, foisting them on us to "protect us from lockdowns". Which don't work.
Jeez, that doesn't sound familiar. But don't worry at least we've got gormless twats like Baker and Wiles on the case. Must be two of the most underwhelming intellects in history.

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Covid is a Godsent for the Pharma and the Political incumbents. Let them give us money by tax rebate. I am all for it.

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How much tax health budget money does it cost to vaccinate each individual? Are there not costs in health administration, advertising and promotion, education about the risks and what they do and dont acheive so that people are fully informed and avoid misunderstandings, purchasing vaccines, distributing them, administering them and any repeats, tracking vaccinees, collecting statistics, authenticating vaccine status for travel etc., dealing with government indemnity health issue liabilities from vaccine induced adverse events for however long they will take to manifest etc.?

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I'm sorry, what? Is this a serious article or a parody? I cannot tell anymore.

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Why is that? It's an extremely well written, well thought out article. We live in the age of extreme selfishness, and it seems manifest on the right especially.

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Using the same reasoning of contributing to hospital costs for poor personal choices, next stop will be a tax on how fat you are.
A third of cabinet ministers would argue against it though, some quite strongly.

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The New Zealand Health Survey 2019/20 found that:
around 1 in 3 adults (aged 15 years and over) were obese (30.9%)

Could be a good idea!

https://www.health.govt.nz/our-work/diseases-and-conditions/obesity#:~:….

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The notion the State should tax (thieve) citizens' money to coerce them into receiving an experimental vaccine is simply abhorrent.

This is not a matter of left vs right but of liberty vs tyranny.

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On the other hand, why should the State "tax (thieve) citizen's money" to pay for medical care for unvaccinated individuals when the costs would be much lower were they to receive a vaccine? People not getting the vaccine will impose a massive cost that is borne by all taxpayers.

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Including themselves, because they obviously pay tax and so are equally entitled to their share of medical assistance.

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But that works on the assumption that unvaccinated people would require medical care. Why would that be the case?
I doubt there are many vulnerable people who are not planning on getting vaccinated (over 65, super fat, diabetic or any other unwell people). And for them it would be foolish, the risk of covid is far higher than any vaccine risk and if they only have another few years (which is all most people who die of covid have anyway) then unknown long term effects of that vaccine aren't a concern.
Most people who don't take the vaccine are making a risk assessment. If you are healthy and under 50 the chance of you dying from covid is pretty small. Under 30 and it's the same as flu. Under 20 and flu is more dangerous. Yet under 20s aren't forced to take flu vaccine and flu is still pretty dangerous to old people as well. So why was it not a "social responsibility" to take the flu vaccine but it is to take the covid vaccine?
There are risks with the vaccine. Though very small they are not non existent. And no one knows what the long term effects are because you only find them out in the long term.
And it seems they don't stop you catching covid and they don't stop it spreading as evidenced by Israel. So really why bother?
Most people who catch covid do not burden the health system and most of the ones that end up hospitalised are already burdening the health system through their old age, their obesity, hypertension, or diabetes or.....insert your favourite comorbidity here.

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I don't know where you're getting your data from, but hospitalisation rates are significant event amongst the 18-50 age group with over 1/1000 [1] people needing it in the US through September last year so it would be much higher now. That would overwhelm our hospitals and lead to deaths not just in the covid patients, but also others whose medical care was delayed or compromised.

[1] https://www.statista.com/statistics/1122354/covid-19-us-hospital-rate-b…

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I get my data from all over the place. The CDC have been woeful at times and Walensky is up to hear eyeballs in fear porn, but I take their data to be as reliable as anyone's:
https://gis.cdc.gov/grasp/covidnet/COVID19_5.html
I don't get your point. We can clearly see at the height of covid hospitalisations only 26% were 18-49 age range. Well over half were over 65.
And this paper they looked at over 30 thousand medical records I the US and found that in covid deaths over 50% had 3 or more comorbidities:
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed…
Covid is and has always been a diseases that overwhelmingly effects the old and already sick. It is truly baffling that people are so afraid of this. The nudge unit has had an awesome pandemic for sure.
Hospitalisations in the US are nowhere near as bad now as at the worst in January of this year, and seem to be flattening. So, the vaccine is stopping severe infections. But cases are exploding. It is not stopping the virus at all. We need to get over it and get on with our lives.
The "hospitals would be overwhelmed leading to deaths in other areas" meme has been done to death but like so much of the fear porn there isn't any real data to support it. Unless you vount modelling. Which is been shown to be BS repeatedly. Even Sweden, with no lockdowns, or masks, or a vaccine barely used its tent hospitals:
https://www.reuters.com/article/us-health-coronavirus-sweden-field-hosp…
The Nightingale hospitals were not used in the UK and the NHS has a "crisis" every single winter:
https://www.kingsfund.org.uk/blog/2021/04/nhs-nightingale-hospitals-wor…
This article was written at the peak of New York’s worst time of the outbreak. They didn't really use their extra capacity either:
https://www.nytimes.com/2020/04/10/nyregion/new-york-coronavirus-hospit…
The narrative of fear is based on outrageous modelling that has repeatedly shown to be far from the truth, weak politicians who rule by focus group, and a media who does not understand science and relies on the same trophy idiots to comment again and again and again.
Baker, Wiles, Hendy rinse and repeat. Never a word from a virologist incidentally.
Cuomo is out due to being a bit of an old pervert. But he should already have gone because of what he did to care homes. Over 50% of deaths were in care homes in New York, because Cuomo sent untested people back to care homes, to "protect the health system". Sweden did they same (over 60% deaths in care homes).
This brings us neatly to the Great Barrington Declaration and plain common sense. If we had protected the vulnerable (ie care homes) we wouldn't have needed lockdowns and death and hospitalisations could have been halved or better. But instead we get twats like Siouxsie Wiles saying it makes more sense to lock everyone down then just the frail and elderly.

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You nailed it denature. 100% agree.

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Morepork -

On the other hand, why should the State "tax (thieve) citizen's money" to pay for medical care for obese individuals when the costs would be much lower were they to eat less? People not maintaining a healthy weight will impose a massive cost that is borne by all taxpayers.

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leave the boomers out of this

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Given the amount NZ is spending on advertising the vaccine, it might be better bang for our buck to just give your a $20 if you get a jab, would probably work better too

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Throw in a Sausage roll and I am in.

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Scary stuff, surprised an article like this was posted here...

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They could pay for this by taxing back some of the out sized gains in the property market, after all there is about 1.3b nzd to lay our hands on there!

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Well they can try to implement whatever stupid ideas like this they want as long as it stays in the USA.

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Given your couple of weeks in MIQ costs money, and the reduced or removed MIQ time for vaccinated individuals, I can definitely see their being a "fee" in NZ for non-vaccinated individuals that want to travel overseas.

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How about waiting for the results of appropriately termed trials and go from there.

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The government will likely require vaccinations for events, travel, religious gatherings etc and that should be sufficient incentive for most.

The government also need to issue guidance for the unvaccinated to make sure they are self-isolating, wearing masks when in public areas, avoiding social gatherings or personal contact etc. when borders reopen. At that point the government has probably discharged it's responsibility.

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Get F&^$#D!

The vaccine doesnt even work. Yes it reduces the impacts and the death rate, so is still a net benefit and worth getting in a country with ongoing outbreaks.
But, it does not stop the person getting re infected with covid, especially the variations such as Delta, and they can still spread it.
Also the vaccines appear to be wearing off after several weeks, so will require constant jabs for what, the rest of your life for all 7b people?

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rest of the country is entitled to protect itself.

Notice that word ENTITLED in there? That is her forcing her opinions and wants on other human beings, who also have their own autonomy. and right to choose what happens to their body.

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The vaccine doesnt even work. Yes it reduces the impacts and the death rate, so is still a net benefit and worth getting in a country with ongoing outbreaks.

So you make a claim like "doesn't even work" and then immediately contradict yourself by acknowledging that it works.

It's pretty clear that it is very effective, as shown by these graphs: https://mobile.twitter.com/richardzussman/status/1420078157357477888/ph…

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Ideally a vaccine would allow your body to identify the foreign body, and kill it completely. But this is not the case for the covid vaccine.
Their definition of "work" is that we will be able to build up herd immunity and vaccinated people would not transmit covid. So it clearly fails to meet societies definition of work, does it not?
I am not saying it is entirely pointless, just that on an individual basis, people have to weigh up the costs and benefits, and the benefits are obviously less than they have been touted to be, while the costs is an endless amount of booster shots, or a recall every time a new strain is discovered...

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Their definition of "work" is that we will be able to build up herd immunity and vaccinated people would not transmit covid. So it clearly fails to meet societies definition of work, does it not

The goal has always been a vaccine that protects the individuals who are given it. Remember the threshold for what was considered a useful vaccine was if it improved outcomes in only 50% of cases. The mRNA vaccines are around 95% effective against the original COVID strain; less effective against Delta but still in the 85-90%+ range.

Do these vaccines prevent onwards transmission as is normally the case for other vaccines? No. Are they unique in this regard? No, vaccines for other diseases work like this as well, such as whooping cough. Have the vaccines failed? No.

Do they work? Yes.

Trying to have some debate over whether they "work" or not is rather a waste of time and distraction. We know that these vaccines are very effective at protecting individuals from severe illness and also death. We know they have very very low side-effects for the general population. We know they are somewhat effective at preventing illness and somewhat effective at stopping forward transmission. Trying to debate whether they "work" or not and holding up some ideal for what vaccines "should" do is rather irrelevant given that what we have is already very effective at the thing that matters most - preventing death and severe illness.

We can wish for better vaccines, but to spurn the current ones because they don't measure up to some mythical ideal of a perfect vaccine is asinine.

The situation now with delta is realistically: get the vaccine, or get delta. Personally I've already received my vaccine. If you want to roll the dice with delta, go ahead. I just wish my taxes wouldn't have to pay for your selfish decisions.

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Good points there, cant expect everything to be perfect.

Except your last part The situation now with delta is realistically: get the vaccine, or get delta.
Actually its "get the vaccine AND still get delta".... So good on you for getting the vaccine, but you can, and more than likely would (if you were in an infected country), to still get the delta variant. And probably the Gamma, Epsilon, Zeta, theta, kappa etc variants.

Good thing I also pay my own taxes, you know, to pay for my medical care if ever I need it. Still better than a person who is overweight, smokes and/or drinks a lot.

(just to note, I am vaccine hesitant. ie I will put off getting it as long as possible until I need to travel, or we are about to open up with the potential to start getting cases in NZ)

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The breakthrough rate for fully vaccinated people, even with the Indian Delta variant, is only a fraction of a percent. It's hardly a nullification of the vaccines effectiveness:
https://www.kff.org/policy-watch/covid-19-vaccine-breakthrough-cases-da…

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This is inaccurate... Consider just what the "breakthrough" rate is for unvaccinated people... That is also only a fraction of a percent. That is, only a fraction of a percent of unvaccinated currently have covid.

I recommend a wander through the data dashboard for israel: https://datadashboard.health.gov.il/COVID-19/general?tileName=Vaccinati…

I give strong kudos to Israel for publishing real data in a timely manner. This is quite the opposite of the US, which has made it a policy of applying obfuscation.

Note that if you do not speak hebrew, you may wish to avail yourself of the services of google translate. Note carefully that there are more vaccinated severely ill covid patients in israel than there are unvaccinated patients, as well as a huge number more vaccinated patients with covid than unvaccinated patients with covid. Yes, there are more vaxxed people than unvaxxed there. Believing in the concept that getting vaxxed will protect you from getting covid, or prevent you from passing along covid is silly. The data doesn't support those beliefs. There is an interesting study showing the viral loads for covid positive patients that were vaxxed vs unvaxxed, and the viral loads were similar (slightly higher in the vaxxed although not a statistically significant delta hence my description of "similar"). The primary benefit at present is that there is a small reduction in the average severity of the illness. Using the mRNA vax to build herd immunity is a failed concept based on the actual data with the delta variant.

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Note carefully that there are more vaccinated severely ill covid patients in israel than there are unvaccinated patients, as well as a huge number more vaccinated patients with covid than unvaccinated patients with covid.

Yes, it's called Bayesian Theory.

https://twitter.com/kennyshirley/status/1417177778013843456

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Umm... you missed the rather obvious aspect of "with covid"...

This is NOT bayesian Theory.

Also note that the vax vs unvax is not 20:1 as per your twatter picture. The ratio is age dependent in Israel, which does skew the bias in older people.

There is a rather large amount of data on the Israel website I linked, and more data detailed if you choose to download the .csv data (which I highly recommend for interested people).

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That’s great data – I’m Just looking at severely ill (however they define that) as a function of vaccination status from last month up until now for under 60 year olds:
Unvaxxed attack rate 2.1 people per 100k = 2.1x10^-5
Vaxed attack rate 0.5 people per 100k = 5x10^-6
RRR (Relative Risk Reduction) = 1 - vax_attack_rate / unvax_attack_rate = 76%
AAR (Absolute Risk Reduction) = unvax_attack_% – vax_attack_% = 0.0016%
NNV (Number Needed to Vaccinate) = 1/AAR = 62,500

So although it looks like the vaccine is 76% effective for under 60s, the absolute risk reduction is so low that you’d need to vaccinate 62,500 people to prevent 1 severe case. (description of calculations here)

Imagine what the data would look like for under 40, under 30 under 20 - and 12 to 16 year olds.

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Except that the vaccines are not very good at protecting people from severe disease and death. 66% of Covid deaths in the UK are of vaccinated people. Exactly how is that "very effective" at preventing death?

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Baye's theory. I already linked to an example of how it works above. It's counter-intuitive at first glance. The example shows how two thirds of people in hosptial can be vaccinated, even though vaccination reduces hospitalisation rates by 90%. Pretty much the same for deaths.

The reason vaxxed people make up a high proportion of deaths of because most people are vaxxed. If they weren't vaxxed the death rate would be even higher.

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Or Delta is simply less lethal than previous variants (which is now being proven as research studies are published) so even the unvaccinated don't face the same risk of dying as they did last year. There is very little difference between the death rates of people in countries with low vaccination rates like Sweden (only 9 deaths in July) and the UK. So claiming vaccination is "very effective" is confusing correlation with causation.

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Ah Sweden. The golden unicorn.

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The body's response to the virus is a mutli-layered one. It's not just antibodies that are at work. You have various T cells as well which kick in after the antibodies fight the virus (the first responders, so to speak). So even if antibody count may drop, the body will still have the T cells which are prepared to tackle the virus.
For more vulnerable people, it only makes sense to continue the jabs. Just like the flu jabs - some people need them and some don't. I've never had a flu jab in my life and have not had the flu in seven years. Doesn't mean I won't have them if my doctor tells me to or if I get old enough I really need it...
And remember, SARS-Cov-2 works the opposite to the normal flu - you're infectious FIRST and then you feel sick. So you'll be spreading it before you even realise you've got it.
So vaccinating makes sense for everyone, not just those who may be at risk. And 90% of those hospitalised anywhere around the world are the unvaccinated, so...
I'd sooner believe the virus has escaped a Wuhan lab than that the vaccines aren't helping or that future vaccines such as Novavax won't be even more effective than even the best of the current ones. Stay tuned about Novavax - it's very promising...

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In July 57% of Covid patients in UK hospitals were unvaccinated. Not 90%. The month before it was 62% so the ratio is declining quickly even as the numbers of hospitalised people are rapidly increasing.

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At one stage the UK had over 1000 Covid deaths a day, now it’s under 100 despite less restrictions and a more serious mutation. That number is currently growing though so will be interesting to see how it ends up, but at the moment the 95% effectiveness seems about true.

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The UK seems like a perfect environment to evolve a vaccine resistant strain, given that the current mRNA vaccines are somewhat "leaky".

We may need a plan B, or to simply learn to live with this thing.

Given that it mostly kills the very old (older than life expectancy) or those other issues (primarily obesity), perhaps channeling resources into help people to get fit is a good strategy.

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The death rate would diminish without vaccines and lockdowns, as you would quickly run out of the sick and old that succumb to the illness. The problem has never been the fact that people who are old and sick die, just that fact of them all dying at the same time.

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In the future governments will try to pretend that it was masks, vaccines, and lockdowns got covid under control. The reality is vulnerable cant die twice. Naturally acquired immunity is protective. Seasonality plays a big role, and it's pharmaceutical interventions like ivermectin in India which smashed covid into submission.

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This is a pretty crazy suggestion really, since the US government wouldn't do it.

You know who can do pretty much the same thing, though? Private health insurers, who are bearing the costs for COVID hospitalizations anyway.

They can simply ramp up their premiums on unvaccinated people. Just like they ramp up the premiums on people who smoke.

Perfectly fair, and requires no government intervention.

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I sincerely hope that insurers start collecting data on their insured population, and adjust the premiums accordingly. BMI > 25, 125% rate increase. BMI>30, 200% rate increase. Smoker, 300% rate increase, etc. (numbers are WAG for effect, not based on reality actual relative risk)

I also hope that they collect data on the relative risk for vax vs unvax, and charge accordingly. BTW, you may be surprised as to how that eventuates... we still have the spectre of ADE and OAS for the future.

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I know that some health insurance providers in the US do charge higher premiums for smokers. I'd be surprised if there weren't other conditions they increased premiums for - that was part of the reason for the pre-existing conditions coverage included in the Affordable Care Act, which was the best watered-down government healthcare option the US government was able to negotiate.

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BMI is a terrible metric to use, you know that just about the entire AllBlacks team would fail that test don't you ? Some body fat scales are a far better way to measure body fat, even the cheap ones do a reasonable job without going all out and putting people in a Bod Pod.

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Fully agreed. Simplistic methods rarely capture the details.

In a similar manner, the relative risk of death from covid for a young and healthy person with zero comorbidities is about four orders of magnitude lower (!!!) than an elderly person with one or more comorbidities.

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BMI is used for population measures, because when you're tring to assess the relative health of a large population of people, you make do with the data that you have available, because you can't go out and do new measurements.

What data is often available? Height and weight. So you see if you can use those to get a measure of how overweight/obese people are. Turns out there is such a measure, it's called BMI and it's very effective at assessing the health of *the population at large*, letting people make comparison between sets of people for statistical purposes, including in medical studies.

For individuals, BMI is also a good general guidance point to use. If you're over 25 BMI you're probably overweight and should do something about it, if you can. You may have all sorts of individual factors that mean BMI is less relevant for you, such as:
1. You have one or more limbs amputated
2. You are an elite athlete and so the standard population model doesn't apply to you
3. You're a male of Indian ethnicity (BMI does not correlate well for negative health outcomes for this demographic)
4. For any other reason that your body is quite far from 'average'

There's nothing wrong with BMI, when it's used properly, and people saying "the All Blacks are all obese when using BMI as a metric" are using a misapplication of BMI as a means to say it's useless. Instead, such people should learn about what the metric is and what it's useful for, and then use it for those things, and don't use it for the things where it's a bad tool. And instead of repeating "All Blacks are obese according to BMI" they should repeat what I've just said instead.

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This is already the case, well, not using BMI but various other risk factors will increase/decrease the cost of your health insurance. However for anyone in a job the employer gets group coverage with average rates for the population, or wears the cost of claims directly. But then basically no one pays for their own insurance premiums over there, you either get it through your job, parents, medicare or medicaid. There are complicated and expensive schemes like COBRA that let you hang onto a similar health insurance if you lose your job, but they are still exorbitantly expensive.

COVID health care costs are for the most part being covered by the federal government in the US, if not you would definitely be getting massive fees/subsidies for not getting a vaccine.

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They will tax fat people next

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Sugar tax is coming one day.

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"They" haven't, and aren't taxing anyone. Who's they? The left bogeyman? Or the right bogeyman?

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"They" are the strata of society that hold the levers of power, regardless of whether we vote left or right. You can see "them" in action when Western nations introduce steps in unison - be it "hate speech" laws or vaccine passports.

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What about people with High BP ?

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Do people choose to have high blood pressure?

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As someone who has very recently been diagnosed with hypertension... the short answer is yes, at least for the large majority of cases. I do not get as much aerobic exercise as I should, I stupidly consume a few too many carbs (mostly partially digested by little yeasty things), and enjoy my food a bit too much.

There is a hereditary aspect involved, although lifestyle choices predominate.

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Worldometer shows 16.5m active Cv19 cases.
In a world pop of 7.85 Billion
I know its a pandemic and nasty but good grief, this is not the plague

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Thalidomide

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That was an extremely ugly debacle.

A sibling of my childhood friend was a thalidomide baby. Even with seeing their challenges up close and in person, it is rather difficult to imagine the life that this person had to live with for their entire life.

In more recent times, how about Vioxx? Pfizer paid a few $B in criminal fines for that debacle...

The vax manufacturers have negotiated for zero liability for any adverse effects from their products prior to delivering a single dose. This is not the norm in business.

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This article raises a bigger question. Mr Watson identifies that far fewer people got vaccinated, but doesn't ask why. He probably thinks he already knows, but what is clear in NZ that the US has a significant problem in that very few people actually trust their Government and politicians. I think this is a worldwide problem, but it is just so much more apparent in the US. But Government's don't actually ask this question or seek to find out why, when they genuinely try to help people (I'm not suggesting they are do that here or not), that the first thing most people ask is "what's the catch?"

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Well the government is adding taxes to just about every other area of society so this should appeal to them

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The problem with this idea and others like it, is that they are all stuck in the past where they still believe that being vaccinated will stop you from getting covid and requiring healthcare, and stop you from spreading covid to others who will require healthcare. Well, the truth is that the vaccines do neither. Vaccinated people are going to get covid and become ill, many will die, and there will be more and more sick vaccinated people over time as their immunity wears off and new variants become more vaccine resistant. Lets see how many vaccinated people are going to be willing to sign up to being jabbed with experimental vaccines every 6 months .... and where is the empirical evidence to prove that constant vaccination with this virus is safe?

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It's a new virus so course there is no evidence. If you want a body of evidence you will need to have a branch of society continuously vaccinated and another branch unvaccinated and see what happens over 10 years or so. There is a close corollary look at the flu shots.

This experiment is already happening in rich vs poor countries and also in areas like the US where vaccination is still under 50% in large swathes of the south. Some people who have had the vaccine will die. Perhaps 2-5 in every 100 deaths.

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Many is not a very descriptive term. You should have said 95% less will die than unvaccinated. That 95% makes a significant difference to the total number of deaths and the total number of people in hospital.

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Class A troll. The virus is still spreading because…Far fewer people than expected got their vaccines. Not true, vaccinated spreading it just like unvaccinated and getting hospitalised. Show me statistical evidence using case data from the last 6 months that this is not the case. Also variants now make vaccine obsolute and more are coming just like seasonal flu being a virus. Secondly, people with a vitmain D deficiency and or comorbidities such as being over weight are the ones taking up hospital beds. Perhaps charge them? Time to focus on reducing comorbidities and treatments as that is looking promising.

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Must admit my thoughts have changed a lot since reading these comments. I am halfway to being vaccinated and will get the other jab, but if the vaccine doesn’t stop the spread then it really is personal preference. If however you are unvaccinated and you do get sick and the hospitals are overwhelmed, maybe you should end up at the back of the queue regardless of how life threatening it is.

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Most of the comments here are very ill-informed or are using cherry-picked data or misinterpreting the data.

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It is interesting.

I would put you in that very category, and you would put me in that category.

I have read through hundreds of peer reviewed papers, as well as evaluating the underlying data.

I do have to agree with a Stanford University epidemiologist (Dr John Ioannidis)...

https://en.wikipedia.org/wiki/Why_Most_Published_Research_Findings_Are_…

https://blogs.bmj.com/bmj/2021/07/05/time-to-assume-that-health-researc…

BTW, I strongly appreciate his rational and thoughtful evidence based comments regarding the effects of covid on the population.

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Segregation is a slippery slope. If that happens, expect anarchy.

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My solution : Ask the Pharma companies to produce the vaccine in micro powder form, then spray it over the entire country and its population like Agricultural spraying. Sorted.

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Alternative administration methods are under active development.

The ideal is a pill, but failing that a nasal spray will help a lot.

The problem with needles is you need trained people to do it - not a huge barrier in developed countries but still desirable to avoid it. In developing countries it's a huge barrier to uptake.

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Lanthanide - I appreciate your well informed comments.

A question I've been unable to answer is whether these vaccines will give us the herd-immunity which was promised earlier in the year. Driving r0 below 1 was the goal earlier in the pandemic.

Will these vaccines achieve that? If not, are we doomed to Covid pinging between vaccinated individuals until it mutates around the protection provided by training our immune systems to attack the spike protein?

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Delta seems to produce much more COVID viral particles much more quickly than the original strain, or its evolved variants such as Alpha. However it isn't specifically more deadly itself, just once you get infected with delta you are likely to progress through the stages of the disease more quickly, which in turn means life-saving efforts will be less successful with this strain than with the earlier ones as there's a shorter window of operation for them and delta can overwhelm the counter-measures more readily.

As a result:
1. The R0 of Delta is somewhere around 5-7
2. Classic COVID normally had people infectious about 5-6 days after they themselves were infected, giving a window of time for contact tracing to put people into isolation. For delta this is more like 3.5 days, making outbreaks much harder to contain.
3. The high viral load and quick replication of delta seems to make it more readily able to infect people who have been vaccinated, and also for those vaccinated people to shed viral particles to others who can then get infected. There isn't a lot of clear data, but with earlier strains of COVID both of these things still happened, but at a much lower rate. I haven't seen clear data saying how often someone who is vaccinated will pass on the disease to someone else, but my *guess* is it's something like 30-50%.

Experts are now saying that 'herd immunity is impossible with delta' - I think this is a simplistic and exaggerated statement. I think really the situation is that the threshold for effective herd immunity is now something like 90-95% of the total population being vaccinated (including children), which is going to be very difficult for most countries to reach, given vaccine hesitancy, misinformation, conspiracy theories and the attitude held by some that vaccines are at heart a purely personal health choice and not a public health choice. The closer we get to 100% vaccination uptake, the smaller and less severe any outbreaks of COVID will be, as it simply will have trouble spreading amongst a resistant population.

Measles has an R0 of about 12-18, which is why when an outbreak happens it can quickly move through the unvaccinated population. The difference is that the measles vaccine it very successful at preventing infections and also onward transmission. But measles has been eradicated in NZ and most other developed countries, with only occasional flare ups.

So I don't think it's a given that everyone is going to get delta, whether vaccinated or not. Maybe 50-60% of people get delta, including vaccinated people. Or maybe 80-90% of people get delta, but for those who are vaccinated many don't display any particular symptoms and don't pass it on.

The situation is ripe for the virus to mutate such that it can 'escape' the present vaccines. But there is active development happening to produce new vaccines that better target the current mutations, as well as other vaccine technologies under development that attempt to target a broader sample of proteins from the virus, so that the virus is caught in a pincer grip which will make it much harder for it to mutate in enough places at once to evade the broader range of antibodies.

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Agreed, the robust immunity conferred by a traditional style vaccine is far superior to the spike protein only style vaccine currently in vogue.

I would far rather have n-protein antibodies than s-protein antibodies myself, the nucleocapsid protein is far more complex and is much less likely for the virus to mutate around the vaccine protection if the n-protein was used.

And why are covid recovered individuals being coerced into getting the vaccine? That is utter insanity...

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This is a very informative and easily understandable summary. Many thanks.

Does this mean 1) the Vaccine development that has happened till now are band aid varieties without the ability to stop the spread forever ?
2) Are there efforts in a totally different manner (like the measles, small pox, shingles vaccines etc) with more sustainability in fighting the virus and capable of being administered when spikes in infections happen ?

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You have described the primary issue with leaky non-sterilizing vaccines. For vaxxed individuals in Israel that were vaxxed 6 months ago, their vax effectiveness is around 20%. If you wish to learn more about the risks of non-sterilizing vaccines, have a look at the evolution of Mareks disease in poultry after a leaky vaccine was introduced.

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This is my concern. Perhaps we will just need natural immunity - which in my crude understanding is more "comprehensive" - amongst those healthy enough to survive the infection.

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Too many people such as the author of this piece are happy to promote the loss of our personal liberties. Freedom of choice is what we want, NOT "freedom" from choice! (remember Devo?). Don't forget the wars we fought (and celebrate every year) for our freedom, or so we were told. Freedom is not safe. Freedom is always risky. Be careful what you wish for and use your brain -- it's elementary my dear Watson (of Mauldin Economics)!

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See https://www.youtube.com/watch?v=haG1yKJVVAw This Dr is suggesting that the current vaccines work in the lower respiratory tract and not in the upper respiratory tract. Would this explain virus establishment and transmission via the upper respiratory tract in vaccinated people?

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What I don't get, is why people like Watson are willing exponents of coercion! He is no doubt double vaxed and believes that he has done "his bit" to save humanity and therefore everyone should be forced onto his "ark". Well, if you look closely Mr Watson, your ark has sprung a leak and I would rather not join you on that particular vessel.

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New variants inevitably become weaker with each new one. True, they seem to be more virulent but they burn out faster than the original. (If covid doesn't behave that way, then we really need to examine if this really was manufactured by the lab in Wuhan for gain of function - i.e. intentionally making it deadlier - research and had escaped somehow)

If you look at numbers for the countries first hit by Delta (UK & India), the numbers have tapered off sharply. 40k (Jul 21) vs 400k (May 21) a day in India, for example. That's because as the population becomes accustomed to measures and follows them more strictly with more speed than previously, new infections get eradicated sooner than later. So you see sharper spikes but shorter durations too.
And let's not forget that the general aka mainstream corporate media loves bad news, so they will focus on the bad more than the good. Fear is their business, so while there is tragic loss of life and suffering, it is not as bad as they say it is... That's what I like about Interest.co.nz - they're fair, balanced and unswayed by the corporatist/commercial agendas prevalent in media these days.
For those who have had Covid, their immune response will now be much stronger, so even if they do get it again, their bodies' strengthened immune response will help them get better faster. So the unvaccinated get Covid but they (who survived) will have a stronger immune system against Covid.

The vaccinated may also get Covid but they will have less of a difficult time with it and their risk of death is almost zero. Any cases you'll have heard of (again in the media) have had extenuating circumstances. one woman in the US died after receiving the vaccination. Did she die of the vaccine? No, she ODed on tylenol which caused liver failure that then led to other organ failures.

There has never been a guarantee that anyone will not get Covid if they get vaccinated. A look at the history of viral-related illnesses such as mumps, TB, measles, etc, show that it can take years even decades before it is eradicated by proper hygeine practices and vaccines. Covid will be no different.

Think of it this way: Covid is a bunch of gunmen going around shooting everyone. Vaccines are bulletproof vests (at the moment they are one-size-fits-all). Some people may still get shot, and most will have the vest stop the bullets, but some will be hit in areas not protected by the vest. Worse still, some vest don't fit well and may slip off or not give good coverage. BUT vests are still a good idea and a good thing to have and will in general save your life. Same with the vaccines.

As I've said elsewhere, I'd sooner believe that the virus escaped the Wuhan level-4 virology lab than believe that the Covid vaccines don't work. They may not work perfectly (show me something that does) yet but they do work. So better to have it than not...

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