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I am a mathematical modeler of infectious disease. I believe models are very powerful, valuable, and tell us a lot. https://twitter.com/NateSilver538/status/1340533431638355968
Nate has relied heavily on a model to inform his opinion. If I developed a model that produced the same outcomes as that model, I would not believe that Nate's opinion is justified.
I would not be comfortable with such a small difference in modeled deaths being used as the *sole* determinant of how to implement a complicated vaccine distribution.
And even if I believed that the best strategy was purely age-based (and do I marginally lean that way), I would not be comfortable using the level of rhetoric that Nate has been using.
This policy decision is difficult. The optimal decision is affected by:
- how soon the next batch of doses are coming.
- how quickly we can vaccinate individuals in the different groups. (especially given the fact that the freezers needed for the vaccine are not common)
- how soon the next batch of doses are coming.
- how quickly we can vaccinate individuals in the different groups. (especially given the fact that the freezers needed for the vaccine are not common)
- whether the vaccine might be more protective against transmission and/or symptoms in middle age than in elderly
- whether we care about a 40 year old with young children dying more than an 80 year old
- whether we care about long-term disability
- whether we care about a 40 year old with young children dying more than an 80 year old
- whether we care about long-term disability
- whether vaccine gives temporary immunity to infection and later only protection against symptoms (and whether this differs by age)
- whether quickly slowing transmission would free up hospital space faster
- whether some age groups are more able to isolate
- whether quickly slowing transmission would free up hospital space faster
- whether some age groups are more able to isolate
- the societal impact of being able to open more of the economy as more workers are vaccinated
- the fact that some people are going to refuse the vaccine, and so for vaccine distribution, it doesn't matter if you include them in a priority group.
- the fact that some people are going to refuse the vaccine, and so for vaccine distribution, it doesn't matter if you include them in a priority group.
All of these things and more affect what the right decision is.
Not one of them is included in the model that Nate has highlighted. That's not a criticism of the model, but it's an issue that needs to be thought about as the decision is made.
Not one of them is included in the model that Nate has highlighted. That's not a criticism of the model, but it's an issue that needs to be thought about as the decision is made.
So yes, Nate may be right about what the correct decision is. But he may also be wrong.
What is definitely wrong is insisting that the choice the policy makers made was "indefensible".
What is definitely wrong is insisting that the choice the policy makers made was "indefensible".
I am a fan of Nate's. I read his website regularly (my wife would say too often). But even with 15 years modeling infectious disease spread, I would not claim to be qualified to unilaterally make the judgement he is making. https://twitter.com/NateSilver538/status/1238319062549233664
And for the record - looks like the person who made the model Nate is using seems to share at least some of my concerns https://twitter.com/GidMK/status/1340537758675161088?s=20
