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Two predictions - one from a skeptic, the other the vaccine-loving conventional wisdom.
Only one can be right. Let's check back in six months.
Call it a natural experiment.
For 18 months, Covid has made fools of anyone who dares to predict its course. Neil Ferguson of Imperial College managed to be completely wrong in both directions in barely a week in March 2020 - keeping his perfect record of failure intact.
I’ve been wrong too, as the bluechecks on Twitter never tired of reminding me. We’ve all been wrong. The future is hard to predict.
But when it comes to vaccines, the stakes of these predictions are particularly high. If last 18 months have proven anything, it’s that virus gonna virus. Our interventions may marginally change the course of the epidemic, for better or worse. But over time, everyone will be exposed to Covid.
The vaccines change that equation. Vaccines - particularly the mRNA and DNA/AAV vaccines - are not masks or “social distancing.” They aren’t feel-good but useless interventions. They are incredibly powerful biological tools, even if our public health authorities have spent the last year portraying them as simple and largely risk-free.
And they don’t just work on us.
They have the power to drive the evolution of Sars-Cov-2. A “perfect” or “sterilizing” vaccine would all-but-eliminate the coronavirus in the wild. The virus would not have enough chances to reproduce to escape the vaccine’s power to stimulate our immune systems. This power is why we don’t have to reformulate most other vaccines regularly.
But - like flu vaccines - the coronavirus vaccines are the opposite of sterilizing. They are “leaky.” They do not keep vaccinated people from being infected or passing Sars-Cov-2 to other people.
And along the way they drive the virus to mutate away from the protection they offer. This problem is particularly serious for the mRNA Covid vaccines, which cause the immune system to be focused not just on the spike protein but one particular part of the spike protein, the “receptor binding domain.”
At its most dangerous, this process may result in “antibody-dependent enhancement.” ADE occurs when a virus mutates so that vaccine-generated antibodies actually help it attach to its targets on our cells. ADE is - fortunately - infrequent. For it to occur, the virus must change shape in a very specific way, so most mutations will not drive it.
But even if full-blown ADE does not occur, vaccines will exert “selective pressure” on viruses to mutate against them. For example, studies have shown that the Delta variant replicates more rapidly than other Sars-Cov-2 variants (for reasons scientists still do not completely understand).
Speed of replication may be a particular advantage for a virus trying to defeat a vaccinated population - since vaccines are designed give the immune system a head start on finding and defeating pathogens.
The broader issue is this: our immune systems are engaged in an incredibly complex race with viruses and other pathogens. The effect of leaky vaccines can make the outcome of that race even harder to understand, much less predict.
But we know for certain that worldwide mass vaccination campaigns in 2021 have coincided with the rise of the Delta variant, which has nearly completely replaced all other Sars-Cov-2 variants. The Delta variant does not seem to be more dangerous than other variants (notwithstanding anecdotal evidence from the United States about young people dying, the hard data from Britain and Israel does not show higher mortality rates). But it does appear to be more transmissible, which all by itself can cause problems for health-care systems.
So what’s next?
The public health establishment - the same public-health establishment that said we would get to herd immunity if we could reach 70 or 80 percent adult vaccination levels (that’s what they said, and don’t let them pretend they didn’t) - is now promising that if we just vaccinate kids and give boosters to the adult population, we will essentially defeat Covid. I’m not exaggerating. An NPR article yesterday was headlined:
Is The Worst Over? Modelers Predict A Steady Decline In COVID Cases Through March
And contained this happy graphic:
Of course, this happy news results from the miracle of vaccinations: “Getting everyone who is eligible vaccinated is still key to preventing further deaths,” NPR writes.
And then there’s the bear case. Bearish for humanity, bullish for the virus, I suppose.
As the Substacker who calls himself Eugyppius - I’ve mentioned him before - explained:
[After the vaccines] then it was Corona’s move, and Delta is the hand it played.
Nothing about how the pandemic plays out now can be disentangled from the vaccination campaign. The more aggressive spread of Delta among the unvaccinated is as much a part of this campaign, as its continued spread among the vaccinated. We have totally changed the environment in which SARS-2 circulates, and in response SARS-2 has become more aggressive across the board.
Eugyppius fears - and I fear he is right - that our current vaccination scheme will drive the rise of more virulent variants.
The vaccine fanatics will argue that the answer is 100 percent vaccination (certainly in the high 90s). But it is hard to see how the United States and other democratic societies can reach those vaccine levels without becoming unrecognizable to themselves. And even if they somehow could, the mRNA vaccines will continue to fail within months.
Near the end of his Stack, Eugyppius offers this warning:
Third and probably even fourth doses will be administered widely in the coming months. Delta-specific vaccines are also in the works. All of these will increase pressure on the virus, very likely in the same direction. These vaccinations will favour more transmissible, more pathogenic strains…
Sounds like a fun winter!
And so the fighters have entered the ring. In one corner, the public health establishment, the best n’ the brightest, with beautifully mapped predictions relayed to you by the sonorous voices of NPR - National Public Radio, whose very name screams trust us.
On the other, a guy who goes by the name of a dead monk.
My money (and the last 18 months) are on the dead monk.
I hope like hell I’m wrong.