Exiting Covid Requires a Strategic Pivot
This past spring, after enduring a disruptive year of the Covid pandemic, the world looked brighter as state lockdowns and mask mandates ended, many schools returned to in-person classes, restaurants reopened, and sporting events welcomed back fans. We had been promised by our public health agencies that vaccines were our pathway to herd immunity and it appeared that they were delivering on that promise. By the early summer nearly 60% of the U.S. population was fully vaccinated, and of the approximately 40% who were unvaccinated, some health professionals estimated that at least half of those had gained natural immunity from a prior bout with Covid. We were told by governmental bureaucrats that, if you were vaccinated, you were protected and could circulate freely. As we approached the Fourth of July holiday, Americans were beginning to feel safe because with 80% of the population either vaccinated or naturally immunized, it looked like herd immunity was settling in and the long Covid winter was coming to a close.
However, as the summer progressed, that sense of safety was shattered as the Delta variant moved through the population and we experienced a measurable increase in cases, hospitalizations, and deaths. And while the majority of the morbidities and mortalities were among the unvaccinated, there were enough hospitalizations and deaths among the vaccinated to shake the confidence of those who rolled up their sleeves for the shot. A sense of fear had been rekindled among the vaccinated and the danger had a face: it was obviously the unvaccinated who were the culprits.
Governmental bureaucrats quickly labeled the new state of affairs as the “pandemic of the unvaccinated,” and advocated for what they claim is the obvious solution: vaccine mandates. The implicit logic behind this thinking is that, if everyone is vaccinated, the problem would be solved. For those who subscribe to this assertion, the vaccine hesitant—no matter what their reasons—represent a clear and present danger to our social well-being. Their supposed ignorance and selfishness should not be tolerated because the public good trumps personal choice, even though we know that an unusual number of people have died after taking the vaccine or suffered troubling adverse effects. But are the unvaccinated really modern day lepers who are to be feared, ignored, and shunned or are they scapegoats in a narrative that has completely lost touch with reality?
Compelling Data
Nina Pierpont, who holds an MD degree from Johns Hopkins University and a PhD from Princeton University in evolutionary biology, provides insight into this question in a recently published paper that analyzes the results of three key studies on the effectiveness of Covid vaccines.
The first study, which focused on 469 cases from residents of Provincetown, Massachusetts who had attended several public gatherings in July 2021, showed that 74% of the Covid cases occurred in fully vaccinated people at a time when the vaccine coverage among Massachusetts residents was 69%.
The second study involved 900 staff members at a hospital in southern Vietnam, who were fully vaccinated in March and April 2021. As part of the study, PCR tests were administered to the staff in mid-May 2021 and 100% tested negative. However, a month later, when the staff was retested, 53 individuals tested positive for the Delta variant.
Both of these studies are disturbing because, as Pierpont points out, vaccines have two purposes. The first is to protect vaccinated people against a particular illness, and the second is to keep people from carrying the illness and transmitting it to others. While there is evidence that vaccines are serving the first purpose by providing strong protection against severe illness, the Massachusetts and the Vietnam studies raise concerns that the vaccines are missing the mark on the second goal of curbing person-to-person transmission.
The third study is the most illuminating. It involved a large randomly selected sample of households in the U.K. for the period from January through mid-August 2021. Between January and mid-May, Alpha was the dominant strain of the coronavirus. Of the 12,287 cases identified during this time, 88% were among people who were both unvaccinated and who had not had prior infection, 0.5% were from the fully vaccinated, and 0.6% from people who had prior Covid-19 infection. This data shows that, with regard to the Alpha variant, the vaccines were serving their two purposes. The vaccinated were protected and they were not carrying nor transmitting the illness. The data also shows that natural immunity was highly effective in preventing the acquisition and the transmission of the disease.
However, after mid-June, when 92% of Covid cases in the U.K. were from the Delta variant, the results were strikingly different. Of the 1,939 cases identified during the Delta-dominant period, 17% were from unvaccinated people without prior Covid infection, only 1% were from unvaccinated people who had prior infection, and 82% were fully vaccinated. Unlike the Alpha-dominant period, the percentage of Covid cases of vaccinated people in the Delta-dominant period was similar to the percentage of the vaccinated among the U.K. population. This is a significant finding.
As Pierpont points out, “To go from 0.5% of randomly sampled new infections in vaccinated people (under Alpha) to 82% (under Delta) in several months, as the population is becoming more and more vaccinated—these are extraordinary numbers.” She goes on to say, “If 82% of randomly obtained positive tests occur in vaccinated people, and about 82% of people are vaccinated, then vaccination is not reducing the likelihood of infection at all. Efficacy at preventing infection has become zero.” In other words, the extensive data coming from the U.K. study provides compelling scientific evidence that Covid-19 vaccine mandates are pointless because the current approved vaccines are useless in keeping people from catching the Delta variant and passing it on to others.
A False Narrative
Despite their assurances that they are following the science and that questioning them is questioning science, the mental model that has been crafted by the governmental bureaucrats and used to guide their policies doesn’t make sense. The only reason that could justify the use of coercive tactics by government bureaucrats to move a population toward universal vaccination is that the vaccines are highly effective in meeting the two objectives of providing individual protection and preventing person-to-person transmission. However, the evidence indicates that the vaccinated and the unvaccinated are highly likely to have equal chances of contracting and spreading the Delta variant. In other words, if the government bureaucrats were successful in getting every single person in the population fully vaccinated, it would not necessarily end the Delta variant. This certainly seems to be the recent experience in Israel—one of the most fully vaccinated countries on the planet—where the number of Delta cases has been exploding.
Calling this a pandemic of the unvaccinated is a false narrative employed by government bureaucrats and their private sector allies to sustain a failed strategy designed for a world as they would like it to be rather than for the world as it actually works. What we are seeing is the classic behavior of bureaucratic leaders who are overly invested in a particular outcome. To continue to believe that the three approved vaccines are our pathway out of this pandemic is as senseless as Kodak believing that photography would always involve film, Blockbuster insisting that late fees were the foundation for a sustainable business model, and the Digital Equipment Corporation (DEC) insisting that there would never be a need for computers in the home. The leaders of each of these once great enterprises enabled their failures because they could not adapt their strategies. They remained fully invested in the world as they wanted it to be rather than in the world as it actually worked.
The virus, on the other hand, has made no such investment. It is winning over the vaccines because it is adaptable and has changed its strategy for survival. Ironically, the bureaucrats have made the virus’s job easy by designing vaccines around one particular characteristic of Covid-19: the spike protein. Unlike traditional vaccines, which inject a weakened or dead version of the whole virus, the novel technology in the mRNA vaccines enables the recipient’s cells to produce a replica of a small part of the original version of Covid-19 to generate the antibodies needed to fight off the virus when they recognize the targeted part. However, through the process of evolutionary selection, the Delta variant became dominant because it found a way to adapt this part so it wouldn’t be recognized by the antibodies, neutralizing the vaccine’s power to inhibit the transmission of the virus.
This evolutionary process has been driven by the vaccinated, not the unvaccinated. That’s because those unvaccinated people who did not have the benefit of natural immunity continued to be susceptible to the earlier versions of the virus, thus, there was no need for the virus to adapt. It was the vaccinated who created the circumstances that required the virus to adapt to sustain itself. Once that adaptation was made, the virus now had the freedom to infect the vaccinated as well as those unvaccinated who lacked natural immunity. Remarkably, because of the low incidence of Delta among those in the U.K. study who had been previously infected, the much ignored natural immunity appears to be as effective against Delta as it is against Alpha. Clearly, the unvaccinated have been made into scapegoats to reinforce the groupthink of a failed strategy. But more importantly, contrary to the groupthink, vaccine mandates won’t solve the problem.
Accepting Reality
One of the problems with bureaucratic leaders who employ command-and-control tactics is that they find it difficult, if not impossible, to admit when their strategies have failed. Instead, as happened with Kodak, Blockbuster, and DEC, they can get locked into mindsets that spell their demise as they demonstrate the much quoted adage, “Insanity is doing the same thing over and over again, but expecting different results.” When in this mindset, bureaucrats can become trapped into unconscious confirmation bias as they amplify information consistent with their point of view and dismiss or even avoid the collection of data that might challenge the logic of their strategy. This seems to be the case with the governmental bureaucrats who make little distinction between deaths with Covid and deaths from Covid, create a cumbersome system that requires an arduous effort to report adverse vaccine reactions, actively discourage the proactive investigation of promising off-label generic treatments, refuse to acknowledge the superior effectiveness of natural immunity, and partner with social media companies to censor any information that does not support their entrenched biases. The last is most disturbing because there are numerous medical professionals who do not agree with the official vaccine strategy who want to speak out but have been silenced for fear of losing their jobs. That’s bureaucracy at its worst.
However, as happened with Kodak, Blockbuster, and DEC, reality always wins. A false narrative eventually succumbs to the evidence of data. That’s why, as Billy Bean learned in using the Moneyball strategy to build baseball teams, smart leaders trust the evidence of data over the opinions of experts. Experts are human and are not immune from being trapped by unconscious biases when they are overly invested in a particular outcome.
The key observation from Pierpont’s paper that, despite the best of intentions, the current approved vaccines are not inhibiting the spread of the Delta variant can no longer be ignored. It’s time to accept reality as it is and make a fundamental change in our strategy to win against Covid.
Accepting reality means coming to terms with the high probability that Covid is never going away and that, like colds and flu, it’s something we will have to learn to live with. If it hasn’t already, it will eventually move from a pandemic to an endemic. And it is likely to become an endemic not of the unvaccinated, but of the unhealthy. The overwhelming majority of Covid deaths are attributable to people who have co-morbidities and weakened immune systems.
With this in mind, we need to focus the population on different metrics. Up until now, we have been riveted on Covid outcome measures: number of cases, number of hospitalizations, and number of deaths. While it is important to measure outcomes to know whether we are winning or losing against the virus, these measures are not helpful in managing the problem. Helpful measures are leading indicators that let you know what you need to do now to reduce or eliminate unwelcome outcomes later. In the case of Covid, three measures have emerged as likely candidates: the level of Vitamin D, Body Mass Index (BMI), and the number of co-morbidities. If these measures are all favorable, chances are your risk of an adverse reaction to Covid is extremely low. On the other hand, if one or more of these measures are unfavorable, your risk may be significant. If we had shifted our focus to these measures 18 months ago when the pandemic began, we could have given people tools to proactively diminish their risk to this novel virus by managing their Vitamin D and BMI and working with their doctors to do everything possible to diminish or possibly eliminate their co-morbidities. Rather than propagating a fearful sense that we are all potential passive victims, our public health agencies could have provided us with a sense of hope by encouraging us to proactively take charge of our health.
Accepting reality also means acknowledging and exploring two observations that remain stubbornly hidden in plain sight: natural immunity is highly effective and early treatment with repurposed drugs shows significant promise. It’s time to stop the censorship of those who think differently, especially the multitude of highly educated medical and scientific professionals whose alternative mental models make more sense because they better align with the way the world is actually working.
It’s Time to Make a Strategic Pivot
It’s time to seriously consider the strategic framework presented in the Great Barrington Declaration, which was proposed in October 2020 by three public health scientists from Harvard, Oxford, and Stanford Universities and has been signed by over 59,000 medical and public health professionals. In managing the population, this approach advocates for a focused protection of those who are at high risk for Covid and complete freedom of movement of those who are at low risk.
Protecting the high risk means minimizing their exposure to the general population and making a serious investment in the existing promising therapeutics whose application in the first days of the onset of the disease could greatly reduce both the number of hospitalizations and the number of deaths. Free movement of the low risk population is likely to accomplish the herd immunity that has eluded the novel biogenetic vaccines.
When the data shows that vaccines don’t stop person-to-person transmission of the Delta variant and that you are no safer in a crowd of fully vaccinated people than you are in the general population, there is no rational basis for either vaccine mandates or passports. Just because it’s easier to prove who has been vaccinated than who has innate or acquired natural immunity doesn’t make proof of vaccination a valid measure of safety. This is another mistake that bureaucrats make that often leads to poor choices and bad strategy: they track what’s easer to measure rather than what’s important to measure. Vaccination is a means; immunization is the end. It’s immunization—no matter how it is acquired—that matters most. A rational strategy focuses on what’s important, not what’s easy.
The fact that a strategy doesn’t work is not necessarily a strategic failure. Strategies are designed for particular circumstances and circumstances can change as we have seen with the novel vaccines and the Delta variant. Strategic failure happens when we become overly invested in a particular outcome that isn’t working and refuse to recognize we need to make a strategic pivot. When Alpha was the dominant strain, the vaccine strategy was accomplishing the mission, but when the virus successfully adapted into the Delta variant, the tables were turned. As the virus has adapted, so must we. We need to make a strategic pivot because doing more of the same and expecting a different result really is insanity.