Did the CDC favor social-justice optics over American lives?

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Painfully stupid decision if true. Not only because of it’s most immediate consequences in terms of human lives, but also because of the optics feed straight into the extreme left vs extreme right political polarization we’ve seen so much of lately.

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Not sure if this is part of the reasoning, but an 85 year old has an actuarial life expectancy of ~6y, versus ~48y for a 30 year old. So if the goal is maximizing the years of life saved rather than the number…

None of this is particularly pleasant to think about, and often there are no good options and many hidden problems. Then again, if this was part of the reasoning, they really should have explained that. Because the rationale as presented in the original presentation is more dubious.

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DeSantis, the governor of FL, who has previously made some terrible decisions, has reversed the order for over 65 to be among the first to receive the vaccine.

If the goal was maximising the number of years of life saved then I expect it would still come out in favour of prioritising the elderly, because even though they have fewer years remaining the save, they’re much more likely to be saved by a vaccine than a 30 year old, as mortality from the virus is so radically different in the different age groups.

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The issue is complicated by the fact that younger people tend to be more social, making it more likely that the virus would be spread by younger people.

That’s the odds of death given infection, that is:

p(mortality|exposure,>65) > p(mortality|exposure,<65)

Then again, the elderly are at much lower risk of infection, so most of the vaccinated elderly would never be exposed to covid anyway. On the other hand, the younger group has significantly higher infection risks. So we actually need to determine if:

years*p(exposure,mortality|>65) > years*p(exposure,mortality|<65)

I don’t know how that math shakes out, and I’m inclined to think that vaccination by age in 5 year increments starting with those over 80 would be the best strategy. But again, I don’t know and I recognize the complexity of the issue. I just wish the people at the CDC had presented that complexity, rather than the mess they did.

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Anyone with HIPPA training should have an understanding of why equity and justice are valid considerations for vaccine allocation. I can also see where vaccinating essential workers who cannot quarantine might be the best way to slow the infection rate, and might ultimately save more lives than prioritizing the most vulnerable.

I’d go with a reasonable policy that is easy to implement and gets the vaccine to people quickly, over one that requires complex judgements.

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