Back in late February I made a bet with a friend for $101.52 that within 3 years at least 50 million Americans would have the coronavirus. This was at a time when there were 15 confirmed cases in the US. My best guess presently, based off the antibody surveys researchers have done in various US cities, is that so far 22 million Americans have ever had coronavirus. So, there is a lot of confusion and unknowns in the short term, and I havent won yet, but unfortunately it looks like I am on my way to winning my bet.
As I write this, the economy has been in lock down for 2.5 months, and everyone seems to feel like we are on the eve of opening up and returning to our previous lives. Indeed, some people seem to think that we beat the virus entirely. However, when I look at the trends and the number of new cases, I dont see the virus on the brink. I see it at least patiently waiting for us to come back outside, if not growing even under the current lock down measures.
Two weeks ago I made a second bet for $119, with my fellow Arizonan hacker and facebook friend Ryan McDermott, that we wont be seeing any treatment or vaccine for the coronavirus. Of course, that would be very good if there were a treatment, but focusing on just the facts, my expectation is that we wont be seeing anything like that soon. Our bet was born from discussions about the plausibility of a vaccine, which lead to us wanting to bet on it. We realized that there are lots of hypothetical vaccine-like immunity-granting treatments that arent technically vaccines and we really wanted to include those in the spirit of the bet. We dont want anyone winning on a technicality.
And, before we get any further into the meat of this post I want to say Thanks to Ryan. I think both of us admire the incentive to think carefully and stick to what you think is true, and not just run your mouth; for us betting embodies that. Thanks Ryan.
We came up with these exact terms:
There will NOT be a treatment for Covid 19 in the next 1.5 years that meets the following conditions:
- It is used by at least 10% of the US population
- It is at least 80% effective at granting immunity to Covid 19
- It induces side effects that are below 25% as bad as catching Covid 19
So, if such a treatment does not exist in 1.5 years, then I win. (Coming up with terms, by the way, is half the fun of betting; it means forcing yourself to be exact and objective about what it is you are thinking about to begin with. It is always a delight to see your own understanding evolve and change under the pressure of wanting to win a bet.) Below I would like to spell out why I think I will win.
My big reason for thinking there will not be such a treatment in such a time period is that no vaccine has ever been developed that fast. Like a lot of things, I could be wrong, but as far as I know, a vaccine has never been made so quickly. As far as I know, the fastest turn around time from outbreak to vaccine is 4 years for Mumps. So, given that context, a coronavirus vaccine in 1.5 years would be super exceptional. And of course most things, by definition, are not exceptional. You would need exceptional reasons to think the coronavirus vaccine would show up so quickly and I just havent seen an exceptional reason yet.
Below I will try and address what seem to be common reactions and counter-arguments to my position.
HIV is a big counter example. HIV kills about half a million people each year, and it used to be worse. Theres been a lot of effort to find a vaccine, all the way up until today with all our modern technology. And, it is still a problem. Hepatitus C, also deadly, also old. Herpes isnt deadly, but that is another virus that we just live with and desire a treatment for.
You dont have to tell me how bad the coronavirus is. I have a hard time convincing anyone its as bad as I think it is. But, when I look at the grand scheme of things, it doesnt seem worse than other viruses we have had to live with. HIV and Hepatitus C are both pretty deadly. Humanity used to just live with Measles for hundreds of years. Virtually everyone used to get Measles by the age of 15, and it was more deadly than the coronavirus. Besides, I just dont see this badness / solution correlaton that many people seem to subscribe to.
Yeah, but its not really one year of development from flu strain to vaccine. They do some tricks pull of a new flu vaccine each year. Firstly, there are many unique flu strains and unique vaccines are developed for each of them independently. The annual flu vaccine is a cocktail of various existing vaccines, none of which, as far as I know were developed within 4 years. Secondly, the flu vaccine is surprisingly ineffective (at least I was surprised to learn this). Every year public health experts have to plan for the next years flu season, which basically entails taking a good guess as to which flu strains will be a problem and then shipping out a vaccine for those strains. But you know, its a gamble which strains will be prevalent and which ones you will catch and they dont always have vaccines for every strain. Between all those variables the annual flu vaccine is only 30%-50% effective at protecting you from a flu virus.
That suggests that it is possible invent such a vaccine. But, it not just a question of the possibility, but will it happen in the time period in question.
Yes, I think there is a lot of promise to new alternative treatments that are not vaccines. Convalescent sera, where they transfer antibodies from one person to another. Innoculation, where you are deliberately infected but with a safely small dose. I have heard fun ideas about just manufacturing antibodies and putting them into people. There probably is some kind of undiscovered treatment that works very well, we just dont know what it is. Could we find these new undiscovered treatments? Yes, I think its possible, but the important question is if it will happen, and not if it could happen. The fact is, we dont go out of our way to find such treatments. I could imagine it takes a lot of fresh thinking and daring R&D and violating the FDA's rules. All perfectly realistic and possible. But, society and the process that goes into making treatments is just not a feature of who we are and we arent going to evolve into different kind of people overnight. So, since our track record is not doing those things, despite the ability to, I can only expect that we will keep going on that path for the near term.