Monday, August 03, 2020

The Real Surprise is, there won't be an "October Surprise"


Greg Sargent is partly right:

In the end, it’s likely that Trump’s long trail of deliberate uses of the government to bolster his deceptions, agitprop and corrupt designs will itself undo any vaccine Hail Mary. Even if Trump does manage to rush forward such an announcement, why would voters trust him to carry forward the long and complex process to follow in good faith or out of any meaningful conception of what’s in the national interest?

But there are two primary factors working against Trump unveiling an "October surprise," and one is the value of an "October surprise."

1) Timing.

Even announcing the vaccine in October is too late.  If Trump can't announce it now, and back up his announcement with deliveries of vaccine even just to "front-line" workers in just the hardest hit states (14, at current count), it's too late and it's another empty lie.  Trump has trotted those out so fast and furiously (recently denying federal officers were leaving Portland, while claiming "hundreds of thousands" would soon descend on Chicago) now it's impossible to ignore them.  So for a vaccine "October surprise," it's now or never.  He can even proclaim it in September; but if deliveries aren't already on the way, fuggedaboutit.

It's actually not clear even Trump understands that:

While White House officials do not specifically mention the election during the board’s discussions, people familiar with the conversations say they ask regularly about October, a date that hangs over the effort. Trump campaign advisers privately call a pre-election vaccine “the holy grail.”
Reality, however, is a cruel teacher.

Besides, teachers and students aren't going to get it, so what benefit will it really be to Trump?

2)  Efficacy.

It's little remembered now, but Salk pushed hard for his polio vaccine to get to market, even as Sabine moved cautiously to develop his.  If you've forgotten, or never knew, the Salk vaccine was an injection, and was developed from live poliomyelitis bacterium.  The Sabine vaccine used dead polio cells.  Both worked, but the pressure to produce and distribute the vaccine led to a catastrophe:  a lab insufficiently vetted and incapable of meeting requirements, produced vaccine with live polio, and distributed it.  Almost all the children vaccinated got polio, not protection from polio.  That was only one batch, and one time; but it was a horror that could not be repeated.  This is the primary reason vaccines take time to develop and get distributed.  And yet do not doubt the Trump administration prefers not to learn from that example:

Scientists have argued that it would be unwise to cut corners on a vaccine that is to be injected into some 300 million Americans, adding that a failed effort would fuel public distrust of vaccines generally.

But a senior White House official, who discussed the matter on the condition of anonymity, said that it would also be unethical to withhold an effective vaccine for an extra three or four months while more people died just to check the boxes of a more routine trial process.
That was the argument used against Sabine's approach and in favor of Salk's.  But Sabine's vaccine never gave anyone polio.

I'll admit I don't remember who paid for the Sabine vaccine I remember taking on a sugar cube (I'm fairly sure I had the Salk vaccine earlier in my life.  I had a lot of shots.  But nobody was taking chances on polio; belt and suspenders were the order of the day).  I just know it was paid for, and not, I think, by my parents.  The public health need was too great to leave vaccination to those who could pay.  That was a massive effort; it took time to organize and implement.  Even if Trump makes a vacuous claim in October (or September), who is going to see the benefit of it?  Nurses and hospital staff?  Deserving, surely, but what does that do for teachers, school staff, students, parents, grandparents?  Not a damned thing.  Surprisingly, not that many people suddenly change their minds based on promises that have no chance of being fulfilled until months later, if at all.

We need a vaccine; there is no question about it.  But even as it is distributed, the disease will persist. The dangers of contagion still exist until a majority of the world's population can be vaccinated.  The dangers of contagion within cities will persist until a majority of that city's population can be vaccinated, and a majority of the state residents, and a majority of the country.  We have 335 million people in this country, and in 6 months we've still only managed to test less than 10% of them, while our President insists it's our "excellent" testing that makes us think we have so many cases of covid-19.  If he starts bellowing about a vaccine that will save us all, I honestly wonder how many people will even listen.  The problem then is not what his premature announcement would do to the election outcome; it's what it would do to public health.

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