“In the long run, we are all dead” John Maynard Keynes
Rewind your memories to August of last year (2020). The Oxford group have just published a landmark report, ChAdOx1 nCoV-19 vaccine against SARS-CoV-2 (20th July in Lancet). For the planet that was reeling under Covid 19, it was a rare piece of good news.
Vaccines and Side Effects
Fast-forward a year, and the world has a few more candidates, and everyone expects vaccination to start in full steam. But the excitement has partly given way to confusion and scepticism. The news of rare blood clots dominated the news, governments gave conflicting guidance, and the public was puzzled. And the anti-vaxxers got more ammunition for their kitty.
Perceptions of Risk in Life
Life is not risk-free. Let us start with the birth of a person: the chance of a child dying at birth in the US is 6 in 1000, 28 in India, 2 in Japan, etc. Once you survive that risky event, you get a 5 in a million chance of dying from murder, 100 in a million in road accidents, and 170 in a million pregnancy-related (all in the US). That, too, without considering the leading causes of death, namely heart disease and cancer. Does that prevent anyone from giving birth or travelling by road?
The Life of Trade-Offs
Consider this: 740,000 of the total 330 million population are dead in the US (as of today, 28/10/2021) due to COVID-19. It is not clear what proportion of the total population was infected. In other words, 0.74 in 330 (0.2 % or 2 in thousand) is a reasonable estimate of the risk of dying due to COVID-19. A similar calculation for India is 3 million deaths (from the median estimate for excess deaths in 2020-21, from various scientific assessments such as the one by Deshmukh et al., MedRxiv) of the total 1400 mln population. The ratio comes out to be 0.21%. A similar estimate for the UK is 140,000 (official count as of today) out of a population of 67 million, also 0.2%. Brazil is 0.28%, and the list goes on. Note that this represents the average risk of dying from COVID-19 (averaged over age, incident rate, comorbidities, suggesting that the case fatality ratio can only be higher).
[in fact, 0.2% seems so powerful that it is a good measure of identifying “cheaters” in this pandemic!]
Now, what is the chance of dying due to vaccination? Based on various studies, it is about 1 in a million, slightly more than being struck by lightning in a given year in the US (1 in 1,222,000). So the comparison is between 2 in a thousand and 1 in a million. Or, it is a comparison between 2000 and 1. That is the trade-off you must make. What will you do?
And that is where we humans sometimes lose perspective.
PS: The author and his family are happy recipients of the ChAdOx1 nCoV-19 vaccine.
Further Reading
[1] Johns Hopkins University (JHU) dashboard
[2] Excess mortality in India: MedRxiv
[3] Vaccine and Deaths: Australian Academy of Science
