Mirage of Health

My personal update is that I'm recovering day by day, but it's taking a while. I get a little stronger, a little more stamina each day and I expect to get back to my previous full strength in time to put in a solid week of work starting Monday. Meanwhile a little down time isn't the worse thing that could have happened.

I've gotten some very odd comments which show that some people harbor very basic misunderstandings about heath, illness and medicine. As I have noted here many times, medical intervention was largely ineffective until the 20th Century. It has grown more effective over the past 100+ years, but you need to keep in mind some important reservations. I'll list some of the most important:

Erratic progress, blind alleys, and big mistakes: Progress has been very far from straightforward. We tend to remember the sudden and dramatic solutions to long-term scourges: penicillin, the polio vaccine, insulin. (The latter not a cure, of course.) But the past 100 years is better characterized by long periods of futility throwing money and effort against problems; entrenched practices that turned out to be useless or even harmful after decades of being the standard of care; false breakthroughs such as bone marrow transplant for breast cancer; and fundamentally wrong theories, such as gastric ulcers having a psychological cause. (They're actually an infectious disease.) Over time, many such mistakes were recognized and rectified, and medical intervention has continued to become incrementally safer and beneficial, but . . . 

Heterogeneity of treatment effect: Even many usually efficacious treatments have highly variable effectiveness, for many reasons. People metabolize drugs differently, disease processes may be similar enough to warrant a common intervention but not really identical, people's underlying constitution or immune systems vary, an empirical diagnosis may turn out not to be entirely correct, pathogens may be treatment resistant, and more. 

In the case of the Covid-19 vaccines, they are advertised as having some percentage of effectiveness against severe disease or death. What this means is a bit tricky. Let's say a comparable unvaccinated person who is exposed has a 10% chance of "severe disease," which is usually defined as requiring hospitalization. Eighty percent effectiveness means that if you're vaccinated, your chance is now 2%. 

This is pretty fuzzy obviously. I can't know for sure what my prior probability was exactly, deciding whether somebody needs to be hospitalized is a judgment call, and I might feel pretty damn severely sick without going into the hospital. (I did, in fact.) Still, there is a very strong presumption that if I hadn't been vaccinated and boosted, I would have ended up a lot sicker. Nevertheless, you can't expect medical care to assure that you'll feel perfectly health and be cured of everything and never have adverse effects or treatment failure. All that will happen, it's a matter of trade offs.

Social determinants of health: While medicine has become more effective, it still doesn't account for most of people's condition of health and longevity. The genetic lottery obviously has something to do with it, and of course we lose ground with age. The latter, however, is a matter of degree that is greatly affected by our life circumstances and experiences. Psycho-social stress, nutrition, living conditions, education, air pollution, smoking and drinking and other drug habits, physical activity, social support -- all these and more are more important to our health than the medical care we receive. In fact a lot of what medicine does is fix problems after the fact that never needed to happen in the first place. So a lot of our massive investment in medical intervention is misdirected.

All that said, get your vaccinations and boosters! Don't be a fucking idiot! There are no significant risks of adverse effects. If you're worried about Bill Gates tracking you, he already is. It's absolutely 100% free to everybody, you don't even need to have Commie health insurance. Yeah I got sick but I might be dead, which I am pleased to say I am not. So do it for yourself and people who care about you, assuming you care about them.