April 2, 2021

I’M NOT SAYING THAT DOING THE OPPOSITE OF WHAT ANTHONY FAUCI RECOMMENDS IS ALWAYS THE BEST COURSE, BUT IT’S THE WAY TO BET: U.S. Falls Behind Britain.

In both countries, the number of daily deaths peaked in January—3,352 on Jan. 12 in the U.S. and 1,248 on Jan. 23 in the U.K. Since then, the U.S. count has declined 72%—which sounds impressive until you put it up against Britain’s 96%. U.K. deaths now average 47 a day. The U.S. figure, 938, is 20 times as high in a country less than five times as populous.

Many public-health experts thought the U.S. should take the “one dose is better than none” approach, including Ashish Jha of Brown University, Robert Wachter of the University of California and Christopher Gill of Boston University. Even Michael Osterholm of the University of Minnesota, a member of President Biden’s Covid task force known for speaking his mind, suggested delaying second doses. “We could get more of our over-65 age group vaccinated,” he told the Star Tribune. “I think the data will support that actually is a very effective way to go.”

But Anthony Fauci publicly disagreed. On one occasion, Dr. Fauci warned of “the danger” that could come from focusing on the first dose. And at a Feb. 19 White House briefing Dr. Fauci played down a single-dose study from Israel. White House senior adviser Andy Slavitt chimed in, telling reporters, “We’re not going to be persuaded by one study that happens to grab headlines.”

The Israeli study demonstrated that the first Pfizer dose was 85% effective at two to four weeks. But it isn’t the only study. Moderna’s phase 3 trial included 2,000 people who received only a single injection of either a placebo or the vaccine. In that group, the efficacy of the single vaccine dose was 80% to 90%. A Feb. 17 New England Journal of Medicine letter notes that first doses of Pfizer and Moderna had an extraordinary 92% effectiveness at three to four weeks. The authors concluded: “A scarce supply of vaccine could be maximized by deferring second doses until all priority group members are offered at least one dose.” I agree. Why use half the nation’s vaccine supply to boost immunity by 3% to 15% in the short-term when we could give lifelines to more vulnerable Americans during a vaccine shortage?

But this week, in response to a new Centers for Disease Control and Prevention study showing a first-dose efficacy of 80% at two to four weeks, Dr. Fauci said that it isn’t known whether the protection drops “off a cliff after two weeks or three weeks.” That doesn’t happen with other vaccines. Why dismiss data and real-world U.K. experience with an untested hypothesis?

“Follow the science” except when it means follow a hunch.

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