COVID risk perception in 2021
Let's run some numbers and discover how COVID risk changed from 2020 to 2021
A vaccinated elder in Germany is 9x less likely of dying of COVID than if he were unvaccinated, and yet only 46% less likely of dying of COVID compared to one year ago (source).
Yesterday, I read that daily COVID deaths in Germany reached about the same level as one year ago (192 vs 204), and I wondered: isn’t it strange? After all, this year we have a vaccine we didn’t have last year, so why didn’t deaths decrease?
So, I decided to dig deeper.
Germany has more than 4 times as many cases as it had one year ago. Even though vaccines decrease the chances that someone catching the virus dies of it, more cases means that one is more likely of catching it. The result is what I wrote above: a vaccinated elder in Germany is 9x less likely of dying of COVID than if he were unvaccinated, and yet only 46% less likely of dying of COVID compared to one year ago.
This gets worse if you’re not vaccinated. The average unvaccinated adult German (18-59 years old) is THREE TIMES more likely of dying of COVID today than he was one year ago.
And a vaccinated German is more than twice as likely of dying of COVID today than a vaccinated Italian. (The same holds true when comparing unvaccinated.)
Spread matters.
What herd immunity?
The last paragraph above is particularly shocking if we think about herd immunity. 70% of Germans are fully vaccinated; shouldn’t this protect the unvaccinated? Yes and no.
Yes, meaning that of course things are relatively better than if no one vaccinated.
No, meaning that in absolute, the virus spreaded too much, and the net effect of the spread is larger than the net effect of the herd immunity. The unprotected are more at risk than ever. Those who said that herd immunity would protect the unprotected regardless of spread were wrong.
What about countries other than Germany?
So far, I only presented data regarding Germany. Things get better or worse depending on the country considered.
For example, in Bulgaria, things get worse. The average vaccinated is only 9% less likely to die of COVID compared to one year ago. That’s because only 24% of the population is vaccinated, and the virus spreaded a lot since 2020.
Instead, in Italy, things get better. The average vaccinated is 94% less likely to die of COVID compared to one year ago, and the average unvaccinated is also 78% less likely to die of COVID compared to one year ago. Herd immunity works when paired to a curb in cases.
Of course, things are more complex than apparent. Herd immunity both influences and is influenced by spread, for example. Still, the following principle holds: equal vaccination situations will produce different risk results depending on the local viral spread.
This means that we cannot just take data from one country and port it to another. Context matters. How much the virus is present in a country influences outcomes. A vaccinated person in one country might be more at risk than a vaccinated in another country.
As another example, why could Sweden afford to survive relatively well without major lockdowns while Italy had to close down for weeks to avoid an ecatomb? Most probably, because there was more virus circulating in Italy than in Sweden to begin with. Local spread matters. One cannot just say, “Sweden got it relatively good without restrictions, so other countries should adopt the same approach.” Some probably should, and others probably shouldn’t. Local spread matters.
Risk perception
I wrote this article because I’m under the impression that, in 2021, most people have the idea that, especially if they’re vaccinated, they’re less at risk of dying of COVID than they were one year ago. And they might be right or wrong, depending on the country they live in. This last point is critical, and often missed by our globalized media, and by countries imitating each other’s policies regardless of local context.
It’s both important that people who live in countries with low spread know that their individual risk decreased compared to 2020 and that those who live in countries with high spread know that their individual risk increased. I urge everyone to run the numbers for the country they live in, to know their true risk and act accordingly. Some will discover they’ve overestimated their individual risk, and others that they underestimated it.
The second implication is that the individual risk of dying of COVID is affected not just by vaccinations but also by viral spread (also, it’s spread and not vaccinations that cause variants, and variants such as delta are at partially responsible for the increase in risk) and other factors. Hence, why “COVID will become endemic anyway” isn’t a valid argument to justify dropping all precautions. Two equal countries with endemic COVID, one with X cases per year, and one with 10X cases per year, will have two very different outcomes. Local spread matters.