The right of no-vaxes versus the right of all – Lavoce.info

The consequences of the right to choose

The no-vax workhorse – the fundamental principle to which they appeal – is that the right of every single person to choose whether to get vaccinated or not cannot be questioned.

But, numbers in hand, it is immediate to show that, although the unvaccinated represent only 14.6 per cent of the population over 12 years old, their choice already has consequences for the stability of the health system. Consequences that are plausibly destined to worsen within a few weeks. In other words, their right to choose conflicts – in fact, not in theory – with everyone’s right to have a functioning health system.

ICUs are the front line of the health system. Patients are hospitalized there who could not survive elsewhere, as the acute illnesses they suffer from put their lives at risk. It is not surprising that since the beginning of the Covid-19 crisis, attention has been very high above all on the maintenance of these departments, essential for the survival of people affected by the virus in an acute form as well as that of people suffering from other diseases. Taken from the latest update of the Higher Institute of Health, row 2 of table 1 shows the number of admissions to intensive care units, broken down by vaccination status, over the period 8 October-7 November. Line 3 shows the entry rate (per one hundred thousand inhabitants) by age group, observed on the unvaccinated (it is the ratio between line 2 and line 1, multiplied by 100 thousand). For comparison, row 4 reports the rate of entry into intensive care (per one hundred thousand inhabitants) observed on full-cycle vaccinees.

The columns from the second to the fifth of the row show the number of ICU admissions that would have been observed on the unvaccinated if they had been vaccinated: it is obtained by applying to the number of unvaccinated in row 1 the ICU admission rate of the vaccinated in row 4.

If everyone had been vaccinated, in the month under consideration we would have had 260 admissions to intensive care instead of the 662 actually observed: 60 percent less. Moreover, if the unvaccinated had been vaccinated, the circulation of the virus would have been lower, so that the rate of entry into intensive care of the vaccinated would also have been lower. Therefore, in the “all vaccinated” scenario, the number of ICU admissions would probably have been less than 260.

The return of the exponential

Figure 1 shows the daily trend of the total number of people admitted to intensive care starting from 1 November. The vertical axis is on a logarithmic scale: the good adaptation to the data of the interpolating line means that the total number of patients admitted to intensive care grows according to an exponential law. Nothing new: it is the law that governs the growth of all the numbers of Covid-19, in operation since the end of February 2020. The slope of the interpolating line corresponds to a doubling time of the total number of hospitalized in intensive care equal to approximately 38 days. For the record, last year on the same date the doubling time was about 20 days.

Using this doubling time, column 2 of table 2 reports the progression of the number of ICU patients between 38, 76 and 114 days, starting with the number inpatients in that ward on 21 November (520). These numbers are obtained under the assumption that they remain unchanged:

• the number of vaccinated and unvaccinated
• the ICU admission rate of vaccinated and unvaccinated
• the doubling time, that is, the speed of spread of the infection
• the containment measures of the contagion, to date those envisaged in the white area.

In this scenario, already at Christmas the number of people in intensive care would exceed one thousand; at Carnival we would be over two thousand; as of March 15, the number of people admitted to intensive care would be 4,160, almost equal to the maximum reached in the previous three waves.

Column 3 of Table 2 reports the progression we would have if everyone were vaccinated. It is obtained by reducing by 60 percent the number of people admitted to intensive care as of 11/21: this is the reduction factor seen above for admissions to intensive care in the period 8 / 10-7 / 11. For the same length of stay in intensive care, the same reduction factor also applies to the total number of patients hospitalized in the ward. Applying the same doubling time of 38 days to this initial condition – 208 ICU patients – progression in column 3 is achieved.

The effect of the (hypothetical) vaccination of unvaccinated people on the trend over time is clear: in the “all vaccinated” scenario, we would reach the threshold of spring with a high number of hospitalized in intensive care – 1,664 – but much lower than the maximum reached in the past twenty months and, above all, compatible with the tightness of the system.

It may seem counterintuitive that a relatively small number of unvaccinated people make all this difference – after all, they are only 14.6 percent of the 12+ population. But the explanation is simple:

• the unvaccinated have rates of entry into intensive care much higher than the vaccinated: 7.3 times higher among the 80+, up to 30 times higher in the younger groups (see table 1).
• the large difference in ICU admission rates gives rise to very different initial conditions in the two scenarios: the number of ICU admissions observed as of 11/21 is well over double the number we would have had at the same date if all had been vaccinated.
• the difference in the initial conditions combined with the exponential growth trend gives rise to the outcomes documented in table 2.

The right to choose freely invoked by the no-vaxes has a price: it concretely jeopardizes the right of all to have a functioning health system. In particular, it risks reopening the crisis of the first line of the health system, intensive care: the crux of the system that makes the difference between living and dying.