"Christie Aschwanden is a science journalist in Cedaredge, Colorado." This is not by an epidemiologist.
It looks like Israel will be the first country to hit a very high vaccination level. 55.4 percent of Israelis have received the first dose of the coronavirus vaccine. Over 70% of old people. The government is pushing hard on this.
Pfizer says they're seeing 97% vaccine effectiveness at preventing illness.
Israel cut a deal with Pfizer to get priority on vaccine shipments in exchange for sending extensive data on how it is working back to Pfizer.[1] So Israel has more than enough vaccine for their population.
Already, Israel's coronavirus death rate is down to 0.15 deaths/day/100K people. It was 0.72 back in January.
So watch Israel to see what happens when the vaccination percentage gets to a high level.
First and foremost SARS-CoV-2 will never go away because it infects animals. Because it is so infectious, it will go through an entire herd or farm within days and eventually cause mutations and jump back to humans. So it will never go away and we need to prepare for it.
The main goal is to make it survivable, ie. akin to the flu, and not cause hospitals to get overrun like we have seen so many times around the world in the last year.
> Because it is so infectious, it will go through an entire herd or farm within days and eventually cause mutations and jump back to humans. So it will never go away and we need to prepare for it.
This is also one of the main mechanisms for antibiotic resistance in bacteria that infect humans[1].
COVID infections can give way to opportunistic bacterial pneumonia infections, which can have a 20% - 37% mortality rate[1]. Many pneumonia-causing strains of bacteria are antibiotic resistant[2], and being on a ventilator raises the risks of developing severe pneumonia[2]. Ventilator-associated pneumonia is more likely to be caused by antibiotic-resistant bacteria[2].
2: One of the problems a lot of people see barring the use of bacteriophage therapy for combating bacterial infection in the clinic is the really fine specificity of most phages to their hosts. The skeptics will suggest that you'd need to essentially design a new phage therapy for each individual infection.
With the advances we're seeing in microfluidics, diagnostics, gene sequencing, computational biology, laboratory automation, and the theory of precision medicine, that host specificity can turn from a disadvantage to an advantage. We know there are a lot of human-dwelling bacteria we wouldn't want to knock but can't save from a broad-spectrum treatment. With a personalized phage therapy, this isn't as much of a concern.
Bacterial infections are less transmissible than viruses.
Diseases like the bubonic plague require a carrier such as fleas to infect humans in mass, while antibiotic resistance can be an issue with sanitary practices it’s far easier to contain bacterial pathogens than airborne viruses.
Rabies infects animals and it's been eliminated from large parts of the world. Vaccinating animals is sometimes an optoin.
Not saying this is comparable, or that SARS-COV2 will be eliminated in a similar way. I think it's currently unclear what will be possible, but in the medium to long-term there are a lot of options to be explored. I wouldn't put elimination in the "impossible" bucket just yet.
What's the infection rate for rabies? COVID is transmissible via respiratory droplets, while rabies requires direct contact through broken skin or mucus membranes, or eating infected tissues.
The other part of this is that it can't be contained, either. Very recently, Auckland had a lockdown because of community spread. It could be from animals, or it could be a handful of 1% events happening, but New Zealand tried really hard to prevent this and wasn't able to.
Like that article suggests, it's likely that we'll have to learn to live with it. The interesting, open question right now is how various mitigation measures, everything from quarantines, masks, work from home, lockdowns, vaccines, will impact the evolution of the virus.
Minks have already been a problem leading to Denmark culling 17 million of them alone, with the problem being present in several other countries[0].
The virus is tearing through the farms[1]:
> In Denmark, the world’s largest producer of mink pelts, authorities are struggling to control farm outbreaks, despite extensive control measures. In many affected farms, almost all animals have antibodies against the virus.
It's mutating and jumping back to people[1]:
> Fonager says researchers in Denmark have sequenced viral samples from 40 mink farms and identified some 170 coronavirus variants. He adds that in viral samples from people — representing about one-fifth of the country’s total COVID confirmed cases — they’ve found some 300 people with variants that contain mutations thought to have first emerged in mink.
> [...]
> One mink-associated mutation has spread more widely in people. The mutation, Y453F, also encodes an amino acid change in the spike protein and has been found in about 300 sequences from people in Denmark, as well as sequences from mink and people in the Netherlands. An experimental study suggests that virus variants with the Y453F mutation partially escaped detection by a commercial monoclonal antibody.
Like most things SARS-CoV-2 right now, we don't exactly have a rigorous academic study. Just rumblings. But so far there's some evidence pointing this direction.
> The culling of the Mink Farms in Denmark should be evidence enough that it can travel through animals.
Not that I think you're wrong, but that's circular logic. "Minks were culled because it can travel through animals. Minks being culled is evidence it can travel through animals."
All the covid restrictions we've put in place have turned this flu season extremely mild. Meanwhile, we've seen far more COVID cases than flu cases.
I don't think it's a great leap to say "COVID is far more infectious than the flu" and it's not a great leap to say "The flu is a very infectious disease".
(I say all this knowing that the flu is several types of coronaviruses.)
> The main goal is to make it survivable, ie. akin to the flu, and not cause hospitals to get overrun like we have seen so many times around the world in the last year.
There is a secondary main goal, one that the world should have learned after SARS v1, MERS, or the swine flu: get rid of the conditions that infectious agents need to spread. There's a reason that pandemic events have exploded over the last two decades: we have way too many animals and humans in way too shitty conditions. This means, list not exhaustive:
- end mass farming of animals in conditions that require feeding them with reserve antibiotics, washing meat with chlorine or washing eggs in order to keep the produce at least somewhat safe to serve. Farm animals of all kind (meat, eggs, milk, fur) need space and quality food (thankfully we got... mostly rid of feeding carcasses after BSE). *Keeping the status quo is only going to serve us yet another pandemic*!
- end or massively restrict shipping around animals and animal products across the world to prevent the spread of diseases (like the African Swine Pest/Fever currently making its way across Europe, after wiping out the Chinese pig farms).
- generally, reduce the amount of meat in diets. The less animals are farmed for meat, the lower the risk that some bug jumps species.
- end mass working of people in conditions that are beneficial to spreading of infections agents: enough space, enough closed off space (=ban "open floor" and "cubicle farm" setups), mandatory sick leave, no exceptions, and a mandatory send-home order for employees showing symptoms of respiratory illness. It's not good if someone is forced to come into the office or a restaurant despite having a cough. Also, unsanitary conditions for worker accomodations should be banned (e.g. no "pack 10 dudes into a 8 m² room" as it's way too common on farms). Also, to reduce stress (and thus, increase immune system strength), work hours / weeks should be drastically cut: 4 or 6 hours a day, and four days a week.
- drastically reduce unnecessary traveling across the world. This includes a full ban of cruise ships (who have been often enough in the news as sailing norovirus incubators, not to mention their climate impact), but also incentivizing companies to use videocalls and electronic signatures in favor of flying staff across the oceans just to sign a contract and other similar absurdities.
Most of what I've listed should not only be done as pandemic prevention, but also to protect the climate. I know most of it sounds either expensive or "revolt provoking", yet there is no other scientifically viable choice.
This is a lot less depressing when you consider that vaccines have shown astounding results so far at preventing disease. COVID is a lot less scary if you’re extremely unlikely to get very sick from it. This article touches on that a bit, but it’s buried until the end.
There’s a lot of optimism to be had here, I think. Let’s not let perfect be the enemy of good — maybe we can’t eradicate COVID, but we can make it a lot more tolerable to share this planet with it.
>This is a lot less depressing when you consider that vaccines have shown astounding results so far at preventing disease.
I'm less convinced by the common narrative. It appears that sanitation and nutrition played a key role in preventing diseases and co-coincided with wide spread vaccine use. Put another way vaccines did not work where sanitation + nutrition was abysmal.
(Cannot find references, because I came across them a long time back))
I think the biggest win will be disinfecting shopping cart handles. A few years before, I even have posts about it, how it didn't make sense that these where not disinfected during Flu season. I thought it was disgusting actually since people are handling food, between touching these handles.
We will probably get some innovation in face masks too.
For anyone in the construction/renovation industry having access to better working face masks will help prevent all kinds of lung damaging diseases.
There's probably other benefits, like more people working from home.
But overall, its been terrible. I see homeless people in my city like never before. Huge surge in mental health issues too.And nursing homes with their current configurations are old people slaughter houses.
i wonder what kind of damage we're doing with all the disinfection of touch surfaces. what dangerous microbes we're selectively breeding, and what beneficial ones we're destroying.
No human-infecting microbes can survive pure alcohol or bleach, so selection pressure is not an issue. And beneficial microbes don’t grow much on tabletops and guardrails either.
At most, the cleaner environment might lead to ill-calibrated immune systems in kids.
I think facemasks are going to be the biggest change to daily life that I don't see going away.
2020 had a nearly non-existent flu season and that is likely related to all the COVID restrictions (I think facemasks being a key).
If I were to guess, I think people wearing facemasks when they are sick (or even just through flu season) is going to be a lot more common and socially acceptable from now on. Hopefully that will translate into less severe flu seasons from here on out.
I was living in South Korea 2015-2019, where use of face masks was already a normal fact of life seasonally (air pollution) and habitual when experiencing cold symptoms. It's not amazing, but also not a big deal. I did wonder about the trash/recycling factor.
Frankly - living as an immigrant in a very looks/appearance-conscious society, it had its practical perks. Quick late-day dash to the shop without having a shave? Masks takes care of that ...
OTOH, I enjoy how the lockdowns have been a sobering reset button to everyone's vanity and fashion proclivities, too. Hair styling fast fashion cycles seem like very silly preoccupations nowadays.
The biggest change will be WFH or online learning when you feel like you might just be a little bit sick. That alone should put a huge dent in flu season.
In Sweden we're also seeing very low flu numbers for 2020-2021 but we have almost non-existent mask usage so I wouldn't attribute it to masks alone. I think social distancing plays a big part.
I mean, that could also just be a fact that worldwide everyone is masking up. One nation not participating doesn't matter as much because everyone else is. I'm guessing you've got far fewer visitors to Sweden due to all the travel restrictions.
They aren't 99% effective against the flu. They might not be effective at all for the flu.
Pre-covid studies were mixed as best, but many found that asymptomatic mask wearing wasn't significantly effective at reducing flu infections.
You are really only contagious with the flu for a day before symptoms show up (and even then you aren't that contagious until the symptoms get worse).
We'd eliminate the flu spreading by just self-quarantining after the onset of flu symptoms + wearing a mask when sick to go essential things like showing for essentials or going to the drug store.
I would have thought we learned something from the pandemic about staying home when sick. But when my wife's work found out she had covid symptoms it was STAY HOME. But the tests confirmed it wasn't covid--just a cold--COME IN. Now the whole office has a cold. They learned nothing.
Easy, it takes less exposure to COVID to get you ill. Meaning, it's a more infectious disease.
And masks aren't ineffective against COVID-19. Everyone wearing a mask does a pretty good job at preventing the spread of disease. However, there are a lot of people that aren't as strict about following mask rules and guidelines.
Also, masks don't filter all the viruses, they just reduce the amount you breathe in. Viral load is important, an infection will be less likely to lead to a disease if the viral load is low, e.g. because you are wearing a mask or keeping distance.
If there is, in addition, a partial immunity, e.g. from a former flu infection, the threshold for the necessary viral load to cause a disease is even higher. Which is why masks are usually more effective against the flu.
I think its fascinating to think about it. Once you get infected, its basically a battle of doubling rates.
Will your immune system buildup up defences before the virus doubles to unstoppable overwhelming numbers. So a smaller starting initial number of the virus, gives the immune system a much longer time to organize.
So far there is no real experimental evidence that lower initial viral dose reduces the risk of developing disease symptoms. It's a plausible hypothesis but remains unproven.
In the Netherlands, shopping carts and masks became mandatory in shops. The shopping cart is/was used as a way to keep track of the amount of people allowed in the store. This had the counter-productive effect of having to have someone disinfect shopping cart handles with alcohol or in worst case a do-it-yourself system where disinfectant is provided but only AFTER you've already had to touch the cart of physically prevent anyone from grabbing a cart by claiming the single disinfectant spray and paper before reaching the cart.
All of this could have been avoided if the handles were made of copper.
Copper helps, but it isn't magic. It takes about 1->2 hours to self disinfect.
You'd still need a step of disinfecting the handles.
That said, I'm not sure how often flu goes from cart handle to person, I've my doubts that it's a major disease vector. I'd think just being in a store with a bunch of idiots coughing on each other probably spreads the flu more readily.
I think its a better option than do-it-yourself disinfection.
Really, coronavirus presents itself as a virus that is not stopped by any means we currently have employed. on the micro level all these techniques are tried and tested (by the likes of almost perfectly sterile enviroments as surgical rooms) but at the macro level coronavirus spreads trough humans in a way that cannot be seen or prevented.
Maybe we could actually shut down next time rather than doing what we did: unenforced and ignored stay-at-home orders, unenforced and ignored business closures, and unenforced and ignored mask mandates. Do it right and then perhaps we could get rid of the disease in a shorter amount of time.
Yes, so much this. Everyone was shocked about the Chinese methods in spring 2020, but looking back, the Chinese did something right there. Maybe nailing shut doors was a little excessive, but their success proves them right. (If one can trust their numbers, that is).
Last spring the US was like "Hey, travel from Italy is all good, let's not worry about it" at the time when severe travel restrictions might have been effective.
I'll grant that people wouldn't put up with them for long, but reasonable measures employed before the infection base gets big can have an enormous impact on the total number of people that get infected.
It's really hard unless you can control borders. Even if the US locked down for 3 months and got to zero, it could be undone by one group of illegal immigrants crossing the border with COVID.
The US and EU were already pretty well infected before they realized what was happening. Only China, S. Korea, and Australia had major outbreaks that were contained, and even those, the outbreaks were fairly isolated (Wuhan, Shincheonji Church, Melbourne).
There is some threshold below which contact tracing and isolation work. A few dozen infected people crossing the border could be dealt with.
We've not bothered to do much support for isolation, have high case counts and a year of encouraging people to respond poorly to contact tracing, as if consenting to disease control measures is some unforgivable affront to autonomy.
> A few dozen infected people crossing the border could be dealt with.
There are something between 50 000 and 100 000 people each year who are caught trying to illegally cross southern US border. The number of people who are not caught is obviously a multiple of that. This probably could be dealt with, if the government was actually trying to do that.
Right there are at least four other endemic human coronaviruses, with HCoV-OC43 being very similar to SARS-CoV-2. Without a vaccine the safest option for most individuals is to catch it as a child. The resulting immunity isn't perfect but it usually protects most people from serious symptoms with later reinfections.
I suspect that, in retrospect, the first inclination of many parents when the pandemic began to hold "COVID parties" for children like the familiar "chicken pox parties"—inclination that wasn't followed, because of dire warnings about long-term health effects—was the right one.
Fairly definitively that was always the wrong answer.
In the future:
1. Most people will get SARS-CoV-2 antibodies from their mothers
2. Early life exposure will happen
3. The SARS-CoV-2 virus will be force to make expensive mutations to avoid immune escape will come at a cost to fitness.
None of the conditions can be created by what you suggest. You have the problem of having the relatively most-lethal / most-transmissible version of the virus spreading unhindered in a population of >40 year olds who have no natural immunity. The "COVID party" solution maximizes the death and cost of the virus.
HCoV-OC43 is an endemic betacoronavirus very similar to SARS-CoV-2 (COVID-19). We don't have significant herd immunity to it. Instead most people get infected as youths and develop a level of immunity which protects against severe symptoms during subsequent reinfections. But it still kills frail elderly and immunocompromised patients.
We don't have proof of when HCoV-OC43 first emerged but circumstantial evidence indicates that it probably caused the 1889-1890 pandemic and killed about 0.06% of the world population. If we allowed SARS-CoV-2 to run it’s course without vaccination then the outcome would probably be similar or a little worse because the population today is on average older with a higher incidence of co-morbid conditions. (I am not suggesting we follow that approach.)
Well, we are already at roughly .04% worldwide deaths, and that with quite some doing to contain the disease in most of the world. I would suggest that letting COVID-19 run it's course, the numbers would be quite a bit higher, and even with current measures in place and vaccinations underway, we will certainly exceed .06% by the end of the year.
Is it possible however they are attributing death counts in 1890 are different than they are today? Maybe if they used the same standards for who dies today that they did in 1890 the n umbers back then could be higher?
Maybe. But precise counts are a challenge even today, because different countries use different methods of counting. E.g. some only count corona deaths after a PCR test, some after an autopsy, some require just symptoms of COVID to be there, some count every dead infected person as corona death, even if it was a car accident, etc. So direct comparisons even between countries today are unprecise. I have no idea at all, what things looked like back then.
It will be different this time!!(says the media) <- no it won't.
I like to base my findings on history and previous pandemics and how they were dealt with. The swine flu of 1918-1919[1] which was more deadly(IFR rate 2% [2]) than covid-19(IFR rate 1.15% [3]) did in fact go away, it was the last major pandemic the world has endured and once herd immunity is reached the virus will no longer have any "tinder" to burn through as either the vaccine or catching the virus to get antibodies will stop the virus in its tracks.
But what about mutations? coronaviruses mutate more slowly compared to the flu virus[4], and sequencing and testing is already underway for vaccines for the new variants[5].
Lastly the thing no one is really talking about is people die every year during flu season. The really old, the really sick etc, so I suspect that a good amount of deaths with covid are non-preventable and would have happened anyways due to the flu, which by the way is pretty much non-existent this year[6] <- with that link look at one year ago and you will see a stark change in the activity of the flu, its incredible as every state has the lowest activity the CDC measures.
The 1918 pandemic didn't "go away" until 1957, it circulated as seasonal influenza.
The mutation rate of this coronavirus is also 1/4 per base pair and 1/2 per whole genome of influenza. That is fairly comparable to influenza (given that viral mutation rates span many orders of magnitude they're practically the same).
The variants with the mutations in spike which have higher binding affinity to ACE2 suggest that the virus also has "room to mutate". OTOH, there are 20-ish epitopes on the spike protein and would need to mutate a bunch to achieve complete immune escape. Depending on what wild-assed-guess you take as to which of those is more important you'll come up with the likelihood of if it'll mutate to achieve immune escape or not. Anyone who says they know the answer -- no matter how many degrees they have and books and papers they've published -- is lying (they may wind up being correct, but to assert they know the answer right now is a lie).
Since HCoV-NL63 has been endemic to the human race for likely centuries and similarly binds ACE2 my guess is that this coronavirus will also become endemic.
Given the H1N1 is now seasonal influenza and that HCoV-NL63 is a common cold coronavirus this is likely what is going to happen to SARS-CoV-2 now:
This remains to be seen, and some of the experts guess this isn't a major risk. (Obviously it's possible, but there are scads of other viruses that could mutate until they're deadly in humans, too.)
Right now the vaccines are effective against current mutations but yes! It’s very likely that we’ll see more than one covid vaccine during our lifetimes as it mutates.
@OP [cyptus] this is a good question, there is no need for animal resivoir to establish variants/mutation as this happens concurrent with human infection as well.
@spivak you sound on track, the current thought in the lab is polyvalent vaccine. The problems include mRNA duplex interference, meaning 2 species of mRNA may anneal at complementary regions of the sequence to produce localized folding that derails the translation enzymes of the host.
There's a lot between "herd immunity via vaccination" (very good) and "uncontrolled spread" (very bad). Protecting a lot of people is not as good as protecting everyone. But it's better than protecting nooone.
Everyone or as many 9’s as possible getting vaccinated and regular testing of anyone who can’t get the vaccine. Like it doesn’t have to be obnoxious but people who can’t get the vaccine should get tested when any symptoms show.
It’s gonna be like the flu, but ya know deadlier, where the name of the game is control and stamping out outbreaks aggressively.
My gut feeling is that it would take strong and probably obnoxious enforcement to get us to one 9, we probably can’t even get two 9s (as in 99%, since some people think that means 99.99%) due to the number of people medically ineligible. And all that’s after approving any vaccine for kids, which we haven’t done yet.
I mean you think that 30+ million people in the US will be medically ineligible? Every single vaccine in my state is being administered as fast as they can ship them out. And after a while kids will have to be vaccinated to go to school same as we do with other vaccines. There is no current prediction that the vaccine won't be safe for kids.
The biggest groups that are ineligible are people with vaccine allergies and people with some autoimmune diseases which is vanishingly small.
Quite the same as if the vaccinations were causing herd immunity: Everyone who wants a shot will get one. Everyone on the vulnerable list should think really hard and really get a shot. The rest can suffer of their own free will.
Or: make vaccinations mandatory if you want to protect those who cannot get a shot for health reasons.
Remember, the reason is vaccination hesitancy or refusal. A perfect example of antisocial and stupid behaviour.
> Or: make vaccinations mandatory if you want to protect those who cannot get a shot for health reasons.
To put this one in perspective, we already make vaccinations mandatory for public school attendance, and colleges go one step further and require vaccinations for attendance, too.
Thanks for sharing those. While encouraging, the first obvious issue is that "reduce" != "prevent". There's also the related issue of how long that partial immunity lasts: I think the conventional wisdom is that it won't be for decades or anything, but would love to know if I'm wrong.
Both of those factors make COVID vaccination quite different from, say, measles vaccination (~97% prevention, lifelong immunity), and seemingly more similar to the flu vaccine, which is not required by any schools (that I know of).
I didn't read the original study, but I think the 75 to 95% reduction is in the number of cases, not in viral load. So this would be, in other words, a 75 to 95% prevention.
As to the time the immunity lasts, that remains to be seen. Since it is brand-new, we will only know when new cases from previously-vaccinated people pop up. Maybe it'll be yearly, maybe a booster every 10 years, maybe lifelong. There is research showing that the antibodies from a corona infection last about half a year, but that is not the only factor that may provide immunity. And the yearly flu shot is because the flu virus mutates very rapidly, which corona doesn't as much.
The way forward requires coming to terms with the fact that none of this needed to happen in the first place. This disease is really just not that deadly for non-elderly and non-obese people, and we've known for a while.
Every institution under the sun failed.
We say we need to trust the science, but the scientists were all wrong: LANL put out a preprint paper that estimated r0 at ~7 near the beginning of the pandemic, where it's more like 2.5. The scientists told us that a vaccine wouldn't be ready for years, it was actually ready in months. The media was so addicted to the story that they failed to inform the public of these changing expectations. Meanwhile, the government spent a lot of money, and it's not entirely clear that it did anything except bubble up tech stocks. Did it save many jobs? No, not really, just like all these other institutions failed.
The way forward won't happen, at least for a while, because these institutions are powerful and need to save face.
I don't really wanna be part of a society that sacrifices the old and unfit at the expense of the whatever point you are trying to make. 500,000 COVID deaths across the country shouldn't be taken lightly.
I am surprised if you are taking all "scientists" as a collective group that you are focusing on early attempts to create models rather than the delivery of a vaccine (by scientists) and overall improvement of disease handling by scientists.
What powerful institutions need to save face exactly?
> I don't really wanna be part of a society that sacrifices the old and unfit at the expense of the whatever point you are trying to make.
That's an easy way to dismiss the real harm that has been done with lockdowns. If it's cost-free, of course, let's value and protect all life. But these lockdowns have a huge impact on people, too. It's a trolley problem, can we at least be honest about that?
just playing the devil's advocate. I don't support as well the idea of sacrificing the old and unfit and neither believe that "only the strong should survive", but isn't the old and unfit from today responsible for the status-quo and all the bad decisions that we took regarding research, environment and health in the last 30 years?
I don't understand this reasoning, it's such hyperbole, we are not sacrificing anyone. You are already part of a society that makes these types of tradeoffs and calculated risks all the time. We don't spend an endless amount of money on extending everyone's life at any cost. And people who are overweight and unfit have a personal responsibility as well, and can also isolate themselves, why do we have to traumatise a whole population of healthy people unnecessarily with lockdowns.
It's so unbelievable far fetched, that asymptomatic people should still transfer virus through contact surfaces and that this will in any significant way increase the infected health care professionals at the elderly peoples homes, despite them having professional equipment, and those elderly people, who are a part of the risk group, while another VERY large part of the risk group can isolate themselves, still would be enough to motivate a lockdown.
It's getting so incredibly unreasonable, everything will be impossible if you put an endless price to every second of a human life.
We could have had a hard strong lockdown in early 2020, but people like you made the arguments you're making now, and so we've had a see-saw year of restrictions being imposed and lifted, and here we are: the economy's fucked, huge numbers of people are dead, we have new variants[1] in circulation, and we're now saying "let's just kill off anyone who'd, or obese, or has diabetes, or asthma".
[1] Notice how all the worrying variants are from countries with inadequate lockdowns?
You don't know that. There are already plenty of examples of countries that have had hard lockdowns, no lockdowns and medium lockdowns, and the results are really inconclusive. The only pattern I can see is that the number of the infections is following the weather and the season, like flu viruses always do.
"huge" numbers of people are not dead, look at excessive mortality, adjusted for population, compare 15 years back. Lo and behold we have had several deadlier years.
In Germany all restrictions were lifted for six months and nothing happened, then suddenly infections went up when the weather got cold and OMG it's because we let people go out. Then we lift the restrictions slightly and now when infections go up again, following the next spell of cold weather, we are certain that it was because we let some people go to the hair dresser.
In Germany, the end-of-summer spread happened due to several factors, bad weather because autumn, lowered restrictions (as were all summer) and start of schools after the summer holidays. There is no single silver bullet to stop the spread (except maybe "prevent all contact"), but there are several factors that need to play together.
However, the lowered restrictions during German summer also had a visible effect, look at the numbers between June 2020 and August 2020 and you will see a distinct rise there. It isn't nearly as bad as in September, but it is there.
You realise that cancer kills many many times the number of people that die from corona, but we still continue to "sacrifice" those people just to have a functioning society, make profits and also just for fun, by producing cigarettes etc. How can you be part of such a society?
> The scientists told us that a vaccine wouldn't be ready for years, it was actually ready in months
I remember the messaging at the beginning of last year being to expect at least 18 months, possibly much longer. For most people, 18 months will be about accurate, for a few people, they will have beat the estimate, but that's not surprising - it's an estimate. It's a hell of a lot more accurate than a couple months.
> these institutions are powerful and need to save face
You just explained above that these institutions are not powerful, and that they have limititations. Which one of these are true?
Messenger RNA vaccines, which are a new technology, turned out to work much better than expected. They can be synthesized fast. It took two days to make the first mRNA vaccine molecules for coronavirus. Traditional vaccine technology is slower. Bulk production was a problem; encapsulating those fragile mRNA molecules without breaking them requires a difficult bit of microfluidics technology. But it's difficult in the sense that IC manufacturing is difficult. Once the manufacturers got the tooling and the process right, it worked well.
Here's the list of vaccines under development.[1] There are 105 different vaccines in the pipeline. Most of those are more traditional approaches and don't work yet, need further testing, don't work as well, or have other problems. What we have now is the minimum viable product - two doses, difficult handling and distribution, requires an injection. Some of the ones in the pipeline are skin patches, nasal sprays, or pills. The Merck pill, though, turned out to be a dud - provides only weak protection.
The non-injection schemes may help overcome some of the vaccine resistance problems.
Throwing money at the problem did help. Usually, vaccine R&D consists of finding the most likely candidate, setting up the Phase I/II/III trials, and waiting to see how it works. If it doesn't work, the developers go on to another candidate. Developing 100 different vaccines in parallel improved the odds. A lot.
> I remember the messaging at the beginning of last year being to expect at least 18 months, possibly much longer.
I remember messaging about timelines of several years. The fact that science eventually arrived at a consistent and accurate message doesn't mean that there wasn't consensus around the wrong opinions when it was most critical.
> You just explained above that these institutions are not powerful, and that they have limititations. Which one of these are true?
Nowhere did I claim they are not powerful, I simply claimed that they made bad decisions.
US deaths in 2020 jumped about 15% from 2019. Even if you think the pandemic response was a failure that somehow made it worse, you can’t also think that the crisis didn’t justify a strong reaction. That’s an enormous increase in mortality for a single year.
I have no idea why you've been downvoted, you made a really strong point. The only thing I can really say in response is that there's gotta be some sort of middle ground between the reaction we had and under-reacting.
I feel like that’s assuming that our reaction was over done. If anything, that we still had 500 thousand dead Americans seem to suggest we should have reacted harder, faster, and possibly differently.
A new paper estimates the economic benefits of the first billion spent on vaccines at $17 trillion, and $1 trillion for each of the next few billions spent. We should have spent a lot more money on vaccines.
“Herd immunity is only relevant if we have a transmission-blocking vaccine. If we don’t, then the only way to get herd immunity in the population is to give everyone the vaccine,” says Shweta Bansal, a mathematical biologist at Georgetown University in Washington DC.
Does... Not... Compute. She is contradicting herself in the very next sentence.
Herd immunity is only possible with a transmission blocking vaccine. This makes sense, as once you’re vaccinated, you are unable to transmit the virus to someone else.
With that first statement, herd immunity is now not relevant, and therefore is not possible, so why mention it as a possibility?
It’s not possible, but we’re just going to vaccinate everyone anyways. Is she benefiting financially from this or something? I don’t understand.
Until we have transmission blocking vaccines, the concept of herd immunity is irrelevant. That goes not just for COVID-19, but for every other vaccination campaign as well. Large scale vaccination campaigns likely decrease transmission, but it doesn’t guarantee the end of any outbreak.
People need to accept that humans are mortal and that we can’t “beat” every disease. This modern fragility is pitiful and self-destructive. Life must go on.
Also, the US still has a very poorly designed system to promote herd immunity. Basically, you are charging people to contribute to herd immunity, rather than paying people to contribute to herd immunity.
COVID isn't even some "perfect bug" that maximizes the strategic/policy failures of US healthcare and preys on our self-interest. It's a very very mild pandemic compared to 20-40% death rate pandemics of yore. Maybe a death rate at those levels would spur "healthcare consumer self-interest" to vaccinate... but if there was an outright 3% death rate, would people's behavior change? 5%? 10%?
And for god sakes, stop letting perfect be the enemy of good. "Herd Immunity" isn't necessarily 100% resistance. We can achieve a great reduction with vaccinations even if it isn't perfect.
Edit: I was reading that I would be charged a 40-100$ administration fee. I guess that is being charged back to the government.
"Vaccine hesitancy" is the term for antivaxxers plus people who would not refuse in principle, but prefer to wait for more results, are too lazy or something like that.
The high death rate of pandemics of yore is also due to the healthcare system of yore being shit. You just couldn't properly ventilate people during the spanish flu, not to speak of ECMO or useful drugs like cortical steroids. I would guess that of those people hospitalized for COVID-19, at least half would have died back then. Of those put on a ventilator nowadays, all would have died back then. And hospitalization rates would maybe also have been higher, because where nowadays the doc sends you back to home quarantine with an asthma inhaler, back then they could just watch you suffocate...
What is your argument here? The US has a poorly designed system for herd immunity? Free shots, huge supply, most shots given in the world, one of the highest vaccination rates in the world?
I would prefer not to consent to a possibly dangerous 'weaker' version of COVID. This idea would completely take choice away and experiment on the human populace.
it's a last resort, it's true... but with variants mutating, i think we have to ask ourselves how much of a existential threat does this thing pose to the species.
moreover, what's the difference if vaccines become mandatory anyhow? all the vaccines do is expose humans to the spike protein... if anything, hacking the virus seems safer than hacking the human body to produce the spike protein.
i suppose it's hard to stop, where you can halt a vax campaign. i don't believe it would be impossible to establish a safety profile for a modified virus that is on par with those of the vaccines.
Sure, except that's it's already happened. The US currently has something like twice as many vaccinated as recorded infections, with vaccination growing at something like 5x the rate of infections.
If viral infections actually followed am exponential growth curve then we would be close to 100% infections by now. Obviously that hasn't happened. In reality infections generally follow a logistic curve, in which only the very early part approximates an exponential curve.
it's tempting to think that, but no, in the simple non-mutating case, the exponent is fixed. the growth rate is exponential but the exponent does not grow with spread. they say the exponent ranges from 2-5 for covid, and drops with mitigation methods. that seems to clearly put it in n^2 to me.
that said, the mitigations do cause the exponent to fluctuate... and in countries where people are willing to cooperate it has dropped below 1 and the epidemic has been mitigated.
it is possible that this is actually a case calling where asymptotic analysis is inappropriate and in fact you have to resort to the raw data and measurement.
now that i think of it though, if you allow for mutations that are more infectious, then the exponent is not fixed and increases with spread... yikes.
I'm somehow still not convinced by your explanation. What exactly is N and what exactly is this measuring. I thought that N was a time period, and that the equation is something like
Infected count = O(R^t)
But apparently you mean that N is the number of infection? And what are you measuring?
??? = O(n^R)
Where the ??? is also linear with the amount of people vaccinated?
That wouldn't work as viruses don't compete for a limited resource (as long as they don't kill all infected). So unlike animals, where one species eats the food of the other and can drive it to extinction, this won't work.
>> "Israel began vaccinating its citizens in December 2020 [...] Now the problem is that young people don’t want to get their shots,” Aran says, so local authorities are enticing them with things such as free pizza and beer.
Forget the pizza. I would pay good money for a vaccination but in my area (Canada) vaccination is still only open to the elderly. At work I am doing double shifts to cover for all the people who are "working from home". I haven't seen my parents or other extended family in over a year. It has been six months since I've eaten in a sit-down restaurant. I've had to cut my own hair since christmas. If the kids in Israel aren't accepting the vaccine then ship those does to me and I'll give them to people who actually want this all to end.
While we are arguing semantics (and I agree that improbable would be a better word for the title) there is a difference. Improbable refers to odds. Probably impossible refers to odds of some binary outcome.
My winning the lottery is improbable. We all agree I have a shot at it, but it's very unlikely. But it's definitely not impossible, assuming it's not rigged.
Solving an NP problem with a P time algorithm is probably impossible. Either it can be done or it can't be. We suspect the latter, but we don't know 100%. Once we prove it one way or the other, it will will either be possible or impossible, in a binary sense.
Rather, "improbable" denotes a wide range of probability where the likelihood is less than 50%. "Probably impossible" denotes likelihood much closer to 0%.
I disagree with this. I think think there's a significant difference between:
"This event is certainly possible, but only has a 10% chance of occurring" and "This event may or may not be possible we don't yet know, but our best guess is that it is not possible, and we are 90% confident in that prediction"
I am truly baffled why the epidemiology community ever thought herd immunity will work. There is ample evidence that it is not a panacea. e.g. influenzae, hepatitis, meningitis, measles, mumps, rubella, yellow fever.
Most of the diseases you list are examples of herd immunity working in developed world communities. People without immunity to them are pretty safe from them.
Herd immunity isn't eradication, it's just a reduction of the likelihood of infection among people who aren't immune themselves.
It wasn't clear to me that you meant "flatten the curve and ride this out to herd immunity", since this article was about herd immunity via vaccination.
Did the epidemiology community ever think that? I remember as early as March of last year, epidemiologists saying that herd immunity was not the way forward, and that this would likely become endemic. It seemed to mostly be reporters and politicians who pushed the herd immunity angle.
For a while early on allowing the virus to spread through the population, with limited distancing and lockdown measures to control the rate of spread, in order to achieve herd immunity was official British government policy.
I'm not knocking them to be honest. In the early months so little was known for sure that it was a matter of making best estimates, and as better data came in they quickly adapted their strategy.
It's really difficult to tell from the sidelines the difference between Cassandras and the Trelawneys. Is there a concrete way to get the pulse of the epidemiologists over time?
I can believe that. I have not dug much into the historical herd immunity statements, so it is possible they were not, although purported to be, by experts.
I don't want to necessarily attribute it to "epidemiologists" but there has been a pretty clear line from policymakers since about three weeks into the lockdowns (which was as long as we were initially told they would need to last to "flatten the curve") that we needed to stay locked down, keep wearing masks and distancing etc. until vaccines could be given to enough people to effectively end Covid transmission. There's a whole movement of prominent policy & medical leading lights that you can find with the #ZeroCovid hashtag on Twitter pushing this line.
Because COVID doesn’t spread very easily. Mumps has a basic reproduction factor of 10-12, Covid is closer to 3-5. Cut Mumps transmission by 80% and nothing happens, cut COVID by 80% and it goes away fairly quickly.
Other coronavirus are endemic in China, but they rarely spread outside the country.
I think there was a glimpse of hope for a global effort to not add a new virus to that list, because it's not like we don't have enough of them.
But I always thought that window closed in April 2020 last year when the stance of the majority was to live with the virus, the whole "new normal" campaign. Some thought the virus was slow enough to mutate to still handle it, but they forgot that with millions of people being virus factories it would be a matter of time.
In this context I think herd immunity counts vaccine driven immunity. That is how we successfully control diseases such as measles, mumps, and rubella.
They possibly thought based on previous outbreaks in Asian countries that people would see the severity of the problem and that it could be contained enough (and with that likelihood of mutations lowered) until vaccination efforts have reached their threshold. The probably didn't expect that multiple big countries would just let people go about their daily lives normally for a long time and spread the virus in that proportion.
Well, the pox, diphteria and polio are gone or almost gone due to vaccinations, at one point or the other we had herd immunity with those. Its just that some small pockets of society refused to vaccinate and played incubators, so the rest of us wouldn't miss all the "fun"...
Quite the same for all the other diseases you enumerated, just that we never managed to get herd immunity due to antivaxxers ruining it.
Yes, the oral polio vaccine is a live vaccine that can cause polio. More advanced vaccines, practically everything in use in developed countries nowadays, don't contain live virus. It's just that third-world countries cannot afford better vaccines.
So yes, you are right that there are some corner cases.
This article isn't about natural herd immunity from everybody getting the disease, with most recovering and becoming immune. The article is worrying that even with vaccination, we may not be able to reach herd immunity. Too many variants; too slow deployment; too many vaccinated people still transmitting the disease.
There are 3 possible scenarios related to viruses and humanity on Earth.
1) Normalcy: People live their lives as they have for thousands of years, and some percentage of people die from any number of viruses, but never enough to permanently trigger one of the other scenarios.
2) Extraterran: Humanity can no longer survive one or more of the viruses on Earth. Those of us who continue to live here must do so as if it were a foreign planet filled pathogens that will surely kill us, because they do.
3) Extinction: Humanity is ended by one or more viruses.
Of these 3 possible scenarios, the 1st one seems more likely than the others, and is what we should aim for before being forced into the 2nd one to avoid the 3rd. Right now we are living somewhere between the 1st and 2nd, and my intuition tells me that all our efforts related to coronaviruses, regardless of the strain, won't be able to save those whom are genetically unlucky enough to be predisposed to die from them forever. They will mutate, and eventually infect everyone, not unlike the common cold, and humanity will move on having lost somewhere between 1% and 10% of it's population, just as it would have had no curtailing measures been taken or vaccines developed at all; no different than it has been through the vast majority of our time on earth. While a higher population and the ease of global travel does mean that the virus side of the immunological arms race is boosted, all that does is raise the bar for ours. Either we'll pass, or we wont. Finally, while the deaths that have happened, and the future deaths that are likely to happen, on our path back to normalcy are certainly tragic: they have been, and will be, part and parcel of existing as organic beings living on a wild world. We cannot expect to only exist in nature when it is convenient for us. As long as we remain natural beings, we must accept that some of us will be eaten.
It looks like Israel will be the first country to hit a very high vaccination level. 55.4 percent of Israelis have received the first dose of the coronavirus vaccine. Over 70% of old people. The government is pushing hard on this. Pfizer says they're seeing 97% vaccine effectiveness at preventing illness.
Israel cut a deal with Pfizer to get priority on vaccine shipments in exchange for sending extensive data on how it is working back to Pfizer.[1] So Israel has more than enough vaccine for their population. Already, Israel's coronavirus death rate is down to 0.15 deaths/day/100K people. It was 0.72 back in January.
So watch Israel to see what happens when the vaccination percentage gets to a high level.
[1] https://www.ft.com/content/3aae4345-46cc-4636-a3f9-a93a6762f...