The end of the pandemic is near | Hacker News Reader

The end of the pandemic is near

donaldgmcneiljr1954.medium.com

198 pointsmpweiher365 comments

Here in Israel, it really feels like it's "over". There are still some restrictions, but more and more people are just going about their lives like normal.

Masks are not mandatory outside (though many people still wear them), they are mandatory inside (though many people don't wear them inside anymore).

And the most important thing - social events are back with a vengeance. You can basically do everything you could do a year and a half ago.

How do you feel about only ~60% of Israel's population is vaccinated? Does this seem to have a effect?

I'm not sure what the exact numbers are, but case counts are down to like ~20 per day so it seems like the vaccinations were enough to stop it entirely. Also, I live in Tel Aviv, which was never the hardest hit area.

You’re saying that a large city was hit less than other less populated areas? How did Tel Aviv manage to mitigate the infections prior to the vaccinations? Complying citizens? Education campaigns?

Here in Germany the highest incidence numbers in the last months were raging in sparsely populated areas. The smaller the region the easier it is to have x incidents per 1000 people.

Look, I'm not exactly an expert. Tel Aviv was hit somewhat badly, one of the worst, but not the absolute worst. Mostly because most of the population here was somewhat more serious about social distancing / etc. Or rather, there were several other cities that were really really not careful (mostly religious areas). Tel Aviv also got vaccinated fairly fast compared to other places.

At least that's my impression.

Cities actually have more going for them than you might think. The population tends to be younger and therefore more "compliant" regarding public health. That means more mask-wearing indoors, distancing whether in or out, and more self-isolating when symptomatic. Delivery of food and groceries is better established. Easier access to testing facilities. Good internet speeds means less inclination to go and see friends in person.

> You’re saying that a large city was hit less than other less populated areas?

Can't speak for Israel but I live in London, which is far from the hardest-hit place in the UK. As far as I know, large cities outside Wuhan and maybe NYC haven't been hit especially hard.

According to the economist there is well over 90% (adults?) vaccinated first dose and near 90 for the second

Does that include the captive Palestinian population?

https://ourworldindata.org/covid-vaccinations paints a different picture?

I wonder if you add in confirmed and unconfirmed cases and the accompanying immunity, what percentage that would equate to.

It's the same in Kazakhstan, people only wear masks indoors when there's someone controlling them, otherwise no one cares.

It's so sad to see you receiving hate comments for a simple, completely unrelated comment.

Rest assured, not all people think that way.

When an Islamic terrorist group deliverately uses human shields of women and children, and they get killed, the blame falls on that terrorist group. Not on Israel.

And your comment was unrelated, you shouldn't have faced the hate you faced.

Funny how a similar comment aimed at a Chinese person for treatment of Uighurs will be anti-Asian hate speech.

Yet another shining example of western hypocrisy: ignoring and apologizing for a well documented genocide of Palestinians, and spreading a RFA/CIA narrative blowing an anti-extremist integration campaign in China way out of proportion.

Of course I'll get downvoted to hell for saying this, because everyone here agrees with you, but that's just how it is on this website.

I also believe that the "anti-extremist integration camps" are blown out of proportion.

But how the hate speech GP has faced would be considered hate speech if there were a Chinese person at the receiving end is an hypothetical example of hipocricy. If a Chinese person indeed faced it, that is hate speech in my purview, and so is this person facing hate speech just for being from Israel.

Hate speeches are not justified. Whether someone is from China or from Israel.

If you put enough people on a small enough pen, you're not going to be able to miss the civilians. I'd certainly blame the cage maker for making the cage too small.

Its highly unrelated to the pandemic though

Hamas could have chosen areas that are not civilian areas.

They want death to Israel and genocide of Jews. Israel wants a two-state solution.

This is just one example [0].

[0]: https://www.theatlantic.com/international/archive/2014/09/ha...

> On the other hand, I’m not willing to fly to India just now. Not as much out of fear of Covid but because, if I happened to have, say, a heart attack, I clearly would be unable to get a hospital bed or an oxygen mask.

It's very region-dependent. Mumbai peaked in early April. 60%+ of O2 beds in Mumbai are vacant.

The O2 shortage blows my mind. Doesn't India have any industry it could have have redirected O2 production form?!

India did redirect industrial 02 production towards the hospitals. Part of the o2 shortage is zoning and logisticsz Delhi has zoning laws that ban manufacturing 02 within the city limits so all 02 has to be transported in.

> Because of the sudden surge in demand for medical oxygen, currently most of the industrial oxygen in India is undergoing an additional purification step, and then being diverted for medical use. A major challenge is getting this oxygen from factories in eastern and southern states to the northern and western states which are most struggling with supply. It takes hours to fill a tanker with the highly flammable liquid oxygen, and once on the road, these vehicles must follow a strict speed limit of no more than 25 mph as well as not travelling at night, to avoid road accidents.

https://www.gavi.org/vaccineswork/why-indian-hospitals-are-r...

(Readers who paid attention in school may recall oxygen isn't actually flammable - but it does considerably increase fire risks)

It's strange that oxygen cannot be transported at night. In Europe all the critical and big volume transports goes often at night (wind turbines parts, ship components etc.)

You don’t lose an entire city block if a wind turbine truck flips and spills it’s cargo in a bad crash.

It would depend on infrastructure quality and traffic law adherence.

Lots of places around the world have really terrible roads and nonexistent or nearly entirely unenforced road laws. Places like that you might want to be careful to not drive an enormous tank of flaming death around when you’re not so sure you can see each of 500 pot holes, or an oncoming driver.

Basic infrastructure things are easily taken for granted.

You never have been to India or have never seen a video of a street in India. There are no streets as we in the western know. There is a road and traffic just everywhere and nobody cares about traffic rules. It‘s a dangerous place to live. [Maybe a bit exxagarated].

Otherwise you would know that this _may easily_ result in an accident and no-one wants to have a truck full of O2 to blow up in the night in the middle of nowhere. At least during the day „you see where you go“.

Oxygen might not be flammable, but it is caustic. Plus, does the distinction of what is flammable really matter when spilled LOX is 'allowing' everything around it to combust at the slightest spark?

They redirected ISRO's O2 production output to hospitals [1].

[1] https://www.indiatvnews.com/news/india/geo-imaging-satellite...

I plan to keep wearing my mask on public transit and crowded places forever. I like the anonymity and I'll be protected from influenza and the common cold. It's a small price to pay.

I don't know anymore what the latest is (it changes from yourself, others, both, none in the newspapers here), but doesn't the person wearing the mask protect others, not themselves by wearing it?

All masks provide some protection for the user from air born droplets produced by coughing and sneezing. N95 masks or the equivalent provide significant protection from catching the disease. Though eye protection is still very important when treating patients with COVID.

Also, it’s important to realize that initial viral load makes a significant difference in how sick people get. Simply reducing exposure can therefore reduce how sick someone becomes.

The jury is out on whether N95's provide any extra protection over a thick bandana or blown plastic surgical masks for the general public, isn't it? The average person cannot be expected to fit an N95 properly.

A totally unfit N95 has way less leakage than a very carefully fit surgical mask.

Just try it for yourself, put a N95 on you face and don't even press the metal nose thing, and then see if you can fit a surgical mask better than this unfit N95.

This is another meme which needs to die.

> Just try it for yourself, put a N95 on you face and don't even press the metal nose thing, and then see if you can fit a surgical mask better than this unfit N95.

I have, with a proper fit tester. If you use a half mask respirator with cartridges, sure, the rubber seal is better by default. However, most N95 masks I've seen in public are are the cheap rigid masks leaving large gaps all around the circumference, whereas the surgical masks/bandana cling to the skin better.

That would be a to-do item for after the pandemic then: make sure that there is sufficient supply with quality N95 masks and training people how to use them, also perhaps: offer several sizes to ensure perfect fit. There is no good reason not to own a small supply of masks going forward.

>Also, it’s important to realize that initial viral load makes a significant difference in how sick people get.

While that was an early hypothesis, I'm not sure that has really been proven. A lot of the early data wasn't really "initial" viral load, but viral load when they presented in the hospital. That's not necessary an indication of initial viral load.

In the end most viruses have similar interactions with the body. The immune system simply takes a while to physically respond which is why initial viral load is important.

So, initial viral load is not COVID specific. Also viral load at first detection is a different yet important criteria for EBOLA, COVID, and other diseases. https://www.jci.org/articles/view/83162

It doesn't follow that viral load at infection matters because the immune system takes a while to respond. You have a built in assumption that immune response is exactly the same whether there is 1 (arbitrary unit) virus vs. 50 (arbitrary unit) virus. I'm not sure that is true. I could imagine the body starting a heavy immune response at 100 virus--which would mean the difference between 1 and 50 might have little affect on outcome.

Your paper is about viral load at diagnosis--not infection. Diagnosis happens after your immune system has been fighting a while.

That study was not supposed to refer to viral load at initial infection, you need to test viral load at exposure in a lab.

The 1 vs 50 difference is known to be based in part on the innate immune system not just the adaptive immune system. Most of the time you don’t need to create specific antibodies etc. If only a single virus enters the body it’s likely for you to fight off the infection without noticing though with the downside of failing to develop long term immunity.

https://en.m.wikipedia.org/wiki/Innate_immune_system

The 50 vs 50,000 is a related though less proven idea. Extreme exposure can simply overwhelm the immune system and extreme cases directly result in septic shock, but the middle ground is harder to test.

Depends on the mask and what exactly you are protecting against. The medical masks are good against droplets and protects others in the case of Covid, FFP2 (N95) masks give good self-protection.

With N95 you filter a whole lot of things out of the air. I’ll consider wearing a mask in special ocasions as well. Another one is in the winter, wearing the mask when the air is cold and gusts of wind blow in your face helps too. Or when on a bike or e-scooter or running through a very polluted area should help somewhat as well

No that was a scientifically incorrect meme spread by health authorities (which historically have been anti mask pre pandemic) and people motivated by altruism.

Studies are clear though. This one found non-N95 masks filter 20-80% of particles. https://jamanetwork.com/journals/jamainternalmedicine/fullar...

It defies common sense to say that won’t help the wearer! We haven’t done challenge trials, but the burden of proof is on those saying that a material covering the face and which filters out 20-80% of virus sized particles somehow won’t stop viral infections.

Even good medical masks didn’t protect Li Wenliang. There was always agreement about well fitted n95 but we’re told, even by your linked article not to use those. Sorry but this seems like politics not science. Obviously if you layer enough masks you can almost get to n95 levels of protection but why not just use an n95 at that point?

The point is not that it gives you perfect protection or even n95 protection. It does give you more protection than maskless. Also the lower the viral load you're exposed to, the longer your body has to prepare. How the disease progresses is dosage dependant.

A low enough load is like a natural vaccination. You don't get sick, but you get some immunity. A high enough load and you can get the sickness very severely. It's a gradient, and masks help put you lower on that gradient than otherwise.

Sure but it’s all about quantifying that accurately so that it can be compared to for example better building ventilation. If, hypothetically, better ventilation had 100x the effect of mask wearing, then focusing attention on masks would be counter productive no? Make no mistake I’m pro mask but mostly for psychological, ethical and economic reasons. I feel their benefits in terms of personal protection are vastly overstated, often in bad faith by those with a desire to impact other people’s behavior albeit with the best of intentions.

Why can't you do both? Mask wearing is simple, cheap, and available to all. That's like asking if it's better to focus on masks or vaccines. The answer is both.

As long as it's even marginally effective (and evidence suggests it's more than marginally effective) then it is a good idea.

From a mechanical perspective it would seem it would be more effective at filtering air going in rather than air going out: when you inhale it creates a lower pressure which causes a better seal around the mouth. When you exhale you create pressure under the mask which can “break” the seal and allow more unfiltered air through.

It was kind of a way to make people with valves n-95 masks feel “guilty” for wearing them.

One of the challenges is communicating context.

20% to 80% of filters is not good enough in a healthcare setting since a provider may be in a room absolutely filled with virus particles.

In a public setting, 20% to 80% might be enough to limit incidental viral loads enough to prevent infection.

It's hard to define the effectiveness across a wide variety of settings a cloth mask might be used in.

It does not at all defy common sense. For example if you gave me a shield that deflected 80% of bullets, it would not defy common sense to feel that shield was not effective at protecting me from someone with a machine gun.

The infectious dose of SARS-CoV-2 is as low as 10 viral particles and a single cough can release 123,000 viral particles.

If I shot 123,000 bullets at you, would you be happy with a shield that protected you from 80% of them?

At any rate, masks have proven to be incredibly effective, but the truth is that we don't know exactly how... common sense has not been particularly informative in understanding the spread of this virus.

You don’t see 100% infection rates when a positive person is in a a room. Reducing the amount of particles inhaled in such circumstances must be of use.

You would on the other hand expect a 100% fatality rate if you fired 123,000 bullets at each person in a room. So your analogy is faulty.

I hear this all the time "masks have proven to be incredibly effective" Have they? Data didn't really bear that. And there are tons of studies that day, for the lay person, we don't know. Or they say n95 and surgical masks may be effective but cloth masks are an unknown.

Surgical masks are mostly about protecting the everyone else from the weaer, yes, but do provide a small benefit to the wearer as well as least with virions for influenza and coronaviruses. Depending on what study, rates of transmission reduction were 10-20% for the wearer, which doesn't sound huge but greatly reduces transmission at scale.

The filter masks like N95s (which are usable for all kinds of non-medical purposes like working around airborne particles of fiberglass or metal debris or whatever) offer a high degree of protection to the wearer as well.

Exactly. For personal protection you use n95 or better and know it’s not perfect. If you don’t care about personal protection but want to reduce spread in a community then getting large groups to wear any face covering will help, but not nearly as much as social distancing which renders masks meaningless. For community spread, again not personal safety, it’s best to just stay home altogether. Masks are like pulling out during sex, a very imperfect way to compensate for bad behavior (not social distancing).

Normal or surgical mask, yes. N95 mask protects oneself very well, too.

Does it matter that much? Both are good.

It really does.

There is a non-zero cost to wearing masks. It is important to be able to make the cost-benefit analysis when deciding which mitigation to implement.

nothing is zero-cost but wearing a mask in public is as near to zero as any practical cost can be. Costco had a sale a few weeks ago, 250 masks for 5 bucks, or you can buy a re-usable one and wear it for months.

as far as the "human cost" of wearing a mask... grow up. Asian societies like China/Japan/Korea have been wearing masks forever and they're fine. Now that the consequences of spread are more severe (vs just plain old flu) it's time for this custom to spread more widely.

again, the hilarious thing is it's always adults who are so childish about this whole thing. Kids intuitively get it, just like they grasp a lot of the boomer issues that society is burying its head about.

It's so ironic that in modern society, the children are adults and the adults are childish.

> as far as the "human cost" of wearing a mask... grow up. Asian societies like China/Japan/Korea have been wearing masks forever and they're fine

This is a racist meme that needs to die. You would see some people wearing masks. By no means did everyone wear them. Not even close.

The only people claiming that mask adoption was common across asia have never spent significant time there.

Another benefit is that masks help if you’re not in „camp good-looking“ or „camp daily toothpaste“. Also, Years ago, when I switched from public transport to car I noticed a significant reduction in being sick / year. So yeah to (voluntary) masks in public Transit

It would be great if we could establish, that everyone who has an infect of any kind would wear masks in public. That alone could cut down infections considerably. And of course it is normal behavior in Asia.

This makes complete sense. It’s really just like having the courtesy to use a tissue when you blow your nose or cough.

nice

I think that's not quite what we want, however it might be what we have to accept.

Ideally, people who are stick will stay home, rather than put on a mask and go out into public. However the current state (pre-pandemic) is 'be sick, go out into public and claim it's just allergies'. So perhaps putting a mask on is a good substitute.

It depends. You are right that if you can work from home, you definitely should, if infected. But we cannot expect people to be quarantined because of a cold, you might have to buy groceries for example. Or travel to a doctor. Or if you have to come to work. In those cases, wear a mask!

A lot of people will simply lose their jobs if they don't go in to work, whether they're sick or not. A lot of those jobs are in food service. Wearing masks in extremely crowded public areas going forward is probably a good idea.

There are simply situations where people are sick but still need to be out in the public. For example, if you are sick but your child still needs to be taken a school event or needs something from the store, you may still need to go out in public.

Plenty of selfish Americans would think doing anything that's done in Asia is unamerican cause personal responsibility and all that.

It's a position that makes no sense but I bet we can expect people who put on masks to be harassed in the long term.

No we cannot wear mask because there will be no scientific research showing that masks will specifically reduce the transmission of what you have.

We are science oriented here folks, not a flat earther.

It's the reason Fauci used in the beginning where they didn't recommend masks.

What an idiot. Fauci is fortunate that Trump was a bigger idiot.

Ditto. Anecdotally winter 2020 was the healthiest I've had in years. It became a personal expectation for me that I would be vaguely sick from November to March which was not the case in 2020.

I rarely get sick, but getting a cold a couple times a year wasn't unusual. I haven't had a cold since mid 2019.

Airplanes and airports definitely.

Caught too many viruses going on vacation.

Japan (and other Asian countries) have been doing this for a while now. Seems to work for them.

So they don't have flu epidemics?

Let me rephrase: is there any (peer reviewed with a control group) evidence that this has any real effect on e.g. flu?

You will not be protected from influenza and common cold. All prior literature on masks and these viruses have found little/no effect.

Moreover: “mask-wearing countries” like Japan, Korea and China have plenty of cold and flu to go around.

Japan in particular had a record breaking flu season in 2019.

Millions of flu cases.

https://www3.nhk.or.jp/nhkworld/en/news/backstories/370/

I'd continue with frequent hand-washing/sanitising to this. I remember reading that Influenza virii spread via touch as well [0]. Plus, it's just good hygiene :)

[0]https://www.cdc.gov/flu/about/disease/spread.htm#:~:text=The....

This is the way.

As a Westerner living in Asia for a while now, masks in public was one of the no-brainers that was very easy to adopt. It's like taking your shoes off in the home, it just makes sense.

Good for anononimity, may be bot so good at influenza prevention: https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article

"those top 10 causes of death are abetted by risks some of us long ago rationally (or semi-rationally) decided to accept: smoking, drinking, overeating, driving, kissing, chainsaw-juggling and so on."

I wish we could, as a society, rationally work on reducing some of those risks. Smoking is on its way out, finally, with substantial public education, taxes, peer pressure, etc. But smoking mostly only affects oneself, second-hand smoke notwithstanding.

Some risks, like choosing to drive all the time including while angry, sleep-deprived, distracted, etc., or choosing not to be vaccinated, aren't just on yourself, they're increasing the risk for everyone around you.

I can't safely go the store even if I choose to walk or bike because some jackass might decide to pick up a french fry instead of look where they're going and jump the sidewalk or veer into the bike lane and turn me into paste. There's not really anything I can do about it, except huddle in fear in my house. It's infuriating.

Similarly while I'm vaccinated and thus my risk of hospitalization or death from COVID 19 is effectively 0, my three year old son is not. People choosing not to vaccinate are putting him at risk, which really twists me up inside.

This post is akin to someone pinching me and saying "hey, we live in polarized country!" The so called culture wars just seem to be escalating.

What part of this is in any way related to "culture war"?

Attitudes toward balancing risk versus convenience are cultural. Historically, the United States was pretty accepting of risky and risk creating activities. These days much less so.

Attitudes toward driving are deeply cultural and affect many aspects of life. I just got back from Dallas. It’s extremely car-oriented, with a vast network of express lanes connecting far-flung suburbs. It also has low housing costs and tons of kids and kid-related activities. These are all related: wrangling one kid on a subway train is doable, much less so three. When you say “driving is bad” you’re touching on myriad aspects of how people have chosen to structure their live, including their reproductive choices.

I know you meant the car centric anecdote to be an analogy and not the point itself, but I must nitpick.

Public transportation/buses/subways are honestly quite convenient even if you are wrangling 3 kids around. The problem is that public transportation in the US at its best (NYC, Boston) is still a far-cry from actually 'good' public transportation systems. In many places kids as young as 11 are able to independently navigate the city without the parents help when public transportation is well built. If anything, car dependence means that kids take 5 more years (16) before they can be independant and parents will often struggle to meet diverging needs of 3 children when the car is a single bottleneck.

Not-just-bikes does a great contrast between North America and the Netherlands to highlight how car-dependence can lead to struggles as a parent: https://www.youtube.com/watch?v=ul_xzyCDT98

Also, given that most upper middle class families usually have 3 cars (2 for parents work and 1 for a 16-yr old child), if public transport allows you to go from 3 -> 1, that's already a huge plus. It is not like families in European capitals do not own 5 seater hatchbacks. Public transport isn't against cars. It's is against car essentialism. If anything, moving people to public transport will improve the experience of those who need cars by declogging highways.

Lastly, car essentialism, highways, the suburban dream and white flight were all distinctly post-WW2 phenomena and heavily subsidized to be that way. It is by no means a part of American culture. Most pre-ww2 cities such as the ones in the NE had perfectly acceptable public transportation for the time, which has since not been maintained as well. Even smaller cities such as Portsmouth NH and Portland ME are incredibly walkable, dense and public transport friendly. (rural culture is an entirely different point. If you own 10,000 acres of corn fields ofc you own a tractor or a pickup. No one is suggesting public transportation for them)

Older American suburbs are actually far less cardependent than you'd think: (https://www.youtube.com/watch?v=MWsGBRdK2N0, https://www.youtube.com/watch?v=dVeSiWTU74s)

Dallas style urban design has existed for less than 70 years, and was specifically engineered by politicians and corporate interests rather than being a natural outcome of American cultural desires.

Arguing that a phenomenon is less than 80 years old doesn't mean that it's not a part of American culture.

And there is more than just public transportation keeping 11 year olds from navigating the city by public transit. We also have crime rates far higher than western Europe or Asia.

Making public transit suitable for unaccompanied children would involve an unacceptable, probably illegal curtailment of the freedoms of mentally ill homeless people to do as they please in public spaces.

The birth rate in transit friendly European cities has collapsed, so I’m not sure what that gets you. You make a good point about older children, but if you have 3 kids (American women in average want closer to 3 than to 2) you’re going to spend 15 years or so with at least one kid below 10.

Of course you can have three kids in the city, but you can also do your laundry by hand. That doesn’t mean people want to go back to that way of living. And birth rates in cities were never particularly high in the modern era. Most people in America at the turn of the 20th century lived in rural areas.

Also, a bunch of other stuff has changed since the pre-suburbanization era. Both parents typically work, and have to reconcile commuting to work with child care drop off and pickup (which isn’t necessarily located near transit).

That said, I know someone with three young kids living in Chicago without a car. But she’s a champion, and most people aren’t as hard as her. Dallas-style cities make a lot of the ancillary aspects of parenting much easier.

Street design can help a lot with pedestrian (and bicycle) safety. Unfortunately most of our efforts most have been put towards the safety of the people inside the car instead.

"People choosing not to vaccinate are putting him at risk". This might not exactly be the strongest point to make, as the Covid IFR rate for those under 17 is 20 in 1,000,000, or a 99.998% survival rate. Sure, there's a non-zero chance of death but it's effectively zero. It's great to say we should reduce risks further as a society, but is it really worth the costs to reduce risks like that further?

Source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

Consider then my family member, who is elderly and immuno-compromised such that the vaccine may not be effective.

Immunocompromised people always have been at risk and always will be at risk. The presence of one more endemic coronavirus doesn't really change anything. Other endemic coronaviruses already have a high fatality rate in that population. I don't mean to minimize your family member's situation but that's just medical reality.

https://academic.oup.com/jid/article/223/9/1564/5899001

Having an already-high baseline risk before adding covid is a reason to be more cautious, not less. The point is that this particular vector is so trivially preventable.

"IFR" (infection fatality rate) is not the be-all end-all metric of danger.

you don't have to die to suffer harmful long-term consequences from COVID, it appears to cause all kinds of organ damage including to the brain, this includes "the young", and these people usually did not suffer "severe" acute reactions during their infection.

https://www.bmj.com/content/371/bmj.m4470

https://www.webmd.com/lung/news/20210401/many-show-long-term...

https://www.nytimes.com/2020/12/28/health/covid-psychosis-me...

it's not safe to get covid period the end, even if you're "young" and even if it doesn't kill you outright or even hospitalize you. it's still a dangerous disease and the spread still needs to be minimized.

What are the numbers on how often people are having those effects?

In a University of Washington longitudinal study, 32.7% of participants had persistent long-term side effects, and around 9% had moderate to severe long-term side effects.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

Really don't know why some people are so determined to deny that COVID is a serious disease with a decent incidence rate of serious side effects. 10% of the population getting moderate to serious side effects from a single source within a year is a lot, and it sucks if you're that 10%! And another 20% get minor side effects on top of that. And it isn't just "the old" or anything like that, those side effects cut across the whole population, young and old.

I guess it's just the next iteration of the old "it's no worse than the flu" denialism. But a single bout of the flu doesn't leave 10% of the population with serious long-term side effects.

It wouldn't be 10% of the population, though, right? It would only be 10% of the people who caught a case of the flu bad enough to be hospitalized or outpatient-treated?

Hmmm, I couldn’t find how exactly the study population was selected. Where did you see that?

it's 30%/10% of all cases, including weak/asymptomatic.

That study wasn't controlled. The most common reported symptom was fatigue. Many people who have never been infected also report fatigue symptoms. We'll need more research to reliably quantify how many patients experience long term symptoms.

It looks like they did have a control group, although it was fairly small with only 21 people.

I honestly hadn’t seen any hard numbers and was hoping to become more informed on the matter. That study looks decent, thank you for sharing it.

I think the study mentioned that this is largest and longest study about long-term effects, which I find a bit disappointing given the massive impact of the pandemic. The control group was quite small with only 21 people.

Anyways, I have adjusted my priors a bit. I’m not some sort of rabid denier :). But I am a bit wary of people arguing for very strict measures. The vaccine exists and is widely available (in the US). We won’t have a more powerful tool than that anytime soon. We need to start moving on with our lives. Not recklessly, but it needs to happen. Thankfully, the numbers seem to be getting better and better. Hopefully the trend continues.

I'm sure you mean well are are just trying to help, but please be very very careful when repeating claims like this. You could also make it clear and indicate what the articles actually assert as fact (versus just reporting data) to avoid confusing the lay public. The differences between what we know, what we suspect, what we think is likely, etc are nuanced and subject to being misunderstood.

Are you seriously implying that the only negative outcome is death?

Some people have long term side effects. Even if you fully recover if you have a bad case you could be out of work for a long period of time. The negative impact is significantly higher on the poor who can't afford health insurance or to take time off.

Stop looking at death and look at the total impact.

Lockdowns have also had a high negative impact on the poor around the world by preventing them from working and earning income. Hunger is more dangerous to many of those people than COVID-19.

Remember that death isn't the only bad outcome: just because you survive doesn't mean you're out of the woods, unfortunately. I'm afraid "Long COVID" is a thing, for adults and children.

"Evidence from the first study of long covid in children suggests that more than half of children aged between 6 and 16 years old who contract the virus have at least one symptom lasting more than 120 days, with 42.6 per cent impaired by these symptoms during daily activities. "

There are folks that are still debilitated, almost a year after their "recovery". We don't know if/when their sequelae will disappear. Time will tell.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927578/

This isn’t a paper, it’s an editorial, and it’s utter trash, printed in a bad “journal” (New Scientist is essentially a mass-market magazine, on par with Discover). The only evidence advanced for the claim is this:

https://www.medrxiv.org/content/10.1101/2021.01.23.21250375v...

This is a survey of parent-reported symptoms in 129 children, and of the “long-term” symptoms, all are vague, (e.g. headache, fatigue, muscle pain) overlapping substantially with the aches and pains of daily life.

They don’t even bother to link to it directly in the editorial; they simply mention the doi in the text. This wasn’t even proofread by an editor.

How hard is it to get vaccinated? Just get the fucking shot.

did you get yours?

We had to wait until just this last week to receive second doses. Shots have been rationed and rolled out by appointment only in our state.

That said, now everyone in our family is fully vaccinated.

Unless I'm mistaken, if we look strictly at risk of serious injury and death — not inconvenience and cost of hospital admission, etc. — then it should be less deadly to enter a crowded public place while infected with COVID than to enter the same crowded public place eating peanuts messily.

Of course, you shouldn't do either, and you should probably doubly not do the COVID thing; I'm just trying to get a baseline of risk to compare to.

Have the statistics changed for people under 10 with covid? Early on data suggested almost no hospitalizations or deaths for young people.

According to this link 287 out of 568.000 has died from Covid, though that is in the age group 0-17 years.

https://www.statista.com/statistics/1191568/reported-deaths-...

If you assume that lung damage is to an extent irreversible and accumulates over time (peobbat less true for pre-puberty children than adults), then you'd expect lung damage to be less immediately fatal in the young yet still have similar effect, just delayed.

That is not a valid assumption. There is no evidence that lung damage is common in children, or that it is irreversible.

In a good chunk of the US driving is unavoidable due to long distances and poor options. There was a story a few years ago about a Detroit man who walked 21 miles to work https://amp.freep.com/amp/22660785

I like building out transit but to be quite realistic we are never going to get to China levels of building out fast enough transit covering a majority of jobs and we can’t undo the great big sprawl of places like Houston or Dallas or Atlanta.

> Similarly while I'm vaccinated and thus my risk of hospitalization or death from COVID 19 is effectively 0, my three year old son is not. People choosing not to vaccinate are putting him at risk, which really twists me up inside.

It appears that you understand that the vaccine doesn't make you immune to COVID but rather reduces the symptoms. Given this, you can still catch it and pass it to your child. You are probably still their most likely vector. Have you changed your habits (being more social) since receiving the vaccine? If so, is your argument that those you are now socializing with are responsible for spreading it to your son through you?

This is outdated. The CDC guidelines about masks explicitly stated that studies in the real world confirm that you are exceedingly unlikely to get or spread covid after vaccination with the mRNA shots. That’s why they said it is not needed for vaccinated people to wear masks.

This is not outdated, The CDC website still says this is an active area of research. “Early data” indicates otherwise but we already know vaccines are not 100% effective. I don’t know why you’re believing the CDC on this after they pulled the same stunt on masks early on to achieve a political mission (reserve PPE for medical people) and even admit this is to incentivize those who are opposed to getting vaccinated by dangling the “no mask required” carrot in front of them. The default stance of the CDC should be cautious towards early data and not use it as a means to alter people’s behavior.

Wow, you're next level. Have you thought about how that comment reads to a worried parent?

I think your perspective shows one side of a continuum between Personal Freedom <----> Collective Safety. It would seem that at some point maybe in the 50's or maybe the 80's a majority of people decided the debate around this was solved and the US would favor personal freedom over everything else. It's clear that as a society we have decided to re-open this debate.

While the answer probably lies somewhere in the middle the most important part of this issue is the nuance. It's become very common to lash out and villainize people on the other end of the spectrum or just people in a slightly different place on the spectrum. I think we first need to carefully consider the variables and hedge our statements.

For example, a friend of mine in her 50s was recently verbally accosted, by an employee of the store she was at, for not being vaccinated because she was wearing a mask after it wasn't required . But she is in fact vaccinated and wants to continue to wear a mask because she has many health problems.

Just assuming the other side is needlessly putting other people at risk because they are selfish is overly simple and will fail to address the root issues at play. The same is true for the other side of the argument, assuming people hate freedom and want to make all your decisions for you because their evil or think your stupid is also failing to address the real issues.

With some nuance and understanding injected into these conversations we might be less polarized and have options that work for more people.

At the bottom of it all, different people have different values and there's no way around that.

And some people are hateful and aggressive due to their personal mental state.

> But she is in fact vaccinated and wants to continue to wear a mask because she has many health problems.

Does she know that a mask, by itself, offers effectively no protection from being infected by covid-19?

That is not true.

One of the biggest upsides of self-driving car tech developing further is that it will make life safer for pedestrians and cyclists. (But it definitely isn't there yet).

Self-driving cars will not work well until we realize and accept that there will be casualties caused by these autonomous vehicles.

I think it could work on the freeway and similar controlled environments, but it won't work in cities unless we start to modify the city environment, e.g. no bicycling allowed and so on.

Not quite familiar with the term twist me up, but i take it that you take offense with people freely choosing not to be vaccinated.

To me that kind of thinking while understandable has to go away. You have exactly the same situation with the flu, yet here we don't judge.

So when the vaccines start doing their thing, i sincerely hope that this judgemental attitude will go away.

In the same vein we should also treat vaccinated and non-vaccinated equal, otherwise it will be very hard to live with the virus.

I think Covid will lead to a reevaluation of flu, and people have been disregarding the flu deaths and illness occurrenc rate as inevitable for too long.

I judge the shit out of people who don't get the flu shot, too.

Get your goddamn vaccinations and protect yourself and everyone around you. It's real simple.

We do judge for measles, mumps, and rubella. In the us, we don't allow the unvaccinated to attend schools.

Good point, to be specific i was only talking about the flu and Covid.

More freedoms in Europe when it comes to that matter.

Your three year old son is at 20x greater risk of dying from Influenza than COVID:

https://freopp.org/the-chances-of-dying-from-covid-19-90cd5b...

Hence why he has gotten and will get a flu shot every year.

>Similarly while I'm vaccinated and thus my risk of hospitalization or death from COVID 19 is effectively 0, my three year old son is not.

When will you get your son vaccinated?

As soon as vaccines are available for his age group.

We just got started. SARS, Mexican Flu, MERS, SARS v2. Following each other up in increased velocity due to ever increasing inter-connectivity.

The same seems to be happening in the bio-industry : nowadays there always seems to be some infectious disease present, be it affecting chickens, cows or pigs.

Especially industrial husbandry is an invitation for diseases to spread and maybe manage to jump to humans. In severe cases, mass culling is the only way to stop epidemics among farmed animals. Which affects the price of animal products. Unless our governments subsidize that away...

Do you have any sources for diseases spreading from industrial husbandry which led to epidemic problems? This speculation is repeated over and over again, but is it really true or just speculation?

I know mad cow disease came from farm raised cattle in the UK. People ate the beef and got mad cow disease.

https://en.wikipedia.org/wiki/Bovine_spongiform_encephalopat...

There are many cases of diseases jumping from animals too humans, I know of Mad Cow Disease.

But it was not an epidemic problem IIRC.

Salmanella, E.Coli, Avian Flu, Swine Flu...

Are these epidemic problems?

I didn't get Swine Flu in 2009 from a pig.

African swine fewer is a pretty serious pandemic that is still ongoing. The first outbreak was reported in the beginning of the 20th century when pig farming started to reach truly industrial dimensions. It can be spread by ticks, direct or indirect bodily contact, or contact with bodily fluids and pork products, and is quite difficult to contain. Also, it is endemic in wild boar populations and slowly progressing across the old world.

Fortunately for us, it does not cause diseases in humans (yet). But it causes huge economic damages and is devastating for wild boar populations.

In general, many diseases are not specific to humans, but also affect animals, or are transmitted by them.

Well the good news is that now that we have mRNA vaccine technology we can develop vaccines just as fast as those viruses come.

It blows my mind that we had the coronavirus sequenced the first weekend after it was discovered, and the first current, same-as-in-production-now Moderna vaccine ready in February of last year, before the epidemic even came to the U.S. All the time since then was spent on clinical trials and ramping up manufacturing capacity.

But now that the mRNA platform up and running, I expect subsequent vaccines for new viruses can move through the process much faster, if need be.

I wonder how much head start the Chinese labs had vs February of 2020 in terms of sequencing the virus. (I'm not trying to make any remotely xenophobic claims here, but it seems like there is substantial evidence that something unusual was happening in Wuhan as early as late fall of 2019.)

The rest of your comment stands strongly, but I'm not so sure about "the first weekend" as being entirely correct and repeatable.

Depends on the virus.

Coronavirus is an "easy" one to create a vaccine against. HIV would be the toughest one, regular approaches don't work, which is why we don't have a vaccine despite 30 years of trying.

For HIV you need a different approach, called "germ-line targetting", where instead of presenting the virus, you are trying to direct the evolution of antibody producing cells towards a specific kind which is able to produce working antibodies. If you just present the virus, you get useless antibodies.

So if we are hit by a "hard" virus like HIV, mRNA vaccines will be useless, since it takes years to figure out that germ line targeting.

Yes mRNA gives us some good weapons against future viruses. More important than that would be to react quicker when a new pandemic looms. Make sure that all air travel is checked (the US banned travel from China, while infected people would arrive from Europe...), be quick with local lockdowns while the virus isn't spread around the country. Especially, watch out early for local outbreaks.

Also improvements to public health information systems. It seems like there are a lot of people employed in public health in the US across the local, state and federal levels and those people are not served by good systems.

The fact that for most of the pandemic, a volunteer effort run by The Atlantic magazine was better at reporting disease statistics than the CDC is a flashing red sign.

My own county’s system seemed designed for tracing and reporting a handful of cases per week for TB outbreaks or the like and was knocked over when the COVID surges happened.

>(the US banned travel from China, while infected people would arrive from Europe...)

It's worse than that. We banned some non-citizens from entering the US if they had been in China, we did not ban travel from China.

the formulation of the vaccine was very fast and relatively simple compared to the 12+ year span required to understand the virus to the extent that a working vaccine could be formulated.

we were lucky with this one, and we need to put more effort into surveillance of novel pathogenic threats and facillitate investigation regarding molecular characteristics

if this pandemic involved a pathogen that we have only a nodding familiarity with we would be having some very different concerns and probably have a pandemic that goes full bore until burnout with no vaccine available until such time as we learn how to make one.

The optimism around the mRNA vaccines should be tempered: there are reports of coronavirus vaccines causing heart inflammation (particularly in youngsters); and causing substantial changes in the immune responses. These admittedly infrequent or possibly benign consequences will need to be understood much better for mRNA vaccines to become mainstream.

If we're now a fertile ground for pandemics, it really does ask for a response in kind: changing another parameter in the differential equations. And that could come in shortening the response time.

BioNTech had the vaccine weeks after they began studying the virus. Herd immunity is only being approached a full year later. Vaccine approval procedures and production logistics really do have a hugely wide margin of improvement.

It took two days to make moderna. If it hadn't because because of the rules about medicine we could started the US roll out _before_ the first case.

If there ever is a serious pandemic with high numbers like MERS we will.

The title is true for some definition of "near" and some definition of "here". Here in India, the official "second wave" now has been brutal. Just a few months ago, nobody thought there could be any further lockdowns since the ones earlier last year hit the economy and livelihood of hundreds of millions of people quite hard. But here we are, with extended lockdowns for several weeks in many states.

Unlike other countries, vaccine procurement wasn't given a big enough push last year by the Indian government. Some other countries were also good at vaccine stockpiling with massive orders to producers. By some estimates, [1] vaccinating a higher percentage of the Indian population (required for herd immunity and to keep the rate of new infections lower) would go well into 2024! The same is said to apply for the rest of the world. [2] I don't think reality would be so bad though. Ramp up will accelerate quicker with more producers lining up. But we'd probably be still looking at end 2022 or later in India for mass vaccination to be done. The cost to the society is quite high with lockdowns and restrictions (not saying that these are totally unnecessary).

Anyone who's optimistic that "the end is near" would have to ensure that movement of people from other countries (with other variants and higher rates of infection) is prevented or highly restricted. That's easier said than done when the time frame is long. You wouldn't even know that there are new variants until they have taken ahold in large numbers.

I have to conclude that the end is not anywhere near right now.

[1]: https://www.business-standard.com/article/economy-policy/at-...

[2]:https://www.msn.com/en-us/health/medical/we-wont-have-enough...

And lots of other countries rely in India for their vaccines and oxygen. If India Restriffs exports of both for a long time, these countries are in real trouble.

Yes only if you look at the USA. Look right across at Colombia, Brazil, Africa, India and the middle east and tell me it's over ..

I know India is vast and it has a long way to go, but there is a general downward trend in the cases in India.[1]

[^1]: https://mobile.twitter.com/ShamikaRavi/status/13974936885115...

That's encouraging but it's far from under control. And the trends are upward here in South Africa, and a lot of other countries.

Even though our numbers are fairly low right now we've seen how this thing resurges really quickly. Without enough people vacinnated or with antibodies it's not under control.

also the more people that get it the more chance for it to mutate, potentially in ways that the vaccines will no longer catch.

getting the developed world vaccinated is a start but letting the developing world continue to be a petri dish will eventually come back to bite us.

Sure, and the US and Canada had a downward trend last year before new peaks happened in fall/winter.

I'm in the US, so I should be fine now, right? Nope. I got sick last March, before testing was a thing, the case was mild, I lived upstairs in isolation from my family for a month. However, ever since I'm short of breath.

It's been a year, I went through all the tests, heart, lungs, and even had an invasive probe of the pressures inside my heart. They had no reasons. Then I got laid off and insurance went away. Recently I found that If I stand, my heart rate rises 15 beats per minute, and goes right back down when I sit. Nobody knows how much damage this has done to those who are "over it". This is "long covid".

I've been physically tired for a year. To know there are so many people like me, to see the pollicization, and subsequent complete disregard for the tools of science, is heart crushing.

Sure, go ahead, think it's over... but what is over is a normal world. We HAD the chance to stop this, but blew it.

What we're going to find we are collectively left with is the most horrid words anyone can hear in medicine, "a new normal".

FYI I'm no doctor but an internet search suggests heart rate rising 15 beats per minute when someone stands is normal:

"Normally, the heart rate increases by 10 to 15 beats per minute when standing up, and then it settles down again."

https://www.google.com/url?q=https://newsnetwork.mayoclinic....

It's encouraging to see some reason right there. I figured portions of the population would find, sense, and think of all sort of post diagnosis symptoms that simply aren't related to an infection. Given the talent media have shown on scaring everyone, it wouldn't surprise me that some people catch a flu-like disease simply out of stress, fear, and paranoïa. All it takes is a weaken immune system for a random bug to cause the well known common consequences, now systematically blamed on the craze virus. Fever, nausea, soar throat, difficulties to breath perhaps, probably diarrhea.

What if the "cases" of infection were in fact, for the most part, patients impacted by random bug, directly caused due to their heigher than usual stress levels, due to totally virtual fears. Diagnosed as such because of the constant obsession to identify hosts.

I do wonder how often "confirmed" cases are taken a blood test sent to a lab among other non infectious blood samples for actual confirmation of the virus presense.

Have you been tested for POTS? If you're afraid of heart rate issues and fatigue, especially when combined with small amounts of exercise, that's the syndrome to look for.

Buuttt.. POTS is when you have an increase of 30+ beats, not 10-15, I'm pretty sure that's a very normal amount of increase. Going from sitting down to standing up is weirdly enough a very difficult exercise for your body. A Lot of blood needs to rush to your thighs in a very short amount of time, body compensates for that by just pumping a little bit harder for a short amount of time.

Ask for a tilt table test. POTS usually takes a while to diagnose because tests are done to rule out fatal conditions.

I have POTS, you feel like shit a lot of the time but it’s very manageable.

It’s usually caused by a viral infection.

Sorry you’re going through this. I have a close loved one with long Covid related issues and it’s been a miserable year for them, with a lot of uncertainty about the future. A young, otherwise healthy person. I understand your sentiment — while people are ready to move on, a lot of people are still working through either the trauma or continued physical effects of this disease.

> Recently I found that If I stand, my heart rate rises 15 beats per minute, and goes right back down when I sit.

This is absolutely a normal rise. Standing is a lot of work!

This says nothing about your other symptoms, but your standing pulse is fine. Mine is about 58-65 while resting, about 80 while standing, and 90-100 while walking.

>Sure, go ahead, think it's over... but what is over is a normal world. We HAD the chance to stop this, but blew it.

At what point did we have a chance to stop this?

Right about when the CDC said NOT to wear masks for political reasons.

Seems like the cat was out of the bag at that point as the virus had already traveled across the world.

If there was ever at all a chance at stopping it, it was in November and December of 2019 when Chinese doctors were sounding the alarm but were silenced and punished by their government for "creating disturbances".

is this "long covid" or is it just the result of a year of physical inactivity?

It happened right away, and hasn't improved, even after getting completely vaccinated. I'm not in the greatest shape, but I was able to walk long distances before, the only limiting factor being a bum ankle.

Have you gotten the vaccine? I've heard it relieves symptoms in some (not all) people with long covid.

For the context: Donald G. McNeil Jr., the author of the article, was a prominent journalist for New York Times leading their COVID-19 coverage from the beginning of the disease. He was abruptly dismissed from NYT citing his use of some questionable language while on trip to Peru [0]. I wonder what role if any his COVID coverage played in his firing.

[0] https://en.wikipedia.org/wiki/Donald_McNeil_Jr.

EDIT: wikipedia link ends in dot `.` that is stripped by the HN URL validator. If the link does not open add dot `.` at the end.

For future reference, write the dot as %2e in the URL and it will not be molested by the validator. Like this: https://en.wikipedia.org/wiki/Donald_McNeil_Jr%2e.

>I wonder what role if any his COVID coverage played in his firing.

The Times was pushing hard for McNeil to get a Pulitzer for his COVID19 coverage until his firing.

So were the epidemiologists wrong about herd immunity and the USA has hit herd immunity at 50% vaccinated (plus natural infections, some of whom also got vaccinated)? I do not think we know what is going on right now, it is very strange that infections are receding in the USA. It is not due to weather, the USA South had spread last Summer while the NorthEast receded. We have been experiencing waves but it is not entirely clear what is causing them. 50% vaccinated is not enough to stop the spread so something else is. My theory is that there is much more asymptomatic spread than we know of and the waves are due to variants. Each new variant spreads and burns itself out till the next takes over. People who were naturally infected instead of vaccinated may be more susceptible to variants; what happened in the Saychelles may support that idea:

https://www.channelnewsasia.com/news/commentary/covid-19-vac...

If that is not the cause of the waves, were the epidemiologists just wrong about herd immunity and we are already there? If variants are the cause of waves we could see another wave in the USA in several months as vaccinations taper off. I have not seen a good explanation for the waves yet. Some say people's behavior is the reason, but that can not explain what is currently happening in the USA.

That was extremely pragmatic and well written.

All the respiratory viruses we currently live with probably started as pandemics. The 1918 flu became seasonal flu, other human coronaviruses probably were much worse when they first jumped to humans.

> Taming a pandemic

> One year after its emergence, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become so widespread that there is little hope of elimination. There are, however, several other human coronaviruses that are endemic and cause multiple reinfections that engender sufficient immunity to protect against severe adult disease. By making assumptions about acquired immunity from its already endemic relatives, Lavine et al. developed a model with which to analyze the trajectory of SARS-CoV-2 into endemicity. The model accounts for SARS-CoV-2's age-structured disease profile and assesses the impact of vaccination. The transition from epidemic to endemic dynamics is associated with a shift in the age distribution of primary infections to younger age groups, which in turn depends on how fast the virus spreads. Longer-lasting sterilizing immunity will slow the transition to endemicity. Depending on the type of immune response it engenders, a vaccine could accelerate establishment of a state of mild disease endemicity.

https://science.sciencemag.org/content/371/6530/741

It's been over for a long time for me. I decided one day that it is obvious, this virus is here to stay, and I won't live my life like a bug, hiding in corners afraid to be squashed. If the virus will exist forever but these conditions cannot, what better time than now to stop behaving in this unnatural way? So I did. And I've been happier because of it.

I saw the news this week and the first stories were not about Covid. That is the first time I can remember, in a while.

The pandemic is clearly coming to an end. Herd immunity or not, the systemic risk is going away in the US and other rich countries, leaving only the personal risk.

If anything I wish the communication between the difference in systemic risk and individual risk had been better. People on Facebook have been talking about the 98% survivability for a long time. That sure sounds like a high number even though, a lottery with a 2% chance of winning sounds amazingly plausible. But the real risk has always been systemic. An exponential growth that overwhelms the healthcare system and leads to people dying, even those unaffected by Covid itself. Because they "chose" a day with an overwhelmed health care system, they may die when they have a heart attack or a traffic accident.

With vaccination rates north of 60%, the systemic risk is gonna become smaller and smaller. As the article says, vaccinated people and people who have had it before will act as control rods for the reaction.

Since Covid will not go away, the number of vaccinated will grow with vaccination efforts and the number who had it before will grow by itself.

I strongly believe that most people on this planet are gonna be exposed to the spike protein, either through vaccination or Covid itself, herd immunity or no her immunity.

I fell that makes an incredibly convincing case for vaccination, but I have not been able to convince any anti-vaxer with it, so there's that.

I don't disagree with you, just want to mention that people on Facebook are very dumb if they think 98% survivability is a good rate, given how easily this disease is transmitted without stringent measures.

Luckily, the estimated fatality rate with modern medical care is much lower.

for an individual, it's "good" if you accept to have one chance over 50 to die of it.

for a population, it's a lot of deaths.

all depends if you think "you first" or "the other first"

Well I just did a test with a tool for lung cancer risk. Assuming I smoked half a pack a day for 25 years and stopped at 40, my risk would be 1 in 1000.

Yet noone would say it's "good" to smoke. Even if the risk is 10% of the risk of dying of COVID.

A 2% death chance may look small on its face, but Covid is not the only thing you can die from. If you accept a 2% death chance ten separate times, your death chance overall is 18.3%. I bet those are numbers which a lot of people won't be comfortable with anymore.

The current best estimate of worldwide infection survivability rate is now 99.77%. However the error bar on that number is rather wide.

https://pubmed.ncbi.nlm.nih.gov/33716331/

.3% is about the percentage of American population killed in in WWII.

Can you cite evidence this is the "current best estimate"?

The author of that study has been downplaying COVID since the start. Here's him last March:

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...

> If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.

(We're at well over 500k now.)

His estimates last April from Santa Clara, California were wildly inaccurate as well.

https://www.wired.com/story/new-covid-19-antibody-study-resu...

> Skeptics have noted that the conclusions seem at odds with some basic math. In New York City, where more than 10,000 people, or about 0.1 percent of the population, have already died from Covid-19, this estimated fatality rate would mean nearly everyone in the city has already been infected.

And this:

https://www.buzzfeednews.com/article/stephaniemlee/ioannidis...

> And in May, Ioannidis presented a picture of the virus’s deadliness based on antibody study data from around the world, including his Stanford study. This preprint was roundly criticized for including groups of patients who don’t reflect the general public and, in earlier versions, omitting data from large groups with higher fatality rates, among other errors.

If you have specific evidence that the numbers in that article are wrong then I recommend you contact the editors of the Bulletin of the World Health Organization and let them know.

https://www.who.int/bulletin/editorial_board/en/

You said it was the "current best estimate", not "accepted for publishing in a journal". Those are very different standards.

Could you give a journal article citation for a better current worldwide IFR estimate?

"Better" is gonna take time to determine. I'm not hitching my wagon to Ioannidis as the winner in the end, though, given his track record thus far on failed predictions/modeling.

https://www.imperial.ac.uk/mrc-global-infectious-disease-ana...

> Using these age-specific estimates, we estimate the overall IFR in a typical low-income country, with a population structure skewed towards younger individuals, to be 0.23% (0.14-0.42 95% prediction interval range). In contrast, in a typical high income country, with a greater concentration of elderly individuals, we estimate the overall IFR to be 1.15% (0.78-1.79 95% prediction interval range).

Confounding matters: any currently published estimate is likely to lack data from the current large spike in India.

Ioannidis is not exactly a trustworthy source on COVID information at this point. He just keeps doubling down.

> I fell that makes an incredibly convincing case for vaccination, but I have not been able to convince any anti-vaxer with it, so there's that.

People who don't want to be vaccinated with the new vaccines are not necessarily anti-vaxers tho. You didn't spell it out, but you speak about COVID in the previous sentence. Vaccination is also not meant to be some cult rite where you need to believe in it. It needs to be tested and that did not yet happen properly, so it is actually more sane to wait. This becomes even more important because even the basic mechanism is not studied for vaccinations long-term at all.

In Germany they push for vaccinating kids which is especially cynical given they have a COVID death rate which is lower than the death rate of some established vaccines. And COVID vaccines have way higher death rates even by official numbers (which are the lower bound).

Just to make it more obvious: In Germany in total 21 people died with/because COVID in the age of 0-19 (~15M pop in that age). Do you not see the insanity of this?

Don't we need to vaccinnate kids to reach herd immunity? Sure it doesn't make sense when you look at young people in isolation but that is beside the point.

The vaccines are not sterile, so they do not stop the spread either.

This statement makes no sense.

The mRNA vaccines are sterile; there's no active virus or bacteria in them. It's also conclusively determined they reduce transmission.

(The sterility of a vaccine has no impact on its ability to reduce transmission, anyways; they're not linked. Live-virus vaccines like the flu nasal spray vaccine can still prevent disease.)

I think the comment was alluding to 'sterilizing immunity', rather than the aseptic nature of the vaccines themselves.

Not when you factor in immunity from recovered people.

If we get to 60% of the total population plus 25% of the rest being immune from recovery, that is 70% total.

You did not understand the difference between systemic and individual risk the parent mentioned. Of course, 12+ year olds are not vaccinated for their own safety, but to supress infection chains that might reach someone more vulnerable. I don't see any insanity in this as testing HAS happened properly.

> This becomes even more important because even the basic mechanism is not studied for vaccinations long-term at all.

It is spouting shit like this that makes people call you an anti-vaxer. What the hell are you on about?

There are no long-term studies for mRNA vaccines.

So what? What's the mechanism you're concerned about?

>What's the mechanism you're concerned about?

What do you mean?

We can't know what the long term side effects of drugs are until we have long term data.

Even with long term data showing significant negative side effects of drugs, we often dont understand the "mechanism"

> What do you mean?

Apologies, don't mean to pick on you but wanted an example for a future comment.

This maintains context worse than GPT-3

If the drug breaks down rapidly in the body, yes, we can indeed know that. Then there can be no mechanism by which it can have long term effects. That's what happens with the delivered mRNA.

What is the "mechanism" from the vaccine which has caused some people to get thrombocytopenia, bells palsy, temporary deafness, and other such side effects in just the short term?

Hyperactive immune response gone wrong?

Scientists don't know what causes auto immune reactions/disorders, or why they have seemingly been on the rise for decades.

I'm fully for vaccination as I wrote above.

But out of interest, what about the people who have long-haul COVID, do we know the mechanism how they experience long term effects from the actual disease.

Would it be possible that vaccines created long-term effects in the same way?

"I've been smoking cigarattes for the past year and nothing bad has happened to me, i guess they are perfectly healthy"

That is not strictly speaking true. There have been no long term studies for the most recent mRNA vaccines, but mRNA technology has been in development for many years with much of the effort going into studies of human safety. This long period of development and testing is how the method of packaging the mRNA in a precisely engineered blob of fat came about.

>mRNA technology has been in development for many years with much of the effort going into studies of human safety.

Have there been any long term human trials of mRNA vaccines?

Yes, though that might depend on your definitions of both long term and vaccine. There is actually a quite interesting body of literature surrounding these developments, so it might be worth doing some searches and some reading.

Do you have any sources for long term mRNA vaccine trials on humans?

My searches seem to indicate there are none, other than the preliminary, limited scope short term trials

What about long-term studies for the actual COVID?

Pfizer is in the process of completing the normal licensing process: https://www.pfizer.com/news/press-release/press-release-deta...

What's the next hurdle after that for being 'properly' tested?

vaccines are supposed to have years of testing to prove they are truly safe in the long term. your own link says pfizer is trying to extend the emergency use authorization to apply to younger people, nothing about completing approvals. true FDA approval is still years away.

The headline is Pfizer and BioNTech Initiate Rolling Submission of Biologics License Application for U.S. FDA Approval of Their COVID 19 Vaccine

Biologics License Application for U.S. FDA Approval is the final thing. The next step after that is safety monitoring of the fully licensed product.

The 16 and over there is about the applicability of the resulting BLA.

I got the vaccine, but in retrospect, I should have waited. I should have gotten antibody tests first.

A few things: my odds of dying from COVID in a given year are about the same as me dying in a car crash— and that is given the admittedly liberal COVID death stats.

My very strong reaction to the first dose (the only one I took, in the end) suggests that I already had COVID and didn’t know it. It probably makes sense to test for antibodies before taking the vaccine. If you’re in a low risk category and have antibodies, I’d pass on the vaccine.

The vaccine was rushed by all accounts, and I have personally participated in drugs that are now banned due to side effects not detected during more rigorous trials. It may take a long time before we know of serious side effects from the vaccines. On the other hand, it will take a long time before we can be confident the vaccines have no serious side effects (whose manifestations are delayed). No one knows at this point because due process was tossed (for good reasons).

I think the rational thing to do is to look at what statistical group you are in. If you are high risk, get the vaccine. If not, wait.

All of that to say, folks who are hesitating are not illogical antivaxers. I’ve got good friends with PHDs in microbiology and bioinformatics who are informed, intelligent, and divided on the topic. It’s plainly not black and white.

Say a new variant emerges that has a 90% mortality rate. Would you still wait to get the vaccine because it was "rushed" and not fully tested? Would you rely on antibodies from the current variants?

In that situation I would do whatever it took to get the vaccine. And I would feel extremely silly and irresponsible for doubting the science.

You’re saying exactly the same thing as I am, I think? It’s a risk / reward calculation.

A 90% chance of death would make the vaccine very attractive.

I mean I get it that there is some hesitation. I probably shouldn't have used anti-vaxer as that would indicate that every person who is against getting a COVID vaccine is against vaccines in general which is not true.

But that is beyond the point. My point is, that you will get exposed to COVID either way, through vaccine or naturally.

Looking at the numbers I'd rather take my chances with the vaccine. It sure seems a lot less risky.

Good for Americans really. It’s not over for the rest of the world. “Murica!”

For me, the best part is that we very well may have stopped the pandemic in its track, with vaccines. I don't think we have a precedent.

The usual way we dealt with pandemics was to let people die, a lot until things settled down. We could "flatten the curve" but we didn't really have a way to fight back.

Vaccines helped fighting diseases that were already endemic. But here, it looks like we are beating covid before it has reached its full potential.

The Black Death ended. And yes, in those cases, herd immunity did it.

Did the Black Death really end because of herd immunity?

Herd immunity is easier when 1/3 of the herd died from the disease. But they also did figure out quarantines eventually. "Quarantine" comes from the 40 day waiting period imposed on ships as a result of the black plague.

AFAIK nobody knows. A lot of things changed at the same time.

And now that it's ending there are, besides all the negative outcomes of course, some amazing benefits that have come out of the pandemic or at least were sped up:

- the breakthrough of RNA based vaccins

- a deeper understanding of how air based viruses spread (although much more research still needs to be done)

- a lot of practical lessons learned about managing global virus outbreaks

>the breakthrough of RNA based vaccins

My understanding is that we were at that breakthrough anyhow. This was just the first chance to test it. The emergency sped up that testing, but it didn't create the breakthrough.

The rest I agree with though. There's a ton of information we learned from this experience, and we're still learning.

Commercialization counts as breakthrough here I think. We’ve demonstrably solved all the problems required to get from labs to billions of arms

>> - a lot of practical lessons learned about managing global virus outbreaks

You would think, but I feel like with each wave (and therefore each opportunity to learn from previous mistakes) countries repeated the mistakes of the past. I have very little confidence that if we were faced with a similar threat in the near future that things would be different.

I think the biggest benefit will be that mRNA vaccines may be used more in cancer treatments.

Now that we know they are safe (we've just had an informal clinical trial with hundreds of millions of patients) maybe they will get used more.

This is just the first article I could find on treating cancer with mRNA immunotherapy: https://molecular-cancer.biomedcentral.com/articles/10.1186/...

I'm sure there are many more.

So thankful for Operation Light Speed. It truly delivered amazing results.

I haven't heard of any strains that were not seriously harmed by the vaccines.

We are going to put the vaccines in the arms of pretty much the entire western world and a good part of the third, with more to come.

We can, and should, kill this sucker just as dead as we did smallpox.

Smallpox only transmitted through humans.

If you want to attempt to erradicate covid19, you'll also have to vaccinate all the animals, wild and domesticated, which carry the virus.

Beside everything we've been doing to fight Covid (lockdowns, testing, vaccinations), there's one more thing that we can do, and I don't think it's being discussed enough anywhere: eliminate as many of the Covid comorbidities as we can.

I'm not an epidemiologist, nor am I a medical doctor, so take this with a grain of salt. Admittedly based on little data (ie. my reading the news, some stats here and there), I came up with the hypothesis that Covid is not killing old people more often, _but instead_ it's killing people with preexisting conditions. It just happens that old people are more likely to have comorbidities. Young people with comorbidities are killed too.

Therefore, if we work on eliminating comorbidities, such as obesity (which would reduce the heart disease too), we may be able to reduce the impact of Covid. Obviously, tho, this is a long term plan.

If anyone is aware of public conversations on this topic, please do share.

If you're 5 pounds overweight, you have a "comorbidity". If you die of COVID, I guess you were going to die anyway so it doesn't matter, right?

No, your hypothesis is wrong. COVID has massively increased death rates, indicating that people who wouldn't have died before are dying now.

Ugh, you are literally putting words in my mouth. Don't do that to anyone, it's just horrible. I haven't said anything remotely like "if you die of COVID, I guess you were going to die anyway".

Re-read my comment. I said that people with comorbidities are more likely to die of Covid. Hence, it follows, eliminating comorbidities will reduce the Covid death risk. And that, in the context of fighting _against_ Covid.

I re-read my own comment, and I just don't see how you could misunderstand it so badly. Either you just glanced it and drew poor conclusions, or you are intentionally attempting to misdirect people who first read your comment (since you probably also made sure to downvote my own).

Edit:

Here's data from CDC to support the claims. Some of these are clearly things that can be improved.

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...

Obesity and related metabolic disorders are serious risk factors for COVID-19.

https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e4.htm

There are public conversations on reducing obesity all the time. It has been an ongoing conversation for decades now. Unfortunately, though some people have been able to solve the problem on an individual level, we don't have any good ideas on how to solve it at a population level.

> All epidemics end, vaccine or no vaccine. The Spanish Flu ended. The Black Death ended.

…HSV? HIV?

I do not in any way mean to disregard the suffering of those living with HIV, but let's face it: the HIV epidemic is getting under control. The virus was a death sentence for much of the 80s and 90s. Now (in developed countries) you can live a full life with it. I am not a virologist, but it is my impression that the experts see that virus, too, being beat down in the next couple of decades.

So while the HIV epidemic hasn't ended, we're winning. And it is likely to end.

I feel like you're confusing society having a virus under control & an individuals treatment keeping an infection under control.

With treatment, an individual can keep an HIV infection under control. Ultimately, you are still probably going to die of something HIV related. Earlier than you would have otherwise. It's expensive and not available to everyone.

HIV itself is in no way under control. We have literally nothing other than testing people and trying to encourage those who are HIV positive to avoid behaviors that spread the disease. That's it. The only reason why it isn't any worse is because it already is so bad in some areas.

We are getting HIV spread under control in some countries through the use of PrEP drugs in high risk populations. Those appear to be highly effective.

From [1]:

> An estimated 1.7 million individuals worldwide acquired HIV in 2019, marking a 23% decline in new HIV infections since 2010....

> However, progress on the prevention of HIV transmission remains far too slow, with the estimated total number of new infections in 2019 more than three times higher than UNAIDS’s 2020 target.

That's not "under control" or even remotely close to it, not even by UNAID's own goals. Needle exchange programs and general attitude shifts have certainly improved the situation in developed countries but cost, education, and logistical challenges with drug cocktails still hold back the rest of the world.

[1] https://www.hiv.gov/hiv-basics/overview/data-and-trends/glob...

What are monoclonal antibodies ? I only hear about vaccines on the TV...

> our Great National Misery is ending

Side note but, Americans take note: when you conflate "the world" with America like this, it really grinds everyone else's gears. This is an International misery.

I’m an American and reading this was like sand grinding into my phone screen. :)

I think he's probably talking in the context of the United States because you can't say that the world's misery is over. India, for example, is still experiencing bad numbers. If anything, if he had said the world's misery is ending, that would be US centric.

You're still missing the point. "National Misery" is where the error is coming, it's not National, it's affecting everyone

International Misery is made of many more or less separate National Miseries. This particular one, that affects the author personally the most is ending.

Just because the world is experiencing it doesn't also mean that a nation can't experience it. A family is Syria escaping the civil war can say their misery is ending without the civil war ending.

Do you have a problem with statements like "The Great Depression was the worst economic disaster in American history" because the same economic disaster was happening elsewhere (such as Germany, where it aided the rise of the Nazis).

https://wwwnc.cdc.gov/travel/notices/covid-4/coronavirus-sey...

Stuff like this can still happen in a highly vaccinated population within a larger, widely un-vaccinated population.

I usually agree wholeheartedly that Americans conflate "the world" with America, and that it's really annoying. I can't say that's happening here, though: it's true that the great pandemic misery is near its end in the nation of the USA (and in some other nations). That's a fact. Stating it doesn't mean that one does not care that the misery goes on elsewhere.

The author is refering to the "National Misery", which is not "National", is global, is affecting all of us.

There is a pandemic. It is a global misery. Part of this pandemic is happening in country X. In country X it is also a national misery.

Declaring something a national misery does not preclude it from also being a global one.

The thing is that is called pandemic because a reason: the virus is still mutating, and I don't know how possible it is and it's up to discussion, but a mutation is possible and your nation (which by the way still has many cases) can be reinfected again.

To think that "my nation has less cases, all is over now for us" is to don't understand what pandemic means.

Pure speculation. Sure, the misery may come back. But for the US, UK, Israel, Australia, New Zealand and soon a bunch of European countries, the pandemic will soon be over. It is not over elsewhere, and it may come back to the aforementioned places. That doesn't mean one can't rejoyce that the misery is over (whether it's for now or for good).

I mean, it's both. It is a national misery and a global misery. The national misery is almost over. The global probably isn't.

From the beginning of the pandemic I've found myself calling it "my pandemic" owing to some recognition that in fact, my experience of it is so far removed from others as to be a different story altogether. For some people, their pandemic ended their lives in the early months before they even knew to fear it. For others it's still very present in their lives. My pandemic was quiet, anxious at first but gradually more settled and relaxed. It is now over; I'm vaxxed up and have little to fear from the virus, so whatever I am living now is just an early 2020's lifestyle. I still take precautions, but I am essentially in a holding pattern for the city to finish its reopening plans, and then I'll be doing some of the things I was doing last year before it hit.

I agree with your comment. It grinds the gears of many Americans when people conflate the USA with America as well though.

If you mean the conflation of two continents those are “The Americas” plural with a definite article.

No, I mean America. The big landmass that spans the 2 hemispheres, and depending on how you subdivide it you can get 2, 3 or 4 continents.

Having been born and raised in America but quite far from the USA, it grinds my gears when people try to shove that distinction down my throat.

In the modern English language no such thing exists. There is North America and South America. There is a sub continental region called Central America, but that’s not a continent and the demonym is Central American, not American.

It may be that a different language treats things differently but wishing it in English doesn’t make it so.

"The Americas, which are also collectively called America, are a landmass comprising the totality of North and South America. The Americas make up most of the land in Earth's Western Hemisphere and comprise the New World."

https://en.wikipedia.org/wiki/Americas

A couple of things:

It’s two landmasses not one. They are connected by an isthmus.

Claiming “America” is what people call both North America and South America together in standard modern English is being pedantic. Yes it is a rarely used vestige form, but it’s very rare in modern usage. It’s like claiming Ceylon is a proper name for Sri Lanka because we have Ceylon tea and Ceylon cinnamon, etc. and it was widely used in the XIX century, or Kampuchea for Cambodia, etc.

In normal usage of modern standard English the combination of two continents in the Western Hemisphere are referred to as “The Americas”.

Moreover, a colleague in MDF confirms Americans (US to be clear) are referred to as americanos, norte americanos and less so as “estadunidense”. Gringos being rather informal.

Now, refer to French, German, Japanese, etc, and they all use a transliterated or translated version of American[1] for people from the USA.

[1] https://en.m.wikipedia.org/wiki/Demonyms_for_the_United_Stat...

> It’s two landmasses not one. They are connected by an isthmus.

Merriam-Webster's definition of landmass [0]:

"a large area of land"

Example of its usage in a sentence (also [0]):

"the islands of Ireland and Great Britain were once part of the Eurasian landmass"

So, you see, if Eurasia, including the British Isles, can be considered a landmass, surely using the Isthmus of Panama as a reason for America not being one is at least a little pedantic.

> Claiming America is what people call both North America and South America together in standard English is being pedantic.

I did no such thing. This is a strawman.

> Moreover, a colleague in MDF confirms Americans (US to be clear) are referred to as americanos, norte americanos and less so as “estadunidense”.

This is true. Americano(a) is probably the most common way to call the people from the US, closely followed by norte-americano. That doesn't mean it's not also used to reference people from the other American countries. Usually context can be used to make the distinction, or people can ask for clarification.

That said, nobody that I know refers to the USA as America over there, so this part of your argument is another strawman.

Quick side question: what's MDF in this context?

> In normal usage of modern standard English the combination of two continents in the Western Hemisphere are referred to as “The Americas”.

Perhaps. Also perhaps it's time to recognise that this can be seen as a form of cultural domination and change it.

In any case, you had said: "In the modern English language no such thing exists." and that's what I was refuting, so this is yet another strawman.

> Now, refer to French, German, Japanese, etc, and they all use a transliterated or translated version of American for people from the USA.

I have no idea why you are bringing this up as it doesn't seem to relate to the issue at hand in any way.

[0] https://www.merriam-webster.com/dictionary/landmass

I’m sorry but this makes the whole discussion moot:

“ This is true. Americano(a) is probably the most common way to call the people from the US, closely followed by norte-americano. That doesn't mean it's not also used to reference people from the other American countries. Usually context can be used to make the distinction, or people can ask for clarification.”

Given that OP complained of that exact usage and moreover in English this ambiguity does not exist.

MDF: capital district of Mexico.

You were responding to my comment that read:

> It grinds the gears of many Americans when people conflate the USA with America as well though.

As you can see, I was not complaining about the usage of "Americans" but rather about the conflation of "USA" and "America".

I did say it grinds the gears of many Americans when that happens, which might be the cause of your confusion.

> MDF: capital district of Mexico.

Thanks! I did think you were not talking about medium-density fibreboard! :D

All Americans I know take USA and America to be one and the same, so no complaints here.

As far as I know people from the southern continent call themselves sudanericanos or alternatively sulanericanos in their native languages. Again, in English there is no confusion about what the word America refers to. It may make a difference in Brazilian or South American Spanish, but that’s their problem, not an English problem.

> All Americans I know take USA and America to be one and the same, so no complaints here.

Perhaps not for you, but that's pretty much the main point here. :)

> As far as I know people from the southern continent call themselves sudanericanos or alternatively sulanericanos in their native languages.

Sudamericanos, latinoamericanos, sul-americanos, latino-americanos OR americanos. They all work.

> Again, in English there is no confusion about what the word America refers to.

I'm pretty sure I speak English daily, and there is definite confusion. There's also the problem that this language excludes a lot of people.

> It may make a difference in Brazilian or South American Spanish, but that’s their problem, not an English problem.

Allow me to pick a small nit: the language is Portuguese. In some contexts it may make sense to distinguish the American from the European variety but it's still mainly Portuguese in the same way that US/American English is still English. That doesn't affect the point you're making in any way, of course.

"Since the 18c, a name of the United States of America. The second sense is now primary in English:"

No. In English, America refers to the US, the continents are North America and South America.

In Spanish and some other languages, America refers to the entire landmass from Alaska to Argentina.

This is equivalent to a Frenchman and German arguing over what countries are called in their language: of course they are different, the argument is nonsense, and they are both correct.

https://en.wikipedia.org/wiki/Americas

This is an English vs. Spanish issue. When talking in Spanish, one shouldn't use America to discuss just the USA.

But in English, you'd confuse the shit out of your audience if you said, "I went to America on vacation, Santiago is a cool city."

Similarly, in the English world, North and South America are considered two continents. Being the same landmass isn't the definition of continent--otherwise Europe, Asia, and Africa should be a single continent.

> This is an English vs. Spanish issue.

It is absolutely not.

> But in English, you'd confuse the shit out of your audience if you said, "I went to America on vacation, Santiago is a cool city."

Perhaps. That said, most people in the UK tend to take a second or two to realise what I mean, which seems like a soft signal that they know I'm not wrong despite the fact that my usage of the term might not be the most common one (if you follow the rest of the thread you'll find that I provided Wikipedia and dictionary proof).

> Being the same landmass isn't the definition of continent

I never said it is.

The author isn't conflating anything - by saying "national misery" he is making it very clear that he's talking about the US situation.

I disagree. If someone writes the great national misery is over and they say it in South Korea or they say it in Bulgaria, I mean, great!

I don’t go and say, I’m glad it’s over for you but we’re still in the midst of it, so it’s not really over so get off your high horse!

Even if you're going to ignore every country other than your own - before you use terms like "Great National Misery", please make it clear which nation you are talking about!

It's an American writing for what's presumably a mostly American audience (he was a reporter at the New York Times). It's unfortunate that despite his use of "Great National Misery", links to graphs depicting the pandemic in America, "3 million Americans die each year", etc. is not enough to set the context for the average reader. He's not conflating the world with America, he's pretty much talking about America. Covid is a plague on the world, but this article is about America.

,,We will probably have bad seasons and good seasons, as we do with flu''

The author underestimates the efficiency of the mRNA vaccines. Manufacturing still didn't ramp up to the levels necessary to vaccinate the whole world, but I would be surprised if the yearly mixed shot of flu/COVID vaccine wouldn't significantly decrease the endemics as well in the next few years.

As a personal example, my mother was not taking the flu shot, because she experienced serious side effects that were not worth for her in return for the low efficiency.

The flu "epidemic" never ended. The common cold "epidemic" never ended. If COVID mutates fast enough it will stay with us forever, with a potentially much higher mortality than the flu. The argument of the article boils down to "that's OK, you'll get used to it"

I mean, what is the alternative? We spend the rest of our lives hiding in our houses? He is right - at some point we will collectively decide COVID is a risk worth running to actually live life. And it might be that it does make day-to-day activities more risky than before, but again, what is the alternative?

Vaccination. Once herd immunity is reached, and maybe maintained by regular booster shots, the risk of returning to normal life is negligable. And that's why this whole conspiracy nonsense around vaccines is so dangerous.

The flu vaccine didn't stop the flu, it mutates faster than vaccines can keep up. You can make the argument [0] that vaccinating during a pandemic (during which new variants arise faster) creates evolutionary pressures that favor variants resistant to vaccines, increasing the chance that virus mutation can get ahead of vaccine development. (Which is not to say we should stop depoying vaccines of course)

[0]: https://www.youtube.com/watch?v=2PgIUDn__WU

Oh, sure. That's why yearly flu shots are a mix against the most likely flu strains for the given flu season. For Covid, I am not aware of a particular mutation defeating the existing vaccines. Besides the Indian one, which seems to cope better with a population that is to large extent vaccinated. And even that variant is then only dangerous for those not vaccinated.

Short version: Any vaccine is better then no vaccine.

I don't know about conspiracy, but the general population hasn't needed constant vaccination before.

Maybe it's bad, maybe it's good and I suppose it's not that different than seasonal flu shots... but immunity by subscription still feels new to me.

If we take it to the logical limit, does that look like family subscriptions to McAfee mRNA edition? A flu is sequenced in London and x weeks later the vaccination is included in my quarterly update package?

EDIT: I'm getting downvoted a lot and I haven't even started on future doctor's office mRNA printers yet! Regulated to heck, partly for security reasons, vendor locked consumables and they use proprietary encryption. They have to jailbreak them in sanctioned countries and enterprising hackers work to decrypt the updates. You wouldn't pirate a vaccine! Would you?

Constant vaccination? Are we all collectively forgetting all the vaccines we received as children...? The fact we’ve eradicated most childhood viruses because we vaccinated the general population? None of this is new.

Just like the recommended seasonal flu vaccine. Most folks won’t bother to get their seasonal covid vaccine. If you were in that group before. Your life hasn’t changed.

I'm pro vaxx!

If covid is more severe than the flu yet requires a similar vaccination cycle (nobody knows yet!) that does seem like a major change to me.

Childhood and travel vaccinations are once-offs and seasonal flu vaccination is a good idea but not a big deal for most.

You say that nobody knows whether covid will require a similar vaccination cycle to the flu, but that seems overly pessimistic. We have a fairly good idea how fast covid mutates and how fast the flu mutates and they are not in the same league, so it's very unlikely we would need a similar schedule.

I also think this is likely but there are a lot of people writing about needing regular boosters and treating that as no big deal.

In my view that would be a very interesting development.

What do you mean? In the past, deadly diseases reduced population and now we can protect ourselves.

Here an image wearing masks from 1918: https://www.google.com/amp/s/www.wthr.com/amp/article/sports...

And if you're living in the US, there should be some info from your the history lessons about deadly diseases killing most of the native population...

And a lot of people volunteer for flu shots, protecting those unwilling to do so.

There absolutely have been pandemics requiring vaccination drives to end them. Polio and Small Pox are two prominent examples that come to mind. And those worked extremely well in controlling those outbreaks.

Second, the yearly flu vaccine already does "updates" to your immune system. That is also not a new concept, and I see nothing ridiculous about it. From what I have read, the portion of the virus targeted by the mRNA vaccines does not mutate as easily as say the flu, which is why these vaccinations still work. You will probably need a booster just to keep your immune system "remembering" the virus, but it probably won't be shifting around as much as a flu shot would

Sorry - to you and sibling poster who made a similar point, I wrote poorly.

By "constant vaccination" I didn't mean at a population level, I meant a personal need for regular boosters. I agree it's not that likely and I also hope they aren't required.

Some vaccines do need constant boosters, for example Tetnus. Its common to forget or otherwise skip these, and I suspect skipping COVID booster vaccines will be common too.

Polio and Small Pox are two prominent examples that come to mind.

And in relation to parent comment, I haven't had a polio or smallpox booster in decades, nor do I expect to ever receive one again. I believe you have misunderstood parent comment.

> but the general population hasn't needed constant vaccination before.

Uh, mass vaccination is 100% a thing https://en.wikipedia.org/wiki/MMR_vaccine https://en.wikipedia.org/wiki/Polio_vaccine#

I would say that we "Need" it. You could say that we don't, but it's vaccines or Polio outbreaks, so IMHO there's only one rational choice and it's not Polio.

Yes, there are "vaccinate everyone" vaccines cited above. There are also "seasonal" vaccines for the flu.

There has never been a need for a vaccine that is both of those. And once the disease is under control, it doesn't seem like covid-19 will be one.

> I don't know about conspiracy, but the general population hasn't needed constant vaccination before.

This is a bald faced lie. As you say yourself, there's the flu shot. Kids need their shots for school. We need to get various vaccines before traveling between certain regions. There are all sorts of vaccine boosters and new vaccines they have been recommending to my elderly parents since they were late middle age.

Hell this isn't even the first (or second, or third) mass vaccination campaign - there was smallpox and polio and measels and chicken pox/shingles.

To say that the general population hasn't needed it is literally the exact opposite of anything resembling the truth: we've been constantly getting vaccines for longer than I've been alive.

My issue is with the article calling that scenario "the end".

You're misrepresenting what OP is saying.

> The flu "epidemic" never ended. The common cold epidemic never ended.

It's almost like you didn't read the article because the point was made very clear that the "epidemic" does end when it transitions to something "endemic".

Most people wouldn't regard the common cold as an epidemic as you suggest it is. You're correct that we still live with it, but that doesn't make it an epidemic. As daily deaths continue falling at some point people will stop seeing COVID-19 as an epidemic but something that's endemic and treat it more like seasonal flu. It's not the eradication of the virus that marks the end of a epidemic, but it's declining severity and our changing approach to the virus.

You're misrepresenting what I'm saying. I put "epidemic" in quote marks for the reason you suggest. The argument that an epidemic ends when people get used to it is in itself nonsense. You need declining severity to an acceptable baseline too, and there's no guarantee that will happen with COVID. I mean you wouldn't replace a vaccination campaign with a "just get used to it" campaign, right? Although many people have actually tried to suggest that now that I think about it...

Stopping world travel would’ve worked it out better. Like New Zealand and Australia. Suppression strategy with vaccines would have a solid effect.

Here's an interesting geological fact about New Zealand and Australia: they're both islands! Believe it or not, it's much easier to control population flow into an island, than it is over a land border.

Why is it hard to police a land border? Cameras and weapons are effective deterrents.

The uk is an Island too and it didn't seem to help them

The idea is that an island helps with closing borders. The borders have been and are open in the UK.

It could have helped the UK, but you have to make use of it.

If "it's much easier to control population flow into an island" then you still have to step up and control it. The UK government did not even show interest in doing that.

The UK government mismanaged their borders, and most other aspects of the pandemic; notable exception being vaccination.

The UK gave up the ability to do that when previous governments decided to integrate our economy with Europe and build the Channel Tunnel. Every day, huge numbers of trucks travel directly from Europe to the UK with their drivers carrying all kinds of goods, including critical stuff like food for supermarket shelves. You may recall that this was one of the reasons why Brexit was supposed to be so dangerous and impractical.

There are many things that the UK government could have done at borders that they did not do, or delayed and did only when damage had already been done. It is a mischaracterisation to suggest that it was out of their hands, or that the UK faced unique problems that other countries did not also have, and handle better.

> Here's an interesting geological fact about New Zealand and Australia: they're both islands!

Not really, Australia is an continent not an island.

And to be precise, only Europe and Asia are connected by land borders (suez canal, panama canal).

More, UK is an island, also Ireland, Japan... and they don't have much less cases then the rest of the world

> Stopping world travel would’ve worked it out better.

The movement of people is a good thing. Hence stamping it out would have a huge cost, both emotionally and financially. The vaccines are comparatively cheap.

Aye. Health and avoiding death aren't the goal of living. They are needed to live to some extent, but they're not the reason for living. Those disproportionately obsessed with self-preservation fail to live. There are more important things.

And people seem to forget the other part: your death will come for you eventually so it's not as if by avoiding COVID you've avoided a car accident. Besides, the danger of COVID has been vastly exaggerated, but irrational and disproportionate fear has gripped the brains of a lot of people.

People (typically white collar) also forget the deaths and health effects of the lockdown itself.

I don’t think most people being cautious are scared of Covid-19. I know I’m not but I’m still not visiting my parents until they’re fully vaccinated because I don’t want to spread it and I don’t want to kill my parents who are both in a much higher risk group. I’m not remotely scared of Covid-19 now that we have more data though.

So what is the goal of living then Bob?

Thats a subjective question.

My answer: to live life fully with what little time we have. Memento mori.

It is subjective and I do believe love is the answer.

Avoiding death may not be the goal of living, but it certainly is a prerequisite.

There was never a lockdown vs no lockdown. The entire point was to slow it down temporarily until we get treatments, vaccines and hospital capacity. We won't need quarantines any more if it stays slow enough. The biggest problem last year was no treatments and no hospital beds.

The alternative was to lock down properly for a few weeks early on and prevent it from becoming endemic, but that cat is out of the solar system at this point.

Its too late for that and as it turns out it’s very hard to accomplsh. If a small group doesn’t comply they can re-spread it when the lockdown is over or eases

You'd also have to make sure no new cases were imported (which means closed borders--i.e. troops on the ground not just canceling flights), AND you'd have to eliminate every internal case.

It took Melbourne like 3 months to eliminate all cases. Far more than a "few weeks."

It would take the sort of effort (for the US or EU) only possible with total hindsight. But if Trump tried to seal our borders with force in Jan 2020, there is no way Democrats would have accepted it. They'd call it rationalization for an attack on immigration.

>It would take the sort of effort (for the US or EU) only possible with total hindsight. But if Trump tried to seal our borders with force in Jan 2020, there is no way Democrats would have accepted it. They'd call it rationalization for an attack on immigration.

Much worse than that. Remember, Trump's (first) impeachment by the House had occurred in December 2019. He was not acquitted in the Senate until early February.

Patient Zero for the US is believed to have entered on January 15. Had Trump on January 14 announced a total and complete shutdown of the US border, Democrats and 95% of mass media would immediately have denounced it as Trump preparing a coup to seize total power, using the ridiculous pretext of a disease that had had zero impact on the US (and was racist to ascribe in any way to China).

My understanding is that the reason for the high mortality rate is its novelty. I.e., because it’s unfamiliar, it’s a big task for the immune system to learn how to beat it, and elderly/impaired people lack the strength/energy to do it.

Other cold and flu strains are less deadly these days as we’re all mostly adapted to them.

Why would that not happen with this coronavirus too? Why do we assume that this coronavirus will mutate more quickly than the other coronaviruses that are already endemic?

The flu has a "baseline death rate" it reached after coevolving with humanity. We don't know what tha baseline will be for COVID, and we don't know if we will deem that acceptable or not.

You seem to be insisting that there is likely something different about this coronavirus that means it won't end up becoming mostly-harmless-to-most-people, the way all the other influenza, rhinovirus and coronaviruses have done. What is the basis for this fear?

Sure you can keep saying things "might" happen or "we don't know" this or that, but we do have a lot of historical precedent for these kinds of viruses, so it's reasonable to presume that it will become not-that-big-a-deal, the way all the others viruses like it have done.

We don't know if it will, and what the costs will be. Saying "The end is near" as the article suggests is not justified by current evidence. So far the increase in the virues' virulence with new mutations wasn't correlated with decrease in deaths as far as I know, and the pandemic has been here for a while now (I only know about inverse correlation). This is not just like the flu.

You seem to be ignoring my point. The death rate is not because there's something special about the virus itself that makes it highly lethal. It's just that it's novel, so our bodies have to work harder to learn how to fight it off, and the frailest people don't have the fortitude to do that.

Ergo, as it becomes endemic, and all of our immune systems learn how to respond to it, it's completely reasonable to expect that it will become benign to most people. (After all, it already is pretty benign to many/most people, compared to the original SARS and MERS).

Repeating "we don't know" is an easy response, and something you can say in response to anything like this, but it's not really addressing the logic I'm presenting. You really have to demonstrate why this virus is substantially different to all the other respiratory viruses that have become endemic and mostly benign, which you've not attempted to do. You just keep saying "we don't know". Sure, but we actually have some solid historical precedent, and this virus is so-far showing no signs of being any different from all those before it.

You're ignoring my argument why this virus is different, and just repeating the same argument that it's like the flu. In addition, nothing in your argument implies that the "end is near", only that there is an end.

I can't see anything you've written about why this virus is different; that's what I've been asking you to do, but you haven't addressed it, from what I can see.

Nevertheless, on the way in which it is widely regarded as being different, I just addressed that in a reply to another commenter here: https://news.ycombinator.com/item?id=27290964

For what it's worth I'm not really saying it's "like the flu" - more that we should expect it to be like other coronaviruses, unless there's significant evidence to the contrary.

I wrote "So far the increase in the virues' virulence with new mutations wasn't correlated with decrease in deaths as far as I know" which suggests the virus is not evolving to be less deadly as you suggest. In fact the British variant was both more virulent and more deadly than the original COVID strain:

https://www.bmj.com/content/372/bmj.n579

This contradicts your position that COVID evolves just like the flu does. Do you have evidence to the contrary?

This is why I said you were ignoring my point. I specifically didn’t claim that the virus is “evolving to be less deadly”.

My point was that human vulnerability is due to it being novel, and that as more people’s immune systems become attuned to it (whether via contracting the virus, vaccination or being exposed to fragments in the environment), it will become less novel and less deadly to those exposed to it. Therefore, we should still expect the fatality rate to be steady among those who have never been exposed to it, but that will start dropping off quickly as immunity becomes more widespread, which is what we're seeing.

Based on everything we know, a “new” “novel” virus would most likely hit us via a jump from another species, not through continued evolution of this virus.

As for higher fatality rates from B.1.1.7 or other strains - reports about this are contradictory [1], and notably the headlines about it being no worse than other strains are always much smaller/less-prominent that the those trying to terrify us about it being much worse.

[1] https://www.contagionlive.com/view/sars-cov-2-b117-variant-m...

There is something different about this virus. The idea that viruses become less harmful as the years go by is based on an evolutionary pressure.

If a virus kills its host before it has the chance to spread, then it has an evolutionary pressure to evolve into a less harmful variant.

The difficulty with this coronavirus is that it can spread asymptomatically AND it takes up to a week before you notice any symptoms.

That's a problem, this virus has less of an evolutionary pressure to evolve towards a more benign variant. Imagine if it were to kill 100% of its hosts after 10 days, if you don't get a single symptom in the first 5 days while you're still able to transmit it, this virus will have barely any evolutionary pressure to evolve towards a more benign form.

Still, the less a virus kills the more it is able to spread, a virus's ultimate goal is to make as many copies of itself as possible.

There are plenty of viruses that have not gotten more benign over time, HIV for example.

Everything considered, I do personally believe that over the longer term 10-30 years, the disease caused by sars-cov-2 ancestors will be less bad than they are now, taking into account vaccination and our immune systems getting used to this newest virus as well.

> Imagine if it were to kill 100% of its hosts after 10 days, if you don't get a single symptom in the first 5 days while you're still able to transmit it

Sure, but as you say, this is an imaginary scenario, not the reality.

In reality, it's symptomless/benign for most people for 5-7 days, then in some people it becomes symptomatic, and in relatively few cases - of impaired/frail people (or occasionally people who seemed "healthy" but had some hidden vulnerability) - it becomes severe and potentially lethal. But that last part is due to the fact that it is novel and takes time/effort to fight off, not because it has some magical quality that makes it sit dormant in your system for 5+ days before it wakes up and says "surprise, you're suddenly nearly dead".

HIV is a totally different kind of virus, so comparisons to it are mostly unhelpful. Whereas plenty of coronaviruses and other respiratory viruses have become endemic and mostly-benign before.

There's no reason to believe the rate of severe cases won't decline (more quickly than 10-30 years) once more people's immune systems become attuned to it.

>The difficulty with this coronavirus is that it can spread asymptomatically

Can someone point me to the latest information on asymptomatic transmission of covid-19? Last I had seen asymptomatic transmission wasn't likely:

https://www.nature.com/articles/s41467-020-19802-w

Pretty much anything becomes acceptable to people after they've had a few years to get used to it. Preventable chronic diseases kill more people than COVID-19. Apparently that's acceptable to most people because they do little or nothing to reduce their risks.

And some colds are caused by betacoronaviruses very similar to SARS-CoV-2. The only reason those don't kill many people today is that most of us are exposed as children and build up immunity. There is strong circumstantial evidence that another coronavirus emerged in 1889 and killed about 0.06% of the world population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/

Absolutely. In my not quite uneducated but nowhere near professional opinion, SARS-CoV-2 is not going anywhere, even in a best-case scenario of vaccine production and vaccination programmes, and will become endemic in the World population. However, the clinical presentation of COVID-19 as we know it will slowly disappear, and over the course of the next 5, 10 or 20 years will just become another common cold virus in circulation. There will indeed be severe cases resulting in pneumonia, of course, but there are severe cases of other common cold viruses. I think that what we've been living through in 2020 and at the moment is the birth of a new common cold virus from scratch. We're just lucky enough that our vaccine technology is advanced enough for our societies to speed up the process of training our immune systems to become accustomed to it with less loss-of-life than if nature had taken its full course.

Indeed. Has there ever been a society that did not eventually make peace with the world's virome after a pandemic and carry on? Vaccine or no?

The author literally addresses this directly, indications are that it mutates slower than the flu.

The article says this:

Luckily, because coronaviruses mutate more slowly than influenza viruses, they will probably be better matches than flu shots are.

Many common cold viruses are coronaviruses, and we haven't eradicated them either.

> Many common cold viruses are coronaviruses, and we haven't eradicated them either.

There's hasn't been an incentive to - cost high, benefit low, after all it's just a cold.

Maybe that will change now.

There are new weapons in humanity's arsenal in the form of mRNA vaccines, and a huge incentive do develop this and to take these viruses more seriously.

It doesn't need to be eradicated. If it mutates slower, vaccinations and herd immunity would mean the symptoms experienced are mild and your resistance would build on that as time goes by being exposed to new variants which are only slowly mutating.

Yeah but coronaviruses don’t mutate as rapidly as flu viruses, the vaccine from last year will protect against next year’s coronavirus. This will probably become like the measles where everyone gets a jab at age 3. And maybe a booster shot every 10 years afterwards. I don’t know anyone who’s ever caught the measles.

>Yeah but coronaviruses don’t mutate as rapidly as flu viruses, the vaccine from last year will protect against next year’s coronavirus.

All RNA viruses mutate in the same fashion because of the way RNA polymerase functions. Its close to a statistical certainty. The absolute number of mutations is not strictly causal. What is relevant is whether the mutation(s) is beneficial (more internal spread while escaping host immune system) and whether this local variant has the fitness to dominate and spread externally.

Or maybe I'm misunderstanding you - can you explain what you mean ?

I’m not a scientist, I’m just repeating what I’ve heard and read. The consensus seems to be that covid mutates much more slowly than the flu.

https://www.google.com/amp/s/www.livescience.com/amp/coronav...

https://www.google.com/amp/s/theconversation.com/amp/how-the...

Certainly, we can't all be experts in everything. I work in biotech but I only have a tiny area where I can feel comfortable making assertions. In any case, the articles you linked to are theories and speculation, not consensus.

Fair enough, I suppose we’ll find out..

"If COVID mutates fast enough it will stay with us forever, with a potentially much higher mortality than the flu."

Most likely not. If C19 mutates in a fashion that allows it to "stay with us forever" it will almost certainly come with lower (cold-level) mortality.

That is one of the trade-offs that the virus genome has to "make" as it mutates. More lethality is a genetic dead-end because of vaccines. Cold level lethality is a genetic steady state that would allow it to thrive.

I think it important to distinguish between pandemics, covering most countries simultaneously, and isolated national epidemics.

Flu is epidemic flu. Hopefully we are coming to the end of the pandemic - assuming new variants don't play stupid

Well, maybe. It's amusing to picture this article being written, in some variant, after each of those peaks with a different choice of x- and y-axis cutoffs.

Comprehensive vaccination seems to be working, and I'm not one of those "amazing new variant" doomsayers who imagines that every variant is going to overcome vaccine resistance. The idea that we have a large pool of unvaccinated people coupled with a lot of cases seems like a neat way to exert selection pressure towards the creation of strains that are at least quite virulent, if not necessarily dangerous-to-vaccinated-people.

But I'd say the air of celebration in these articles is premature, and the cliche that "oh, it will become endemic and we'll learn to live with it" tends to overlook that "endemic" covers a huge range of outcomes, including some unacceptably bad ones.

The graphics there seem less than scientific somehow. Like messing with the y-axis marks. They also seem to only cover from April in at least one graph, but show dates from February 2020. Kinda seems suspect.

I think the Spanish Flu and others ended by tapering off. Ie over a period of several months? I imagine society needs to learn it can trust the threat has passed by seeing an extended period of time without large surges.

The core question that the author doesn't touch because he only deals with the absolute number of cases is: what happens with long covid? With prior epidemics, people were dead and that's it or they were alive and healthy soon-ish, the rate of survivors with horrible, lasting after effects always was low (such as with polio which left only ~1200 people in 1959 with an iron lung).

Coronavirus in contrast is much, much more evil - even in young, healthy people such as athletes, there are numerous reports of a wide variety of symptoms: permanent lung damage due to scarring first and foremost, but also neural symptoms (ME/CFS), GI issues or mental health issues.

Unfortunately, this isn't talked about much and - unlike an iron lung or scars - most symptoms can't be seen from just looking at a corona survivor, which leads to a widespread ignorance in just how immensely dangerous this virus is.

One of the bits of good news recently has been that vaccination apparently helps with long COVID too. But I agree with the idea of not being blasé about COVID due to the long-term morbidity effects. It will be interesting to see what sort of hangover Sweden has from their frankly idiotic policies.

Sweden have had fewer infections than a lot of other regions. If longcovid is a problem, I would be more worried about places like New York and London.

Metropolitan areas might not be the best comparison for a territorial state like Sweden. The actual effect of policies might be more visible when viewed next to comparable countries, like their nordic neighbours.

Here are the case numbers per inhabitant from the Johns Hopkins university dataset plotted against time (moving average with a window of seven days):

https://mackuba.eu/corona/#compare.daily?pop=1&c=no,fi,dk,se...

Cases are not the same thing as infections. Comparing cases between countries doesn't work, even when corrected for positivity rate. Deaths should be a more fair comparison. Then there are a lot more countries with higher death rate.

I didn't mean that it is fair to compare a metropolis to Sweden when it comes to "who did the right thing". But it is a fair comparison when considering the effects of longcovid.

Sweden only stands out when compared to Nordic countries, not when compared to the rest of the world. Thus bad effects from longcovid should be more visible in harder hit places.

>Unfortunately, this isn't talked about much and - unlike an iron lung or scars - most symptoms can't be seen from just looking at a corona survivor, which leads to a widespread ignorance in just how immensely dangerous this virus is.

It's because there's absolutely no statistical evidence that any kind of serious, lasting long-term consequences are more common with covid than with existing respiratory viruses.

> It's because there's absolutely no statistical evidence that any kind of serious, lasting long-term consequences are more common with covid than with existing respiratory viruses.

Well, there are indications to the contrary: https://www.cnbc.com/2020/10/21/long-covid-these-factors-mak...

The key problem is that there is a vastly higher number of total (and severe) cases of covid than the flu which means that inevitably the amount of long-covid cases will be higher. Add to that that covid19 is linked to multi-organ distress including neural symptoms, and you have the recipe for a perfect storm of hundreds of thousands of people who will be dependent on others for the rest of their lives.

People who did not need the iron lung still had other problems, including things like weakened lungs. Some conditions reappeared later in life afaik.

I believe if Covid were disfiguring but not deadly it would have been taken much more seriously by a lot of the population.

Meh, people don't care that much about STDs (hello herpes) either...

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