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Comment by sprafa | Hacker News Reader

Im not sure we’ll “go back” to the happy days anymore. Even with booster shots my impression is we have a deadly disease that’s here to stay. But people lived with constant plague for hundreds of years, we just convinced ourselves we’d “left that behind” and that might not be true anymore. HIV and COVID demonstrate modern plagues can still come and overwhelm us.

No one ever went back to pre-HIV, we still use condoms. We just don’t let people die of it quite so easily anymore. But there was never a moment where HIV has stopped being a problem or having ended the possibility of non-deadly unprotected sex. Maybe COVID is the same - we will remember the pre COVID days as this wonderful time where we didn’t have to shoot RNA onto our arms every six months.

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Funnily enough, I’ve lived in a zero covid area (nova scotia) and eliminating it was actually a far easier way of living than the “learn to live with it” approach practiced elsewhere. You have less travel, and you have to react quickly to small threats, but in exchange you get months and months of essentially normalcy.

I think it would still be feasible for the rich world to do in spring 2022, when it is warm season again, if we get tired of this. It could then be maintained with border agreements. We don’t accept endemic tuberculosis even though that is airborne.

The other thing that would make it easier would be if we actually started acting in the knowledge that it is airborne. We have treated SARS-Cov-2 as a droplet and fomite disease. This has meant we avoid easy and effective solutions (HEPA, open windows, co2 monitors, N95) in favour of inconvenient and ineffective solutions (six feet rule, hand washing, no hugs, deep cleaning). You’re infinitely safer giving a hug and holding breath for a couple seconds (if you choose) than going into an unventilated meeting six feet apart.

(I wash my hands of course, but it is a colossal error to make that the centerpoint of public health advice)

Pretty much every country that aimed at elimination achieved it pretty easily! Or at least for less aggregate effort than countries aiming at mitigation. For some reason we chose the latter.

>The other thing that would make it easier would be if we actually started acting in the knowledge that it is airborne

If you have a sincerely held belief that is controversial, then it's helpful to provide information about why you hold the belief and how you came to reject some other consensus.

The CDC page is pretty clear about aerosol transmission methods. And that’s only updated as of May 7th: https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...

The widely documented superspreader events are impossible to explain by droplet or fomite transmission. Literally impossible. You think an infected bar patron goes around within 6 feet of 80 other people and shakes their hands or breathes on them?

224 people were infected at this Quebec city gym. Aerosol is the only viable mechanism to do that: https://www.cbc.ca/news/health/superspreading-event-canada-m...

Here’s a couple articles summing things up:

https://www.theatlantic.com/health/archive/2020/07/why-arent...

https://www.nytimes.com/2021/05/07/opinion/coronavirus-airbo...

Sorry for the misunderstanding, the possibly controversial beliefs I was referring to were such as - "we" haven't been acting as if it was airborne, that there is a sharp distinction between droplets and airborne particles, and that the precautions that are appropriate are as you listed and the others are mostly useless.

Airborne particles are indeed in the CDC FAQ; I don't know how far back that goes.

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

Cdc added them may 2021 or so. The WHO still denies airborne spread. Plenty of jurisdictions still vigorously fight against recognizing aerosol spread as it would involve more work to fight. For example Ontario: https://www.thestar.com/news/gta/2021/08/26/ontario-fought-a...

And yes, if you have a virus that cam infect 245 people in the gym through the air, then ventilation is more important than handwashing. I’m not sure anyone has even established evidence for fomite spread! I expect it is a mechanism too but the point is it has been treated as default for some reason despite lack of evidence and evidence for other methods.

>Cdc added them may 2021 or so

The Delta variant took over in the US around the beginning of July.

Doesn't the type of spread you are harping on mainly pertain to Delta?

If so, then the CDC was anticipating it a month or more in advance; that doesn't seem like a belated response.

> We don’t accept endemic tuberculosis even though that is airborne.

Isn't the R0 of tuberculosis way lower than the R0 of COVID, especially the delta variant?

Yes, but TB has been as high as 3.5-4.3, depending on local conditions: https://theunion.org/our-work/covid-19/covid-19-and-tb-frequ...

We do lots of work to contain it.

What I find most interesting about this pandemic is how everyone seems to have become a virologist, epidemiologist, or both! The medical schools must be bursting at the seams. Tell me - where is it that you got your degree from?

Influenza is also a deadly disease that is here to stay.

If you knock down its ability to cause severe disease by a factor of 20 or so and it becomes just another viral pneumonia, then we don't have a pandemic any more.

If everyone would just get vaccinated, we'd be there and it'd be over by now. Doomerism is counterproductive and doesn't help that.

What do you mean everyone? BC, Canada and Israel have some of the highest vaccination rates in the world. Yet cases continue to rise and restrictions are getting tighter.

And as I wrote in my initial post, it is summer. This is the easy time!

What do you mean what do I mean by everyone?

I MEAN EVERYONE

https://i.imgur.com/fTTBLia.gif

100%, Including kids under-12.

The one thing delta really changed was that we're all either getting vaccinated or getting infected and recovering.

What we're doing now is dragging it out while the virus burns through the unvaccinated population still trying to flatten the curve to keep the hospitals from getting knocked over.

We could have no restrictions tomorrow if everyone were fully vaccinated today.

That's an incredible claim which I disbelieve.

First of all, there will be no 100% vaccination globally.

Second of all, variants will continue to emerge while we play wack a mole. Yes, in the vaccinated.

Never mind potential animal reservoirs.

You actually don't mean variants you mean a future new strain that achieves escape mutation.

That won't escape T-cells recognition to the currently circulating strain of the virus. Once everyone is vaccinated or recovered the disease burden of any future strain will go down by an order of magnitude at least.

This is what happened with H1N1 which became endemic as simply seasonal influenza. After being displaced in 1957 by H2N2 it circulated in pigs for 50 years before jumping back into humans in 2009 -- but people born before 1957 still had cross-reactive T-cell immunity to the H1 protein of that virus. Existing human coronaviruses now just cause the common cold, even though HCoV-OC43 may have caused the last great pandemic of the 19th century with the 1889 pandemic.

These respiratory pandemics all burn out as they transition to endemic spread and nearly everyone gains cross-reactive immunity to future strains.

No, I mean variants.

That's a lot of claims.

Immunity to Pre-1950 H1N1 Influenza Viruses Confers Cross-Protection against the Pandemic Swine-Origin 2009 A (H1N1) Influenza Virus

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457446/

Complete Genomic Sequence of Human Coronavirus OC43: Molecular Clock Analysis Suggests a Relatively Recent Zoonotic Coronavirus Transmission Event

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC544107/

> We could have no restrictions tomorrow if everyone were fully vaccinated today.

I believed this for the 2 months or so that mask mandates and other restrictions only applied to people who weren't fully vaccinated.

Maybe? Back in July, 94% of english adults had antibodies! Their cases peaked and are rising again. This 94% doesn’t include kids, but with plenty of cases and vaccinations since then, not obvious high prior immunity makes it like flu. Influenza is basically dead right now with our current precautions, incidentally.

The UK is in summer, snd the virus is still spreading at near record rates with 94% adult immunity. On what basis do you believe it to be like the flu?

This isn’t doomerism btw. My position is SARS-Cov-2 likely isn’t livable, and we should eliminate it. Multiple societies have succeeded at it. Readily possible.

Maybe the winter will prove you right, but if it doesn’t I’m hoping people will come round to actually trying to get rid of the thing. Basically every country that tried to succeeded. It’s possible. Frankly the people who say we can’t beat it seem like the pessimists to me.

https://gizmodo.com/whopping-94-of-adults-in-england-have-co...

I can't find the methodology of that survey but if its not controlled for demographics it may oversample the vaccinated population.

And kids count and I really mean 100%. Also, if 20 year olds only have an 80% rate due to less vaccine uptake it'll still spread in that subpopulation of the UK and the near 100% vaccination rate of 80 year olds doesn't affect that spread because 80 years old aren't at the nightclubs where 20 year olds are spreading the virus.

Also obviously if kids under 16 in the UK only have a seropositivity of ~20% due to no vaccination then the virus will happily spread in that reservoir, particularly through the schools where kids are in close proximity to hundreds of other kids, before "hopping back" into adults. Much like a reservoir species (which incidentally is the reason why eradication of this virus is impossible)

We’ll see how it goes in the UK. Could be they’ll just decline over winter, I admit that’s certainly possible.

Regarding animal reservoirs, has there been a single confirmed or suspected case anywhere? Especially in a place that had transmission, like Wuhan, or Nova Scotia. Or with good contact tracing like South Korea. That’s certainly possible, but I don’t know it’s proven to be a certain problem. You’d expect lower animal transmission if it wasn’t rampant in humans too.

40% of white tailed deer in the US are seropositive for SARS-CoV-2:

https://www.nature.com/articles/d41586-021-02110-8

In the case of the mink cluster 5 there were confirmed cases of the mink-adapted SARS-CoV-2 genome in infected workers on the farms.

Without similar genotyping its impossible to say if there's other similar events happening with other species, but the SARS-CoV-2 virus infects enough other species to be considered promiscuous.

I’d heard of the mink. That would be easy enough to control with herd isolation and culls. Deer are trickier, but as the article notes we don’t know the state of active transmission.

On the basis of existing evidence I think it’s premature just to give up and say it’s impossible, without having tried.

The point isn't to fixate on the deer or the mink. The problem is multispecies and there's dozens of them at least. It is large enough to not be solvable.

I'd love it if we'd just give up entirely world-wide on mink farming already, but eradicating wild species is a non-starter.

And we will likely never even identify all the species out there which could be reservoirs. You'd need to fully survey African nations and we still can't figure out where Ebola is coming from.

There's going to be many times more species of animals that can be infected and be reservoirs of this virus that we don't know about than we do know about. And all those species in Africa count every bit as much as the minks closer to home.

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