Comment by mike_hearn | Hacker News Reader

Comment by mike_hearn | Hacker News Reader

It's painful, watching history be rewritten.

> Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times.

It was not on everyone's mind. It was the exact opposite: pre-existing immunity was one of the many things that was officially forbidden to notice. The party line was that because SARS-CoV-2 was "novel", 100% of the population would become infected upon exposure. I have very clear memories of telling lockdown-obsessed people that the models assumed a 100% susceptibility rate yet the Diamond Princess outbreak had showed this was far from true, so the modeling justifying lockdowns was wrong. The response was usually derisive. Who are you, rando programmer, to challenge expert epidemiologists?

Another case that sticks in the mind: I was having dinner with some work colleagues. They were complaining about getting COVID repeatedly post-vaccination, and reacted with amazement when I told them I'd never had COVID and also never been vaccinated. One suggested I should report myself to the authorities so they could test me and find out how I could possibly be immune despite having never been sick. I laughed and said no, I'm not going to do that. Cue appalled expressions. How could you not want to help? Well, there are lots of people who have prior immunity, this has been known for years and the authorities have deliberately ignored us because they ignore anything they don't understand and thus can't model <bafflement, shock>.

Note that the nasal spray challenge study they talk about was done in 2022. Their citation for their claim that pre-existing immunity was previously "unproven" actually goes to a study of healthcare workers from 2021 which begins "Individuals with potential exposure to SARS-CoV-2 do not necessarily develop PCR or antibody positivity, suggesting that some individuals may clear subclinical infection before seroconversion." Although they didn't understand the exact mechanism, the wrongness of the public health assumptions was well known at the time by the relevant people and they said nothing.

While I agree with some of what was said here, most discussion of “pre-existing immunity” was around immunity acquired from already having had COVID, not immunity carried in from prior conditions. I thought the conversation (or lack thereof by prominent “establishment” sources) was more egregious, as adaptive/acquired immunity is a very well understood mechanism. It’s the same mechanism that vaccines are attempting to leverage.

What you’re describing, however, I would imagine is harder to test for/understand, and makes more sense that it wouldn’t immediately be at the forefront of the conversation. Genetic or otherwise inherent immunity would be hard to prove, and the mechanisms that result in that are probably not always immediately obvious in terms of what they even are, let alone how they work.

It's probably quite hard to explain at the microbiological level for sure, but you don't need to be able to explain it to understand how it will impact outcomes. You just need to be able to measure it.

Pre-existing immunity is by definition immunity that existed pre-exposure, immunity that comes from already being infected before was referred to as natural immunity. The latter was accepted as real right up until the vaccines arrived. The former never was, I guess it still isn't as this is just a university press release, not something formal from public health agencies.

And is there any reliable estimate of the prevalence of this a priori immunity?

This has been observed for all kinds of diseases; there's even someone who's immune to HIV. https://en.wikipedia.org/wiki/Innate_resistance_to_HIV

There's just not very many of them. And if the susceptibility is 99% rather than 100% that doesn't really make a difference.

Yes, from the Diamond Princess wiki page:

> As of 16 March, at least 712 out of the 3,711 passengers and crew had tested positive for the virus.[22][23] As of 14 April, fourteen of those who were on board had died from the disease.

Exposure on the Princess was 100%, which we know because everyone was confined to quarters yet cases appeared randomly throughout the ship without there being any locational clustering, which is only possible if the virus got everywhere. IOW it was capable of spreading between cabins and floors.

So the rate at which passengers went positive was something like ~20%, but half of those were asymptomatic, so the true susceptibility rate was more like 10%.

IIRC contact tracing studies found a similar susceptibility rate, based on how many people started testing positive when locked into their homes with a test-positive housemate. But I don't have a citation for that offhand, I'd have to go dig it up again.

IFR was in that case 1.9%, but this is biased high due to the age of the passengers which is very unrepresentative of the population. You could get more accurate IFRs using serosurveys.

Obviously, the modelling projections were all wrong by an order of magnitude just due to ignoring susceptibility alone. And then you have the IFR that was also way too high. Fix both of those and you can start to explain why the epidemiologist's predictions were so far off the real numbers. Also their models assumed very strongly that SARS-CoV-2 could not move long distances on air currents, but indeed that's not compatible with what happened on the ship. If you take all those factors into account then lockdowns did not make any sense as a policy (nor many other policies).

My buddy’s wife worked at a local “red zone” as a nurse 12 hours a day, and it didn’t feel to her like a seasonal flu.

I’m not an expert of any kind here, but I think the world got it right not risking itself for just a year of immobility, instead of turning it into a potential “don’t look up” scenario. Post-thoughts are always retrooptimistic and clear, but try to coordinate that in the moment at the country level without overestimating heavily.

> I’m not an expert of any kind here

You don't have to be an expert to have seen that it wasn't remotely sensible to react the way that people did - and that authoritarians, the whole world over, reacted stupendously irrationally and censored their opponents who said that perhaps we should keep things running as normally as possible and shelter the vulnerable. That was the consensus disaster response plan until George Bush took guidance from some girl's school science fair project.

Despite those precautions lasting until we got vaccines, the world life expectancy dropped noticeably:

https://commons.wikimedia.org/wiki/File:Life_expectancy_in_s...

https://ourworldindata.org/life-expectancy

> That was the consensus disaster response plan until George Bush took guidance from some girl's school science fair project.

I have no idea what you're referencing, but you do realise Bush wasn't in charge of the world even before he stopped being president, right?

I agree with most of what you said, but most people I know didn't assume or believe that exposure automatically meant infection. At the very least, we all found this out empirically very early on. Someone would get COVID and then text everyone they'd been in proximity with (even masked, 6 feet away, etc.) for the past week or so to let them know. Only a small percentage of the people exposed ended up getting sick in most of those instances. And even in cases where a decent percentage of people got sick (say someone had an indoor gathering that wasn't well ventilated), it was never 100%.

Sure, some of that was probably due to masking and distancing sometimes being effective. But most people I know intuitively got the idea that sometimes your body can fight off certain amounts of the virus, and you never actually become infected enough to test positive or show symptoms.

And yeah, there were some people who I didn't see at all for like 3 years. While I may have thought that was a bit much, that was their comfort level, so... so be it.

People saw, but how many really saw? Not many, I think. My post is now sitting at -3 (as expected), which is what usually happens on HN COVID threads whenever a new chunk of the narrative falls off and someone points out it was known from the start.

Whilst some people might have seen and registered the mismatch in private, very few were willing to point it out in public. Instead people acted as if everyone was guaranteed to be infected immediately. This incorrect belief about susceptibility rates was the basis of the models that predicted one giant wave in April 2020, it's what justified all the lockdowns, mandates, travel shutdowns etc. To point out that some people weren't getting sick was to attack the entire COVID narrative, because if you use a correct IFR and multiply by the real immunity rate, you get a number too low to pose problems to the health system.

Yes, your post is down-voted by a logic and rational thought denialists. You are not attacking the view but you are attacking them because they have become believers of the Covidian Church

I downvote comments that are uninteresting. The last thing I want to do is rehash politics that don’t matter anymore. Literally don’t care, stop talking.

This kind of attack on people for disagreeing is what most of us come to HN to avoid. Conspiracy theories are fun entertainment but anathema to discussion.

Were you on the front lines of the pandemic? Respectfully it sounds like you weren't. When nurses and doctors are using trash bags against a novel disease because supplies have run out—that's posing a problem to the health system. When they have to move ventilators from upstate NY to NYC—that's posing a problem to the health system. You're not going to find a source from an epidemiologist saying 100% of exposures lead to an infection. Otherwise you would have already posted it as part of your conspiracy theory.

They even deployed the national guard in areas to set up tent hospitals because the local hospitals couldn't keep up. The reason saying "not everyone gets sick!!!1!!" attacks the narrative is not because it's correct (although it is). It attacks the narrative because people can be asymptomatic carriers. Can't believe the same shit is being rehashed now, several years into a new endemic illness that could have been overcome with a global version of the lockdowns that Vietnam and China did (until realizing literally no other country cared enough).

Lastly—how the fuck is a government supposed to get the IFR absolutely 100% correct for a novel virus without rolling out mandatory testing and reporting? I don't know what people expect from the government. Magic I guess. Didn't lock down but you should have? Right to jail. Locked down but things weren't as bad as we thought? Right to jail.

The real criticism of the US government should be for the economic policy it chose to pursue over the real lives and health of its citizens. Don't expect that conversation on here.

Also note that in Washington State we had originally received a field hospital, but the quarantine was so effective at preventing our health system from collapsing that the army redeployed it to California by April.

There’s this constant misconception that the quarantine was about keeping people safe from COVID. It wasn’t. What it was about was preventing our hospitals from being so overwhelmed they could no longer treat emergencies or acute medical problems. The trigger for a lockdown here was pretty straightforward: over N% bed occupancy in the state hospital system was the trigger.

> if you use a correct IFR and multiply by the real immunity rate, you get a number too low to pose problems to the health system

Both the "correct number" and the "real immunity rate" were not known at the beginning of the pandemic, and, had they been different, many more people could have died before we would have realized and taken corrective action. In the face of these unknowns, wouldn't you agree that being cautious was the more responsible course of action?

They were both known early on thanks to the outbreak on the Diamond Princess, which was a perfectly sealed environment yielding data on the worst case scenario (cruise ships are full of the elderly). Officials just ignored it.

But it was also known that IFRs measured early on in an epidemic are always too high, because the less serious cases don't get reported or detected. There's discussion of that problem in the literature pre-dating COVID. So you'd expect some attempt to compensate for that, which there wasn't.

And finally once more accurate data did become available, epidemiologists typically ignored it. They were still happily publishing models assuming a 1% IFR in 2021.

W.R.T. acting in the face of unknowns, no, would not agree. The precautionary principle can be used to justify literally any action no matter how crazy. It's informally called the politician's fallacy (something must be done, this is something, therefore it must be done). You do have to make decisions based on data. Not having data or understanding doesn't give permission to make everyone do literally anything you want. It means you can't take morally legitimate action until you do have that understanding.

> because if you use a correct IFR and multiply by the real immunity rate, you get a number too low to pose problems to the health system

You don't have to estimate, because the actual outcome in terms of number of infections frequently overwhelmed local health capacity in many countries. Certainly UK policy ended up in a loop of hospital overload -> lockdown -> rate goes down but still prevalent -> unlock -> infection rises.

Lockdowns had no effect on case numbers, as has been proven in several different ways by now. The Swedish healthcare system for example did not collapse.

People's understanding of the hospital situation have been badly distorted by the problem of officials lying about it, which happened distressingly frequently. Officials often just made things up when it came to hospital overload. They knew people wouldn't suspect they were lying and it would make people obey, which seemed to be their only priority :( Consider this case from November 2021 where the head of NHS England said “The NHS is running hot...We have had fourteen times the number of people in hospital with Covid than we saw this time last year”. That was not only a 100% false statement, it was absurd on its face. In reality hospital load was lower, not higher. FullFact wrote about it here:

https://fullfact.org/health/amanda-pritchard-nhs-hospitalisa...

Then when asked why she said that, the NHS lied again! They claimed the comparison was actually between August of each year because there was no more recent data, even as daily updated data could be downloaded from their own dashboard:

https://capx.co/why-is-the-head-of-nhs-england-peddling-dodg...

Nobody in the media challenged any of this. They were happy to repeat her lies uncritically. Now think about how often they did this without getting caught.

This wasn't a UK specific problem. Similar things happened in Switzerland: the government held a press release where they said hospitals were overloaded even as their own dashboards directly contradicted them, showing no unusual level of bed demand. It was remarkable that health officials so frequently said things directly contradicted by their own data, and how no "journalists" ever called them on it. Did these people even realize these dashboards existed at all? Often it seemed not.

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