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Comment by guscost | Hacker News Reader

> The whole human population is immunologically naive to it.

This study provides direct evidence that the “novel factor” is not as important as was previously thought. Maybe no-one has cleared a virus exactly like this one before (we can’t be sure), but it is looking more and more like many people have pre-existing immune responses that can clear this one.

> Suppression/eradication is the only way forward.

You may end up being right, but to me this is sounding less and less like a scientific conclusion, and more and more like a religious creed.

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You may end up being right, but to me this is sounding less and less like a scientific conclusion, and more and more like a religious creed.

The way to say is ..."the only way we can count on" is eradication. Sure, keep working on the other approaches but relying on them is foolish.

I don’t know, SARS-CoV-2 may be the most well adapted and widespread potentially deadly human infection in the world right now. If any possible endpoint, “suppression/eradication” seems the least likely.

This. SARS-2 is a great spreader but a poor killer. (See: SARS-2’a early course interferon-mediated immunosuppression which probably explains the presence of pre-symptomatic spread). Worst possible candidate for suppression.

And eradication is literally impossible. It just shows how little these people know. It’s a zoonotic virus with abundant animal reservoirs, a high reproduction rate and pre-symptomatic spread. Even with a vaccine it fails the zoonotic requirement.

It’s endemic and here to stay. Anyone paying attention has known that from the start. I’ve personally been saying this for months and I’m just a deterministic algorithm operating on fixed-length groups of bits called blocks.

Eradication has been achieved in New Zealand. Much of East Asia is also close. Before anyone says 'people need to travel' - no they don't. It would be entirely feasible to operate a total human barrier, with goods being quarantined before passing the barrier.

True, another spillover from animal reservoirs is likely, either this virus or a similar one. Early warning with prompt response will be needed to control another outbreak. Immediately shutting down all international air travel would be a first action. Imagine if the next spillover is with a virus that is deadly as SARS-1 but as transmissible as SARS-2.

Nothing you have described is even remotely feasible. I don't think you understand how the worldwide supply chain works. Plus it is impossible to deal with conflict zones and failed states.

> Eradication has been achieved in New Zealand.

This isn't quite true, but even if I accept that as true, you haven't addressed the problem that this is a zoonotic virus. There are abundant animal reservoirs that will never go away.

> Imagine if the next spillover is with a virus that is deadly as SARS-1 but as transmissible as SARS-2.

I used to say exactly that, until realizing that a virus as deadly as SARS-1 will never spread as well as SARS-2. Granted, if this hypothetical virus had SARS-1 lethality with SARS-2 incubation period, it would do a lot "better" than SARS-2.

Anyway, having thought deeply about this - and I'm sure you will strongly disagree here - even a SARS-1 danger virus with SARS-2 spread, I would be against (a) obviously eradication since I've already discussed why eradication is impossible, but more importantly: (b) I'm against trying to contain highly infectious respiratory viruses period.

That leaves open the question of whether we can indeed count on eradication. There are reasonable arguments that we can certainly. But there are also reasonable arguments that we can't, and I've seen a concerning number of people who won't listen to that second set of arguments. I'd guess about half of my friends refuse to acknowledge the possibility of not eradicating the virus, and I feel like I sense a similar proportion in most discussion forums.

Suppression, then a long decade of elimination.

Nobody credible thinks eradication is possible, because we would have to eliminate it from the extensive animal reservoirs. What, are we going to genocide every pangolin, bat, and housecat in existence?

Meow?

Is there evidence that more than one person caught it from an animal? I haven't heard of any. I expect that is the kind of thing one can learn from genetic sequencing of the virus - ie when a new strain is seen that has multiple genetic differences from any previous sample from humans, that would be evidence for re-infection from an animal species were the virus had been circulating for a while.

It literally came from an animal originally. That's what zoonotic means.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095063/

As for what that means for eradication:

See https://en.wikipedia.org/wiki/Eradication_of_infectious_dise...

> The targeted organism must not have a non-human reservoir (or, in the case of animal diseases, the infection reservoir must be an easily identifiable species, as in the case of rinderpest), and/or amplify in the environment. This implies that sufficient information on the life cycle and transmission dynamics is available at the time an eradication initiative is programmed.

^ This is why we can never eradicate it. There's a couple of other requirements. For example we could eventually pass this check:

> An efficient and practical intervention (such as a vaccine or antibiotic) must be available to interrupt transmission of the infective agent.

I think the media is partly to blame here. For example, here in the UK a whole bunch of experts have been warning that the virus will be with us for decades - and the British press spun this not as a debunking of eradication, but of the idea that we could carry out a "significant return to normality" by Christmas.

The problem is that the second set of arguments lead to policy responses that end up killing large numbers of people. See Sweden.

Believing eradication is possible if it isn't will also end up killing large numbers of people.

It is not a scientific conclusion, but a policy statement that takes into account the best science that we can get at this moment, and then defines what should be done to minimise the damage this virus will cause.

At its heart is the understanding that controlling the virus is the single most important thing right now - that this is a total war. This policy can only work, however, in societies with effective governance and a strong social fabric.

> At its heart is the understanding that controlling the virus is the single most important thing right now

You misspelled “belief”.

Apparently this is killing 1000 Americans a day?? I'm not sure what your threshold is...

This stuff is difficult to talk about because most people are not used to clinical reasoning about health outcomes. There are essentially priorities to balance between the COVID group and the other 8000 dying every day. And between the extra people dying right now and the extra people who will die ten years from now, and so on. There’s no way to just point to some “threshold” where you wouldn’t still have to make triage decisions all the time.

..request to change word "religious" to non-equivalent "statements without supporting evidence" .. good?

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