Will SARS-CoV-2 become endemic?
science.sciencemag.org
science.sciencemag.org
If the Covid virus does the same and causes yet-another-cold, who cares? Whereas if we're fighting Covid-the-disease for decades to come, well, God help us!
https://journals.plos.org/plospathogens/article?id=10.1371/j...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4361674/#!po=0....
https://en.wikipedia.org/wiki/Common_cold#Viruses
https://en.wikipedia.org/wiki/Coronavirus#Infection_in_human...
Did you know there are four coronaviruses that cause cold-like symptoms? I didn't, because I didn't really care. That's all Op is saying.
Regular mask wearing and careful avoidance of problematic public situations is already more effective than any vaccine for this virus will ever be.
What do you mean? Don't do what?
Please don't make that argument your making? Please don't make your argument in that way? Please don't argue at all? Please don't ask questions?
Literally, all the comment you responded to did what ask a question to invite further discussion of an idea they were interested in.
When I hear "please don't do that" I picture kids pulling up flowers in someone's yard and they yell out "please don't do that!" It seems aggressive and unspecific for a civilized discussion among equals.
In recent history we haven’t bothered fighting colds at all and this attitude has not served us well. Up until March 2020 it was socially acceptable to roll into your office, church, or school coughing and sneezing everywhere. In 2020 we even had to produce public health videos to teach people how to wash their hands and why it was a good idea to do so! This was taking place in high income, well educated countries that would consider themselves technologically advanced and socially sophisticated.
That casual posture is obviously gone for a generation, but what underpinned it was our collective delusion that we had conquered infectious disease while all visibly ill from all the infectious disease circulating in the population every year.
The research efforts are interesting because it seems to be a very tough vaccine candidate due in part to the sheer number of viruses and strains you’re dealing with. I’ve not seen the financials, but I’d be surprised if we were spending anything like the estimated costs of tens of billions of dollars on finding a solution. I guess it’s a case where the costs are borne in a very diffuse way but the solutions have to come out of specific research budgets. Why bother researching and getting approval for a vaccine, when you can just sell people over the counter snake oil like cough medicine?
We don’t have to shrug when our low baseline expectations for life get even worse. We can and must do better if we believe in progress.
At the medical science level, we absolutely do investigate common cold pathogens and others, and have developed a battery of techniques, all of which were very rapidly brought to bear on Covid-19.
Where I think we do need to do a lot better is in international co-operation and co-ordination. In the USA the CDC needs competent leadership again, they need their seat back at the US national Security Council and they need their international outreach budget back. Europe needs to develop their own equivalent to the CDC that's well funded and effective.
The WHO also needs thoroughly upgrading. I think given the way national governments have ensured the WHO stays a political football, they actually overall do a lot of good. A lot of nations are thoroughly reliant on them for advice and technical assistance, but clearly their chronic dependence on the good will of nation states has severely compromised their ability to act as an independent and effective organisation. They need more funding and more independence, not bullying by China and the USA to serve domestic agendas.
Keyword being existing. Future advances may change the landscape significantly, and not just for colds. For that, we need a stable society, competent governance, and investment in foundational science.
It seems quite strange to me that this should be multiplicative. There should be some economics of scale, especially for viruses from the same family.
(It is also quite strange to me that the SARS-2 vaccine takes some long, as if we have to invent the vaccine technology from scratch. But granted, I don't know much about this field. Maybe it is not a technology problem but mostly testing and approval)
It would be cool if we could test a method, rather than a vaccine, and next time just whip up a vaccine with the tested method and apply it quickly.
For the “common cold” vaccine, you’re looking at hundreds of strains across about nine types of virus, so a pretty tall order using traditional approaches.
A couple of hundred does seems tall at all, especially when it is basically just 9 different types. It seems to me that this is easy to scale once a general approach is found.
But since there is basically no progress on the common cold, I assume it is just not solved for any of these families, so the total number of strains or families doesnt matter anyway. Or it is mutating faster than we do anything. But I dont get how a small number like couple of hundred should matter - at least from the technogical perspective.
Do regular challenges play a role in modulating immune response and health?
Quarantines, maybe. The vulnerable already have to shield themselves as protection, and the economic losses are pretty steep before you factor in the human cost of suffering.
But nobody will accept a full quarantine, commerce restrictions, or any of the other heavy actions for fighting a normal cold. And with a lot of reason. It's best if people don't even propose carrying those practices after the disease gets less lethal, because even proposing them can bring bad consequences right now.
And if so, how does the old strand die out in our world?
Basically, mutations of the virus that cause it to spread more make it more likely for the strain to persist. Usually this means, virus becomes more benign, doesn’t kill people quickly and instead causes some minor illness, which gives the patient more opportunities to spread it.
But it’s not a given. It could for example mutate to become more deadly, but with a longer infectious period. This is what happened to myxomatosis in rabbits in Australia.
Why "Spanish flu" and not H1N1-A-18? That flu is called "Spanish" only because Spain's newspapers openly talked about the epidemic. The actual origin, according to wikipedia, was "likely Kansas".
HIV has killed around 50 million over the past 40 years, and we know how to stop that but it is still endemic and will be for at least a century.
/joke
[] https://www.independent.co.uk/news/world/americas/us-politic...
While your points about the obscene cost of Truvada are spot on, your point about US incomes is not.
For 2019 the median US income was $36,000 [1] (not ~$20,000). The median US full-time income was around $52,000 [2]. The median family income was $86,011 [3] and the median household income was $68,703 [4].
[1] https://fred.stlouisfed.org/series/MEPAINUSA672N
[2] https://www.census.gov/library/publications/2020/demo/p60-27...
This seems especially hard to do though, since compliance would need to be nearly universal. You could potentially wipe out influenza and the common cold at the same time too though potentially.
Edit: This comment is being downvoted for some mysterious reason so I'll add a reference: "HIV/AIDS is considered by some authors a global pandemic. However, the WHO currently uses the term 'global epidemic' to describe HIV." [1]. There may some confusion as to what 'endemic' means by some commenters here...
Practically speaking HIV is a solved problem.
From the middle of the article:
"Should reinfection prove commonplace, and barring a highly effective vaccine delivered to most of the world’s population, SARS-CoV-2 will likely become endemic"
And the closing sentence:
"A duration of immunity similar to that of the other betacoronaviruses (~40 weeks) could lead to yearly outbreaks of SARS-CoV-2, whereas a longer immunity profile, coupled with a small degree of protective cross-immunity from other betacoronaviruses, could lead to apparent elimination of the virus followed by resurgence after a few years. Other scenarios are, of course, possible, because there are many processes at play and much that remains unresolved."
The last time I can recall reading a credible 'we can stop this' message was around February; Stat news IIRC.
Once this is over, if the virus remains in some sort of steady state in a given area, i.e. person to person transmission never stops so that a least a few cases always exist, then it will have become endemic in that area.
Globally it might become endemic, or it might not, or a large-scale vaccination program might kill it off anyway. We don't know.
It remains to be seen if most people will even get vaccinated if/when a safe and effective vaccine becomes available.
Even if people got vaccinated once, to actually eradicate COVID-19 they might have to get revaccinated multiple times, possibly over a span of years. We can't even get everyone to get flu shots. Getting everyone to get a new vaccine to a disease towards which there's so much disbelief will be even more difficult.
We eradicated smallpox, but that was a fluke. Take a look at the eradication efforts towards HIV, measles, and polio. Much more progress could be made on these fronts, but paranoia, ignorance, and long-held beliefs and behavior patterns stand in the way.
Even if COVID-19 itself is eradicated, something else to consider, that virologists have been pointing out, is that there are plenty of other coronaviruses in various animal species that could make the jump to infect humans, possibly causing another pandemic which is just as bad or even worse.
A major shift in thinking and priorites has to happen globally, on many different fronts to make humans less vulnerable to this kind of disease in the long-run.
Instead of acting with compassion and trying to convince people of the dangers of this disease, but also providing some sort of perspective of where we are going, we’re just calling everyone who has a different opinion an anti-* and be done with it.
From just a week ago: "Covid deaths three times higher than flu and pneumonia"[1]
And that's taking in to account all the lockdown, mask-wearing, and social distancing measures. Without those it'd be even worse.
And yet if COVID-19 was no more dangerous than the flu you'd expect to see equal result form those mask wearing and social distancing measures.. but you don't.
COVID-19 is just way more deadly.
Less than 217000 people died of COVID-19 during the epidemic in the USA while some 1.5 million people died from other causes in the same time frame. Why the obsession with COVID-19?
Go ahead, make people not take you seriously.
I felt this was a really interesting piece explaining how covid deaths are reported deaths versus flu deaths are just estimated and how the two are very different numbers to base comparisons off.
I also kind of liked how the article was written with the narrative of the eureka moment in realising how the stats were not comparable.
https://blogs.scientificamerican.com/observations/comparing-...
> I decided to call colleagues around the country who work in other emergency departments and in intensive care units to ask a simple question: how many patients could they remember dying from the flu? Most of the physicians I surveyed couldn’t remember a single one over their careers. Some said they recalled a few. All of them seemed to be having the same light bulb moment I had already experienced: For too long, we have blindly accepted a statistic that does not match our clinical experience.
> The 25,000 to 69,000 numbers that Trump cited do not represent counted flu deaths per year; they are estimates that the CDC produces by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms. These coefficients are based on assumptions of how many cases, hospitalizations, and deaths they believe went unreported. In the last six flu seasons, the CDC’s reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which far lower than the numbers commonly repeated by public officials and even public health experts.
Like that hasn't been done non-stop since the world heard the term "coronavirus"?
A significant percentage of the population prefer not to listen to the science and instead believe in conspiracy theories. Science literacy in the general population is abysmal. That's just a fact.
Many people prefer to listen to what their morning talk show tells them than listen to the CDC.
This kind of ignorance could be overcome to some extent through massive information campaigns, but so far the US government at least is incapable or unwilling to do that. If anything, on some of the highest levels it's doing quite the opposite.
That kind of obviously harmful attitude is not just ignorant, it's borderline malicious.
People certainly have and will probably continue to die because of it.
I think at this point we have enough data to understand what happens when we try to force people to think or believe things on a massive scale. Its not great.
I don't necessarily disagree with this, but I don't think the current mitigations can reasonably be long-term solutions. Think about how the lockdowns have caused small businesses to close down, people to lose their jobs, etc. We count deaths caused by COVID-19, but do we count the deaths and quantify the damage caused by our mitigation strategies?
However in the last 3 months, I've had both a friend and a relative kill themselves unexpectedly, both laid off since March, unable to work, financial issues, no hope and one just recently in an area just gone back into lockdown.
It is very much easier for those of us who are able to WFH taking Zoom meetings in PJs with Amazon Fresh delivering groceries to the door. But for a big chunk of the populace, these are really hard times.
I do not know what the right answer is, but you have a very good point.