if we're back to normalish by spring next year I think that would be a great outcome, if the messaging to the public would be, buckle down until then I think lockdown complaince could go up
Even if we had a vaccine ready for the roll-out today, I don't see us going back to normalish until late 2021 at earliest.
As with any vaccine, you'd need about 80% of the population to vaccinate in order for herd immunity to kick in. I feel like we're gonna have trouble reaching that amount for years to come.
Getting a working vaccine is only step 1 towards eradication path, not the end goal.
The US has five million people who tested positive and have recovered. Likely also another 30-50 million who were never tested because their symptoms were to minor. And another 66-165 million who have cross reactive T-cells.
Some researchers have concluded that the herd immunity threshold for sars-cov-2 could be as low as 10% or as high as 50%. I don’t think anyone sees it as high as 80%.
The mayo clinic suggests it could be 70%, and I have seen others suggest 80%. I have not seen anyone suggest as low as 10/20% so I think that suggestion is a huge outlier and even the paper you link says as much.
One of the papers hypothesized that this demonstrates why areas like NYC got hit so hard initially and have remained stable since. Seroprevalence surveys back in the early summer indicated that between 20-30% of NYC residents had contracted Covid already. The lockdowns obviously blunted the surge, but unlike other areas of the country, as NYC has opened back up, there hasn't been much of a second wave at all. With more than 2/3rds of the population still without any kind of exposure to the virus, you would expect a dense city like NYC to see a large increase. The paper concluded that this is evidence that might suggest that the herd immunity barrier is far lower than initially estimated. I've seen some papers suggest something closer to 20-50%, but nothing so low as 10%. I'll see if I can dig up some of the preprints to post here.
We're not going to eliminate the virus completely. That's a given, we should stop aiming for that.
If we get to a point where there's a stable number of daily deaths then we're good. (like we have for literally every single fatal illness.)
Smallpox. And if you consider within the borders of a given country, a dozen others (polio, measles, mumps, rubella, chickenpox).
Fair enough. I would consider a virus eradicated when the general population gives zero thought to it, and effectively no one dies from it. Doesn't meet the strict medical definition, but I thought the description of "If we get to a point where there's a stable number of daily deaths then we're good" was overly pessimistic.
That's not how it works. Just because you don't see an outbreak for a while, that is never a reason to stop immunizing children. Pathogens can and do have natural reservoirs. This is why when some idiots stopped taking the Measles vaccines we had an outbreak here in the US.
"If it bleeds, it leads"
Deaths is the only relevant measure.
You can also corroborate this by comparing it to new hospitalizations, which are also up.
“Deaths is the only relevant measure” - not sure where to start with this except to say that this is not at all what epidemiologists seem to think and I won’t address it further without some very dramatic reasoning and evidence.
No, it suggests that you’re doing more testing, and finding more cases. Which, exactly as the OP said, is a metric that can be manipulated by doing more testing.
The whole reason we emphasize positivity rate is to try to compensate for the inherent bias in reporting raw case counts.
There have been far more cases than we have ever formally detected with testing. There’s plenty of room to increase that number by testing more people, but it will not affect hospitalizations or deaths - which is exactly what we’re seeing.
Positive test rates measure what was happening about a week ago. Hospital admissions reflect activity a week or two before that, and deaths often get reported a month or more after the events that caused people to get infected.
You have to look at all the data to get an idea of what is happening.
I don't know about you but I'm feeling like simply "getting to a stable number of daily deaths" doesn't cut it. Also, that statement alone doesn't make sense to me - a fatality rate of 50% could potentially maintain a stable rate of daily deaths... Of thousands.
You don't need to eradicate the virus, just stop it affecting the most vulnerable. Everybody else can then carry on as normal (albeit with a slight chance of getting a nasty flu-like illness).
Because of this high dispersion rate, it may make sense to earmark a certain amount of vaccine doses for people who are not themselves at risk of complications when contracting Covid, but who are at risk of becoming a superspreader.
(Disclaimer: I'm not an epidemiologist.)
At least then we stand a chance of getting the economy back on its feet.
For instance, I'm a vulnerable person because of preexisting conditions, so I'll likely be offered a vaccine relatively soon after approval. But that won't have a large impact on economic recovery: I'm in the home office in a single-person household and don't have any care obligations, so I'm at a comparatively low risk anyway. And I won't change my current behavior until the disease is fully gone anyway.
Not to mention that we already know about long term side effects that have nothing to do with a specific age group, and that there's a chance of re-infection.
If we just vaccinated 65+ year olds, we'd cut deaths by 80X%, where X is the effectivelness of the vaccine. Even if the vaccine was only 80% effective, that's still 65% reduction.
Add in people with dangerous conditions, heart conditions, cancer, morbidly obese, etc., and you could probably knock it down further.
And as the percent of the population with immunity rises, the spread will slow quite a bit.
We don't need heard immunity to open back up.
Wrong. The herd immunity threshold (HIT) for influenza is 33%-44%. HITs are different for every infectious disease. Current estimates for COVID-19 are 60-75%.
Furthermore, I know of at least 3 leading statisticians that hypothesized (very early on) that the variance of infection trends pointed to pre-existing immunity in various populations. The evidence supporting this is mounting.
"I think the first thing we to review is who is Peter Doshi? And why is he so insistent on getting this data?
Peter Doshi received his BA in anthropology from Brown University, MA in East Asian studies from Harvard University, and Ph.D. in history, anthropology, and science, technology and society from the Massachusetts Institute of Technology. Those would be fine credentials for someone who is going to teach history or anthropology."
https://www.skepticalraptor.com/skepticalraptorblog.php/pete...
Literally, right now we are seeing case rates explode, but the number of casualties is paradoxically very low because it's mostly the younger cohorts getting sick - which is probably a social function of things like 'back school' and 'risky behaviours' among younger groups.
If we could get everyone 50+ vaccinated, we may be largely safe - maybe not 'back to normal safe' - but the combination of 'partial herd immunity', 'much lower rates of hospitalization' etc. may mean we can 'kind of get back to normal'.
At minimum younger people who have had covid are looking at a lot more regular check-ups for the rest of there life.
There's not a single peer-reviewed study showing a significantly higher frequency of long-term adverse effects in healthy individuals compared to other respiratory illnesses.
https://covid19.healthdata.org/global?view=infections-testin...
https://covid19.healthdata.org/united-states-of-america?view...
But notice, in the latter chart, that in the US the number of infections is predicted to peak in January and then start going down. It seems plausible that by March, we'll achieve some level of herd immunity, relative to the precautions that are currently being taken. We might have a situation like Europe over this pas summer, with small numbers of cases until a second spike in Fall/Winter 2021. That would buy us the spring and summer to roll out a vaccine.
Of course, I'm far from sure that this is what will happen -- but it certainly seems plausible to me.
For example, I'm a professor at the University of South Carolina. Here we've had around 2,500 confirmed Covid cases, and perhaps around 10,000 cases in actuality. Nearly all of them happened in the first few weeks of the semester, and now the positive test rate is extremely low.
Looking around town, it's pretty clear what happened. There are some students that have acted like nothing is happening, partying and drinking constantly. That population has presumably hit herd immunity already. Meanwhile, there are many students (and staff) that are exercising precautions, and not venturing out a lot, and probably few of them have contracted the disease.
Now, we can't just go back to normal, or else cases would spike among this second group -- but locally it seems that we can afford to relax a bit.
And, also, we're at 8.8 million confirmed infected -- the actual numbers are presumably much higher.
The most we're going to get out of a vaccine is a tool that can be used in conjunction with physical distancing, and masks, to keep the infection rate and hospitalization rate sustainable.
Even with a vaccine, COVID-19 will remain one of the leading causes of death among the sick and elderly. The percentage of chronically ill people who live, and the percentage of people who make it past age 65, will plummet.
Everyone who's alive now will almost certainly need to socially distance (and should wear an N95/KN95 mask in public indoor spaces) for the rest of their lives.
What's happening now is humanity's normal.
Is it? Current studies, AFAIK, give very variable attack rates, from low zeros to around 30%. Only higher if due to close contacts for longer periods of time (carriers, fishing boats, meat packing plants). This preprint on trasmission dynamics and evidence from September[1] has lower figures.
> Everyone who's alive now will almost certainly need to socially distance (and should wear an N95/KN95 mask in public indoor spaces) for the rest of their lives.
I wonder how we're even supposed to build a society that can live without any or very reduced form of contact. I think it's socially unsustainable.
[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3692807
What's there to deal with? Let people make that personal choice and leave them alone.
This is demonstrably false. Some places are already back to life as normal, like Florida and Sweden, with no business closures. And in spite of this they still have lower deaths per capita than some places with heavy lockdowns like New York, Peru, Belgium and Spain.
That's the part I'm referring to by "not caring" - just ignoring the close orders, especially since "two weeks to slow the spread" has been so completely abandoned.
* What law? In the US, the lockdowns were under emergency powers of the executive branch, which are supposed to only last a limited time (30 days where I am, for example). Several of these were challenged and found to be unlawful.
* The US lockdowns were originally only mean to prevent hospitals from being overloaded. We are way way past that point where that was an issue - all the emergency capacity has been dismantled for months.
* As sibling comment implies, something like half the states in the US aren't under any lockdown now, businesses there aren't having issues staying open, and their stats are no worse than the locked-down states.
* Speaking of preventable deaths, suicide and overdose are climbing where lockdowns are still in place.
In some cases there have been legal challenges to those laws so there aren't givens but even if those are successful, my point was that even if you do re-open you can't force customers to come back when they feel unsafe. Even in the states where restrictions have been relaxed, a large number of people are not comfortable hanging out at a bar or restaurant — the problem being the risk of a serious disease, not the countermeasures deployed against it.
> The US lockdowns were originally only mean to prevent hospitals from being overloaded. We are way way past that point where that was an issue - all the emergency capacity has been dismantled for months.
The lockdowns were, as clearly communicated at the time, intended to slow community spread. Avoiding hospital overload was part of that but so was avoiding large numbers of people getting a serious disease with potentially life-changing impact when they don't need to.
> As sibling comment implies, something like half the states in the US aren't under any lockdown now, businesses there aren't having issues staying open, and their stats are no worse than the locked-down states.
And that commenter was wrong just like you are wrong. Anyone who follows this issue knows that the cases have been rising recently (~35%) and there's a noticeable correlation with the states which re-opened high risk activities and those who did not.
For example, they mentioned South Dakota which is at an all-time peak:
https://www.nytimes.com/interactive/2020/us/south-dakota-cor...
Compare with, say, New York which is roughly 20 times larger even before you account for density differences:
https://www.nytimes.com/interactive/2020/us/new-york-coronav...
A common cause of error here are people looking at the all-time cumulative stats rather than the last week or two and missing that while, say, NYC was hit early with quick community spread in a dense environment and thus had a brutal spring but the increased lockdown have kept levels low since then.
I encourage you to visit one of the no-lockdown states like Florida or South Dakota sometime and see how much of a complete falsehood this is.
By then it will kill at least a million people at the current trajectory. So US needs to start acting more aggressively now.
Can you also share some of those sources you mention? Thanks!
> Two of those companies, Moderna and Pfizer, are now in Phase 3, large-scale clinical trials. The 30,000 volunteers in each of the trials are getting two doses, with Moderna spacing their shots out 28 days apart and Pfizer spacing theirs out by 21 days.
> AstraZeneca is expected to start Phase 3 trials this month. Their Phase 1 and Phase 2 trials used two doses given 28 days apart.