Hacker News Reader

Comment by glangdale | Hacker News Reader

I think it's reasonable to be way more cautious about COVID than the "just a flu" and "it'll become endemic" (for some value of 'endemic') crowd seem to think.

The UK brain imaging study is a (small, not-yet-peer-reviewed) data point in that direction also:

https://www.medrxiv.org/content/10.1101/2021.06.11.21258690v...

There seems to be somewhat of suggestion that COVID may have serious long-term neurological effects. Given the massive numbers that it has affected already (and how many it would affect if it becomes endemic), even relatively small risk factors (i.e. single digit percentages) for things like Lewy body dementia and Parkinsons could have huge effect on public health.

It's worth reminding ourselves that we don't have any data on the mid-to-long term effects of COVID beyond about a 2 year window.

View on HN

> I think it's reasonable to be way more cautious about COVID than the "just a flu" and "it'll become endemic" (for some value of 'endemic') crowd seem to think.

But unless you want to live like a recluse in a bunker, what are your options?

The way I see it, you're bound to catch it no matter how many precautions you take. Case in point: I know a guy with paranoid level of precautions that still got it and while he was confined with his family none of them caught it (this was before we had any vaccines in my country).

> But unless you want to live like a recluse in a bunker, what are your options?

We can:

• Try not to get infected

• If inevitable: Get as little of it as we can

• Help the body clear the illness and after-effects

• Contract the illness as late as possible, as medicine advances faster than mutations

• Seek to support the science of figuring this thing out

• Do this together

• Seek to reduce the amount of contagious people in our local and global environment

Practically, we can:

• Wear masks. Better masks are better

• Use air conditioning, advocate for air conditioning and fresh air

• Exercise. Eat well. Go outside.

• Get vaccinated

• Read papers

• Discuss the science

• Participate in studies

• Fund science

• Explain to people what the scientific process is and how we know what we know

• Should we arrive at the opinion that certain substances, drugs, or supplements may have a protective effect, we might take those

• We can be the living scientific process: When we choose to experiment, seek to carefully note down the results and publish them

• Help others

• Fund healthcare for those who are less well off than we are

• Establish robust social immunity by discussing the options we do have to reduce infection

I think we need to put considerably more effort into discussing existing and new scientific endeavors before we consider funding. I am not saying we should pause or reduce funding, but rather the reach of our public coffers has increasingly exceeded our understanding of what we are or are not accomplishing with that funding.

The amount of noise, publicity, and politicization of scientific research makes it very difficult to wisely set public policy at both the national and local levels.

I would agree, although not completely – but will I also claim that this falls under discussing, studying, funding, and doing more science %D

Ah, and, it didn’t occur to me to make the distinction, but I was thinking of personal and direct funding of science. As something each of us might arguably do. It’s interesting to consider it because we arrive at the same question: What to fund?

> Seek to support the science of figuring this thing out

It's "funny" because a few months ago, I read that it was definitely an airborne virus, so hands contagion was absolutely not a concern.

Then yesterday I read the complete opposite.

In both case, they were reputable scientists.

Thanks for the advises anyway.

Exactly! And which leads us to asking: How do we know???

> But unless you want to live like a recluse in a bunker, what are your options?

It depends on work and family circumstances. But, stuff that works:

* Be outdoors, and socialize outdoors

* If in indoor unventilated spaces, wear a mask. Ideally N95 if lots of people and they aren’t mask

* Exercise more caution during local waves

* If socializing with others indoors, open a window. This can be done even during heat waves or winter: the greater the temp differential the more the air circulation for a given amount of window opening. Doesn’t raise costs too much, yet people treat it as impossible

* Buy a hepa filter for your home. Humidifiers can also help in winter

* Avoid indoor restaurants and bars and unmasked venues

* In risky venues, choose glasses over contacts. Eye protection is another layer

* Don’t hang out with symptomatic or unvaccinated people

* Get vaccinated

Whether you should choose to do this is another thing, but that’s what to do if you don’t want to catch a respiratory virus.

This above is consistent with: seeing friends, small indoor gatherings, travel (wear n95 + glasses!), etc. It certainly isn’t living in a bunker.

It does present problems during winter though, and it is also quite inconvenient in places with frequent large waves. Small ventilated indoor gatherings with vaccinated friends should be ok in low prevalence, but are risky in a big wave, for example.

I would quite literally rather contract covid than live like that for any period of time.

Apart from the masks, it’s how much of Canada lives for four months of the year (summer). We hardly do any indoors socializing.

It’s what I based the above on. Both pandemic summers Canada has had collapsing cases even while there were surged in parts of the world with winter or that use AC more than us.

Go to any restaurant with a patio and you’ll hardly see anyone inside. Everyone goes to the patios in summertime. And people tend to open windows rather than use AC on anything but the hottest days. Backyard dinners or rooftop drinks are one of the main ways people socialize privately.

Difference being that Covid restrictions take away the free choice of the individual, remove restrictions and let each get on with their lives as they choose.

I should add, of course, that I mainly wrote that for those who 1. Really would like to avoid catching the virus for now, but 2. Think it requires ungodly levels of isolation to do

What I wrote is less social than the average (one hopes) but more social than a lot of people lived the past year!

But if you’d rather live less restricted and are vaccinated, go nuts. The vaccines protect quite well against severe disease and it doesn’t strike me as a bad choice to not worry about it.

There is absolutely no way that we can implement the above, WITHOUT losing a lot of what makes us humans in the process.

I'd rather keep our pre-Covid level of human interaction than limiting it forever.

But to each their own, one thing is that we must remove all restrictions so that each can choose their own way freely.

This last part is what politicians have a hard time to realize, but it's a necessity.

Literally nothing in my list was a covid restriction. It is a list of things someone can do if they decide they don’t want to catch covid at the moment while we wait for more info.

Delta, so far, seems to infect whole households with ease in a way that we didn't see. Sydney, Australia is on severe lockdown at the moment thanks to a delta outbreak (it hasn't helped that, like many countries that handled the lockdown/test-and-trace methodology well, we fucked up the vaccination program).

I would imagine that a combination of mass vaccination (which seems to reduce transmission, although not by as much as was hoped) - and continued reasonable measures (mask wearing in crowded indoor places, better ventilation) we could achieve eventual elimination.

Alternately, on route to this less-than-comfortable-outcome, we could make strides in treating the long-term illness, improve short-term treatments and improve vaccines.

The other option is that maybe we'll work our way through the entire Greek alphabet of variations (and beyond; perhaps the Omega variation is followed by double-Alpha) with a large pool of sick people and vaccine escape whack-a-mole because people decided there was no options between "live in a bunker" and "free for all".

> Delta, so far, seems to infect whole households with ease in a way that we didn't see.

According to the latest data out of the UK, Delta is approximately as contagious as Alpha:

https://assets.publishing.service.gov.uk/government/uploads/...

There is simply no basis for these claims of dramatically increased contagion. It’s a meme that was based on early speculation, and repeated mindlessly by the press.

> According to the latest data out of the UK, Delta is approximately as contagious as Alpha

Are you talking about page 34, which compares secondary attack rate week by week? Can you explain how you read that chart?

> what are your options?

We're a year and a half into it. We have the data. Aside from vaccination and some degree of proper ventilation, you need to:

1. Not be old. 2. Not be fat.

We talk a lot about #1, but #2 is taboo. We, as a society, prefers that you die unnecessarily young from COVID than feel a little bit of shame. Not to mention #2 was already murdering nearly half a million Americans annually on its own prior to COVID.

This needs to be fixed. Sugar/corn industry lobbyists and fast food advertisers should have been publicly hanged decades ago. Now we have even more incentive to address the issue, but I suppose slowly dying at the age of 37, gasping for breath, is a small price to pay to avoid feeling slightly negative about being 300lbs or impact the dividends of the Coca Cola Corporation.

You are absolutely right.

Number 2 is hard to fix as lobbyists and fast food companies have a lot of influence.

But it is concerning that of US women from age 20 and up, 60% or more are considered overweight.

A woman 50 years old has an average weight of 80 kg, using the Miller ideal weight formula and a height of 170 cm, the weight should be 62.5 kg.

https://www.healthline.com/health/womens-health/average-weig...

There should be some kind of reward or benefit for those that can keep to the ideal weight for a longer period of say 1 year.

>but #2 is taboo.

where?

There’s no reason to believe catching COVID-19 is inevitable. Consider that the best estimates about the Spanish flu of 1918 are that about a third of the world caught it before that pandemic ended. Today we have much better knowledge and hygiene, and extremely effective vaccines.

Most people in the world have not contracted COVID-19. Personal precautions are well understood and vaccine distribution is well underway.

I’m sorry that your friend contracted it. In contrast I would characterize my family’s precautions as normal, and none of us have contracted it. Two of us are now vaccinated as well.

The Spanish Flu never went away, it just became "The Flu™".

> But unless you want to live like a recluse in a bunker, what are your options?

You mean like social distancing, wear respiratory masks in closed spaces, revise public spaces to improve air filtering and forced congregations, improve public transportation to avoid high concentration of passengers, and don't force returns to office in industries that do not require them?

You're talking about bunkers and recluses as if you are totally unaware that a) working from home means neither and b) people overwhelmingly prefer it.

There are no options obviously.

I am fully vaccinated, if you offer me a booster I will take it. If you offer me whatever, I will take it.

At that point I have done all I can do. If someone wants to stay in a bunker because things are beyond their risk preference then they should not be forced out of the bunker.

Forcing me back in a bunker though being fully vaccinated is absolute bullshit if anyone can get vaccinated.

Exactly, at some point the cure will become worse than the disease. The fact this makes people uncomfortable is no reason to push it under the rug!

It’s hard to confidently assert that the cure is worse than the disease if we don’t know the long-term effects of the disease yet. (Which is why we’re discussing the Lancet article.)

How many years of lockdown will people put up with?

I could see some places where someone’s entire childhood memory is being under lockdown.

If an actual proper hard lockdown is done, it takes only a matter of weeks.

COVID-19 has only existed as a problem for less than twenty months - what childhood is that short? And even if that statement had some relation to reality, anyone would take a childhood lockdown vs a lifetime of impairment (&, yes I get that lockdown itself can have some long-term effects, but these are much more easily counteracted vs biological deficits).

Yes, intellectually speaking, 20 months is not an entire childhood. But from a relative perspective- let’s take a five year old- that’s about 40% of his lifetime to date. That feels very significant to him/her.

That said, having kids that age, I would say my kids handled this pandemic way better than most adults. They adapt quicker and don’t have the emotional baggage (“masks are an evil plot to control the population” for example) to get through.

We have been lucky that they were able to attend school in person though - very strict COVID protocols plus a small population ensured that we never had an outbreak. Things would have been different if we didn’t have that ability.

ok, even if we are talking about a significant part of lifetime to date, it is still a pretty well-spoilt view from any historical perspective.

And even new variants and vaccine delays cause us to get to years of lockdown that actually constitutes significant portions of full childhoods, are you arguing that childhoods full of funerals and an adulthood full of diminished mental capacity [1] and COVID sequalae are better?

The 'modern' world is not a stable reality, it is a priveliged bubble. In general, and throughout most of history, it is a harsh place with most things trying to kill us. Having to simply take protective measures is as old as humanity, from standing guard through the night watching for other apex predators, to avoiding invaders and plagues, it is a part of what it is to be human (and not even to mention how much easier it is then for other creatures). To view any alteration to our modern routines due to actual biological reality as some injustice is provileged and myopic. Better to turn it into a teaching moment and illustrate how it is a part of history, and in this case, a very mild version of what was previously endured.

[1] https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

On a personal level, get vaccinated. That seems to reduce risks by a factor of at least 1000.

On a social level: use the Aus model. Actually lockdown, get case numbers down to the 10s per million. The UK, US etc model is the opposite, it relies on having as many people as possible infected and not really engaging in any full lockdowns. So far that's meant more and longer lockdowns. It's also meant more variants. And it means the maximum number of people with long term effects. It's the worst of all worlds, even the economic one.

That study is somewhat alarming, but I think they were only looking specifically at parts of the brain related to smell and taste, not the brain as a whole, as stated here:

"Based on prior expectations based on animal models and post mortem findings, we chose to focus a priori our primary analyses on a subset of 332 regions-of-interest (297 of which passed the reproducibility thresholding) from the available IDPs that anatomically corresponds to the telencephalic primary and secondary connections of the olfactory and gustatory cortex"

It is endemic. What you think of that fact is irrelevant. It’s a contagious respiratory virus with multiple animal reservoirs. Even if you could somehow vaccinate every person on earth tomorrow, the virus would still be here.

This virus is not going to be eliminated, and it’s well past time to move on from that discussion.

I was just thinking about this today as I prepare for another transatlantic flight: we seem to all be planning for a time when mask mandates and lockdowns are over.

But what if they're never over?

The US and Western Europe have, by now, enough high-quality vaccine for everyone, and we're all stuck at, what, 60% of the population vaccinated?

A bunch of people died, a bunch of people went broke, but during this pandemic the rich have mostly gotten a whole lot richer. Even the rich who don't think of themselves as rich: own a house in Silicon Valley, have a dozen years of 401K and some stock -- these people have done very well.

We have to fight the virus; but we also have to fight the anti-vaxxers and the apathetic, and we have to do it in a world where the people with real power are actually gonna be just fine if everything locks down for four months out of every year.

I've started trying to imagine life in that kind of future. Say two lockdowns every year, in a good year it's a month each time, in a bad year maybe you're locked in your apartment half the time, and that's for people who get their booster shot every year.

Maybe forever. What does society look like in that scenario?

> But what if they're never over?

They’re over. The only people clinging to them are either playing political games, or are completely uninformed about the scientific evidence (and yes, I include the CDC and LA county’s public health authorities in those groups).

Masks were maybe slightly better than nothing when we didn’t have vaccines. They are utterly pointless now. There is zero evidence that they have any marginal benefit in a vaccinated population. This stuff has risen to the level of superstition, and like any superstition, there will be adherents who refuse to let go. That’s fine, but they’re not reflecting science or rational thinking. They are marginal.

Those who are scared of the virus should get vaccinated. Those who are not can do whatever they like, but their choices do not affect me, and they don’t affect you.

Smallpox is gone and polio is almost gone.

We have the technology to completely eradicate the 2019 novel coronavirus if we have the collective will to use it.

Other coronaviruses will evolve to infect humans, yes. We’ll never eradicate infectious disease in general. But we’re talking about one specific distinctive virus here. One for which we already have multiple effective vaccines.

Oh stop it.

Smallpox has exactly one host (us), had an amazingly effective vaccine, the virus doesn’t mutate quickly or spread as readily, and it still took almost 200 years to eradicate it.

Polio is NOT eradicated, it spreads only through contact with fecal matter, and the remaining areas where it is endemic make a great illustration of exactly why this virus isn’t going anywhere either: Afghanistan and Pakistan.

That you would suggest that either of these make an argument for eradication of a flu-like illness with multiple non-human hosts shows how detached from reality you have become.

SARS-COV-2 is a single distinct virus with little variation. While it appears to be able to infect some domestic animals from human hosts, we have yet to find an animal reservoir. (If we had, that would be the end of the lab leak theory.)

And we have two vaccines against it with near 95% effectiveness, which compares with the estimated effectiveness of the smallpox vaccine.

If you want another point of comparison, look at measles. It’s not eradicated, but it’s not endemic either. In fact it is quite rare (far rarer than the flu) in counties with competent child vaccination programs.

> small, not-yet-peer-reviewed) datapoint in that direction

Since we tend to mock such studies when done by antivax, we should also reserve all judgement here. Let’s keep the bar high for good science, the last year has been a flourish of unverified correlated statistics.

> Given massive numbers it has affected already

I don’t think people optimize for normal life either. For example, lockdowns do provoke effects which are at least as dangerous: We spend billions a year telling people to move more to fight obesity, so we are 100% sure that lockdowns have a negative effect on obesity and cardiovascular diseases, but also families breaking up, unemployment, loneliness, lack of sports (maybe close to weight gains of a 5-10 pounds in average, I’d be curious), and all those factors multiply further in the future and increase the risk of asthma, cancer, suicide, mental breakdowns (including knife attacks), we haven’t see the real delayed effects.

So, overreaction already killed more than even the (reasonable) estimated worst case scenario.

Let’s not focus just on Covid, and let’s look at everything else we don’t generally care about. My rule is, since they don’t care for my suicide, which is about 2 orders of magnitude higher than my Covid risk, I won’t vaccinate.

I love how you pivot from "demanding peer review" and a "high bar for science" to unleashing a great pile of anecdata about overreaction. Much of the science on depression and social ill effects of lockdowns is no more conclusive, but you're already 100% convinced of it, even making up numbers for average weight gain.

I find it bizarre that all the stuff about depression, unemployment, etc is always neatly pigeonholed into "lockdown did it". Yeah, like if we were all just going about our business having Brazil-levels of disease and death , we'd all be really cheerful and gainfully employed.

Anti-lockdown people somehow interpret the world entirely through this narrow lens - perhaps some people are depressed/suicidal thanks to dread of the disease or personal losses of friends/family members to the disease. There's an amazing rush to judgement to assume that all the risks are due to lockdown, especially in countries that have high rates - as yet I don't think we know what suicide and unemployment rates are for people with Long COVID.

It's something of a right-wing bit of unpleasantry to say this, but "facts don't care about your feelings" (ugh). If there is a looming risk of - say - 2% of long COVID suffers getting Lewy Body Dementia or Parkinson's as a result of "mild COVID", that's a lot of new horrible cases - potentially with years of suffering involved.

If these ill effects are in fact looming, they will ensure that 'bad lockdown' stuff is lost in the noise.

I'm not advocating 'lock everyone down hard forever'; I just think this is a counterpoint to the whole "freedom day" nonsense where it's assumed that once we have a goodly portion of people vaccinated we can just let the virus rage through the population unchecked.

>So, overreaction already killed more than even the (reasonable) estimated worst case scenario.

How did you come to this conclusion?

>My rule is, since they don’t care for my suicide, which is about 2 orders of magnitude higher than my Covid risk, I won’t vaccinate.

Not sure if I'm reading this correctly but basically not vaccinating out of spite?

Since you also focus that you want to keep a high bar for good science, where are you studies that claim that “ overreaction already killed more than even the (reasonable) estimated worst case scenario”?

Reply on news.ycombinator.com