For scientists, path to Covid-19 endgame remains uncertain
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In Manhattan numerous restaurants constructed "outdoor dining" areas, but since eating outside in 20F weather kind of sucks (I can attest from personal experience), many are fully enclosed and have heating and A/C. They are literally indoor dining except located on the street and not built to code, but we all pretend that this is making a difference.
Everyone knows that children in schools are a major vector for disease. Pre-covid it was always parents with school-aged kids bringing in colds and flu. Everyone knows that testing is largely performed only on people showing symptoms and children do not show severe COVID symptoms, but parents got tired of having their kids at home so we got a round of articles claiming children don't spread COVID and reopened schools while everything else was shut down.
I could go on with many more examples but we all know them. The response is a joke. The lockdown largely hasn't affected the elite and wherever it has we get COVID theater and special exceptions, but it's also become political and part of the identity for a certain highly influential strata of society so we keep moving the goalposts with no plan.
EDIT: And I'll add I mention this out to point out the absurdity and double standards that have been applied here.
There are plenty of outdoor dining structures that provide good airflow, but those ones don't support "dining in cold or inclement weather". Personally, I won't dine outside unless the outdoor dining setup actually provides good airflow.
Here's the US CDC: https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
"Findings from several studies suggest that SARS-CoV-2 transmission among students is relatively rare, particularly when prevention strategies are in place. An Australian study of 39 COVID-19 cases among 32 students and seven staff traced contacts across 28 schools and six early childhood centers and found only 33 secondary positive cases (28 students and five staff members) out of 3,439 close child contacts and 385 close staff contacts.58, 59 Several contact tracing studies have found limited student-to-student transmission in schools."
It's honestly a pretty interesting phenomenon given the fact that most people's "common sense" is that kids transmit viruses extremely well.
Many people think we're going to eradicate covid-19. Even before the delta variant that seemed like an impractical longshot, and that it was inevitable that it would be endemic. I'm already starting to see polarizing politics on the fringes start to turn endemic into a dirty word instead of the likely reality.
People should be prepared and understand that over a 2+ year time frame they have a 99% chance of catching covid-19. And getting the vaccine so they don't start from zero immunity is likely the best we can do.
When you say all this, do you mean to say endemic means benign? Or do you mean to say out world is a fair bit worse than it was, but that’s the reality.
Endemic is consistent with “fairly harmful”. Malaria, Dengue, tuburculosis, HIV are all endemic diseases. Time has not made them milder either.
I’m asking as a genuine question because the people arguing for endemicity seem to often conflate it with “mild, like a cold”, but that isn’t what the words means.
I think “our world is worse now but very unlikely to eradicate” is probably true, but I’d like to get a sense of what people mean by endemicity.
The common cold is endemic and so is dengue. So: are you describing a scenario that is:
1. Business as usual (once we get enough immunity medium/long run)
2. A small bit worse than 2019
3. Quite a bit worse than 2019
4. Substantially worse than 2019
?
My point is the word endemic doesn’t mean anything other than “disease is present”. But people say it as if the word includes severity. When people say that I take them to indicate belief in scenario 1, or possibly scenario 2.
I think it probably will be endemic but we’re minimum scenario 3. I don’t think that is what endemicity proponents believe however.
I think the variables are:
1. Vaccine that prevents infection/transmission at a significantly more substantial rate
2. Significant waning of vaccine effectiveness per new variants
3. Unexpected increase (or decrease) in virulence of new strains.
4. Significant improvements in treatment (including medications)
These are, of course, unknowns. But, holding these constant, I believe we can calculate with fair accuracy how bad it will be as a direct function of the percentage of the population that's vaccinated.
It sounds like you're tone policing people based not on what basic mathematics says, but what you want the world to be like.
Eradicating covid is impossible, ergo it will become endemic.
What that looks like depends on what the next mutations of the virus look like. I don't have a crystal ball to guess that.
Endemic's basic and technical meaning is just that it's persistently present in the community, with no connotation on severity, and ancestor comment was using it in that force.
Vaccinated people overwhelmingly don't experience severe symptoms when they get COVID. I expect that new vaccines will soon be developed as well that can better target these variants. The biggest losers are those who cannot get vaccinated for legit medical reasons.
Without the vaccine you have a small number of cases and a large portion being severe enough to end up in hospital.
With the vaccine you a have large number of cases and a small portion being severe enough to end up in hospital.
You can end up with a collapsing health system even if everyone is vaccinated if the number of people who get sick despite the vaccine is large enough, where large means more than 5 in 100,000.
> Without the vaccine you have a small number of cases and a large portion being severe enough to end up in hospital.
Without the vaccine you have an even larger number of cases (than with the vaccine) and a large portion being severe enough to end up in hospital.
Vaccination blunts both symptoms and transmission (I didn't mention the latter in my initial comment).
Probably the same could happen to covid, assuming that the we could stop seeing testing treatments for covid as a political issue and strictly keep it as a discussion of science.
All we can do is get fully vaccinated, have good public health measures such as masks in high density areas and isolation of sick people (with income support) and that is about it. When we hit 80% full vaccinated here in Australia the non-essential flights are going to resume and states that have maintained Covid zero for nearly 2 years are going to be asked to give that up. It is a public discussion we are having here and I think people are accepting. The arguments are mostly about when and how we pull down the quarantine measures rather than if we will do it. I think we are walking into this with our eyes open.
Opening up will need to happen at some point, but apart from NSW and maybe Victoria who have lost control of the spread, I don't see the other states doing anything but kick the can down the road. I predict 80% will become 90% which will become booster shoot #1.
I also think extrapolating from those numbers to 10 years doesn't make sense given the multiple variables involved.
Here's a Nature published study that says probably at least double what you suggest: https://www.publichealth.columbia.edu/public-health-now/news...
> “I truly, truly think we are in the endgame,” said Monica Gandhi, an infectious-disease specialist and professor of medicine at the University of California at San Francisco. “The cases will start plummeting in mid-to-late September and by mid-October, we will be in a manageable place, where the virus is a concern for health professionals, but not really for the general public.”
Monica Ghandi has been an eternal optimist and routinely wrong.
Here she is in february arguing that india had herd immunity from prior infection and cross reactive immunity. Right before devastating delta wave: https://twitter.com/monicagandhi9/status/1361856248275079170...
Here she is in may agreeing many us areas were at herd immunity. This also proved wrong: https://twitter.com/monicagandhi9/status/1389808375437824000
She admits in the article she was wrong, but about people, not the virus. But she was very wrong about the virus.
Jay Bhattacharya was one of the three people behind the Great Barrington Declaration. Their ideas won, but it’s far from obvious they were right. Instead of elimination, they argued for living with the virus. This currently is causing oxygen shortages in Florida, and renewed restrictions as countries experience rising waves.
https://en.wikipedia.org/wiki/Great_Barrington_Declaration
He writes:
> that’s the endpoint of the epidemic because we really can’t do better than that
Multiple countries have eliminated the virus. In fact, virtually every country that aimed at it succeeded at this goal. They had better economic outcomes and more normalcy. Bhattacharya wants to persuade that because this would be hard in the short term it is literally impossible.
His barrington declaration also failed at its goals: countries that tried it had both worse economic outcomes and also worse health outcomes.
> You yourself are completely protected against the delta variant, and you should go and enjoy your summer. It’s been a hard time, and people should have their summer. Delta variant, delta shmariant.
From May. This proved completely false. Efficacy is a relative risk reduction, not an absolute. 95% efficacy against severe disease means 1/20 will still have severe results.
“Completely protected” was patently false. The vaccines are great but that doesn’t warrant lying to boost them.
https://slate.com/technology/2021/06/delta-variant-covid-vac...
Edit: Covid is a miserable disease, but it seems that some of us want to abandon the joy of living because, in the big scheme, slightly more people die than usual. The price of being alive is death, and it's well worth it.
They reversed course and deleted the video. Masks have returned. The video was like Bush’s “Mission Accomplished” photo op in 2003 to declare the end of the Iraq war. He was happy too, but wrong.
Frankly, I have little interest in quibbling with those that have made 'cumulative deaths with covid per million' the ultimate measure of human worth and achievement. Have a great day.
Australia’s NSW also did not aim to eliminate. Other australian states do, and have their borders closed to NSW. Complicated story down there. Victoria
China has beaten the delta wave, down to 26 cases a day from 100. I expect they’ll hit zero. New Zealand on the same track, as is Taiwan.
The Atlantic region of Canada was another example.
Vietname I’ll admit has now failed. Not sure if they changed policies or simply couldn’t do it now with Delta.
Then there are some caribbean islands. And that’s about the full list of countries worldwide that did try for zero. Every other country aimed for mitigation.
Victoria has had 6 or 7 waves of Covid (depends how you count it) and failed only at the last one.
This came at the cost of human rights violations, police brutality, the largest non-wartime increase in government debt, a tripling of teen suicides, night time curfew and a cumulative 220 days of lockdown with no end in sight.
At this point euthanising everyone over 70 could be a viable policy with less long term harm than continuing with the current policies.
Which countries have eliminated the virus? Aren't you playing out the exact same kind of baseless optimism you accuse Monica Gandhi of?
New Zealand, Atlantic Canada, Taiwan, most of Australia (NSW doesn’t have elimination as a goal), some caribbean islands, China
Many of those places have outbreaks, but they’re beaten them or have beaten them.
There was a week-long lockdown in July coming straight after school holidays, so it was like getting a bonus week.
There have been many changes for things like wineries and restaurants, and limits on home gatherings at times, but I assume that's pretty standard worldwide.
Currently with risk of delta arriving from interstate, I wear a mask entering a public space, but that's about it. We're comparably isolated though compared to the rest of the world, and have strict policies for international travel (quarantine on your return that costs thousands of dollars).
There are strong restrictions back in early 2020, but I think we'd taken our kids out of school voluntarily, and I don't know if there was ever a full lockdown.
There was the initial lockdown of 60-80 days or so, then a lockdown from october-may, including curfew from january-may.
We’re on track for needing restrictions again this winter.
To write how you pronounce Gandhi you normally have words like “Khan” or “Ghana” etc. at least with the words I’m familiar with.
So it makes a switch I have to constantly manually remember. Possible I have the pronunciation wrong of course.
Subsaharan Africa learned to live with malaria by eating the human and economic costs of a forever epidemic. We can too!
From the start of the pandemic, health experts and the media did lots of what I can only call expectation management and said that any vaccine with over 50% efficacy would be good, more than 60% or 70% would be absolutely marvellous. I think because this was the first time people were tuning in to news about vaccine efficacy, it has skewed people's perception and many think all vaccines are 65-85% effective. In reality, while flu vaccine is like that, the vaccines commonly used for more serious diseases such as measles are close to 100% effective. And this efficacy is not just against death or serious disease, but against catching the disease at all or passing it on.
Vaccine efficacy against transmission greatly affects the percentage of the population that need to be vaccinated in order to achieve herd immunity. With low enough efficacy and high enough R value, herd immunity is impossible even if 100% of the population is vaccinated. And some variants of COVID may have high enough R value for this.
[1] https://www.canada.ca/en/public-health/services/publications...
More fundamentally, these questions and the policy around them should not be the domain of abstract science to decide for social rules and laws. Other considerations that affect all of us, economic, freedom-related, emotional and social have to be considered. Scientists can easily get carried along by narrow policy advocacy based on their science, without considering external factors. As another comment here mentioned, that's a dangerous mentality for legal decision making.
Different viruses respond differently to vaccines.
It's like asking where's the dodo gone when trying to eradicate the rat.
Only about half of US adults are vaccinated. Parents are literally fighting with and attempting to "arrest" school officials who are trying to keep kids safe with commonsense measures. Then, there's the whole family of theories on the "gov't is trying to kill us with 5G and take away our freedom" continuum, some of which motivates the former behavior and has them preferring anything but science-backed treatments (bleach, animal de-wormer, etc).
I could go on, but I think you get the point. Many of the same people who resist efforts to get the virus under control are the ones decrying lockdowns and prohibitions.
So, perhaps one answer to your question of preferable alternatives is in there somewhere. That is, I don't see how we can ignore this outlandish disinformation pipeline that motivates counterproductive behavior and mistrust of the most basic things required for a functioning society, then just throw our hands up and say, "well, some people are just going to die. What choice do we have?"
As for this idea of controlling "disinformation pipeline that motivates counterproductive behavior". What I hear is nearly Orwellian terminology there... It's based on very tenuously sustained affirmations about an information problem that magically only started being a problem under specific recent political circumstances and also tries to undermine some very important parts of how the free societies we've built over centuries work.
I didn't lump "those people together", which is evidenced by the transitional sentence that began, "Then, there's the whole family of theories...".
"Then" is used here, as in "additionally". So, no reasonable people were "smugly disdained" in the production of that comment.
Secondly, I did indeed state that some of the egregious behavior I described is directly linked to this massive peddling of the idea that the government's efforts to fight the pandemic are really efforts to curb freedoms and/or harm them in some way. And to further clarify, those ideas do exist in degrees, up to and including the insane conspiracy theories at the extreme end.
But, let's be clear: the very idea that what the gov't is doing to control the pandemic is really intended to harm people or confiscate their freedoms is itself a conspiracy theory. And, if it motivates effectively the same behavior, then it functions in the same manner, irrespective of what its adherents believe about 5G or vaccine microchips.
So, I do think some who don't go as far as believing the extreme stuff can still be demoralized by disinfo and cultivate a distrust of gov't as a result, in much the same way as ads affect us all, even when we don't think they do.
>As for this idea of controlling "disinformation pipeline that motivates counterproductive behavior". What I hear is nearly Orwellian terminology there
I never wrote "controlling". That was your word. But, what I did state was that it's a problem when disinformation motivates behavior at scale, and that it's a threat to a functioning society.
>very tenuously sustained affirmations about an information problem
Some polls show up to 56% of Republicans believe that a theory that involves Dems eating babies and running a global pedophile ring is all or partly true. The theory involves a secret person who provides them with clues.
That's 25% of the population. It's become a cult and a growing mass psychosis. So, I'm not understanding why you think the idea of addressing problems like that is "Orwellian", but the problems themselves are of little concern. I find this mass psychosis chilling beyond whatever comes after Orwellian.
>that magically only started being a problem under specific recent political circumstances and also tries to undermine...free societies...
Magically? I'm sorry my friend, but that reads like a conspiracy theory. The plain read is that we had a president who trafficked in lies and disinfo, was buttressed by elements who did the same, and benefitted from it. If the "magic" that you're alluding to finds no culpability there, then it's magic indeed.
That is incredible.
But, straw men aside, I'd still appreciate a reply to the core question, because I'm genuinely interested in understanding the base POV at work here...
That is, there's an entire swath of people who resist even the most basic efforts to control the virus. And, these people also tend to be the very same who decry lockdowns and other "prohibitions" as an intrusion on their freedoms.
So, exactly what responsibility do they have here? And, what exactly do you believe governments are justified in doing to protect the public health?
My sister is a nurse in the COVID ward. The other day she said they had 10 people on vent, 9 of them hadn’t been vaccinated, and that’s normal. Georgia is like 40% vaccinated even though you can walk into any Walgreens and get it. I haven’t really thought through the ethics of it, but I’m frustrated enough to think that if you’re an adult and you deny vaccines until you get COVID, we shouldn’t waste ER resources on you. It’s like we need to create a parallel society for the religious freedom anti-vaxers.
>Google putting an info box like that on conspiracy content is even more evidence that it must be true, because Google is in on it.
Yeah, it's disheartening to say the least. I know someone who was sucked in and her thought processes have completely changed. These ideas are like living parasites: fiercely self-protective to the point of impenetrability. The ideas become fused with their identities, so criticizing the theories is attacking the person and the world becomes binary: you're either in or out. And, if you're out, well then you're part of the conspiracy (or duped by it). It's very much like what you read about cult-conditioning.
So, I've seen the logic: If Google instead removed it altogether, someone would screenshot it and make the claim that "Google tried to hide it". If Google just disallowed it in the first place or banned accounts, then that becomes evidence of a bigger conspiracy and, additionally, the freedom of speech arguments enter (as if there are no exceptions).
So, I'm not sure that it's winnable in our current social media formats. Too many motivated bad actors with troll-farms and bots; and too many fertile minds who are growing more and more agitated, and whose worldviews and identities now rely on the disinfo.
So, we've got a problem with both supply and demand.
Either way, no return to normalcy, though if we choose to reduce polluting we would improve our lives.