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Comment by GDC7 | Hacker News Reader

As always Bill Gates called it:

This will only be solved or contained once we vax the developing world, so that we curb and slow down the emergence of variants.

Problem is that nobody in the developed world wants to be found with their briefs down and no vaccine availibility so the West is stockpiling jabs for people who essentially don't want it.

The west has been stuck around 67-70% for months now, with no tangible progress.

Those jabs, are the "use it or lose it" kind, if a vaccine resistant variant emerges in the 3rd world, all those stockpiles won't do any good, at that point for nobody.

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"This will only be solved or contained once we vax the developing world"

Careful here. There is no guarantee that once 95% of the world is vaccinated that this will be solved. Respiratory viral infections are notorious for mutating and spreading regardless of vaccines or treatment.

IMO its important not to simplify the situation and say if group A just did this than everything would be okay. Its quite possible this virus is simply here to stay and a multi array of treatments will hopefully continue to improve outcomes.

> IMO its important not to simplify the situation and say if group A just did this than everything would be okay.

Well said. And at this point we should pray this doesn't turn into a Marek's disease replica https://en.wikipedia.org/wiki/Marek%27s_disease#Prevention

He is making an A is a necessary condition for B claim, not an A is a sufficient condition for B claim.

> There is no guarantee that once 95% of the world is vaccinated that this will be solved. Respiratory viral infections are notorious for mutating and spreading regardless of vaccines or treatment.

Especially true since the virus lives in animals, so it will never be eradicated.

96% of mammel biomass are humans, pets, or farm animals.

We could vaccinate all of those. If we needed to do the last 4% of wild animals, I'm betting we could vaccinate more than half of those too.

Does the collective mass matter? Seems like the important number would be the number of mammals, not their mass.

Biomass is a rough proxy for prevalence.

There are remarkably few mamallian species with > 1m population. Virtually all are grazing animals, sea mammals, or rodents.

I'm not sure what species SARS-COV-2 is compatible with, though I've mostly heard of animals > 5kg mass (e.g., domesticated cats, dogs, deer, wildcats), with the very notable exception of bats.

The virus has been detected in 20--40% of sampled deer in the US in multiple states, which is a particularly bad sign.

If it's gained foothold in rodent populations ... well, it could be around for a while.

From April of 2021:

Results obtained from experimental studies indicate that animal species such as cats, ferrets, raccoon dogs, cynomolgus macaques, rhesus macaques, white-tailed deer, rabbits, Egyptian fruit bats, and Syrian hamsters are susceptible to SARS-CoV-2 infection, and that cat-to-cat and ferret-to-ferret transmission can take place via contact and air. However, natural infections of SARS-CoV-2 have been reported only in pet dogs and cats, tigers, lions, snow leopards, pumas, and gorillas at zoos, and farmed mink and ferrets. Even though human-to-animal spillover has been reported at several instances, SARS-CoV-2 transmission from animals-to-humans has only been reported from mink-to-humans in mink farms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8128218/?report...

That's not to say that broader transmission isn't possible (the abstract doesn't mention deer, and I'm aware they're found to be infected). The science is still being established.

We have trouble managing rats infestation in certain zones, good luck vaccinating them as fast as they reproduce!

If that were true, why has New Zealand failed to stop COVID? They're a couple of islands surrounded by over a thousand miles of ocean between them and neighboring countries, they did lockdowns and achieved over 90% vaccine compliance, and after all this time they recently admitted that they no longer believed they could stop the virus.

https://www.yahoo.com/news/zealand-once-paragon-covid-zero-0...

Don't forget that, yes, a certain percentage of that remaining 10% have either natural immunity or aren't going to experience symptoms.

I'm pretty skeptical at this point that any doubling-down is going to lead to anything but more doubling-down.

They made too many exceptions on entry protocols for the rich, powerful, and well connected.

The numbers just don't add up for me. There are almost 8bn people in the world. Sceptical countries get 50% of their population vaccinated. Compliant countries say 80%. Even if it's 80%, that still means after everyone you can has been vaccinated you still have 1.6bn-4bn people unvaccinated.

You also can't vaccinate everyone at once. Vaccinating the world inevitably takes years, not months.

That leaves a lot of room for mutations. I don't see logistically how you get over that, you just can't. It sounds good but I don't see the practical solutions.

(And then we haven't even talked about cross infection with animals, deers are now 80% infected or something with covid? What happens when they cross over back with some new variant?)

Superbug, anyone?

Massive difference between 4 billion and 1 billion. We are already at 4 billion now. Also, some countries are hitting 90%.

If a large portion of the population is vaxxed, it stops spreading as much even among the unvaxxed, which reduces opportunity to mutate.

Deer don't have the same selective pressure as we do.

On a viruses mutation potential? 1bn and 4bn is not orders of magnitude different. I don't think 1bn unvaccinated people is a guarantee of no more mutations. Especially when the vaccinated are still spreading, and selecting for more infectious mutations also.

Nothing is a guarantee of no mutations, that is why we think of the world probabilistically.

But there is a multiplicative effect - the sparser unvaxxed people become, the less general spread there will be.

The vaxxed are still spreading and it is true they cause selection, but this has been well studied and widespread vaccination absolutely would help reduce the rate of mutation.

> [...] this has been well studied and widespread vaccination absolutely would help reduce the rate of mutation.

I don't understand how this could be. Studies have shown that peak viral load is the same for vaccinated/unvaccinated, that means roughly the same number of replicative cycles in vaccinated as in unvaccinated. Each replication is a chance for the virus to aquire mutations, so same number of replicative cycles in vaccinated/unvaccinated means same rate of mutation in vaccinated/unvaccinated.

The science is not at all set on whether peak viral load is the same or not. Most of it seems to suggest that it is not the same initially, but might revert to it after 6-9 months after being vaxxed.

Spread is also less common among the vaxxed as I said, so even if it turns out to be no difference in load, there is still less opportunity for selection.

https://twitter.com/trvrb/status/1462816243245719558?t=9OCuB...

> even if it turns out to be no difference in load, there is still less opportunity for selection.

How so? Load means number of virus particles. Number of virus particles increases with the number of replication cycles. The probability of mutation increases with the number of replications. So, same number of replication cycles, (roughly) same chance of mutation.

Due to difference in rate of infection, both by spread and risk of contraction. Your UC Davis article does not show otherwise (it is conditioning on aspects of the infection among those already infected and does not measure the risk of being infected - only percent of days you test PCR positive), and there is extensive evidence showing less risk of both among the vaccinated.

https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...

https://jamanetwork.com/journals/jama/fullarticle/2786040

The science around viral dynamics re: viral loads is much more uncertain than this - so I am not saying it is definite that the viral loads are less, only that there is both a mechanism and some evidence to suggest it is either less or quicker to go down (but the evidence here is mixed and it likely wears off).

But nonetheless, the science on transmissibility - even with breakthrough, is more certain.

You seem to be spreading misinformation all over this thread.

Here[0]'s a study from Nov 19th, saying that:

No significant differences were detected in duration of RT-PCR positivity among fully vaccinated participants (median: 13 days) versus those not fully vaccinated (median: 13 days; p=0.50), or in duration of culture positivity (medians: 5 days and 5 days; p=0.29).

[0] - https://www.medrxiv.org/content/10.1101/2021.11.12.21265796v...

Please provide some citations to back up your claims.

Nothing I said has anything to do with duration of positivity?

A few citations on why the evidence leans towards reducing the spread being more effective at reducing variant selection: https://twitter.com/trvrb/status/1462816243245719558?t=9OCuB... Here is a citation regarding viral load. https://www.nature.com/articles/s41591-021-01575-4

Quote from the study you linked: "[...] we found that BTIs[breakthrough infections] in recently fully vaccinated individuals have lower viral loads than infections in unvaccinated individuals. However, this effect starts to decline 2 months after vaccination and ultimately vanishes 6 months or longer after vaccination."

Is there any actual evidence of decreased spread because of the vaccine? I was under the impression that it simply changed the intensity of the disease.

Yes, the evidence is there - it is less likely to transmit and less likely to be caught. Most of this evidence comes from testing of contacts because unfortunately there are pretty large confounding effects around likelihood to get tested based on severity of illness.

Also, the vaccine has been shown to reduce viral load which has an impact on rate of mutation even if you are infected.

> the vaccine has been shown to reduce viral load which has an impact on rate of mutation even if you are infected.

This doesn't seem to be the case⁰:

A new study from the University of California, Davis, Genome Center, UC San Francisco and the Chan Zuckerberg Biohub shows no significant difference in viral load between vaccinated and unvaccinated people who tested positive for the delta variant of SARS-CoV-2. It also found no significant difference between infected people with or without symptoms.

When they analyzed the data, the researchers found wide variations in viral load within both vaccinated and unvaccinated groups, but not between them. There was no significant difference in viral load between vaccinated and unvaccinated, or between asymptomatic and symptomatic groups.

⓪ - https://www.ucdavis.edu/health/covid-19/news/viral-loads-sim... (Link to study in the article)

The evidence is mixed https://www.nature.com/articles/s41591-021-01575-4

Don't forget that animals also get and transmit covid.

Up to now, Covid hasn't been lethal enough or common enough for 100% of people to want to be vaccinated.

It takes multiple people among one's friends and family dropping like flies to convince people in vaccine-hesitant places with ample supply (e.g. Bulgaria) to chose to get vaccinated.

Also it wouldn't hurt if vaccines were actually effective at preventing infection (rather than allowing infection but preventing severe disease)... and if they lasted more than half a year.

The vaccines last more than half a year. Certain nice-to-have bonus effects beyond "you probably won't die or suffer long-term effects and you're less likely to spread it" fade a bit after six months. The booster is for the nice-to-haves, like reducing symptomatic but minor-moderate infections.

Every single benefit of the vaccines seem to fade over six months or so - not justt symptomatic infections, but also protection against serious effects, hospitalization, and death. That's why there's been so much push for boosters even in countries like the UK which have given up on stopping the spread of the virus. (Yes, I know the WHO is opposed to booster shots, but frankly they seem to be a bunch of idiots who care more about what's politically useful than reality these days.)

Not necessarily disagreeing with the thrust of your comment but South Africa asked vaccine manufactures to delay vaccine deliveries because it has too much stock: https://www.reuters.com/world/africa/exclusive-south-africa-...

It's not just the matter of shipping out vaccines to the developing world.

> the West is stockpiling jabs for people who essentially don't want it.

...and also don't need it (boosters for healthy, young people). The WHO has repeatedly begged the western world to stop prioritizing boosters for healthy people, but the west continues to do this, instead of getting shots to the rest of the world:

https://archive.md/BnEtn#a-scandal-who-says-the-rate-of-boos...

This all seems to be a tragic attempt by politicians to appease their terrified base, coupled with incompetent scientists who continue to pursue eradication as a goal.

Egged on by the media who loves parading dead children on screen with the admonishment "If only someone had protected them".

I don't think there is a terrified base. People either vaccinated or scream very loud they don't want to.

I do think the politicians are getting terrified. They have been incompetent since at least the 90's. Until now, first world circumstances were good enough that nobody cared much.

Corona changed that. There is a need for coordination on a massive scale, and they simply aren't up to it. You can't blather your way out of Covid. People are looking at them, and it's almost impossible to notice they aren't good for just about anything.

There are definitely vaccinated people who continue to believe they're "at risk", and are demanding boosters, loudly. I know some personally, and I see this all over social media.

Agreed about the politicians being terrified, but I tend to be more sanguine: this is a modern re-telling of Canute and the tide, but the leaders aren't intelligent.

https://en.wikipedia.org/wiki/King_Canute_and_the_tide

The people are demanding that the tides be pushed back, and the leaders are doing the bidding of the people (and CNN is on 24/7, with Chris Cuomo and Don Lemon telling people that the tides are coming to get them and their children.)

The original sin here was giving them the power to take away our fundamental rights in the first place. The rest was sadly predictable.

Elderly people, many of whom received their last dose >9 months ago, are definitely at some risk again despite being technically vaxxed. IMO boosters were not pushed hard enough for this population in the early fall. Now Thanksgiving is past and we only have a few weeks to administer boosters that would be effective in time for Christmas gatherings.

> Elderly people, many of whom received their last dose >9 months ago, are definitely at some risk again despite being technically vaxxed.

No, not all elderly people -- I was careful to put "healthy" in there, and I meant it. Honestly, I probably should have added "not obese" as well. There is not enough risk stratification happening in discussions of this illness.

But sure, at a high level, if we want to put third doses in the arms of people over 65, I think that's more evidence-based than the current recommendations.

>This will only be solved or contained once we vax the developing world, so that we curb and slow down the emergence of variants.

Cases have been surging for at least a month in 70-95% vaccinated countries. It is absolutely clear at this point that these vaccines will not eradicate covid. This madness over vaccines needs to end.

The 1918 flu pandemic ended without a vaccine. Covid will pass as well. In many parts of the US life is effectively back to normal - and if ICUs are still out of capacity after two years of this pandemic then clearly there's a different, more readily solvable problem. Covid is not going anywhere but the hysteria is not justified - people are dramatically overestimating the risks.

At least you could mention that the cases are mainly surging in the unvaccinated.

Also I don’t think anybody has said vaccines are going to eradicate covid, it is just a matter of saving peoples lives from completely preventable suffering and death.

The problem is the healthcare system. If the healthcare system collapses because doctors and nurses die, get long covid and can't work, or just burn out and leave, then the chances of dying from literally everything else go up significantly. Easily treatable cancers don't get treated because there's no capacity. People who get hurt in car crashes don't get seen and die of infections or sepsis or whatever because there aren't any ER beds. Everyone delays elective care because there's no capacity.

In short, it's never been about saving the population in general, although that is a desirable side effect. The entire lock down and vaccination push has been about preserving the healthcare system. Doctors and nurses take many years to make, it's not exactly a quick fix.

Sure, but despite global leaders knowing that this would be a forever thing, barely anyone has even begun to train more healthcare professionals.

Qualified nurses take 3-4 years to train, doctors even longer.

Right, so when do we start?

I don't see coronavirus going anywhere.

We're nearing the 2nd year of the pandemic.

> If the healthcare system collapses because doctors and nurses die, get long covid and can't work, or just burn out and leave,

...or get fired because of vaccine mandates. Let's not forget about that, because it really does put the lie to the underlying concern here. Are folks worried about "health system collapse", or are they just indiscriminately terrified?

If you're truly worried about the former, then it probably doesn't make a ton of sense to place a vaccination mandate on a group of people who largely got infected and recovered early in the pandemic -- at least offer recognition of natural immunity for health care workers!

A significant portion of the people that end up in an ICU don't make it out. It's not surprising that expanding ICU capacity (beyond an emergency basis) isn't a huge focus.

Presumably, they'd be much less likely to survive if there was no ICU available.

Sure, my point is that expanding ICUs isn't really a great plan A.

The 1918 pandemic also killed 17-50 million people at a time that there were many fewer people.

While it is probably an under-count, it appears that Covid has killed at least 5 million.

Public health measures and vaccines have prevented a rather spectacular number of deaths as we have worked to find a way to coexist with this virus.

It seems likely that with a sufficient number of infections and waves, yes, humans would eventually force Covid to evolve in the direction of other more-benign viruses. The question at hand is really: how many waves and variants are we willing to tolerate to get there (and how much human suffering is acceptable?)?

We have tools and tactics that can help to speed the end of the pandemic and decrease the number of people who die. We should use them well.

> and if ICUs are still out of capacity after two years of this pandemic then clearly there's a different, more readily solvable problem

You can't just spawn medical personnel, especially in the conditions that are prevalent due to Covid cases ( lots of work, burnout, etc.). It literally takes years to educate medical personnel, you can't just YOLO it.

> It is absolutely clear at this point that these vaccines will not eradicate covid. [...]

> The 1918 flu pandemic ended without a vaccine. Covid will pass as well.

You're begging the question here. As best as we can tell, variants tend to come up when individual people mount a marginally effective immune response to the virus -- just enough to keep it in check but not enough to eradicate it. Effectively, they become a walking "gain of function" experiment.

Vaccines help at the outset by strengthening the immune response. They also help on a statistical basis by simply reducing the background rate of covid in a society. Given the development of new mutations with vaccine availability, we'd be likely to see as many or more mutations without widespread vaccination. If "covid will pass" without vaccination, then it will pass faster with, and the reverse implication is not necessarily true.

Remember, while the media often calls variants of concerns "vaccine escapes," the real effect is immune escape. If a new variant is more likely than average to cause a breakthrough case in a vaccinated person, it's also more likely than average to cause a reinfection in a recovered person.

If you want to be optimistic, then you can still hold out hope that new, more infectious variants may be less severe. The "human gain of function experiment" process for creating variants would select for both infectivity and non-severity. However, I do not have any data on the relative severity of B.1.1.529, and summer/early fall reporting on Delta suggested that it tended to cause somewhat more severe illness than Covid Classic.

It's also a lot easier for a virus to burn out when there's limited international travel.

Which wasn't the case back then due to WW1, by 1921 half to two thrids of the world became infected with the flu

In the 1889–1890 pandemic (possibly the origin of human coronavirus OC43), the virus spread around the world within the first six months. There were subsequent waves for one or two years.

https://en.wikipedia.org/wiki/1889%E2%80%931890_pandemic

There hasn't been limited international travel for a long time.

Vaccinating the developed world is a start - but it isn't a panacea.

If the global Covid #s are accurate - the majority of the Covid infections happening are in the developed world.

It'd be great if we could stop the spread in the developing world - but we need to stop it in the developed world, too - or else mutations are still bound to happen.

If we want to be nihilists, it’s spreading throughout deer populations and I doubt anybody is even entertaining the idea of vaccinating wild populations.

Very different selection effects. Plus less selection in close proximity to vaccinate individuals.

lol global covid #s are not close to accurate, obviously.

# observed infections = # of infections * probability of testing * probability of authority trustworthiness. Alas, in the developing world test penetration is low and authorities are not particularly trustworthy.

In this particular case, South Africa is having trouble vaccinating its population with sufficient supply.

https://www.reuters.com/world/africa/exclusive-south-africa-...

I wonder how much of that is hesitancy and how much is logistics or corruption.

Except our current vaccines only act as a reduction in severity/spread of disease.

We could have 100% worldwide vaccination including animal reservoirs and still get mutations.

There is no easy out here unless we develop sterilizing immunity. Life is just a bit more dangerous now and that's that.

You’re talking about a continent that has endemic malaria, tuberculosis, and HIV.

Not saying the factors you brought up aren’t important. They are, but it’s not so simple.

Strange then that he made sure that developing countries would have to rely on the developed world for the vaccines by fighting against open science and sharing of know-how. https://newrepublic.com/article/162000/bill-gates-impeded-gl...

Of course it would have been great for people who are already dealing with malaria and HIV to inject with a vaccine put together in a factory somewhere in Kinshasa where the measuring instruments for quantities are just two : left and right eyeball.

Let's see how we do on the next pandemic if we screw the IP out of all of the producers who stepped up to produce a vaccine.

If the scenario is that they'd still have their mRNA IP if they had decided not to make a vaccine, that is not the incentive structure we want to setup.

It's also not where the constraint lies.

So far the variant is very rare (unless there are newer numbers than I found yesterday). There’s a lag of months, I think, between these numbers and where it becomes a phenomenon you’re likely to interact with at the local store.

Further, the world should be reacting to Covid at the global level. So far it’s like we’re not even addressing the beast on the turf it’s attacking us. And the price to do so, say 70 billion USD at a cost of 10$/dose (which it probably isn’t), is nothing compared to the reacting we’re seeing here today and will continue to see.

It has rapidly displaced all other variants in South Africa. It's only rare from a global perspective. It will be commonplace soon.

Those "rapdily displaced" numbers are based on a small number of samples and are not to be trusted. The fact that they're being repeated now is essentially fear-mongering by the news media.

The number of cases in South Africa before this was very low as well, there aren’t many other cases of delta to compete with

Bill, like many CS people, doesn't understand biology well enough to couch his statements. We could do what he said, and not have that outcome. In particular, I really doubt that some sort of magical herd immunity shows up when; that's been a wild guess of some scientists for a while, but it's not really a firm prediction.

BTW, with some of the newly designed vaccines, if the virus mutates, the vaccine can be rapidly changed to respond to that (because it's sequence based). That changes things a lot.

Who's to say that the person who harbored this mutation wasn't vaccinated? The only thing we know is that they suspect it developed in an individual with HIV.

Keep in mind that South Africa is currently pausing shipments of vaccines because there’s not enough demand for them.

I’m not saying that vaccine availability isn’t a problem anywhere in the emerging world but it’s not the only issue.

One of the best returns on investment the U.S. government could make would probably be to pour money into ramping up vaccine production to give to poor countries. I believe the cost would be tiny relative to the economic risk of allowing more mutations and continued spread of Covid.

How is Bill Gates more competent to talk about vaccines than anybody else here?

Because he's been in the health battleground called Africa since 2000.

His foundation has been trying to fight/wipe out various communicable diseases since 2000...

https://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundat...

I am aware of his billions and the many ways he makes them. I have a machine sitting at my desk that never got close to an inch close to Windows, runs exclusively Linux, but a part of the money I paid for the hardware, ends up at Microsoft.

But if I donate 10 billion to promote child education does not make me an expert on it.

I am however, aware of some his efforts to restrict global access to vaccines something that will definitely be shown to be a mistake as new Covid mutations emerge outside of the rich "triple vaccinated world"

"How Bill Gates Impeded Global Access to Covid Vaccines" https://newrepublic.com/article/162000/bill-gates-impeded-gl...

The West is not monolithic. Portugal is at 90% for instance.

How does immunity from prior infection play into these numbers?

I think you can find a more reputable source than Bill Gates? He's got some cred issues these days.

What do you think is Bill Gate's cred issues? Bill Gates' credibility with me is at an all time high.

He has financial interests in the health sector.

Who doesn't? He's independently wealthy regardless of whether startup investments got to zero or not.

Being independently wealthy is irrelevant. Do you stop caring how your investment portfolio does, just because it won't bankrupt you if it goes to 0?

Do you go to extreme efforts, enduring public lambasting simply in order to get returns on 0.002% of your portfolio? When you've already got so much money you can't give it away fast enough?

I think it takes some exceptionally motivated reasoning to believe that Mr. Gates is doing this because he only wants money.

Vaccines are a band-aid fix for a much deeper systemic issue. The real fix is to sever the codependency of peoples separated by thousands of miles. Why should a disease outbreak in some far away Mongolian village affect me here in my village? Why are we moving to and through everyone else's villages so frequently? Coupled with a too-efficient and codependent (fragile) logistics system, look at how damaging the outbreak of a relatively minor [1] disease has proven to be. What happens when an actual black swan strikes at our codependent little global village? What then?

"The wise person reduces the importance of governments And simplifies the modes of living, So that people use fewer tools and wares And treasure simplicity in their lives, So that, though there are vehicles, People do not take them. And, though there are weapons, People do not carry them. And, though there are records, Tying knots will serve the record-keeping purpose. Thus, the highest political achievement is one In which people savor their food, Like the beauty of their clothes, Appreciate their safe and peaceful homes, Enjoy their social customs; And in which roosters and dogs Can be heard between countries; But people, all their lives, Have no need to go across the borders." - Translated by Liu Qixuan, Chapter 80 of the Tao Te Ching by Laozi

[1] relative to bubonic plague, smallpox, polio, etc.

You say “real fix”, but this is a fantasy.

This hasn't been possible since the silk road and was created. No one is going back to the pre-modern world.

>94% vaccinated in Ireland, and we're still hoarding boosters, and demonising the unvaccinated.

Meanwhile, our schools remain fully packed, with no additional resources for air quality, and the government have even told schools not to inform parents of COVID cases in classrooms.

I can't help but wonder if all this cack-handedness is in relation to the contracts Pfizer "negotiated" with governments - https://www.citizen.org/article/pfizers-power/

PS Bill Gates is still responsible for an almost incalculable amount of harm, because of his actions against free and libre software and small businesses.

> PS Bill Gates is still responsible for an almost incalculable amount of harm, because of his actions against free and libre software and small businesses.

Free and libre software was always doomed because people who are worth their weight in gold due to their programming abilities want a nice mansion in Naples, FL with a nice dock and a 40 footer boat , not just a tap on their shoulders for a job well done.

> Free and libre software was always doomed

.. Then why did Bill have to try so incredibly hard to fuck them up?

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