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Comment by amluto | Hacker News Reader

Not even close, sadly. Consider New Zealand, Taiwan, and China: if you take extreme measures and eliminate all COVID, then there is no COVID. It doesn’t appear from nowhere. (Just like in 2018 there was no COVID.) On the other hand, if you eliminate half the transmission of a highly contagious disease, everyone may well still get it, and while you have flattened the curve, you haven’t actually saved many lives.

For those who remember Chicken Pox, almost everyone got chicken pox. To the extend any NPIs reduced transmission (e.g. keeping kids out of school), the primary result was delaying chicken pox or avoiding major outbreaks, and delaying chicken pox may have been a bad thing.

As a different analogy, if you have a Windows XP system in the Internet, it will get pwned. If you update it to Vista, you get a worse UI and it still gets pwned. Sometimes half measures are much less than half effective.

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> if you take extreme measures and eliminate all COVID, then there is no COVID.

This is false because COVID also has animal reservoirs. It will never get eradicated like polio or smallpox, which only had human reservoirs.

It appears that in 2022 it is now finally understood that COVID-19 will not get eradicated, the vaccines do not prevent transmission or infection (in fact, the original RCT never even showed it -- it was just assumed!), and that cloth masks have much more limited effectiveness than initially assumed. Omicron is highly contagious (but much milder!) so it appears that almost everyone will get it eventually.

> It will never get eradicated like polio or smallpox, which only had human reservoirs.

Quick aside, polio hasn't been eradicated. Only smallpox and a cat virus I forget the name of.

> that cloth masks have much more limited effectiveness than initially assumed

I recall multiple studies early on stating cloth masks were not effective and should be avoided if you have access to surgical or n95 masks.

My impression is that the (US) government didn't want to nuisance this discussion as it'd only open further criticism of mask mandates.

Nearly everyone will eventually be immune to it, but CDC data still is showing that the majority of vaccinated people will not get sick with it to get there.

> if you eliminate half the transmission of a highly contagious disease, everyone may well still get it, and while you have flattened the curve, you haven’t actually saved many lives.

Assuming all other things are equal in both cases, sure.

In reality though, by flattening the curve we have avoided greater collapse of health systems, we got more time to understand better what works and what doesn't when fighting the disease, we got more vaccinated people, etc. These things combined might have saved a lot of lives.

I'm not sure why delaying chicken pox may have been a bad thing, what do you mean by that?

I agree that flattening the curve should have benefitted society and saved lives.

Regarding chickenpox, it becomes more and more dangerous the later in life you catch it. Getting it as a 5yo is annoying. Getting it at 15 can be quite a bit more dangerous. getting it for the first time at 40 can be lethal.

I see what you mean.

How does that work out in reality though? There are always people in all those age groups in society and if you let the disease run amok, that just means the 40yo of now are more likely to catch it before there's a vaccine or better treatments, doesn't it? OTOH if you slow down the kids getting it, they will be less likely to spread it to the teens and middle-aged kids :D until those are available. i.e. pretty much the same, is it not?

Disclaimer: I'm pulling those ideas out of my arse, I have no real data or knowlege to back my thoughts.

When I was kid, before the chickenpox vaccine, it was common practice to ensure your kids got it by intentionally exposing them. I guess our parents had all had it, so there was no risk of getting it again.

Now we have a vaccine so I assume this doesn't happen anymore.

Ah interesting. I didn't know that, but it does make sense.

> I guess our parents had all had it, so there was no risk of getting it again.

This is not the case with COVID though. Everyone is getting infected for the first time, and we're still unsure how long and how strong immunity-through-exposure is. In fact, there are multiple reports of people catching it multiple times (I know of a person who had it 5 times :-o ).

There is no serious doubt that most infections produce durable cellular immunity, just as with all similar viruses. Of course patients will occasionally be reinfected, but symptoms are typically less severe. With any disease that has infected billions of people there will be occasional statistical outliers.

https://peterattiamd.com/covid-part2/

Statistical outliers??

Sorry, but not too long ago I ran into a figure that 2/3 of Omicron cases had previously been infected with another variant.

Covid is mutating fast enough that prior infection provides only limited protection. If you're lucky your body locks onto the spike protein and the protection works pretty well against all pre-Omicron variants. But you're not guaranteed that, your body might go for a much less stable target and do little against a variant.

We are seeing this with the Chinese vaccines. They're killed-virus vaccines, they worked well at first. Not anymore.

That is misinformation. Did you even listen to the above linked explanation by infectious disease expert Dr. Monica Gandhi?

Reinfections are meaningless. What matters is severity of symptoms. Infection by earlier variants gives most recovered patients durable cellular immunity against Omicron.

https://www.nature.com/articles/s41591-022-01700-x

I have not seen any evidence that this form of immunity is responsible for a reduction of severity of a reinfection.

I didn’t listen to the podcast, but I did read the notes, and I thought “wow, Omicron is no big deal! The data is great! Let me click those links!” Then I clicked the links and they didn’t seem amazing. Apparently previous infection reduces severity, and Omicron is less severe, but neither of these effects is anywhere near as strong as the show notes made them out to be.

Wouldn't you MUCH rather get covid today than in April 2020?

Yes.

I’m not claiming that NPIs are useless. I’m saying that half an NPI may be vastly less than half as effective. I think the OP can speak for itself.

Extreme measures would have to remain in place until the threat has been mitigated, which is not realistic because the world is not capable of taking equal measure like that on a global scale

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