Girl who died of bird flu did not have widely-circulating variant (H5N1)
nature.com
nature.com
Zoonotic plagues are not new but pandemics can spread much faster now due to cheap travel and relatively open borders.
https://doi.org/10.1126/science.abn2222
> The key issue, then, is not that zoonotic diseases appear in humans, but that their emergence seems to be increasing in frequency (3). Major changes in land use, increasing urbanization, and global connectedness are well documented as driving disease emergence through increasing human–animal contacts and accelerating transmission rates, and climate change will similarly accelerate the rate of zoonotic events.
It's not a paper in itself but it says what I've been saying above way more eloquently. It also cites this paper:
https://doi.org/10.1038/nature06536
> Here we analyse a database of 335 EID ‘events’ (origins of EIDs) between 1940 and 2004, and demonstrate non-random global patterns. EID events have risen significantly over time after controlling for reporting bias, with their peak incidence (in the 1980s) concomitant with the HIV pandemic. EID events are dominated by zoonoses (60.3% of EIDs): the majority of these (71.8%) originate in wildlife (for example, severe acute respiratory virus, Ebola virus), and are increasing significantly over time.
Lastly, some other recent research: https://doi.org/10.1038/s41467-022-29378-2
To be quite honest, citing research on a politically polarized topic is not as useful as it used to be.
The political polarization within the academy means that there is a lot of pretty loose research that may get through if it has the appropriate orientation. In practice, you can almost always find (low quality) research supporting one’s position if the position is lefty.
Speed of travel certainly makes things worse, but even in the 1300s diseases were able to spread widely.
What is new is the virus gets on a plane and goes 500 mph.
Stop eating and wearing so many animal products and we'll be fine even with billions and billions of people all over the world.
Seriously, I know I'm coming off as an angry veg here, but are people blind to the fact that COVID likely came from a meat market (I mean the lab leak is also possible but the original meat-market theory is pretty likely too), and bird flu will come from meat-animal industrial farms and fur farms?
COVID was milder than expected. The next one might not be.
In natural spillover, the disease gets a single shot at infecting and then transmitting.
In a lab leak, the disease has been kept alive and cultured with human cells for hundred of generations. Then undergone various genetic tweaks to see where if might attack and take hold in humans. If it can escape the lab, it has astronomically better odds of surviving in humans and transmitting to other humans.
I'm doubtful we see more than 2 or 3 natural spillover events in the next 50 years. I'm expecting a dozen lab leaks in that time the way technology and collection efforts are going.
The 2030s are going to be a shit show. The crispr tools available.... OmG
90% of the population used to have direct contact with farm animals
Population density to spread in? Large open plan workplaces, public transit, concert halls...
> 90% of the population used to have direct contact with farm animals
A localized, fairly small, not very mobile set of farm animals.
I imagine this is one reason for the low-key tone of the article. Had any of those other 12 close contacts, who presumably don't also have contact with the poultry on the farm, tested positive - this would be consistent with human-to-human transmission.
The father is more likely to have been in contact with the poultry, which could explain his positive test.
Still, knowing little about a risk is not the same as knowing that the risk is low:
> Everyone was quite concerned that the girl might have had the strain 2.3.4.4b, which is circulating around the world and causing major problems in Europe, North America and South America right now. 2.3.4.4b is a new viral clade, and we don’t know a lot about it.
Also, check assumptions before concluding that this is the result of encroachment into native habitat:
> We know that, in Cambodia, the pandemic increased the amount of backyard poultry farming. Many people, for example tour guides, couldn’t work and had to supplement their incomes and sources of food for their families. All over the world, people are still struggling, which has resulted in changes in agricultural practices that can increase spillover risk. And changes to people’s health, for example malnutrition or being overweight, can make people more susceptible to getting infected.
In some ways we passed the test pretty well. In others, not so much.
My question to HN is: what could we do better next time?
edit: to be clear, "we" in what could we do better = our global civilization and maybe separately in each user's country of residence.
Yes, as a civilization is what I meant. But good question. Also maybe in any HN'ers home country.
About everything. For a start weighting in more factors like quality of life, economy, health (everything else than the pandemic at hand & including mental health) than just just a few metrics.
Second graduating the response to the dangerosity of the disease. It was clear 3 months in that only a small subset of the population was really at risk so it made no sense to punish the whole population. Young people were affected proportionally harder than older folks: best of social and love life gone, poor education for a few years, difficulty to enter the job market, while the people most at risk already lived for more than a century, have a home, often kids, etc.
Third let citizens have basic human rights. I shouldn't have to right it, but if basic human rights like movement and commerce can be removed with a finger snap (they were) we are not living in a democracy.
Four, don't push untested pharmaceutical products made by firms with proven contempt for human life on millions of people. Don't put resistants in camp (Australia) and don't censor divergent opinions like an autocracy: public debate must be this, a debate and made publicly.
Five, base policies on real science, not the reverse around where "science" is twisted to fit a narrative.
I would love to see an even handed comparison of the different responses in all countries to know if any had meaningful impact. But with how wildly different the virus acted in places, I am worried nobody will believe any analysis. At the least, we know not everyone will.
And I fully cede my understanding may be sadly behind. I remember the damage/death it was doing at the beginning in Italy and how we were all trying to not overwhelm hospitals. Then, the next few years had case counts that were off the charts, and I'm not sure what changed. Do we have a good handle on that, now?
There are personal values in play here, but very roughly, if we have a pandemic with an x% risk of death or serious debilitating injury then it's worth spending x% of our time, resources, etc trying to prevent its' spread.
Everyone is going to have a different number there, some will think we should just never give up ever, others will just think "screw it, I'll take the personal risk", but that's a good average.
We do this all of the time - people can get post viral syndromes from common colds, but we accept that this is an incredibly unlikely situation and so most people don't get into a panic when around other people.
And that's actually what we saw with coronavirus. The vast, vast majority of people at least in the first weeks of the pandemic took it seriously. After a few months a lot of people simply stopped caring because it wasn't as fatal as we feared. For whatever reason this became extremely politicised in a way that I can't quite understand.
People are not very good at evaluating risk. From an evolutionary perspective, we mainly do it by copying others. I cannot comprehend what a X% fatality rate really means on a personal safty evaluation. But seeing what other people are doing gives favorable odds. Of course, this heuristic has its pros and cons.
In my small company we are cca 25 people and we have very cramped quarters. However, it has been more than once that some colleagues have had covid but nobody else was infected, despite being in meetings with the sick guys.
You can get lucky, but not this lucky with something that's really contagious.
There is some irony that it may be much of the really poor aspect of our diets came from health programs of the last century that were grossly miss targeted. Of course, the frustration there is it was not some nefarious push by folks. We just got it wrong.
Back to covid, I share the incredulity in how the deaths are driven largely by unvaccinated numbers. Even crazier when you see stories like https://www.npr.org/2022/01/12/1072411820/law-enforcement-de..., where the very groups that are seeing rises in deaths pushing back against vaccines. Truly mind numbing.
https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Yet, despite those odds, an enormous segment of the population of the US failed to all sorts of cognitive biases, and is convinced, contrary to all evidence [2], that it's better to get covid than a vaccine. This indicates to me that the US has failed as a society to respond well to such a preventable disease.
Denmark ( where I lived during Covid ) handled it much better and is a similarly capitalistic society, but with a different attitude towards institutions, and the issue was not politicized. The general population listened to the CDC-equivalent institution. The government offered free testing, (rapid+the more expensive ones), and was proactive with respect to vaccination. The government coordinated a very successful booster vaccination campaign in early January of 2022, effectively ending the covid era.
[1] https://ourworldindata.org/mortality-risk-covid
[2] https://ourworldindata.org/grapher/united-states-rates-of-co...
And the initial wave being so high just screams that we weren't counting the accurate number, as we didn't know how widespread infections were. As we learned that more and more infections were effectively asymptomatic, early numbers on what was happening are hard to take at face value.
None of which is to downplay it. Lots of people died. I hope we can find actionable things to help for any future outbreaks.
According to [1], it's 40.5% of the confirmed population. It's indeed a high rate, but those cases are also taken into consideration wrt to mortality rate as far as I am aware. It also highlights just how transmissible this virus is, allowing it to eventually infect the vulnerable population.
We also learned that covid was a component in a very large portion of excess deaths. Yes, somebody may have died of cancer, but covid was also present. It's possible that the patient sans covid would not have died.
Plus, there is the inverse, long covid and its symptoms lingering and weakening the population making it susceptible to subsequent diseases.
The problem however, in all of this, is that any trust to certain institutions in the US is now gone, which will only cause more harm.
[1] https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
> In this meta-analysis of the percentage of asymptomatic SARS-CoV-2 infections among populations tested for and with confirmed COVID-19, the pooled percentage of asymptomatic infections was 0.25% among the tested population and 40.50% among the confirmed population.
I still get people that are 100% convinced young people were somehow not getting it during the initial waves. Which frankly is non-sensical. Knowing that kids can get it, there is no explanation I have seen that could somehow magically have kept it out of every school that hadn't closed yet in the first year.
And testing is still... interesting. With many I know that test positive only doing so weeks after any symptoms, such that I was even told that 'loss of smell' is no longer a defining symptom? Schools have flat given up on either testing or requiring negative before the kids are allowed back. Ours at least encourage and support masking during the return period.
I don't think it is trust in the institutions, necessarily. Though, that certainly isn't helping. I think it is lack of certainty period. In large because we just don't have anyone with a 100% handle on the situation.
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...
This however, reinforces my point, even with an exaggerated deathrate we failed to properly contain the disease and take things seriously.
We didnt know that at the time. The statistics at the time showed a very different story.
You can compare the handling of the situation across countries and regions with similar socioeconomic conditions and observe that certain states performed significantly worse than counterparts outside.
I didn’t speak about indefinite mandates either and mentioned Denmark repeatedly, for a good reason.
In Denmark we didn’t have vaccine or mask mandates, and opened well before most countries in January of 2022 while sustaining far fewer deaths compared to say Sweden.
And for added benefit that would also apply to other potential disasters.
Like imagine the impact if the Port of Los Angeles couldn't operate for X period due to an awful earthquake.
I'm sure there is an inflection point on the "deadly" nature versus the "spreads" factor.
That said, I fully endorse your closing question. I'm not at all sure what we learned. Other than folks get heavily invested in their narratives and don't back down. Pretty much ever. (Though, I think we already knew that?)
Cholera is an interesting example of this because it relied on the fecal transmission route, where it would easily spread through tainted water. It didn't matter all that much if the hosts died, as long as it got into the water supply.
You should read up on smallpox. 30% death rate and extremely transmissible.
That depends fairly heavily on how much more, and how long before symptoms and death you're infectious. Measles, for example, is insidious in part because it's infectious days before the rash appears.
They are not useless, to be sure. But they will be very dirty in the stats.
Though I cede it may as well be wishful thinking on why we have never seen one like it, since.
https://www.nbcnews.com/news/latino/don-t-leave-him-here-ecu... https://elpais.com/sociedad/2020-04-01/el-coronavirus-desbor...
It got to the point that the COVID task force coordinator had to issue an apology: https://twitter.com/EcuadorTV/status/1245492946675347460?s=2...
I think your comment really proves my point. Even when there's overwhelming evidence of how bad it really was, there's always someone who will downplay it or even deny it.
https://nypost.com/2023/02/27/10-myths-told-by-covid-experts...
Wasn't the AIDS pandemic already a good test run? It appears AIDS killed twice as many people in the African region in the year 2021 alone than COVID-19 has all told. Particularly with respect to the Americas, I expect AIDS would have proven to be far more deadly if it weren't for our effective proactive measures. That we seemed to be running around like chickens with our heads cut off when COVID-19 came around, even after the lessons learned from the previous major pandemic not that many years earlier, suggests that we simply don't learn (or tells that pandemics can be different enough that the lessons aren't transferrable).
https://www.nbcnews.com/health/health-news/nasal-covid-vacci...