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Comment by ramraj07 | Hacker News Reader

This brings up an important point many folks may not realize: our immune system a robust multilayered, highly redundant response against any normal bacterium or virus. Thus, Any pathogen that currently still causes disease by definition has to code multiple specialized workarounds that hack these immune responses.

And importantly, pathogens that cause fatal diseases are typically not very old in evolutionary time scales, it’s generally considered to be a bad idea evolutionarily speaking to kill hosts you infect, and most of these pathogens are considered to be in the path towards evolving into more benign invaders of their hosts.

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Rabies is generally fatal and is not new or genetically novel, and like the article linked, is a CNS infection that travels the peripheral nervous system. First recorded case was 4000 years ago, suggesting it’s likely ancient through pre-history.

AFAIK is also isn't super contagious, less opportunity for it to evolve

It’s super contagious in the reservoir species. But it’s not in humans. The point made above was about age if the pathogen not infectiousness.

But it isn't very lethal in that species, is it? In the species that it spreads rapidly in, it likely won't be very lethal which was the point

How many humans get rabies per year versus how many that get influenza?

I’m not sure that’s relevant? I didn’t see anything stated about rates of infection. Absolutely if influenza were as fatal as rabies we would be extinct. But we also wouldn’t be posting on hacker news about it either. The statement was about longevity of the pathogen and fatality.

> Absolutely if influenza were as fatal as rabies we would be extinct.

The chance that it would evolve to be as infectious would be greatly reduced. They teach this in first semester immunology.

Not necessarily. What would be reduced is the likelihood of showing any symptoms while still being infectious.

I don’t see why you think that’s true - if infections are latent long enough to spread and it’s virulent enough, with a fatal outcome, it could rapidly wipe out most people. There’s no reason to believe a viral infection that mutates from an animal infection to human wouldn’t be both easily transmitted and highly lethal. It’s not a great evolutionary adaptation for the long term, but transitory effects can often be sub optimal and catastrophic.

COVID is a perfect example. It could easily have been significantly more lethal and it was very infectious in its first blush with humanity. What process other than luck prevented it from being both highly lethal and highly contagious rather than moderately lethal and highly contagious?

If you have a reference to a first semester immunology text that supports this supposition I’m very interested to read the justification. Otherwise this feels like a big of an appeal to authority.

Is not really designed for surviving outside. Very long filaments are fragile out of vascular systems.

Viruses like rabies are interesting because they are actually not as serious in the species they evolved to infect; just turns out they rapidly kill some other species (us) that they don’t care about.

Make no mistake, rabies virus also has multiple immune evading mechanisms that are unluckily supercharged in humans.

Yeah I expect that’s the case - the bubonic plague spread via the reservoir fleas and rats, etc.

That may actually have not been the case: https://theconversation.com/the-black-death-may-not-have-bee...

Sounds a little like funnel web spider venom - just an evolutionary accident it's so potent to humans, at no evolutionary drawback for its main role.

Thought rabies usually killed dogs?

https://www.cdc.gov/mmwr/volumes/68/wr/mm6823e1.htm#:~:text=....

CDC says it kills 99% regardless.

Why would it evolve this way?

I doubt that rabies has evolutionary developed to target dogs. It’s just a “happy” accident that dogs are so plentiful and can infect many other animals (until recently at least).

If I had to guess I’d say rabies had evolutionarily targeted species that today are largely asymptomatic and can easily survive a rabies infection, like bats or birds.

Rabies most probably evolved from a virus from plants so is very "alien" to animals. As long as can hide in their main host, it does not care about killing everybody else (if accidentally ends in the wrong place). This can be also and advantage and selected by evolution in some cases ("enemy of my host is my enemy" situations).

Tuberculosis is likewise at least 5000 years old, and kills around 50% of those infected.

>Roughly one-quarter of the world's population has been infected with M. tuberculosis, with new infections occurring in about 1% of the population each year. However, most infections with M. tuberculosis do not cause disease, and 90–95% of infections remain asymptomatic.

https://en.wikipedia.org/wiki/Tuberculosis#Epidemiology

5000 years is literally a blip in evolutionary timescales.

Is that an imperial or metric blip?

> it’s generally considered to be a bad idea evolutionarily speaking to kill hosts you infect

That sound's like it's giving some kind of agency to the pathogen ;) when in fact it's more like: everyone that's severly infected isolates or dies, so the more harmless variants of the pathogen can replicate faster.

it's merely a different way to lay down the explanations.

it's not "in fact" like you say; you merely provide an alternative way to understand what's going on and to describe it.

it's incorrect to claim that either is wrong because of the other.

in the end, we gotta learn to have multiple ways to explain the same things and it's best to shift between these 'theories' of what is going on as it serves our purposes. It's stupid to have this alternatives "fighting each other"; see? I just have agency to the ways to conceptualize, understand, and explain phenomena.

When it comes to viruses, I think it is important to understand that they simply replicate because they can. The virus has no interest in keeping you alive or killing you; it just infects cells and that’s it.

It’s just an abstraction used to ease the conversation. If a disease is inclined to behave like X, that’s just a shortcut to say, “it’s evolutionarily advantageous if the mutations result in X behaviour.”

Prions are so hyper-intelligent that they've even hacked this "the host dying kills you too" problem.

Pathogens will evolve to best survive and replicate - for fitness. If a pathogen kills a patient quickly before much chance of spread then yes they wouldn't be very fit and mutations delaying death would be beneficial.

However this certainly does not imply that all pathogens evolve to become 'mild'. Killing the host (or permanently incapacitating them) is not necessarily incompatible with effective spread.

Indeed, we have no strong evidence of a pathogen evolving to become milder. We do have lots of examples of hard won population immunity reducing the harmfulness of pathogens.

Unfortunately it has become a bit of a 'natural is best' trope that viruses necessarily become weaker, but in fact nature will quite happily slaughter us, and it is our artificial interventions that keep us fit and healthy.

Except for anthrax, whose lifecycle explicitly includes killing its host and staying dormant in the soil where the host decomposes.

Sometimes our immune systems don’t work though. In that case we need vaccines. Please don’t forget that

Sometimes, but other times e.g. COVID-19, our immune systems work extremely well in all except the very elderly and obese.

I’m sorry you are a victim of deplorable disinformation. The vaccines actually prime our immune system to fight the infection, and Covid is killing children not just the elderly and body positive

Sorry this is ot, but I can't help but note: replacing "obese" with "body positive" is a wildly Orwellian linguistic move. They aren't remotely synonymous, nor do the groups they actually denote fully overlap (not all obese people are body positive, nor are all body positive people obese).

It's so over the top that it actually registered as cynism with me.

The evidence is all out in the open now - there's really no hiding from it any more.

In randomized control trials of the mRNA COVID-19 vaccines here in the UK, we now know the risk of serious adverse effects was 12.5 per 10,000 vaccinated i.e. a ~1 in 800 change of serious adverse effects:

22-Sep-22 https://pubmed.ncbi.nlm.nih.gov/36055877/

The UK government has now published its estimate of the number of people needed to vaccinate to prevent a COIVD-19 hospitalisation:

25-Jan-2023 https://assets.publishing.service.gov.uk/government/uploads/...

For example in the 20-29 year no-risk group, the number needed to vaccinate to prevent one hopitalisation is 168,200. To prevent one serious hospitalisation requiring oxygen or ventilation you would need to vaccinate 706,500.

Even in the at-risk group for 20-29 years, the numbers are 7500 and 59,500 respectively.

In fact there was no group except for 70+ where the risk of hospitalisation (not severe requiring oxygen), came close to the risk associate with vaccine injury.

It's for this reason, that these mRNA vaccines are no longer being offered by the NHS.

Look - I'm sorry you were lied to, but at some point you've just go to hold your hands up and admit the truth of the matter.

Edit: plenty of downvotes, but no refutation.

Here’s your refutation: many of these results confound pre omicron Covid with omicron Covid - the former was 10-100x deadlier, and totally warranted global mandating of the vaccines even with the published SAR rates. After omicron, it is absolutely true that the adverse reaction rate from mRNA vaccines might not be worth the benefit of avoiding the relatively less fatal omicron variant diseases for young individuals.

I will agree that regulatory agencies and many pro vaccine arguments are doing a disservice by not being thorough about such distinctions. That doesn’t mean the choices made pre omicron were invalidated. The mRNA vaccines did a great job and did them in time to protect millions more lives from being lost.

You're comparing apples with oranges.

The majority of the serious adverse effects reported in the original trials the first paper rehashes (15.1 effects per 10000 above a 6.4 effect per 10000 placebo baseline with some people reporting multiple effects, after the authors stripped out SAE's where the placebo group reported worse outcomes...) did not involve hospitalisation, never mind intubation.

And a significant proportion of COVID infections that do not require hospitalisation (i.e not counted in the NNV metric) nevertheless involve serious adverse effects including both those credibly associated with vaccine side effects but more commonly in symptomatic COVID patients (myocarditis) and those not thought to have any association with the vaccine such as long term brain fog. The vaccines were found to have a high efficacy at reducing these types of symptomatic infections though....

More generally and unfortunately for the cranks, its noticeable that excess deaths and hospitalisation peaks follow COVID infection spikes, not the ramp up of vaccinations, and have declined considerably since the vaccination programmes began. It's almost like the professionals know better than someone who thinks influenza is a coronavirus...

1/1000 people are dead in the US. Much more in places like in India. And yet here we are people still underplaying it. It’s amazing seeing rewriting of history right in front of your eyes for sure.

As I say, most of those are in extremely elderly or obese category.

This is a misunderstanding of how statistics work, and part of the lie that Covid is an old people and obese person’s problem. Not that you’re directly making this argument, but for posterity: It’s not just their problem. Unless you feel cardiology and oncology are also old and fat people’s problems, since they die more of cancer and heart disease?

The extremely elderly and obese die of all causes disproportionately. But Covid lowers life expectancy and increases mortality of all age groups starting around age 30 even after all mitigating measures (vaccines, masks, etc) are taken in to account.

The young lower their own life expectancy when they betray an inter-generational commitment to the older generations to take care of them. This won’t be the last pandemic, and the young won’t always be young.

We have no idea what the long term effects of COVID-19 infection will be, however there's no reason to think the long-term impact will be any different from any other coronavirus flu.

And given that the virus is endemic, and the vaccines only provided fleeting protection (they're not even being offered by the NHS here in the UK any more), we'll all get it sooner or later. There's no choice about it. Fortunately for the vast majority of people, COVID-19 is a mild disease that they will recover from quickly.

You have no idea what you’re talking about and are spreading misinformation.

1. SARS-CoV-2 is not influenza.

2. Influenza is not a coronavirus.

3. Influenza usually kills 300,000-500,000 people annually

4. Consensus estimates of excess deaths from COVID-19 are 14 million over the two years of 2020-2021. 2022 isn’t looking great either.

5. All developed countries highly recommend the annual Influenza vaccine even with its variable annual efficacy, as a way of lowering the intensity and spread.

The same will likely continue in many countries for COVID-19, where the recent Bivalent vaccines show reduced but still significant effectiveness against the recent variants of SARS-CoV-2.

6. COVID-19 has raised all cause mortality and lowers life expectancy across all age groups starting before middle age.

7. The UK NHS continues to offer standard two dose and 3rd shot booster COVID-19 vaccines (all mRNA now) for children over aged 5 and adults. This has not stopped.

Beyond this, they’ve limited additional boosters to seasonal programs for target populations that are at greater risk. They had one in the Autumn of 2022 and is staring a new one for Spring of 2023 for the immunocompromised and elderly (75+). The UK also signed a deal with Moderna to begin producing mRNA vaccines within the UK by 2025.

The vast majority of the UK population have COVID antibodies and are at far less risk than they were in 2020, but this continues to be monitored and may require broader seasonal vaccination campaigns if immunity wanes.

8. As with any disease vector there always is a choice to use mitigations such as masks in crowded indoor spaces, vaccinations, etc. to lower the spread. This is something other countries learned decades ago.

> You have no idea what you’re talking about and are spreading misinformation.

I actually do know what I'm talking about.

> 1. SARS-CoV-2 is not influenza. > 2. Influenza is not a coronavirus.

I know. It's a flu-like respiratory illness from a class of illnesses that humans face every season.

> 5. All developed countries highly recommend the annual Influenza vaccine even with its variable annual efficacy, as a way of lowering the intensity and spread.

No they don't. The UK does not offer flu vaccine for anyone except member of vulnerable groups, young children or medical workers.

> 6. COVID-19 has raised all cause mortality and lowers life expectancy across all age groups starting before middle age.

The all cause mortality has risen. There's every indication that this is due to the mRNA vaccines.

> Beyond this, they’ve limited additional boosters to seasonal programs for target populations that are at greater risk.

Any why are they doing that?

It's because the likelihood of hospitalisation due to a vaccine injury (1 in 800) [1] is greater than the liklihood of being spared from a hospitalisation due to COVID [2] in every age category except 70+.

[1] https://pubmed.ncbi.nlm.nih.gov/36055877/ [2] https://assets.publishing.service.gov.uk/government/uploads/...

> The vast majority of the UK population have COVID antibodies and are at far less risk than they were in 2020

The vast majority of the UK population were at minimal risk of COVID to begin with. I myself recovered from it in less than a day.

As the Danish mask study shows, the mask mandates were nothing more than securiy theater. The vaccines only offer fleeting protection of a few weeks, so it's not possible to keep the population on a 3-monthly treadmill of boosters.

> This is something other countries learned decades ago.

No the UK had a policy that explicitly recommended against mask mandates - especially paper and cloth masks.

Hiya, here to help. In reviewing the HN guidelines at the bottom of the page I was reminded that my initial reaction to your performance on this thread here today was uncouth, to be avoided.

Instead I'll take the high road. For an account created ten months ago it seems possible you haven't read the guidelines for commenting. Maybe it will help you understand a bit of why you've been downvoted on this thread today.

https://news.ycombinator.com/newsguidelines.html

My two cents, your mind appears to be made up on this topic. It shows. It also tips your hand as to what media sources you likely consume beyond HN.

Please consider (beyond the emotional reactions associated with this thread on this day) that you could perhaps use some improvement on having constructive discourse in this sort of forum. Chiming in because I like this place and have been here since near the beginning. I'd like to see discourse not devolve into factionalism or whatever more appropriate word could take it's place in this context.

Really not uncouth. Maybe misinformed but mostly just arguing opposing viewpoint that's been getting somewhat more legitimate with all the other "dangerous misinformation" that turned out to be true.

I know the NHS is poor but not even being able to afford flu shots is pretty poor indeed.

> no reason to think the long-term impact will be any different from any other coronavirus flu.

Long covid is real and seems to affect up to 5% of covid patients. We have no clue what the risk will be with repeated infections and 1.05^n is a pretty steep exponential curve when viewed in decades.

> We have no clue what the risk will be with repeated infections and 1.05^n is a pretty steep exponential curve when viewed in decades.

This is fantasy

Head over to /r/covidlonghaulers and read it yourself.

There is zero evidence of the exponential growth you are describing.

Not yet, data collection takes time. On that link above there are stories of people who got long covid on their 3rd or 4th infection. If that could happen with repeated infections, would that lead to mass disability over time (e.g. 25% workforce with ME/CFS unable to do pretty much anything)?

> Not yet, data collection takes time.

There is no evidence except for a few sketchy anecdotes from hyperchondriacs

Life is the best teacher to cure arrogance. Once it happens to somebody you are close to or even to yourself, then you might change your mind. I hope you won't do too much damage by then.

Selection/sampling bias and lizardman's constant are both important to remember.

So you are just going to ignore them?

Do you understand what those two things I mentioned are? Do you know the scale we're dealing with here?

> The young lower their own life expectancy when they betray an inter-generational commitment to the older generations to take care of them

I get what you're trying to say, but this isn't the correct argument for it. Social precedent relies on people not having any excuses that allow special-casing, which obviously doesn't apply here.

The "commitment" is already betrayed wherever eternal pyramid growth bumps up against reality.

Doesn’t the US have a population of 330 million? And I think we’re at a million dead from COVID? So 1 in 330, right?

Of course, taking into account time, population turnover, and tourists, the ratio may actually be closer to yours depending on how we decide to design the metric.

It's kind of the opposite, the majority of deaths from covid were due to cytokine storm, which is your immune system working too well, and producing too many inflammatory cytokines.

What’s your point? I literally said any pathogen that causes disease in us has to break our immune system first. Of course we need vaccines to help fight those disease.

A vaccine works by stimulating the immune system with a pathogen-like substance to produce a response that trains it. Ergo, if the immune system doesn't work, a vaccine is useless!

> Sometimes our immune systems don’t work though. In that case we need vaccines.

Sorry, but that sounds a bit confused.

Vaccines bring information to the immune system to train it to recognise something as a threat faster than it would otherwise. Think of it as a "wanted dead or alive" poster. The poster doesn't go out and kill the baddies on its own. The poster is distributed to the sheriffs of the towns, so if the baddie shows up they recognise it for what it is before the baddie robs the bank. In this parallel the baddies are the infectious material (virus, or bacteria), the sherrifs are the immune system, and the poster is the vaccine.

If your immune system don't work, first of all that is very bad, second you don't need a vaccine. Because it won't help you! Same as sending wanted posters to a town with nobody who could act on them wouldn't make the town more secure.

The problem comes if a mimic of the baddies gets attached to hostages e.g. spike proteins attached to heart muscle tissue. In this case, the immune system will attack the "baddies" causing harm to the heart muslcle tissue in the cross-fire. Heart muscle tissue never regenerates, hence the spike in Myocarditis cases.

> Heart muscle tissue never regenerates

Given the importance of the heart, that seems like a strange way that this has evolved, given that other tissue does regenerate

Hard to fix a machine that can never ever go offline.

> And importantly, pathogens that cause fatal diseases are typically not very old in evolutionary time scales, it’s generally considered to be a bad idea evolutionarily speaking to kill hosts you infect, and most of these pathogens are considered to be in the path towards evolving into more benign invaders of their hosts.

This isn't necessarily true. https://abcnews.go.com/Health/debunking-idea-viruses-evolve-...

How sad that chatgpt does a better job than most of the commenters here.

>> ChatGPT: There are a few issues with this:

The statement that "Any pathogen that currently still causes disease by definition has to code multiple specialized workarounds that hack these immune responses" is not entirely accurate. While many pathogens have evolved strategies to evade or suppress the immune system, not all pathogens rely on these mechanisms to cause disease. Some pathogens may cause disease by producing toxins, disrupting host tissues, or interfering with cellular processes, without necessarily having to evade the immune system.

The claim that "pathogens that cause fatal diseases are typically not very old in evolutionary time scales" is not necessarily true. While some pathogens that cause fatal diseases may be relatively new, others have been around for a long time and have co-evolved with their hosts. For example, malaria is caused by a protozoan parasite that has been infecting humans for millions of years.

The statement that "it’s generally considered to be a bad idea evolutionarily speaking to kill hosts you infect" is an oversimplification. While it is generally true that pathogens that kill their hosts too quickly may be less successful at spreading to new hosts, this is not always the case. Some pathogens may benefit from causing rapid, severe disease if it increases the likelihood of transmission to new hosts.

The claim that "most of these pathogens are considered to be in the path towards evolving into more benign invaders of their hosts" is also not entirely accurate. While it is possible for some pathogens to evolve to become less virulent over time, this is not a universal trend, and many pathogens may continue to cause severe disease for extended periods of time. Additionally, the evolution of a pathogen is influenced by a wide range of factors, including the host population, the environment, and the selective pressures imposed by the immune system.

No single statement I made was absolute for a reason which is that exceptions exist, and while what gpt wrote is quite amazing you can see how you can’t trust it yet. I’m not communicating to an audience that’s well versed in immunology, but to one that’s new to it. Exposing them to some common ideas and thoughts of why biological systems are the way they are to give them better understanding without overloading them with the vagaries of biological variety.

The reply from the bot sounds more like the smug 1st year graduate student sitting at the back of the lecture who thinks they’re smart because they made a technically correct counter point. Technically correct yes, but you won no fans here for sure.

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