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What is our plan if Covid-19 doesn't go away after you recover from an infection?

snissn 7y ago
i think our plan would be to come up with a new plan
jdavis703 7y ago
Something like PREP (anti-HIV drug for people in high risk groups) probably. There also might be a lot of deaths and suffering if it takes a long time to create a coronavirus prophylaxis medicine.
12yrprogrammer 7y ago
No politician wants to say it, but the plan regardless was to quarentine until a vaccine comes out in 1 or 2 years. That or accept the 0.5 percent death rate with the "flatten the curve" method where we all catch it. Your concern means we'd only have situation 1, quarentine for 1 or 2 years.
- TaylorGood 7y ago
  Logic says this too. Deadly, contagious virus with no vaccine, which takes roughly 18 months. There aren't too many options. I've heard chatter that big co's started telling their employees they're planning 18 months WFH.
  - rpiguy 7y ago
    Logic says just to live with it like we live with the flu and go on with life. The mortality rate is comparable. CDC is projecting 60K deaths if we open up most of the economy by the end of May. In the 2018-2019 flu season flu killed 80,000. Once the disease surge in densely populated ends areas it appears to become quite manageable.
    - yyyk 7y ago
      It's a prediction given previous containment measures. Without those measures, a far higher count is predicted. We'll probably wear masks this entire time, and there'll probably another closure next time the disease surges. Until we find an effective treatment or a vaccine.
      - rpiguy 7y ago
        The prediction assumes containment measures are eased by the end of May.
        yyyk 7y ago
        That's exactly my point. You're comparing COVID with containment measures to a flu without containment measures, and from that you conclude we'll manage COVID without containment and that we'll "live with it like with the flu". That doesn't make sense at all. If there's a second wave, we'll probably need those containment measures again just to bring it down to the flu level.
        rpiguy 7y ago
        All indications are that COVID does not mutate like the flu, so preceding waves should be mild. Every flu season it’s one of many very different strains. Furthermore we have data from countries that have not locked down that show comparable mortality. This is an illness that needn’t shut down countries once the densely populated areas have their initial outbreaks. Hospitals outside of those areas are so slow hospitals are furloughing workers. The total deaths across the US are down year over year for the month of March. If this were a raging pandemic this would not be the case.
        yyyk 7y ago
        Countries which have not locked down with comparable mortality? E. Asian countries use a strict screen-and-test routine (+ a few restrictions), and if/when that slips they turn to a lockdown until they can control the outbreak enough to return to screen-and-test (e.g. Singapore just these recent days). That's a data point, but I don't think it supports the 'just get back to usual' POV. The US has far more entry points than Singapore, even after it manages to control the disease internally. The UK abandoned their no-lockdown policy because it didn't work. That leaves us with.. Sweden which doesn't look good at all compared to its neighbours which have locked down?
- asveikau 7y ago
  I don't think so. It's not like somewhere like China got to lower numbers now because most of them got it and are immune. As percentage of population the number that got it is quite small. They got control of the situation because the people who had it didn't spread and they recovered. Now they are vulnerable to it being reintroduced. But they don't need full lockdown. So another scenario is that active cases subside and we don't travel or amass in large groups for a while. This is short of your two year quarantine (which by the way you didn't spell correctly, a hint for how to spell it is that it derives from Italian 'quaranta', meaning 40, for a 40 day isolation).
- lbeltrame 7y ago
  > No politician wants to say it, but the plan regardless was to quarentine until a vaccine comes out in 1 or 2 years. This is unfeasible for most of the population, and a vaccine may not work at all (people assume it will, but there's no guarantee). If they work, drugs are what will be needed to turn the tide short-term.
- SpicyLemonZest 7y ago
  Note to readers that there's been a flood of new accounts like this one, whose first and only comment is "haha we'll be in quarantine for 2 years". This is the third one I've noticed in the past 2 days. Either it's a popular troll or someone's making a concerted effort to manipulate the discourse; in either case I think it's important not to take this seriously.
  - Trasmatta 7y ago
    I had to step off Reddit entirely for this very reason. Comments like this are commonplace, and get thousands of upvotes. It's bizarre.
    - rootusrootus 7y ago
      Reddit has been invaded by legions of newly minted authoritarians who think we should lock everything down with martial law and shoot anyone who dares to come out of their house. On the flip side, there's more than a few people suggesting this is all an elaborate hoax designed to give the gov't vastly increased control of the citizenry. They feed off each other. And HN isn't entirely immune. I see some of it happening here too, though it is not as prevalent as on Reddit.
  - 12yrprogrammer 7y ago
    Nah I just keep getting shadow banned because dang works for Apple. Also, look at the argument, not the user. You have appeal to authority fallacy.
  - dang 7y ago
    Please don't post this sort of insinuation of astroturfing. There's a site guideline specifically against it: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html The reason is that people are far too quick to leap to this interpretation, and since we have next to no data about each other from HN posts, pretty much every divisive topic gets drowned in such insinuations if allowed to. Lots more explanation here: https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix=true&page=0&query=by:dang%20astroturf https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
- Trasmatta 7y ago
  There's not going to be a 2 year quarantine, but I do see these things happening, in various places (depending on a bunch of local factors): * Mandatory mask usage * Mandatory temperature checks in certain places (restaurants, airports, etc?) * Many companies continuing their WFH policies * Greatly expanded testing and contact tracing, allowing local outbreaks to be more easily contained * Quarantines for high risk individuals
- rpiguy 7y ago
  The mortality rate is low, I suspect we will just live with it like we do with the flu until a vaccine is found.
ping_pong 7y ago
Given that the virus doesn't mutate very quickly, it would be extremely unusual to not become immune for a time being after infection. If, however, it's the absolute worst case scenario that we don't get any immunity after infection and thus a vaccine is useless, then basically there's nothing we can do except build more hospitals and research treatments that prevent death. We would probably have to live a very different life going forward, ie. wearing masks all the time and other changes. In such a worst case scenario, at some point I would think our ability to detect the virus would become almost instantaneous, so we can have scanners/detectors at every entrance to allow for immediate detection and immediate quarantine. That would probably help keep the spread down immensely.
Softcadbury 7y ago
This plan of collective immunity was only the plan of a few countries, like the UK, and they quickly changed their mind... So I don't think this news change everything. Still a bad news though.
- StevenWaterman 7y ago
  I keep seeing people saying that the UK has given up on herd immunity as an end-goal, but I can't remember the government every saying they'd changed their plan. Do you have a link or a source for that? Having read the reports on the government's initial modelling, it still seems like they're sticking to their initial plan. They recommended enacting social distancing and lockdown measures to keep the infection rate manageable for the NHS, relaxing and tightening the measures to keep the spread at the maximum sustainable rate. Lockdown hasn't been relaxed as the infection rate still hasn't started going down, but their initial 'review in 3 weeks' was based on the incubation period, as they expected to see a slowdown after 3 weeks. The advice said explicitly that social distancing measures would need to be in place for `at least most of a year` and the strictest restrictions would need to be in place for about 6 months. That explains why the UK is still refusing to close businesses, and just recommending that you work from home where possible. While other countries are attempting to stop the spread completely, the UK is trying to keep it at a manageable level. Their judgement is that it's impossible to control this virus unless most of the population is immune, and that it's also impossible to irradicate it through social distancing and lockdown. The only solutions therefore are to stay in lockdown until a vaccine is developed, or let 70% of the population get infected and become naturally immune. They don't think a 12-18 month lockdown is feasible, so they are going for option 2. Within that goal, they are trying to minimise the death toll: * make sure that the 70% infected are young and healthy, with over 70 and anyone at increased risk quarantined inside their homes for 4 months * Keep the infection rate low enough that the NHS is within capacity meaning a mortality rate of ~1% instead of ~5% * Give up on mass testing and containment, asking people to isolate once they notice symptoms - they want people to spread it
buboard 7y ago
lock up everyone in the world with food for 8 weeks to extinguish it.
- sigmaprimus 7y ago
  That might work, but how much food does everyone get? Do fat people get more or less? Who gets the steak and who gets the rice? Besides people need water long before food, an who gets to make these decisions? After we are all locked up who holds the keys? Would you have a problem with me holding the keys? How can we ensure once the virus is gone everyone is released? I can think of a few groups that might need to stay locked up a bit longer...drug addicts, terrorists, orange tinted politicians etc. I know you were just making an abstract point and agree that if it were possible it would work but unfortunately people are not livestock. If you are a religious person consider the fact that even god can't or wont take away the free will of men, wiping everyone out with a flood or plague seems more doable.
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- rootusrootus 7y ago
  Before we can do that we will need to conscript and train a large fraction of the population.
- bathtub365 7y ago
  I’m skeptical there’s 8 weeks worth of food for every person on earth just lying around, let alone that could be transported to them.
onlyrealcuzzo 7y ago
I was initially worried about this, but my understanding now is that they're pretty sure it goes away. There's viruses that go dormant and become invisible to your immune system like how Herpes viruses go dormant in your nervous system, and there's viruses that get into your DNA like HIV and then are pretty much impossible to get rid of without getting rid of all of your cells. Coronaviruses don't do either of these things.
- MaupitiBlue 7y ago
  Duration of Antibody Responses after Severe Acute Respiratory Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/ “ Among 176 patients who had had severe acute respiratory syndrome (SARS), SARS-specific antibodies were maintained for an average of 2 years, and significant reduction of immunoglobulin G–positive percentage and titers occurred in the third year. Thus, SARS patients might be susceptible to reinfection >3 years after initial exposure.”
lawrenceyan 7y ago
Then the end game is the prescription of an antiviral drug and vaccine for everyone regardless of infection or not until the virus is eradicated.
- rpiguy 7y ago
  Perhaps outside of the US. Forced vaccination would never be accepted here. If we can’t get people to vaccinate against diseases that spread faster with a higher mortality rate that also kill children, like measles and whooping cough, there is no way. The US will be forced to live with the herd immunity strategy, but they won’t call it that. The final mortality of Covid is likely to be lower than the flu according to the latest CDC projections (60K vs. 80k flu last season). Not scary enough for forced vaccinations.
aaron695 7y ago
Maybe 10-20% of the world dies. It's not a joke, we are only 3 months into looking at the virus, we can't be sure what it's doing. What is happening here? We started to see this a month ago in Japan. Given every step so far in all countries leaders have shown no understanding of even the obvious and what to do, I think they are just choosing to ignore it at our peril.
- rpiguy 7y ago
  We have an excellent idea of how the disease progresses and what it looks like in countries that don’t isolate like Sweden. We will carry on and live with it, like we do with the flu. Mortality rate is .37% in Germany. Here in the US we are at around .5%. The CDC projects 60K total deaths, which is less than the flu. Although I think it is doubtful, if it does end up killing 10-20% like the Spanish Flu then better to get it over with instead of stretching it out. The good news is that after the Spanish Flu we had the roaring 20’s so there is still light on the horizon.
  - bathtub365 7y ago
    The problem with “getting it over with instead of stretching it out” is that the healthcare system will be overwhelmed and more will die as a result. This is careless and irresponsible to suggest and I don’t know why it keeps being brought up.
- Trasmatta 7y ago
  Nearly 800 million deaths? That's not going to happen, even if there was no mitigation.

i think our plan would be to come up with a new plan

Something like PREP (anti-HIV drug for people in high risk groups) probably. There also might be a lot of deaths and suffering if it takes a long time to create a coronavirus prophylaxis medicine.

12yrprogrammer 7y ago

No politician wants to say it, but the plan regardless was to quarentine until a vaccine comes out in 1 or 2 years. That or accept the 0.5 percent death rate with the "flatten the curve" method where we all catch it. Your concern means we'd only have situation 1, quarentine for 1 or 2 years.

TaylorGood 7y ago
Logic says this too. Deadly, contagious virus with no vaccine, which takes roughly 18 months. There aren't too many options. I've heard chatter that big co's started telling their employees they're planning 18 months WFH.
- rpiguy 7y ago
  Logic says just to live with it like we live with the flu and go on with life. The mortality rate is comparable. CDC is projecting 60K deaths if we open up most of the economy by the end of May. In the 2018-2019 flu season flu killed 80,000. Once the disease surge in densely populated ends areas it appears to become quite manageable.
  - yyyk 7y ago
    It's a prediction given previous containment measures. Without those measures, a far higher count is predicted. We'll probably wear masks this entire time, and there'll probably another closure next time the disease surges. Until we find an effective treatment or a vaccine.
    - rpiguy 7y ago
      The prediction assumes containment measures are eased by the end of May.
      - yyyk 7y ago
        That's exactly my point. You're comparing COVID with containment measures to a flu without containment measures, and from that you conclude we'll manage COVID without containment and that we'll "live with it like with the flu". That doesn't make sense at all. If there's a second wave, we'll probably need those containment measures again just to bring it down to the flu level.
        rpiguy 7y ago
        All indications are that COVID does not mutate like the flu, so preceding waves should be mild. Every flu season it’s one of many very different strains. Furthermore we have data from countries that have not locked down that show comparable mortality. This is an illness that needn’t shut down countries once the densely populated areas have their initial outbreaks. Hospitals outside of those areas are so slow hospitals are furloughing workers. The total deaths across the US are down year over year for the month of March. If this were a raging pandemic this would not be the case.
        yyyk 7y ago
        Countries which have not locked down with comparable mortality? E. Asian countries use a strict screen-and-test routine (+ a few restrictions), and if/when that slips they turn to a lockdown until they can control the outbreak enough to return to screen-and-test (e.g. Singapore just these recent days). That's a data point, but I don't think it supports the 'just get back to usual' POV. The US has far more entry points than Singapore, even after it manages to control the disease internally. The UK abandoned their no-lockdown policy because it didn't work. That leaves us with.. Sweden which doesn't look good at all compared to its neighbours which have locked down?
asveikau 7y ago
I don't think so. It's not like somewhere like China got to lower numbers now because most of them got it and are immune. As percentage of population the number that got it is quite small. They got control of the situation because the people who had it didn't spread and they recovered. Now they are vulnerable to it being reintroduced. But they don't need full lockdown. So another scenario is that active cases subside and we don't travel or amass in large groups for a while. This is short of your two year quarantine (which by the way you didn't spell correctly, a hint for how to spell it is that it derives from Italian 'quaranta', meaning 40, for a 40 day isolation).
lbeltrame 7y ago
> No politician wants to say it, but the plan regardless was to quarentine until a vaccine comes out in 1 or 2 years. This is unfeasible for most of the population, and a vaccine may not work at all (people assume it will, but there's no guarantee). If they work, drugs are what will be needed to turn the tide short-term.
SpicyLemonZest 7y ago
Note to readers that there's been a flood of new accounts like this one, whose first and only comment is "haha we'll be in quarantine for 2 years". This is the third one I've noticed in the past 2 days. Either it's a popular troll or someone's making a concerted effort to manipulate the discourse; in either case I think it's important not to take this seriously.
- Trasmatta 7y ago
  I had to step off Reddit entirely for this very reason. Comments like this are commonplace, and get thousands of upvotes. It's bizarre.
  - rootusrootus 7y ago
    Reddit has been invaded by legions of newly minted authoritarians who think we should lock everything down with martial law and shoot anyone who dares to come out of their house. On the flip side, there's more than a few people suggesting this is all an elaborate hoax designed to give the gov't vastly increased control of the citizenry. They feed off each other. And HN isn't entirely immune. I see some of it happening here too, though it is not as prevalent as on Reddit.
- 12yrprogrammer 7y ago
  Nah I just keep getting shadow banned because dang works for Apple. Also, look at the argument, not the user. You have appeal to authority fallacy.
- dang 7y ago
  Please don't post this sort of insinuation of astroturfing. There's a site guideline specifically against it: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html The reason is that people are far too quick to leap to this interpretation, and since we have next to no data about each other from HN posts, pretty much every divisive topic gets drowned in such insinuations if allowed to. Lots more explanation here: https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix=true&page=0&query=by:dang%20astroturf https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
Trasmatta 7y ago
There's not going to be a 2 year quarantine, but I do see these things happening, in various places (depending on a bunch of local factors): * Mandatory mask usage * Mandatory temperature checks in certain places (restaurants, airports, etc?) * Many companies continuing their WFH policies * Greatly expanded testing and contact tracing, allowing local outbreaks to be more easily contained * Quarantines for high risk individuals
rpiguy 7y ago
The mortality rate is low, I suspect we will just live with it like we do with the flu until a vaccine is found.

ping_pong 7y ago

Given that the virus doesn't mutate very quickly, it would be extremely unusual to not become immune for a time being after infection. If, however, it's the absolute worst case scenario that we don't get any immunity after infection and thus a vaccine is useless, then basically there's nothing we can do except build more hospitals and research treatments that prevent death. We would probably have to live a very different life going forward, ie. wearing masks all the time and other changes. In such a worst case scenario, at some point I would think our ability to detect the virus would become almost instantaneous, so we can have scanners/detectors at every entrance to allow for immediate detection and immediate quarantine. That would probably help keep the spread down immensely.

Softcadbury 7y ago

This plan of collective immunity was only the plan of a few countries, like the UK, and they quickly changed their mind... So I don't think this news change everything. Still a bad news though.

StevenWaterman 7y ago
I keep seeing people saying that the UK has given up on herd immunity as an end-goal, but I can't remember the government every saying they'd changed their plan. Do you have a link or a source for that? Having read the reports on the government's initial modelling, it still seems like they're sticking to their initial plan. They recommended enacting social distancing and lockdown measures to keep the infection rate manageable for the NHS, relaxing and tightening the measures to keep the spread at the maximum sustainable rate. Lockdown hasn't been relaxed as the infection rate still hasn't started going down, but their initial 'review in 3 weeks' was based on the incubation period, as they expected to see a slowdown after 3 weeks. The advice said explicitly that social distancing measures would need to be in place for `at least most of a year` and the strictest restrictions would need to be in place for about 6 months. That explains why the UK is still refusing to close businesses, and just recommending that you work from home where possible. While other countries are attempting to stop the spread completely, the UK is trying to keep it at a manageable level. Their judgement is that it's impossible to control this virus unless most of the population is immune, and that it's also impossible to irradicate it through social distancing and lockdown. The only solutions therefore are to stay in lockdown until a vaccine is developed, or let 70% of the population get infected and become naturally immune. They don't think a 12-18 month lockdown is feasible, so they are going for option 2. Within that goal, they are trying to minimise the death toll: * make sure that the 70% infected are young and healthy, with over 70 and anyone at increased risk quarantined inside their homes for 4 months * Keep the infection rate low enough that the NHS is within capacity meaning a mortality rate of ~1% instead of ~5% * Give up on mass testing and containment, asking people to isolate once they notice symptoms - they want people to spread it

buboard 7y ago

lock up everyone in the world with food for 8 weeks to extinguish it.

sigmaprimus 7y ago
That might work, but how much food does everyone get? Do fat people get more or less? Who gets the steak and who gets the rice? Besides people need water long before food, an who gets to make these decisions? After we are all locked up who holds the keys? Would you have a problem with me holding the keys? How can we ensure once the virus is gone everyone is released? I can think of a few groups that might need to stay locked up a bit longer...drug addicts, terrorists, orange tinted politicians etc. I know you were just making an abstract point and agree that if it were possible it would work but unfortunately people are not livestock. If you are a religious person consider the fact that even god can't or wont take away the free will of men, wiping everyone out with a flood or plague seems more doable.
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rootusrootus 7y ago
Before we can do that we will need to conscript and train a large fraction of the population.
bathtub365 7y ago
I’m skeptical there’s 8 weeks worth of food for every person on earth just lying around, let alone that could be transported to them.

onlyrealcuzzo 7y ago

I was initially worried about this, but my understanding now is that they're pretty sure it goes away. There's viruses that go dormant and become invisible to your immune system like how Herpes viruses go dormant in your nervous system, and there's viruses that get into your DNA like HIV and then are pretty much impossible to get rid of without getting rid of all of your cells. Coronaviruses don't do either of these things.

MaupitiBlue 7y ago
Duration of Antibody Responses after Severe Acute Respiratory Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/ “ Among 176 patients who had had severe acute respiratory syndrome (SARS), SARS-specific antibodies were maintained for an average of 2 years, and significant reduction of immunoglobulin G–positive percentage and titers occurred in the third year. Thus, SARS patients might be susceptible to reinfection >3 years after initial exposure.”

lawrenceyan 7y ago

Then the end game is the prescription of an antiviral drug and vaccine for everyone regardless of infection or not until the virus is eradicated.

rpiguy 7y ago
Perhaps outside of the US. Forced vaccination would never be accepted here. If we can’t get people to vaccinate against diseases that spread faster with a higher mortality rate that also kill children, like measles and whooping cough, there is no way. The US will be forced to live with the herd immunity strategy, but they won’t call it that. The final mortality of Covid is likely to be lower than the flu according to the latest CDC projections (60K vs. 80k flu last season). Not scary enough for forced vaccinations.

aaron695 7y ago

Maybe 10-20% of the world dies. It's not a joke, we are only 3 months into looking at the virus, we can't be sure what it's doing. What is happening here? We started to see this a month ago in Japan. Given every step so far in all countries leaders have shown no understanding of even the obvious and what to do, I think they are just choosing to ignore it at our peril.

rpiguy 7y ago
We have an excellent idea of how the disease progresses and what it looks like in countries that don’t isolate like Sweden. We will carry on and live with it, like we do with the flu. Mortality rate is .37% in Germany. Here in the US we are at around .5%. The CDC projects 60K total deaths, which is less than the flu. Although I think it is doubtful, if it does end up killing 10-20% like the Spanish Flu then better to get it over with instead of stretching it out. The good news is that after the Spanish Flu we had the roaring 20’s so there is still light on the horizon.
- bathtub365 7y ago
  The problem with “getting it over with instead of stretching it out” is that the healthcare system will be overwhelmed and more will die as a result. This is careless and irresponsible to suggest and I don’t know why it keeps being brought up.
Trasmatta 7y ago
Nearly 800 million deaths? That's not going to happen, even if there was no mitigation.