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Yes, a vaccine MAY be possible, but the news reports I'm hearing are wildly optimistic at best. It will also take an enormous amount of energy/willpower to quar

Yes, a vaccine MAY be possible, but the news reports I'm hearing are wildly optimistic at best. It will also take an enormous amount of energy/willpower to quarantine until then. It might be more economically efficient (and convenient) for the strong and healthy to purposefully self-infect, and build up anti-bodies naturally. Herd immunity will eventually be built and corona will no longer be a problem.

klmadfejno 6y ago
In case anyone is thinking similarly, remember that vulnerable people (old people)'s social networks are mostly other vulnerable people. Even if herd immunity was "achieved" in the younger cohort, the old would be at basically the same level of risk because if one old person gets infected, it'll spread through the unprotected social network quite easily. You need it to be well mixed to be effective. That all being said, if theories of initial viral loads making a difference are true, it's not that crazy to imagine individuals choosing to self infect with a very small initial viral load so they can just stop needing to tip toe around life with the concern that they infect others, while continuing to isolate on their own. If I lived alone I'd be tempted.
- ashtonkem 6y ago
  You need to balance not jut your chance of death, which is low if you’re very young, but your chances of getting very very sick. Spending a few weeks in the ICU is a good way to bankrupt yourself on the path towards returning to regular work, let alone how hard a ventilator is on even survivors. Plus, we have no idea what happens to the infected a few years or a decade from now. If given the choice, not getting sick at all is the best possible outcome.
  - notRobot 6y ago
    > Spending a few weeks in the ICU is a good way to bankrupt yourself Only in the US :|
    - lucioperca 6y ago
      LOL yes, only in the US your worst fear about spending a few weeks in a ICU are the bankrupting costs.
  - steveeq1 6y ago
    > Spending a few weeks in the ICU is a good way to bankrupt yourself on the path towards returning to regular work, let alone how hard a ventilator is on even survivors. Ok, I'm willing to consider devil's argument, but this is just plain ridiculuous. The great bulk of infected people classsify this as "mild". If you're young, strong, and healthy, your chances of dying from this are basically zero in any common sense way. And far more people are going to "get bankrupt on the way to work" as you say using the current method. We're not trying to find a perfect solution, we are trying to find the better one.
    - mullingitover 6y ago
      > If you're young, strong, and healthy, your chances of dying from this are basically zero in any common sense way There are zero longitudinal studies about the long-term effects of infection. For all we know, young healthy people could appear to beat the virus, only for it to hide out and plague you with severe health problems down the road. We could have an massive epidemic of a neurodegenerative disease caused by Covid-19 twenty years from now. I have no desire to roll the dice on that even if the odds look good for me at the moment.
      - steveeq1 6y ago
        Oh come on, you can say that for any flu epidemic.
        mullingitover 6y ago
        Yes you can[1], which is exactly why you don't really want to roll the dice even if you appear okay after the initial infection. [1] https://epmonthly.com/article/neuropsych-complications-flu-virus/ https://epmonthly.com/article/neuropsych-complications-flu-v...
        steveeq1 6y ago
        But you "roll the dice" with every flu epidemic.
  - klmadfejno 6y ago
    I don't know why you would think the risk of death is dependent on age but the risk of severe illness is not. Age affects both. You're highly unlikely to get put in an ICU if you're young. It would be pretty improbable for a disease like this to have long term consequences unless you start going hypoxic and have organ damage. not impossible, but probably a low concern.
- steveeq1 6y ago
  Yeah, let herd immunity kick in so it's harder for the virus to spread and then STRICTLY quarantine the old. As in much stricter than what they have now. I realize that's not great for grandma, but at some point, society has to make a reasonable tradeoff. If you're young, strong and healthy, your probability of dying from it is basically a rounding error.
  - pohl 6y ago
    We don’t even know if individuals can acquire immunity from infection, yet. (That’s a prerequisite to herd immunity.)
    - standardUser 6y ago
      We have no reason whatsoever to think infection doesn't confer immunity. All other human-infecting coronaviruses do. And with no confirmed cases of reinfection yet, there is no evidence showing that this virus breaks the norm.
      - steveeq1 6y ago
        Stop spreading misinformation. There are studies in South Korea that reinfection does not occur.
        standardUser 6y ago
        You may have misread my comment.
empath75 6y ago
The strong and healthy are also dropping dead and we don’t know what the chronic, long term effects will be
- rpiguy 6y ago
  Doesn’t matter - a good portion of the US will never accept contract tracing, a prolonged shut down, mandatory antibody testing, or forced vaccination. It is illegal for states to prevent persons from neighboring, more constrictive states from traveling in and out. Given the Supreme Court make up it is unlikely any of the above would be upheld as constitutional. Therefore the US is heading toward a herd immunity strategy regardless of what technocrats think the end game will be. I laugh when I hear people talking about a vaccine. We can’t get people to vaccinate for diseases like measles that spread faster, are deadlier, and kill kids.
  - maxerickson 6y ago
    MMR (measles is one of the M) vaccination rates are plenty high enough to get us to herd immunity for SAR-CoV-2 (we need something like 70% of the population being immune). Even in states with the worst coverage. It's closer to 90% in most of the country: https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxview/data-reports/mmr/trend/index.html https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxv... So what are you laughing at?
    - rpiguy 6y ago
      The idea that a vaccine could be mandatory. But thank you for agreeing we are heading toward herd immunity.
      - maxerickson 6y ago
        A 70% vaccination rate is one way to get to herd immunity. There's not much question about getting there eventually. The path we take is the question. You are apparently laughing that 10% of people will refuse a working vaccine and expose themselves to future risk? Fun.
skuhn 6y ago
Herd immunity is easier said than done. A portion of the people who become infected require medical intervention, and many parts of the US medical system are inadequate to meet this need. It will take years to get to herd immunity levels through any kind of controlled infection alone, and many will die. Take a look at the forecasts of hospital bed utilization if 20, 40, 60% of the population were to be infected over a 6, 12, or 18 month period: https://projects.propublica.org/graphics/covid-hospitals https://projects.propublica.org/graphics/covid-hospitals Anywhere on those maps that show red indicates people dying due to hospital resource exhaustion, either from COVID-19 or unrelated health issues. To a lesser degree this is happening in yellow areas as well. And ProPublica is only considering beds! Medical personnel, supplies and equipment are finite resources as well. Personnel cannot handle 18 months of 200% bed utilization, and they don't have the PPE they need as it is. There is no easy fix to this situation; we are facing the kind of problem that is best met with thorough preparation, but unfortunately we don't have that. The government can print money, and implement programs to distribute food and other necessities. They can't print tests or masks or vaccines -- once the resources are put in place, it simply takes time. Realistically, it will be a long time before even one of those three things is in a good place. Probably not this year. A more achievable goal than herd immunity is to find a workable way to reduce the number of viral carriers and limit transmission while we wait for the tests, masks and vaccines that we need to get society back on track. That requires leadership and coordination, but it especially requires us to accept the seriousness of the situation and behave responsibly.
- lostapathy 6y ago
  The big question about natural herd immunity is really how far the disease has already spread and what that means for true IFR. If New York has "survived" this wave tolerably and 20% of people are immune, they may well be a quarter of the way to herd immunity. Which is still a lot of suffering to go, but it's also not going to take 18 months of 200% hospital bed utilization either.
  - rallison 6y ago
    1) The healthcare system barely handled the load, and that was with heroic efforts to reposition ventilators and build up temporary capacity. We barely handled it because most of the country was not nearly as hard hit, so we could still shift resources around. If everywhere was hit this hard at the same time, that would be a different story. It would need to be spread out more than you imply if we wanted to have all of the country trying to stay just below capacity. 2) New York City has lost .2% of their entire population to get to that ~20% number. Extrapolated out, that's once again back to the 1-2 million deaths range for the country to hit herd immunity.
KCUOJJQJ 6y ago
>It might be more economically efficient (and convenient) for the strong and healthy to purposefully self-infect If someone told me I should deliberately catch a cold I'd say no. What about Ebola? I'd say no! A germ that I don't know? I'd say no! If a police patrol arrived somewhere and someone ran away, that person would be suspicious. If I'm asked to get any germ I'd suspect that it's very dangerous, even if it was just a cold. So telling people to infect themselves deliberately won't work.
- steveeq1 6y ago
  Yeah, but strong young healthy won't die from it, but grandma will. Best to self-infect and quarantine so you don't accidentily infect grandma. It's the civil thing to do.
  - Tomte 6y ago
    That's wrong. The probability of dying is much lower when you're young and without obvious preconditions, but there are twenty year old patients dying that seemed perfectly healthy.
    - steveeq1 6y ago
      That's an outlier.
      - willbw 6y ago
        Yes but it's still a significant risk, would you not say? The coronavirus outbreak itself could be described as an outlier event, should we discount it?
        steveeq1 6y ago
        No, it's not a "significant risk". It's basically the flu to the young. The IFR for that age range in good health is basically in the ballpark of the flu, which is a rounding error.
Joof 6y ago
A vaccine seems weirdly plausible. We had a discussion on sending everyone under 30 to a giant Coachella for a month. I'd be so down.
- tpnCC 6y ago
  The issue with this approach is, it will not be possible to control the quantity or 'Infectious dose', which in the case of Covid19, may or may not affect how severely a person gets ill after infection. https://www.newscientist.com/article/2238819-does-a-high-viral-load-or-infectious-dose-make-covid-19-worse/ https://www.newscientist.com/article/2238819-does-a-high-vir...

klmadfejno 6y ago

In case anyone is thinking similarly, remember that vulnerable people (old people)'s social networks are mostly other vulnerable people. Even if herd immunity was "achieved" in the younger cohort, the old would be at basically the same level of risk because if one old person gets infected, it'll spread through the unprotected social network quite easily. You need it to be well mixed to be effective. That all being said, if theories of initial viral loads making a difference are true, it's not that crazy to imagine individuals choosing to self infect with a very small initial viral load so they can just stop needing to tip toe around life with the concern that they infect others, while continuing to isolate on their own. If I lived alone I'd be tempted.

ashtonkem 6y ago
You need to balance not jut your chance of death, which is low if you’re very young, but your chances of getting very very sick. Spending a few weeks in the ICU is a good way to bankrupt yourself on the path towards returning to regular work, let alone how hard a ventilator is on even survivors. Plus, we have no idea what happens to the infected a few years or a decade from now. If given the choice, not getting sick at all is the best possible outcome.
- notRobot 6y ago
  > Spending a few weeks in the ICU is a good way to bankrupt yourself Only in the US :|
  - lucioperca 6y ago
    LOL yes, only in the US your worst fear about spending a few weeks in a ICU are the bankrupting costs.
- steveeq1 6y ago
  > Spending a few weeks in the ICU is a good way to bankrupt yourself on the path towards returning to regular work, let alone how hard a ventilator is on even survivors. Ok, I'm willing to consider devil's argument, but this is just plain ridiculuous. The great bulk of infected people classsify this as "mild". If you're young, strong, and healthy, your chances of dying from this are basically zero in any common sense way. And far more people are going to "get bankrupt on the way to work" as you say using the current method. We're not trying to find a perfect solution, we are trying to find the better one.
  - mullingitover 6y ago
    > If you're young, strong, and healthy, your chances of dying from this are basically zero in any common sense way There are zero longitudinal studies about the long-term effects of infection. For all we know, young healthy people could appear to beat the virus, only for it to hide out and plague you with severe health problems down the road. We could have an massive epidemic of a neurodegenerative disease caused by Covid-19 twenty years from now. I have no desire to roll the dice on that even if the odds look good for me at the moment.
    - steveeq1 6y ago
      Oh come on, you can say that for any flu epidemic.
      - mullingitover 6y ago
        Yes you can[1], which is exactly why you don't really want to roll the dice even if you appear okay after the initial infection. [1] https://epmonthly.com/article/neuropsych-complications-flu-virus/ https://epmonthly.com/article/neuropsych-complications-flu-v...
        steveeq1 6y ago
        But you "roll the dice" with every flu epidemic.
- klmadfejno 6y ago
  I don't know why you would think the risk of death is dependent on age but the risk of severe illness is not. Age affects both. You're highly unlikely to get put in an ICU if you're young. It would be pretty improbable for a disease like this to have long term consequences unless you start going hypoxic and have organ damage. not impossible, but probably a low concern.
steveeq1 6y ago
Yeah, let herd immunity kick in so it's harder for the virus to spread and then STRICTLY quarantine the old. As in much stricter than what they have now. I realize that's not great for grandma, but at some point, society has to make a reasonable tradeoff. If you're young, strong and healthy, your probability of dying from it is basically a rounding error.
- pohl 6y ago
  We don’t even know if individuals can acquire immunity from infection, yet. (That’s a prerequisite to herd immunity.)
  - standardUser 6y ago
    We have no reason whatsoever to think infection doesn't confer immunity. All other human-infecting coronaviruses do. And with no confirmed cases of reinfection yet, there is no evidence showing that this virus breaks the norm.
    - steveeq1 6y ago
      Stop spreading misinformation. There are studies in South Korea that reinfection does not occur.
      - standardUser 6y ago
        You may have misread my comment.

empath75 6y ago

The strong and healthy are also dropping dead and we don’t know what the chronic, long term effects will be

rpiguy 6y ago
Doesn’t matter - a good portion of the US will never accept contract tracing, a prolonged shut down, mandatory antibody testing, or forced vaccination. It is illegal for states to prevent persons from neighboring, more constrictive states from traveling in and out. Given the Supreme Court make up it is unlikely any of the above would be upheld as constitutional. Therefore the US is heading toward a herd immunity strategy regardless of what technocrats think the end game will be. I laugh when I hear people talking about a vaccine. We can’t get people to vaccinate for diseases like measles that spread faster, are deadlier, and kill kids.
- maxerickson 6y ago
  MMR (measles is one of the M) vaccination rates are plenty high enough to get us to herd immunity for SAR-CoV-2 (we need something like 70% of the population being immune). Even in states with the worst coverage. It's closer to 90% in most of the country: https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxview/data-reports/mmr/trend/index.html https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxv... So what are you laughing at?
  - rpiguy 6y ago
    The idea that a vaccine could be mandatory. But thank you for agreeing we are heading toward herd immunity.
    - maxerickson 6y ago
      A 70% vaccination rate is one way to get to herd immunity. There's not much question about getting there eventually. The path we take is the question. You are apparently laughing that 10% of people will refuse a working vaccine and expose themselves to future risk? Fun.

skuhn 6y ago

Herd immunity is easier said than done. A portion of the people who become infected require medical intervention, and many parts of the US medical system are inadequate to meet this need. It will take years to get to herd immunity levels through any kind of controlled infection alone, and many will die. Take a look at the forecasts of hospital bed utilization if 20, 40, 60% of the population were to be infected over a 6, 12, or 18 month period: https://projects.propublica.org/graphics/covid-hospitals https://projects.propublica.org/graphics/covid-hospitals Anywhere on those maps that show red indicates people dying due to hospital resource exhaustion, either from COVID-19 or unrelated health issues. To a lesser degree this is happening in yellow areas as well. And ProPublica is only considering beds! Medical personnel, supplies and equipment are finite resources as well. Personnel cannot handle 18 months of 200% bed utilization, and they don't have the PPE they need as it is. There is no easy fix to this situation; we are facing the kind of problem that is best met with thorough preparation, but unfortunately we don't have that. The government can print money, and implement programs to distribute food and other necessities. They can't print tests or masks or vaccines -- once the resources are put in place, it simply takes time. Realistically, it will be a long time before even one of those three things is in a good place. Probably not this year. A more achievable goal than herd immunity is to find a workable way to reduce the number of viral carriers and limit transmission while we wait for the tests, masks and vaccines that we need to get society back on track. That requires leadership and coordination, but it especially requires us to accept the seriousness of the situation and behave responsibly.

lostapathy 6y ago
The big question about natural herd immunity is really how far the disease has already spread and what that means for true IFR. If New York has "survived" this wave tolerably and 20% of people are immune, they may well be a quarter of the way to herd immunity. Which is still a lot of suffering to go, but it's also not going to take 18 months of 200% hospital bed utilization either.
- rallison 6y ago
  1) The healthcare system barely handled the load, and that was with heroic efforts to reposition ventilators and build up temporary capacity. We barely handled it because most of the country was not nearly as hard hit, so we could still shift resources around. If everywhere was hit this hard at the same time, that would be a different story. It would need to be spread out more than you imply if we wanted to have all of the country trying to stay just below capacity. 2) New York City has lost .2% of their entire population to get to that ~20% number. Extrapolated out, that's once again back to the 1-2 million deaths range for the country to hit herd immunity.

KCUOJJQJ 6y ago

>It might be more economically efficient (and convenient) for the strong and healthy to purposefully self-infect If someone told me I should deliberately catch a cold I'd say no. What about Ebola? I'd say no! A germ that I don't know? I'd say no! If a police patrol arrived somewhere and someone ran away, that person would be suspicious. If I'm asked to get any germ I'd suspect that it's very dangerous, even if it was just a cold. So telling people to infect themselves deliberately won't work.

steveeq1 6y ago
Yeah, but strong young healthy won't die from it, but grandma will. Best to self-infect and quarantine so you don't accidentily infect grandma. It's the civil thing to do.
- Tomte 6y ago
  That's wrong. The probability of dying is much lower when you're young and without obvious preconditions, but there are twenty year old patients dying that seemed perfectly healthy.
  - steveeq1 6y ago
    That's an outlier.
    - willbw 6y ago
      Yes but it's still a significant risk, would you not say? The coronavirus outbreak itself could be described as an outlier event, should we discount it?
      - steveeq1 6y ago
        No, it's not a "significant risk". It's basically the flu to the young. The IFR for that age range in good health is basically in the ballpark of the flu, which is a rounding error.

Joof 6y ago

A vaccine seems weirdly plausible. We had a discussion on sending everyone under 30 to a giant Coachella for a month. I'd be so down.

tpnCC 6y ago
The issue with this approach is, it will not be possible to control the quantity or 'Infectious dose', which in the case of Covid19, may or may not affect how severely a person gets ill after infection. https://www.newscientist.com/article/2238819-does-a-high-viral-load-or-infectious-dose-make-covid-19-worse/ https://www.newscientist.com/article/2238819-does-a-high-vir...