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1 is insufficiently clear. Is the endgame 1) getting new infections down to such a small number that they can be individually detected and isolated, 2) keeping

1 is insufficiently clear. Is the endgame 1) getting new infections down to such a small number that they can be individually detected and isolated, 2) keeping hospital utilization from overrunning capacity while allowing the population to reach herd immunity, or 3) staying in lockdown until we have a vaccine or cure? Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.

ceejayoz 6y ago
#1 likely isn't possible in the US. The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.
- dabbledash 6y ago
  I agree that 1 seems impossible. I think 3 is impossible without complete economic and social collapse. 2 would involve loosening restrictions and allowing spread that doesn’t quite max out capacity. It looks like 2 is functionally what the states are going to pursue, while no one admits it out loud, and the people who thought we were doing #1 express horror. Edited: meant to say states are doing 2 (comment initially said they are doing 3)
  - deleted 6y ago
    [deleted]
  - ceejayoz 6y ago
    No reason you can't do #2 while waiting for #3 to work.
    - Zach_the_Lizard 6y ago
      The longer you do #2, the less you need #3, if the goal of #2 is to keep hospitals being utilized at the highest sustainable capacity with whatever safety margins are required. As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced. Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller. I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
      - lbeltrame 6y ago
        Most of the companies and universities working on vaccines have experience on earlier coronaviruses: for example Moderna and the Jenner Institute / Vaccitech worked previously with MERS vaccines. So they're not starting from scratch. Other companies like Sinovac have also been doing challenge testing already (I believe Oxford too, but AFAICS they haven't published anything yet) in animals, so far with good results. EDIT: Sinovac findings were a preprint, but now it's been published in Science, so I guess it has more weight. Also to speed up trials, Oxford is doing a hybrid Phase II / Phase III trial, hoping to get emergency use authorization in September if vaccine responses are positive. Lastly, most companies and consortia are ramping up manufacturing at-risk (because there's no guarantee vaccines will work) to make sure the demand is met earlier. So it is likely that if a vaccine works, it will be around earlier than before. Whether everyone will be able to have it, is a different matter entirely.

ceejayoz 6y ago

#1 likely isn't possible in the US. The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.

dabbledash 6y ago
I agree that 1 seems impossible. I think 3 is impossible without complete economic and social collapse. 2 would involve loosening restrictions and allowing spread that doesn’t quite max out capacity. It looks like 2 is functionally what the states are going to pursue, while no one admits it out loud, and the people who thought we were doing #1 express horror. Edited: meant to say states are doing 2 (comment initially said they are doing 3)
- deleted 6y ago
  [deleted]
- ceejayoz 6y ago
  No reason you can't do #2 while waiting for #3 to work.
  - Zach_the_Lizard 6y ago
    The longer you do #2, the less you need #3, if the goal of #2 is to keep hospitals being utilized at the highest sustainable capacity with whatever safety margins are required. As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced. Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller. I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
    - lbeltrame 6y ago
      Most of the companies and universities working on vaccines have experience on earlier coronaviruses: for example Moderna and the Jenner Institute / Vaccitech worked previously with MERS vaccines. So they're not starting from scratch. Other companies like Sinovac have also been doing challenge testing already (I believe Oxford too, but AFAICS they haven't published anything yet) in animals, so far with good results. EDIT: Sinovac findings were a preprint, but now it's been published in Science, so I guess it has more weight. Also to speed up trials, Oxford is doing a hybrid Phase II / Phase III trial, hoping to get emergency use authorization in September if vaccine responses are positive. Lastly, most companies and consortia are ramping up manufacturing at-risk (because there's no guarantee vaccines will work) to make sure the demand is met earlier. So it is likely that if a vaccine works, it will be around earlier than before. Whether everyone will be able to have it, is a different matter entirely.