5 ms·

Third option: we fight it with drugs and we prevent / reduce hospitalizations, and it becomes a disease like every other.

zxexz 6y ago
Vaccines will help with that, like with the flu.
missosoup 6y ago
No, that's the first option - it will eventually infect the whole world no matter how much you improve outcomes or slow it down. Unmitigated R0 of SARS-CoV-2 is extremely high, we can't keep it contained with spreaders all over the globe creating micro clusters every day. I didn't say it'll kill the whole world, just infect. Many countries have already brought their case rates down to almost 0, and every single one that attempted to resume economic activity saw the case rates spike again, with many now re-introducing distancing measures again. This genie is not going back into the bottle. The first option is actually potentially more viable on a reasonable timeline than vaccination, especially if we manage to find some kind of effective therapeutics which reduce the ICU and mortality rates. There is however a potential issue, which is based on SARS data, immunity in recovered individuals only lasts 1-2 years. So unless there's a concerted effort to eradicate via immunisation, there's a measurable risk that SARS-CoV-2 will become a seasonal repeating wave like Influenza.
- lbeltrame 6y ago
  I have no hard data (and I don't think anyone has, at this point), but eradication is IMO going to be tricky even if we have a very potent vaccine, at least looking at how much it took for chicken pox.
  - missosoup 6y ago
    Oh absolutely. Eradicating this thing via vaccination any time in the next 24 months will take a completely unprecedented feat of worldwide collaboration. But I'm optimistic, the current situation has everyone focused on the issue. Except Trump trying to get some special deals for early access or whatever the fuck it is that he's doing.
    - SpicyLemonZest 6y ago
      Any country that physically manufactures vaccine doses isn't going to allow many exports until they have a sufficient domestic supply. That's not just a Trump thing.
      - lbeltrame 6y ago
        That's precisely why many vaccine producers are seeking partnership and starting manufacturing at risk. As an example, Moderna teamed up with Lonza (and also got a big grant from BARDA). Oxford / Vaccitech has deals with Astra Zeneca, Merck, and a few other manufacturers.
rsynnott 6y ago
If a useful treatment shows up, that would certainly be an option, though vaccination would be preferable if feasible.
SpicyLemonZest 6y ago
The obvious comparison is tuberculosis, where vaccination (albeit not universal vaccination) is a critical component of our control measures. Even if we find a strongly effective treatment, which I agree there's reason for optimism on, we'll still want a vaccine.
- teknopaul 6y ago
  Yeah, lockdown == prevent. ICU == treat. At the moment thats all we have
  - lbeltrame 6y ago
    Many doctors are actually experimenting different treatments, even handling in the ICU has shifted compared to two months ago. The problem is that most of the pharmacological evidence is sparse and anecdotal at worst (except for remedisivir, and now lopinavir/ritonavir/ribavirin/interferon beta). Trials are ongoing and should at least give better answers, or hints. Protocols change among countries or even across hospitals, so it's kind of hard to figure out which treatment is best. There's a lot of road to cover to come to proper treatments, but if we are to believe case reports, it is undoubtedly much better than when the pandemic started hitting the West.

zxexz 6y ago

Vaccines will help with that, like with the flu.

missosoup 6y ago

No, that's the first option - it will eventually infect the whole world no matter how much you improve outcomes or slow it down. Unmitigated R0 of SARS-CoV-2 is extremely high, we can't keep it contained with spreaders all over the globe creating micro clusters every day. I didn't say it'll kill the whole world, just infect. Many countries have already brought their case rates down to almost 0, and every single one that attempted to resume economic activity saw the case rates spike again, with many now re-introducing distancing measures again. This genie is not going back into the bottle. The first option is actually potentially more viable on a reasonable timeline than vaccination, especially if we manage to find some kind of effective therapeutics which reduce the ICU and mortality rates. There is however a potential issue, which is based on SARS data, immunity in recovered individuals only lasts 1-2 years. So unless there's a concerted effort to eradicate via immunisation, there's a measurable risk that SARS-CoV-2 will become a seasonal repeating wave like Influenza.

lbeltrame 6y ago
I have no hard data (and I don't think anyone has, at this point), but eradication is IMO going to be tricky even if we have a very potent vaccine, at least looking at how much it took for chicken pox.
- missosoup 6y ago
  Oh absolutely. Eradicating this thing via vaccination any time in the next 24 months will take a completely unprecedented feat of worldwide collaboration. But I'm optimistic, the current situation has everyone focused on the issue. Except Trump trying to get some special deals for early access or whatever the fuck it is that he's doing.
  - SpicyLemonZest 6y ago
    Any country that physically manufactures vaccine doses isn't going to allow many exports until they have a sufficient domestic supply. That's not just a Trump thing.
    - lbeltrame 6y ago
      That's precisely why many vaccine producers are seeking partnership and starting manufacturing at risk. As an example, Moderna teamed up with Lonza (and also got a big grant from BARDA). Oxford / Vaccitech has deals with Astra Zeneca, Merck, and a few other manufacturers.

rsynnott 6y ago

If a useful treatment shows up, that would certainly be an option, though vaccination would be preferable if feasible.

SpicyLemonZest 6y ago

The obvious comparison is tuberculosis, where vaccination (albeit not universal vaccination) is a critical component of our control measures. Even if we find a strongly effective treatment, which I agree there's reason for optimism on, we'll still want a vaccine.

teknopaul 6y ago
Yeah, lockdown == prevent. ICU == treat. At the moment thats all we have
- lbeltrame 6y ago
  Many doctors are actually experimenting different treatments, even handling in the ICU has shifted compared to two months ago. The problem is that most of the pharmacological evidence is sparse and anecdotal at worst (except for remedisivir, and now lopinavir/ritonavir/ribavirin/interferon beta). Trials are ongoing and should at least give better answers, or hints. Protocols change among countries or even across hospitals, so it's kind of hard to figure out which treatment is best. There's a lot of road to cover to come to proper treatments, but if we are to believe case reports, it is undoubtedly much better than when the pandemic started hitting the West.