4 ms·

I mostly agree with you, but have a couple of disagreements. and in my opinion, less COVID-19 mortality over the medium-term. I think you're missing one facto

I mostly agree with you, but have a couple of disagreements. and in my opinion, less COVID-19 mortality over the medium-term. I think you're missing one factor, which is the fact that evolutionary pressures will cause the virus to become better able to transmit, but also less likely to cause fatalities. That's the normal course of such things - consider that a virus that kills its host is no longer able to transmit itself to others, so strains that don't kill the host will reproduce more effectively. And there's some evidence that this is happening with covid-19. Ignoring other factors, being able to stretch things out over time to amplify this evolutionary pressure will probably result in fewer fatalities, even with the same total number of effected. But I don't know how that balances against the other factors that you're pointing out. We have good bounds on our IFR, leading me to settle on a final number of around .30%. The latest scenarios published by the CDC, as of a day or two ago, puts the most likely scenario at 0.65% EDIT: citation for my 2nd point: https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html#table-1 https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...

bad_user 6y ago
Evolutionary pressure selects for survival, however the "less likely to kill" is entirely your assumption. Case in point – the second wave of the Spanish flu was much deadlier than the first wave. And the third wave was less deadly than the second, but still more deadly than the first wave. If the virus infects hosts efficiently, and this one does, no, it will not have evolutionary pressure to be milder.
- CWuestefeld 6y ago
  Evolutionary pressure selects for survival, however the "less likely to kill" is entirely your assumption. No. For example: https://www.westernmassnews.com/news/could-covid-19-weaken-over-time-local-microbiologist-weighs-in/article_dffaa0ea-a9c7-11ea-936b-f3747ca78635.html https://www.westernmassnews.com/news/could-covid-19-weaken-o... Two Italian doctors claim they are increasingly seeing weaker and less deadly cases of COVID-19 in the country. Hamilton said it's not uncommon for a virus to become less pathogenic as time goes on. “Over time they become less dangerous or less virulent because they just want to live in you and replicate in you,” she said. Hamilton said viruses, in general, are trying to pass on their genetic material. “In some pathogens, it’s actually better if they don’t kill you because if you’re still alive, you’re more likely to spread them around,” she said. This is why she said some of the most successful viruses raise the fewest red flags “Things like head colds or warts,” she said.
  - bad_user 6y ago
    Yes, still an assumption. It's like saying evolution selects for intelligence, which would be silly because no, it doesn't, even if it happened for a couple of species. If the virus transmits efficiently, having a high enough R0, it has no pressure to evolve to something milder. SARS-Cov-1 lacked the contagious pre-symptomatic period. Note how SARS-Cov-2 keeps going strong despite the worst restrictions we've seen in our lifetime.
amluto 6y ago
> I think you're missing one factor, which is the fact that evolutionary pressures will cause the virus to become better able to transmit, but also less likely to cause fatalities. That's the normal course of such things - consider that a virus that kills its host is no longer able to transmit itself to others, so strains that don't kill the host will reproduce more effectively. And there's some evidence that this is happening with covid-19. Citation, please. As I undetermined it, coronaviruses evolve quite slowly compared to many other viruses. In a perhaps optimistic scenario in which we have a widely available, safe, effective vaccine in early-mid 2021, there may well be no appreciable evolution of the disease before it’s mostly eradicated from the developed world. In that scenario, the real outcomes to consider are the number of deaths and disabilities caused over the next year or so, the economic and other costs of people getting sick, and the cost (economic, social, etc) of the lockdowns and other countermeasures. My personal belief is that countries like Taiwan and New Zealand are taking the right approach. If they continue on their current course and a vaccine shows up next year, then they will manage to keep total deaths near zero at moderate economic cost. If the entire world had pulled this off, then COVID-19 could plausibly be gone by now.
- CWuestefeld 6y ago
  Citation, please. https://justthenews.com/politics-policy/coronavirus/doctors-around-world-say-covid-19-losing-its-potency-becoming-less https://justthenews.com/politics-policy/coronavirus/doctors-... Quoting the article, and if you go there, there are numerous links to the actual studies: Some physicians and scientists in the United States have lately also announced findings that the disease is getting weaker. One of them, Donald Yealy—the chair of emergency medicine at the University of Pittsburgh Medical Center—claims that "some patterns [of COVID-19] suggest the potency is diminished." "The virus may be changing," he said earlier this week, adding that fewer people in the Pittsburgh area are contracting the disease, and the infections themselves appear weaker. Maria Van Kerkhove, an epidemiologist with the World Health Organization, told media after Yealy's remarks that neither the virus's transmissibility nor its severity have diminished as Yealy claimed. Yet several other American scientists, including some at Arizona State University, announced findings in May that could bolster claims that the virus is less deadly than it once was. The scientists at ASU said that they had detected a gene deletion in one sample from several hundred Arizona patients that potentially reduced the fitness of the disease. Notably, they claimed it was similar to a deleted sequence observed in the 2003 SARS virus that was observed near the end of that disease's epidemic—possibly signaling that COVID-19 may be bound for a similar fate. Those conclusions were echoed by scientists in Spain this week, who proposed that COVID-19 may have adopted what the researchers call a "don't burn down the house" strategy, "reducing the severity of the infection and tissue damage without losing transmission capability." In effect, the disease could be opting to become less lethal so that it can spread more easily—a hallmark of evolutionary behavior, and also a boon for anyone who gets infected with the milder strain. Data do appear to indicate that the virus may be losing its edge. The statistics website Worldometers, for instance, shows an unmistakably lopsided trend: Though the number of confirmed global cases has been increasing since the start of the pandemic, the number of global deaths has been trending downward since mid-April. If that pattern holds, it may point to the conclusion that these few skeptical doctors are correct: That the coronavirus, like SARS before it, will eventually burn out in part due to its own viral mechanisms, without the need for a vaccine or for lockdown measures that have slowed the global economy.
__blockcipher__ 6y ago
(1) Yes, the evolutionary pressures are possible. There's also the related notion of treatments getting better over time, etc. Basically, and you alluded to this, my position is those effects may occur to some extent, but will be massively dwarfed by the downsides of trying to slow down the timeline. (2) As far as the CDC, I hate to be that guy but I don't trust their numbers very much. I'm just a bit suspicious of them upwardly revising their number at this point in time, especially given the statements coming out of the CDC head which seem to lack any type of nuance. In particular, they are modelling asymptomatic spread but not pre-symptomatic? Weird. But yes, I generally give a range of .1-.7%, but settled on .30% as the best number for my purposes. It's more-or-less pulled out of my ass, although it is almost exactly the median in the big spreadsheet of IFR estimates which I now cannot find the link to (grr) Anyway, the important thing is for my "argument", it actually doesn't matter to me if the IFR is .3% or .9%. The costs of lockdown just end up being too risky. So, feel free to ignore my mistrust of the CDC. Note that Ferguson's classic (albeit incredibly myopic) paper models an IFR of .9% and 82% of the US population being infected, with an end result of 2.2 million. With these T-cell findings and other findings, we might see like 1/4 as many total infections, so even with the same IFR that gives us a shitty upper bound of 600k.

bad_user 6y ago

Evolutionary pressure selects for survival, however the "less likely to kill" is entirely your assumption. Case in point – the second wave of the Spanish flu was much deadlier than the first wave. And the third wave was less deadly than the second, but still more deadly than the first wave. If the virus infects hosts efficiently, and this one does, no, it will not have evolutionary pressure to be milder.

CWuestefeld 6y ago
Evolutionary pressure selects for survival, however the "less likely to kill" is entirely your assumption. No. For example: https://www.westernmassnews.com/news/could-covid-19-weaken-over-time-local-microbiologist-weighs-in/article_dffaa0ea-a9c7-11ea-936b-f3747ca78635.html https://www.westernmassnews.com/news/could-covid-19-weaken-o... Two Italian doctors claim they are increasingly seeing weaker and less deadly cases of COVID-19 in the country. Hamilton said it's not uncommon for a virus to become less pathogenic as time goes on. “Over time they become less dangerous or less virulent because they just want to live in you and replicate in you,” she said. Hamilton said viruses, in general, are trying to pass on their genetic material. “In some pathogens, it’s actually better if they don’t kill you because if you’re still alive, you’re more likely to spread them around,” she said. This is why she said some of the most successful viruses raise the fewest red flags “Things like head colds or warts,” she said.
- bad_user 6y ago
  Yes, still an assumption. It's like saying evolution selects for intelligence, which would be silly because no, it doesn't, even if it happened for a couple of species. If the virus transmits efficiently, having a high enough R0, it has no pressure to evolve to something milder. SARS-Cov-1 lacked the contagious pre-symptomatic period. Note how SARS-Cov-2 keeps going strong despite the worst restrictions we've seen in our lifetime.

amluto 6y ago

> I think you're missing one factor, which is the fact that evolutionary pressures will cause the virus to become better able to transmit, but also less likely to cause fatalities. That's the normal course of such things - consider that a virus that kills its host is no longer able to transmit itself to others, so strains that don't kill the host will reproduce more effectively. And there's some evidence that this is happening with covid-19. Citation, please. As I undetermined it, coronaviruses evolve quite slowly compared to many other viruses. In a perhaps optimistic scenario in which we have a widely available, safe, effective vaccine in early-mid 2021, there may well be no appreciable evolution of the disease before it’s mostly eradicated from the developed world. In that scenario, the real outcomes to consider are the number of deaths and disabilities caused over the next year or so, the economic and other costs of people getting sick, and the cost (economic, social, etc) of the lockdowns and other countermeasures. My personal belief is that countries like Taiwan and New Zealand are taking the right approach. If they continue on their current course and a vaccine shows up next year, then they will manage to keep total deaths near zero at moderate economic cost. If the entire world had pulled this off, then COVID-19 could plausibly be gone by now.

CWuestefeld 6y ago
Citation, please. https://justthenews.com/politics-policy/coronavirus/doctors-around-world-say-covid-19-losing-its-potency-becoming-less https://justthenews.com/politics-policy/coronavirus/doctors-... Quoting the article, and if you go there, there are numerous links to the actual studies: Some physicians and scientists in the United States have lately also announced findings that the disease is getting weaker. One of them, Donald Yealy—the chair of emergency medicine at the University of Pittsburgh Medical Center—claims that "some patterns [of COVID-19] suggest the potency is diminished." "The virus may be changing," he said earlier this week, adding that fewer people in the Pittsburgh area are contracting the disease, and the infections themselves appear weaker. Maria Van Kerkhove, an epidemiologist with the World Health Organization, told media after Yealy's remarks that neither the virus's transmissibility nor its severity have diminished as Yealy claimed. Yet several other American scientists, including some at Arizona State University, announced findings in May that could bolster claims that the virus is less deadly than it once was. The scientists at ASU said that they had detected a gene deletion in one sample from several hundred Arizona patients that potentially reduced the fitness of the disease. Notably, they claimed it was similar to a deleted sequence observed in the 2003 SARS virus that was observed near the end of that disease's epidemic—possibly signaling that COVID-19 may be bound for a similar fate. Those conclusions were echoed by scientists in Spain this week, who proposed that COVID-19 may have adopted what the researchers call a "don't burn down the house" strategy, "reducing the severity of the infection and tissue damage without losing transmission capability." In effect, the disease could be opting to become less lethal so that it can spread more easily—a hallmark of evolutionary behavior, and also a boon for anyone who gets infected with the milder strain. Data do appear to indicate that the virus may be losing its edge. The statistics website Worldometers, for instance, shows an unmistakably lopsided trend: Though the number of confirmed global cases has been increasing since the start of the pandemic, the number of global deaths has been trending downward since mid-April. If that pattern holds, it may point to the conclusion that these few skeptical doctors are correct: That the coronavirus, like SARS before it, will eventually burn out in part due to its own viral mechanisms, without the need for a vaccine or for lockdown measures that have slowed the global economy.

__blockcipher__ 6y ago

(1) Yes, the evolutionary pressures are possible. There's also the related notion of treatments getting better over time, etc. Basically, and you alluded to this, my position is those effects may occur to some extent, but will be massively dwarfed by the downsides of trying to slow down the timeline. (2) As far as the CDC, I hate to be that guy but I don't trust their numbers very much. I'm just a bit suspicious of them upwardly revising their number at this point in time, especially given the statements coming out of the CDC head which seem to lack any type of nuance. In particular, they are modelling asymptomatic spread but not pre-symptomatic? Weird. But yes, I generally give a range of .1-.7%, but settled on .30% as the best number for my purposes. It's more-or-less pulled out of my ass, although it is almost exactly the median in the big spreadsheet of IFR estimates which I now cannot find the link to (grr) Anyway, the important thing is for my "argument", it actually doesn't matter to me if the IFR is .3% or .9%. The costs of lockdown just end up being too risky. So, feel free to ignore my mistrust of the CDC. Note that Ferguson's classic (albeit incredibly myopic) paper models an IFR of .9% and 82% of the US population being infected, with an end result of 2.2 million. With these T-cell findings and other findings, we might see like 1/4 as many total infections, so even with the same IFR that gives us a shitty upper bound of 600k.