8 ms·

I think this is the silver lining for this pandemic. Covid-19 is lethal, I'm not discounting that, but in terms of real lethality, this was a good test run to

by kemiller2002 6y ago

I think this is the silver lining for this pandemic. Covid-19 is lethal, I'm not discounting that, but in terms of real lethality, this was a good test run to show that this approach works. (At least in my lay person's knowledge.) What really scares me are the highly lethal flu strains (I think H5N5?) The fact that we can produce a vaccine this quickly now gives me hope when we encounter a scenario like out of the movie Contagion.

tialaramex 6y ago
High lethality is often associated with reduced transmissibility. Which makes sense - dead people certainly aren't going to cough on you. In a Sci Fi movie maybe the virus has a long delay, you're infectious for a month with no symptoms, then drop dead in seconds. But in the real world that's less likely the more extreme it gets. One thing that did make this virus more dangerous was that many humans became infectious significantly before they realised they had symptoms. With some viruses you get symptoms, then (sometimes as a result of the symptoms) you become infectious, making it easier for public health messages to be effective. "Stay at home if you have symptoms" is extremely effective if people aren't vectors until 12-24 hours after the symptoms are obvious, but almost useless if they're infectious a week earlier. I'd argue that countries which think the lesson is "We developed a vaccine quickly, good job" are mistaken. The lesson was just, "Elimination strategy works" and the many countries that didn't even attempt that got lucky they weren't decimated for their incompetence.
- fat-chunk 6y ago
  It makes me wonder how the world would cope today with a Bubonic Plague or Spanish Flu, those two I reckon would probably be more similar to your hypothetical Sci-Fi disease.
  - detaro 6y ago
    Bubonic Plague is still around, quite deadly if untreated, antibiotics work if given quickly enough (and are used as a preventative measure for contact persons). Large outbreaks are rare.
  - brodie 6y ago
    There's a sci-fi example of this in the TV show Counterpart. Kind of surreal watching it and then becoming a part of a real life pandemic.
    - ahepp 6y ago
      What does "non-hypothetical sci-fi" mean? Surely all sci-fi is hypothetical, in that "fi" stands for "fiction"?
      - brodie 6y ago
        Sorry, I misread the comment upthread. I meant to say the show is an instance of an actual sci-fi show that covers the topic.
      - RobertoG 6y ago
        I suppose that "hypothetical sci-fi" could be sci-fi that could be written but has never been
  - vonmoltke 6y ago
    On the Spanish Flu specifically, the evidence indicates most people who died were killed by secondary bacterial infection, not the virus itself[1]. This was the result of a combination of poor hygienic conditions and lack of antibiotics. Considering that, I think what we are witnessing with SARS-CoV-2 is about what the Spanish Flu would look like today. [1] https://academic.oup.com/jid/article/196/11/1717/886065 https://academic.oup.com/jid/article/196/11/1717/886065
    - heavyset_go 6y ago
      Bacterial pneumonia has a 30% death rate these days.
- ashtonkem 6y ago
  In many ways, this was a worst case scenario for countries without a history of fighting respiratory diseases. It’s lethal enough to rack up a significant body count, but “safe” enough for large portions of the population to disregard the risk and potentially transmit it. Oh, and it’s airborne and you’re infectious before you have symptoms. Ironically, a disease with a much higher case fatality rate probably would’ve killed fewer Americans, since we’d be more aligned on stopping it, and it would have a greater tendency to burn itself out.
  - soperj 6y ago
    You've got over 18000 people a week dying in the US from Covid-19. How many more people do you need?
    - ashtonkem 6y ago
      What a weirdly accusatory tone. For the record, I’m staying at home and I wear a mask. Save your accusations for those who actually advocate for behavior you disagree with. My point is entirely that the perception of risk has had a huge impact on compliance for social distancing and mask wearing. The fact that 99% of those infected survive (age dependent) has had a negative impact on compliance. If this had been a pandemic with a higher CFR, then compliance would have been even higher. I have an extremely hard time imagining there being an anti-lockdown movement for an outbreak of Ebola, for example.
      - soperj 6y ago
        1% is a huge amount of people dying. Death rate doesn't matter so much as the number of people getting it, why is why SARS with a much high death rate killed far fewer people than Covid-19.
        ashtonkem 6y ago
        Read what I said more carefully before replying. You’re largely reiterating what I’ve already said. Yes, 1% CFR is a lot of deaths, which is why ~3k Americans are dying per day. But 1% of personal risk is perceived as a low risk thing, hence the low compliance. Transmissibility is also a factor, of course.
- matz1 6y ago
  >Elimination strategy works If the strategy is 'everybody stay at home' then it work in the same way shot gun works in eliminating cancer. It works but the cure is worse than the disease.
  - lostlogin 6y ago
    It’s normal here in NZ and with the exception of borders, restrictions were removed a fair while ago. The economy is considerably better off than most expected too. https://i.stuff.co.nz/business/123696832/gdp-jump-of-14-per-cent-completes-nzs-vshaped-recovery https://i.stuff.co.nz/business/123696832/gdp-jump-of-14-per-...
    - matz1 6y ago
      Didn't nz had strict lockdown? Also from the article: However, Stats NZ national accounts manager Paul Pascoe said the effects of Covid-19 on different industries had varied “and for some industries these may persist for some time”. The rebound was not enough to make up for the lost activity during the lockdown period, with GDP in the 12 months ended on September 30 down 2.2 per cent on the prior year.
      - lostlogin 6y ago
        > Didn't nz had strict lockdown? Yes, and more than one. Community transmission was eliminated several times. The point is to compare the strategy to others.
        tialaramex 6y ago
        The entire country only locked down once, starting March, reducing to milder conditions in April and totally ending (going to "Alert Level 1" which isn't the same as before COVID but it's pretty much normality in everyday life) on June 9th. But Auckland (their biggest city), locked back down after another cluster of unknown origin was detected, perhaps related to an import business, for several weeks from August, and the rest of the country was at "Alert Level 2" in that period until the first week of October. Subsequent small outbreaks have not triggered a lockdown because their government remained confident it understood the scope of the infection although one leak got close, they asked people not to travel into central Auckland for a day or two at one point and sealed off a residential building while they tested everybody who lives there. They anticipate continuing to have occasional small outbreaks detected, e.g. a border worker gets infected, infects a family member before a test spots it - and their plans assume they will either quickly achieve confidence they've contained the outbreak or they'll lock a region or if necessary the entire country back down to eliminate. For example at a press conference the press basically wanted to know if the government was imagining people should prepare to pay for an extra week's accommodation on vacation in case they can't return home (obviously unaffordable to many families) but the government seemed to be more thinking about if you've left a week's cat food and instructions for a neighbour, do you have a way to tell them they need to feed your cat for an extra week? So, personal anxieties rather than population scale ones, the government can pick up a hotel bill but it can't bring your pets back to life.
- grokys 6y ago
  I've been wondering - would it be possible that something like HIV comes along, only airborne? This would be a nightmare scenario obviously, but is it possible?
  - kennywinker 6y ago
    Definitely possible, but I (not an expert) think unlikely. Viruses still have to contend with physics and limited resources. For example, by “something like hiv” do you mean something that acts very slowly, but eventually kills you? That indicates a low viral reproduction rate - which means you’re spreading far fewer virus particles than something like covid, thus a low transmission rate, even if airborn. Do you mean “attacks the immune system”? How does it get airborn, if it’s in the relatively few immune cells in the lungs? I suspect if you inhaled an aerosol of hiv particles you might catch it, but it doesn’t have a way of getting in the air. Again, not an expert/wild speculation, but I think the risk of something fast acting, highly transmissible, and highly lethal, is more of a concern than a slow-acting lethal virus.
- enraged_camel 6y ago
  >> High lethality is often associated with reduced transmissibility. I think the scariest combo would be long incubation time + transmissibility while asymptomatic + high lethality when symptoms appear. This type of virus would spread far and wide before it’s detected, and would also be very deadly.
  - sjg007 6y ago
    I mean HIV is this type of virus. It's not airborne though.
- inglor_cz 6y ago
  "High lethality is often associated with reduced transmissibility. Which makes sense - dead people certainly aren't going to cough on you." The worst case I can think of is an ubiquitous animal vector (rats? mice?) that only gets a mild form of the disease but can spread it, while people fall dead all around.
  - _ph_ 6y ago
    Like with the plague. This is why it stuck around for centuries while causing high death rates. Without the animal transmission it would have been much more contained. Obviously, it was made worse by people blaming cats and killing their best defense.
- Spooky23 6y ago
  The nasty part of coronavirus is that while you are most contagious in the first 24 hours of symptoms presenting, you are also meaningfully contagious for about 48 hours prior to symptoms appearing.
  - mixmastamyk 6y ago
    Interesting, have any links to this?
    - Spooky23 6y ago
      Sure. Here’s one link: https://medical.mit.edu/covid-19-updates/2020/07/how-long-symptom-onset-person-contagious https://medical.mit.edu/covid-19-updates/2020/07/how-long-sy... Contact tracing protocol is built around this, so I’m sure other references exist as well.

tialaramex 6y ago

High lethality is often associated with reduced transmissibility. Which makes sense - dead people certainly aren't going to cough on you. In a Sci Fi movie maybe the virus has a long delay, you're infectious for a month with no symptoms, then drop dead in seconds. But in the real world that's less likely the more extreme it gets. One thing that did make this virus more dangerous was that many humans became infectious significantly before they realised they had symptoms. With some viruses you get symptoms, then (sometimes as a result of the symptoms) you become infectious, making it easier for public health messages to be effective. "Stay at home if you have symptoms" is extremely effective if people aren't vectors until 12-24 hours after the symptoms are obvious, but almost useless if they're infectious a week earlier. I'd argue that countries which think the lesson is "We developed a vaccine quickly, good job" are mistaken. The lesson was just, "Elimination strategy works" and the many countries that didn't even attempt that got lucky they weren't decimated for their incompetence.

fat-chunk 6y ago
It makes me wonder how the world would cope today with a Bubonic Plague or Spanish Flu, those two I reckon would probably be more similar to your hypothetical Sci-Fi disease.
- detaro 6y ago
  Bubonic Plague is still around, quite deadly if untreated, antibiotics work if given quickly enough (and are used as a preventative measure for contact persons). Large outbreaks are rare.
- brodie 6y ago
  There's a sci-fi example of this in the TV show Counterpart. Kind of surreal watching it and then becoming a part of a real life pandemic.
  - ahepp 6y ago
    What does "non-hypothetical sci-fi" mean? Surely all sci-fi is hypothetical, in that "fi" stands for "fiction"?
    - brodie 6y ago
      Sorry, I misread the comment upthread. I meant to say the show is an instance of an actual sci-fi show that covers the topic.
    - RobertoG 6y ago
      I suppose that "hypothetical sci-fi" could be sci-fi that could be written but has never been
- vonmoltke 6y ago
  On the Spanish Flu specifically, the evidence indicates most people who died were killed by secondary bacterial infection, not the virus itself[1]. This was the result of a combination of poor hygienic conditions and lack of antibiotics. Considering that, I think what we are witnessing with SARS-CoV-2 is about what the Spanish Flu would look like today. [1] https://academic.oup.com/jid/article/196/11/1717/886065 https://academic.oup.com/jid/article/196/11/1717/886065
  - heavyset_go 6y ago
    Bacterial pneumonia has a 30% death rate these days.
ashtonkem 6y ago
In many ways, this was a worst case scenario for countries without a history of fighting respiratory diseases. It’s lethal enough to rack up a significant body count, but “safe” enough for large portions of the population to disregard the risk and potentially transmit it. Oh, and it’s airborne and you’re infectious before you have symptoms. Ironically, a disease with a much higher case fatality rate probably would’ve killed fewer Americans, since we’d be more aligned on stopping it, and it would have a greater tendency to burn itself out.
- soperj 6y ago
  You've got over 18000 people a week dying in the US from Covid-19. How many more people do you need?
  - ashtonkem 6y ago
    What a weirdly accusatory tone. For the record, I’m staying at home and I wear a mask. Save your accusations for those who actually advocate for behavior you disagree with. My point is entirely that the perception of risk has had a huge impact on compliance for social distancing and mask wearing. The fact that 99% of those infected survive (age dependent) has had a negative impact on compliance. If this had been a pandemic with a higher CFR, then compliance would have been even higher. I have an extremely hard time imagining there being an anti-lockdown movement for an outbreak of Ebola, for example.
    - soperj 6y ago
      1% is a huge amount of people dying. Death rate doesn't matter so much as the number of people getting it, why is why SARS with a much high death rate killed far fewer people than Covid-19.
      - ashtonkem 6y ago
        Read what I said more carefully before replying. You’re largely reiterating what I’ve already said. Yes, 1% CFR is a lot of deaths, which is why ~3k Americans are dying per day. But 1% of personal risk is perceived as a low risk thing, hence the low compliance. Transmissibility is also a factor, of course.
matz1 6y ago
>Elimination strategy works If the strategy is 'everybody stay at home' then it work in the same way shot gun works in eliminating cancer. It works but the cure is worse than the disease.
- lostlogin 6y ago
  It’s normal here in NZ and with the exception of borders, restrictions were removed a fair while ago. The economy is considerably better off than most expected too. https://i.stuff.co.nz/business/123696832/gdp-jump-of-14-per-cent-completes-nzs-vshaped-recovery https://i.stuff.co.nz/business/123696832/gdp-jump-of-14-per-...
  - matz1 6y ago
    Didn't nz had strict lockdown? Also from the article: However, Stats NZ national accounts manager Paul Pascoe said the effects of Covid-19 on different industries had varied “and for some industries these may persist for some time”. The rebound was not enough to make up for the lost activity during the lockdown period, with GDP in the 12 months ended on September 30 down 2.2 per cent on the prior year.
    - lostlogin 6y ago
      > Didn't nz had strict lockdown? Yes, and more than one. Community transmission was eliminated several times. The point is to compare the strategy to others.
      - tialaramex 6y ago
        The entire country only locked down once, starting March, reducing to milder conditions in April and totally ending (going to "Alert Level 1" which isn't the same as before COVID but it's pretty much normality in everyday life) on June 9th. But Auckland (their biggest city), locked back down after another cluster of unknown origin was detected, perhaps related to an import business, for several weeks from August, and the rest of the country was at "Alert Level 2" in that period until the first week of October. Subsequent small outbreaks have not triggered a lockdown because their government remained confident it understood the scope of the infection although one leak got close, they asked people not to travel into central Auckland for a day or two at one point and sealed off a residential building while they tested everybody who lives there. They anticipate continuing to have occasional small outbreaks detected, e.g. a border worker gets infected, infects a family member before a test spots it - and their plans assume they will either quickly achieve confidence they've contained the outbreak or they'll lock a region or if necessary the entire country back down to eliminate. For example at a press conference the press basically wanted to know if the government was imagining people should prepare to pay for an extra week's accommodation on vacation in case they can't return home (obviously unaffordable to many families) but the government seemed to be more thinking about if you've left a week's cat food and instructions for a neighbour, do you have a way to tell them they need to feed your cat for an extra week? So, personal anxieties rather than population scale ones, the government can pick up a hotel bill but it can't bring your pets back to life.
grokys 6y ago
I've been wondering - would it be possible that something like HIV comes along, only airborne? This would be a nightmare scenario obviously, but is it possible?
- kennywinker 6y ago
  Definitely possible, but I (not an expert) think unlikely. Viruses still have to contend with physics and limited resources. For example, by “something like hiv” do you mean something that acts very slowly, but eventually kills you? That indicates a low viral reproduction rate - which means you’re spreading far fewer virus particles than something like covid, thus a low transmission rate, even if airborn. Do you mean “attacks the immune system”? How does it get airborn, if it’s in the relatively few immune cells in the lungs? I suspect if you inhaled an aerosol of hiv particles you might catch it, but it doesn’t have a way of getting in the air. Again, not an expert/wild speculation, but I think the risk of something fast acting, highly transmissible, and highly lethal, is more of a concern than a slow-acting lethal virus.
enraged_camel 6y ago
>> High lethality is often associated with reduced transmissibility. I think the scariest combo would be long incubation time + transmissibility while asymptomatic + high lethality when symptoms appear. This type of virus would spread far and wide before it’s detected, and would also be very deadly.
- sjg007 6y ago
  I mean HIV is this type of virus. It's not airborne though.
inglor_cz 6y ago
"High lethality is often associated with reduced transmissibility. Which makes sense - dead people certainly aren't going to cough on you." The worst case I can think of is an ubiquitous animal vector (rats? mice?) that only gets a mild form of the disease but can spread it, while people fall dead all around.
- _ph_ 6y ago
  Like with the plague. This is why it stuck around for centuries while causing high death rates. Without the animal transmission it would have been much more contained. Obviously, it was made worse by people blaming cats and killing their best defense.
Spooky23 6y ago
The nasty part of coronavirus is that while you are most contagious in the first 24 hours of symptoms presenting, you are also meaningfully contagious for about 48 hours prior to symptoms appearing.
- mixmastamyk 6y ago
  Interesting, have any links to this?
  - Spooky23 6y ago
    Sure. Here’s one link: https://medical.mit.edu/covid-19-updates/2020/07/how-long-symptom-onset-person-contagious https://medical.mit.edu/covid-19-updates/2020/07/how-long-sy... Contact tracing protocol is built around this, so I’m sure other references exist as well.