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I really want to see positive news, and the vaccination rollout (despite how uneven it is) is definitely positive. But the focus on herd immunity, if conflated

I really want to see positive news, and the vaccination rollout (despite how uneven it is) is definitely positive. But the focus on herd immunity, if conflated with immunity after infection, is misleading: Look at what's happening in Manaus: https://www.bmj.com/content/372/bmj.n394 https://www.bmj.com/content/372/bmj.n394 The news there are definitely sobering :( Unfortunately, the multiplication of strains of covid19 was inevitable, due to the decision of multiple countries to let the disease spread almost unchecked through its population :/

alfiedotwtf 6y ago
AFAICS this isn’t talked about enough! If lockdowns were taken seriously from the start, it would had prevented going wild and risking new strains. But here we are
- carlmr 6y ago
  >If lockdowns were taken seriously from the start, it would had prevented going wild and risking new strains. I don't think a strategy that needs every country on earth to cooperate this tightly ever had a chance to work. Most countries aren't the first world, most countries don't have the resources to test and quarantine properly, most countries can't afford lockdowns. On top of that a lot of countries have much worse disease to deal with, Malaria for example, for them this is just one of many, and not such a terrible one. There will be mutations, this will come back a few times, maybe it becomes milder on its own, but thinking you can keep it from mutating is Quixotic.
  - tialaramex 6y ago
    The long distance travel which spreads a pandemic so fast now is predominantly a First World thing. We could and should have shut that down. A month after we knew we were in deep trouble it was still perfectly normal to decide hey this is boring I'll go on vacation to somewhere with nowhere near the capacity needed to handle COVID-19. Oh, I have a little cough, never mind if I feel sick I'll just fly home after I'm done infecting these people. Remember this is SARS-CoV-2. Where's the mutations and endless new strains of SARS-CoV-1? There aren't any, it was eliminated in humans. So yes it is now sadly likely we're stuck with this, but we ought to be clear it's our fault in countries that didn't do even one tenth of what they should to prevent it.
    - carlmr 6y ago
      >Remember this is SARS-CoV-2. Where's the mutations and endless new strains of SARS-CoV-1? There aren't any, it was eliminated in humans. I think this is only because it was contained in China before it reached the world. They had an excellent pandemic response and quashed it before it reached other countries. This time around it had spread around the world before we even heard about it. It was completely predictable containment efforts would be futile.
      - nopzor 6y ago
        sars definitely reached other countries outside of china..
      - curlypaul924 6y ago
        > I think this is only because it was contained in China before it reached the world Is this true? According to the CDC, there were SARS cases reported in Europe and the Americas prior to containment in China. Why was it different this time around?
        cperciva 6y ago
        SARS was more lethal and people actually took public health measures seriously.
        lazide 6y ago
        Additionally, SARS v1 was not contagious until there were visible symptoms - a huge difference from COVID/SARS v2.
        cperciva 6y ago
        I wouldn't put too much confidence in that. SARS wasn't known to be contagious presymptomatically, but neither was COVID-19 for many months. Levels of presymptomatic transmission similar to COVID-19 are entirely consistent with the evidence we have from SARS.
  - acdha 6y ago
    > I don't think a strategy that needs every country on earth to cooperate this tightly ever had a chance to work. It doesn’t need anything that drastic: imagine an alternate history where the Taiwanese warnings in December 2019 had been taken seriously and international travel was locked down with a mandatory three week quarantine (adjusted by the later availability of tests) on arrival. That would require no cooperation from any other government, and it would have kept spread down below the level where contact tracing and other measures could be effective. Making it a delay avoided the obvious failures like an outright ban packing as many people as possible into crowded transportation and customs facilities, and means that critically important travel could still happen. The problem was that businesses like the travel industry are influential and delayed until it was too well established in most countries and once it had successfully been turned into a political shibboleth, the chances of lighter approaches working plummeted.
    - berdario 6y ago
      > Taiwanese warnings The disease originated in Wuhan, mainland China, not Taiwan. The emergency was communicated in China (as well as Taiwan): http://py.cnhubei.com/py_news/2019/1231/3290.shtml http://py.cnhubei.com/py_news/2019/1231/3290.shtml Sure, listening to any official source would've been better than what happened... But shutting down travel to/from the whole of China (since otherwise you'd have to trust every passenger to declare if they had been in Wuhan) while there were less then 30/40 cases of pneumonia, and not a single death would've been a really difficult measure to sell
      - acdha 6y ago
        > The disease originated in Wuhan, mainland China, not Taiwan. Yes, I’m aware - try more carefully reading my comment and note that I never said otherwise. What I was referring to was Taiwan being faster to acknowledge human to human spread when the Chinese government was still in damage control mode and WHO was following their official statements saying there was no confirmation of retransmission. This happened 2 weeks later: https://www.who.int/csr/don/14-january-2020-novel-coronavirus-thailand-ex-china/en/ https://www.who.int/csr/don/14-january-2020-novel-coronaviru... Taiwan had begun health screenings of travelers from Wuhan on December 31st, following their request to WHO and the China CDC for more information. By the time the first case was detected 3 weeks later they’d already activated a substantial public health plan — not because they were prescient but because SARS had given key officials a strong sense of the importance of not delaying.
  - jimbokun 6y ago
    > Most countries aren't the first world, most countries don't have the resources to test and quarantine properly, most countries can't afford lockdowns. The United States meets all these criteria, and has the highest number of cases and deaths in the world. (And near the top in per-capita measures, too.)
    - makomk 6y ago
      Of course a country with the resources to test properly has the highest number of cases and deaths in the world, because if you can't test properly you can't detect Covid-19 cases and deaths. I know the American press has fed its citizens a load of nonsense about this for nakedly partisan reasons, just like it has with every other part of the Covid-19 crisis, and it's getting tiring...
      - carlmr 6y ago
        That of course is another thing to mention. Kind of like the EU countries talking badly about England after they discovered a more infectious mutation. In Germany at the time they didn't even sequence enough viruses to detect mutations before they're widespread.
    - carlmr 6y ago
      I was listing the necessary, not the sufficient criteria. The United States could but it doesn't because the political system is too federalized for a centralized response.
  - tgsovlerkhgsel 6y ago
    > I don't think a strategy that needs every country on earth to cooperate this tightly ever had a chance to work. It doesn't need that though. It needs countries to close the borders tightly except to countries that do cooperate, as many Asian countries have successfully done.
    - carlmr 6y ago
      If your goal is to stop mutations from happening, yes, you need everyone in the world to go on full lockdown for 4 weeks. And then test everybody and quarantine until the disease is gone. The situation right now is that you have plenty of breeding grounds for new mutations, and it only needs some minor crossing of borders for these to get through. I would also say it's infeasible for non-island nations that need to trade with other countries to completely lock the borders.
- cwhiz 6y ago
  Lockdowns were never going to work, and any strategy that relied on them was doomed to fail. A strategy that involves convincing every country, and every little province, to destroy their local economies, all at the same time. I can’t believe it didn’t work! Maybe if we just keep trying.
  - praestigiare 6y ago
    Lockdowns do not destroy the economy. Anti-maskers destroy the economy, by decreasing the effectiveness of lockdowns, and making them a chronic rather than acute necessity.
    - Mediterraneo10 6y ago
      The relationship between COVID and the local economy is highly country-dependent. For example, several Balkan countries’ economies are very dependent on their diasporas (and the occasional tourists) driving/flying back and spending loads of money earned in the West. This is why even now they have remained open to travelers and avoided hard lockdowns, even if COVID deaths might result. And then there are countries where the economy is based on resource extraction. Only a relatively tiny amount of people is necessary to work the oil and gas industry, or whatever, and thinktanks have sometimes bluntly referred to all the remaining millions of people as "superfluous population". So, whether you let COVID spread or not has little overall effect on the economy.
      - armagon 6y ago
        I live in Alberta, Canada, which is heavily reliant on resource extraction -- namely, oil. With all the lockdowns (and people voluntarily staying at home), demand for oil has tanked. If there weren't lockdowns (and people were travelling again), our economy would be doing much better. [With all that said, and while I dearly missing socializing, it isn't obvious to me that removing the lockdowns would improve things; on the other hand, it isn't obvious to me that letting the disease run rampant would be worse than the mental and emotional toll the lockdowns are taking on people and the economy. So many poorly understood trade-offs.]
cheph 6y ago
> Manaus shows that pursuing herd immunity through natural infection is not a guarantee. Not a guarantee of what? Are we suggesting that we have a virus here that, unlike every previous virus, we can only reach herd immunity for with a vaccine?
- reissbaker 6y ago
  > Unlike every previous virus Have we reached "herd immunity" for syphilis? Herpes? Was smallpox eradicated via "herd immunity" that wasn't reached via a vaccine? Polio? It is extremely common for viruses to not be eradicated unless there is a vaccine. Even vaccines are not guaranteed to be enough, e.g. with most influenza strains, although flu vaccines have managed to keep the death toll low enough for us to move on with our lives.
  - timr 6y ago
    > Have we reached "herd immunity" for syphilis? Syphilis is a bacterial infection. You can get it more than once. There is no such thing as herd immunity. > Herpes? ...is transmitted via intimate, direct contact. You don't get herpes by walking into a crowded room, and there's no way to be "immune" to herpes without also being a carrier. Herd immunity isn't a relevant concept. > Was smallpox eradicated via "herd immunity" that wasn't reached via a vaccine? Smallpox was eradicated by herd immunity that was achieved via a mixture of natural and vaccine-induced immunity. Initially, a large portion of the population was immune due to natural infection. Over time, vaccinations were targeted to local outbreaks. > Polio? We have not eradicated polio. In some (now 3) countries, polio is endemic, and outbreaks are self-regulated by herd immunity. Herd immunity does not mean that a disease is eliminated. It means that the spread of the disease is naturally controlled.
    - ganafagol 6y ago
      > Herd immunity does not mean that a disease is eliminated. It means that the spread of the disease is naturally controlled. Not necessarily "naturally".

alfiedotwtf 6y ago

AFAICS this isn’t talked about enough! If lockdowns were taken seriously from the start, it would had prevented going wild and risking new strains. But here we are

carlmr 6y ago
>If lockdowns were taken seriously from the start, it would had prevented going wild and risking new strains. I don't think a strategy that needs every country on earth to cooperate this tightly ever had a chance to work. Most countries aren't the first world, most countries don't have the resources to test and quarantine properly, most countries can't afford lockdowns. On top of that a lot of countries have much worse disease to deal with, Malaria for example, for them this is just one of many, and not such a terrible one. There will be mutations, this will come back a few times, maybe it becomes milder on its own, but thinking you can keep it from mutating is Quixotic.
- tialaramex 6y ago
  The long distance travel which spreads a pandemic so fast now is predominantly a First World thing. We could and should have shut that down. A month after we knew we were in deep trouble it was still perfectly normal to decide hey this is boring I'll go on vacation to somewhere with nowhere near the capacity needed to handle COVID-19. Oh, I have a little cough, never mind if I feel sick I'll just fly home after I'm done infecting these people. Remember this is SARS-CoV-2. Where's the mutations and endless new strains of SARS-CoV-1? There aren't any, it was eliminated in humans. So yes it is now sadly likely we're stuck with this, but we ought to be clear it's our fault in countries that didn't do even one tenth of what they should to prevent it.
  - carlmr 6y ago
    >Remember this is SARS-CoV-2. Where's the mutations and endless new strains of SARS-CoV-1? There aren't any, it was eliminated in humans. I think this is only because it was contained in China before it reached the world. They had an excellent pandemic response and quashed it before it reached other countries. This time around it had spread around the world before we even heard about it. It was completely predictable containment efforts would be futile.
    - nopzor 6y ago
      sars definitely reached other countries outside of china..
    - curlypaul924 6y ago
      > I think this is only because it was contained in China before it reached the world Is this true? According to the CDC, there were SARS cases reported in Europe and the Americas prior to containment in China. Why was it different this time around?
      - cperciva 6y ago
        SARS was more lethal and people actually took public health measures seriously.
        lazide 6y ago
        Additionally, SARS v1 was not contagious until there were visible symptoms - a huge difference from COVID/SARS v2.
        cperciva 6y ago
        I wouldn't put too much confidence in that. SARS wasn't known to be contagious presymptomatically, but neither was COVID-19 for many months. Levels of presymptomatic transmission similar to COVID-19 are entirely consistent with the evidence we have from SARS.
- acdha 6y ago
  > I don't think a strategy that needs every country on earth to cooperate this tightly ever had a chance to work. It doesn’t need anything that drastic: imagine an alternate history where the Taiwanese warnings in December 2019 had been taken seriously and international travel was locked down with a mandatory three week quarantine (adjusted by the later availability of tests) on arrival. That would require no cooperation from any other government, and it would have kept spread down below the level where contact tracing and other measures could be effective. Making it a delay avoided the obvious failures like an outright ban packing as many people as possible into crowded transportation and customs facilities, and means that critically important travel could still happen. The problem was that businesses like the travel industry are influential and delayed until it was too well established in most countries and once it had successfully been turned into a political shibboleth, the chances of lighter approaches working plummeted.
  - berdario 6y ago
    > Taiwanese warnings The disease originated in Wuhan, mainland China, not Taiwan. The emergency was communicated in China (as well as Taiwan): http://py.cnhubei.com/py_news/2019/1231/3290.shtml http://py.cnhubei.com/py_news/2019/1231/3290.shtml Sure, listening to any official source would've been better than what happened... But shutting down travel to/from the whole of China (since otherwise you'd have to trust every passenger to declare if they had been in Wuhan) while there were less then 30/40 cases of pneumonia, and not a single death would've been a really difficult measure to sell
    - acdha 6y ago
      > The disease originated in Wuhan, mainland China, not Taiwan. Yes, I’m aware - try more carefully reading my comment and note that I never said otherwise. What I was referring to was Taiwan being faster to acknowledge human to human spread when the Chinese government was still in damage control mode and WHO was following their official statements saying there was no confirmation of retransmission. This happened 2 weeks later: https://www.who.int/csr/don/14-january-2020-novel-coronavirus-thailand-ex-china/en/ https://www.who.int/csr/don/14-january-2020-novel-coronaviru... Taiwan had begun health screenings of travelers from Wuhan on December 31st, following their request to WHO and the China CDC for more information. By the time the first case was detected 3 weeks later they’d already activated a substantial public health plan — not because they were prescient but because SARS had given key officials a strong sense of the importance of not delaying.
- jimbokun 6y ago
  > Most countries aren't the first world, most countries don't have the resources to test and quarantine properly, most countries can't afford lockdowns. The United States meets all these criteria, and has the highest number of cases and deaths in the world. (And near the top in per-capita measures, too.)
  - makomk 6y ago
    Of course a country with the resources to test properly has the highest number of cases and deaths in the world, because if you can't test properly you can't detect Covid-19 cases and deaths. I know the American press has fed its citizens a load of nonsense about this for nakedly partisan reasons, just like it has with every other part of the Covid-19 crisis, and it's getting tiring...
    - carlmr 6y ago
      That of course is another thing to mention. Kind of like the EU countries talking badly about England after they discovered a more infectious mutation. In Germany at the time they didn't even sequence enough viruses to detect mutations before they're widespread.
  - carlmr 6y ago
    I was listing the necessary, not the sufficient criteria. The United States could but it doesn't because the political system is too federalized for a centralized response.
- tgsovlerkhgsel 6y ago
  > I don't think a strategy that needs every country on earth to cooperate this tightly ever had a chance to work. It doesn't need that though. It needs countries to close the borders tightly except to countries that do cooperate, as many Asian countries have successfully done.
  - carlmr 6y ago
    If your goal is to stop mutations from happening, yes, you need everyone in the world to go on full lockdown for 4 weeks. And then test everybody and quarantine until the disease is gone. The situation right now is that you have plenty of breeding grounds for new mutations, and it only needs some minor crossing of borders for these to get through. I would also say it's infeasible for non-island nations that need to trade with other countries to completely lock the borders.
cwhiz 6y ago
Lockdowns were never going to work, and any strategy that relied on them was doomed to fail. A strategy that involves convincing every country, and every little province, to destroy their local economies, all at the same time. I can’t believe it didn’t work! Maybe if we just keep trying.
- praestigiare 6y ago
  Lockdowns do not destroy the economy. Anti-maskers destroy the economy, by decreasing the effectiveness of lockdowns, and making them a chronic rather than acute necessity.
  - Mediterraneo10 6y ago
    The relationship between COVID and the local economy is highly country-dependent. For example, several Balkan countries’ economies are very dependent on their diasporas (and the occasional tourists) driving/flying back and spending loads of money earned in the West. This is why even now they have remained open to travelers and avoided hard lockdowns, even if COVID deaths might result. And then there are countries where the economy is based on resource extraction. Only a relatively tiny amount of people is necessary to work the oil and gas industry, or whatever, and thinktanks have sometimes bluntly referred to all the remaining millions of people as "superfluous population". So, whether you let COVID spread or not has little overall effect on the economy.
    - armagon 6y ago
      I live in Alberta, Canada, which is heavily reliant on resource extraction -- namely, oil. With all the lockdowns (and people voluntarily staying at home), demand for oil has tanked. If there weren't lockdowns (and people were travelling again), our economy would be doing much better. [With all that said, and while I dearly missing socializing, it isn't obvious to me that removing the lockdowns would improve things; on the other hand, it isn't obvious to me that letting the disease run rampant would be worse than the mental and emotional toll the lockdowns are taking on people and the economy. So many poorly understood trade-offs.]

cheph 6y ago

> Manaus shows that pursuing herd immunity through natural infection is not a guarantee. Not a guarantee of what? Are we suggesting that we have a virus here that, unlike every previous virus, we can only reach herd immunity for with a vaccine?

reissbaker 6y ago
> Unlike every previous virus Have we reached "herd immunity" for syphilis? Herpes? Was smallpox eradicated via "herd immunity" that wasn't reached via a vaccine? Polio? It is extremely common for viruses to not be eradicated unless there is a vaccine. Even vaccines are not guaranteed to be enough, e.g. with most influenza strains, although flu vaccines have managed to keep the death toll low enough for us to move on with our lives.
- timr 6y ago
  > Have we reached "herd immunity" for syphilis? Syphilis is a bacterial infection. You can get it more than once. There is no such thing as herd immunity. > Herpes? ...is transmitted via intimate, direct contact. You don't get herpes by walking into a crowded room, and there's no way to be "immune" to herpes without also being a carrier. Herd immunity isn't a relevant concept. > Was smallpox eradicated via "herd immunity" that wasn't reached via a vaccine? Smallpox was eradicated by herd immunity that was achieved via a mixture of natural and vaccine-induced immunity. Initially, a large portion of the population was immune due to natural infection. Over time, vaccinations were targeted to local outbreaks. > Polio? We have not eradicated polio. In some (now 3) countries, polio is endemic, and outbreaks are self-regulated by herd immunity. Herd immunity does not mean that a disease is eliminated. It means that the spread of the disease is naturally controlled.
  - ganafagol 6y ago
    > Herd immunity does not mean that a disease is eliminated. It means that the spread of the disease is naturally controlled. Not necessarily "naturally".