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My understanding is that the reason for the high mortality rate is its novelty. I.e., because it’s unfamiliar, it’s a big task for the immune system to learn ho

My understanding is that the reason for the high mortality rate is its novelty. I.e., because it’s unfamiliar, it’s a big task for the immune system to learn how to beat it, and elderly/impaired people lack the strength/energy to do it. Other cold and flu strains are less deadly these days as we’re all mostly adapted to them. Why would that not happen with this coronavirus too? Why do we assume that this coronavirus will mutate more quickly than the other coronaviruses that are already endemic?

0-_-0 5y ago
The flu has a "baseline death rate" it reached after coevolving with humanity. We don't know what tha baseline will be for COVID, and we don't know if we will deem that acceptable or not.
- tomhoward 5y ago
  You seem to be insisting that there is likely something different about this coronavirus that means it won't end up becoming mostly-harmless-to-most-people, the way all the other influenza, rhinovirus and coronaviruses have done. What is the basis for this fear? Sure you can keep saying things "might" happen or "we don't know" this or that, but we do have a lot of historical precedent for these kinds of viruses, so it's reasonable to presume that it will become not-that-big-a-deal, the way all the others viruses like it have done.
  - 0-_-0 5y ago
    We don't know if it will, and what the costs will be. Saying "The end is near" as the article suggests is not justified by current evidence. So far the increase in the virues' virulence with new mutations wasn't correlated with decrease in deaths as far as I know, and the pandemic has been here for a while now (I only know about inverse correlation). This is not just like the flu.
    - tomhoward 5y ago
      You seem to be ignoring my point. The death rate is not because there's something special about the virus itself that makes it highly lethal. It's just that it's novel, so our bodies have to work harder to learn how to fight it off, and the frailest people don't have the fortitude to do that. Ergo, as it becomes endemic, and all of our immune systems learn how to respond to it, it's completely reasonable to expect that it will become benign to most people. (After all, it already is pretty benign to many/most people, compared to the original SARS and MERS). Repeating "we don't know" is an easy response, and something you can say in response to anything like this, but it's not really addressing the logic I'm presenting. You really have to demonstrate why this virus is substantially different to all the other respiratory viruses that have become endemic and mostly benign, which you've not attempted to do. You just keep saying "we don't know". Sure, but we actually have some solid historical precedent, and this virus is so-far showing no signs of being any different from all those before it.
      - 0-_-0 5y ago
        You're ignoring my argument why this virus is different, and just repeating the same argument that it's like the flu. In addition, nothing in your argument implies that the "end is near", only that there is an end.
        tomhoward 5y ago
        I can't see anything you've written about why this virus is different; that's what I've been asking you to do, but you haven't addressed it, from what I can see. Nevertheless, on the way in which it is widely regarded as being different, I just addressed that in a reply to another commenter here: https://news.ycombinator.com/item?id=27290964 https://news.ycombinator.com/item?id=27290964 For what it's worth I'm not really saying it's "like the flu" - more that we should expect it to be like other coronaviruses, unless there's significant evidence to the contrary.
        0-_-0 5y ago
        I wrote "So far the increase in the virues' virulence with new mutations wasn't correlated with decrease in deaths as far as I know" which suggests the virus is not evolving to be less deadly as you suggest. In fact the British variant was both more virulent and more deadly than the original COVID strain: https://www.bmj.com/content/372/bmj.n579 https://www.bmj.com/content/372/bmj.n579 This contradicts your position that COVID evolves just like the flu does. Do you have evidence to the contrary?
  - azeirah 5y ago
    There is something different about this virus. The idea that viruses become less harmful as the years go by is based on an evolutionary pressure. If a virus kills its host before it has the chance to spread, then it has an evolutionary pressure to evolve into a less harmful variant. The difficulty with this coronavirus is that it can spread asymptomatically AND it takes up to a week before you notice any symptoms. That's a problem, this virus has less of an evolutionary pressure to evolve towards a more benign variant. Imagine if it were to kill 100% of its hosts after 10 days, if you don't get a single symptom in the first 5 days while you're still able to transmit it, this virus will have barely any evolutionary pressure to evolve towards a more benign form. Still, the less a virus kills the more it is able to spread, a virus's ultimate goal is to make as many copies of itself as possible. There are plenty of viruses that have not gotten more benign over time, HIV for example. Everything considered, I do personally believe that over the longer term 10-30 years, the disease caused by sars-cov-2 ancestors will be less bad than they are now, taking into account vaccination and our immune systems getting used to this newest virus as well.
    - tomhoward 5y ago
      > Imagine if it were to kill 100% of its hosts after 10 days, if you don't get a single symptom in the first 5 days while you're still able to transmit it Sure, but as you say, this is an imaginary scenario, not the reality. In reality, it's symptomless/benign for most people for 5-7 days, then in some people it becomes symptomatic, and in relatively few cases - of impaired/frail people (or occasionally people who seemed "healthy" but had some hidden vulnerability) - it becomes severe and potentially lethal. But that last part is due to the fact that it is novel and takes time/effort to fight off, not because it has some magical quality that makes it sit dormant in your system for 5+ days before it wakes up and says "surprise, you're suddenly nearly dead". HIV is a totally different kind of virus, so comparisons to it are mostly unhelpful. Whereas plenty of coronaviruses and other respiratory viruses have become endemic and mostly-benign before. There's no reason to believe the rate of severe cases won't decline (more quickly than 10-30 years) once more people's immune systems become attuned to it.
    - floxy 5y ago
      >The difficulty with this coronavirus is that it can spread asymptomatically Can someone point me to the latest information on asymptomatic transmission of covid-19? Last I had seen asymptomatic transmission wasn't likely: https://www.nature.com/articles/s41467-020-19802-w https://www.nature.com/articles/s41467-020-19802-w
- nradov 5y ago
  Pretty much anything becomes acceptable to people after they've had a few years to get used to it. Preventable chronic diseases kill more people than COVID-19. Apparently that's acceptable to most people because they do little or nothing to reduce their risks.

0-_-0 5y ago

The flu has a "baseline death rate" it reached after coevolving with humanity. We don't know what tha baseline will be for COVID, and we don't know if we will deem that acceptable or not.

tomhoward 5y ago
You seem to be insisting that there is likely something different about this coronavirus that means it won't end up becoming mostly-harmless-to-most-people, the way all the other influenza, rhinovirus and coronaviruses have done. What is the basis for this fear? Sure you can keep saying things "might" happen or "we don't know" this or that, but we do have a lot of historical precedent for these kinds of viruses, so it's reasonable to presume that it will become not-that-big-a-deal, the way all the others viruses like it have done.
- 0-_-0 5y ago
  We don't know if it will, and what the costs will be. Saying "The end is near" as the article suggests is not justified by current evidence. So far the increase in the virues' virulence with new mutations wasn't correlated with decrease in deaths as far as I know, and the pandemic has been here for a while now (I only know about inverse correlation). This is not just like the flu.
  - tomhoward 5y ago
    You seem to be ignoring my point. The death rate is not because there's something special about the virus itself that makes it highly lethal. It's just that it's novel, so our bodies have to work harder to learn how to fight it off, and the frailest people don't have the fortitude to do that. Ergo, as it becomes endemic, and all of our immune systems learn how to respond to it, it's completely reasonable to expect that it will become benign to most people. (After all, it already is pretty benign to many/most people, compared to the original SARS and MERS). Repeating "we don't know" is an easy response, and something you can say in response to anything like this, but it's not really addressing the logic I'm presenting. You really have to demonstrate why this virus is substantially different to all the other respiratory viruses that have become endemic and mostly benign, which you've not attempted to do. You just keep saying "we don't know". Sure, but we actually have some solid historical precedent, and this virus is so-far showing no signs of being any different from all those before it.
    - 0-_-0 5y ago
      You're ignoring my argument why this virus is different, and just repeating the same argument that it's like the flu. In addition, nothing in your argument implies that the "end is near", only that there is an end.
      - tomhoward 5y ago
        I can't see anything you've written about why this virus is different; that's what I've been asking you to do, but you haven't addressed it, from what I can see. Nevertheless, on the way in which it is widely regarded as being different, I just addressed that in a reply to another commenter here: https://news.ycombinator.com/item?id=27290964 https://news.ycombinator.com/item?id=27290964 For what it's worth I'm not really saying it's "like the flu" - more that we should expect it to be like other coronaviruses, unless there's significant evidence to the contrary.
        0-_-0 5y ago
        I wrote "So far the increase in the virues' virulence with new mutations wasn't correlated with decrease in deaths as far as I know" which suggests the virus is not evolving to be less deadly as you suggest. In fact the British variant was both more virulent and more deadly than the original COVID strain: https://www.bmj.com/content/372/bmj.n579 https://www.bmj.com/content/372/bmj.n579 This contradicts your position that COVID evolves just like the flu does. Do you have evidence to the contrary?
- azeirah 5y ago
  There is something different about this virus. The idea that viruses become less harmful as the years go by is based on an evolutionary pressure. If a virus kills its host before it has the chance to spread, then it has an evolutionary pressure to evolve into a less harmful variant. The difficulty with this coronavirus is that it can spread asymptomatically AND it takes up to a week before you notice any symptoms. That's a problem, this virus has less of an evolutionary pressure to evolve towards a more benign variant. Imagine if it were to kill 100% of its hosts after 10 days, if you don't get a single symptom in the first 5 days while you're still able to transmit it, this virus will have barely any evolutionary pressure to evolve towards a more benign form. Still, the less a virus kills the more it is able to spread, a virus's ultimate goal is to make as many copies of itself as possible. There are plenty of viruses that have not gotten more benign over time, HIV for example. Everything considered, I do personally believe that over the longer term 10-30 years, the disease caused by sars-cov-2 ancestors will be less bad than they are now, taking into account vaccination and our immune systems getting used to this newest virus as well.
  - tomhoward 5y ago
    > Imagine if it were to kill 100% of its hosts after 10 days, if you don't get a single symptom in the first 5 days while you're still able to transmit it Sure, but as you say, this is an imaginary scenario, not the reality. In reality, it's symptomless/benign for most people for 5-7 days, then in some people it becomes symptomatic, and in relatively few cases - of impaired/frail people (or occasionally people who seemed "healthy" but had some hidden vulnerability) - it becomes severe and potentially lethal. But that last part is due to the fact that it is novel and takes time/effort to fight off, not because it has some magical quality that makes it sit dormant in your system for 5+ days before it wakes up and says "surprise, you're suddenly nearly dead". HIV is a totally different kind of virus, so comparisons to it are mostly unhelpful. Whereas plenty of coronaviruses and other respiratory viruses have become endemic and mostly-benign before. There's no reason to believe the rate of severe cases won't decline (more quickly than 10-30 years) once more people's immune systems become attuned to it.
  - floxy 5y ago
    >The difficulty with this coronavirus is that it can spread asymptomatically Can someone point me to the latest information on asymptomatic transmission of covid-19? Last I had seen asymptomatic transmission wasn't likely: https://www.nature.com/articles/s41467-020-19802-w https://www.nature.com/articles/s41467-020-19802-w
nradov 5y ago
Pretty much anything becomes acceptable to people after they've had a few years to get used to it. Preventable chronic diseases kill more people than COVID-19. Apparently that's acceptable to most people because they do little or nothing to reduce their risks.