5 ms·

We have a terrible national heritage here and I understand the reluctance. But this isn't how we handled smallpox or polio. There really isn't any other option

We have a terrible national heritage here and I understand the reluctance. But this isn't how we handled smallpox or polio. There really isn't any other option than vaccination given that coronaviruses can reach up to 35% fatality (1). We are extremely lucky right now that the current fatality rate (IFR) is hovering around 1%. That could change. Or if there is another option, what is it? We are a year and a half into this thing with no end in sight. And it has already demonstrated it can mutate past herd immunity for those who have already had it or who have been vaccinated. But it's also pretty clear that those who have been vaccinated are more likely to survive by a huge margin. I'm a huge believer in letting people destroy themselves. But I don't believe in letting them destroy everyone else. I'm weird I guess. 1. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1007566/S1335_Long_term_evolution_of_SARS-CoV-2.pdf https://assets.publishing.service.gov.uk/government/uploads/...

iammisc 5y ago
this is fear mongering. The fatality rate of COVID, even at the beginning of the pandemic when we didn't even have proper metrics, was never measured to be more than about 7-8%, which is very high, but not 35%. The paper you cite is about a hypothetical. Stop with the fear mongering.
- varelse 5y ago
  The IFR seems to be about 1% now that we a have a lot of data, and a bit higher in the US. But that could change or are you asserting it won't? And are you completely unconcerned about new variants? We'll have to disagree on that. The Delta variant has saturated ICUs again, no problemo I gather? And you're misrepresenting the paper. It doesn't claim 35% fatality, it cites the 35% fatality of MERS, a distantly related coronavirus and the 10% fatality of the original SARS pandemic, a closer related virus (1), both mostly settled science, as potential upper bounds of what variants could emerge if we don't get this under control. Viruses evolve to do one thing: make more virus particles. If there is a gain of function that increases the fatality rate then so be it. Usually they become less deadly because that makes them spread more effectively but there are exceptions. It's comforting to assert that it's impossible for a virus to evolve to become more deadly but it's also false. 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718587/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718587/
  - iammisc 5y ago
    > But that could change or are you asserting it won't How can you interpret what I wrote to say that a new virus or variant certainly won't cause a higher fatality rate? Anything can happen at any time. For all we know, a new virus could become prevalent. Typically though, we base public policy based on things that have already happened and the likelihood of future things. There is little reason to believe COVID will evolve into something more deadly. In general viruses rarely make this evolutionary step. Pathogens do not gain reproductive advantage by killing their host. This is why zoonotic pathogens are so dangerous ... when such a pathogen crosses over, they can go from causing no damage to their original host (bats) to becoming very deadly in the context of a human body. Indeed, if history is any guide, endemic human viruses eventually evolve to be mild infections or beneficial (there are theories that placental development is due to the presence and integration of ancient viruses in mammalian DNA). Given that, unlike the flu which has natural reservoirs in birds and crosses over very frequently to humans, COVID does not seem to be bouncing between animal hosts, it is highly unlikely based on every understanding I have of pathogenic evolution that the virus will become more deadly. Indeed, delta variant, while more infectious (as to be expected) is not as deadly. > . It doesn't claim 35% fatality, it cites the 35% fatality of MERS, a distantly related coronavirus Except, MERS and SARS-Cov1 are zoonotic viruses, whereas the COVID variants are human evolved and thus unlikely to become more pathogenic. Zoonotic viruses evolve to be less deadly in their hosts. The zoonotic crossover is a chance event and given the viruses were evolved to not kill bats, they had not been exposed to any selective pressure to not kill humans. Now they are exposed to that pressure so we will see the fruits of that selection. Also, as you point out, MERS is only distantly related. If this pandemic were MERS with a higher infection rate, then it would have been more concerning to begin with, but of course then it would also have evolved faster to be less pathogenic because the selection pressure would be stronger. But it's not. Even the earliest estimates (again, with assuredly bad data) were a fatality rate of 7-8%. They've gone drastically down, by orders of magnitude, and the new variants will continue to drop that. It is good new variants are being created. The higher infection rate + lower death rate will lead to quicker herd immunity against a broader spectra of Sars-COV2 family viruses.
    - varelse 5y ago
yobbo 5y ago
I think the USA made the mistake of using the communication channels from the health authorities for political purposes. Trust in authorities is weakened and the effectiveness of their communications is now low. Every day they continue this they make it worse. It seems that spokesmen have had mixed stakes beyond being responsible for peoples' health. There might be some progress if the authorities somehow "repented" and became trustworthy. There's probably a lot going on at the local level where the communication and organization is happening that I can't speak to. At the moment, this seems to be coming to an end in western Europe. The majority of unvaccinated are young, and many have had covid. Delta variant is spreading covertly without causing much symptoms or illness, so few people are getting tests. If it can't be stopped, it might be preferable that it spreads during the summer. No one knows what happens this winter, but the outlook seems good.

iammisc 5y ago

this is fear mongering. The fatality rate of COVID, even at the beginning of the pandemic when we didn't even have proper metrics, was never measured to be more than about 7-8%, which is very high, but not 35%. The paper you cite is about a hypothetical. Stop with the fear mongering.

varelse 5y ago
The IFR seems to be about 1% now that we a have a lot of data, and a bit higher in the US. But that could change or are you asserting it won't? And are you completely unconcerned about new variants? We'll have to disagree on that. The Delta variant has saturated ICUs again, no problemo I gather? And you're misrepresenting the paper. It doesn't claim 35% fatality, it cites the 35% fatality of MERS, a distantly related coronavirus and the 10% fatality of the original SARS pandemic, a closer related virus (1), both mostly settled science, as potential upper bounds of what variants could emerge if we don't get this under control. Viruses evolve to do one thing: make more virus particles. If there is a gain of function that increases the fatality rate then so be it. Usually they become less deadly because that makes them spread more effectively but there are exceptions. It's comforting to assert that it's impossible for a virus to evolve to become more deadly but it's also false. 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718587/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718587/
- iammisc 5y ago
  > But that could change or are you asserting it won't How can you interpret what I wrote to say that a new virus or variant certainly won't cause a higher fatality rate? Anything can happen at any time. For all we know, a new virus could become prevalent. Typically though, we base public policy based on things that have already happened and the likelihood of future things. There is little reason to believe COVID will evolve into something more deadly. In general viruses rarely make this evolutionary step. Pathogens do not gain reproductive advantage by killing their host. This is why zoonotic pathogens are so dangerous ... when such a pathogen crosses over, they can go from causing no damage to their original host (bats) to becoming very deadly in the context of a human body. Indeed, if history is any guide, endemic human viruses eventually evolve to be mild infections or beneficial (there are theories that placental development is due to the presence and integration of ancient viruses in mammalian DNA). Given that, unlike the flu which has natural reservoirs in birds and crosses over very frequently to humans, COVID does not seem to be bouncing between animal hosts, it is highly unlikely based on every understanding I have of pathogenic evolution that the virus will become more deadly. Indeed, delta variant, while more infectious (as to be expected) is not as deadly. > . It doesn't claim 35% fatality, it cites the 35% fatality of MERS, a distantly related coronavirus Except, MERS and SARS-Cov1 are zoonotic viruses, whereas the COVID variants are human evolved and thus unlikely to become more pathogenic. Zoonotic viruses evolve to be less deadly in their hosts. The zoonotic crossover is a chance event and given the viruses were evolved to not kill bats, they had not been exposed to any selective pressure to not kill humans. Now they are exposed to that pressure so we will see the fruits of that selection. Also, as you point out, MERS is only distantly related. If this pandemic were MERS with a higher infection rate, then it would have been more concerning to begin with, but of course then it would also have evolved faster to be less pathogenic because the selection pressure would be stronger. But it's not. Even the earliest estimates (again, with assuredly bad data) were a fatality rate of 7-8%. They've gone drastically down, by orders of magnitude, and the new variants will continue to drop that. It is good new variants are being created. The higher infection rate + lower death rate will lead to quicker herd immunity against a broader spectra of Sars-COV2 family viruses.
  - varelse 5y ago

yobbo 5y ago

I think the USA made the mistake of using the communication channels from the health authorities for political purposes. Trust in authorities is weakened and the effectiveness of their communications is now low. Every day they continue this they make it worse. It seems that spokesmen have had mixed stakes beyond being responsible for peoples' health. There might be some progress if the authorities somehow "repented" and became trustworthy. There's probably a lot going on at the local level where the communication and organization is happening that I can't speak to. At the moment, this seems to be coming to an end in western Europe. The majority of unvaccinated are young, and many have had covid. Delta variant is spreading covertly without causing much symptoms or illness, so few people are getting tests. If it can't be stopped, it might be preferable that it spreads during the summer. No one knows what happens this winter, but the outlook seems good.