3 ms·

A question to consider is, how to we move from pandemic to endemic? COVID-19 isn't going away and will join the other endemic viruses like chicken pox, the othe

by mfer 5y ago

A question to consider is, how to we move from pandemic to endemic? COVID-19 isn't going away and will join the other endemic viruses like chicken pox, the other widely out there coronaviruses, etc.

meheleventyone 5y ago
It's got to be something like how much of the population are getting sick. I presume when a disease is endemic you have a fairly steady rate of illness and death taking into account seasonal variation. Whereas right now covid still seems to be spreading quickly through the population and causing large numbers to get sick at once.
- mfer 5y ago
  When I think about this I think of two parts of it. First, there are other endemics. Influenza is one of them. In the US along millions get sick from it and tens of thousands die each year. We live within that realm. There will be people with different degrees of risk and levels for being ok with going back to "normal" as COVID-19 is just out there. How do we decided (as groups in the world population) what we are ok with? Second, what do we do to proactively push the population towards endemic? Different groups will go toward different things with different levels of risk. There is no quantitative right answer. What things can we do and how does that affect things.
  - meheleventyone 5y ago
    For me before we can even talk about covid being endemic it needs to reach a steady state and we're nowhere near that right now. In terms of risk management flu is a good example because most humans encounter various versions in childhood but we still offer vaccination every year against the most likely variants. And we can still have flu pandemics. It's largely in a steady state though but the reality of that means we actually need to do a lot of management as risk profiles change locally. And largely this is a medical issue not a political one.
  - marcosdumay 5y ago
    > Second, what do we do to proactively push the population towards endemic? Vaccinate people.
nradov 5y ago
Probably the same as what seems to have happened with the last coronavirus pandemic in 1889. HCoV-OC43 probably killed a lot of people worldwide with symptoms similar to COVID-19. Now most of us get infected as children and gain immunity that protects us later in life. Fortunately now we have vaccines to cut the death toll, but even most vaccinated people will eventually get infected with SARS-CoV-2. https://ec.europa.eu/research-and-innovation/en/horizon-magazine/qa-why-history-suggests-covid-19-here-stay https://ec.europa.eu/research-and-innovation/en/horizon-maga... https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8 https://www.businessinsider.com/delta-variant-made-herd-immu...
graeme 5y ago
Chickenpox is no longer endemic in the sense that covid proponents say covid will be. Chickenpox has am effective vaccine, get that and you don’t get chickenpox. Vaccination has substantially reduced it and could eliminate it in local areas. Endemicity proponents argue it will be like the common cold. But that’s unproven. Endemic just means “present”. Malaria is endemic, dengue is endemic. HIV is endemic in certain areas and groups. The word itself tells you nothing. Absent restrictions and even with vaccinations you’d expect most people to get a covid infection 1x per year or two. Same way we generally do with other coronaviruses. The hope is that SARS-Cov-2 is just like any other coronavirus and with immunity won’t cause long run issues upon repeat reinfection. We’ll find out the answer by 2024 or so.
tzs 5y ago
If it goes like the other four coronaviruses that are endemic it will reach a state where (1) if you catch it but already have some immunity (from a prior infection or a vaccine) your chances of serious illness are low, (2) if you are a kid your chances of serious illness are pretty low even if you don't yet have any immunity, (3) you catch it every year or two or three for the rest of your life which keeps boosting your decaying immunity so there is a good chance we may not need vaccine booster shots (a lot depends on what variants become endemic and what vaccines are available). At that stage we probably won't even bother to track it. It will just be another of a large group of viruses (including those other four endemic coronaviruses) that cause similar symptoms and risk that we lump together and collectively call a "common cold". Right now we are at the stage where we have a lot of people who aren't kids and who have no prior immunity. For past pandemic => endemic transitions that meant everyone went through their first infection without immunity (and often without good treatments available for the serious illnesses that resulted because these past pandemics were often before modern medicine). We have better treatments in general nowadays, so that route would not be as bad as it was for pandemics a couple hundred years ago, but it still would kill a lot of people. With this one we've got a chance via vaccination for almost all of the teen and above population that hasn't yet been infected to get some immunity before their first infection. (Eventually pre-teens will be included once vaccines are authorized for them).

by mfer 5y ago

A question to consider is, how to we move from pandemic to endemic? COVID-19 isn't going away and will join the other endemic viruses like chicken pox, the other widely out there coronaviruses, etc.

meheleventyone 5y ago

It's got to be something like how much of the population are getting sick. I presume when a disease is endemic you have a fairly steady rate of illness and death taking into account seasonal variation. Whereas right now covid still seems to be spreading quickly through the population and causing large numbers to get sick at once.

mfer 5y ago
When I think about this I think of two parts of it. First, there are other endemics. Influenza is one of them. In the US along millions get sick from it and tens of thousands die each year. We live within that realm. There will be people with different degrees of risk and levels for being ok with going back to "normal" as COVID-19 is just out there. How do we decided (as groups in the world population) what we are ok with? Second, what do we do to proactively push the population towards endemic? Different groups will go toward different things with different levels of risk. There is no quantitative right answer. What things can we do and how does that affect things.
- meheleventyone 5y ago
  For me before we can even talk about covid being endemic it needs to reach a steady state and we're nowhere near that right now. In terms of risk management flu is a good example because most humans encounter various versions in childhood but we still offer vaccination every year against the most likely variants. And we can still have flu pandemics. It's largely in a steady state though but the reality of that means we actually need to do a lot of management as risk profiles change locally. And largely this is a medical issue not a political one.
- marcosdumay 5y ago
  > Second, what do we do to proactively push the population towards endemic? Vaccinate people.

nradov 5y ago

Probably the same as what seems to have happened with the last coronavirus pandemic in 1889. HCoV-OC43 probably killed a lot of people worldwide with symptoms similar to COVID-19. Now most of us get infected as children and gain immunity that protects us later in life. Fortunately now we have vaccines to cut the death toll, but even most vaccinated people will eventually get infected with SARS-CoV-2. https://ec.europa.eu/research-and-innovation/en/horizon-magazine/qa-why-history-suggests-covid-19-here-stay https://ec.europa.eu/research-and-innovation/en/horizon-maga... https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8 https://www.businessinsider.com/delta-variant-made-herd-immu...

graeme 5y ago

Chickenpox is no longer endemic in the sense that covid proponents say covid will be. Chickenpox has am effective vaccine, get that and you don’t get chickenpox. Vaccination has substantially reduced it and could eliminate it in local areas. Endemicity proponents argue it will be like the common cold. But that’s unproven. Endemic just means “present”. Malaria is endemic, dengue is endemic. HIV is endemic in certain areas and groups. The word itself tells you nothing. Absent restrictions and even with vaccinations you’d expect most people to get a covid infection 1x per year or two. Same way we generally do with other coronaviruses. The hope is that SARS-Cov-2 is just like any other coronavirus and with immunity won’t cause long run issues upon repeat reinfection. We’ll find out the answer by 2024 or so.

tzs 5y ago

If it goes like the other four coronaviruses that are endemic it will reach a state where (1) if you catch it but already have some immunity (from a prior infection or a vaccine) your chances of serious illness are low, (2) if you are a kid your chances of serious illness are pretty low even if you don't yet have any immunity, (3) you catch it every year or two or three for the rest of your life which keeps boosting your decaying immunity so there is a good chance we may not need vaccine booster shots (a lot depends on what variants become endemic and what vaccines are available). At that stage we probably won't even bother to track it. It will just be another of a large group of viruses (including those other four endemic coronaviruses) that cause similar symptoms and risk that we lump together and collectively call a "common cold". Right now we are at the stage where we have a lot of people who aren't kids and who have no prior immunity. For past pandemic => endemic transitions that meant everyone went through their first infection without immunity (and often without good treatments available for the serious illnesses that resulted because these past pandemics were often before modern medicine). We have better treatments in general nowadays, so that route would not be as bad as it was for pandemics a couple hundred years ago, but it still would kill a lot of people. With this one we've got a chance via vaccination for almost all of the teen and above population that hasn't yet been infected to get some immunity before their first infection. (Eventually pre-teens will be included once vaccines are authorized for them).