14 ms·

For scientists, path to Covid-19 endgame remains uncertain

35 points by harambae 5y ago

graeme 5y ago
This optimists in this article were routinely wrong in the past. Why trust their optimism now? > “I truly, truly think we are in the endgame,” said Monica Gandhi, an infectious-disease specialist and professor of medicine at the University of California at San Francisco. “The cases will start plummeting in mid-to-late September and by mid-October, we will be in a manageable place, where the virus is a concern for health professionals, but not really for the general public.” Monica Ghandi has been an eternal optimist and routinely wrong. Here she is in february arguing that india had herd immunity from prior infection and cross reactive immunity. Right before devastating delta wave: https://twitter.com/monicagandhi9/status/1361856248275079170?lang=en https://twitter.com/monicagandhi9/status/1361856248275079170... Here she is in may agreeing many us areas were at herd immunity. This also proved wrong: https://twitter.com/monicagandhi9/status/1389808375437824000 https://twitter.com/monicagandhi9/status/1389808375437824000 She admits in the article she was wrong, but about people, not the virus. But she was very wrong about the virus. Jay Bhattacharya was one of the three people behind the Great Barrington Declaration. Their ideas won, but it’s far from obvious they were right. Instead of elimination, they argued for living with the virus. This currently is causing oxygen shortages in Florida, and renewed restrictions as countries experience rising waves. https://en.wikipedia.org/wiki/Great_Barrington_Declaration https://en.wikipedia.org/wiki/Great_Barrington_Declaration He writes: > that’s the endpoint of the epidemic because we really can’t do better than that Multiple countries have eliminated the virus. In fact, virtually every country that aimed at it succeeded at this goal. They had better economic outcomes and more normalcy. Bhattacharya wants to persuade that because this would be hard in the short term it is literally impossible. His barrington declaration also failed at its goals: countries that tried it had both worse economic outcomes and also worse health outcomes.
- graeme 5y ago
  Another Ghandi quote: > You yourself are completely protected against the delta variant, and you should go and enjoy your summer. It’s been a hard time, and people should have their summer. Delta variant, delta shmariant. From May. This proved completely false. Efficacy is a relative risk reduction, not an absolute. 95% efficacy against severe disease means 1/20 will still have severe results. “Completely protected” was patently false. The vaccines are great but that doesn’t warrant lying to boost them. https://slate.com/technology/2021/06/delta-variant-covid-vaccines-risk-monica-gandhi.html https://slate.com/technology/2021/06/delta-variant-covid-vac...
  - bilal4hmed 5y ago
    This video of Monica should be saved https://twitter.com/ibrake4ants/status/1415701882178314248 https://twitter.com/ibrake4ants/status/1415701882178314248
    - graeme 5y ago
      Thanks. For anyone who’d rather not watch a video: it’s a short clip of Monica Ghandi at a June 15th mask/ribbon cutting ceremony, jumping with excitement as happy days are here again plays.
      - angelzen 5y ago
        The horror! Edit: Covid is a miserable disease, but it seems that some of us want to abandon the joy of living because, in the big scheme, slightly more people die than usual. The price of being alive is death, and it's well worth it.
        graeme 5y ago
        The point is that they were wrong, not that they were happy. They reversed course and deleted the video. Masks have returned. The video was like Bush’s “Mission Accomplished” photo op in 2003 to declare the end of the Iraq war. He was happy too, but wrong.
        angelzen 5y ago
        The point it that they were hopeful. Piling on them, even if wrong, is distasteful.
        graeme 5y ago
        Hold it. Those aren’t just regular people being happy. They’re leaders in what is equivalent to a wartime situation. When they’re wrong, people die.
- cavisne 5y ago
  Which ones? South Korea, Vietnam, China and Australia all come to mind, they are all facing Delta waves now.
  - graeme 5y ago
    South Korea never aimed at elimination, important distinction. They aimed to keep circulation low. Australia’s NSW also did not aim to eliminate. Other australian states do, and have their borders closed to NSW. Complicated story down there. Victoria China has beaten the delta wave, down to 26 cases a day from 100. I expect they’ll hit zero. New Zealand on the same track, as is Taiwan. The Atlantic region of Canada was another example. Vietname I’ll admit has now failed. Not sure if they changed policies or simply couldn’t do it now with Delta. Then there are some caribbean islands. And that’s about the full list of countries worldwide that did try for zero. Every other country aimed for mitigation.
    - makomk 5y ago
      I think you're reversing cause and effect there. The reason NSW and now Victoria in Australia are no longer aiming to eliminate Covid is because their efforts to do so simply did not work once the Delta variant hit and could not be made to work. Similarly, Vietnam couldn't do it either - they went so far as completely stopping people living in the most affected city from leaving their homes even to buy food, despite not being able to put in place any working way of delivering food to all 9 million people living there, because lesser measures hadn't worked, and that also didn't work.
    - kongin 5y ago
      >Australia’s NSW also did not aim to eliminate. Other australian states do, and have their borders closed to NSW. Complicated story down there. Victoria Victoria has had 6 or 7 waves of Covid (depends how you count it) and failed only at the last one. This came at the cost of human rights violations, police brutality, the largest non-wartime increase in government debt, a tripling of teen suicides, night time curfew and a cumulative 220 days of lockdown with no end in sight. At this point euthanising everyone over 70 could be a viable policy with less long term harm than continuing with the current policies.
- angelzen 5y ago
  > Multiple countries have eliminated the virus. In fact, virtually every country that aimed at it succeeded at this goal. Which countries have eliminated the virus? Aren't you playing out the exact same kind of baseless optimism you accuse Monica Gandhi of?
  - graeme 5y ago
    I didn’t say it would be easy for many countries to eliminate. My point is it is possible, whereas the person I am criticizing says it is impossible to do better than a vaccine alone. That’s clearly false as there are living, breathing counterexamples. Hard does not equal impossible. New Zealand, Atlantic Canada, Taiwan, most of Australia (NSW doesn’t have elimination as a goal), some caribbean islands, China Many of those places have outbreaks, but they’re beaten them or have beaten them.
    - prawn 5y ago
      In Australia, NSW and Victoria are locked down. Other states, including my own, at the sign of sometimes a single case, lock down. And the status quo comes with minimal international movement (need approval and expensive quarantine) and restricted movement between states. Not sure how practical or palatable that would be in Europe, the Americas, etc.
      - nicoburns 5y ago
        How much time have you sepnt locked down in total since the pademic started? Here in the UK it's been about 6 months, and I'm interested to compare the two strategies.
        prawn 5y ago
        Probably less than a fortnight in total? I'm in South Australia. We had a six day lockdown in Nov 2020 that was lifted after 3-4 days. There was a week-long lockdown in July coming straight after school holidays, so it was like getting a bonus week. There have been many changes for things like wineries and restaurants, and limits on home gatherings at times, but I assume that's pretty standard worldwide. Currently with risk of delta arriving from interstate, I wear a mask entering a public space, but that's about it. We're comparably isolated though compared to the rest of the world, and have strict policies for international travel (quarantine on your return that costs thousands of dollars). There are strong restrictions back in early 2020, but I think we'd taken our kids out of school voluntarily, and I don't know if there was ever a full lockdown.
- hm10 5y ago
  Off topic, but it always amazes me how often I see Gandhi misspelled as Ghandi. I'm not American, so I am curious if they always teach this wrong spelling in schools? Check the other replies here. OP literally quoted the right spelling but still misspelled it later.
  - graeme 5y ago
    I thought about it, and in my case I think it’s because the pronunciation is unintuitive. You often hear people saying “Gandhi” like “Band”, which is wrong I think. To write how you pronounce Gandhi you normally have words like “Khan” or “Ghana” etc. at least with the words I’m familiar with. So it makes a switch I have to constantly manually remember. Possible I have the pronunciation wrong of course.
  - angelzen 5y ago
    'gh' is somewhat common in American English. ghost, ghetto, aghast. 'dh' is unheard of.
- Clewza313 5y ago
  The only countries that have consistently managed to keep COVID at bay are China, Taiwan and New Zealand. All the rest of the former COVID Zeros, including Australia, Vietnam and Singapore, have succumbed to Delta, and it's a matter of time until the three holdouts do so too.
- wffurr 5y ago
  Thanks for the perspective on the interviewees. Overall seems like a really terrible article trying to present a "balance" of perspectives and not once considering there's truth to be had.
nanis 5y ago
Such decisions involving comparing benefits and costs do not belong to scientists.
- version_five 5y ago
  Under-rated comment (I'm banned from modding). Technical experts can be trusted for information about cause and effect. They have no expertise about people, of compromise, of other goals people have, etc. This is a leadership task, ideally a coming from a good politician, limited by a good constitution. We seem to pretend that scientific statements about causality are the same thing as government policy instruction. They are not, technocracy serves nobody.
- guscost 5y ago
  Yep, and we’re taking them back, cheers.
- tomjen3 5y ago
  I don't disagree, but they certainly do not belong to politicians.
legerdemain 5y ago
I think it's very simple. America has learned to live with Covid and this is the new normal: 300,000+ deaths per year, dramatically lower life expectancy, and a drag on the consumer economy. Subsaharan Africa learned to live with malaria by eating the human and economic costs of a forever epidemic. We can too!
- helloworld11 5y ago
  the flu cuases a certain annual death toll as well and has for a long time. Once the initial lack of partial or even full immunity to COVID diminishes in the U.S and elsewhere, it will become part of the regular background of manageable infectious diseases, and this is what people will adapt to, fairly well I think. Your extrapolating the large existing death toll forward over the years is misguided. Aside from all this, what alternative would you prefer? Perpetual rolling lockdowns and endless streams of prohibitions until some highly ambigious future time?
  - legerdemain 5y ago
    Measles is more infectious than Covid, less fatal than Covid, and (outside of pockets of anti-vaccination activists) has been largely vaccinated out of existence.
    - smnrchrds 5y ago
      The big difference is that measles vaccine has an efficacy of ~100%. [1] From the start of the pandemic, health experts and the media did lots of what I can only call expectation management and said that any vaccine with over 50% efficacy would be good, more than 60% or 70% would be absolutely marvellous. I think because this was the first time people were tuning in to news about vaccine efficacy, it has skewed people's perception and many think all vaccines are 65-85% effective. In reality, while flu vaccine is like that, the vaccines commonly used for more serious diseases such as measles are close to 100% effective. And this efficacy is not just against death or serious disease, but against catching the disease at all or passing it on. Vaccine efficacy against transmission greatly affects the percentage of the population that need to be vaccinated in order to achieve herd immunity. With low enough efficacy and high enough R value, herd immunity is impossible even if 100% of the population is vaccinated. And some variants of COVID may have high enough R value for this. [1] https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html#p4c11a4 https://www.canada.ca/en/public-health/services/publications...
hatchnyc 5y ago
What now? There is no plan. We have the vaccine, at least in the US and EU we have enough doses, and they are more effective than many expected them to be. We are many, many days into "three weeks to slow the spread". In Manhattan numerous restaurants constructed "outdoor dining" areas, but since eating outside in 20F weather kind of sucks (I can attest from personal experience), many are fully enclosed and have heating and A/C. They are literally indoor dining except located on the street and not built to code, but we all pretend that this is making a difference. Everyone knows that children in schools are a major vector for disease. Pre-covid it was always parents with school-aged kids bringing in colds and flu. Everyone knows that testing is largely performed only on people showing symptoms and children do not show severe COVID symptoms, but parents got tired of having their kids at home so we got a round of articles claiming children don't spread COVID and reopened schools while everything else was shut down. I could go on with many more examples but we all know them. The response is a joke. The lockdown largely hasn't affected the elite and wherever it has we get COVID theater and special exceptions, but it's also become political and part of the identity for a certain highly influential strata of society so we keep moving the goalposts with no plan.
- deelowe 5y ago
  As a parent, I didn’t get tired of my kids being at home. Their grades were slipping to the point where we had no other option.
  - hatchnyc 5y ago
    I mean lots of people lost their jobs and businesses, and saw their lives and standard of living derailed as a result of the lockdowns, but we've been told that this was worth the sacrifice. EDIT: And I'll add I mention this out to point out the absurdity and double standards that have been applied here.
- Clewza313 5y ago
  McSweeney's had a great piece on the absurdity of outdoor dining enclosures: https://www.mcsweeneys.net/articles/i-am-the-designer-of-this-restaurants-outdoor-seating-space-and-this-is-my-artists-statement https://www.mcsweeneys.net/articles/i-am-the-designer-of-thi...
WaitWaitWha 5y ago
What is the "endgame", quantitatively? Who defines what is the "endgame"?
- Clewza313 5y ago
  That's kind of the point of the article. We used to think "endgame" meant eliminating COVID, now it's become pretty clear that's not going to happen and the best we can do is get to state where we can live with it.
TheCowboy 5y ago
One of the biggest failures still happening is the lack of communication on this. Many people think we're going to eradicate covid-19. Even before the delta variant that seemed like an impractical longshot, and that it was inevitable that it would be endemic. I'm already starting to see polarizing politics on the fringes start to turn endemic into a dirty word instead of the likely reality. People should be prepared and understand that over a 2+ year time frame they have a 99% chance of catching covid-19. And getting the vaccine so they don't start from zero immunity is likely the best we can do.
- graeme 5y ago
  > I'm already starting to see polarizing politics on the fringes start to turn endemic into a dirty word instead of the likely reality. When you say all this, do you mean to say endemic means benign? Or do you mean to say out world is a fair bit worse than it was, but that’s the reality. Endemic is consistent with “fairly harmful”. Malaria, Dengue, tuburculosis, HIV are all endemic diseases. Time has not made them milder either. I’m asking as a genuine question because the people arguing for endemicity seem to often conflate it with “mild, like a cold”, but that isn’t what the words means. I think “our world is worse now but very unlikely to eradicate” is probably true, but I’d like to get a sense of what people mean by endemicity.
  - TheCowboy 5y ago
    Basically trying discredit people who communicate in any way the possibility that covid-19 will be endemic.
    - graeme 5y ago
      Yes, but what do you or those people mean by “it will become endemic”. If Malaria became endemic in every country that would be a catastrophe. There’s nothing gentle about the word. The common cold is endemic and so is dengue. So: are you describing a scenario that is: 1. Business as usual (once we get enough immunity medium/long run) 2. A small bit worse than 2019 3. Quite a bit worse than 2019 4. Substantially worse than 2019 ? My point is the word endemic doesn’t mean anything other than “disease is present”. But people say it as if the word includes severity. When people say that I take them to indicate belief in scenario 1, or possibly scenario 2. I think it probably will be endemic but we’re minimum scenario 3. I don’t think that is what endemicity proponents believe however.
spodek 5y ago
I don't know what return to normalcy anyone is expecting given pollution and climate change. If normal for Americans means polluting and emitting greenhouse gases, we'll accelerate tremendous suffering, including ourselves. If we want to avoid that suffering, we can change our lifestyles (which could increase health, longevity, stability, and more since we waste so much, despite our culture telling us it would cause deprivation and sacrifice). Either way, no return to normalcy, though if we choose to reduce polluting we would improve our lives.

35 points by harambae 5y ago

This optimists in this article were routinely wrong in the past. Why trust their optimism now? > “I truly, truly think we are in the endgame,” said Monica Gandhi, an infectious-disease specialist and professor of medicine at the University of California at San Francisco. “The cases will start plummeting in mid-to-late September and by mid-October, we will be in a manageable place, where the virus is a concern for health professionals, but not really for the general public.” Monica Ghandi has been an eternal optimist and routinely wrong. Here she is in february arguing that india had herd immunity from prior infection and cross reactive immunity. Right before devastating delta wave: https://twitter.com/monicagandhi9/status/1361856248275079170?lang=en https://twitter.com/monicagandhi9/status/1361856248275079170... Here she is in may agreeing many us areas were at herd immunity. This also proved wrong: https://twitter.com/monicagandhi9/status/1389808375437824000 https://twitter.com/monicagandhi9/status/1389808375437824000 She admits in the article she was wrong, but about people, not the virus. But she was very wrong about the virus. Jay Bhattacharya was one of the three people behind the Great Barrington Declaration. Their ideas won, but it’s far from obvious they were right. Instead of elimination, they argued for living with the virus. This currently is causing oxygen shortages in Florida, and renewed restrictions as countries experience rising waves. https://en.wikipedia.org/wiki/Great_Barrington_Declaration https://en.wikipedia.org/wiki/Great_Barrington_Declaration He writes: > that’s the endpoint of the epidemic because we really can’t do better than that Multiple countries have eliminated the virus. In fact, virtually every country that aimed at it succeeded at this goal. They had better economic outcomes and more normalcy. Bhattacharya wants to persuade that because this would be hard in the short term it is literally impossible. His barrington declaration also failed at its goals: countries that tried it had both worse economic outcomes and also worse health outcomes.

graeme 5y ago
Another Ghandi quote: > You yourself are completely protected against the delta variant, and you should go and enjoy your summer. It’s been a hard time, and people should have their summer. Delta variant, delta shmariant. From May. This proved completely false. Efficacy is a relative risk reduction, not an absolute. 95% efficacy against severe disease means 1/20 will still have severe results. “Completely protected” was patently false. The vaccines are great but that doesn’t warrant lying to boost them. https://slate.com/technology/2021/06/delta-variant-covid-vaccines-risk-monica-gandhi.html https://slate.com/technology/2021/06/delta-variant-covid-vac...
- bilal4hmed 5y ago
  This video of Monica should be saved https://twitter.com/ibrake4ants/status/1415701882178314248 https://twitter.com/ibrake4ants/status/1415701882178314248
  - graeme 5y ago
    Thanks. For anyone who’d rather not watch a video: it’s a short clip of Monica Ghandi at a June 15th mask/ribbon cutting ceremony, jumping with excitement as happy days are here again plays.
    - angelzen 5y ago
      The horror! Edit: Covid is a miserable disease, but it seems that some of us want to abandon the joy of living because, in the big scheme, slightly more people die than usual. The price of being alive is death, and it's well worth it.
      - graeme 5y ago
        The point is that they were wrong, not that they were happy. They reversed course and deleted the video. Masks have returned. The video was like Bush’s “Mission Accomplished” photo op in 2003 to declare the end of the Iraq war. He was happy too, but wrong.
        angelzen 5y ago
        The point it that they were hopeful. Piling on them, even if wrong, is distasteful.
        graeme 5y ago
        Hold it. Those aren’t just regular people being happy. They’re leaders in what is equivalent to a wartime situation. When they’re wrong, people die.
cavisne 5y ago
Which ones? South Korea, Vietnam, China and Australia all come to mind, they are all facing Delta waves now.
- graeme 5y ago
  South Korea never aimed at elimination, important distinction. They aimed to keep circulation low. Australia’s NSW also did not aim to eliminate. Other australian states do, and have their borders closed to NSW. Complicated story down there. Victoria China has beaten the delta wave, down to 26 cases a day from 100. I expect they’ll hit zero. New Zealand on the same track, as is Taiwan. The Atlantic region of Canada was another example. Vietname I’ll admit has now failed. Not sure if they changed policies or simply couldn’t do it now with Delta. Then there are some caribbean islands. And that’s about the full list of countries worldwide that did try for zero. Every other country aimed for mitigation.
  - makomk 5y ago
    I think you're reversing cause and effect there. The reason NSW and now Victoria in Australia are no longer aiming to eliminate Covid is because their efforts to do so simply did not work once the Delta variant hit and could not be made to work. Similarly, Vietnam couldn't do it either - they went so far as completely stopping people living in the most affected city from leaving their homes even to buy food, despite not being able to put in place any working way of delivering food to all 9 million people living there, because lesser measures hadn't worked, and that also didn't work.
  - kongin 5y ago
    >Australia’s NSW also did not aim to eliminate. Other australian states do, and have their borders closed to NSW. Complicated story down there. Victoria Victoria has had 6 or 7 waves of Covid (depends how you count it) and failed only at the last one. This came at the cost of human rights violations, police brutality, the largest non-wartime increase in government debt, a tripling of teen suicides, night time curfew and a cumulative 220 days of lockdown with no end in sight. At this point euthanising everyone over 70 could be a viable policy with less long term harm than continuing with the current policies.
angelzen 5y ago
> Multiple countries have eliminated the virus. In fact, virtually every country that aimed at it succeeded at this goal. Which countries have eliminated the virus? Aren't you playing out the exact same kind of baseless optimism you accuse Monica Gandhi of?
- graeme 5y ago
  I didn’t say it would be easy for many countries to eliminate. My point is it is possible, whereas the person I am criticizing says it is impossible to do better than a vaccine alone. That’s clearly false as there are living, breathing counterexamples. Hard does not equal impossible. New Zealand, Atlantic Canada, Taiwan, most of Australia (NSW doesn’t have elimination as a goal), some caribbean islands, China Many of those places have outbreaks, but they’re beaten them or have beaten them.
  - prawn 5y ago
    In Australia, NSW and Victoria are locked down. Other states, including my own, at the sign of sometimes a single case, lock down. And the status quo comes with minimal international movement (need approval and expensive quarantine) and restricted movement between states. Not sure how practical or palatable that would be in Europe, the Americas, etc.
    - nicoburns 5y ago
      How much time have you sepnt locked down in total since the pademic started? Here in the UK it's been about 6 months, and I'm interested to compare the two strategies.
      - prawn 5y ago
        Probably less than a fortnight in total? I'm in South Australia. We had a six day lockdown in Nov 2020 that was lifted after 3-4 days. There was a week-long lockdown in July coming straight after school holidays, so it was like getting a bonus week. There have been many changes for things like wineries and restaurants, and limits on home gatherings at times, but I assume that's pretty standard worldwide. Currently with risk of delta arriving from interstate, I wear a mask entering a public space, but that's about it. We're comparably isolated though compared to the rest of the world, and have strict policies for international travel (quarantine on your return that costs thousands of dollars). There are strong restrictions back in early 2020, but I think we'd taken our kids out of school voluntarily, and I don't know if there was ever a full lockdown.
hm10 5y ago
Off topic, but it always amazes me how often I see Gandhi misspelled as Ghandi. I'm not American, so I am curious if they always teach this wrong spelling in schools? Check the other replies here. OP literally quoted the right spelling but still misspelled it later.
- graeme 5y ago
  I thought about it, and in my case I think it’s because the pronunciation is unintuitive. You often hear people saying “Gandhi” like “Band”, which is wrong I think. To write how you pronounce Gandhi you normally have words like “Khan” or “Ghana” etc. at least with the words I’m familiar with. So it makes a switch I have to constantly manually remember. Possible I have the pronunciation wrong of course.
- angelzen 5y ago
  'gh' is somewhat common in American English. ghost, ghetto, aghast. 'dh' is unheard of.
Clewza313 5y ago
The only countries that have consistently managed to keep COVID at bay are China, Taiwan and New Zealand. All the rest of the former COVID Zeros, including Australia, Vietnam and Singapore, have succumbed to Delta, and it's a matter of time until the three holdouts do so too.
wffurr 5y ago
Thanks for the perspective on the interviewees. Overall seems like a really terrible article trying to present a "balance" of perspectives and not once considering there's truth to be had.

nanis 5y ago

Such decisions involving comparing benefits and costs do not belong to scientists.

version_five 5y ago
Under-rated comment (I'm banned from modding). Technical experts can be trusted for information about cause and effect. They have no expertise about people, of compromise, of other goals people have, etc. This is a leadership task, ideally a coming from a good politician, limited by a good constitution. We seem to pretend that scientific statements about causality are the same thing as government policy instruction. They are not, technocracy serves nobody.
guscost 5y ago
Yep, and we’re taking them back, cheers.
tomjen3 5y ago
I don't disagree, but they certainly do not belong to politicians.

legerdemain 5y ago

I think it's very simple. America has learned to live with Covid and this is the new normal: 300,000+ deaths per year, dramatically lower life expectancy, and a drag on the consumer economy. Subsaharan Africa learned to live with malaria by eating the human and economic costs of a forever epidemic. We can too!

helloworld11 5y ago
the flu cuases a certain annual death toll as well and has for a long time. Once the initial lack of partial or even full immunity to COVID diminishes in the U.S and elsewhere, it will become part of the regular background of manageable infectious diseases, and this is what people will adapt to, fairly well I think. Your extrapolating the large existing death toll forward over the years is misguided. Aside from all this, what alternative would you prefer? Perpetual rolling lockdowns and endless streams of prohibitions until some highly ambigious future time?
- legerdemain 5y ago
  Measles is more infectious than Covid, less fatal than Covid, and (outside of pockets of anti-vaccination activists) has been largely vaccinated out of existence.
  - smnrchrds 5y ago
    The big difference is that measles vaccine has an efficacy of ~100%. [1] From the start of the pandemic, health experts and the media did lots of what I can only call expectation management and said that any vaccine with over 50% efficacy would be good, more than 60% or 70% would be absolutely marvellous. I think because this was the first time people were tuning in to news about vaccine efficacy, it has skewed people's perception and many think all vaccines are 65-85% effective. In reality, while flu vaccine is like that, the vaccines commonly used for more serious diseases such as measles are close to 100% effective. And this efficacy is not just against death or serious disease, but against catching the disease at all or passing it on. Vaccine efficacy against transmission greatly affects the percentage of the population that need to be vaccinated in order to achieve herd immunity. With low enough efficacy and high enough R value, herd immunity is impossible even if 100% of the population is vaccinated. And some variants of COVID may have high enough R value for this. [1] https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html#p4c11a4 https://www.canada.ca/en/public-health/services/publications...

hatchnyc 5y ago

What now? There is no plan. We have the vaccine, at least in the US and EU we have enough doses, and they are more effective than many expected them to be. We are many, many days into "three weeks to slow the spread". In Manhattan numerous restaurants constructed "outdoor dining" areas, but since eating outside in 20F weather kind of sucks (I can attest from personal experience), many are fully enclosed and have heating and A/C. They are literally indoor dining except located on the street and not built to code, but we all pretend that this is making a difference. Everyone knows that children in schools are a major vector for disease. Pre-covid it was always parents with school-aged kids bringing in colds and flu. Everyone knows that testing is largely performed only on people showing symptoms and children do not show severe COVID symptoms, but parents got tired of having their kids at home so we got a round of articles claiming children don't spread COVID and reopened schools while everything else was shut down. I could go on with many more examples but we all know them. The response is a joke. The lockdown largely hasn't affected the elite and wherever it has we get COVID theater and special exceptions, but it's also become political and part of the identity for a certain highly influential strata of society so we keep moving the goalposts with no plan.

deelowe 5y ago
As a parent, I didn’t get tired of my kids being at home. Their grades were slipping to the point where we had no other option.
- hatchnyc 5y ago
  I mean lots of people lost their jobs and businesses, and saw their lives and standard of living derailed as a result of the lockdowns, but we've been told that this was worth the sacrifice. EDIT: And I'll add I mention this out to point out the absurdity and double standards that have been applied here.
Clewza313 5y ago
McSweeney's had a great piece on the absurdity of outdoor dining enclosures: https://www.mcsweeneys.net/articles/i-am-the-designer-of-this-restaurants-outdoor-seating-space-and-this-is-my-artists-statement https://www.mcsweeneys.net/articles/i-am-the-designer-of-thi...

WaitWaitWha 5y ago

What is the "endgame", quantitatively? Who defines what is the "endgame"?

Clewza313 5y ago
That's kind of the point of the article. We used to think "endgame" meant eliminating COVID, now it's become pretty clear that's not going to happen and the best we can do is get to state where we can live with it.

TheCowboy 5y ago

One of the biggest failures still happening is the lack of communication on this. Many people think we're going to eradicate covid-19. Even before the delta variant that seemed like an impractical longshot, and that it was inevitable that it would be endemic. I'm already starting to see polarizing politics on the fringes start to turn endemic into a dirty word instead of the likely reality. People should be prepared and understand that over a 2+ year time frame they have a 99% chance of catching covid-19. And getting the vaccine so they don't start from zero immunity is likely the best we can do.

graeme 5y ago
> I'm already starting to see polarizing politics on the fringes start to turn endemic into a dirty word instead of the likely reality. When you say all this, do you mean to say endemic means benign? Or do you mean to say out world is a fair bit worse than it was, but that’s the reality. Endemic is consistent with “fairly harmful”. Malaria, Dengue, tuburculosis, HIV are all endemic diseases. Time has not made them milder either. I’m asking as a genuine question because the people arguing for endemicity seem to often conflate it with “mild, like a cold”, but that isn’t what the words means. I think “our world is worse now but very unlikely to eradicate” is probably true, but I’d like to get a sense of what people mean by endemicity.
- TheCowboy 5y ago
  Basically trying discredit people who communicate in any way the possibility that covid-19 will be endemic.
  - graeme 5y ago
    Yes, but what do you or those people mean by “it will become endemic”. If Malaria became endemic in every country that would be a catastrophe. There’s nothing gentle about the word. The common cold is endemic and so is dengue. So: are you describing a scenario that is: 1. Business as usual (once we get enough immunity medium/long run) 2. A small bit worse than 2019 3. Quite a bit worse than 2019 4. Substantially worse than 2019 ? My point is the word endemic doesn’t mean anything other than “disease is present”. But people say it as if the word includes severity. When people say that I take them to indicate belief in scenario 1, or possibly scenario 2. I think it probably will be endemic but we’re minimum scenario 3. I don’t think that is what endemicity proponents believe however.

spodek 5y ago

I don't know what return to normalcy anyone is expecting given pollution and climate change. If normal for Americans means polluting and emitting greenhouse gases, we'll accelerate tremendous suffering, including ourselves. If we want to avoid that suffering, we can change our lifestyles (which could increase health, longevity, stability, and more since we waste so much, despite our culture telling us it would cause deprivation and sacrifice). Either way, no return to normalcy, though if we choose to reduce polluting we would improve our lives.