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Long term plan in my mind was to get enough people vaccinated that community spread stops being a thing. We were almost there in late spring prior to delta var

by elihu 5y ago

Long term plan in my mind was to get enough people vaccinated that community spread stops being a thing. We were almost there in late spring prior to delta variant showing up, but now the situation has changed and the percentage of the population that has to be immune to stop the virus has gotten a lot higher. So now the long term plan is for the holdouts to either change their minds and get vaccinated (and many of them have), or for natural herd immunity to take over when there aren't enough people who have neither been infected or vaccinated for the virus to spread to. It seems like the current wave has probably hit a peak. No idea what happens next. New infections could dwindle away to almost nothing, or we might have another big wave. At this point anyone in the U.S. who wants the vaccine can get it. It's sad that over a thousand people a day are still dying of this, but those are the risks that people have for some reason chosen to take. If we continue to have waves of new infections, I don't know what the long term strategy is. We could drop all restrictions and "let nature run its course". A substantial portion of vaccinated people are probably going to be on board with that as long as we don't have a new variant that the vaccines are ineffective against. We could keep rigid restrictions on masking, social distancing, and large gatherings. That's really disruptive though to schools and churches and a lot of businesses, not to mention taking a long term toll on mental health. I do wish those in wealthier countries like the U.S. were more invested in getting vaccines to everyone that wants it, anywhere in the world. New variants can come from anywhere.

VintageCool 5y ago
I think the current wave is going to drift Northwards as the weather turns colder and people spend more time socializing inside.
cjdaly 5y ago
> get enough people vaccinated that community spread stops being a thing The problem with this plan is that vaccinated people still catch and spread the virus. The available vaccines do not create "herd immunity" in the traditional sense. I think the best argument for getting a vaccine now is you will be much less likely to get hospitalized (and/or die) if you catch COVID after being vaccinated. But that argument may not apply to people who already caught it, recovered and now have some natural immunity.
- thebraxton 5y ago
  Don't they have a lower probability of catching it so it does have a serious impact
  - Texaner 5y ago
    Right. Also a lower chance of hospitalization and death, therefore preventing hospitals from clogging up.
    - glogla 5y ago
      Yes but it even one vaccinated person gets COVID it means the whole vaccine is useless!!!11! Ugh. The antivax stance on HN makes me think wbole of the banned Reddit antivaxx subs moved here.
- elihu 5y ago
  That's a good point. I suspect that being vaccinated reduces the likelihood of spreading it to other people somewhat, but I don't know if the data supports that.
droidist2 5y ago
> Long term plan in my mind was to get enough people vaccinated that community spread stops being a thing. We were almost there in late spring prior to delta variant showing up Was this your plan back in March 2020 or did it become your plan somewhere down the line? What I remember from March 2020 is that the plan was to "flatten the curve" with temporary restrictions. The possibility of a vaccine was theorized to be between 18 months away to possibly never.
- elihu 5y ago
  My plan in March 2020 was to wait it out and do whatever I could not to get infected myself. I think at the time I said something to the effect of "I can't imagine this lockdown lasting less than six months." At first I think I expected most people to get it eventually, and the main concern was to keep the hospitals from being overwhelmed all at once. Then after awhile it became apparent that it could be kept under control or not depending on how well people adhered to social distancing and masking. The vaccines arrived, which were supposed to be the thing to end the pandemic. It almost worked. Now we have Delta variant which is far more contagious. Looks like we may be over the hump in the current wave (speaking from a U.S. centric point of view). What happens next depends on whether we can achieve a level of immunity that prevents the virus from spreading.
  - LurkingPenguin 5y ago
    > What happens next depends on whether we can achieve a level of immunity that prevents the virus from spreading. Sir Andrew Pollard, the head of the Oxford Vaccine Group that developed the AZ vaccine, does not think this is possible because vaccinated people can still get and spread the virus. https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-with-the-covid-delta-variant-experts-say.html https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi... > “The problem with this virus is [it is] not measles. If 95% of people were vaccinated against measles, the virus cannot transmit in the population,” he told the U.K.’s All-Party Parliamentary Group on the coronavirus. > Pollard said that while Covid vaccines might slow the spread of the virus — because fully vaccinated but infected people appeared, in studies, to shed less virus, giving the virus less opportunity to spread — new variants were likely to emerge that would also spread. > “I suspect that what the virus will throw up next is a variant which is perhaps even better at transmitting among vaccinated populations and so that’s even more of a reason not to be making a vaccine program around herd immunity.” It is increasingly obvious that we are going to have to find ways to live with this virus. It will be (and basically already is) endemic. Hopefully over time it will become more and more like a cold but until then, aiming for the impossible is only going to make the situation worse because more and more people are seeing that the narrative and claims presented by politicians and technocrats don't add up.
nradov 5y ago
The virus is now endemic and can never be eradicated. The Delta variant is so contagious that there will be no significant herd immunity effect to protect unvaccinated people. All of us can expect to be exposed occasionally no matter what we do. https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8?r=US&IR=T https://www.businessinsider.com/delta-variant-made-herd-immu... In the US, adults who want to be vaccinated have been vaccinated. Children aren't at significant risk. So the best approach is to drop all restrictions and accept the risk.
- jonnycomputer 5y ago
  Nonsense. 1. Many diseases have been considered endemic but were eradicated. Don't be a doomer. 2. The whole schtick about anyone who wants to get the vaccine can get it, so it should be a personal choice makes this common but very much mistaken assumption that a vaccinated individual is safe from harm. It just isn't so. Your personal risk is not affected only by your acquired immunity, but the acquired immunity of everyone around you. Vaccines fundamentally require a communal, cooperative endeavor to succeed.
  - nradov 5y ago
    We eradicated smallpox and (almost) polio because we had highly sterilizing vaccines and no animal hosts. That situation doesn't obtain with SARS-CoV-2. Vaccines are highly effective at preventing deaths and I do encourage vaccination, but vaccinated people can still catch and spread the virus. They are probably less contagious on average, but unfortunately that isn't enough to control community spread. https://www.nature.com/articles/d41586-021-02187-1 https://www.nature.com/articles/d41586-021-02187-1 https://www.nature.com/articles/s41586-021-03944-y https://www.nature.com/articles/s41586-021-03944-y Acknowledging reality isn't being a doomer. Don't engage in magical thinking.
    - jonnycomputer 5y ago
      Delta variant has an R0 of about 7-8. Measles 12-18. And yet, measles is nearly eradicated in the US. You are overstating the extent to which vaccinated individuals are likely to be infectious. But more importantly, you are ignoring the importance of the network effects involved. For x to get to z through y, x has to infect y, and y has to infect z. If probability of infectious breaktrhough and a contact event is 20%, the probability of it getting to z from x, is .2^3 = 0.008. And yet, a 20% is really high-end estimate of that likelihood. You need to both have a breakthrough infection and be in the vicinity of others for potential transmission.
nomel 5y ago
> So now the long term plan is for the holdouts to either change their minds and get vaccinated (and many of them have) This makes the huge assumption that the variants stop. The Mu variant, which appears to be vaccine resistant, is here already: https://www.newsweek.com/mu-variant-which-may-vaccine-resistant-all-50-states-after-nebraska-case-1627297 https://www.newsweek.com/mu-variant-which-may-vaccine-resist... My question is, have we ever mass distributed a non-sterilizing vaccine before?
- yosame 5y ago
  Yeah, every flu vaccine ever made.
- mike00632 5y ago
  Your assumption is that vaccine production has stopped.
  - nomel 5y ago
    No, I question if the vaccines that are currently being produced will remain effective through later strains, requiring new vaccines to be developed, produced, and then redistributed to the populations of the world, in a global game of cat and mouse. Vaccinated people getting and spreading delta show a crack in the armor [1]. More than that, it goes against what was communicated to the public, about these vaccines: > People infected with the Delta variant, including fully vaccinated people with symptomatic breakthrough infections, can transmit the virus to others. 1: https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-variant.html https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-var...
- elihu 5y ago
  I'd assume that new variants arise roughly in proportion to the number of people who are infected at a given point in time. Each infection is like a lottery ticket for developing a new variant. Covid might be around for a very long time, but if we can keep the pandemic under control to the point where we have thousands rather than millions of people getting infected every day, then I'd expect the risk of variants to go way down. (Maybe this is completely right, and the mutations accumulate over time, but either way fewer infections would mean lower risk, even if it isn't exactly a linear relationship.) The question then is can we get new infection under control all around the world? Maybe it'll happen naturally due to herd immunity in places where vaccination is rare, but I'd rather we exported more vaccines to those places. We're all in this together. Interesting thing from that article you link is that just over 99 percent of Covid cases in the U.S. are delta variant. I'm inclined to be skeptical of claims that any variant is bypassing vaccine protections unless we have pretty solid evidence. It's just the nature of news to speculate about worst-case scenarios.

by elihu 5y ago

VintageCool 5y ago

I think the current wave is going to drift Northwards as the weather turns colder and people spend more time socializing inside.

cjdaly 5y ago

> get enough people vaccinated that community spread stops being a thing The problem with this plan is that vaccinated people still catch and spread the virus. The available vaccines do not create "herd immunity" in the traditional sense. I think the best argument for getting a vaccine now is you will be much less likely to get hospitalized (and/or die) if you catch COVID after being vaccinated. But that argument may not apply to people who already caught it, recovered and now have some natural immunity.

thebraxton 5y ago
Don't they have a lower probability of catching it so it does have a serious impact
- Texaner 5y ago
  Right. Also a lower chance of hospitalization and death, therefore preventing hospitals from clogging up.
  - glogla 5y ago
    Yes but it even one vaccinated person gets COVID it means the whole vaccine is useless!!!11! Ugh. The antivax stance on HN makes me think wbole of the banned Reddit antivaxx subs moved here.
elihu 5y ago
That's a good point. I suspect that being vaccinated reduces the likelihood of spreading it to other people somewhat, but I don't know if the data supports that.

droidist2 5y ago

> Long term plan in my mind was to get enough people vaccinated that community spread stops being a thing. We were almost there in late spring prior to delta variant showing up Was this your plan back in March 2020 or did it become your plan somewhere down the line? What I remember from March 2020 is that the plan was to "flatten the curve" with temporary restrictions. The possibility of a vaccine was theorized to be between 18 months away to possibly never.

elihu 5y ago
My plan in March 2020 was to wait it out and do whatever I could not to get infected myself. I think at the time I said something to the effect of "I can't imagine this lockdown lasting less than six months." At first I think I expected most people to get it eventually, and the main concern was to keep the hospitals from being overwhelmed all at once. Then after awhile it became apparent that it could be kept under control or not depending on how well people adhered to social distancing and masking. The vaccines arrived, which were supposed to be the thing to end the pandemic. It almost worked. Now we have Delta variant which is far more contagious. Looks like we may be over the hump in the current wave (speaking from a U.S. centric point of view). What happens next depends on whether we can achieve a level of immunity that prevents the virus from spreading.
- LurkingPenguin 5y ago
  > What happens next depends on whether we can achieve a level of immunity that prevents the virus from spreading. Sir Andrew Pollard, the head of the Oxford Vaccine Group that developed the AZ vaccine, does not think this is possible because vaccinated people can still get and spread the virus. https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-with-the-covid-delta-variant-experts-say.html https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi... > “The problem with this virus is [it is] not measles. If 95% of people were vaccinated against measles, the virus cannot transmit in the population,” he told the U.K.’s All-Party Parliamentary Group on the coronavirus. > Pollard said that while Covid vaccines might slow the spread of the virus — because fully vaccinated but infected people appeared, in studies, to shed less virus, giving the virus less opportunity to spread — new variants were likely to emerge that would also spread. > “I suspect that what the virus will throw up next is a variant which is perhaps even better at transmitting among vaccinated populations and so that’s even more of a reason not to be making a vaccine program around herd immunity.” It is increasingly obvious that we are going to have to find ways to live with this virus. It will be (and basically already is) endemic. Hopefully over time it will become more and more like a cold but until then, aiming for the impossible is only going to make the situation worse because more and more people are seeing that the narrative and claims presented by politicians and technocrats don't add up.

nradov 5y ago

The virus is now endemic and can never be eradicated. The Delta variant is so contagious that there will be no significant herd immunity effect to protect unvaccinated people. All of us can expect to be exposed occasionally no matter what we do. https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8?r=US&IR=T https://www.businessinsider.com/delta-variant-made-herd-immu... In the US, adults who want to be vaccinated have been vaccinated. Children aren't at significant risk. So the best approach is to drop all restrictions and accept the risk.

jonnycomputer 5y ago
Nonsense. 1. Many diseases have been considered endemic but were eradicated. Don't be a doomer. 2. The whole schtick about anyone who wants to get the vaccine can get it, so it should be a personal choice makes this common but very much mistaken assumption that a vaccinated individual is safe from harm. It just isn't so. Your personal risk is not affected only by your acquired immunity, but the acquired immunity of everyone around you. Vaccines fundamentally require a communal, cooperative endeavor to succeed.
- nradov 5y ago
  We eradicated smallpox and (almost) polio because we had highly sterilizing vaccines and no animal hosts. That situation doesn't obtain with SARS-CoV-2. Vaccines are highly effective at preventing deaths and I do encourage vaccination, but vaccinated people can still catch and spread the virus. They are probably less contagious on average, but unfortunately that isn't enough to control community spread. https://www.nature.com/articles/d41586-021-02187-1 https://www.nature.com/articles/d41586-021-02187-1 https://www.nature.com/articles/s41586-021-03944-y https://www.nature.com/articles/s41586-021-03944-y Acknowledging reality isn't being a doomer. Don't engage in magical thinking.
  - jonnycomputer 5y ago
    Delta variant has an R0 of about 7-8. Measles 12-18. And yet, measles is nearly eradicated in the US. You are overstating the extent to which vaccinated individuals are likely to be infectious. But more importantly, you are ignoring the importance of the network effects involved. For x to get to z through y, x has to infect y, and y has to infect z. If probability of infectious breaktrhough and a contact event is 20%, the probability of it getting to z from x, is .2^3 = 0.008. And yet, a 20% is really high-end estimate of that likelihood. You need to both have a breakthrough infection and be in the vicinity of others for potential transmission.

nomel 5y ago

> So now the long term plan is for the holdouts to either change their minds and get vaccinated (and many of them have) This makes the huge assumption that the variants stop. The Mu variant, which appears to be vaccine resistant, is here already: https://www.newsweek.com/mu-variant-which-may-vaccine-resistant-all-50-states-after-nebraska-case-1627297 https://www.newsweek.com/mu-variant-which-may-vaccine-resist... My question is, have we ever mass distributed a non-sterilizing vaccine before?

yosame 5y ago
Yeah, every flu vaccine ever made.
mike00632 5y ago
Your assumption is that vaccine production has stopped.
- nomel 5y ago
  No, I question if the vaccines that are currently being produced will remain effective through later strains, requiring new vaccines to be developed, produced, and then redistributed to the populations of the world, in a global game of cat and mouse. Vaccinated people getting and spreading delta show a crack in the armor [1]. More than that, it goes against what was communicated to the public, about these vaccines: > People infected with the Delta variant, including fully vaccinated people with symptomatic breakthrough infections, can transmit the virus to others. 1: https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-variant.html https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-var...
elihu 5y ago
I'd assume that new variants arise roughly in proportion to the number of people who are infected at a given point in time. Each infection is like a lottery ticket for developing a new variant. Covid might be around for a very long time, but if we can keep the pandemic under control to the point where we have thousands rather than millions of people getting infected every day, then I'd expect the risk of variants to go way down. (Maybe this is completely right, and the mutations accumulate over time, but either way fewer infections would mean lower risk, even if it isn't exactly a linear relationship.) The question then is can we get new infection under control all around the world? Maybe it'll happen naturally due to herd immunity in places where vaccination is rare, but I'd rather we exported more vaccines to those places. We're all in this together. Interesting thing from that article you link is that just over 99 percent of Covid cases in the U.S. are delta variant. I'm inclined to be skeptical of claims that any variant is bypassing vaccine protections unless we have pretty solid evidence. It's just the nature of news to speculate about worst-case scenarios.