10 ms·

Based on the five or six "variants being monitored" that present actual threats, it seems like the virus adapts within 18 months, which is pretty fast for resea

Based on the five or six "variants being monitored" that present actual threats, it seems like the virus adapts within 18 months, which is pretty fast for researchers to find new solutions, test them in a population safely, and then get the FDA to safely approve them. Are we going to get to a situation like the annual Flu vaccine, where it is tested and released in (what I'm guessing) less than a year? Otherwise, it seems like we'll be chasing this virus with outdated solutions forever. Moderna and Pfizer are both currently testing a vaccine that is specific to Delta, but by the time it's approved (my guess: January/February) the current wave will be long behind us.

bawolff 5y ago
I don't think that follows. I don't see why rate of adaption would stay consistent with the early stages of a new virus in later stages. I don't see how you conclude the virus adapted after 18 months due to six variants of concern existing. Especially because existing solutions are still very effective with the new variants, even if its somewhat of a decline. Even if you accept that as "adaption" its still a sample size of 1.
amluto 5y ago
The latest papers suggest that delta has very little vaccine-evading ability. It’s more contagious in general, and the Pfizer/BioNTech vaccine is less effective after several months than would be ideal. Of course, this means that most breakthrough infections are delta.
xapata 5y ago
While we may have some uncertainty about SARS-CoV-2 specifically, it seems clear to me that in the long run we'll need to treat coronaviruses in general much like influenza viruses. So, yes.
- nradov 5y ago
  There are already 4 other endemic coronaviruses. We seldom treat them with anything stronger than chicken soup and Tylenol. Most of us get infected when we're young and the resulting immunity protects us as we age.
  - xapata 5y ago
    Remember SARS-CoV-1? There will be more. It's like "the big one" earthquake, just a matter of time. But, I suppose we stick our heads in the sand for all sorts of things, so we might ignore this one (again).
postalrat 5y ago
Sounds like a money machine.
colechristensen 5y ago
There are evolutionary pressures on viruses that tend to weaken them over time. You get variants competing with each other and the more silent ones get advantages over the ones with worse outcomes. It isn’t clear exactly what is going to happen, but as more people get vaccinated and natural immunity and the variants continue to evolve the situation might change a lot or become unnoticeable. I would love to see an epidemic expert comment on the long term evolutionary effects of different mitigation strategies which might differ in preferences than short term trying to reduce number of infections.
- somewhereoutth 5y ago
  > tend to weaken them over time Perhaps you could furnish us with some examples of such viruses? Every virus I can think of certainly hasn't weakened over time.
  - colechristensen 5y ago
    The 1918 “Spanish” influenza pandemic that killed 1-5% of the human population still has descendants in circulation both direct and through horizontal gene transfers. Basically all influenza A infections contain at least a piece descended from 1918.
- wrl 5y ago
  > There are evolutionary pressures on viruses that tend to weaken them over time. Those evolutionary pressures relate to transmissibility. Basically, a virus that kills its host before it can spread doesn't spread very far at all. SARS-CoV-2's defining feature of asymptomatic spread decouples this and so far hasn't led to weakening – indeed, Delta is both substantially more transmissible and more likely to cause severe disease and death.
  - jdavis703 5y ago
    Right, and because of severe disease and death health authorities introduced more stringent rules to reduce transmission. Evolutionary this should eventually pressure the virus in to becoming less severe (assuming public health policy continues to be focused on preventing severe disease and death).
murphyslab 5y ago
There's some evidence that major mutations are happening in severely immunocompromised patients, since COVID is able to stick around longer. [0] The length of infection seems to be one aspect allowing for evolutionary success of the virus: > A leading hypothesis is that these variants, characterized by a large number of nonsynonymous mutations, originated within individuals with long durations of infection during which the virus was subject to prolonged immune pressure (7, 8), and that this was potentially facilitated by the within-host emergence of deletions (49). [0] Consequently, some have suggested that monitoring for new strains might focus on such patients as a way to predict future adaptations in the wild, as scientist have observed some mutations re-occurring within immunocompromised individuals. So it might be possible to predict some mutations. [0] : https://www.nytimes.com/2021/03/15/health/coronavirus-variants-immunocompromised-patients.html https://www.nytimes.com/2021/03/15/health/coronavirus-varian... [1] : https://www.science.org/doi/full/10.1126/science.abg0821 https://www.science.org/doi/full/10.1126/science.abg0821
- beebmam 5y ago
  People usually aren't very contagious past the initial stage of the disease. And yes, there are virologists who are studying the mutation-space of the virus and are planning a vaccine regimen which targets all possible mutations of SARS-CoV-2. Check out this absolutely terrific lecture by Paul Bieniasz about his work on exploring the mutation space of SARS-CoV-2: https://www.youtube.com/watch?v=LIcaSqQFrX0 https://www.youtube.com/watch?v=LIcaSqQFrX0
  - nradov 5y ago
    Right patients with normal immune systems aren't really contagious past 10 days from initial infection (often less). But the issue is that immunocompromised patients can have persistent infections lasting much longer, which both allows more opportunities for viral mutation and gives more time to transmit the infection to others.
raphlinus 5y ago
On the question of whether we need to update the vaccines: Sara Gilbert spoke to this in some detail in her TWiV interview [813]. They have been testing versions specific to other variants, but haven't found a real need. Delta is not very different antigenically than the ancestral type - beta and gamma are more so, but delta is winning because it's more transmissible. The story becomes quite complex when you get into details - the T and B memory cells broaden the response, so are unlikely to need much updating. [813]: https://www.youtube.com/watch?v=A_5o6qZyyQk&t=1145s https://www.youtube.com/watch?v=A_5o6qZyyQk&t=1145s

bawolff 5y ago

I don't think that follows. I don't see why rate of adaption would stay consistent with the early stages of a new virus in later stages. I don't see how you conclude the virus adapted after 18 months due to six variants of concern existing. Especially because existing solutions are still very effective with the new variants, even if its somewhat of a decline. Even if you accept that as "adaption" its still a sample size of 1.

amluto 5y ago

The latest papers suggest that delta has very little vaccine-evading ability. It’s more contagious in general, and the Pfizer/BioNTech vaccine is less effective after several months than would be ideal. Of course, this means that most breakthrough infections are delta.

xapata 5y ago

While we may have some uncertainty about SARS-CoV-2 specifically, it seems clear to me that in the long run we'll need to treat coronaviruses in general much like influenza viruses. So, yes.

nradov 5y ago
There are already 4 other endemic coronaviruses. We seldom treat them with anything stronger than chicken soup and Tylenol. Most of us get infected when we're young and the resulting immunity protects us as we age.
- xapata 5y ago
  Remember SARS-CoV-1? There will be more. It's like "the big one" earthquake, just a matter of time. But, I suppose we stick our heads in the sand for all sorts of things, so we might ignore this one (again).

postalrat 5y ago

Sounds like a money machine.

colechristensen 5y ago

There are evolutionary pressures on viruses that tend to weaken them over time. You get variants competing with each other and the more silent ones get advantages over the ones with worse outcomes. It isn’t clear exactly what is going to happen, but as more people get vaccinated and natural immunity and the variants continue to evolve the situation might change a lot or become unnoticeable. I would love to see an epidemic expert comment on the long term evolutionary effects of different mitigation strategies which might differ in preferences than short term trying to reduce number of infections.

somewhereoutth 5y ago
> tend to weaken them over time Perhaps you could furnish us with some examples of such viruses? Every virus I can think of certainly hasn't weakened over time.
- colechristensen 5y ago
  The 1918 “Spanish” influenza pandemic that killed 1-5% of the human population still has descendants in circulation both direct and through horizontal gene transfers. Basically all influenza A infections contain at least a piece descended from 1918.
wrl 5y ago
> There are evolutionary pressures on viruses that tend to weaken them over time. Those evolutionary pressures relate to transmissibility. Basically, a virus that kills its host before it can spread doesn't spread very far at all. SARS-CoV-2's defining feature of asymptomatic spread decouples this and so far hasn't led to weakening – indeed, Delta is both substantially more transmissible and more likely to cause severe disease and death.
- jdavis703 5y ago
  Right, and because of severe disease and death health authorities introduced more stringent rules to reduce transmission. Evolutionary this should eventually pressure the virus in to becoming less severe (assuming public health policy continues to be focused on preventing severe disease and death).

murphyslab 5y ago

There's some evidence that major mutations are happening in severely immunocompromised patients, since COVID is able to stick around longer. [0] The length of infection seems to be one aspect allowing for evolutionary success of the virus: > A leading hypothesis is that these variants, characterized by a large number of nonsynonymous mutations, originated within individuals with long durations of infection during which the virus was subject to prolonged immune pressure (7, 8), and that this was potentially facilitated by the within-host emergence of deletions (49). [0] Consequently, some have suggested that monitoring for new strains might focus on such patients as a way to predict future adaptations in the wild, as scientist have observed some mutations re-occurring within immunocompromised individuals. So it might be possible to predict some mutations. [0] : https://www.nytimes.com/2021/03/15/health/coronavirus-variants-immunocompromised-patients.html https://www.nytimes.com/2021/03/15/health/coronavirus-varian... [1] : https://www.science.org/doi/full/10.1126/science.abg0821 https://www.science.org/doi/full/10.1126/science.abg0821

beebmam 5y ago
People usually aren't very contagious past the initial stage of the disease. And yes, there are virologists who are studying the mutation-space of the virus and are planning a vaccine regimen which targets all possible mutations of SARS-CoV-2. Check out this absolutely terrific lecture by Paul Bieniasz about his work on exploring the mutation space of SARS-CoV-2: https://www.youtube.com/watch?v=LIcaSqQFrX0 https://www.youtube.com/watch?v=LIcaSqQFrX0
- nradov 5y ago
  Right patients with normal immune systems aren't really contagious past 10 days from initial infection (often less). But the issue is that immunocompromised patients can have persistent infections lasting much longer, which both allows more opportunities for viral mutation and gives more time to transmit the infection to others.

raphlinus 5y ago

On the question of whether we need to update the vaccines: Sara Gilbert spoke to this in some detail in her TWiV interview [813]. They have been testing versions specific to other variants, but haven't found a real need. Delta is not very different antigenically than the ancestral type - beta and gamma are more so, but delta is winning because it's more transmissible. The story becomes quite complex when you get into details - the T and B memory cells broaden the response, so are unlikely to need much updating. [813]: https://www.youtube.com/watch?v=A_5o6qZyyQk&t=1145s https://www.youtube.com/watch?v=A_5o6qZyyQk&t=1145s