34 ms·

Children develop robust and sustained cross-reactive immunity after Covid

164 points by malchow 5y ago

mikeyouse 5y ago
Finally some glimmers of hope in moving past Covid.. if Omicron continues on its current track of highly infectious but less serious —- and infection confers reactive immunity to a variety of strains, we could be closer to the endemic but manageable end game. Good vaccines + mild severity illness are basically the best case. What a stroke of luck that we are here vs a more infectious strain of Delta or some other nightmare that would keep this rolling.
- jokethrowaway 5y ago
  Indeed! I really hope governments will start recognising this and give us back our freedom. Media messages and restrictions are still pretty negative, despite the lack of severity. I don't know how can they talk about another lockdown. Delta also had lower mortality than the first wave: this was confirmed by some fact-checkers and not by others (depending on how alarmist the fact-checker is) but looking at numbers, it does seem to be case. It seems to be an evolutionary trend where the virus mutations that are successful became more transmissible and less deadly (probably because a dead host doesn't spread as much as an alive one).
  - johnchristopher 5y ago
    > It seems to be an evolutionary trend where the virus mutations that are successful became more transmissible and less deadly (probably because a dead host doesn't spread as much as an alive one). Covid spreads while still being non-symptomatic so that explanation doesn't stand that much. Flu is not getting milder. Also, how many times more do you think you can get hit in the face by Manny Pacquiao instead of Mike Tyson and survive because his punches are milder ? How many times can we keep catching mild covid and escape long term damages (edit: and death and everything in between) ?
  - kiba 5y ago
    Indeed! I really hope governments will start recognising this and give us back our freedom. Media messages and restrictions are still pretty negative, despite the lack of severity. I don't know how can they talk about another lockdown. A lockdown is probably impractical at this point, but we are stuck with a disease that will be a health burden on humanity that will be difficult to eliminate. For example, if a disease kills 40,000 people per year. That's 400,000 people in a decade. A drop in the bucket of humanity for sure, but that's about a city size population. That's not counting the collectively lost days in term of feeling terrible.
    - indigochill 5y ago
      > For example, if a disease kills 40,000 people per year. That's 400,000 people in a decade. A drop in the bucket of humanity for sure, but that's about a city size population. That's not counting the collectively lost days in term of feeling terrible. Heart disease kills 659,000 people a year in the US alone (https://www.cdc.gov/heartdisease/facts.htm https://www.cdc.gov/heartdisease/facts.htm), but for some reason we're not having COVID-level panic about it. I'm struggling to find annual statistics for COVID, but I did find an article written September '21 stating there had been over 630,000 COVID deaths in the US since the start of 2020, so that's over a year and a half-ish, so a bit less than heart disease. Of course, heart disease isn't contagious (at least not in the traditional sense - genetics and lifestyle factors could be considered contagious if you're flexible with the term), but it's also a cause of death we've grown disconcertingly accustomed to for how prevalent it is. I expect once this outbreak has run its course, we'll probably see annual COVID deaths settle at a much lower number thanks to vaccinations/immunity. I'm not sure when we'll come to accept it as just another risk of life, though.
      - pessimizer 5y ago
        I don't understand this argument at all. Are you saying that if heart disease went from killing 650 thousand people a year to 1.3 million people a year, that wouldn't cause a massive freakout?
      - fader 5y ago
        > Heart disease kills 659,000 people a year in the US alone (https://www.cdc.gov/heartdisease/facts.htm https://www.cdc.gov/heartdisease/facts.htm), but for some reason we're not having COVID-level panic about it. I think you answered this yourself: > Of course, heart disease isn't contagious If heart disease were contagious and could be effectively curtailed by wearing masks and getting a vaccine, I think you'd see a similar reaction to it that you're seeing to covid.
  - ummonk 5y ago
    Delta had equal or higher severity per infection than alpha which in turn had higher severity than the original variant. It just had lower mortality than the first wave because people had higher preexisting immunity, treatment had improved, and some of the most vulnerable had already been culled from the herd. You have to compare between two variants at the same time, not against previous waves. Omicron is the first major variant to actually be less severe on this metric.
  - nradov 5y ago
    Freedom is seldom given. It usually has to be taken.
- Amezarak 5y ago
  The question ever since it became clear that this coronavirus was endemic has been what a "manageable end game" is: that is, what level of risk and mortality are we prepared to accept, given that deaths from Covid will never be zero. This is, in my opinion, the primary underlying disagreement. Some people think that no amount of deaths from Covid is acceptable. Some people believe that even the peak pandemic mortality is acceptable. And others fall somewhere in between, by, for example, focusing on hospital capacity. I don't think there is any long-term solution to Covid as a social issue, something we talk about and can't move past, until some kind of consensus is reached on this.
  - epgui 5y ago
    And from my point of view as someone in the field, arguments on either side are almost always based on an intuitive gut feeling about morality. Very few people actually try to wrangle with putting numbers on the cost (in dollars) of a human life, or the economic burden of disease. There are no right or wrong numbers, but only if you begin there can you say you're rationally considering the economic or political tradeoffs. Edit: and deaths could absolutely reach zero. If we threw everything and the kitchen sink at the problem, we would eradicate it in absolutely no time. The underlying question is the same here, namely whether the cost of eradicating the disease would be larger or smaller than what we would gain from doing it.
    - ummonk 5y ago
      I think you overestimate our ability to “eradicate it in absolutely no time”. Eliminating it from both human and animal reservoirs (and permanently quarantining any immunocompromised carriers) worldwide would be a long and arduous process.
      - epgui 5y ago
        You make a great point about animal reservoirs, but the transmission bandwidth between humans and animals is afaik much lower than between humans. If you accept this assumption, and if we also assume that we really wanted to eradicate this thing, we could limit human transmission such as to reduce Rt well below 1 by implementing well-coordinated and strict policies. Then you're left with the "leaky bucket" of transmission between humans and animals... But this is a known vulnerable point which could be monitored effectively and very cheaply.
- soperj 5y ago
  >What a stroke of luck that we are here vs a more infectious strain of Delta or some other nightmare that would keep this rolling. How do we know we won't end up with that? Omicron evolved from Beta, which had pretty well disappeared when Omicron sprung up.
  - ummonk 5y ago
    The better omicron is at spreading the more people it will confer natural / hybrid immunity to, reducing the dangers of a future variant.
    - soperj 5y ago
      Hopefully... the history of diseases before vaccines (polio, measles, smallpox, black plague, etc) doesn't exactly fill me with a lot of hope for it just becoming less deadly naturally, even if there are examples (Spanish flu) where they have.
      - lotsofpulp 5y ago
        What are the histories of the other coronaviruses? And would those histories be more relevant than histories of non coronaviruses?
        nradov 5y ago
        Another coronavirus probably caused a worldwide pandemic starting in 1889. It killed a lot of people, but the survivors gained natural immunity which gave them significant protection against symptomatic reinfections. The same virus HCoV-OC43 is still endemic today. This seems relevant to the current pandemic. https://sfamjournals.onlinelibrary.wiley.com/doi/10.1111/1751-7915.13889 https://sfamjournals.onlinelibrary.wiley.com/doi/10.1111/175... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/
        nawgz 5y ago
- deleted 5y ago
  [deleted]
- DanBC 5y ago
  > a more infectious strain of Delta What? Omicron is a more infectious version of Delta. Omicron causes the same number of deaths and hospitalisations and long covid as delta. It just also infects a lot more people more easily, and those people are at low risk and push the CFR down.
  - rsfern 5y ago
    As the data becomes more available from South Africa, the UK, and Denmark, it’s starting to look like Omicron is a more infectious version of the wild type, maybe 40% less virulent than Delta, at least in terms of putting people in the hospital. There’s still not enough data to conclude about mortality. The good news is that prior immunity seems to confer a large degree of protection from severe illness still https://www.lesswrong.com/posts/YBB9yZNJuz5j8hLdP/omicron-post-9 https://www.lesswrong.com/posts/YBB9yZNJuz5j8hLdP/omicron-po...
    - DanBC 5y ago
      https://twitter.com/dgurdasani1/status/1475061938010865665?s=20 https://twitter.com/dgurdasani1/status/1475061938010865665?s... > Your risk of getting hospitalised with SARS-CoV-2 (any variant) depends on two things? 1. how likely are you to get infected? 2. what is your chance of getting hospitalised once infected > In simple terms, because omicron can escape immunity from past infections and vaccines, your protection against infection against omicron is vastly lower than with delta. This means risk of 1. is vastly increased- as you're less protected & also v. high background transmission.
  - oh_sigh 5y ago
    Omicron isn't a version of Delta.
    - DanBC 5y ago
- skocznymroczny 5y ago
  There's no moving past covid until an exit plan is announced. If there isn't one, the only hope of moving past covid is resistance. If people stopped rushing for the latest vaccine, stopped getting tested regularly, even without symptoms, we would be past covid already.
  - runjake 5y ago
    You’re going to have to lay down the logic behind this one for me. I am not getting it.
    - adam_arthur 5y ago
      The gist OP is getting at, though not put so eloquently, is that covid is endemic and there will continue to be deaths, even in a world with 100% vaccinated and boosted people. So covid being "over" is really a state of mind/choice of when to accept that it's endemic and drop the hysterics/restrictions. Omicron should be cheered as an effectively natural vaccine that looks to quickly end the worst of covid, yet media continues to fear monger about case counts, by and large. I am seeing some articles speaking to it as beneficial though. The fear a lot of people have over covid is totally out of proportion with the actual data, and media by and large continues to stoke these fears.
      - zerocount 5y ago
        That was elegant and much more insightful.
      - bonzini 5y ago
        > Omicron should be cheered as an effectively natural vaccine that looks to quickly end the worst of covid In the medium term yes; in the short term, with millions of unvaccinated people and a very fast exponential growth, it still has potential to overflow healthcare.
      - amanaplanacanal 5y ago
        I dunno, people working in the health care system are getting burned out and quitting in droves. I'd kind of like there to be doctors and nurses there to take care of me if I need to go to the hospital for whatever reason. Your state of mind seems irrelevant to this.
- hinkley 5y ago
  If infection grants more generalized immunity, doesn’t that mean a tailored vaccine would do the same?
  - nradov 5y ago
    Possibly yes. https://www.defenseone.com/technology/2021/12/us-army-creates-single-vaccine-effective-against-all-covid-sars-variants/360089/ https://www.defenseone.com/technology/2021/12/us-army-create...
- johnchristopher 5y ago
  > Good vaccines + mild severity illness are basically the best case. If it was a common cold or a flu ? Maybe. > “Although COVID-19 has been described as a respiratory syndrome, evidence supports the involvement of multiple organ systems, with fibrosis, and inflammation in the lung, heart, kidneys, central nervous system (CNS), liver, adrenal glands, bone marrow, lymph nodes, and gastrointestinal tract. SARS-CoV-2 infection has also been associated with serious thrombotic complications, including strokes, pulmonary embolism, and cardiac injury.” https://www.wsws.org/en/articles/2021/11/10/leon-n10.htm https://www.wsws.org/en/articles/2021/11/10/leon-n10.htm Endemic we want ? Then we want yearly (or 6months it seems) vaccines. And masks. And ventilation. Reinfections will get more severe with age once vaccine or infection elicited sera wanes. > What a stroke of luck that we are here vs a more infectious strain of Delta or some other nightmare that would keep this rolling. Omicron being the new kid on the block doesn't mean another more dangerous variant isn't building itself up in a body somewhere. Maybe two years into the pandemic is not enough to let the reality sink in that we will never come back to before. Maybe we need ten years but by then we'll all be used to the new normal anyway. “Learn to live with the virus”, they said. Indeed.
  - iamdamian 5y ago
    I'm not sure why we wouldn't be able to go back to normal, and taking a stance that we never will strikes me as somewhat defeatist. I'm more of an optimist. Having a small percentage of the population that's at greater risk of serious implications from infection (respiratory or otherwise) is something we've learned to live with before (see: the flu) without masks, mandates, or dramatically rearranging the way we live.
    - johnchristopher 5y ago
      > I'm not sure why we wouldn't be able to go back to normal, There are no path back to normal unless the virus disappears. We have vaccines that work for a limited time, we'll soon have pills@home. It will still not be `back to normal`. > and taking a stance that we never will strikes me as somewhat defeatist. We'll also never have FTL spaceships or teleportation star trek style. > I'm more of an optimist. Having a small percentage of the population that's at greater risk of serious implications from infection (respiratory or otherwise) is something we've learned to live with before (see: the flu) without masks, mandates, or dramatically rearranging the way we live. Covid is not the flu. Hoping it'll magically turn into a flu or that we can manage it like a flu is ignoring the reality currently unfolding. 40 years later and we still need condoms. We are not back to sex as it was in the 70's. Generations of teenagers have had their first time with a condom. This is what is normal now.
- lamontcg 5y ago
  Omicron's lower hospitalization rate is likely just due to vaccination and recovery from infection with Delta. Delta was transmissible enough to complete the vaccination program. Given that Omicron has higher viral loads, shorter serial interval and shorter incubation period than Delta, it is much more likely that Omicron is more intrinsically virulent as well and would be worse if you dropped it on a totally naive population in the summer of 2019. The current population, however, is longer immunologically naive, and I think that researchers are underestimating the existing seroprevalence. At the same time if there's still pockets of entirely unexposed/unvaccinated people out there in rural areas or something, Omicron will likely find them since it seems to largely ignore unboosted Nabs to prior infection or vaccination. Kids in colleges will be taking Omicron home for Christmas to rural families right about now and a few weeks from now we should find out how many seronegative people are left. If it Omicron fizzles though it is going to just be that Delta didn't leave anyone immune naive in its wake.
  - jacquesm 5y ago
    Another factor (though I'm not sure how large that factor is) is that a chunk of the susceptible population isn't around any more.
    - lamontcg 5y ago
      Literal survivorship bias. There may also be a hard-to-infect/hard-to-seroconvert portion of the population left that could practically walk unmasked through a COVID ward in a hospital and not get infected. If they exist then the seronegative proportion of the population will start to be composed mostly of them over time through "purifying selection". This is also why I'm somewhat skeptical about all the vaccine efficacy numbers that studies are throwing around. I don't think an adequate control group exists any more.
      - jacquesm 5y ago
        That's a good point: having a control group is pretty much a must to be able to get reliable numbers on efficacy and any future vaccine or medicine is going to have to some extent work with corrupted data from day #1.
- nikolay 5y ago
  It will be Omicron for a short period of time. Then it would split into different variants. So, don't keep your hopes up!
abduhl 5y ago
So the long Covid we’ve been afraid of for our children this whole time has actually been long term immunity? How ironic that our own push to vaccinate and save our children could put them in a worse position immunity-wise. Like rain on your wedding day.
- epgui 5y ago
  Biochemist here: your claim that vaccination puts children in a worse position is neither supported by this paper, nor substantiated by any other data point to the best of my knowledge.
  - jokethrowaway 5y ago
    I think his point is that the immune response from the vaccine is lower than from just getting covid and the risks from getting covid for children are really low. Still, I don't think it makes much of a difference either way, especially for kids who don't have much to fear from covid.
    - epgui 5y ago
      "immune response from the vaccine is lower than from just getting covid" {{citation needed}} My point is that this is unsubstantiated. And it does make a big difference, because this reduces the likelihood of children going through multiple periods of infectivity: the fewer times children are infectious to others, on average, the more herd immunity we have, collectively, against SARS-CoV-2.
      - abduhl 5y ago
        epgui 5y ago
        I have no idea what you mean. I believe (and at least I was hoping that) my comment was helpful.
epgui 5y ago
Biochemist opinion: somewhat speculative, but what I take from this is that immunity in children makes them less likely than adults to shift from 'removed' to 'susceptible', in the SIR model. [1] [1] https://en.wikipedia.org/wiki/Compartmental_models_in_epidemiology#The_SIR_model https://en.wikipedia.org/wiki/Compartmental_models_in_epidem...
disambiguation 5y ago
We're going to look back on our treatment of children these past 2 years as one of the greatest blunders in the history of public health policy.
- jacquesm 5y ago
  You may want to read this: https://www.washingtonpost.com/health/2021/12/24/omicron-children-hospitalizations-us/ https://www.washingtonpost.com/health/2021/12/24/omicron-chi...
- daenz 5y ago
  We sacrificed the mental health of the young for the physical health of the old.
  - wiseowise 5y ago
    But hey, grandma gets to live another year now. Who cares if the poor family never recovers after financial crisis.
    - objektif 5y ago
      I am sure anyone can recover from financial troubles. It is possible.. The other one? Not so much...
      - wiseowise 5y ago
        Yep! Anyone can pull themselves by their bootstraps.
        mechanical_bear 5y ago
        Yes.
    - deleted 5y ago
      [deleted]
    - 5y ago
rsfern 5y ago
So one of the main conclusions is that SARS-CoV-2 in children produces antibody responses to all the other human coronaviruses (this happens in adults too, but the effect is stronger in children) In the discussion section they speculate that maybe recent infection with these other coronaviruses could give some level of protection against SARS-CoV-2, and that this could possibly explain some of the unusual-ness of the age-severity relationship, I.e. that very young children are not hit as hard by SARS-CoV-2 as by other diseases like the flu (relatively). That would be really interesting to see investigated carefully
nradov 5y ago
So it's the same as other coronaviruses like HCoV-OC43. There's no vaccine available for those other ones so most of us get infected as youths, and the resulting immunity protects us as we age. But they can still be dangerous to immunologically naive older patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/
- clairity 5y ago
  it's been obvious since march of last year that this was the inevitable outcome of covid, yet we've spent nearly two years hand-wringing and fearmongering over it. it's the novelty of the virus combined with the general unpreparedness of our immune systems (obesity, sickness of all sorts, and age correlate with lowered immune preparedness) that's created this wave of initial severity as the virus works it's way to a steady-state similar to other coronaviruses. most people had, and still have, very little idea about how these things work, yet grandstand and moralize on about ineffective but distruptive remediations like masks and lockdowns that they hear about via propagandized media. even vaccines need only be seriously considered by the aforementioned immune-deficient (obese, elderly, etc.), not everyone (this article providing that evidence for children specifically).
  - bjoli 5y ago
    I think it has been pretty clear for a very long time that covid is something we will all get, and that it might even become something bot unlike the seasonal flu. The message has to my ears been "less contact = less infection = better access to healthcare for those who really need it". What would you suggest instead? I am all for discussing the losses contra gains of lockdowns, but I dont think any options have sounded much better.
    - clairity 5y ago
      frankly, there wasn't a whole lot we could do to alter the trajectory we were on. even a month(s)-long, wuhan-style lockdown could only temporarily arrest infection rates, unless the whole world literally did it together. even then, reintroduction via animal reservoirs would be a significant threat. that's what we should have come to grips with early on, accepting that we are not the masters of even our own little earth out of the vast universe. regarding "= better access to healthcare for those who really need it", that was entirely a political and economic choice to focus primarily on profit over critical care services and availability (not just the past 2 years, but decades). even so, hospitals aren't overflowing, as we keep hearing on the news, except in short-lived, isolated cases. 'exponential growth' was mediopolitical fearmongering, not mathematically sound modeling. if anything, that our limited hospital capacity has weathered the storm gives more hope, not less. the biggest mistake we (that is, our various levels of government) made was not hyperfocusing on the immune deficient, and only the immune deficient (obese, chronically ill, elderly, etc.). for instance, we should have locked down care facilities immediately (along with care staff, perhaps 2 weeks on, 1 week off, 1 week quarantine, with generous benefits/pay). we should have enouraged physical fitness nine ways to sunday (more bikes, less cars!). beyond that, give people timely and accurate information (as in, if it's uncertain, tell people how uncertain), encourage (don't mandate) pro-social (not self-righteous) behavior, and then ride it out. people already modulate their behavior (e.g., distancing, socializing) based on prevailing local conditions, so mask mandates and (theatrical) lockdowns really have had very marginal (and possibly no) effect on infections, hospitalizations, and death. certainly don't shut down gyms, parks, restaurants, small businesses, offices, and the like. perhaps consider limiting venues that encourage hypersocial behavior (i.e., partying), like bars and clubs. again, we already modulate our behavior, so shutdowns likely had no or marginally small effect. once vaccines were emergency-approved, encourage the immune deficient to take them, and allow the risk-averse to take them as well. don't mandate them for anyone, since they're non-sterilizing (and mRNA tech is new). with that, we'd probably be right around where we are now, but without all the stress, fear, anger, and divisiveness.
TeeMassive 5y ago
Serious question: should we let this more infectious but less dangerous run its course to achieve natural immunity? What are the arguments for and against this strategy? I know that if it is 5 times less likely to put people in hospitals but 10 times more transmissible then there will be 2 times more people in hospitals, but are there more arguments?
- philovivero 5y ago
  Yes. We should do that. We won't. Pro: everyone is fine, the hospitals aren't overwhelmed, the anti-vaxxers will be fine along with everyone else. Con: can't speak with disgust and disdain anymore to those who disagree with your medical opinions, or have concerns with how quickly you're forcing your experimental medications on the entire planet. Not going to happen. I've already seen the usual suspects talking about how we need bigger, better, stronger vaccines for Omicron. We're pretty excited by this RNA vaccine tech, and we're going to use it, no matter what happens. There's too much money and too much political power on the pro-vax anti-immune-system side of things.
  - pavel_lishin 5y ago
    > everyone is fine Except the people who aren't. > the hospitals aren't overwhelmed Except the ones that are. > forcing your experimental medications on the entire planet No more experimental than any other vaccine; due to how quickly COVID spread, we were able to do the same level of testing on the vaccine as for any other medication. It's as safe as anything else you take.
    - tonguez 5y ago
      “No more experimental than any other vaccine” you are creating more vaccine hesitancy by saying this
    - donkarma 5y ago
      vaccine trials usually last 2 years alone from a quick glance
temptemptemp111 5y ago
fasdf23467 5y ago
Fantastic news. Actual science. Thanks to these folk and gals, so much.

164 points by malchow 5y ago

Finally some glimmers of hope in moving past Covid.. if Omicron continues on its current track of highly infectious but less serious —- and infection confers reactive immunity to a variety of strains, we could be closer to the endemic but manageable end game. Good vaccines + mild severity illness are basically the best case. What a stroke of luck that we are here vs a more infectious strain of Delta or some other nightmare that would keep this rolling.

jokethrowaway 5y ago
Indeed! I really hope governments will start recognising this and give us back our freedom. Media messages and restrictions are still pretty negative, despite the lack of severity. I don't know how can they talk about another lockdown. Delta also had lower mortality than the first wave: this was confirmed by some fact-checkers and not by others (depending on how alarmist the fact-checker is) but looking at numbers, it does seem to be case. It seems to be an evolutionary trend where the virus mutations that are successful became more transmissible and less deadly (probably because a dead host doesn't spread as much as an alive one).
- johnchristopher 5y ago
  > It seems to be an evolutionary trend where the virus mutations that are successful became more transmissible and less deadly (probably because a dead host doesn't spread as much as an alive one). Covid spreads while still being non-symptomatic so that explanation doesn't stand that much. Flu is not getting milder. Also, how many times more do you think you can get hit in the face by Manny Pacquiao instead of Mike Tyson and survive because his punches are milder ? How many times can we keep catching mild covid and escape long term damages (edit: and death and everything in between) ?
- kiba 5y ago
  Indeed! I really hope governments will start recognising this and give us back our freedom. Media messages and restrictions are still pretty negative, despite the lack of severity. I don't know how can they talk about another lockdown. A lockdown is probably impractical at this point, but we are stuck with a disease that will be a health burden on humanity that will be difficult to eliminate. For example, if a disease kills 40,000 people per year. That's 400,000 people in a decade. A drop in the bucket of humanity for sure, but that's about a city size population. That's not counting the collectively lost days in term of feeling terrible.
  - indigochill 5y ago
    > For example, if a disease kills 40,000 people per year. That's 400,000 people in a decade. A drop in the bucket of humanity for sure, but that's about a city size population. That's not counting the collectively lost days in term of feeling terrible. Heart disease kills 659,000 people a year in the US alone (https://www.cdc.gov/heartdisease/facts.htm https://www.cdc.gov/heartdisease/facts.htm), but for some reason we're not having COVID-level panic about it. I'm struggling to find annual statistics for COVID, but I did find an article written September '21 stating there had been over 630,000 COVID deaths in the US since the start of 2020, so that's over a year and a half-ish, so a bit less than heart disease. Of course, heart disease isn't contagious (at least not in the traditional sense - genetics and lifestyle factors could be considered contagious if you're flexible with the term), but it's also a cause of death we've grown disconcertingly accustomed to for how prevalent it is. I expect once this outbreak has run its course, we'll probably see annual COVID deaths settle at a much lower number thanks to vaccinations/immunity. I'm not sure when we'll come to accept it as just another risk of life, though.
    - pessimizer 5y ago
      I don't understand this argument at all. Are you saying that if heart disease went from killing 650 thousand people a year to 1.3 million people a year, that wouldn't cause a massive freakout?
    - fader 5y ago
      > Heart disease kills 659,000 people a year in the US alone (https://www.cdc.gov/heartdisease/facts.htm https://www.cdc.gov/heartdisease/facts.htm), but for some reason we're not having COVID-level panic about it. I think you answered this yourself: > Of course, heart disease isn't contagious If heart disease were contagious and could be effectively curtailed by wearing masks and getting a vaccine, I think you'd see a similar reaction to it that you're seeing to covid.
- ummonk 5y ago
  Delta had equal or higher severity per infection than alpha which in turn had higher severity than the original variant. It just had lower mortality than the first wave because people had higher preexisting immunity, treatment had improved, and some of the most vulnerable had already been culled from the herd. You have to compare between two variants at the same time, not against previous waves. Omicron is the first major variant to actually be less severe on this metric.
- nradov 5y ago
  Freedom is seldom given. It usually has to be taken.
Amezarak 5y ago
The question ever since it became clear that this coronavirus was endemic has been what a "manageable end game" is: that is, what level of risk and mortality are we prepared to accept, given that deaths from Covid will never be zero. This is, in my opinion, the primary underlying disagreement. Some people think that no amount of deaths from Covid is acceptable. Some people believe that even the peak pandemic mortality is acceptable. And others fall somewhere in between, by, for example, focusing on hospital capacity. I don't think there is any long-term solution to Covid as a social issue, something we talk about and can't move past, until some kind of consensus is reached on this.
- epgui 5y ago
  And from my point of view as someone in the field, arguments on either side are almost always based on an intuitive gut feeling about morality. Very few people actually try to wrangle with putting numbers on the cost (in dollars) of a human life, or the economic burden of disease. There are no right or wrong numbers, but only if you begin there can you say you're rationally considering the economic or political tradeoffs. Edit: and deaths could absolutely reach zero. If we threw everything and the kitchen sink at the problem, we would eradicate it in absolutely no time. The underlying question is the same here, namely whether the cost of eradicating the disease would be larger or smaller than what we would gain from doing it.
  - ummonk 5y ago
    I think you overestimate our ability to “eradicate it in absolutely no time”. Eliminating it from both human and animal reservoirs (and permanently quarantining any immunocompromised carriers) worldwide would be a long and arduous process.
    - epgui 5y ago
      You make a great point about animal reservoirs, but the transmission bandwidth between humans and animals is afaik much lower than between humans. If you accept this assumption, and if we also assume that we really wanted to eradicate this thing, we could limit human transmission such as to reduce Rt well below 1 by implementing well-coordinated and strict policies. Then you're left with the "leaky bucket" of transmission between humans and animals... But this is a known vulnerable point which could be monitored effectively and very cheaply.
soperj 5y ago
>What a stroke of luck that we are here vs a more infectious strain of Delta or some other nightmare that would keep this rolling. How do we know we won't end up with that? Omicron evolved from Beta, which had pretty well disappeared when Omicron sprung up.
- ummonk 5y ago
  The better omicron is at spreading the more people it will confer natural / hybrid immunity to, reducing the dangers of a future variant.
  - soperj 5y ago
    Hopefully... the history of diseases before vaccines (polio, measles, smallpox, black plague, etc) doesn't exactly fill me with a lot of hope for it just becoming less deadly naturally, even if there are examples (Spanish flu) where they have.
    - lotsofpulp 5y ago
      What are the histories of the other coronaviruses? And would those histories be more relevant than histories of non coronaviruses?
      - nradov 5y ago
        Another coronavirus probably caused a worldwide pandemic starting in 1889. It killed a lot of people, but the survivors gained natural immunity which gave them significant protection against symptomatic reinfections. The same virus HCoV-OC43 is still endemic today. This seems relevant to the current pandemic. https://sfamjournals.onlinelibrary.wiley.com/doi/10.1111/1751-7915.13889 https://sfamjournals.onlinelibrary.wiley.com/doi/10.1111/175... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/
        nawgz 5y ago
deleted 5y ago
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DanBC 5y ago
> a more infectious strain of Delta What? Omicron is a more infectious version of Delta. Omicron causes the same number of deaths and hospitalisations and long covid as delta. It just also infects a lot more people more easily, and those people are at low risk and push the CFR down.
- rsfern 5y ago
  As the data becomes more available from South Africa, the UK, and Denmark, it’s starting to look like Omicron is a more infectious version of the wild type, maybe 40% less virulent than Delta, at least in terms of putting people in the hospital. There’s still not enough data to conclude about mortality. The good news is that prior immunity seems to confer a large degree of protection from severe illness still https://www.lesswrong.com/posts/YBB9yZNJuz5j8hLdP/omicron-post-9 https://www.lesswrong.com/posts/YBB9yZNJuz5j8hLdP/omicron-po...
  - DanBC 5y ago
    https://twitter.com/dgurdasani1/status/1475061938010865665?s=20 https://twitter.com/dgurdasani1/status/1475061938010865665?s... > Your risk of getting hospitalised with SARS-CoV-2 (any variant) depends on two things? 1. how likely are you to get infected? 2. what is your chance of getting hospitalised once infected > In simple terms, because omicron can escape immunity from past infections and vaccines, your protection against infection against omicron is vastly lower than with delta. This means risk of 1. is vastly increased- as you're less protected & also v. high background transmission.
- oh_sigh 5y ago
  Omicron isn't a version of Delta.
  - DanBC 5y ago
skocznymroczny 5y ago
There's no moving past covid until an exit plan is announced. If there isn't one, the only hope of moving past covid is resistance. If people stopped rushing for the latest vaccine, stopped getting tested regularly, even without symptoms, we would be past covid already.
- runjake 5y ago
  You’re going to have to lay down the logic behind this one for me. I am not getting it.
  - adam_arthur 5y ago
    The gist OP is getting at, though not put so eloquently, is that covid is endemic and there will continue to be deaths, even in a world with 100% vaccinated and boosted people. So covid being "over" is really a state of mind/choice of when to accept that it's endemic and drop the hysterics/restrictions. Omicron should be cheered as an effectively natural vaccine that looks to quickly end the worst of covid, yet media continues to fear monger about case counts, by and large. I am seeing some articles speaking to it as beneficial though. The fear a lot of people have over covid is totally out of proportion with the actual data, and media by and large continues to stoke these fears.
    - zerocount 5y ago
      That was elegant and much more insightful.
    - bonzini 5y ago
      > Omicron should be cheered as an effectively natural vaccine that looks to quickly end the worst of covid In the medium term yes; in the short term, with millions of unvaccinated people and a very fast exponential growth, it still has potential to overflow healthcare.
    - amanaplanacanal 5y ago
      I dunno, people working in the health care system are getting burned out and quitting in droves. I'd kind of like there to be doctors and nurses there to take care of me if I need to go to the hospital for whatever reason. Your state of mind seems irrelevant to this.
hinkley 5y ago
If infection grants more generalized immunity, doesn’t that mean a tailored vaccine would do the same?
- nradov 5y ago
  Possibly yes. https://www.defenseone.com/technology/2021/12/us-army-creates-single-vaccine-effective-against-all-covid-sars-variants/360089/ https://www.defenseone.com/technology/2021/12/us-army-create...
johnchristopher 5y ago
> Good vaccines + mild severity illness are basically the best case. If it was a common cold or a flu ? Maybe. > “Although COVID-19 has been described as a respiratory syndrome, evidence supports the involvement of multiple organ systems, with fibrosis, and inflammation in the lung, heart, kidneys, central nervous system (CNS), liver, adrenal glands, bone marrow, lymph nodes, and gastrointestinal tract. SARS-CoV-2 infection has also been associated with serious thrombotic complications, including strokes, pulmonary embolism, and cardiac injury.” https://www.wsws.org/en/articles/2021/11/10/leon-n10.htm https://www.wsws.org/en/articles/2021/11/10/leon-n10.htm Endemic we want ? Then we want yearly (or 6months it seems) vaccines. And masks. And ventilation. Reinfections will get more severe with age once vaccine or infection elicited sera wanes. > What a stroke of luck that we are here vs a more infectious strain of Delta or some other nightmare that would keep this rolling. Omicron being the new kid on the block doesn't mean another more dangerous variant isn't building itself up in a body somewhere. Maybe two years into the pandemic is not enough to let the reality sink in that we will never come back to before. Maybe we need ten years but by then we'll all be used to the new normal anyway. “Learn to live with the virus”, they said. Indeed.
- iamdamian 5y ago
  I'm not sure why we wouldn't be able to go back to normal, and taking a stance that we never will strikes me as somewhat defeatist. I'm more of an optimist. Having a small percentage of the population that's at greater risk of serious implications from infection (respiratory or otherwise) is something we've learned to live with before (see: the flu) without masks, mandates, or dramatically rearranging the way we live.
  - johnchristopher 5y ago
    > I'm not sure why we wouldn't be able to go back to normal, There are no path back to normal unless the virus disappears. We have vaccines that work for a limited time, we'll soon have pills@home. It will still not be `back to normal`. > and taking a stance that we never will strikes me as somewhat defeatist. We'll also never have FTL spaceships or teleportation star trek style. > I'm more of an optimist. Having a small percentage of the population that's at greater risk of serious implications from infection (respiratory or otherwise) is something we've learned to live with before (see: the flu) without masks, mandates, or dramatically rearranging the way we live. Covid is not the flu. Hoping it'll magically turn into a flu or that we can manage it like a flu is ignoring the reality currently unfolding. 40 years later and we still need condoms. We are not back to sex as it was in the 70's. Generations of teenagers have had their first time with a condom. This is what is normal now.
lamontcg 5y ago
Omicron's lower hospitalization rate is likely just due to vaccination and recovery from infection with Delta. Delta was transmissible enough to complete the vaccination program. Given that Omicron has higher viral loads, shorter serial interval and shorter incubation period than Delta, it is much more likely that Omicron is more intrinsically virulent as well and would be worse if you dropped it on a totally naive population in the summer of 2019. The current population, however, is longer immunologically naive, and I think that researchers are underestimating the existing seroprevalence. At the same time if there's still pockets of entirely unexposed/unvaccinated people out there in rural areas or something, Omicron will likely find them since it seems to largely ignore unboosted Nabs to prior infection or vaccination. Kids in colleges will be taking Omicron home for Christmas to rural families right about now and a few weeks from now we should find out how many seronegative people are left. If it Omicron fizzles though it is going to just be that Delta didn't leave anyone immune naive in its wake.
- jacquesm 5y ago
  Another factor (though I'm not sure how large that factor is) is that a chunk of the susceptible population isn't around any more.
  - lamontcg 5y ago
    Literal survivorship bias. There may also be a hard-to-infect/hard-to-seroconvert portion of the population left that could practically walk unmasked through a COVID ward in a hospital and not get infected. If they exist then the seronegative proportion of the population will start to be composed mostly of them over time through "purifying selection". This is also why I'm somewhat skeptical about all the vaccine efficacy numbers that studies are throwing around. I don't think an adequate control group exists any more.
    - jacquesm 5y ago
      That's a good point: having a control group is pretty much a must to be able to get reliable numbers on efficacy and any future vaccine or medicine is going to have to some extent work with corrupted data from day #1.
nikolay 5y ago
It will be Omicron for a short period of time. Then it would split into different variants. So, don't keep your hopes up!

abduhl 5y ago

So the long Covid we’ve been afraid of for our children this whole time has actually been long term immunity? How ironic that our own push to vaccinate and save our children could put them in a worse position immunity-wise. Like rain on your wedding day.

epgui 5y ago
Biochemist here: your claim that vaccination puts children in a worse position is neither supported by this paper, nor substantiated by any other data point to the best of my knowledge.
- jokethrowaway 5y ago
  I think his point is that the immune response from the vaccine is lower than from just getting covid and the risks from getting covid for children are really low. Still, I don't think it makes much of a difference either way, especially for kids who don't have much to fear from covid.
  - epgui 5y ago
    "immune response from the vaccine is lower than from just getting covid" {{citation needed}} My point is that this is unsubstantiated. And it does make a big difference, because this reduces the likelihood of children going through multiple periods of infectivity: the fewer times children are infectious to others, on average, the more herd immunity we have, collectively, against SARS-CoV-2.
    - abduhl 5y ago
      - epgui 5y ago
        I have no idea what you mean. I believe (and at least I was hoping that) my comment was helpful.

epgui 5y ago

Biochemist opinion: somewhat speculative, but what I take from this is that immunity in children makes them less likely than adults to shift from 'removed' to 'susceptible', in the SIR model. [1] [1] https://en.wikipedia.org/wiki/Compartmental_models_in_epidemiology#The_SIR_model https://en.wikipedia.org/wiki/Compartmental_models_in_epidem...

disambiguation 5y ago

We're going to look back on our treatment of children these past 2 years as one of the greatest blunders in the history of public health policy.

jacquesm 5y ago
You may want to read this: https://www.washingtonpost.com/health/2021/12/24/omicron-children-hospitalizations-us/ https://www.washingtonpost.com/health/2021/12/24/omicron-chi...
daenz 5y ago
We sacrificed the mental health of the young for the physical health of the old.
- wiseowise 5y ago
  But hey, grandma gets to live another year now. Who cares if the poor family never recovers after financial crisis.
  - objektif 5y ago
    I am sure anyone can recover from financial troubles. It is possible.. The other one? Not so much...
    - wiseowise 5y ago
      Yep! Anyone can pull themselves by their bootstraps.
      - mechanical_bear 5y ago
        Yes.
  - deleted 5y ago
    [deleted]
  - 5y ago

rsfern 5y ago

So one of the main conclusions is that SARS-CoV-2 in children produces antibody responses to all the other human coronaviruses (this happens in adults too, but the effect is stronger in children) In the discussion section they speculate that maybe recent infection with these other coronaviruses could give some level of protection against SARS-CoV-2, and that this could possibly explain some of the unusual-ness of the age-severity relationship, I.e. that very young children are not hit as hard by SARS-CoV-2 as by other diseases like the flu (relatively). That would be really interesting to see investigated carefully

nradov 5y ago

So it's the same as other coronaviruses like HCoV-OC43. There's no vaccine available for those other ones so most of us get infected as youths, and the resulting immunity protects us as we age. But they can still be dangerous to immunologically naive older patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/

clairity 5y ago
it's been obvious since march of last year that this was the inevitable outcome of covid, yet we've spent nearly two years hand-wringing and fearmongering over it. it's the novelty of the virus combined with the general unpreparedness of our immune systems (obesity, sickness of all sorts, and age correlate with lowered immune preparedness) that's created this wave of initial severity as the virus works it's way to a steady-state similar to other coronaviruses. most people had, and still have, very little idea about how these things work, yet grandstand and moralize on about ineffective but distruptive remediations like masks and lockdowns that they hear about via propagandized media. even vaccines need only be seriously considered by the aforementioned immune-deficient (obese, elderly, etc.), not everyone (this article providing that evidence for children specifically).
- bjoli 5y ago
  I think it has been pretty clear for a very long time that covid is something we will all get, and that it might even become something bot unlike the seasonal flu. The message has to my ears been "less contact = less infection = better access to healthcare for those who really need it". What would you suggest instead? I am all for discussing the losses contra gains of lockdowns, but I dont think any options have sounded much better.
  - clairity 5y ago
    frankly, there wasn't a whole lot we could do to alter the trajectory we were on. even a month(s)-long, wuhan-style lockdown could only temporarily arrest infection rates, unless the whole world literally did it together. even then, reintroduction via animal reservoirs would be a significant threat. that's what we should have come to grips with early on, accepting that we are not the masters of even our own little earth out of the vast universe. regarding "= better access to healthcare for those who really need it", that was entirely a political and economic choice to focus primarily on profit over critical care services and availability (not just the past 2 years, but decades). even so, hospitals aren't overflowing, as we keep hearing on the news, except in short-lived, isolated cases. 'exponential growth' was mediopolitical fearmongering, not mathematically sound modeling. if anything, that our limited hospital capacity has weathered the storm gives more hope, not less. the biggest mistake we (that is, our various levels of government) made was not hyperfocusing on the immune deficient, and only the immune deficient (obese, chronically ill, elderly, etc.). for instance, we should have locked down care facilities immediately (along with care staff, perhaps 2 weeks on, 1 week off, 1 week quarantine, with generous benefits/pay). we should have enouraged physical fitness nine ways to sunday (more bikes, less cars!). beyond that, give people timely and accurate information (as in, if it's uncertain, tell people how uncertain), encourage (don't mandate) pro-social (not self-righteous) behavior, and then ride it out. people already modulate their behavior (e.g., distancing, socializing) based on prevailing local conditions, so mask mandates and (theatrical) lockdowns really have had very marginal (and possibly no) effect on infections, hospitalizations, and death. certainly don't shut down gyms, parks, restaurants, small businesses, offices, and the like. perhaps consider limiting venues that encourage hypersocial behavior (i.e., partying), like bars and clubs. again, we already modulate our behavior, so shutdowns likely had no or marginally small effect. once vaccines were emergency-approved, encourage the immune deficient to take them, and allow the risk-averse to take them as well. don't mandate them for anyone, since they're non-sterilizing (and mRNA tech is new). with that, we'd probably be right around where we are now, but without all the stress, fear, anger, and divisiveness.

TeeMassive 5y ago

Serious question: should we let this more infectious but less dangerous run its course to achieve natural immunity? What are the arguments for and against this strategy? I know that if it is 5 times less likely to put people in hospitals but 10 times more transmissible then there will be 2 times more people in hospitals, but are there more arguments?

philovivero 5y ago
Yes. We should do that. We won't. Pro: everyone is fine, the hospitals aren't overwhelmed, the anti-vaxxers will be fine along with everyone else. Con: can't speak with disgust and disdain anymore to those who disagree with your medical opinions, or have concerns with how quickly you're forcing your experimental medications on the entire planet. Not going to happen. I've already seen the usual suspects talking about how we need bigger, better, stronger vaccines for Omicron. We're pretty excited by this RNA vaccine tech, and we're going to use it, no matter what happens. There's too much money and too much political power on the pro-vax anti-immune-system side of things.
- pavel_lishin 5y ago
  > everyone is fine Except the people who aren't. > the hospitals aren't overwhelmed Except the ones that are. > forcing your experimental medications on the entire planet No more experimental than any other vaccine; due to how quickly COVID spread, we were able to do the same level of testing on the vaccine as for any other medication. It's as safe as anything else you take.
  - tonguez 5y ago
    “No more experimental than any other vaccine” you are creating more vaccine hesitancy by saying this
  - donkarma 5y ago
    vaccine trials usually last 2 years alone from a quick glance

temptemptemp111 5y ago

fasdf23467 5y ago

Fantastic news. Actual science. Thanks to these folk and gals, so much.