5 ms·

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. Ha

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
  > We have vaccines that work for a limited time This is flat out FALSE. There are two different possible endpoints for vaccine efficacy. One is efficacy against infection, one is efficacy against severe disease and death. Efficacy against infection is very difficult because it is mediated by circulating neutralizing antibodies. It is just difficult to get sterilizing immunity against a muscosally invading respiratory virus in the first place. And then neutralizing antibodies wane over time. Efficacy against severe disease is almost certainly going to be more durable because it is mediated by memory T-cell and B-cells having been already formed due to prior exposure to a related antigen. Unfortunately the result of the phase 3 trails on the mRNA vaccines were way too good on VE against infection and it was sold as being 90% effective and as that waned people declared them to be ineffective. That should never have been the yardstick though. And in fact before those results were announced Fauci was trying to condition the population to expecting a 50% VE against infection number as being good enough. The 90% efficacy results just blew that all away though. What gets lost is that they're still >90% effective against severe disease/death and nothing has changed there. And you can see it in the headlines with Omicron. It is almost still certainly as intrinsically virulent as D614G, if not actually more intrinsically virulent than Delta itself, but hospitalization rates and death rates are plummeting. That is the human humoral immune system working. I'd argue everyone should probably get boosted because of the maturation in immune response which is measured against Omicron. Once we're done with that though I fully expect that people can stop getting any future vaccines and they'll just get a cold next time they catch SARS-CoV-2 until they wind up being over 65 or a cancer patient or something -- just like every other ILI-causing virus. (Or you know keep getting boosters like you get flu shots -- I'm honestly not sure what I'll do about it, but its going to look a whole lot more like yearly flu shots than the world-record mass immunization campaign we've seen up until now).
  - jacquesm 5y ago
    The mutation rate and the number of infected people is what is driving this, as long as we have this many people infected at the same time mutations will be hitting us to the tune of a new one every four to five months or so. The vaccines are quite effective against a variant that is no longer in play and hasn't been for quite a while.
    - lamontcg 5y ago
      The vaccines are quite effective against severe disease and death from Omicron due to somatic hypermutation. The people who are vaccinated against original Wuhan-Hu-1 make memory B-cells against Omicron as well. Even after boosting with Wuhan-Hu-1 spike antigen the neutralization titers against Omicron in the blood are high, even after all the spike mutations. And again, there are around a thousand T-cell epitopes to spike and around 80% of them are conserved with Omicron, and there is very, very good reason to think that number doesn't ever get close to zero. Your naive model of how the immune system works like a key and lock where if you change one of the pins then the vaccine stops working entirely is deeply flawed. The human immune system is the end product of a hundreds of millions of years arms race between organisms and pathogens, and this isn't its first trip around the block with a pandemic virus that mutates. The whole way the humoral/memory immune system works is designed to deal with mutations.
      - jacquesm 5y ago
        > Your naive model of how the immune system works like a key and lock where if you change one of the pins then the vaccine stops working entirely is deeply flawed. That isn't fair on your part. The bit that you picked out is factually correct. It is also correct that the vaccines + previous immunity will give an improved chance at a positive outcome. But it's not the same as it was for the first wave, the vaccines were very specifically developed and tested in that setting and every future mutation had a worse response, due to attenuation due to time and mismatch with the target. This is not a 'lock that doesn't fit the key', it is a vaccine that simply works less well on things that it wasn't very specifically designed for, and that is totally expected. The degree to which the difference materializes changes with time and further mutations, with each of those contributing some element to the final efficacy calculation. How much is impossible to tell ahead of time.
- iamdamian 5y ago
  Reasonable people can disagree here, and I'm not convinced by the case you've put up. I remain a realistic optimist that this will become endemic and we'll put up with the risk as we have when the flu became endemic. Of course the vaccine will help tremendously (relative to, e.g., retroviral STDs), as will the constant pressure for people to return to their normal lives.
- nradov 5y ago
  The virus will never disappear. We can go back to normal as soon as people decide to accept the risk. In fact that has already happened in several states.
  - amanaplanacanal 5y ago
    I think we'll go back to normal when the risk that hospitals will get overwhelmed wanes.
    - johnchristopher 5y ago
      I do believe that too because it seems to be the only and main factor that motivates public authorities decision and plans against covid. And it frightens me a bit because it shows they do not care about our well-being, public hospitals saturated policy has the nice side effect of not killing us but that's it.

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
> We have vaccines that work for a limited time This is flat out FALSE. There are two different possible endpoints for vaccine efficacy. One is efficacy against infection, one is efficacy against severe disease and death. Efficacy against infection is very difficult because it is mediated by circulating neutralizing antibodies. It is just difficult to get sterilizing immunity against a muscosally invading respiratory virus in the first place. And then neutralizing antibodies wane over time. Efficacy against severe disease is almost certainly going to be more durable because it is mediated by memory T-cell and B-cells having been already formed due to prior exposure to a related antigen. Unfortunately the result of the phase 3 trails on the mRNA vaccines were way too good on VE against infection and it was sold as being 90% effective and as that waned people declared them to be ineffective. That should never have been the yardstick though. And in fact before those results were announced Fauci was trying to condition the population to expecting a 50% VE against infection number as being good enough. The 90% efficacy results just blew that all away though. What gets lost is that they're still >90% effective against severe disease/death and nothing has changed there. And you can see it in the headlines with Omicron. It is almost still certainly as intrinsically virulent as D614G, if not actually more intrinsically virulent than Delta itself, but hospitalization rates and death rates are plummeting. That is the human humoral immune system working. I'd argue everyone should probably get boosted because of the maturation in immune response which is measured against Omicron. Once we're done with that though I fully expect that people can stop getting any future vaccines and they'll just get a cold next time they catch SARS-CoV-2 until they wind up being over 65 or a cancer patient or something -- just like every other ILI-causing virus. (Or you know keep getting boosters like you get flu shots -- I'm honestly not sure what I'll do about it, but its going to look a whole lot more like yearly flu shots than the world-record mass immunization campaign we've seen up until now).
- jacquesm 5y ago
  The mutation rate and the number of infected people is what is driving this, as long as we have this many people infected at the same time mutations will be hitting us to the tune of a new one every four to five months or so. The vaccines are quite effective against a variant that is no longer in play and hasn't been for quite a while.
  - lamontcg 5y ago
    The vaccines are quite effective against severe disease and death from Omicron due to somatic hypermutation. The people who are vaccinated against original Wuhan-Hu-1 make memory B-cells against Omicron as well. Even after boosting with Wuhan-Hu-1 spike antigen the neutralization titers against Omicron in the blood are high, even after all the spike mutations. And again, there are around a thousand T-cell epitopes to spike and around 80% of them are conserved with Omicron, and there is very, very good reason to think that number doesn't ever get close to zero. Your naive model of how the immune system works like a key and lock where if you change one of the pins then the vaccine stops working entirely is deeply flawed. The human immune system is the end product of a hundreds of millions of years arms race between organisms and pathogens, and this isn't its first trip around the block with a pandemic virus that mutates. The whole way the humoral/memory immune system works is designed to deal with mutations.
    - jacquesm 5y ago
      > Your naive model of how the immune system works like a key and lock where if you change one of the pins then the vaccine stops working entirely is deeply flawed. That isn't fair on your part. The bit that you picked out is factually correct. It is also correct that the vaccines + previous immunity will give an improved chance at a positive outcome. But it's not the same as it was for the first wave, the vaccines were very specifically developed and tested in that setting and every future mutation had a worse response, due to attenuation due to time and mismatch with the target. This is not a 'lock that doesn't fit the key', it is a vaccine that simply works less well on things that it wasn't very specifically designed for, and that is totally expected. The degree to which the difference materializes changes with time and further mutations, with each of those contributing some element to the final efficacy calculation. How much is impossible to tell ahead of time.
iamdamian 5y ago
Reasonable people can disagree here, and I'm not convinced by the case you've put up. I remain a realistic optimist that this will become endemic and we'll put up with the risk as we have when the flu became endemic. Of course the vaccine will help tremendously (relative to, e.g., retroviral STDs), as will the constant pressure for people to return to their normal lives.
nradov 5y ago
The virus will never disappear. We can go back to normal as soon as people decide to accept the risk. In fact that has already happened in several states.
- amanaplanacanal 5y ago
  I think we'll go back to normal when the risk that hospitals will get overwhelmed wanes.
  - johnchristopher 5y ago
    I do believe that too because it seems to be the only and main factor that motivates public authorities decision and plans against covid. And it frightens me a bit because it shows they do not care about our well-being, public hospitals saturated policy has the nice side effect of not killing us but that's it.