6 ms·

Good article here about "endemic" and the still large problems that portend: https://www.nature.com/articles/d41586-022-00155-x https://www.nature.com/articles/

Good article here about "endemic" and the still large problems that portend: https://www.nature.com/articles/d41586-022-00155-x https://www.nature.com/articles/d41586-022-00155-x > The word ‘endemic’ has become one of the most misused of the pandemic. And many of the errant assumptions made encourage a misplaced complacency. It doesn’t mean that COVID-19 will come to a natural end. > In other words, a disease can be endemic and both widespread and deadly. Malaria killed more than 600,000 people in 2020. Ten million fell ill with tuberculosis that same year and 1.5 million died. Endemic certainly does not mean that evolution has somehow tamed a pathogen so that life simply returns to ‘normal’. > Stating that an infection will become endemic says nothing about how long it might take to reach stasis, what the case rates, morbidity levels or death rates will be or, crucially, how much of a population — and which sectors — will be susceptible. Nor does it suggest guaranteed stability: there can still be disruptive waves from endemic infections, as seen with the US measles outbreak in 2019. Health policies and individual behaviour will determine what form — out of many possibilities — endemic COVID-19 takes.

scarmig 5y ago
Something can be endemic and deadly and still something we accept the consequences of without government imposed restrictions. For example: HIV is something that is now endemic and (still) deadly. And yet we don't go around forcibly shutting down gay bathhouses, bars, and Grindr and implementing condom and prep mandates, even though they would be effective at reducing its spread. And for good reason: it'd be a massive (and homophobic) violation of civil liberties. But because mask and vaccine resistance is red tribe coded, a lot of people who would usually be level-headed about epidemiology and cost-benefit analyses end up in a stance driven more by moralizing than sound science.
- jjoonathan 5y ago
  I don't have to worry about getting HIV every time I go out in public just because some jerk decided he has a god-given right to breathe viral particles into my lungs even though a simple and safe vaccine is readily available.
  - jlack 5y ago
    This makes no sense. It's incredibly clear at this point that vaccinated people with covid spread it just the same as an unvaccinated person with covid.
    - jjoonathan 5y ago
      Yeah, and a car crash does the same damage regardless of Blood Alcohol Concentration. We should still punish a drunk driver for irresponsible behavior.
    - stavros 5y ago
      > just the same AFAIK that's not true.
    - pengaru 5y ago
      IIRC vaccinated people spread smaller quantities of the virus, and the viral droplets they do spread tend to include antigens since their body is actively fighting the infection while they spread it... you know, because their system was primed for the fight thanks to the vaccine. I think this Fridman podcast interview explored such things, either way it was quite informative on the subject: https://www.youtube.com/watch?v=G433fa01oMU https://www.youtube.com/watch?v=G433fa01oMU
    - ashwagary 5y ago
      My understanding, from a study that may be outdated by now, is the window to spread covid is slightly bigger in the unvaccinated, but not by much. 1-3 days of additional self-quarantine solves this issue.
  - scarmig 5y ago
    This is perilously close to "people who get COVID are innocent victims so forcible interventions are justified, while people who got HIV chose to do it so those same nterventions are less justified." I agree that, for the average person, COVID is easier to contract than HIV. But by the same token, COVID is much less severe than HIV, even with modern treatment plans. It's not at core about some abstract principle about how preventing disease spread trumps all other concerns but is instead a cost benefit analysis. Keeping the country shut down perpetually is an extreme cost that we are continually incurring.
- depereo 5y ago
  But we do strongly encourage condom usage and tests. There are education resources and awareness campaigns. Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense. It's not like HIV is something we simply ignore. There are still strong public health measures and laws protecting the public health.
  - scarmig 5y ago
    Most of the anti-mandate people (I'm not one, to be clear) would be quite happy with a world where the interventions around COVID were awareness campaigns. And just as some people insist on not wearing condoms despite the risks, the same will be true of mask wearing and vaccines.
    - Terretta 5y ago
      smoking, and indoor second hand smoking laws ... we know the principles here
    - depereo 5y ago
      Would they be happy with "Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense" for COVID? Ultimately these interventions, mandates and other public health measures, which wind up as a mix of education, awareness and mandates or laws become a balancing act between personal inconvenience and public good; so the work done for HIV is different from the intervention for covid-19 for that and other reasons.
      - scarmig 5y ago
        The standard for criminal HIV transmission (in California, at least; it varies by state) is not "accidentally infecting someone while not knowing your status." It's not even "infecting someone without disclosing that you're HIV-positive while knowing you're HIV-positive." It's "intentionally infecting someone with HIV." And, explicitly, your knowledge of your positive status is not sufficient to establish intent.
- oceanplexian 5y ago
  So we did do that, and there is a bit of irony there. Back in the 80s AIDS was used to push homophobia and lots of states passed laws making promoting homosexuality illegal. At the time Dr.Fauci went on national television to tell the public you could get AIDS simply by touching or being in proximity to someone who had the virus. So if you want to talk about moralizing science, well actually…
  - bruceb 5y ago
    "states passed laws making promoting homosexuality illegal." Did they? Seems laws have only gone one way, decriminalizing since the late 70s
- gonehome 5y ago
  I mostly agree, but I think the core difference with HIV is how it's transmitted. You're more in control of your transmission risk. That's less true with Covid given its contagiousness through the air. I'm of the opinion that private companies have every right to require restrictions they see fit. I'm more mixed about government restrictions now that we're post vaccine (with the exception that requiring vaccine mandates for healthcare workers seems reasonable). What gets to me about this whole thing is it's not binary but people often talk like it is (probably just political tribalism). Vaccinated people who are infected spread the disease like the unvaccinated, that's true - but since vaccinated people are much less likely to get infected on exposure things like the vaccine mandates for restaurant entry do have an affect and are not just theater. They reduce the overall probability of positive people in the restaurant. I think people like Bret Weinstein have done a lot of harm and I'm often surprised by the extent to which intelligence is independent from accuracy. It's really interesting in the context of this book review: https://slatestarcodex.com/2019/06/04/book-review-the-secret-of-our-success/ https://slatestarcodex.com/2019/06/04/book-review-the-secret... Basically, the argument in that is a little reason (incompletely applied or understood) can be a dangerous thing and blindly following consensus is sometimes the adaptive behavior. It's a little misapplied to vaccines since in that case someone did actually know the details and understand the mechanism, but it's possible for a cultural understanding to be entirely selected by natural selection and the reason for it was never understood by anyone! When we see animals do complex behavior we don't usually assume it's because they understand fully why that mechanism is adaptive, but we often misapply this understanding to ourselves. Mostly getting off topic, but I thought this was an interesting thing to think about.
  - app_gorilla 5y ago
    vaccinated people are much less likely to get infected on exposure? With Omicron, vaccinated people are MORE likely to get infected, 90 days post-vaccine. Source: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v2.full https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v...
    - gonehome 5y ago
      Yeah, more likely to get infected on exposure than an unvaccinated person that has not previously had the disease. The source link supports that claim as far as I can tell from what's on that page and doesn't say anything about vaccinated people being more likely to get infected vs. unvaccinated (both without natural immunity).
- TameAntelope 5y ago
  It's not the fact that it's red tribe coded, it's the fact that the arguments against these things started from very stupid places. Mask and vaccine resistance is stupid tribe coded, even if now there might be some valid reasons for talking about it. Stupid tribe and red tribe do happen to overlap, but it's the stupid part that upsets people so universally, not the red part. Also, HIV is not even remotely as contagious as SARS-CoV-2, so it's not really a fair comparison. We absolutely would have shut down whatever we needed to if HIV were airborne.
  - hhh 5y ago
    I really don’t see how you could reasonably talk with someone that isn’t vaccinated and convince them to get vaccinated by calling them stupid. It’s demeaning and completely dismissive of their apprehensions, fears, or any other reason they haven’t been vaccinated. I would likely find myself much more reluctant to get vaccinated if the person attempting to convince me is calling me an idiot and just shouting that i’m wrong instead of providing me data on the subject, and being honest enough to openly discuss the subject. A small amount of humility and respect go a very long way.
    - TameAntelope 5y ago
      Who said anything about convincing people? I'm explaining why it's a challenge to consider a position that may be more valid now, but wasn't valid or was substantially less valid in the past. It was an abjectly stupid position, held by stupid people. Now, it's possible that the situation has changed and it's marginally less stupid of a position, or even not a stupid position at all, given new information. It's hard for people to make that switch.
- nonameiguess 5y ago
  This seems entirely non-sequitur. We don't have condom mandates because there is no practical way to enforce them. We don't have mandates that you need to wear a mask in your bedroom, either. If we allowed sex in stores and restaurants and didn't have condom mandates for people having sex in stores and restaurants, you'd have a point, but we don't allow sex in public. Porn performers don't have condom mandates, but they do have a mandate requiring them to show proof of a recent negative test before they're allowed to perform. I suspect many people you think are level-headed would be entirely supportive of legally mandated condom usage for non-cohabitating partners if there was any remotely realistic way to do it. And, of course, we do have an absolute shit ton of mandated vaccines, so mandating one for Covid is not at all novel. It's even already a condition of federal employment in a lot of cases. If you're serving in the state department or military or something where you need to go overseas to places where anthrax or malaria are risks, you need to get vaccinated, and that's been normal and in-bounds for half a century.
- csdvrx 5y ago
  > And yet we don't go around forcibly shutting down gay bathhouses, bars, and Grindr and implementing condom and prep mandates, even though they would be effective at reducing its spread. And for good reason: it'd be a massive (and homophobic) violation of civil liberties Actually, following some FUD by a now famous doctor, this had a lot of political and popular support back then: https://www.congress.gov/98/crecb/1983/07/14/GPO-CRECB-1983-pt14-4-3.pdf https://www.congress.gov/98/crecb/1983/07/14/GPO-CRECB-1983-... Check page 28, July 14 1983.
CWuestefeld 5y ago
All of this is true, and none of it contradicts anything in the grandparent post.

scarmig 5y ago

Something can be endemic and deadly and still something we accept the consequences of without government imposed restrictions. For example: HIV is something that is now endemic and (still) deadly. And yet we don't go around forcibly shutting down gay bathhouses, bars, and Grindr and implementing condom and prep mandates, even though they would be effective at reducing its spread. And for good reason: it'd be a massive (and homophobic) violation of civil liberties. But because mask and vaccine resistance is red tribe coded, a lot of people who would usually be level-headed about epidemiology and cost-benefit analyses end up in a stance driven more by moralizing than sound science.

jjoonathan 5y ago
I don't have to worry about getting HIV every time I go out in public just because some jerk decided he has a god-given right to breathe viral particles into my lungs even though a simple and safe vaccine is readily available.
- jlack 5y ago
  This makes no sense. It's incredibly clear at this point that vaccinated people with covid spread it just the same as an unvaccinated person with covid.
  - jjoonathan 5y ago
    Yeah, and a car crash does the same damage regardless of Blood Alcohol Concentration. We should still punish a drunk driver for irresponsible behavior.
  - stavros 5y ago
    > just the same AFAIK that's not true.
  - pengaru 5y ago
    IIRC vaccinated people spread smaller quantities of the virus, and the viral droplets they do spread tend to include antigens since their body is actively fighting the infection while they spread it... you know, because their system was primed for the fight thanks to the vaccine. I think this Fridman podcast interview explored such things, either way it was quite informative on the subject: https://www.youtube.com/watch?v=G433fa01oMU https://www.youtube.com/watch?v=G433fa01oMU
  - ashwagary 5y ago
    My understanding, from a study that may be outdated by now, is the window to spread covid is slightly bigger in the unvaccinated, but not by much. 1-3 days of additional self-quarantine solves this issue.
- scarmig 5y ago
  This is perilously close to "people who get COVID are innocent victims so forcible interventions are justified, while people who got HIV chose to do it so those same nterventions are less justified." I agree that, for the average person, COVID is easier to contract than HIV. But by the same token, COVID is much less severe than HIV, even with modern treatment plans. It's not at core about some abstract principle about how preventing disease spread trumps all other concerns but is instead a cost benefit analysis. Keeping the country shut down perpetually is an extreme cost that we are continually incurring.
depereo 5y ago
But we do strongly encourage condom usage and tests. There are education resources and awareness campaigns. Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense. It's not like HIV is something we simply ignore. There are still strong public health measures and laws protecting the public health.
- scarmig 5y ago
  Most of the anti-mandate people (I'm not one, to be clear) would be quite happy with a world where the interventions around COVID were awareness campaigns. And just as some people insist on not wearing condoms despite the risks, the same will be true of mask wearing and vaccines.
  - Terretta 5y ago
    smoking, and indoor second hand smoking laws ... we know the principles here
  - depereo 5y ago
    Would they be happy with "Knowingly infecting someone or non disclosure of positive infection status during possible transmission activities is a jailable offense" for COVID? Ultimately these interventions, mandates and other public health measures, which wind up as a mix of education, awareness and mandates or laws become a balancing act between personal inconvenience and public good; so the work done for HIV is different from the intervention for covid-19 for that and other reasons.
    - scarmig 5y ago
      The standard for criminal HIV transmission (in California, at least; it varies by state) is not "accidentally infecting someone while not knowing your status." It's not even "infecting someone without disclosing that you're HIV-positive while knowing you're HIV-positive." It's "intentionally infecting someone with HIV." And, explicitly, your knowledge of your positive status is not sufficient to establish intent.
oceanplexian 5y ago
So we did do that, and there is a bit of irony there. Back in the 80s AIDS was used to push homophobia and lots of states passed laws making promoting homosexuality illegal. At the time Dr.Fauci went on national television to tell the public you could get AIDS simply by touching or being in proximity to someone who had the virus. So if you want to talk about moralizing science, well actually…
- bruceb 5y ago
  "states passed laws making promoting homosexuality illegal." Did they? Seems laws have only gone one way, decriminalizing since the late 70s
gonehome 5y ago
I mostly agree, but I think the core difference with HIV is how it's transmitted. You're more in control of your transmission risk. That's less true with Covid given its contagiousness through the air. I'm of the opinion that private companies have every right to require restrictions they see fit. I'm more mixed about government restrictions now that we're post vaccine (with the exception that requiring vaccine mandates for healthcare workers seems reasonable). What gets to me about this whole thing is it's not binary but people often talk like it is (probably just political tribalism). Vaccinated people who are infected spread the disease like the unvaccinated, that's true - but since vaccinated people are much less likely to get infected on exposure things like the vaccine mandates for restaurant entry do have an affect and are not just theater. They reduce the overall probability of positive people in the restaurant. I think people like Bret Weinstein have done a lot of harm and I'm often surprised by the extent to which intelligence is independent from accuracy. It's really interesting in the context of this book review: https://slatestarcodex.com/2019/06/04/book-review-the-secret-of-our-success/ https://slatestarcodex.com/2019/06/04/book-review-the-secret... Basically, the argument in that is a little reason (incompletely applied or understood) can be a dangerous thing and blindly following consensus is sometimes the adaptive behavior. It's a little misapplied to vaccines since in that case someone did actually know the details and understand the mechanism, but it's possible for a cultural understanding to be entirely selected by natural selection and the reason for it was never understood by anyone! When we see animals do complex behavior we don't usually assume it's because they understand fully why that mechanism is adaptive, but we often misapply this understanding to ourselves. Mostly getting off topic, but I thought this was an interesting thing to think about.
- app_gorilla 5y ago
  vaccinated people are much less likely to get infected on exposure? With Omicron, vaccinated people are MORE likely to get infected, 90 days post-vaccine. Source: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v2.full https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v...
  - gonehome 5y ago
    Yeah, more likely to get infected on exposure than an unvaccinated person that has not previously had the disease. The source link supports that claim as far as I can tell from what's on that page and doesn't say anything about vaccinated people being more likely to get infected vs. unvaccinated (both without natural immunity).
TameAntelope 5y ago
It's not the fact that it's red tribe coded, it's the fact that the arguments against these things started from very stupid places. Mask and vaccine resistance is stupid tribe coded, even if now there might be some valid reasons for talking about it. Stupid tribe and red tribe do happen to overlap, but it's the stupid part that upsets people so universally, not the red part. Also, HIV is not even remotely as contagious as SARS-CoV-2, so it's not really a fair comparison. We absolutely would have shut down whatever we needed to if HIV were airborne.
- hhh 5y ago
  I really don’t see how you could reasonably talk with someone that isn’t vaccinated and convince them to get vaccinated by calling them stupid. It’s demeaning and completely dismissive of their apprehensions, fears, or any other reason they haven’t been vaccinated. I would likely find myself much more reluctant to get vaccinated if the person attempting to convince me is calling me an idiot and just shouting that i’m wrong instead of providing me data on the subject, and being honest enough to openly discuss the subject. A small amount of humility and respect go a very long way.
  - TameAntelope 5y ago
    Who said anything about convincing people? I'm explaining why it's a challenge to consider a position that may be more valid now, but wasn't valid or was substantially less valid in the past. It was an abjectly stupid position, held by stupid people. Now, it's possible that the situation has changed and it's marginally less stupid of a position, or even not a stupid position at all, given new information. It's hard for people to make that switch.
nonameiguess 5y ago
This seems entirely non-sequitur. We don't have condom mandates because there is no practical way to enforce them. We don't have mandates that you need to wear a mask in your bedroom, either. If we allowed sex in stores and restaurants and didn't have condom mandates for people having sex in stores and restaurants, you'd have a point, but we don't allow sex in public. Porn performers don't have condom mandates, but they do have a mandate requiring them to show proof of a recent negative test before they're allowed to perform. I suspect many people you think are level-headed would be entirely supportive of legally mandated condom usage for non-cohabitating partners if there was any remotely realistic way to do it. And, of course, we do have an absolute shit ton of mandated vaccines, so mandating one for Covid is not at all novel. It's even already a condition of federal employment in a lot of cases. If you're serving in the state department or military or something where you need to go overseas to places where anthrax or malaria are risks, you need to get vaccinated, and that's been normal and in-bounds for half a century.
csdvrx 5y ago
> And yet we don't go around forcibly shutting down gay bathhouses, bars, and Grindr and implementing condom and prep mandates, even though they would be effective at reducing its spread. And for good reason: it'd be a massive (and homophobic) violation of civil liberties Actually, following some FUD by a now famous doctor, this had a lot of political and popular support back then: https://www.congress.gov/98/crecb/1983/07/14/GPO-CRECB-1983-pt14-4-3.pdf https://www.congress.gov/98/crecb/1983/07/14/GPO-CRECB-1983-... Check page 28, July 14 1983.

CWuestefeld 5y ago

All of this is true, and none of it contradicts anything in the grandparent post.