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That presumes infection control is possible. I see two distinct points at which it would have been possible: 1) The initial outbreak. I don't know if this was

That presumes infection control is possible. I see two distinct points at which it would have been possible: 1) The initial outbreak. I don't know if this was ever, in any practical sense, possible. (Honestly, I don't know, maybe it was). 2) vaccine availability, presuming worldwide that we all maintained strict lockdown until the vaccine was universally available and the vast majority of the population took it. This also does not appear to ever have been possible in any practical way, or at least I do not see any realist path for it to have occured. Short of the two above possibilities, I see only a broad spectrum of approaches designed to spread the worst impacts over a period of time that didn't overhwealm health systems even more than some of them were, while protecting the most vulnerable as best as we can. People's tolerance for the different measures for doing this vary along multiple geographic & sociopolitical lines and so we have a patchwork of approaches, a lot of which provide only loose guidance while relying on individuals to make their own personal risk decisions. This is may not be ideal from the perspective of personal risk decisions having an impact on others that decide differently, but again I am also not sure if a different outcome was ever, in a practical sense, possible. At this point I think the main challenges for the world are to ramp up the infrastructure for cyclical vaccine updates & billions of doses to be available worldwide at each step. In terms of infrastructure, the needs are similar, though I would say exceed, those required for annual flue vaccine production and distribution. COVID still presents more serious risks with long term effects not yet understood, so my personal opinion is that cyclical vaccine infrastructure should target something higher than annual flu vaccine cycles.

logifail 4y ago
> presuming worldwide that we all maintained strict lockdown until the vaccine was universally available and the vast majority of the population took it We all remember that the vaccines were described as being able to prevent infection and transmission, certainly by some politicians, perhaps less so by scientists. One of those very politicians is currently Covid positive after four (count them) shots of vaccine. Doesn't mass vaccination, particularly with imperfect vaccines, increase the selection pressure on the virus to mutate? With hindsight I wish there had been much more international focus on protecting and vaccinating those truly at risk. It seems fairly clear by now that fit and healthy under-50s really didn't gain much from vaccination, their risk from this particularly virus was already tiny. After a couple of months the vaccines didn't stop them catching and spreading the virus either, so they weren't even protecting the vulnerable indirectly.
- pertymcpert 4y ago
  I don't think that's true. Vaccination is still beneficial to infection. Selection pressure exists, but they will exist whether or not the immune pressure comes from vaccination or infection, so it's preferable to protect first.
  - logifail 4y ago
    > I don't think that's true. Vaccination is still beneficial to infection. The virus changed, thanks to Omicron not even the WHO agrees with that claim. "Vaccine-induced immunity following a primary vaccine series is modest against infection due to Omicron in the months after vaccination, and wanes significantly over time. Vaccine-induced immunity against Omicron-related mild symptomatic disease, asymptomatic infection, and viral shedding is also modest and short-lived even following a booster dose." https://www.who.int/news/item/01-06-2022-interim-statement-on-hybrid-immunity-and-increasing-population-seroprevalence-rates https://www.who.int/news/item/01-06-2022-interim-statement-o...
    - kenjackson 4y ago
      But from the same report: “ Currently available data from emergency-use listed COVID-19 vaccines show that vaccines provide higher levels of protection than SARS-CoV-2 infection against severe disease outcomes, with modest waning in the 6 months following completion of primary vaccine series. Further, they continue to protect against severe disease, hospitalizations and death due to Omicron, albeit to a lesser degree compared with other VOC.”
      - logifail 4y ago
        > But from the same report: “ Currently available data from emergency-use listed COVID-19 vaccines show that vaccines provide higher levels of protection than SARS-CoV-2 infection against severe disease outcomes [Now that we have them] the vaccines are indeed effective at protecting against severe outcomes. Even before the vaccines, and against this particular virus, being young and healthy is and always was also exceptionally effective: "People of different ages have been exposed to dramatically differing risks. Fatalities among school-children have been remarkably low. Taking women aged 30–34 as an example, around 1 in 70,000 died from Covid over the 9 peak weeks of the epidemic. Since over 80% of these had pre-existing medical conditions, we estimate that a healthy women in this age-group had less than a 1 in 350,000 risk of dying from Covid, around 1/4 of the normal risk of an accidental death over this period"[0] (from May 2020): "Coronavirus risk for young is 'staggeringly low', says UK's top statistician [..] “If we look at under 25s, there're 17 million of them in the country where we have 26 deaths recorded,” he said, suggesting a similar risk would be seen in “a couple of days” in general accidents and sudden deaths. However, he said the risk for the over 90s was 10,000 times as high, with more than one per cent of over 90s having died from Covid-19."[1] [0] https://medium.com/wintoncentre/what-have-been-the-fatal-risks-of-covid-particularly-to-children-and-younger-adults-a5cbf7060c49 https://medium.com/wintoncentre/what-have-been-the-fatal-ris... [1] https://archive.ph/WYas8 https://archive.ph/WYas8 ( https://www.telegraph.co.uk/news/2020/05/10/coronavirus-risk-young-staggeringly-low-says-uks-top-statistician/ https://www.telegraph.co.uk/news/2020/05/10/coronavirus-risk... )
ptx 4y ago
> The initial outbreak. I don't know if this was ever, in any practical sense, possible. (Honestly, I don't know, maybe it was). Yes, Taiwan did it, as described in a JAMA article [1] published at the start of March 2020. In particular, follow the link to the supplement: "eTable: List of Actions Taken by Date and Category". [1] https://jamanetwork.com/journals/jama/fullarticle/2762689 https://jamanetwork.com/journals/jama/fullarticle/2762689
- ineedasername 4y ago
  No. Using Taiwan to make this claim is incorrect-- or insufficient-- in at least two ways. Also keep in mind that I said for all practical purposes, which is very different than theoretically possible. But taking things one at a time: 1) Taiwan has failed to continue it's early accomplishments. It has now has had hundreds of thousands of cases. I'll preemptively address a to this that Taiwan's current cases are a separate topic from it's initial success. This is not an unreasonable point, though I myself do not think they can be separated. A discuss there however seems outside the scope of my response to you. 2) Taiwan was uniquely suited for it's early effective response to COVID. It had learned the lessons from prior scares such as 2003 and put excellent measures in place to to respond to future issues. It was only able to succeed early in the pandemic because of actions taken years earlier. In the context of my comment it is unreasonable to deny my claim on the basis that, had the entire world 10+ years earlier acted differently that Taiwan's success could have been replicated. I clearly made "initial outbreak" the context of my comment while Taiwan's success was rooted in far far earlier actions. The actions listed in your linked article were only so rapidly possible due to that decade long preparation. You might reasonably claim "had the rest of the world followed Taiwan's example 10+ years earlier..." But that would not be a contextual response to my comment. At the initial point of outbreak, especially with early cases in Italy traced back to 2019 & what we know of asymptomatic cases and spread rates, my claim stands: it may have, in any practical sense, been impossible at initial outbreak to have stopped things in their tracks. (I am open to further discussion that I may be wrong, but the example of Taiwan is not sufficient to demonstrate that) The sociopolitical situation in some areas would quite literally have made it impossible as well. In the US for example even the patchwork response by states, often less extreme in restrictions than other areas of the world, prompted sporadic violence including a number of murders over simple mask requirements-- a strict policy in Taiwan that is credited with it's early success. IIRC there was at least one such murder in Germany as well. Finally: I will concede that worldwide response was spotty and inconsistent and that a better job could have been done.

logifail 4y ago

> presuming worldwide that we all maintained strict lockdown until the vaccine was universally available and the vast majority of the population took it We all remember that the vaccines were described as being able to prevent infection and transmission, certainly by some politicians, perhaps less so by scientists. One of those very politicians is currently Covid positive after four (count them) shots of vaccine. Doesn't mass vaccination, particularly with imperfect vaccines, increase the selection pressure on the virus to mutate? With hindsight I wish there had been much more international focus on protecting and vaccinating those truly at risk. It seems fairly clear by now that fit and healthy under-50s really didn't gain much from vaccination, their risk from this particularly virus was already tiny. After a couple of months the vaccines didn't stop them catching and spreading the virus either, so they weren't even protecting the vulnerable indirectly.

pertymcpert 4y ago
I don't think that's true. Vaccination is still beneficial to infection. Selection pressure exists, but they will exist whether or not the immune pressure comes from vaccination or infection, so it's preferable to protect first.
- logifail 4y ago
  > I don't think that's true. Vaccination is still beneficial to infection. The virus changed, thanks to Omicron not even the WHO agrees with that claim. "Vaccine-induced immunity following a primary vaccine series is modest against infection due to Omicron in the months after vaccination, and wanes significantly over time. Vaccine-induced immunity against Omicron-related mild symptomatic disease, asymptomatic infection, and viral shedding is also modest and short-lived even following a booster dose." https://www.who.int/news/item/01-06-2022-interim-statement-on-hybrid-immunity-and-increasing-population-seroprevalence-rates https://www.who.int/news/item/01-06-2022-interim-statement-o...
  - kenjackson 4y ago
    But from the same report: “ Currently available data from emergency-use listed COVID-19 vaccines show that vaccines provide higher levels of protection than SARS-CoV-2 infection against severe disease outcomes, with modest waning in the 6 months following completion of primary vaccine series. Further, they continue to protect against severe disease, hospitalizations and death due to Omicron, albeit to a lesser degree compared with other VOC.”
    - logifail 4y ago
      > But from the same report: “ Currently available data from emergency-use listed COVID-19 vaccines show that vaccines provide higher levels of protection than SARS-CoV-2 infection against severe disease outcomes [Now that we have them] the vaccines are indeed effective at protecting against severe outcomes. Even before the vaccines, and against this particular virus, being young and healthy is and always was also exceptionally effective: "People of different ages have been exposed to dramatically differing risks. Fatalities among school-children have been remarkably low. Taking women aged 30–34 as an example, around 1 in 70,000 died from Covid over the 9 peak weeks of the epidemic. Since over 80% of these had pre-existing medical conditions, we estimate that a healthy women in this age-group had less than a 1 in 350,000 risk of dying from Covid, around 1/4 of the normal risk of an accidental death over this period"[0] (from May 2020): "Coronavirus risk for young is 'staggeringly low', says UK's top statistician [..] “If we look at under 25s, there're 17 million of them in the country where we have 26 deaths recorded,” he said, suggesting a similar risk would be seen in “a couple of days” in general accidents and sudden deaths. However, he said the risk for the over 90s was 10,000 times as high, with more than one per cent of over 90s having died from Covid-19."[1] [0] https://medium.com/wintoncentre/what-have-been-the-fatal-risks-of-covid-particularly-to-children-and-younger-adults-a5cbf7060c49 https://medium.com/wintoncentre/what-have-been-the-fatal-ris... [1] https://archive.ph/WYas8 https://archive.ph/WYas8 ( https://www.telegraph.co.uk/news/2020/05/10/coronavirus-risk-young-staggeringly-low-says-uks-top-statistician/ https://www.telegraph.co.uk/news/2020/05/10/coronavirus-risk... )

ptx 4y ago

> The initial outbreak. I don't know if this was ever, in any practical sense, possible. (Honestly, I don't know, maybe it was). Yes, Taiwan did it, as described in a JAMA article [1] published at the start of March 2020. In particular, follow the link to the supplement: "eTable: List of Actions Taken by Date and Category". [1] https://jamanetwork.com/journals/jama/fullarticle/2762689 https://jamanetwork.com/journals/jama/fullarticle/2762689

ineedasername 4y ago
No. Using Taiwan to make this claim is incorrect-- or insufficient-- in at least two ways. Also keep in mind that I said for all practical purposes, which is very different than theoretically possible. But taking things one at a time: 1) Taiwan has failed to continue it's early accomplishments. It has now has had hundreds of thousands of cases. I'll preemptively address a to this that Taiwan's current cases are a separate topic from it's initial success. This is not an unreasonable point, though I myself do not think they can be separated. A discuss there however seems outside the scope of my response to you. 2) Taiwan was uniquely suited for it's early effective response to COVID. It had learned the lessons from prior scares such as 2003 and put excellent measures in place to to respond to future issues. It was only able to succeed early in the pandemic because of actions taken years earlier. In the context of my comment it is unreasonable to deny my claim on the basis that, had the entire world 10+ years earlier acted differently that Taiwan's success could have been replicated. I clearly made "initial outbreak" the context of my comment while Taiwan's success was rooted in far far earlier actions. The actions listed in your linked article were only so rapidly possible due to that decade long preparation. You might reasonably claim "had the rest of the world followed Taiwan's example 10+ years earlier..." But that would not be a contextual response to my comment. At the initial point of outbreak, especially with early cases in Italy traced back to 2019 & what we know of asymptomatic cases and spread rates, my claim stands: it may have, in any practical sense, been impossible at initial outbreak to have stopped things in their tracks. (I am open to further discussion that I may be wrong, but the example of Taiwan is not sufficient to demonstrate that) The sociopolitical situation in some areas would quite literally have made it impossible as well. In the US for example even the patchwork response by states, often less extreme in restrictions than other areas of the world, prompted sporadic violence including a number of murders over simple mask requirements-- a strict policy in Taiwan that is credited with it's early success. IIRC there was at least one such murder in Germany as well. Finally: I will concede that worldwide response was spotty and inconsistent and that a better job could have been done.