Serious question: does anyone have a plausible end game mapped out? No one bothers talking about what's going to happen 1, 2, 5, 10 years from now. There's no talk about herd immunity or anything besides the immediate concern of getting the last holdouts vaccinated. Places like NYC have 90+% vaccination rate and a lot of political effort is being put on that last 10% hold out, but then what? Is vaccine as a bi-annual service really practical? Is a better vaccine going to come out? Is it just going to mutate into a dud?
Leaving aside variants, the end game is for the virus to become endemic and everybody to encounter it every few months or years.
But you cannot do that while the non-immune part of the population is large enough to overwhelm the healthcare system if they get infected rapidly. Hence the focus on getting as many people vaccinated as possible, and keeping more or less non-pharmaceutical interventions in place.
Over the last months, removing non-pharmaceutical interventions has worked relatively well for some Western societies like Denmark (high vaccination rate) or the UK (lower vaccination rate + many previously infected), but not so well for others like Germany.
Variants change the game, but don't completely reset us to square one: Vaccines still provide some protection, but factors like higher transmissibility may work against that. mRNA vaccines can be adjusted relatively quickly.
We're seeing some congruence in the mutations acquired by different variants and most experts I listen to don't expect the virus to keep mutating forever. There is a limited number of options and population immunity will only become more broad.
On the other hand, the variants seen so far have surprised us quite a bit. Given that, it remains difficult to map out a clear path on the scope of years.
The UK and Germany have very similar vaccination rates averaged across the entire population, but the UK has very high vaccine uptake amongst elderly people who're most at risk whilst Germany doesn't. If you're relying on vaccines to prevent the hospital system being overwhelmed that probably has a disproportionate impact because they're massively more likely to be hospitalized.
The end-game is not so much that the virus adapts (which can happen but mutations are not that easily predicable) but that our immune systems become adapted. We can see this already. Previously infected and/or vaccinated people can get omicron but it will be very mild disease. Next year there will be another variant and people will get sniffles again. Next year another variant that could easily cause severe disease to immuno-naive person but for those who already got 2-3 vaccinations plus mild omicron or whatever it will be just sniffles again.
That's how most cold viruses work. It was clear from the beginning that covid belongs to this category. We just hadn't had previous exposure yet, therefore it was so severe. We overreacted when we thought that we can eliminate cold virus by strict isolation measures.
They predict that SARS-CoV-2 will eventually become something akin to the common cold, as long as 1. immune protection against severe disease persists, and 2.) the virus continues to be relatively mild in kids.
Perhaps, but the first person in the US known to have died from Omicron had already had Covid once before. According to the news, he was also in his 50s with other underlying health conditions.
I think, much like the flu, Covid will continue to be a threat to people who are elderly and/or already in poor health. And much like the flu, yearly deaths will probably decrease somewhat but continue to number in the tens or hundreds of thousands.
For today's elderly or otherwise at risk, that may very well be the case. It's going to be the younger people today who are either vaccinated or survive infection, that become the much more resistant adult and elderly population years and decades from now.
...that they aren't really using effectively (for their own personal or political gain, or to combat the spread of the virus).
This conspiracy theory doesn't pass the laugh test.
I'd love for some governments to start wielding emergency powers in an effective way, even if it were just for graft, to show that they're not clueless.
Yeah it's more like no leader can be caught making any mistake / taking any risk / any measure that goes towards freedom / normalcy, and so while the public doesn't demand it it won't happen. Hard to say where the public stands on this, though it was interesting reading a Reddit thread concerning lockdown measures being enacted in Ontario again, total 180 from the habitual Reddit opinion. So it might be coming, it's obvious people are tired and are ready to understand a one-sided policy is not sustainable.
>Hard to say where the public stands on this, though it was interesting reading a Reddit thread concerning lockdown measures being enacted in Ontario again, total 180 from the habitual Reddit opinion.
I found the thread (<https://www.reddit.com/r/ontario/comments/riqusg/ontario_ann...>) after reading your comment. Wow, you're right about it being a total 180 from the usual Reddit opinion. (Sort by Best or Top, not New.) This comment getting 100 upvotes is one example of the change in sentiment:
>Why don’t they just permanently shut down all small businesses and call it a day. That’s clearly their goal here.
That's not to say that the mods have changed their views; thus the thread being locked, to prevent more wrongthought from appearing.
Things like the Patriot Act, which is about as unpatriotic as could be, were rolled out in response to 9-11. We also have the ludicrous Bank Secrecy Act; not to mention the Wagner Act following the Great Depression.
I've found many people don't understand the truly limited scope of the Federal government, as most Ameicans don't understand it either. But our Federal government has only a very narrow set of responsibilities and those responsibilities are the only things they can do (10th ammendment). They are quite clearly enunerated in Section 1 Article 8 of the Constitution, which in itself is not without controversy over the wording, specifically regarding "general welfare of the US". But thankfully we have a letter from Madison to Pendleton in, I think, 1712 which specifies why that specific language was adopted, and it was done so to remain consistent with the Articles of Confederation, and that specific wording was thought to be the least controversial (how wrong they were!).
Thus, programs like Social Security, ACA, and all other social welfare programs that I can think of are unconstitutional, and day-by-day our federal representatives push for more.
Of course, we amended the Constitution out of relevancy with the 16th Ammendment, giving the government the perfect gunpowder for the spark which was "reinterpreting" S1A8.
I suppose its impossible to make a 5 year plan when the game is changing month after month. With countries having 50% vaccination rate, there's always place to brew new variants that might or not be resistant to vaccines and medicine.
Is there any reason to believe being vaccinated means you're less of a breeding ground for variants? Surely it's not 100%, and if it's not, new variants will always come, including gradually evading vaccines, no?
> With countries having 50% vaccination rate, there's always place to brew new variants that might or not be resistant to vaccines and medicine.
Is it true that new variants are more likely to evolve among more unvaccinated people? US has had significantly more cases that South Africa (per 100k people) for most of the time. I assume mutations are more likely to happen in places with more cases. Not sure if vaccine plays a selective pressure on vaccine mutation (bad or otherwise).
There's nothing indicating vaccines do anything to stop or make variants less likely. Arguably they could make more virulent variants more likely to survive.
Look at the rate of deaths. Last December was about half the death rate of december before that. It's looking like this year will be half of the prior year. This is despite the number of cases generally being higher in the latter years generally. Some dependence on when the virus first hit. Long term side effects and hospitalizations are going to correlate with the death rate more than the infection rate.
There is strong reason to believe that despite omicron's higher spread factor, it won't increase exponentially forever and will instead drop off rapidly as its done every year in every geography sometime soon. It's not a dud yet, but it's trending towards that through a combination of better treatment, vaccinations, immunity, and particularly vulnerable people dying.
Omicron looks like it could reach a much higher number of infected in new york soon, but I doubt we will see a higher rate of hospitalizations or deaths than last year in spite of this. We should have the evidence to confirm or deny these assumptions in a few weeks once we're comfortable with any lagging data issues.
Less snarky though; the phrase "forever" still implies a long horizon of exponential growth. The reality is that exponential spread of disease rapidly drops down much earlier than most people assume. Far far below 100% of the population.
Mathematical concepts do not translate into the real world, it's that pesky little difference between theory and practice. You'll never run out of numbers but you will run out of everything else and usually a lot sooner than you think.
edit: you probably should mark your edits if they materially alter your comment after someone has already replied.
0% fatal, 0.13% ICU, 1.2% hospital
4.3% Covid-recovered
76% double vax, 7% booster
14% unvax, 2% single vax
77% no travel history
IF (will take several weeks to confirm) Omicron is mild and highly transmissible, then people may be infected and recover with protection against a range of variants. While natural antibodies fade, there is likely some ongoing protection from T-cells and memory B cells, e.g. studies showing some SARS1 protection after 17 years.
> "no evidence of Omicron having lower severity than Delta, judged by either the proportion of people testing positive who report symptoms, or by the proportion of cases seeking hospital care after infection."
Isn't the ultimate test of severity death? I know its a lagging indicator but the numbers are so low (14 in UK total) compared to historical (over 100 deaths per day). And no omicron is the majority of cases, wouldn't you expect more deaths if it were as infectious?
> Dr Angelique Coetzee, the senior doctor who first identified the variant, said that the line of treatment for Omicron patients is "quite easy". "We start immediately after the diagnosis with low dosage cortisone and something like ibuprofen to help with the muscle pain and headaches and that's it. That's what we give. There's nothing else. There's no oxygen, not even antibiotics required," she said.
Briefing about the symptoms associated with the variant as it reaches the fifth week of its outbreak, Coetzee said, "Most of the cases reported so far manifest symptoms like body aches, headache, tiredness." "They may or may not have a cough; it is mostly dry cough with a sore and scratchy throat. According to a recent study, it affects the upper respiratory tract and doesn't affect the lower airways like the delta variant," she added.
For anyone on their edge of their seat to commit a stats fallacy, don't forget that the base proportion of the population vaccinated is ~4x higher than the unvaxxed. The unvaxxed are comprising a massively higher share of the infections than their share of population here.
The vaccines are pretty great. I am happy to believe that if a strain of COVID occurs which the vaccines are less effective against, then the strain will necessarily be less severe.
This is plausible because the vaccines target the spike protein.
While it is too early to say definitively—evidence so far seems contradictory—Omicron may be such a mutation.
Bi-annual is not necessary, even if immunity wanes within six months due to the seasonal nature of the beast. So at worst we are looking at something like the yearly flu vaccination. And also very probably younger and healthier people will be able to skip that altogether, just as with the flu vaccine.
> Is vaccine as a bi-annual service really practical?
Sure, why not? The flu vaccine's annual. Hopefully we don't end up there, but if the medium-term end-state is "it's manageable, but everyone needs a booster every six months", that seems... not the worst possible outcome?
I don't think we're going anywhere until we have a real cure. You can have 10 vaccinations but if your immune system is shite they are not gonna amount to anything. And half of the world is still unvaccinated so even with our boosters we're not gonna end variants.
I'm vaccinated myself and think that is smart but friends with some people who'd probably consider death before covid vaccines.
According to them there is a good deal of things one can do to reduce risk of severe infections.
Personally I have started taking extra vitamin D in addition to the one I get from cod liver oil. It sounds smart and it seems science supports it and I don't have to buy into the rest of what I think is kind of crazy.
(to be perfectly clear, I'm vaccinated and I recommend it. Vaccines have small and uncertain side effects. Viruses have large and much more certain effects.)
Taking vitamin D is great and recommended for pretty much everyone, but the evidence for it being an effective prophylaxis against Covid-19 just isn't there[1]. By all means take it for general health reasons (I do too!) but don't expect it to provide you any specific protection.
Let me rephrase it: if one also has a vitamin D deficit the chances of getting seriously ill increases significantly.
Would that be correct?
(Same is AFAIK true for being overweight but unlike increasing vitamin D levels which takes days or weeks, getting down to a healthy weight in a healthy way is a months long process.)
Overall, there is a weight of evidence in favour of vaccines (especially mRNA vaccines) being effective, and very little evidence for the various options that the antivax crowd like to put up as alternatives.
> friends with some people who'd probably consider death before covid vaccines
I know some people like that and I've had some success encouraging them to take the Novavax vaccine (a traditional vaccine that's said to be safer and cheaper [1]) when it's approved. I can't be sure they will but they've said they'd consider it.
> Zinc can play a pathophysiological role in several diseases and can interfere in key processes of microbial growth. This evidence justifies the efforts in applying Zinc ionophores to restore Zinc homeostasis and treat bacterial/viral infections such as coronavirus diseases. Zinc ionophores increase the intracellular concentration of Zinc ions causing significant biological effects. This review provides, for the first time, an overview of the applications of the main Zinc ionophores in Zinc deficiency, infectious diseases, and in cancer, discussing the pharmacological and coordination properties of the Zinc ionophores.
> COVID-19 vaccines will not be enough to withstand the Omicron variant, warned the CEO of BioNTech, the German company behind the mRNA vaccine produced with Pfizer. "We must be aware that even triple-vaccinated are likely to transmit the disease…It is obvious we are far from 95 per cent effectiveness that we obtained against the initial virus."
Boosters are gonna be the norm moving forward, I highly recommend people to check out TWIV (This Week In Virology) Podcast it has a lot of information based on real data and studies coming out.
The norm? I'm highly skeptical. Why isn't there more focus on preventative measures? Even with the Measles vaccine we know to give vitamin A for treating measles.
Here in Europe we already going with preventative measures however if the vaccines have a drop off it's normal to be going for boosters moving forward at least for folks with age 50 and above.
Why is there almost no talk about updating the vaccines? Isn't that supposed to be very easy with mRNA technology?
I get that it would take several months to roll out, and that the old pre-alpha boosters are a good stop gap in the meantime, but it seems like it would make much more sense to have effective Omicron vaccines as soon as possible instead of more and more of less and less effective vaccines.
Seems a bit weird, it'll be fun to find out what the mechanism for this effect is. It seems strange that 2 doses does nearly nothing, then 3 doses suddenly causes the body to figure out Omicron.
Something interesting is that the Omicron mutation seems to very much be about vaccine escape, natural immunity through prior infection offers some protection (linked paper, figure 2C). It isn't totally out off the question that something about the sort of people who get boosters is skewing these results. Table S1 (last page) suggests there are a lot of healthcare workers in the booster sample, maybe they are also people who's immune system is also getting primed from exposure to real coronavirus.
Many vaccines require three shots. A key difference is that the timespan between second and third (booster) shot is much longer than that between first and second shot.
It's a matter of antibody levels. Antibody binding is worse for Omicron, so you need more of them. Booster shots provide you with such increased antibody levels.
Are they still gonna be high enough after a few months? Good question. Afaict, nobody knows yet.
(And this of course leaves aside the whole matter of T-cell immunity still providing protection against severe disease.)
It looks like there might be more factors at play here than that. Natural immunity does a lot better than being only vaccinated, which suggests there is some sort of issues related to quality as well as quantity of antibodies.
This is completely incorrect. As the sibling comment notes, antibody titer against a pseudovirus (synthetic virus containing spike protein; what this figure shows) is a proxy for immunity, and nobody has ever shown that it bears any practical significance at all. Antibody levels go down over time. If they didn't, your blood would be peanut butter.
Antibody levels for absolute neutralization of a synthetic virus in a dish? I have no idea what that means. It's something people look at because it's easy to look at in a dish.
In contrast, a recent paper from JHU and the NIH shows that people who were previously infected have T-Cell responses to spike protein that are almost completely unaffected by mutations in Omicron:
Rare things happen, rarely. It's a big world. Also that "may" in the headline is a logical hole that you can drive a truck through -- being PCR positive prior to death is by no means dispositive evidence that the virus is what killed the person. Pretty much everyone setting foot in a hospital today is tested for Covid, whether they went there for cancer, a heart attack, or the infection itself.
WaPo and "if it bleeds, it leads" coverage like this will give you a completely distorted view of reality. Stop feeding the beast.
This is not reddit. I have no doubt that in 2-3 weeks there will be numerous people who have died of Omicron. Given sufficient time, I'm sure there will be examples of people who die from the virus after reinfection.
As I said: it's a big world, and people die of incredibly innocuous things, every day.
The very first comment I posted -- the one to which you're replying now -- is a link to a paper showing that cellular immunity to Omicron is likely quite robust after exposure to a prior strain. There is now ample evidence that vaccines provide robust protection as well:
hey timr, i really appreciate your level-headed critiques (in the positive sense) of covid research despite the continued negativity you're receiving. few folks have been able to ignore the fearmongering and dig more deeply into the turbulent and harried research to tease out where we're really at in terms of understanding and uncertainty. just wanted to go beyond the anonymous upvote to show some appreciation and support.
I don't see how that's a personal attack. It might be an unsubstantiated inference at best.
The substance is easy to gather using your search tool, however:
> will I find similar baseless dismissive content?
I don't think you'll be very surprised by what you find. There are a number of accounts on HN that have been systematically downplaying the pandemic since the beginning, ranging from wishful thinking to simply not knowing a whole lot about viruses and RNA viruses in particular. The 'usual suspects' promote their preferred solutions, ranging from untested medication to just pretending the problem doesn't exist. It's a bit frustrating that this forum, which prides itself on being so smart harbors some of the worst elements of the conspiracy fueled story lines that are being pushed for way more than they are worth.
With 830,000 Americans verified dead from this virus (and probably a lot more than that once you look at excess deaths for that same period) and on average 1250 new ones added every day, besides the long term effects for the ones that survive a heavy case you'd think that by now even the most hardy of these people would have realized that their mantras are getting a bit long in the tooth.
We have a serious problem, it could easily get much worse and we've squandered our options for cheap and fast solutions. The problem is a global one and as humanity we have a piss poor record of dealing with global problems (except for the Ozone layer issue, but I wonder if we would have been able to deal with that in the political climate that we have today). This isn't over yet and the only way we are going to solve it is by collectively admitting that yes, we do have a problem and that no amount of wishful thinking or quackery is going to get us out of it.
There has to be room for debate and that means room for people who are saying wrong things (or that you or someone else considers wrong). In any complex situation, there will inevitably be a wide spectrum of views. I don't think it's a good idea to lump that spectrum into a binary (which is what phrases like "usual suspects" seem to me to be doing).
Fair enough, but there is an asymmetric component at work here that I think bears identifying: you can have a community of tens of thousands of individuals that are moving in a mutually beneficial way and you can destroy that same community by having a few hundred dedicated people that will shout down every attempt at a reasonable discussion with misinformation and downright junk.
Destruction is simply much easier than construction. The dutch have a proverb about this (they have proverbs on just about anything, so that shouldn't come as a surprise): "Een gek kan meer vragen dan tien wijzen kunnen beantwoorden" -> "One crazy person can ask more questions than ten wise people can answer".
And that gives HN at times a weird imbalance where it might seem to a casual observer that we are on average a bunch of racists, in denial about COVID, that we aim to spread quackery and that letting this junk unanswered is tantamount to agreeing with it. I know that isn't the case, but you could not fault an outside observer for having that view because we put that on display almost every day.
This asymmetry is also present in real life, for instance in the form of vandalism, where destroying something takes a lot less effort than it does to repair it. And PG addressed some of this in his 'no broken windows' article (which I still think is one of his best pieces and exhibits a lot of deep insight).
So there is a difference between 'room for debate and the ability for people to say wrong things' and 'people saying wrong things because it either amuses them or because they aren't trying to debate anything at all, they are just trying to spread their payload to as many eyeballs as possible'.
I recall hearing that as well but I can't quite remember what the rest of the picture is - something about the other parts of the immune system being able to do the needed work? Or that it was shown that someone with zero antibodies could still be immune?
Other parts of the immune system, specifically T-cell response. The simplified bottom line is that antibodies provide a quick response that also prevents many cases of mild disease. T-cell immunity lasts longer, appears more universal against variants and should still work relatively well against severe cases.
It's more like a retraining program. It's almost like the difference between short and long term memory. One shot will turn on short term memory after a week or two. Repeating shots will turn on long term memory.
But what I personally think is interesting is that a natural infection works longer and broader after just one 'dose'.
It is amazing how complitacted the immuunsysteem is. And I also think this is the reason we should be careful with giving healthy young people the vaccins.
It will likely be too difficult to do a study to answer this precisely. But if you recently got your initial vaccination completed, you shouldn't be in a rush to get a booster. The booster is there to reinforce the immunity after it has had to wear off.
They're saying that it had low effect on immediate neutralization of the virus (sterilizing immunity). You're still well-protected against severe disease.
Far too much fear-mongering has happened based on confusion about what different studies are measuring. Measures of "neutralization titer" are pretty much pointless, outside of a lab -- they're a model for immunity with no demonstrated relevance to real-world outcomes.
Studies involving "symptomatic disease" are trying to measure the chance you might get any symptoms at all -- a very low bar. Even the sniffles count here. This is where most of the pro-booster studies have focused, and it's a pretty lame endpoint, unless you continue to harbor the delusion that "zero covid" is a thing that is possible (it is not).
Basically, if you get infected after two doses, you might get cold-like symptoms, unless you're either severely immunocompromised (e.g. on immune suppressants, AIDS, in the middle of a bone marrow transplant, etc.) or so old that your immune system is failing anyway.
I read it as they were surprised that regular vaccinations had no effect on Omicron, but that [recent] boosters did (although to a limited extent).
That seems to jive with what I have seen on the ground, around here (New York). Dozens of friends and acquaintances are sick. None, severely. I am quarantined through Christmas weekend. Tests (at least accurate ones) are rare as hen’s teeth. The home test kits seem to be absolutely worthless. I have not talked to one single person that got a positive from a home test (some were clearly symptomatic, when they took the test, and still came up negative).
My concern is for the other symptoms of covid that could compound. Taking your vaccinations and boosters will generally keep you out of the hospital, but what of the other consequences? Cardiomyopathy, damage to smell and taste, and cognitive impairment could all be cumulative. What happens if they are and we're subjected to decades of repeated damage?
It appears that COVID is a blood disease, as opposed to a pulmonary disease.
I know a 19-year-old girl that had a stroke, as a result of COVID.
I was talking to an acquaintance that is a mortician, a few months ago, and he said they could always tell the people that died of COVID, because their blood had a different consistency.
Well that's interesting because I was also talking to an acquaintance that is a mortician, a few months ago, and he said that anecdotes like this contain absolutely no valuable data at all and only help to sow misinformation.
> Well that's interesting because I was also talking to an acquaintance that is a mortician, a few months ago, and he said that anecdotes like this contain absolutely no valuable data at all and only help to sow misinformation.
That was why I framed it as a personal anecdote. It really happened (unlike yours). It is not supposed to be a valid data point. No double-blind scientific analysis. Just a short personal story.
If I don't have anything other than anectdata, I am careful to frame it as personal experience and PoV.
I thought we didn't do stuff like this (sarcastic personal attacks) on HN, but I am often wrong.
> Be kind. Don't be snarky. Have curious conversation; don't cross-examine. Please don't fulminate. Please don't sneer, including at the rest of the community.
...
> Please don't post shallow dismissals, especially of other people's work. A good critical comment teaches us something.
I just talked to the chap that got a personal test come up "negative," and he talked about it to the people that gave him the PCR test.
He said that the home test has two lines in the display (I think it's a piece of paper, but I'm not sure). One is a control, and the other is a result.
He said that the control line is very clear, but that the result line tends to be fairly faint, so it's entirely possible that people are getting positive results, but aren't seeing the line.
It's possible the Omicron variant is throwing a spike into things. I'll lay odds the tests are for Delta (or earlier) variants.
I was just talking to a friend that is sick with it. He had a negative home test on Monday, and went in for a PCR test, immediately after. That test showed he had a fairly significant viral load. He and his wife are high-risk, and had the monoclonal antibodies treatment. Not sure they will do much good.
> are they saying double vaccination had no noticeable effect on Omicron?
Practically, yes. See Figure 2. Recent vax (< 3 mos.) and distant vax (6 to 12 mos.) neutralization is between the first two eighth ticks for omicron. (Distant vax + infection is a bit less effective than distant vax with the wild type variant, which should put to bed the nonsense around prior infection being equivalent to innoculation.)
We need an updated vaccine and/or to refresh the vaccination requirement to including boosters.
Last page specifically. I think the problem with comparing immunity from infection and vaccination is mostly due to how quickly both fade out with time.
Other papers show that they have no noticeable effect on how the virus can reproduce, however the T-immune cell response to already infected cells is still good, meaning you most likely won’t go to the hospital if you get omicron and your 2nd dose is not too long ago.
https://www1.nyc.gov/site/doh/covid/covid-19-data-vaccines.p...