The current HN title deviates from the original title in a way that is misleading. "Vaccines Are Effective Against Covid Variants" is a wrong affirmation. The original article only states that in vitro experiments show that some vaccines are effective against some variants. Not all vaccines, not all variants, and no test on human beings.
A counter point is that some vaccines seem to be ineffective agains some variants. For instance AstraZeneca against B.A.351 (South-Africa). From a preprint:
"Conclusions A two-dose regimen of ChAdOx1-nCoV19 did not show protection against mild-moderate Covid-19 due to B.1.351 variant, however, VE against severe Covid-19 is undetermined."
https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v...
The US CDC does state that, according to current publications, some variants present a "moderate reduction on neutralization". Their page about "Variants of Interest" and "Variants of Concern" mentions many scientific papers.
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/vari...
Ok, we've reverted the title now. Submitted title was "Vaccines Are Effective Against Covid Variants". Submitters: please follow the site guidelines, which ask "Please use the original title, unless it is misleading or linkbait; don't editorialize."
I've posted this before regarding the SA paper on AZ, worth taking a look at the below.
The probable outcome is minor to moderate symptoms that would normally be blocked by antibodies can still present (So no reduced transmission) but severe symptoms are still prevented by the vaccinated patients T-cells response.
This paper is looking at a small scale human study in SA with mostly younger participants, which does make the results difficult to apply to the wider population.
They also only use a 4 week dosing schedule where the suggestion and actual rollout in the UK is following the 10-12 week schedule between first and second doses which was shown to increase efficacy from ~70 to ~80% after the second dose (UK - Kent variant)
The variant in question seems to escape the majority of Antibody detection, but T-Cells still seem to provide significant protection against severe disease and death.
The main published results aren't yet from human scale studies but here is one in hamsters showing a comparison in organ damage and results between unvaccinated and vaccinated with the Oxford/AZ vaccine.
We've been vaccinating people since December. There ought to be statistical evidence now of whether and how much vaccinated people still get sick from Covid and its variants. Why do we still hear that epidemiologists have no idea about this?
For example, everyone being tested for covid or being admitted to the hospital for covid, should be asked if they've been vaccinated, when, and which vaccination.
70 million people in the US have received vaccinations. There ought to be plenty of data by now.
We do have real world results, and they’re mostly very good. For example, analysis of the real world effectiveness of the Pfizer vaccine in Israel:
> The latest analysis from the MoH proves that two weeks after the second vaccine dose protection is even stronger – vaccine effectiveness was at least 97% in preventing symptomatic disease, severe/critical disease and death.
The AstraZeneca vaccine looks not so good, especially against the South African variant, but the early real world results for the Pfizer and Moderna vaccines look outstanding, and the Johnson & Johnson vaccine looks solid.
This study, from Scotland, looks at risk of hospitalization after first dose of either Pfizer or AstraZeneca vaccine. The Pfizer and AstraZeneca vaccines look equally good. If anything, in the raw numbers AstraZeneca looks a little better that Pfizer, but the difference is well inside error bars.
There is this one study, a proper randomized controlled trial from South Africa with 2000 people. But it only studies the AstraZeneca vaccine. They only saw mild (15 vaccine recipients and 17 placebo recipients) or moderate (4 vaccine recipients and 6 placebo recipients) infections, so they can not say anything about severe disease, because no one got it.
And they only studied AstraZeneca. Unfortunately, this study has been giving AstraZeneca maybe an undeservedly bad reputation, as media goes around saying that AstraZeneca specifically is not effective against the B.1.351 variant, suggesting that other vaccines would be. But as far as I know, similar studies of other vaccines do not exist, so we just don't know yet if they would be, maybe, equally bad against the B.1.351 variant or not.
Note however that Israel has closed its borders tightly, so Israel can't tell us much about the vaccines' effects on variants that haven't entered that country yet.
I've only seen reporting suggesting that every variant listed as a "variant of concern" from the CDC is present in Israel. So their data should be good.
Do we have any educated guesses on why we see a difference between the J&J shot and the AZ one? Is it just luck of the draw regarding different adenovirus vectors, or something deeper?
Disclaimer no experience with vaccine development but...
Two problems with some types of engineered vaccines. The first is people can have existing immunity to some component of the vaccine. And the immune system wipes out the vaccine before it has a chance to generate strong immunity. Second people develop immunity to proteins in the vaccine that aren't present in pathogen you're trying to vaccinate against.
As an example I think one of the vaccines based on modified viruses uses a different virus in the first and second shot.
This should be the top comment. I really wish this was addressed somewhere.
But with all the charts we see of case, hospitalization, and death counts, why isn’t someone charting data for case, hospitalization, and death counts following vaccinations?
You might see some study with possibly some data buried in it, but this should be part of the rest of the data being broadly shared so that it’s clear the effects it’s having.
This kind of reporting on vaccines is the kind of thing that bugged me even before Covid. It's as if the media likes to keep the 'good' facts out for controversy to continue (obviously I don't think that's what's happening, I'm just blaming incompetence).
It always only takes one number to silence the debate, and it's always missing. E.g. "new mumps epidemic, kills 200, wave of low trust against vaccines to blame". Maybe. Maybe not? You could clear this up instantly by also reporting how many of those dead were unvaccinated, and then it's crystal clear. But that kind of info is never in the story.
There are many studies on the Israeli population post-vaccination, since so many Israelis have finished the two-dose course of the Pfizer vaccine.
There are even some studies on the British variant there, since that is now responsible for >50% of infections. TL;DR: the Pfizer vaccine is extremely effective against the British variant as well.
There ought to be statistical evidence now of whether and how much vaccinated people still get sick from Covid and its variants. Why do we still hear that epidemiologists have no idea about this?
How much energy do you want to put into tracking so that you can draw better conclusions?
We have good evidence that people don't become symptomatic, because that is easy to track. But we haven't generally been constantly testing to see how many caught it and fought it off. Or how many could have spread it to unvaccinated people while they were asymptomatic. Which are both very useful for epidemiologists to know for modeling purposes.
Rather then some government conspiracy , I think it's easily explained by media pushing fear to get clicks, leading to people supporting unnecessary measures. I still talk to people who are afraid to even do outdoor dining after they have gotten their second dose (plus 2 weeks incubation). People like that vote, post, and message their representatives, leading to where we are now.
Media is funded by advertisers, the same advertiser that would greatly benefit from the pandemic ending. Zoom and Slack are probably the only stocks that directly benefit in the current situation and I don’t see any ads for them anywhere. Cruise lines are on the other hand huge advertisers and are suffering severely right now. Why would they want the media to keep causing mass hysteria? And if the government is opposed to the media on this, why would they issue health guidelines that say we should isolate?
I can likewise draft a theory that media is pushing a narrative of 'the lockdowns are unnecessary, your government is cheating you' in order to stir up controversy and get clicks.
Both your, and my theories hav little predictive or explanatory power.
And if we're dealing with anecdotes, I can also cite that I know people who were not afraid to be going to crowded bars (Check out central California, if you want to see people flouting lockdown, and spending their stimulus checks on partying in, say, Modesto) over the past ~year, despite not being vaccinated. Do you think those people may have been influenced by the media pushing a narrative that lockdowns are unnecessary?
Here's the actual answer to this dilemma. 'The media' is pushing both narratives. You are just paying more attention to one of them, because that's the one you happen to disagree with. There are very few issues where 'the media' boogieman presents a unified front, and COVID-19 has not been one of them.
Depends on how far you want to assume nefariousness/conspiracy on the part of "TPTB" or the government.
Could just be that it was to help swing a election, or allowed them to paint certain parties as "anti-vaxxer conspiracy theorists". Maybe it's to cover-up nighttime movements by a secretive alien invasion force. Maybe they just love what it's doing to the stock market. Perhaps it's a bold move by online retailers to kill off small businesses or just brick and mortar ones. Maybe they're desensitizing us for something bigger. Maybe they're just incompetent AF and following along with what the media makes them think is what the people want. Maybe it's all ad-click and media-consumption driven as one of the other posters put it.
My personal take is that they have no clue, and most of those in power are just doing things that have been done before and doing them only in ways that have been done previously.
> Why would any government want to justify longer than needed lockdowns?
To avoid protests that annoy it and could challenge it in the next elections. All Europe locked down last spring, but there is an accusation that France’s lockdown was unusually strict because that way Macron's government could, at the stroke of a pen, get rid of the Yellow Vests movement that had been so obnoxious over the preceding months. Meanwhile, in Russia it is clear that social-distancing laws are being used as one more tool against gatherings that the regime doesn’t like (while pro-regime gatherings might go ahead unhindered with zero masks or distancing).
That's a nice quote, but still doesn't answer the question.
No government in their right mind wants to continue lockdowns unnecessarily. Lockdowns cost a lot of money and make a lot of voters angry
Every offical that was selling the initial lockdown. Just have to get the R0 below 1, remember? You really think the masses would have been OK with a year of lockdowns and the despair that entails up front?
Your conclusions don't match reality. States like Florida have open stadiums and are fairing the same as states like California that insist on totalitarian overreach.
California has done somewhat better than Florida overall — and the vast, vast majority of cases in California came from Southern California, where the lockdown and mask rules were largely not followed. California is 40+ million people; it's basically two Floridas. The northern one followed the rules, the southern didn't, and you can see very clearly which way resulted in fewer cases and deaths. Northern California had one of the lowest case rates in the country. Southern California had one of the highest.
Well, in Germany three politicians who had to resign because of corruption where they had made deals with companies manufacturing masks and made hundreds of thousands of euros. And this is just facts and no conspiracy theories, and I bet this goes on at every level. If you find a way to (legitimately) control people and peoples behaviours, of course it's lucrative.
You can't just say it's "lucrative." You have to say how. Are you saying that a controlling number of powerful politicians or their backers are heavily invested in mask manufacture, but not in any of the parts of the economy that are affected negatively by the lockdowns?
And "hundreds of thousands of Euros?" That's a pittance. There has to be more to be made (than maybe enough to buy a studio apartment in Berlin) in order to justify the shutdown of a large part of world industry.
That might happen, but when you think about conspiracies, always think who would be against them.
Ok, they make money from selling masks. But do you really think no shareholders in hotel chains, airlines, airports, etc. are trying to push back against that?
Covid is hurting a ton of businesses. A lot of powerful people are behind those businesses that feel that pain.
They do, but people complaining about this tend to convenient focus on the powerful people making money because of lockdowns while absolutely ignoring the powerful people <<losing>> money because of them.
Agree we should now have data to look at but don't? They can have their kayfabe but when it comes to me injecting stuff to believe it I have questions.
There are thousands of actually qualified professionals looking at that data, including the licensing bodies of every developed nation. The EU has recently gone back-and-forth on the AZ vaccine. which would seem to only make sense under the assumption that they are actually cognisant of possible risks and trying to avoid them (and alternative some might want to argue is their hatred of the British, but that cannot explain the ultimate resolution, since EU still very much hates at least the Johnson government)
If you trust them, get the vaccine. If you don't trust them, why would you trust any data they might release?
For people arguing that not being part of a risk group is a reason not to protect yourself, please take a lesson from brazil. Being part of a 'high risk group' does not saves you from infecting other people who are part of such groups.
That's basically what happened in brazil: people who were not part of risk groups crowded, encouraged by the president himself[0][1][2]. The number of infected poeple soared and variants that affect younger people appeared[3][4]. The health system has now collapsed because there is not enough ICU for such a high number of ill people[5][6].
I am hearing from friends and family in Brasil that the Brasilian variant is more severe among younger victims than the original COVID version. There is an increase of deaths among twenty-year-olds as a result.
The second wave of the 1918 pandemic was also more deadly to younger people.
Various theories have been offered as to why, none of which are proven, including that it may have been observational errors or due to overcrowding conditions due to the war and viral dose.
I wonder if it isn't due to the virus coming under pressure due to a large chunk of the population becoming immune, so evolution favors higher transmissibility. And the easy knob the virus has to increase transmissibility is to increase viral load, which has the side effect of increasing virulence/lethality. That is consistent with that fairly well studied mechanism of parasites/viruses, along with being consistent with what we're observing.
At any rate considerations like that are why I'm not letting my guard down until I'm vaccinated and why it seems stupid to do so.
I dont believe virus ever increase in lethality as pressures increase, I thought the opposite happens, they naturally becomes less lethal to be able to spread more effectively.
Also when you said " stupid to do so" what are you referring to?
Mostly all the virus cares about is increased transmission, particularly with this virus with a long presymptomatic transmission period, it can evolve to become more lethal if that increases transmission. What would not be selected for would be enhanced virulence that shortens the presymptomatic transmission period.
Short term the virus benefits by having higher viral loads and enhanced transmission and enhanced virulence, because it wants those higher viral loads in order to spread more. There's a limit because those higher viral loads are eventually what cause people to feel sick and stay home instead of attend superspreading events, so there's an optimum that its trying to find. As more and more people are immune though, there's probably selection pressure to make the most of whatever superspreading events occur at the expense of non-superspreading transmission. So more people get sick earlier and stay home, but the people who will try to push through a 101F fever the virus wants to have them infecting 100 people instead of 50.
Long term the virus is going to evolve to become less lethal though because eventually we're going to hit herd immunity at the point where it can't evolve along the same fitness function to spread epidemically. At that point it needs to make many more mutations to all its epitopes that might be recognized by antibodies and T-cell and achieve enough immune escape to raise its R0 above 1.0 again.
There's mutations which slide up and down the existing fitness curve (and some lucky mutations that might make the curve even better) but then there's mutations which are costly which are necessary due to the need for stealth and immune escape. Two different things.
Also we have the example of the 1918 pandemic where the later waves were more virulent and lethal than the first wave (but much later it evolved to become seasonal influenza). Got much worse, then got better.
All the more reason to stop all strains as soon as possible. If more contagious strains can be knocked below the sustainability threshold then they'll die out too.
It is not possible to stop all strains. SARS-CoV2 has multiple zoonotic reservoirs, transmits easily, and persists in the population via asymptomatic infection.
We have eradicated one human virus in all of history, and it took a highly effective vaccine and a hundred years. The long tail is very long.
It is still important to stop this particular strain and to achieve sufficient vaccination levels to achieve herd immunity.
That immunity will likely be durable for many years (based on the somewhat recent study of HCoV-229E).
That will force the virus to mutate to achieve true escape immunity (a strain, not a variant, which can reinfect everyone all over) which will likely come at a cost to fitness, since one or two mutations to spike isn't enough, and there will need to be a few tens of mutations to spike.
That virus strain will not be as transmissible or virulent as what we are dealing with now, because it has had to make those costly "decisions".
And this is important for people who for medical reasons cannot be vaccinate or who are at high risk even if they are vaccinated. They're much better off being infected by subsequent strains down the road than being infected with version 1.x of this virus.
This is also what has been observed in the past with 1918 H1N1 which later evolved into seasonal influenza.
For all the reasons I cited above, we are not going to “stop this strain”.
Covid is endemic. It is not going away. It doesn’t meet any of the standards set up by the WHO for eradication, and even if it did, it would take decades of intensive work, on par with what we’ve been doing for polio.
The “logistical” and “political” problems being that they’re endemic in countries with major political and economic instability, where the locals have a bad tendency to kill the people doing the vaccinations.
It isn’t a trivial problem. And oh yeah: Covid is in those countries now, too.
I never said they were trivial, and have argued exactly the opposite elsewhere. But it remains that they are logistical and political challenges, not biological ones.
Sure, the president is responsible for that too https://www.youtube.com/watch?v=N3osqOIT7SQ ? One thing is poor people arguing to have to work. Other thing is this "funk train".. The video is from yesterday. You can count, like 2 or 3 masks on the train.
And the even more selfish evolutionary reason: viruses mutate. If we spread it a ton while it's still "safe" for someone young, we're risking major mutations. It's like playing Russian roulette with 8+ billion bullets x probably millions/billions of viruses per person.
We just need one strain to go to something like 5% mortality + mortality across all age groups for this pandemic to become a civilization ending event. Maybe not ending, but "setting back by 20-40-60 years" event.
And to pile on this, I know a triathelete in my group, 24 years old, who had it in April of LAST YEAR and is still not at 100% (can't do any hard aerobics without getting wildly out of breath).
I have a coworker that never went to the ICU but can no longer taste or smell. Their family was never at a high risk and only felt normally sick. None the less the damage is done. No one wants to be maimed by this. Claiming “I’m not high risk (of death)” does not mean there is no risk of damage.
We all need to do our part to stop the spread of the virus.
We have a friend in their late 30s who also never went to the hospital but got sick with covid five months ago. They have yet to regain their sense of taste or smell.
Isn't mask wearing still required after vaccination because of the enforcement costs? I.e. it's too difficult to prove whose been vaccinated in every situation, so by requiring masks until the community reaches the target threshold
Think it's still preferable just because vaccinated people can still catch and potentially spread it, and the risk of exposure is still pretty high due to all the people not vaccinated.
Mask rules will change as active cases fall. There is a 10-30% of the population that refuse vaccines for political reasons. All we can hope for is everyone else getting the vaccine, and most of the anti-science people getting immunities via an infection.
Vaccinated people have a lower viral load, thus are less contagious, thus lower the R1.
If the r1 is below 1, then you eventually get to herd immunity. The more vaccinated people there are, the less dangerous the disease is, and the less contagious it becomes.
Herd immunity is not binary: it's a gradient, and if you are on the right side, things get better.
Even if vaccinated people can contract the virus, they are likely to fight it off relatively quickly and keep the virus load in their bodes low, keeping their chances of transmitting it much lower than an unvaccinated person would.
Lets say being vaccinated halves your chances of passing on the virus compared to an unvaccinated person. If almost all the population get vaccinated, we can ease the lockdown to the point where we tolerate doubling the chances of re-infection. The lockdown easing and vaccination effect should cancel out. If vaccination reduces your chances of passing on the virus by 10x, then we can tolerate a 10x increased risk due to easing lockdown measures.
Worst case we may have to retain some limitations in social contact for a bit longer, but hopefully nowhere near as onerous or we've had to so far.
It may well be that having already been infected doesn't prevent you passing on the virus, in exactly the same way.
Whether your immune system knows how to fight the virus from previous infection, or from a vaccine, it can take time for your immune system to kick in and fight of a new infection. During that time you might be infectious.
These anecdotes are useful to remind us that many covid survivors still suffer from its damage.
The data doesn't quantify these things yet, so cynical people, maybe people especially like you, might do well to pay them attention. Just because you're unlikely to die from covid, doesn't mean you won't be part of the 10% who retain symptoms past 3 months.
"99.9%" is usually what you see when people are talking about the numbers of people in their whole population who haven't died from it yet. I appreciate the problems in test data when talking about case-mortality, but population-mortality is utter nonsense.
Not to mention that in many places the whole population-mortality is now more than 0.1%. 0.2% of the UK has died from Covid. A few places are worse than that, and many places are on a trajectory for 1% if they can't control it.
Yes, including the Czech Republic, where I live. We have about 0,25% of the entire population dead from the Covid pandemics, one of the worst results worldwide, if not number 1...
Here’s the problem: you cite anecdotes of second- and third-hand stories that are exceptional at best, implausible at worst, then you claim these to be representative of the common case. They are not.
There have now been hundreds of millions of infections, worldwide. Of these, the vast majority (>99.9%) resolve with no major sequelae. These are facts. People need to know this.
'Earlier studies focused largely on long-term effects in hospitalized COVID patients, McCulloch noted. "Our study is unique in characterizing a group consisting of mostly outpatients: 90% of our cohort experienced only a mild COVID-19 illness, yet one-third continue to have lingering effects," she said.
'"Many of these individuals are young and have no pre-existing medical conditions, indicating that even relatively healthy individuals may face long-term impacts from their illness."'
So your best evidence of this phenomenon is an uncontrolled survey of people who knew they had covid, asking them if they feel bad? And the most commonly reported symptom is hypertension, at 13%?
I’ll let the researchers do
the talking here:
”Study limitations include small sample size, single study location, and potential bias from self-reported symptoms, the researchers acknowledged.”
This is certainly not a rebuttal to the fact that there have been hundreds of millions of infections globally, yet the cumulative evidence for “long covid” continues to be a vague constellation of self-reported, mostly mild symptoms in a tiny fraction of people.
If even .1% of 100M infections had severe, long-lasting damage, it wouldn’t be a debate. There would be hundreds of thousands of people to point to.
Are there? This is an opinion piece. This is your evidence? Really?
The OP linked to an uncontrolled, self-reported survey of those who claim to have long covid, and the most that showed is that a small (<13%) number of people show a constellation of mild symptoms, like hypertension. Even the much-discussed “brain fog” was only reported 2% of the time in that biased sample.
Downvote all you want, but you keep making big claims, and backing it with anecdotes and editorials.
Want people to believe you? Bring data. Not blogposts. If there’s so much evidence, it should be easy for you.
That was the "let me Google that for you" response to your own completely unsupported claim. It seems like you're unwilling to look at evidence contrary to your opinions; the 'debate' is amongst deniers who aren't looking at evidence. I suggest some self reflection is in order; you're arguing with the same tactics as a climate change denier.
You’re making the claim. Prove it. Don’t give me an editorial. Don’t give me a wikipedia page. Link to the controlled studies, showing the widespread damage that you’ve claimed.
You can’t, because they don’t exist. You linked to the best there is, and it doesn’t rise to any reasonable standards of scientific evidence. Self-reported data is almost worthless. Uncontrolled, self-reported data is worthless.
I’m perfectly willing to believe you, but editorials won’t convince me.
I'm sorry to hear your search engine got a flat tyre. Belligerently sniping about exactly what it is you want us —your research assistants, seemingly— to hand deliver you, doesn't seem like the best way to retain karma here, let alone have a discussion about something...
It's going to be many years until we have a proper handle on this. Until then you might have to be willing to accept a flood of more anecdotal field data as having some analytical value.
There are two studies linked directly from the Harvard health article, one tracking Italian outpatients, and the other using randomized phone follow-up. Feel free to go read them, and more besides.
There's a constellation of individually imperfect studies pointing in the exact same direction; that's basically how science happens. The studies exist in the first place because people observed Something Strange was happening, and wanted to quickly get a sense of severity and prevalence, to inform public health response.
And if you're not willing to update your priors, I'll be here waiting for the perfect study that proves long covid doesn't exist...
I did not downvote you, but I feel need to comment on this:
"COVID might suck but there are far worse things"
Compared to, say, Auschwitz, everything else is trivial. But that is misleading.
The dead are, well, dead, but we do not yet know how the survivors of severe Covid cases will fare long term. Given that the cohort was fairly big, they may constitute a significant challenge for healthcare capacities.
Even in warfare, crippling an enemy soldier alive is considered more efficient than killing him outright. A disabled survivor requires much more energy and attention than a dead body.
If I'm not mistaken, the rate in the paper is bigger, 0.25% against 22k/11M = 0.20% in Belgium.
But if the newspaper I read are right, there is a catch: when tests were not available, Belgium counted as a covid death every case where it could be suspected. Even nowadays, in case of comorbidity, covid is always written down as the cause of death. So 22k is probably a maximum, and, taking into accound the 25% uncertainty on the denominator, the real rate could very different.
I think you're misreading the comment you replied to. "+/- 25% of a 11M of the population having been infected" means about 25% of 11M, or 2.75M, officially infected. 22k/2.75M would imply a 0.8% fatality rate.
Seems low compared to New York City as well. NYC has already had 30,564 deaths. Even if the whole population had already been infected, that would put the death rate at around 0.36%
Antibody surveys suggest around 40% have been infected which puts the death rate around 0.91%
> Indiana's IFR for noninstitutionalized persons older than 60 years is just below 2% (1 in 50). In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza, 0.8% (1 in 125), among those aged 65 years and older (5).
That is just one factor though in which COVID-19 is worse than the seasonal influenza though.
COVID-19 has a basic reproduction number of 3.3 – 5.7, while the seasonal influenza has one of 0.9 – 2.1 [1], which means that it spreads far more easily. You cannot just wait until summer for influenza season to be over.
With influenza you have a higher rate of existing immunity in the population. With COVID-19 it is basically non-existent, except maybe for a few single people that had SARS or MERS before.
Younger people are also more affected [2]
You are longer sick from COVID-19 and if you have to stay in the hospital you will stay there longer and are more likely to end up on the intensive care unit [2]
In the end you cannot compare a pandemic situation to influenza season.
The paper you're citing says "younger" means 59, vs 66 for influenza:
> Patients with COVID-19 were younger (median age [IQR], 59 [45–71] vs 66 [52–77]; P < 0001) and had fewer comorbidities at baseline with a lower mean overall age-adjusted Charlson Comorbidity Index (mean [SD], 3.0 [2.6] vs 4.0 [2.7]; P < 0.001) than patients with seasonal influenza.
Also, this is data from a single hospital, across two different years. The overall trends for SARS-CoV2 are not even remotely debatable: the risk of mortality rises exponentially with age. It's one of the most striking features of the virus. To claim, based on this one paper, that "younger people are more affected" is to miss the forest for the trees.
"In the end you cannot compare a pandemic situation to influenza season."
You absolutely can, and in fact, you're doing it. What you're trying to say is that Covid is somehow unilaterally much worse than influenza, but that isn't true. It's much worse for the elderly (>65), but for most other age groups, it's about the same, if not a little bit better. You have to squint and split hairs and pick sources selectively to start making strong claims of increased severity in age groups under ~50, and it's simply not a believable claim for people under the age of ~30.
The disease can be bad without exaggerating its threat.
I just took the first study I could find. You seem to claim that it’s conclusions are wrong and that young people are less affected of COVID than influenza. Do you have good studies to back this up?
For every person that dies (an agonizing death akin to medieval torture), a few more are in intensive care fighting for their lives. For every one of those, others end up in the hospital, spread the disease to others, suffer from “long covid”, or merely suffer greatly. Every person that gets covid adds to the likelihood the disease will become uncontrollable in the long term and endemic.
Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
Think about what leads to new variants: every time someone is infected, the virus replicates and has 10e9 chances to come up with something which is advantageous for it. If, like the U.K variant, it lucks into someone with a compromised immune system it might get even more chances to evolve an effective combination.
The way we get it to stop winning is to stop buying it lottery tickets. Masks, vaccines, and other measures like paid sick leave cut into that number enormously.
New variants are going to come, but vaccinated people may have some protection against them, or they may recieve a booster tailored to new variants, if they are extra vulnerable.
Also, treatments are being developed. If we can turn future variants of Covid into something like a common cold, we are going to be fine living with it. We just need to prevent bilateral pneumonia with a cytokine storm that threatens to kill the patient.
The reason COVID=19 hit the way it did was because it was novel; there were not similar diseases from an immunological standpoint being spread widely. Right now, exposure to one COVID strain (or a vaccination against a COVID strain) seems to confer some benefits against infection and/or serious disease from another COVID strain. In other words, as COVID becomes less novel, we become more prepared for new variants. We may end up having to have annual COVID vaccines the way we do flu vaccines, but even people who are unvaccinated against a particular flu strain have antibodies from previous flu strains that offer some measure of protection. That's going to drive down the reproduction rate and the lethality of future COVID strains.
That said, there may not be a clear "end point" in the sense of we go back to how things were before. We may simply be heading towards a new steady state with periodic vaccination efforts and some risk of COVID variants all the time.
Here is something for you to consider: this is the new 'normal'.
That world you lived in 18 months ago? Gone. Not coming back. There is no 'end point', it just goes on and we learn to adapt. Eventually we get better at it, learn more about what is and is not a risk, and a few things start to look like the 2019, but most things don't go back.
I am not saying it is certain, but there is a distinct class of people who expect everything to go back to the way it was and to do so immediately. They need to consider the possibility that things might _never_ return to the way they were. It is possible that all of the vaccines will work better than we expect and covid-19 will become a mostly-controlled intermittent disease that eventually becomes background noise like influenza (still a killer, but almost a part of the landscape), but it is equally possible that it takes more work for a longer period to get it under control.
The person I was responding to was demanding an 'end point to all of this' and I was suggesting that maybe there isn't one. I don't need to provide proof, only to show that it is possible and the request for some sort of definitive planned end to all of the containment and mitigation work is an unreasonable and childish demand.
Many of the components of "back to normal" are about voluntary compliance with disease control measures. For example, I currently hang out with friends only outdoors or in very small groups - not because I couldn't do more, or because I'm afraid to, but because I'm hoping to prosocially blunt the spread of disease. Right now, I've already started going to restaurants (although I was never a big restaurant guy to begin with); I plan to start hosting and attending parties a few weeks after I've been vaccinated, and I plan to stop wearing a mask in public once Covid vaccines become as available as flu vaccines in my local area.
I'm very open to suggestions that it might make sense to wait a little longer before partying or taking off my mask. I'm sure other people are too. But the burden of proof is on you (or others who think the same way) to explain why this is important and what the timeline is. If your position is just a lecture about what we "need" to adjust to, or an assertion that life might never be normal again, that's not really going to get anyone to comply.
If you told people in March, 2020, that this would still be going on over a year from now, and likely 18+ months from now, what do you think the reaction would be? "You're crazy"???
Trump was talking about "reopening" things for Easter last year. He should've said Easter, 2022.
I was looking back at some old texts from a friend, last year around this time... "I hope this isn't going on 6 months from now."
People want to be optimistic. We need to prepare people for reality.
There are already areas of the country where "this" isn't going on, where businesses are open at full capacity and the public is happy to patronize them. Even in the most socially distanced areas, there's lots of people going on vacations and eating in restaurants and having house parties with their friends and family. So when you talk about reopening in Easter 2022, it's hard to connect that with the state of things today, much less the likely results when vaccines finish rolling out.
We will absolutely see another surge before the vaccine roll out is completed. So tens of thousands of more people will die because states reopened too quickly.
Easter, 2022 is no more realistic than Easter, 2020. Expectations need to be set that are reasonable and err on the side of caution and pessimism.
The source of this thread was a comment attempting to set the expectation that things will never get better, and nobody will ever again live the way they did in 2019. There’s a huge chasm between that and your (reasonable) claim that some people have moved a bit too fast and there may be public health consequences.
"Never" is always an exaggeration. I took that to be hyperbole, meaning "not for a very, very long time." Maybe the western world has this fully under control in a year. What about the virus mutating everywhere else? All you need is the next patient zero to get on a plane with some highly resistant variant and this starts all over again.
> For every person that dies (an agonizing death akin to medieval torture)
I think this is wrong, at least in rich countries, at least those that are sane enough to cure their ill citizens.
A friend of mine died of covid last year. Then a family member this year. They were both sedated, and did not suffer at all on their last days in hospitals.
Sedation is death with a respiratory illness like this. How were they feeling before they were sedated? Probably like they’d been drowning for hours. For all intents and purposes, that was the end of their life as far as their experience of it.
Don’t get me wrong, it’s great that we can provide palliative comfort for those final hours/days. But it doesn’t tell the full story.
Just for clarity/augmentation/pedantic detail: you might be sedated and end up an a ventilator.
But ventilators are really bad for COVID survival and really a last ditch, long-shot chance try to salvage your life. Practitioners hold off on the sedation and associated required ventilation as long as possible to try and spare your life.
> Keep wearing your masks and social distancing people. It’s hard, it’s a sacrifice, but together we can conquer this disease and return to life “as normal”.
This ghost is not going back into the bottle. It's way too widespread for that now. Even the WHO has determined that. Even if one country manages it, some tourist will bring it in.
The vaccines don't stop the spread enough either to kill it completely. People will still get sick and spread it, they just don't get as sick in large numbers. The simple fact that even a country that has the ability to rigidly control all outside sources like New Zealand is unable to avoid the occasional outbreak. However they do seem to reduce the risk of severe illness enough to bring it to a level comparable to other endemic diseases. PS: Don't get me wrong, I'm totally pro-vaccine and will get at as soon as I finally can.
I really hope that politics will deem the resulting levels sufficient to drop the other measures like the masks and distancing. Once the danger level is comparable to other endemic diseases I think we should.
And I really hope that SARS-CoV-2 mutates to a variant that isn't as deadly. Most diseases have, after all as evolution favours it (not as deadly means we won't fight it as hard). But I doubt we'll ever be COVID free. That point was passed once we didn't strictly quarantine China back in Feb 2020. But anyway that's water under the bridge.
The vaccines appear to be plenty effective enough to stop the spread, if enough people get them.
We don't have great information about the variants, but the big improvements in Israel and England are encouraging, even with vaccination still ongoing.
> Should reinfection prove commonplace, and barring a highly effective vaccine delivered to most of the world's population, SARS-CoV-2 will likely become endemic.
The thing is, we don't know if reinfection will prove commonplace. We don't know how long immunity will last given a two-shot regimen—though the strong immune response that people are having on the second shot might be cause for hope. We don't know how the virus will mutate on it's point/spike, the main infection vector that the RNA vax target. We just don't know.
Research is emerging, time will tell. In the meantime, it's fear mongering.
Well I will get the vaccine as soon as I can get it (which is not very soon, sadly). I'm not anti-vax, but the last few weeks the news has been all about "Don't be surprised if people still get COVID after being vaccinated". Like here: https://news.ycombinator.com/item?id=26522853
With that in mind I don't think eradication will be achievable. It only takes one person with a resistant mutation. I think we can hope to bring it under control. But not eradicate it.
What does 'control' mean? In humans, if a small number of people are sick and you know who they are, you can eradicate the infection with isolation (it would only take a couple months).
That it infects various animals may make that unworkable, and the difficulty in vaccinating a large percentage of people globally is another problem.
But the effectiveness of the vaccines against the current variants does not appear to be a problem, high levels of vaccination will slow the spread of the virus dramatically in those populations, to the point where it barely exists (compare to polio, which is still endemic in some places around the world).
As far as zoonosis (animal-transmitted human diseases) go...
Rabies infects a lot of animals, but many places of the world are now effectively rabies-free thanks to smart inoculation of foxes etc. with baits.
We had last proven rabies case in the wild in 2002. (The Czech Republic, a landlocked continental country, not an isolated island.)
You can still fall to rabies contracted from bats if extremely unlucky, but compared to countries like India where the disease still runs rampant, rabies is a solved problem in most of Europe.
Maybe there will be a similar way to inoculate the wild mustelids against Covid one day. To be honest, human antivaxxers strike me as a bigger problem than random mink. I don't meet many mink on a regular day, but people with their masks halfway down are all too common.
The title of this article, which performs an in vitro test, is "Neutralizing Antibodies Against SARS-CoV-2 Variants After Infection and Vaccination". The editorialization in the current Hacker News headline ("Vaccines Are Effective Against Covid Variants") is not warranted.
If I can pass on what I’ve learned in the past 12 months as a newly minted virus enthusiast whose peak education in the area was human physiology 101:
“In vitro” means testing outside of the human body. Just because a result is confirmed in vitro does not mean it will be replicated when tested “in vivo” (in the actual human).
Thanks for sharing this. I actually see very little reporting on how this virus spreads among the vaccinated population. I would love to see new case numbers broken down by vaccinated and not-vaccinated people from countries like UK, US and Israel. So far I’m unable to find such data on the internet.
This is not well aligned with other research[1] showing the Pfizer and Moderna vaccines perform little better against the B1351 (South Africa) variant than they do against plain old SARS and distantly related bat COVIDs. They're also only semi-effective against the Brazilian P1 variant.
Right now, all of the vaccines are reasonably effective against the variants commonly circulating in the US (including B117), which is what the JAMA article tested. But I worry for how well they'll perform in a few months when the other variants get a foothold.
As far as I can tell, both the JAMA study linked in this post and the study I linked are describing antibody responses. I was trying to make an apples-to-apples comparison by sharing a similar study with contradictory results on a broader swath of virus variants.
nevertheless, you have to actually support that hypothesis with research. Just the fact that it's ineffective against mild to moderate doesn't mean it will be effective against more severe cases. it might also be ineffective against severe cases, making it just entirely ineffective against those strains.
a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
> a year later and people are still trying to twist studies into support of their favored medical treatments without actual supporting research...
This isn't something he has made up on the spot. It's been repeated countless times in the British media and presumably has some scientific basis. Either that or the whole field is keeping quiet on the basis that the UK has a large supply of the AZ vaccine and it's better to stop deaths from the current dominant strain than to wait for a better vaccine. Since the second option requires the cooperation of vast number of people I tend to believe the former.
They didn’t design the study to look for severe cases in South Africa and this variant isn’t widespread in other countries where the vaccine is in use, so it will be hard to get evidence on effectiveness against severe disease anytime soon.
I am very clueless on the vaccine topic (not a denier of covid or anti vaxxer).
All I know is from listening to some interviews with a scientist in the field.
But i still do not know what is the definition of "effective vaccine". What does it do? If you have covid and take the vaccine, will the covid go away? Are you still contagious after having the vaccine or can you still get the covid but without the bad effects?
What kind of immunity is given by the vaccine and how long does it last?
All I remember is that scientist said that herd immunity will likely never happen, or not in a long time(years, according to him).
There are too little comprehensive sources on the matter and too much superficial noise.
For complete herd immunity we'd need something like 100% that about 80% percent take, which is hard. So, our current goal is to get rid of the bad effects of Covid by limiting spread and limiting severe symptoms.
> But i still do not know what is the definition of "effective vaccine".
I'm not aware of a rigorous definition, but effective vaccine is something that helps us significantly to accomplish the goal. All the vaccines provide very good (90%+) protection from severe symptoms and it seems to be good even with the current variants. The protection is not as good against any kind of infection, but it is still very significant (like at least 66% even with some variants).
> If you have covid and take the vaccine, will the covid go away?
No, you have to take the vaccine before Covid. Usually it takes some time before the vaccine is efficient. Like you have to patch your server before it becomes part of a botnet.
> Are you still contagious after having the vaccine
You may be, but with significantly lower probability.
> can you still get the covid but without the bad effects?
This seems likely outcome of being vaccinated - your body will somehow already know what to do and will with the virus faster.
> What kind of immunity is given by the vaccine and how long does it last?
We'll see how long it lasts. It does not seem to be diminishing, so it should be at least a year or so. From the experience from other vaccines, it will probably last longer, but there is the risk of new strains that evade it.
The rigorous definition, for efficacy in any particular outcome, is one minus the effect estimate from an RCT, usually a relative risk or hazard ratio, depending on how they approached it statistically.
Well, based on my understanding, we don't know for sure.
What we do know, is that they give you a much higher chance of avoiding serious symptoms, including that most serious of symptoms, death. You won't be "virus-proof" completely, but someone vaccinated fully (so 2 doses for vaccines which require it), after a certain immunization period, which varies between 2-4 weeks after being fully vaccinated, will be super resilient to being in contact with Covid patients. Don't go get coughed on by 10 Covid patients, though.
Regarding contagion, apparently after vaccination, you can still get Covid with most vaccines, you just become "asymptomatic", i.e. it doesn't really affect you. However it seems that you're also much less contagious, which is still great, since it reduces the infection rate, it becomes much harder to spread it.
If you get Covid while immunity from vaccination hasn't kicked in fully... you can still be screwed. People have died 1 week after being vaccinated. So you probably want to stay put for a while until your immunity ramps up.
Regarding immunity, as I was saying, it's primarily lack of serious symptoms. I think they also make it harder for you to catch it, but I don't think we have super solid proof of this yet.
And for immunity, it's hard to say. We're basically just counting up days from initial vaccinations to see how long it lasts. For the other vaccines we know the time intervals because... time has passed. So far, for the current vaccines it seems that immunity is at least 6+ months. From what I've read we should be reasonably optimistic that we'll be immune for 1+ years. I don't think anyone expects lifetime immunity, yet.
TL;DR: Get vaccinated, it will keep you much safer, it will probably also help others around you, by making you spread it less if you do get it. You'll still get Covid but it will be much less of a deal. Side effects are temporary and not massive in the vast majority of cases.
I'll take a swing at this, being an infectious disease epidemiologist.
When people talk about the "effectiveness of the vaccine", what's actually happening is that they're talking about a smear of different things, which is why you're (justifiably) confused.
There's a few different aspects to think about:
1) When people say things like "The Moderna vaccine is 95% effective", the statistic they're citing is that in a clinical trial, the participants in the treatment arm of the trial had 5% of the outcomes the study was tracking as compared to the treatment arm. In the case of the early vaccine trials, this is stuff like...well...death or severe disease requiring ICU treatment.
It importantly does not mean you have a 5% chance if you get COVID. You have 5% of whatever the chance of someone who didn't have the vaccine has.
There's a reason that endpoint was chosen. A few actually. First, it's the most important one from a public health standpoint, in terms of immediately addressing the pandemic. It's also straightforward and unambiguous to study, which paves the way for faster licensing and thus getting it into the arms of the public. Studying things like if a vaccine is enough to induce herd immunity is much harder as a statistical problem.
Note that I haven't said anything about stopping the epidemic here. That's because this endpoint doesn't measure that. It's possible, for example, that the vaccine can protect you by reducing the severity of an infection, but that that would just push it to an asymptomatic infection that can be passed to others. That's why there's still public health messaging about wearing a mask even if you're vaccinated, etc.
2) There are follow up studies, which are still being done (and for which we are starting to get results) about whether or not the vaccine also reduces whether or not you can give the virus to others. This is what most people think of when we think about vaccines.
3) We don't know how long it will last, but it's likely fairly long lasting, and this is something that we can (and are) monitoring to make sure people don't need booster shots, etc.
4) Herd immunity depends on point #2 working well, and being at a fairly high level. One thing to keep in mind that I say a lot is that "herd immunity" is about a specific place at a specific point in time. It's possible for example that a city or town can have high enough vaccine levels to have achieved herd immunity, but the country (or the globe...) not being vaccinated enough for SARS-CoV-2 to have "gone away".
Public health thinks about this using a couple terms:
Control - "We've got a handle on this, but we've still got it"
Elimination - "This is gone in our area, but could come back"
Eradication - "This is gone forever"
TB is an example of a disease the U.S. has under Control. This is what we're aiming for with COVID-19 right now. Measles, Mumps and Rubella are, in most of the U.S., considered Eliminated. Smallpox is Eradicated.
Vaccines are ways to mimic infection (hopefully) without the side effects of real infection, like getting sick.
The immune system is complex and layered. The body's primary response to an infection is to make the body inhospitable. We know this as a fever. Some infections, like the common cold, are defeated here.
There are more tools available for more resilient infections, one being antibody production. Antibodies are proteins that bind to pathogens, to act as a marker. Once marked, other mechanisms (white blood cells) can clean up.
It takes time for the immune system to design an antibody that can identify the pathogen. The produced antibodies generally hang around for a few months, or longer. This is driven by chemical factors. Fortunately, Memory T-Cells will last a lot longer, and these contain the information needed to identify the pathogen and produce new antibodies. If the same pathogen appears again, antibodies can be produced quickly.
An antigen is anything that triggers an immune response. This includes pollen, if you have hay fever. In the context of COVID, the antigens are usually spike proteins, which stick out from the surface of the virus.
It's also worth noting that this process isn't perfect. Exposure does not mean immunity. Immunity is not binary, either. T-Cells may prevent symptoms entirely, or their may be a lag.
So, now I think I can answer your questions.
The vaccine provides the antigens using a form of COVID that won't, or shouldn't, cause infection. This will still cause an immune response, which may be strong enough to cause side effects. The body will see the antigens and generate antibodies. The antigen/antibody combination is stored in memory T-cells. This process takes several weeks, and is strengthened by a second exposure.
If you already have COVID, unfortunately the vaccine won't help. Vaccines are primarily preventative. There are a few diseases with post-exposure vaccination (anthrax), but there are usually many contingencies involved. If you have had COVID, you should still get the vaccine, because you are not guaranteed immunity.
You may still be contagious or symptomatic after having the vaccine, but this should (at least) be reduced. There is still a lag between becoming infected and immune response, even if you have immunity. This will be much shorter in the immune group, however.
It's hard to say how long immunity will last for. On an individual level, you can find pessimistic cases indicating very short immunity. Remember everyone's response is unique, and unlikely cases are usually most reported. The wildcard is a mutated virus evading immunity. To eliminate COVID would be to vaccinate the world, which is highly unlikely given substantial portions of the world haven't yet admitted they have it.
Assuming your chance of getting COVID is "100", two weeks after vaccination your chance of getting it will have dropped to "3" and your chance of dying from it will be "0". Changes to your ability to have a symptomless infection and transmit it to others aren't entirely clear yet, but seem to tend towards the "3" as well.
This is for the mRNA vaccines (Pfizer & Moderna). The others are potentially slightly less effective in preventing infection, but seem to be just about as good in preventing serious courses and death.
This was not testing against the South African and Japan/Brazil variants that are much more likely to escape vaccination antibodies. This UK variant is mostly problematic against the unvaccinated.
In the lab the South Africa and Japan/Brazil variants have severe reduction in neutralizing antibodies which is very concerning for vaccine escape. That being said, we don’t have a great way to test for T cell and other immunity which also plays a role. Getting the vaccine decreases severity of illness regardless of the variant.
The answer is get any vaccine as soon as possible. Then get the booster too when it’s available.
The plural ‘variants’ in the title is a bit misleading. Only one of the four viruses they tested is one we are actually concerned about at this time. The first is the original virus, which was displaced by the second early in the pandemic and against which vaccines are already known to be effective. The third one is the UK variant, which is of interest and the fourth is an artificial virus with a single mutation of interest, which doesn’t circulate in nature. This is all good but the study doesn’t add anything that wasn’t already known. It appears that better funded groups at the NIH, UTMB, Fred Hutch and Columbia beat them to the goal and to publication in the even more prestigious publications like NEJM and Nature. In any case, reproducing important research is a laudable and underrated goal. However, I would suggest a more modest title - ‘Study adds to data for vaccines’ effectiveness against the UK variant of SARS-COV-2’.
There are other variants - Brazilian, South African, Californian, New York, etc - which need to be studied in more detail. There are already data from the aforementioned research groups for at least some of these variants that suggest that vaccines will continue to be at least partially effective.
The title implies that "[All] vaccines are effective against [all] variants", but that's a lie. And when people realize this, they'll lose trust in vaccines in general.
EDIT: I see someone mentioning Trump below and I can’t reply. Trump was never interested in managing covid-19 or effective border control. This would’ve been the perfect opportunity for him to show why having smart borders was useful. He would’ve received support from within the government. He would’ve managed covid-19 successfully perhaps, and won re-election.
The problem was Trump was a completely ineffective and incompetent leader, who didn’t care at all about the things he claimed to care about. Mandatory quarantines and tests for people traveling to America would’ve been a lot of work and Trump was allergic to that. He was a man who preferred the cheers at his rallies over the difficult work of administrating and governing.
That, or "Covid behaves like viruses usually do", describes plenty of headlines of the past 15 months. Remember how everyone was worried that antibody levels drop after an infection? Judging by the media coverage, you'd think memory cells and T cells were a recent, Covid-related discovery. We've known about them since the sixties and they continue to work as advertised.
Probably that patience has worn thin for the extremely overly cautious people who have been hiding in their homes for a year when they are realistically at zero risk of severe illness.
We have known since early summer of last year that being fat or being old are your two biggest risk factors. Beyond that, if you have some serious pre-existing condition that makes you susceptible to all illnesses.
The messaging should have been "Stay home if you are a high risk group. Otherwise live your live." All current data shows areas that have taken that approach are significantly better off today than the places that hid in a hole the past year.
We have let people treat this like it's an end of the world scenario and it's been good for no one.
I'm a healthy male who's been "hiding in [my] home for a year". I mean, other than shopping trips, and running, and cycling, and skiing, and.. However, I've done no social events, seen no friends, etc.
But, sorry if you think trying to avoid illness, trying to avoid passing on illness to others who don't have the comfort of working from home, passing on the illness to elderly family members, etc, is a waste of time. It's a pretty minor inconvenience for me to be largely isolated for a year, compared to those who are less fortunate than me.
How about a big 'ol [citation needed] on
> All current data shows areas that have taken that approach are significantly better off today than the places that hid in a hole the past year.
You know, a citation that doesn't involve correlation with countries that happened to have extreme lockdowns initially, acceptance of mass testing and screening and social restriction when necessary, etc.
By the way, my wife works in rehab in a hospital, and sees your "low risk" young people whose lives have been, as far as we can tell, permanently altered by the virus that some of us are seeking to avoid.
My uncle is in the hospital in pretty bad shape, on oxygen so far.
He was spewing conspiracy shit non-stop on facebook.
My father urged him to take the vaccine, then to come to the hospital sooner, he did a CT scan on my uncle, told him, showed him how messed up his lungs were, my uncle refused to be administered in the hospital, made a big fuss that the doctors wanted to kill him in the ICU; two days later he was brought in in an ambulancr.
If he was a stranger, maybe I would have laughed "serves you right", I just cannot understand how an above average intelligence person got himself brainwashed with anti-covid conspiracy theories.
It's nice that you have been able to deal well with the situation this last year, but try to remember that your experience is not necessarily representative of the whole:
> The districts, large and small, rural and urban, serve more than 2.2 million students across the United States. Of the 74 districts that responded, 74% reported multiple indicators of increased mental health stresses among students. More than half reported rises in mental health referrals and counseling. Nearly 90% of responding districts cited higher rates of absenteeism or disengagement, metrics commonly used to gauge student emotional health
> All current data shows areas that have taken that approach are significantly better off today than the places that hid in a hole the past year.
Source?
I'd argue current data shows that those that showed an overabundance of caution, like New Zealand, are the ones significantly better off than everyone else.
And furthermore their border is still essentially closed. Their approach was almost certainly the right one for them but locking down access in that way was never practical for most countries.
You’re totally right. It’s strange to see random self-righteous, presumably highly-educated, safety-minded people suggest that the US should just be New Zealand. There’s been some really wildly unworkable things offered as though it’s just obviously correct.
Hawaii, the only state that requires a COVID test within 36 hours of flying there? I mean, of course they'd have the lowest cases per capita when they're the only ones actively refusing entry to those who have it.
How many entry points does Hawaii have compared to the average state? How do those points of entry compare in terms of staff and systems to operate those restrictions? Hawaii gets a lot more mileage out of its restrictions than Iowa is going to do. We can acknowledge these differences without conceding that restrictions aren’t worth the squeeze; it just means that New Zealand isn’t a good reference point.
A fair number of states did have travel restrictions in place but there were oodles of exceptions and AFAIK no real enforcement although it probably did limit cross-border travel some.
Right, but if all states had a handful of ports of entry manned by TSA who could enforce those restrictions and supply chains that were already inadvertently optimized to prevent disease transmission, then the US would probably look a lot more like New Zealand!
> And if I looked like an eagle I could flap my wings and fly.
???
> We didn't even shutdown widespread commercial traffic between the US and Canada (although otherwise travel was largely shut down).
Why bother? It’s not like any significant number of transmissions are coming via commercial transit with Canada. I don’t pretend to be an epidemiologist but it seems pretty intuitive that a small island nation and one of the largest countries are going to differ.
I think I misread the tone of your reply. Yes, the situations are nothing like the same and the idea that the US could have been just like NZ if only is silly.
Not sure why this is downvoted; it’s absolutely correct. European, Asian, and North/South American supply chains are internally integrated. A truck driver transports goods from the Czech Republic to France and unloads them at the destination. For New Zealand it’s not like the ship’s crew is unloading goods at the last mile. A similar effect is at play in Hawaii, but the latter can’t deny entry to US residents because unlike New Zealand it isn’t a sovereign nation.
> European, Asian, and North/South American supply chains are internally integrated. A truck driver transports goods from the Czech Republic to France and unloads them at the destination.
But does that truck driver need to have direct contact with other people to do their job? Why can't they unload their cargo, sleep at a quarantine facility, and then drive a new truckload in the opposite direction, without an opportunity to infect anyone else?
Also, island nations still have internal traffic. What's different about the borders between parts of Australia that allowed them to be closed when European borders had to stay open?
For a freight truck to cross Europe can take multiple days, especially as drivers are not allowed to drive more than 9 hours a day (all European trucks are outfitted with a tachograph) and in some countries they have to stop for all of Sunday. During those days on the road, drivers need to be able to stop and use a quality toilet and buy food, which generally means a petrol station. That is the existing infrastructure – your vision of hermetically sealed, disease-free places to stop is simply unrealistic as considerable time and money would be needed to build these everywhere in Europe that a driver would need to stop.
> That is the existing infrastructure – your vision of hermetically sealed, disease-free places to stop is simply unrealistic as considerable time and money would be needed to build these everywhere in Europe that a driver would need to stop.
All countries with quarantine facilities I'm aware of are using existing buildings. They don't have to be hermetically sealed, just ensure that people don't come into contact with each other inside.
All those countries with quarantine facilities are using a handful of locations around a handful of airports or ports. Truck drivers in Europe need to stop in an exponentially larger amount of places, and even repurposing existing facilities would be too great a challenge on that scale. Again, you don’t seem to understand how freight transport works in Europe.
>Also, island nations still have internal traffic. What's different about the borders between parts of Australia that allowed them to be closed when European borders had to stay open?
Australian states' borders aren't like those between New York and New Jersey (or Colorado and Wyoming), or Belgium and the Netherlands. There are a handful of highways that can be and were completely blockaded, and otherwise the borders are completely empty desert. (Even on the highways, there are dire warning signs about having sufficient water/gasoline/supplies in the more remote parts.)
Internal traffic among 4 million people is a much easier problem than traffic among a continent of 800 million people.
> But does that truck driver need to have direct contact with other people to do their job?
I’m sure there are better ways to do things, but truck drivers often unload shipments, confirm receipts, etc and they still need to visit truck stops and restaurants for supplies, food, etc.
> Why can't they unload their cargo, sleep at a quarantine facility, and then drive a new truckload in the opposite direction, without an opportunity to infect anyone else?
Quarantining between shipments would mean drivers are mostly idle, driving the cost of shipping through the roof. Changing supply contracts so drivers exchange cargo at the border requires completely reworking highly optimized logistics networks and isn’t going to happen in a few years, certainly not by fiat from some bureaucrat or politician that has no experience in logistics.
> Internal traffic among 4 million people is a much easier problem than traffic among a continent of 800 million people.
Can you fill in the details of how exactly it is easier?
> Quarantining between shipments would mean drivers are mostly idle, driving the cost of shipping through the roof.
Well, if they don't need to sleep between shipments, I guess they can drive back directly and get their supplies and food at home. I wasn't suggesting a full two-week quarantine if they don't intend to have any contact with locals anyway, just staying for the night isolated from anyone they could potentially infect.
Mandatory lockdowns make a lot more sense when you’re an island nation that can plausibly eradicate the disease. You reasonably can expect a month of pain and then resume business as usual, but the America’s, Europe, and Asian enjoy no such hope.
Mandatory lockdowns are like cancer surgery. They can be very effective if everything is still localized, but if the cancer has already metastasized, it really doesn't solve the problem.
I’m not saying it would actually solve anything in the US, only that you can’t just say “look NZ resumed business as usual — the US should too!” because the situations are not at all similar.
Every single person who "didn't do it for me" relied on an enormous network of people putting themselves at risk daily to keep the supply chains functioning.
| at risk daily to keep the supply chains functioning
That sounds like crocodile tears to me. I don't see how going to bars and flying commercial would have made the people working in grocery delivery and amazon safer.
And it would absolutely have put the people in my life who are at the highest risk at an even greater risk if I had done so.
There aren't only americans on this site. FWIW as a european (Belgium resident), your statement doesn't apply. Belgium did a shitty job since the second wave: We didn't go far enough and only applied a weak lockdown which has been in effect since October. So life here has been just bad enough to test everybody's patience for about six months. And now we're in a new uptick and everyone's losing their shit.
Korea meanwhile applied strict, severe, surgical lockdowns and then were able to fully reopen after containment.
People haven't been able to go see their families out of the country. I've not been able to practice my sport (figure skating) since October (they even banned it outdoors during winter!!). And there is a pages-long, ever-changing document on social bubbles, checklists on who you can see which take things such as age and household size into account, etc. It's dumb, people don't follow it, and it has deeply eroded trust in institutions, and it has pushed people into antivax groups because those are the most vocal ones against measures like these (so they are the sole ones sounding like the voice of reason).
The "alternative" to the above is not brazil, and I would personally much rather be in Korea.
And these measures, while on paper sound like they're slowing the spread, are also pushing people to be against government measures as a whole and feed into much more dangerous sentiments. Would you apply a measure that reduces the spread by 0.1% if it also meant a 0.1% decrease in mask usage? Or a 0.25% decrease in vaccine uptake? What if you can't know any of those numbers, you just know they exist?
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Edit: Just to really drive home my point: I've been advocating for this for months. Just as I posted this comment, the following article shows up on the Brussels Times: "Belgium needs a short ‘real’ lockdown, warns expert"
All EU countries screwed up, not just Belgium. Case in point, German states agreed on an "emergency brake" once cases increase over 100 per 100k, 7 day average. Now we are there, 3 days in a row. So, one would assume they would close schools again. No, because it has to be 3 days in a row, weekends don't count so. After that, two days to implement measures. Which means schools will be open next week despite a heavy case load. Only to fulfill the political goal of opening schools before Easter. Nevermind we will close down everything after Easter through April.
There is no strategy, no planning, no logic involved.
The whole concept of restrictions that only apply for high infection rates shows lack of foresight.
If you have a way to halve new infections in x weeks, you can wait for y weeks during which infections double, then apply your countermeasures and after x+y weeks you're back where you started.
Or you could start implementing countermeasures immediately, ease up after x weeks, and after y weeks of growth you're also back where you started.
The only difference between the scenarios is the ordering, but the first leads to a mountain of infections and the second to a valley, i.e. lower total case count and fewer deaths. (Also a chance of extinction if the expected number of infected falls below 1.)
So anything you're willing to do when 100 of 100k are infected is just as good when it's 50 of 100k or really any number greater than zero.
The funny thing is, the 50, or 100, is completely arbitrary. Initially it was 50 because authorities couldn't follow up cases above that. They couldn't below 50, as it turned out. Also, this threshold changes as seems fit. When 50 wasn't realistic anymore it became 100. Only for one state to choose 200. It is utter chaos. And still, a majority still supports these measures. Funny times indeed.
Because the alternative for us was not Taiwan or Korea. They went far and beyond what Americans were willing to tolerate.
I'm in Taiwan (and was for SARS in 2003). We had early travel restrictions and have to quarantine for 14-days after returning from abroad, and have to wear a mask on the subway.
For the past few months there's been a mask rule at some indoor venues but it still allows for restaurants and bars to stay open and maskless. There was a marathon a few months ago with tens of thousands of people.
There hasn't been a lockdown here. Businesses haven't been wrecked. The economy is great. What was so "far and beyond what Americans were willing to tolerate"?
Edit: serious question here! I know there's quite a bit of ignorance about Taiwan internationally, but the rules truly have not been onerous at all. It's gone well because of travel restrictions and an, IMO, justified trust in civic institutions.
I agree, Taiwan of all countries arguably handled Covid best.
It seems irresponsible to discuss Covid policies without reference to,
and good understanding of, Taiwan.
I found that people in the West, often simply don't believe me when I tell them that Taiwan didn't lock down at all, and had hardly any Covid deaths. Reactions I have come across have been: "yeah but Taiwan is a dictatorship" and "They are lying about numbers ..." The amount of ignorance is astonishing.
I think it's a psychological problem: most people are perfectly happy to believe that their home countries have somewhat flawed political systems, but find it near impossible to accept that they are orders of magnitude worse than some others.
‘They both pointed out that while there’s broad public support for the digital surveillance, many people don’t fully understand how the technology works. “The main worry is not knowing what it is, not knowing that turning my phone off means the police will come knocking, not knowing how they’re triangulating my coordinates,” Hsieh said, adding that the onus should be on the government to explain the technology clearly.
The government has said the tracking system would be discontinued after the pandemic passes.’
This is good news. Now maybe Fauci should rethink his idea that people need to wear their masks for another year even after getting vaccinated. One of his reasons was because of worry about the variants.
It’s bizarre to me that so many people seem to equate not having to wear a mask as the ultimate return to normal.
Mask wearing is probably the least invasive, least inconveniencing thing that we have been asked to do throughout this pandemic, yet half the population acts as if it is the equivalent to being handcuffed to a steel post in their basement.
If health officials said “after being vaccinated, do whatever you want, please just wear a mask for the next year and wash your hands while we monitor efficacy”, that would be a success story with respect to returning to normal, to me at least.
Some countries have mandated that masks be worn even outdoors and even when there is no one around. This has been the case in Poland and Romania for many months, for instance. The Polish health minister openly stated there is little scientific basis for this, he just thinks it is more likely that citizens will have their masks on when entering shops or meeting people if they have to wear it at all times.
Think about how much it sucks if you are a glasses wearer and your glasses are fogging up all the time (you can't even see the traffic lights when you want to safely cross the street), or how much it sucks to cycle long distances with this thing on your face.
I think a lot of Europeans would readily accept wearing a mask in shops for the next year. But yes, getting rid of this outdoor mask requirement would be a big relief and major return to normal.
Wearing masks have benefits beyond covid. Think about how many lives per year we could save from the flu let alone other airborne respiratory viruses if mask wearing was normalized.
Or at least bike helmets all the time. Lots of people get seriously injured or killed because of falling and hitting their head.
I expect mask wearing will be more common in cultures where it was almost unheard of like western Europe and the US. But even in a country like Japan where it wasn't unusual, it certainly wasn't anything like the norm.
Amazing how insecure people get when you suggest a simple gesture that would ultimately better society. Mask wearing is normalized in the East, why not in the West? Is it because "mah freedoms?" Grow up.
Your comment wasn't constructive and at worst, sounded like you were making light of mask wearing by suggesting we should just never leave our houses. Of course if everyone was confined to their houses, there would be less sickness but nobody is debating that. We're debating the normalization of mask wearing.
It sounds like your concern is masks, not saving lives. Because if you care more about saving lives you will realize people only need to stay home. Fewer fatal accidents, infections, and other disturbances if people just never ventured outside their homes.
It has been both enlightening and pleasant to not have caught any symptom-causing diseases in the past 12 months. Unknown whether mask wearing played a part of course.
You probably need everyone else wearing masks to have a big effect and that's not likely to be the case going forward although you can obviously take whatever precautions you like.
He's mostly just managing expectations. One problem starting to trouble public health professionals is the wish of vaccinated people to ditch masks even before enough people are vaccinated to reach herd immunity: since it is not easily visible if someone is vaccinated (and even then...) the appearance of more and more unmasked people in stores etc. could lead to a breakdown in adherence.
There will come a time, in early summer for the US, late summer for most of Europe, when it'll be safe to take of the mask. Until then, it's a minor annoyance.
A counter point is that some vaccines seem to be ineffective agains some variants. For instance AstraZeneca against B.A.351 (South-Africa). From a preprint: "Conclusions A two-dose regimen of ChAdOx1-nCoV19 did not show protection against mild-moderate Covid-19 due to B.1.351 variant, however, VE against severe Covid-19 is undetermined." https://www.medrxiv.org/content/10.1101/2021.02.10.21251247v...
The US CDC does state that, according to current publications, some variants present a "moderate reduction on neutralization". Their page about "Variants of Interest" and "Variants of Concern" mentions many scientific papers. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/vari...