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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.


“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".”

I’m not convinced you can absolutely guarantee these changes will make the virus less dangerous, we could be unlucky and it could become worse.


Right now that is what is happening, but as the title shows those variants don't achieve immune escape.

The sum total of mutations necessary to achieve immune escape and overcome herd immunity is a lot more likely to come at a cost to overall fitness.

Also I can't guarantee that West Ham United won't win the Premier League, but the safe money is all on Man City.

Paper on the possibility of mild disease endemicity:

https://science.sciencemag.org/content/371/6530/741

AP coverage of that paper:

https://apnews.com/article/common-cold-india-coronavirus-pan...


I'm not convinced we can get an effective global, rolling vaccination program in place to set up effective population immunity.

From what I can tell, almost all public discussion of the future of Covid is similar to a "happy path."


Curious, what virus we eradicated?


Smallpox. I think we're close on polio?


We're getting there but it's super hard to do it in remote areas and conflict regions.

https://www.gatesnotes.com/health/in-pakistan-victory-agains...


Smallpox. Except for some samples in secure laboratories.


Smallpox and Rinderpest.

Polio and Measles are doable, and at this point more logistical and political problems than biological ones.


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.


Smallpox.




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