Nature magazine, one of the top two science journals in the world, did a survey of 100 immunologists, infectious-disease researchers and virologists working on the coronavirus, asking if they thought that the virus would become endemic in the human population. Ninety percent of them said they thought it would. From just the mathematics of it, and the fact that it’s everywhere in the world now, I agree with that. I don’t see how it can be otherwise.
But that doesn’t mean that our current situation continues. People will be vaccinated; some will acquire immunity by being infected (although current guidance is that they should be vaccinated anyway); and more will continue to die. As immunity spreads, we will be able to relax social precautions, probably this summer or later. We will, perhaps in a couple of years, be able to go back to something like normal.
We don’t know enough about immunity – how long it lasts and how robust it is to variant strains of the virus – to be sure about timing and exactly what “something like normal” will look like. It is likely to include vaccination against SARS-CoV-2, probably as one of the childhood vaccinations.
To understand why we’ve been hit so hard by this virus and why it’s possible to envision something like normal, think about what would happen if measles suddenly appeared out of nowhere, a new virus to which humans had no immunity.
Measles has an incubation period of 11 or 12 days and is transmitted through the air. Children under 5 and adults are more likely to have complications, which include bacterial ear infection, inflammation of the voice box (larynx) or inflammation of the inner walls that line the main air passageways of your lungs (bronchial tubes), pneumonia (particularly in people with compromised immune systems), encephalitis (which may occur right after measles or months later), and problems in pregnancy, including preterm labor, low birth weight and maternal death.
These complications have low occurrence rates, but if large numbers of people are infected, many will suffer complications.
So introduction of measles into a population that had never seen it would look a lot like the SARS-CoV-2 pandemic. It would spread quickly, there would be arguments about needing masks and when to open schools and bars, and it would present varying symptoms of different degrees of severity in different people. Some would have long-lasting effects. Death rates are hard to pin down precisely for any disease, but it looks like measles is less deadly than SARS-CoV-2. Still, large numbers of deaths would occur.
But humans have lived with measles – it has been endemic – for hundreds of years. It probably came to us from cattle. Babies are born susceptible to it, which is why we vaccinate infants. Adults who have been infected or vaccinated are immune.
This is what will happen with SARS-CoV-2. Most of humanity will become immune. We don’t yet know how frequent immunizations will need to be. There will be occasional cases.
Smallpox has been eliminated in the wild. Like measles and polio, it has no animal reservoir. Polio has almost been eliminated, but the pandemic has interfered with progress. Vaccine deniers and other factors make it unlikely that measles can be eliminated any time soon.
SARS-CoV-2 has animal reservoirs. How plentiful they are will affect its control once it calms down to endemic status. We will not eliminate it for a very long time, if ever.
Cervantes
Well, the good news about Covid-19 is that it rarely causes serious disease in children. The bad news is it may not be that infection confers lifelong immunity, unlike the case of measles. So they’re really different problems.
Cheryl Rofer
@Cervantes: Thanks for your expertise.
Damien
This sounds about right, we really missed our window to contain things. Frankly, if COVID actually becomes like flu, then I think we’ll be able to live with it as we did before.
Searcher
The glass half full is that, in a world of vaccines, “endemic” doesn’t have to mean “a never-ending plague”, just “something we always have to take precautions against”.
Major Major Major Major
I think this sounds about right. One bit of good news is that (just my lay understanding) once vaccination becomes widespread the mutation rate will drop dramatically, and the mRNA vaccines are supposed to be very easy to tweak. My guess is that this will become something that overlaps flu season and will have a somewhat higher vaccination rate… which won’t be quite enough, but you know what, I like wearing masks on transit anyway now.
Kent
So basically in the future we get our annual Covid shot just like our annual flu shot. Adjusted annually for whatever new variants are out there. And Pfizer and Moderna are going to make tens of billions of dollars over the next decade.
But life gets back to normal for most of us.
Betty Cracker
I watched a bit of Biden’s town hall earlier this week, and I was dismayed by the prediction that we can return to some semblance of “normal” by next Christmas. That seems so far away. Le sigh.
burnspbesq
If the COVID vaccine becomes an annual nuisance, like flu shots, that’s a state of affairs I think most sentient beings would live with.
Cheryl Rofer
@Major Major Major Major:
Yes on both. A bit of Balloon Juice pedantry says that the mutation rate will stay constant, but there will be fewer mutations with fewer cases.
Major Major Major Major
@burnspbesq: Unfortunately most sentient humans don’t even get a flu shot… at least in America.
@Cheryl Rofer: Oh it means like “per replication cycle” and not “mutations observed on earth per year”? Good to know.
Cheryl Rofer
@Kent: Something like that. We don’t know how long immunity from the vaccines will last, and the vaccines will improve quickly. There are still 100 or so being developed.
The last time I got a Salk-type polio immunization, they told me it would be good for the rest of my life. One more shot I don’t need to take. That’s how much polio vaccines have improved.
Betty Cracker
@burnspbesq: Only about 45% of Americans get a flu shot annually. Some would just rather risk getting the flu than take a shot every year, and tens of millions lack healthcare coverage, which probably plays into the relatively low vaccination rate. I don’t know what the implications of those facts are for COVID-19.
SiubhanDuinne
@Betty Cracker:
It reminded me of all those WWI dramas I’ve watched. “It’ll be over by Christmas!” “The boys’ll be home in time for Christmas!” “Jerry will surrender before Christmas!” Year after year.
I love Biden, and I hope his goal/prediction is right, but I get superstitious about assigning a date certain to unpredictable events.
C Stars
@Betty Cracker: Yeah, when I read two years before normal in Cheryl’s post I did that little inward scowly sad face that has become a bad habit since the pandemic started. I want to take my kids to zoolights NOW
ETA it’s not really inward, as my new frown wrinkles will attest…
Cheryl Rofer
I think all timing predictions, including mine, are only approximate. But I don’t have a gaggle of reporters who would pester me until I made one, as Biden does. Christmas is not a bad guess, and Biden qualified his answer sufficiently that it will be hard for those reporters to make much of it if it’s wrong.
Kent
In my mind? Once we reach an equilibrium point where anyone can walk into a Walgreens or their local medical office and get a Covid shot on demand (ACA should make them free for those with insurance as it is preventative care) then we will have reached a point where those who want to stay healthy will be free to do so, and those who don’t care will still sometimes catch covid, just like they get diabetes, heart disease, cancer, and all other manner of chronic diseases brought on by poor health and habits.
My wife is a primary care physician and she reaches the burnout point on a daily and weekly basis with patients who take no personal initiative in maintaining their health. Covid will just be one more thing to add to that list.
C Stars
@Betty Cracker: My step-sister who is in her mid-thirties believes truly and solemnly that the flu shot literally gives you the flu. Likelihood that she gets a COVID vaccine is, well, not nothing, but pretty low. She’s a restaurant server.
White & Gold Purgatorian
@Major Major Major Major: I kind of like wearing masks at the grocery and in medical offices, too. Also, no appetite for dining out inside a restaurant, maybe forever. It will be interesting to see how a new “normal” evolves as we begin to feel safer outside our homes. Which money-making enterprises will return as popular as “before,” which will never recover, and which new, pandemic-born activities will stick around to become part of the “new normal.” I hope curbside pick up will be in the latte category.
Major Major Major Major
@Kent: A complication of course is that not all those who want to stay healthy can get COVID shots, and unlike diabetes and cancer, COVID is contagious…
azlib
Normal by the Fall is being optimistic, I think. There are two many variables in play right now.
I plan to wear a mask indoors until the infection rate drops dramatically even after I get vaccinated. I get my second shot in two weeks. I am quite aware I may still be able to transmit the virus, even though I am protected by the vaccine. I am one of the lucky ones, since I work 100% from home and have done so for many years before the pandemic.
Betty Cracker
Never mind — what M4 said at #19.
Brachiator
@Major Major Major Major:
Hopefully, this may be the case, but this is not necessarily true. People are taking informed speculation about the virus and prematurely transforming this into slam dunk conclusions.
An ongoing issue might be how quickly vaccines can be developed, distributed and administered.
I have been watching some UK debates about the vaccine distribution. Boris Johnson and his foolish ministers talk about getting the country vaccinated, and completely forgetting about foreign travel into and out of Britain. Similar issues, of course with the US and every other country. We will need an effective ongoing global effort to really attempt to nail this thing.
Another Scott
Thanks for this, Cheryl. It’s an approximation of my gut feeling too. As rapidly as this virus spread world-wide, and how easily it transmits in “super-spreader” events where gregarious humans want to be and where they let their guards down, it’s foolish to expect that it will just go away.
Jenner came up with the Smallpox vaccine in 1796. The last US case was in 1949. The last world case was in 1975.
It would be great if we could eradicate SARS-CoV-2. And maybe we will, ultimately, but we can’t assume it will be easy.
I hope we make more progress on effective treatments soon…
Cheers,
Scott.
Annie
I have thought for some time now that COVID-19 is going to be something we will need a reformulated vaccine for every year.
Cervantes
Yes, a shortcoming of the idea that you will see fewer variant strains if more people get vaccinated is that globally vaccination prevalence is unlikely to get very high any time soon. The rich countries have bought up most of the available doses for the forseeable future. Given that vaccination and/or infection may not provide long-lasting immunity, and it’s inevitable that variant strains will emerge and make it to our shores, regular vaccination is likely to be necessary. But yes, the mRNA system is easy to modify, much easier to keep up with the virus than the old methods of growing influenza vaccine.
Doc Sardonic
@Kent: I think the burnout goes both ways. Personally I’m fed up with the medical community no longer practicing medicine, but practicing insurance.
CaseyL
What strikes me about all the discussion of when we can get back to normal, or something resembling normal, is there seems to be an expectation that no new novel diseases will occur, and we won’t be faced with similar emergencies again, including a need to lock down. That strikes me as very optimistic.
Betty Cracker
@White & Gold Purgatorian: Hubby and I were talking about what “normal” might look like last night. Hard to say, but I told him I would love to burn every fucking mask I’ve ever worn, though it would be impractical to do so since dog only knows what plague will pop up next. But God, how I hate those damned things! I can’t bear the thought of going through another Florida summer with a piece of cloth on my face, but here we are.
Also, I can’t wait to hit the pubs and eat out in restaurants again, but I do hope restaurants keep their take-out game strong in the aftermath…assuming there IS an aftermath.
gwangung
@Brachiator: Actually, with vaccination, mutation rates will almost have to go down, because there are fewer instances of new covid hosts; fewer chances to infect, fewer chances to mutate.
And the total number of mutations will go down.
debbie
Some local health expert said late last week that COVID vaccines would be given annually just like flu shots. I’m someone who hasn’t gotten flu shots, but this experience has persuaded me to start getting them. I remember getting polio and booster shots at the same time every year when I was a kid; I guess I will end like I began.
dmsilev
There’s a lot we just don’t know about the long term. Not surprising; the damn virus didn’t exist in its current form until about 14 months ago, and even the earliest large-scale vaccine trials only have six or seven months of data. Hopefully, we’ll get to the point where the first wave of vaccinations gives enough general-purpose immunity that “as bad as the flu” becomes an accurate statement, and annual booster shots tuned for whatever variants have emerged that year can further ease the cost.
With the current rate of vaccinations and some educated guesses as to what the ramp-up will look like, late spring or early summer for “everyone who wants a vaccine can get one”, maybe late summer for children (those trials are just getting started). That’s in the US. Large swaths of the rest of the world will take a lot longer unless/until global production of vaccines increases by a factor of five or so.
Major Major Major Major
@Brachiator:
I meeean if we’re talking about the global incidence of harmful mutations, it’s just mutation rate times number of replications, right? So assuming that first figure holds steady and the second decreases…
So far, based on the experts I follow, the virus has been behaving more or less how people have been assuming it would for a year now. There are obviously unknowns but, to the extent that any virus is ‘normal’, they say that this one is, too.
As for tweaking the vaccines, I’ve been assuming the big time sink will be clinical trials and regulatory approval. The Pfizer vaccine was developed in like a week, wasn’t it? (Obviously they had a lot of failures during that time period too, but now we have the successful one.)
NotMax
Wonder if anyone has been keeping tabs on infection statistics involving those nutter churches which boasted about installing a magic box that “immediately kills 100% of the virus.”
“Have you gotten hold of them to come check on the thing yet?”
“Not yet. Keep getting a recording that the phone number is no longer in service.”
Another Scott
@Betty Cracker: I recently got a box of 20 3M 8210 N95 masks on eBay. They seem genuine and have a 2025 expiration date.
I find they’re much easier to breathe with than the 3-layer cloth Etsy masks I’ve been using. They seal better too. I rotate between a couple every 5 or so days out in public.
I’m hopeful that things like that will start becoming much more readily available soon.
Cheers,
Scott.
raven
The thing that keeps me going the most is that kids have, for the most part, been spared. Don’t come jumping on me about some case you know about, nothing is universal, but this would be so much worse if the little’s got it.
Fair Economist
The 64 trillion dollar question is how dangerous this is on repeat infection. We know people, even other than elderly or immunodeficient, can get very nasty disease on repeat infection, which is significantly worse that colds or flu. The question is how frequent that is. The very limited reports suggest repeat infection is on average about as bad as initial infection, but there’s some very biased sampling there – minimally symptomatic repeat infections probably don’t get reported much. Even if repeat infection is several times less severe it will still become one of the great health hazards of our age, killing tens of thousands every year. Presumably frequent vaccination will cut that down but given the amount of anti-vax nutters and those tricked by the nutters we may still have a major health hazard.
My rough estimate is that it’s going to be like a bad flu season every year, even after most have had or been vaccinated, and even if most people get vaccinated every year like with the flu. Remember there are Long COVID issues as well as deaths, which are far worse than with the flu, although the similarities to chronic fatigue are making physicians reconsider whether flus and even colds might have similar not properly reported issues. Many have brought up some studies showing people vaccinated for flu have lower rates of heart attacks – SARS2 might not be the only respiratory infection to attack the circulatory system.
Doc Sardonic
@Betty Cracker: You know Betty, I feel the same way. I hate wearing a mask and the thought of another summer in the FLA wearing a face diaper is not thrill inducing, but it does help with the allergies. Funny, born here, lived most of my life here, now I’m allergic to the whole damn place. But, like you, I want to go to restaurants, I want to have large, raucous dinner parties in my home again. In other words I want to live again, not fucking exist, which is what we have been reduced to currently.
Benw
@Betty Cracker: right now just having the coming summer/fall be like last year, where masking up and being outdoors and socially distant meant I could have a nice dinner, walk around the city or a park, let my kids play in the yard with their friends, or take a family trip, seems like a godsend. Far cry from normal, but I’ll take it
WereBear
@Kent:
I don’t have to imagine, I know such people. The classic “I’ll just take pills for that” is infuriating when my partner has a chronic illness, and without our constant vigilance and caution it can get very bad in a twinkling.
scav
@Major Major Major Major: It’s not just mutation rate times replication, see earlier Covid thread today where recombination is now raising its cheerful head.
Fair Economist
@Major Major Major Major:
Not entirely. The enhanced transmission and virulence mutations have been a nasty surprise. Transmission and virulence tend to worsen after initial introduction, but by the time a virus is widespread they usually have reached a plateau. H3N2 has changed very little clinically in the 50 years it’s been circulating, and H2N2 didn’t change dramatically in the 20 years it circulated. Sure, everybody knew it was possible but it wasn’t expected.
Doc Sardonic
@raven:You are right with that. I always used to joke with my elementary teacher relatives about working in a Petri dish and one said “no, we work in a bio-weapons lab. Kid brings in a cold, few trips through my classroom and that cold is weapons grade.” So according to her theory it is good that so far the small ones haven’t been as effected.
Cermet
So what you are saying is, this will certainly replace flu (in numbers) in killing old people near the end of life; a new illness to help people pass on … .
Ruckus
@Betty Cracker:
It’s less time than we’ve be dealing with this so far.
And in a world of a new airborne disease that does/can do a fair amount of damage to the body, and damage that we don’t know the limits/likes of fully yet, 21 months is actually amazing. Look how many companies have come up with what looks like rather effective vaccines in such a short time, that if humanity does have to have these twists and turns in living, we can, if we actually learn something from the experience, move forward. Now if we in the US could get politics to be something besides 2 steps forward, 10 back, rinse/repeat, life could possibly, maybe, be actually better.
Robert Sneddon
@Cervantes:
Other vaccine types other than mRNA can also be quickly adjusted to match the mutations in COVID-19 — the Oxford/AstraZeneca team is already working on new versions of their modified chimp adenovirus vaccine to match the changed spike protein profiles in the mutated viruses known to be in the wild.
Killed-virus vaccines still have a place in the pandemic arms locker but they’re old-school given the sort of gene sequencing, alteration and synthesis we can do today whether for encapsulated mRNA vaccines or modified adenoviruses.
Brachiator
@gwangung:
Yes, this might happen if you successfully vaccinate practically everyone on the planet.
We are not there yet.
CaseyL
@Betty Cracker:
@Doc Sardonic:
I can understand wearing a face mask in high-heat/high-humidity is enough to drive you nuts. I lived in South Florida for many years, and there’s nothing like feeling the air envelope you like a hot wet blanket to make adding any layers to one’s body an exercise in purgatory.
Funnily enough, up here in the PNW, as the weather’s gotten colder, wearing a face mask has been helpful. Keeps the lower face warm. Not bad at all.
I don’t like the disposable masks, which inevitably slide up into my eyes and fog up my glasses. The close-fitting reusable cloth masks are much better on all counts.
NotMax
@Betty Cracker
I don’t find the masks at all uncomfortable or burdensome to wear.
But then there’s a bushy layer of facial foliage between them and the skin.
Kent
What percentage of the population are we talking about? I’m not talking about today. I’m talking about the future when it should be universally available. I tried to google up that information with no luck but found this CDC web page FAQ which says the following:
Basically the CDC doesn’t list any type of underlying medical conditions that preclude one from getting a Covid shot except for those who have had allergic reactions to the shot itself or one of the ingredients. That is a miniscule portion of the population.
Major Major Major Major
@Fair Economist: Did anybody really expect a coronavirus to behave exactly like an influenza virus, though? Trevor Bedford is my go-to for this sort of stuff and I seem to remember that these mutations didn’t really surprise him at all.
@Kent: There are also lots of immunocompromised people for whom vaccines do not work very well, right? My mom has lupus and flu shots aren’t very effective for her, for instance, unless I’m misremembering what she’s told me.
wvng
I can’t imagine a case where this disease is eradicated. It simply has too many stealthy attributes. It becoming endemic seems like the only possible path, unless it suddenly mutates into something deadly that kills us all. Which seems unlikely.
I read sometime last year, probably in Science (I can’t find the reference now), that one of the corona viruses in regular circulation as a “no-big-deal common cold” may well have entered the human population in the mid 1800s and been the cause of a deadly pandemic.
Kent
For example???
debbie
@raven:
Seconded.
Percysowner
@White & Gold Purgatorian: In the Before Times, I would put on a mask in my Doctor’s office, if it wasn’t an annual exam. They had a little sign asking people to wear one if they had any symptoms and they provided surgical masks. I have year round allergies, so I always had symptoms. So I’d throw the mask on to be nice. I will probably continue to mask up when/if this finally gets under control, at least at stores with lots of people. I mean it helps prevent colds and flu too, and I own a ton of masks, so why not keep using them?
I don’t know if I will ever be comfortable going into a restaurant, but boy do I miss going. I loved rewarding myself after a hard week with a meal and drinks at a nice restaurant.
Major Major Major Major
@Brachiator: I mean. It happens at the margins if you vaccinate a single person, all else being equal. There are two numbers involved. Let’s not be silly.
White & Gold Purgatorian
@Betty Cracker: We are at different ends of the comfort zone spectrum, which illustrates the difficulty of predicting what new normal could look like. It may turn out to be a flatter curve than before with more people at both the “party animal” and “wipe those groceries with Clorox” ends of the spectrum than pre-2020.
Kent
According to the CDC they are not precluded from taking the vaccine. I suspect we don’t really have nearly enough information about how well it works to prevent Covid in people with immunocompromised diseases, or the extent to which it reduces the severity of the disease for those who still catch it.
Again, this is just from 30 seconds of googling on my part. I’m truly curious what percentage of the population really can’t take the Covid vaccine for actual medical reasons. 5% 1% 0.1% ??? I have no idea.
Major Major Major Major
@Kent: Not prohibited, no, but I was including the immunocompromised (who would probably like to go about their daily lives) in my slightly misphrased group. I was responding to your statement that “those who want to stay healthy will be able to do so”, and everybody else can just go DIAF and we don’t have to worry about them any more than we worry about people who drink a gallon of soda a day.
ETA: and, to match your own ten seconds of googling, I did my own. 2-5% of the US population is immunosuppressed. People who don’t get vaccinated are hurting that population. My mom had COVID and didn’t develop antibodies for fuck’s sake.
White & Gold Purgatorian
@Percysowner: Yeah, we didn’t eat out often, but I’ve missed the handful of places we used to enjoy. Not sure if dining inside will ever appeal again, but I might get comfortable enough to do takeout if the infection rate gets really low. Once you start thinking about the opportunities for picking up a food borne, airborne or surface acquired bug in a restaurant, it is hard unsee the both hazard and the eewww.
Brachiator
@Percysowner:
I hear you.A restaurant visit, and going out to the movies were a couple of my regular after work treats.
After tax season a friend would always treat me to a special lunch or dinner at a nice or newly discovered restaurant.
There is one cafe I still go to that has outdoor dining, with tables widely spaced out. I also know the owner and have actually observed how scrupulous he is about following health authority guidance.
There are some other places with semi-indoor and outdoor dining that I would not visit if they paid me.
Anoniminous
@Cervantes:
The bad news is even mild cases can cause permanent brain damage.
How Covid-19 can damage the brain
even mild cases can cause permanent brain damage. How COVID-19 can damage the brain
even mild cases can cause permanent brain damage.
Doc Sardonic
@Kent: I have spinal stenosis throughout my lower back and neck moving to meet in the thoracic spine. My neck got slightly surgically repaired and the same thing needs to be done in my lower back. I had the testing done, which significant damage to the motor nerves. Had an MRI done, radiologist comes back with a reading of mild stenosis no spinal issues. Referring doc looks at the pictures and loses his mind pointing to the spinal impingement and scarring on the spinal cord and tells me that all we can do is try PT because given the radiology report that’s all insurance will do.
WereBear
@CaseyL:
Also, paper masks go big and slide all over the place. I’ve discovered one will fit well inside the two-layer cloths ones which work for me, and have a pocket for just that purpose.
Anoniminous
@Anoniminous:
Apologies for the redundant repeating repetitiveness.
Kent
I don’t think we are in disagreement. People who are truly immunosuppressed are going to be at a constant disadvantage and at risk of catching every disease from measles to shingles to Covid to the flu. I’m not sure there is any way out of that. I’m not sure that Covid is going to make their lives dramatically different than it was before. It is one more of a long list of diseases to which they are at risk.
If I were in charge, I’d eliminate all the vaccine exemptions for everything other than medical reasons and require all public sector and public interacting jobs to be vaccinated as a condition of employment. From teachers to students, to cops to Starbucks baristas to flight attendants to meat packing workers. You want to be an anti-vaxer? Fine, go live off the grid in Alaska.
My larger point should have been caveated, which was that once a vaccine is universally available it is going to be life mostly back to normal for the great majority of the population.
Major Major Major Major
@WereBear: I like the 3-layer blue masks the best, but I have a big head. For when I want a tighter fit I got some little hooked plastic strips that go behind your head.
Fair Economist
@wvng:
That’s OC43, which is related to a bovine coronavirus and separated from it in the mid 1800s. If it did cause a pandemic, it was the 1889-90 Russian flu, which is certainly possible. The geography is reasonable since its bovine relatives are from Central Asia and the disease was first noted in, well, Russia. Several attempts to identify the influenza causing the 1800’s Russian flu have failed or generated unconvincing results. I haven’t found any attempt to ID it as OC43.
But the Russian flu was less dangerous than SARS2, even before considering the extremely inferior medical care available at the time.
Frankensteinbeck
Remember when it wasn’t going to be until November of this year that there would be a vaccine at all? Biden is always going to be cautious and conservative in his estimates because that’s the responsible thing to do. We’ll get back to something approaching ‘normal’ in Summer, if vaccination goes the way it looks now. If the virus isn’t totally eradicated as a combination of aggressive vaccination and it burning out in non-vaccinated populations, we’re probably looking at a measles situation. It becomes one of the required vaccinations and only flares up when you get anti-vax flare-ups. Partial immunities also build up in the population, passed from mother to child. My biggest worry is the long-term damage to people who catch it before the vaccination campaign catches up. We’re at, what, 400,000+ confirmed US sufferers?
Kent
My sympathies. But it sounds like your issue is with the insurance industry, not the medical community. They are not the same thing.
NotMax
@Major Major Major Major
“Blue? But I’m a summer.”
//
Anoniminous
@Frankensteinbeck:
As of today: 28,471,974 total cases, 503,043 deaths, 18,610,680 recovered, 9,358,251 active.
With a current death rate of 3% we can expect ~280,000 of the active cases to move to the deaths column.
smith
@Anoniminous:
Going back to the measles analogy, one of my sisters had measles when she was 4 (this was in the Olden Days, before there was a vaccine for it). It turned into encephalitis, and after she recovered she was never able to speak clearly again. It’s impossible to overstate how drastically this affected her life. She was dismissed as developmentally disabled (she was actuality quite brilliant), and bullied all her life, even by adults in her workplace. Not surprisingly, she struggled with severe depression from an early age. She died last April, and her family will never escape the deep sadness of her life.
Long haul covid survivors may be facing similar life trajectories. The contempt I feel for anti-vaxxers for condemning untold numbers of people to lives like my sister’s is inexpressible.
Major Major Major Major
@NotMax: I’ve seen pink ones!
Betty Cracker
@Kent: I could live with the requirement if people could get vaccinated for free.
Betty Cracker
@smith: How horrible. I’m sorry for your loss.
Frankensteinbeck
@Anoniminous:
Thank you. My ability to process numbers is screwy today! That 18 million leaves a lot of room for a LOT of permanently damaged people. That worries me.
Anoniminous
@smith:
Sorry to hear of your loss.
My conclusions re: anti-vax crowd are not fit to print in a public venue.
Kent
I’m pretty sure that is the plan. Do you know something I don’t? Under the ACA it should be free (no deductible) for anyone with insurance. And I think the Biden Administration is planning to make it free for everyone else as well.
Major Major Major Major
@Kent: yeah, fair. But I think the fact that it’s a novel disease puts it in a somewhat different category for them. And the fact that it’s deadlier than most of the other endemic diseases, in the states at least… idk.
Generally agree on vaccination requirements, assuming it’s trivial to get one.
Betty Cracker
@Kent: As far as I know, the initial two (or one for J&J) doses will be free. I don’t know if that will remain the case if people have to get vaccinated annually. I hope so, considering that tens of millions of Americans don’t have insurance coverage and it’s a contagious disease, which makes maximizing immunity a public health issue. Of course, that’s true for the flu too, and those shots aren’t free, so who knows?
debbie
@Major Major Major Major:
My dentist gave me one of the paper masks her practice uses. A soft purple on one side; pale purple flowers on the other. I’m saving it for special! //
Almost Retired
@Betty Cracker: Masks make me feel young. By which I mean wearing them is giving me acne, which I haven’t had since the Carter Administration.
Anoniminous
@Betty Cracker:
Vaccination is free in New Mexico. It is supposed to be free in the US albeit some facilities seem to be charging an “administration fee.”
The rat bastards
OldDave
@Another Scott:
There are fake 3M N96 masks out there….
JanieM
@Almost Retired: I went for a dermatology check-up recently and they said this is so common it has a nickname: “mask-ne.” I’m getting a version of it too.
Kent
Slightly off topic but as a teacher in WA who can’t yet get the vaccine I took note of two conflicting stories on CNN and MSNBC in the past two nights.
Last night Chris Cuomo went on a tirade about school openings and why we couldn’t just take 3 days and get all the teachers in the US vaccinated (3.9 million teachers but probably closer to 5 million if you include all the support staff from aids to bus drivers). And he had on guests who agreed with him. They also took a hard critical look at the Biden Administration which is completely beating around the bush on the issue and talking about how schools *can* be re-opened safely without vaccines if they follow safe procedures (which are impossible at a lot of schools).
The night before Rachel Maddow went on a tirade and had guests on to talk about racial injustice in the vaccine rollout, and how people of color are being vaccinated at much lower rates than what people. Of course, not said in her segment was that we aren’t vaccinating the general population. We are vaccinating groups 1A in many states, which are health workers and the ultra elderly in nursing homes. Both populations which trend heavily white. I don’t know the actual statistics, but I’m willing to bet that the US population of doctors and nurses is much more heavily white than the general population. Or at least much less Black and Hispanic (which was the metric they were using).
Watching these two stories in combination it occurred to me that perhaps the unstated reason why the Biden Administration and many states are reluctant to push teachers to the front of the line and are slow-walking teacher vaccines is because they know that the teaching profession is heavily white. And they don’t want to deal with the optics of pushing another 5 million white people up to the very front of the line. No one ever says this. But thinking it through, I’d be shocked if they weren’t aware of it.
So we are basically spinning our wheels and talking platitudes about how schools can safely re-open if they just follow guidelines like ventilation and sanitation and masks/distancing. When that is literally impossible in many many classrooms. I’ve worked in classrooms that were interior rooms with no windows and no HVAC type ventilation, only steam radiators for heat. That are accessed via passage through other classrooms not hallways. Old overcrowded schools that have been remodeled and added on to over the years have all kinds of crappy ad-hoc classroom spaces that in no way can be properly ventilated without tearing down the whole damn school and building new.
Kent
Preventative care including vaccines is required to be free (no deductible) under the ACA. Obviously it’s not completely free in that it is built into your monthly premium. But there should be no extra cost for anyone with employer-based or ACA insurance (or medicare/medicaid).
So we are really only talking about vaccinating the uninsured. Which honestly is a much larger issue than just Covid. And the answer is to get them insured, not build some ad-hoc Covid shot subsidy thing in the future.
Major Major Major Major
@Kent: I’ve read that vaccine acceptance is also a lot lower in black & latino communities. Also, iirc, white parents are much more likely to want to reopen schools than POC. So those complicate things.
Ruckus
@Kent:
I have, in the past, always gotten rather ill from a flu shot. 105 fever for several days. I got inoculated in boot camp and spent 9 days in the hospital with a 105 fever than didn’t break till after 7 days. And then I was fine. My reaction isn’t different than a lot of people, just more severe. So, should I take the flu shot and see what happens every year, or should I skip it? If a doc listens to me when I explain they say OK don’t take it. If they ignore my answers they say always take it. Someone has to be that 5% that can’t do some things and my reactions to some medications has been the best or worst 5%, with no way to know which it is going to be ahead of time. But this one is one I didn’t fuck with, I took the Pfizer offered, my second shot tomorrow, because the disease can be very bad for someone with my age and comorbidities.
Betty Cracker
@Kent: I agree it would be better to get everyone insured, but I’ve noticed that’s kind of a heavy lift in America. So in the meantime, since there’s a dangerous contagious disease to be brought under control, it might be more expedient to build an ad hoc COVID shot subsidy thingie.
NotMax
@Major Major Major Major
Evidence? Citations? That pat a statement cannot stand unsupported.
Jim, Foolish Literalist
@Kent:
Those are all good and interesting points.
Another thing I’ve notice is that media people– on TV, on twitter, in the tubes– and politicians seem much more eager to get kids back in classrooms than parents, and not just the usual anti-teachers union obsessives like Chait. Hayes had a stat last night (from memory) that about a third of Black parents are ready to send their kids back in school now, just under half of Hispanic parents, and about 60% of White parents. I’d be curious to see how that stat could be broken down wrt the physical conditions, including classroom crowding, of the school buildings those parents know. And the rate of infection and vaccination in their neighborhoods and social circles.
Kent
@Ruckus: Oh, I agree. If you can’t take the shot for medical reasons (as it sounds like in your case) then that’s a valid reason not to take it. I’m talking about the other 95% of the population who are in public-facing jobs. If you are a wheat farmer in North Dakota I don’t give as much of a shit about whether you get a shot than if you are say….a flight attendant.
Another Scott
@OldDave: Indeed there are, and one has to do the best due-diligence that one can.
I, personally, would be careful in regarding even “fakes” as being “worthless” as the official in the story said. Yes, health care workers who are around actual COVID cases all day need to be assured that they’re getting verified genuine N95s whenever possible. But I’m not a heath care worker and if my choice is between finding a mask that fits well and works better than anything else I’ve tried, that may not be “genuine”, and (also maybe not genuine) paper surgeon’s masks that don’t fit well, and home-made cloth masks that don’t all fit well with no testing data either, well, the choice for me is easy.
Finally, these “fake” masks may be made on the same contracted assembly lines as the genuine masks, but are “off-the-books” as far as 3M is concerned. (That’s very, very common with production in China, but I have no evidence one way or the other here). 3M has to protect its distribution network and it’s appropriate for there to be charges if they’re outside 3M’s control.
I looked a lot of places before buying on eBay. McMaster-Carr has no stock. Amazon won’t sell them to me as I’m not a medical person. Etc.
YMMV! :-)
Cheers,
Scott.
Major Major Major Major
@NotMax: CDC: https://www.usnews.com/news/education-news/articles/2020-12-10/cdc-black-latino-parents-more-concerned-about-school-reopenings-than-whites
NYT: https://www.nytimes.com/2021/02/01/us/politics/school-reopening-black-families.html
cain
We do need to pass laws to protect indigenous populations in the Amazon and Africa where something could be devastating.
Cheryl Rofer
@Kent: I’ve stayed away from arguments about priorities for the vaccine. Some younger folks in NM who are doing good things, and also some teachers (who are doing good things) got ahead of me in line, despite the official priorities. Not a problem, as far as I’m concerned, unless it delays my vaccine for months and months, which is not the case.
I regard the priority listings as a way to meter the limited supplies of vaccine, so everyone doesn’t dash for the vaccination centers immediately. I think it’s worth pointing out some of the disparities and perhaps correcting them.
Biden says there will be supplies enough for everyone by the start of the summer. I see in today’s paper that New Mexico is getting a big shipment next week.
The big thing, from a public health pov, is to get as many people vaccinated as soon as possible.
Kent
Right now I’m semi-retired from teaching and pre-Covid I was mostly long-term subbing for HS science teachers in the Vancouver area. So over the past 2 years I worked in a bazillion different classrooms across maybe 8 different high schools. Vancouver is a newer suburban area but even here you get discrepancies between the facilities in the newer affluent white suburban areas, and the older inner-city schools that are more diverse. Some of them are really really crappy. And some of those communities are notoriously poor about passing bond measures to remodel and rebuild schools. So classrooms are crappy and ad-hoc and ancient. You might have a thermostat in your classroom but it is often doubtful whether it is even connected to anything. And you still see old steam radiators in some classrooms so basically no air ventilation. Even in the newest and fanciest school I teach at there is one classroom where you have to pass through 2 other classrooms to even get to it, all interior walls, no windows. It is classroom space squeezed into what was former storerooms when the population grew faster than the school.
There are older schools where I have taught that don’t even have sinks in some bathrooms. They have installed these old water fountain style sinks in the hallway between the girls and boys bathrooms with no hot water or paper towels or soap.
And this is suburban Washington State. I can’t even imagine what things must be like in cities like Detroit, Cleveland, Baltimore, etc.
The other thing about teaching is that you are at the mercy of the most dumbfuck MAGA and anti-vax parents in your district. God only knows what kind of plague rats some of those parents are sending into your classroom. Here in WA we have these weird Russian and Ukrainian immigrant evangelical sects that are completely anti-vax. They are the ones who spun up our recent Measles epidemic two years ago. You are at the mercy of all of these people. That kid is sitting right in front of you for an hour/day.
I’m personally not going back into a classroom until I have the full vaccine regimen. Too much is out of my control.
Ruckus
@smith:
Had measles when just a bit older and also had encephalitis. The fear that I remember from parents and doctor was that along the lines of the effects that unfortunately your sister suffered from but I got lucky and recovered. I have often wondered if some of the things that are affecting people my age and older and your sister are from diseases that at a younger age we all caught because there were no vaccines. I remember the massive fear of polio because of what it did to people but I wonder if the effects long term are catching up with us now. Diseases that folks our or would be our kids age have dealt/are dealing with, are they residual aftereffects from diseases that people my age all got but not much later vaccines were developed for?
Kent
I only object when rigid adherence to hierarchies is slowing down the vaccine rollout. As long as every vial is making it into someone’s arm in a timely manner than I have no great objection.
However there is ZERO chance that I’m walking back into a HS classroom until I get fully vaccinated. I’m not stupid. And I don’t care what the so-called experts tell me about how schools can be made to be safe. I know it is mostly bullshit in the overcrowded and aging schools where I teach.
I know I’m not alone. You want teachers back in schools, give them the vaccine. If in-person school isn’t a societal priority then fine. But that is the choice.
Cheryl Rofer
@Ruckus: There is definitely a post-polio syndrome. A colleague of mine retired early because of it.
BruceFromOhio
I was about to rip this guy for endemic stupidity, thinking he was a journo, turn out he is (was?) a surgeon at Johns Hopkins:
April is two months off, my spidey stats sense thinks “not quite”. But the trends are definitely favorable, let’s keep it going, please.
jl
@Betty Cracker:
” I watched a bit of Biden’s town hall earlier this week, and I was dismayed by the prediction that we can return to some semblance of “normal” by next Christmas. That seems so far away. Le sigh. ”
I’m not sure that’s true, but at least a change from bragging a lot and doing nothing to underselling and trying to do your best.
Life has been semi-normal in some countries for months, but they don’t make the news because they haven’t had spectacular control meltdowns, health system crashes, and doom porn shutdowns.
I hope the US should do much better before Christmas, now that adequate resources will soon be available for a decent control program.
The programs in Taiwan, S Korean, New Zealand, Australia are in the news a lot. Uruguay, Norway, Iceland, Finland, Estonia, Senegal, Mongolia, not so much. And Canada, as always, is too nice to get much attention. But, people can look them up in the Our World in Data site, and the European Observatory on Health Systems and Policies for countries in Europe. Reuters covid tracker is good for seeing which countries have had to endure socially and economically very damaging frequent shutdowns.
The mess in the US is as much a US problem as it is a covid problem. And many spectacular control failures are due to political meddling like we see in the US, the Czech Republic is an example. In Estonia, when a political leader has messed up on covid, the political leader resigns. In the Czech Republic, after their initial fantastic success, public health officials have been fired for politicians’ mess-ups.
Edit: I hope Cheryl is around for the shout out to Estonia.
wvng
@Fair Economist: That sounds right. I can’t seem to find the article that referenced this. It was not the primary focus of the article
jl
@BruceFromOhio: With growing evidence that prevalence of past disease in many counties ranges from 20 to 40 percent of the population, we may be at a point where irreversible declines in the effective reproduction number due to exhaustion of the proportion of susceptibles in the population is large enough to prevent disastrous health system destroying surges.
But, the same shapes we see can be caused by population response to perceived risk of infection, cycles in how long the population can stay hunkered down, or a combination of all three factors.
In California there is some evidence that population mobility and risk precautions picked up substantially as news of the LA County health system crash sunk in. Edit: more than due to public health orders, which recent survey evidence indicates people aren’t paying much attention to anymore, due to growing confusion and sense of that they don’t do much to improve things.
So, I think need to proceed with caution and not count on approaching herd immunity just yet. But that just reminds us that the US needs to do better at traditional sound practices of infectious disease control, which are just now getting the resources to do, which we should be doing anyway.
Cheryl Rofer
@jl:
I haven’t been following Estonia closely, but my currently imperfect understanding is that the covid foulup helped to remove politicians who were undesirable in other ways as well.
NotMax
@Jim, Foolish Literalist
100% certainty of developing hypertension from all the grains of salt which must be ingested along with anything out of Hayes’ lips. He’ll skew to the sensational sliver of a story every time.
Kent
My own gut reaction tells me he is not far wrong. I think you can take the entire American population and put everyone on a spectrum from those who’s behavior and job means they are most likely to catch and spread Covid, and those who are least likely. Say rank everyone from 1 to 100. By April we will be getting pretty close to universal immunity in most of the super-spreader types in the top 10% or top 20% of spreaders. So it will get harder and harder for the disease to spread when all the likely carriers are already immune.
jl
@Cheryl Rofer: I’ll have to go look for the links in my covid notes, but at least two politicians resigned after they defied public health advice. One for a rash reopening, another for going ahead with a big outdoor event that violated attendance caps (which are very generous and would be considered grossly irresponsible by California standards).
I’m envious of what Estonia, Finland and Norway have done. They’ve gotten the prevalence of active cases so low, that their shutdowns look like suicidal reopenings from a US perspective. Sometimes I wish I could go there, but then it occurs to me that my own risk perceptions have changed so much, that if I were in those countries, I’d be afraid to go out.
Estonia has had problems recently, but hasn’t done any worse than San Francisco, but at much less cost to society and the economy.
jl
@Cheryl Rofer: Estonia’s really big foul up happened early when half of Saaremaa probably got sick. As you probably know, that island is a local vacation spot, rural, but with many pockets of poverty and overcrowded housing.
Estonia, Finland, Norway accomplishments have been due, IMHO, to less emphasis on doom and gloom helpless in the face of disaster thinking and more on standard public health practice (edit: with adequate resources).
They designed short effective shutdowns that got prevalence very low, and spent the shutdown time designing sustainable infectious disease control programs. So, a population based surveillance program, early plans to keep non-covid care going, as well as covid care, adequate and free or cheap safe quarantine and isolation spaces, free or very cheap testing asap, strong programs for health education and public participation and engagement in the control programs, free or cheap PPE for all as soon as they could manage it.
Edit: and forgot, free or extremely cheap with hard out of pocket caps, covid treatment, lost earnings compensation for quarantine and isolation.
And they did this next to Sweden! Which, despite its bizarre policies, has managed to do far better than the US in terms of mortality (which says more about the grotesque US disaster than Sweden
Ruckus
@Cheryl Rofer:
Woman in my complex who lived about 4-5 miles from me had polio as a child, with all the attendant issues, braces, crutches and she remarked that as she got into her 20s she rather fully recovered, no braces, no crutches, she had kids and a normal life. She’s now in a wheelchair and many days wears a brace on her affected leg and has told me that this is typical of polio victims, the past is, as it most often does, is catching up with them. A girl I went to elementary/high school with had polio, she showed up at our 10 yr reunion with no crutches/braces and walked in like she owned the place. She didn’t come to our 50th reunion, so I have no idea how she is doing today but I suspect about the same as my neighbor.
Kent
According to https://coronavirus.jhu.edu/data/mortality
US mortality rate is 149.91 per 100,000
Sweden mortality rate is 123.43 per 100,000
Sweden is a bit lower, but not dramatically so. Don’t give the Swedes more credit than they deserve.
By contrast…Finland mortality rate is 13.10 per 100,000 so DRAMATICALLY bette
BTW, the US isn’t even the worst. The UK, Italy, Portugal, Belgium, Slovenia, and a few other small Euro countries all have higher mortality rates than the US.
jl
@Kent: By what standard is an almost 20 percent lower mortality rate negligible? And I don’t see how I gave Sweden much credit.
But to accommodate you, I’ll give Sweden some credit in my response, to make you happy. There is a debate over whether Sweden had a unique problem with its unique constitutional limits on coercive measures to order people to stay home or refrain from certain activities, and the extreme autonomy of its public health department prevented it from doing much more than it did. The country’s head epidemiologist is probably a ‘let it rip’ herd immunity proponent who took advantage of that to push his own agenda.
Below is a link to one side of the debate:
Sweden’s constitution decides its exceptional Covid-19 policy
Lars Jonung 18 June 2020
https://voxeu.org/article/sweden-s-constitution-decides-its-exceptional-covid-19-policy
Kent
@jl: I didn’t use the term “negligible” you did. I’m just pointing out that Sweden is in the same general range as the US whereas the other Nordic countries are at least 10x better. You said the Swedes did FAR better than the US. I’m just quibbling with that characterization.
Sweden did an extraordinarily crappy job in its Covid response for such a small, wealthy, and modern country. Actions have consequences.
jl
@jl: Here is a link to the other side of the debate:
Does Sweden’s constitution really prevent tougher coronavirus measures?
https://www.thelocal.se/20201119/does-swedens-constitution-really-prevent-tough-covid-measures
Denmark had similar, though less severe problems. Both countries passed some significant legislation over the summer to make epidemic control easier.
Japan has had problems similar to Sweden: federal actions to order broad shutdowns, strong privacy laws (which are so strong as to be dangerous to the global effort, because they can’t provide enough info on their cases to participate in surveillance for covid mutations).
I’m being feisty over this for two reasons. First, I don’t think any responsible government was so stupid as to intentionally go all in for a herd immunity policy to let the disease rip through society (I don’t consider Belarus responsible, and they had to cave eventually).
Second, I don’t think its a good idea to give the avoidable disaster of the US response any excuses at all, and in my mind that includes stereotyping other countries that have managed to beat the US performance in any respect.
jl
@Kent:
” Sweden did an extraordinarily crappy job in its Covid response for such a small, wealthy, and modern country. Actions have consequences. ”
Time is better spent focusing on the US, IMHO. Sweden has been trying to fix its problems for some time, we’ve only barely started.
Edit: “a bit”
Kent
I’m not arguing with you. Every country needs to get it’s shit together right now. Doesn’t do any good to just fix Covid in one part of the world when it can spread right back from the rest of the world. It’s going to be a long haul because we live in a global world.
Bill Arnold
@Another Scott:
I recently got a box of 20 on Amazon. Not 3M, but definitely 2-strap N95s, forget the (recognizable) brand name. (Could be counterfeit, but they do fit well with no obvious leakage felt by facial skin.)
Have given away a half dozen so far; I re-use (and the strap seems really solid) and only wear when indoors in public places like stores. Something like $40 for 20, but one could buy with friends and split.
Some years back I started wearing a mask for dust/pollen while lawn mowing. (Northeast, sometimes dry in summer). It turned after-mowing from unpleasant for a day into no problem at all.
An N95 will work better; happy to have them.
jl
@Kent:
We agree 100 percent there, thanks.
My only point is that any country that has done better than the US in any respect deserves careful study, even if their policies seem wrongheaded, and some jeer them in the US.
What has happened in the US is an inexcusable disaster. We need to prove that the problem was the Trumpsters, and not other deeper problems in how we govern ourselves here at home.
Bill Arnold
@scav:
It’s also intra-body selection pressure, by antibodies (natural from infection, semi-natural (vaccine), or monoclonal (regeneron et al)), or antivirals, or whatever. (I haven’t seen this quantified; could have missed it.)
Cheryl Rofer
@BruceFromOhio: Here’s one of my go-to experts on Twitter about that WSJ article:
BruceFromOhio
@Kent: These stats may indicate reduced risk of exposure and infection from a herd perspective; from a personal perspective that risk still exceeds my appetite, mostly because it’s more than just my ass on the line.
My challenge is to decide how to re-assess risk appetite(s), which factors to include and how to weight them, keeping in mind that immunizations and herd immunity are increasing, infections are (for the moment) decreasing. At this point in time, given case counts, ICU admissions and deaths in my region, “return to normal” by April is a fanciful stretch. Your mileage may vary.
ETA: @Cheryl Rofer: Thank you, I regret that WSJ page is going to get a heckuva lot more references than Eric’s tweet.
DCA
“think about what would happen if measles suddenly appeared out of nowhere, a new virus to which humans had no immunity”
Think about what did happen to the Native American population after 1492.
Brachiator
@jl:
Sweden and the UK both had initially shitty responses to the virus based on bad ideas about herd immunity.
Sweden may also have needlessly let some nursing home patients die, but that is another whole issue.
Kent
I live in Washington State. The pandemic actually got it’s start here in the Seattle area. Our current Covid death rate is 63 per 100,000. Our neighbor to the south, Oregon is around 50 per 100,000 which puts us in the same range as Canada at 57 per 100,000.
If the rest of the US did as well as Democratically-managed Washington State, we would have had about 210,000 deaths so far here in the US. Or put another way, we would have saved 300,000 lives.
Mike in Pasadena
@Kent: speaking of shots, just got my second Pfizer and I’m waiting my 15 minutes
catclub
oy.
Which restaurant? not asking for a friend.
catclub
@Kent:
The worst state for mortality per person is New jersey – last I looked.
The impression I got was that Covid raged through their nursing homes early in the game, with devastating effect, getting governance right to stop that, or not, was mostly luck.
catclub
@Cheryl Rofer:
A deeply flawed op-ed in the WallStreet Journal? I am shocked.
Brachiator
@Bill Arnold:
Just ordered some on Amazon that may be what you were referring to. Thanks for the tip.
Bill Arnold
@Brachiator:
The link in my order history doesn’t work, but a search for the same name worked:
“NIOSH Certified Makrite 9500-N95 Pre-Formed Cone Particulate Respirator Mask, M/L Size (Pack of 20 Masks)”
A search will also show similar things, some available.
Not medical, but I don’t care; they fit well on my (shaven) face, close to no leakage felt.
Major Major Major Major
@Kent: but if the rest of the US had done as badly as Democratically controlled New York…
jl
@Cheryl Rofer: Thanks for that link.
I just don’t understand the impulse in the US to try to avoid doing standard work of government in keeping the country’s population safe and society and economy sustainable (OK, I’ll get slammed for not understanding it…)
Shapes in the epidemic curve that we’ve seen can still be due to approaching the herd immunity threshold, or due to population reaction to perceived risk. And there is evidence in the US that populations in red and blue states do respond in a similar way to news headlines of disaster, though to somewhat different degrees.
The crazy ‘let ‘er rip’ herd immunity types just can’t quit their delusion, and want us to count on what can’t reasonably be relied upon. I suppose one motivation is that it is a very bad thing to even allow attempts to show that good public sector performance is ever needed for anything even if it costs hundreds of thousands of lives.
Since you are a dynamic systems maven, below is a link to an article that shows how dramatically population behavior can change the course of an epidemic.
Awareness-driven behavior changes can shift the shape of epidemics away from peaks and toward plateaus, shoulders, and oscillations
https://www.pnas.org/content/117/51/32764.short
We just don’t know where we are wrt to the herd immunity threshold yet, and it is complicated by more transmissible variants. And important to remember that with such a high prevalence of disease, reaching the herd immunity threshold doesn’t mean a stately transition to a stable no or low disease steady state, because there will be overshoot from having to burn off so many infectious people, even if R(t) drops below 1for the foreseeable future.
I think that twitter thread overlooks the population response issue.
Brachiator
@Bill Arnold:
OK. I guess what I got was a cheaper KN95 knock-off, but I am OK with that. I have one scheduled outing soon where I may double mask.
Will note this for the future
Cheryl Rofer
@jl: I think that our relative rapid recent decrease is due to a combination of things – improved behaviors, increasing immunity from disease and vaccine, and perhaps a seasonal effect. Maybe some other things, too. I’ve been watching to see what the experts say, and that’s about what they say.
Short answer: We really don’t know, but it’s probably a bunch of things working together.
jl
@Cheryl Rofer: I agree, except not sure ‘improved behavior’ is the best term. Maybe ‘scrambling to adjust to threat of death and disability’ might be better.
Gvg
@Doc Sardonic: Allergies only happen after you are exposed to something. Most things take several or many exposures. You are more likely to become allergic to home than something rarely encountered.
Gvg
@Another Scott: I got some recently from United Medical Supply, a company I had heard of before Covid, in California. Earlier in the year they were only selling to Medical people, now they seem to have more stock.
LongHairedWeirdo
@Kent:
“Normal” is pretty subjective, in some ways. I wouldn’t be surprised if, by April, we could do most of the stuff we used to, but with masks and lowered capacities, and if grandma&grandpa, and kids&grandkids, are all vaccinated, they can visit, even maskless, but they should be masked in public. (Remember, masking’s primary purpose is to protect others, though it does help protect you, too. So it’ll be okay to be maskless with everyone vaccinated sooner than it will be okay to be maskless in public.)
December might be when everyone can think it’s fine to crowd into a theater, bar, or restaurant without masks.
TruthOfAngels
@BruceFromOhio: A surgeon, you say? Dunning-Kruger strikes again. April my ass.