[HN Gopher] The mutation that helps Delta spread
___________________________________________________________________
The mutation that helps Delta spread
Author : pseudolus
Score : 126 points
Date : 2021-08-20 17:37 UTC (5 hours ago)
(HTM) web link (www.nature.com)
(TXT) w3m dump (www.nature.com)
| jmfldn wrote:
| Purely anecdotal but I'm double vaccinated (Astra Zeneca) and I
| caught Covid recently. It was probably Delta as 99% of cases in
| UK are. I know of quite a few vaccinated friends who've caught it
| recently too. Mainly AZ I think but one was Pfizer (single
| jabbed).
|
| Anyway, none of us had severe illness although I felt pretty
| rough for a few days like I had a really bad cold and smell went
| for a week completely. I was basically fine though and everyone
| else I know is too who got it recently. The point is that it does
| seem like this Delta variant breaks through regularly and it does
| seem (again, purely anecdotal) like it's v infectious. Of course
| the thing to emphasise is that, whilst it might break through,
| the vaccine still stops serious illness to a high degree. It does
| highlight however the need to not be complacent. Vaccines don't
| seem to be stopping the spread right now as much as you might
| think, and the high number of cases combined with high
| vaccination rates is an obvious selection pressure. More variants
| are inevitably coming and it does seem like this virus is bucking
| the trend and not necessarily becoming less potent despite
| increased tranmissability in some variants
|
| My conclusion is that, whilst I welcome the UK being sort of
| "back to normal", let's keep up the mask wearing, hygiene
| standards and so on. It's a balance but I sense things are
| getting a bit too lax. I'm not overly anxious but let's stick to
| the precautionary principle a bit more.
| tommymachine wrote:
| Do you have awareness that your anecdotal data, even if it were
| more than anecdotal, still would not prove that the shots
| you've taken reduced the symptoms, as many cases are
| asymptomatic / mild symptoms anyways?
| jmfldn wrote:
| Sure, it's anecdotal not proof and in no way scientific my
| self assessment. I've just noticed a trend amongst friends
| recently.
| tommymachine wrote:
| The criticism I made wasn't about the anecdotal nature of
| your post, but the lack of logic in the conclusions you
| drew from it.
|
| It's amazing how people of your persuasion must avoid at
| all cost viewing their own thinking from a logical
| framework.
| jmfldn wrote:
| The point in my sharing this as 'anecdotal' is that this
| is my subjective view, and that from where I sit, these
| conclusions might follow but the correlation might be
| coincidental too. I.e maybe I avoided serious illness for
| some other reason; maybe I have no antibodies and the
| vaccine didn't trigger a response in me but I'm one of
| many who had it mildly. There are any number of other
| possible explanations. I'm not making any scientific
| logically bullet proof statements here, I'm speaking as
| an armchair pundit thinking "hmm, seems like a lot of
| vaccinated people I know have the virus all of a sudden.
| Seems like vaccines might be helping with the severity of
| the illness, maybe I was one of them. However, I wonder
| if all this means we should exercise just a bit more
| caution until we're sure this high infection rate isn't a
| problem in the overall fight we're engaged in".
|
| The actual hard logic and policy I'll leave to the
| scientists and policy makers but, in the UK, at least the
| latter have a chequered history.
| technothrasher wrote:
| You invoke "you people" and then draw an unfounded and
| non-sequitur conclusion about your interlocutor's
| motivation while asking _them_ to think with a logical
| framework???
| zzt123 wrote:
| Same. My breakthrough infection lasted over a week. Nothing
| serious, but definitely very infectious, so I self quarantined.
| I've had minimal social contact and just about avoided COVID
| the original, so it was surprising how quickly I caught Delta
| after it became dominant.
| laurent92 wrote:
| Since more people are vaccinated, they don't always know that
| they carry. It adds a lot to the contagiousness. They may
| also be less careful, due to the insurance paradox (insured
| people have more accidents).
| kzrdude wrote:
| It's not normal until we can forget about it all. (So it will
| take time!)
| belter wrote:
| Thanks for sharing your experience.
|
| >"... Of course the thing to emphasise is that, whilst it might
| break through, the vaccine still stops serious illness to a
| high degree...."
|
| Important to note, vaccines do not protect you, its the immune
| response they trigger and the level of antibodies that will
| protect you.
|
| What really should be happening should be a mass vaccination
| program and a mass antibodies level testing program at the same
| time. Except for a few clinical studies, whose results are only
| now starting to come out I do not think any country is doing
| that. Frankly it puzzles me a little bit.
|
| There is not enough data yet to see how these antibodies levels
| reduce with time, but there is already plenty of information to
| show they drop dramatically after 6 months, hence the talk now
| of the third shot.
|
| Hence I think its better to say vaccines will produce level of
| antibodies that will protect...for now.
|
| "Understanding mRNA COVID-19 Vaccines"
|
| https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different...
| criticaltinker wrote:
| _> What really should be happening should be a mass
| vaccination program_
|
| _Compulsory_ mass vaccination using the current vaccines
| poses a serious public health risk [1][2][3]. See my other
| comments here for more explanation and citations. For these
| reasons, vaccination strategies should be highly targeted
| towards vulnerable populations, and should be heavily
| supplemented by additional therapeutic modalities.
|
| _> and a mass antibodies level testing program at the same
| time_
|
| Antibody levels are used as proxy for protection [4], but
| higher levels of antibodies do not necessarily always
| translate to higher levels of protection. In fact,
| individuals with undetectable levels of antibodies can still
| have robust and durable immunity [5][6][7]. There is plenty
| of literature on antibody levels reducing with time [8][9],
| but again, antibody levels are only one aspect of a complex
| immune response.
|
| [1] Risk of rapid evolutionary escape from biomedical
| interventions targeting SARS-CoV-2 spike protein
| https://pubmed.ncbi.nlm.nih.gov/33909660/
|
| [2] Can we predict the limits of SARS-CoV-2 variants and
| their phenotypic consequences?
| https://www.gov.uk/government/publications/long-term-
| evoluti...
|
| [3] Why does drug resistance readily evolve but vaccine
| resistance does not? https://royalsocietypublishing.org/doi/p
| df/10.1098/rspb.2016...
|
| [4] SARS-CoV-2 antibody-positivity protects against
| reinfection for at least seven months with 95% efficacy
| https://pubmed.ncbi.nlm.nih.gov/33937733/
|
| [5] SARS-CoV-2 infection induces long-lived bone marrow
| plasma cells in humans
| https://www.nature.com/articles/s41586-021-03647-4.pdf
|
| [6] Longitudinal analysis shows durable and broad immune
| memory after SARS-CoV-2 infection with persisting antibody
| responses and memory B and T cells https://www.cell.com/cell-
| reports-medicine/fulltext/S2666-37...
|
| [7] Rapid induction of antigen-specific CD4+ T cells is
| associated with coordinated humoral and cellular immune
| responses to SARS-CoV-2 mRNA vaccination
| https://www.cell.com/immunity/fulltext/S1074-7613(21)00308-3
|
| [8] Antibody Responses 8 Months after Asymptomatic or Mild
| SARS-CoV-2 Infection
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920668/
|
| [9] Naturally enhanced neutralizing breadth against SARS-
| CoV-2 one year after infection
| https://www.nature.com/articles/s41586-021-03696-9
| civilized wrote:
| > Compulsory mass vaccination using the current vaccines
| poses a serious public health risk [1][2][3]
|
| None of your references say this or anything remotely
| implying this. Backing up a provocative claim with a
| snowblind of irrelevant references is a shameful
| misinformation tactic and you should stop doing it
| immediately. Doing it in a public health context is
| particularly dangerous and frankly disgusting.
| aplummer wrote:
| Thanks for adding this. Compulsory mass vaccination is
| one of the greatest medical miracles in human history,
| possibly the actual single greatest.
|
| Source: https://en.wikipedia.org/wiki/Iron_lung#/media/Fi
| le:Poumon_a...
| newacct583 wrote:
| Second greatest. Antibiotics take the crown.
| criticaltinker wrote:
| My emphasis is on _compulsory_ , but perhaps I should've
| been more clear. Obviously I've triggered some people
| here.
|
| Vaccines are powerful tools that help save lives and we
| should use them. But if they are used indiscriminately
| they can actually further endanger public health. You
| might be familiar with antibiotic resistance - vaccines
| are subject to the same potential for unexpected
| consequences.
|
| All of the sources I cited support this fact - it is not
| misinformation. Did you read any of them?
|
| Here are some excerpts for you:
|
| Excerpts from [1]:
|
| _> "The spike protein receptor-binding domain (RBD) of
| SARS-CoV-2 is the molecular target for many vaccines and
| antibody-based prophylactics aimed at bringing COVID-19
| under control." _
|
| _> "Such a narrow molecular focus raises the specter of
| viral immune evasion as a potential failure mode for
| these biomedical interventions. With the emergence of new
| strains of SARS-CoV-2 with altered transmissibility and
| immune evasion potential, a critical question is this:
| how easily can the virus escape neutralizing antibodies
| (nAbs) targeting the spike RBD?"_
|
| _> "Our modeling suggests that SARS-CoV-2 mutants with
| one or two mildly deleterious mutations are expected to
| exist in high numbers due to neutral genetic variation,
| and consequently resistance to vaccines or other
| prophylactics that rely on one or two antibodies for
| protection can develop quickly -and repeatedly- under
| positive selection." _
|
| _> "The speed at which nAb resistance develops in the
| population increases substantially as the number of
| infected individuals increases, suggesting that
| complementary strategies to prevent SARS-CoV-2
| transmission that exert specific pressure on other
| proteins (e.g., antiviral prophylactics) or that do not
| exert a specific selective pressure on the virus (e.g.,
| high-efficiency air filtration, masking, ultraviolet air
| purification) are key to reducing the risk of immune
| escape" _
|
| _> "Strategies for viral elimination should therefore be
| diversified across molecular targets and therapeutic
| modalities" _
|
| Excerpts from [2]:
|
| _> As vaccines against SARS-CoV-2 are deployed across
| populations, it is possible to create a selection
| pressure for variants that can escape the vaccine-
| acquired immune response. Over the past few months,
| several variants have emerged which show a reduced
| susceptibility to vaccine-acquired immunity, though none
| appears to escape entirely. These variants largely
| emerged before vaccination was widespread, thus selection
| pressure from vaccines is unlikely to have made a
| significant contribution to their emergence. However, as
| vaccines become more widespread, the transmission
| advantage gained by a virus that can evade vaccine-
| acquired immunity will increase. _
|
| _> There is no historic precedent for the mass
| administration of antiviral medication in the community
| as prophylaxis, apart from the use of anti influenza
| Neuraminidase Inhibitors, which were used to a limited
| extent in this way in the early phases of Influenza
| Pandemic of 2009 in the UK. The safety and efficacy
| profile must be extremely well established for a mass
| administration strategy to work and poor compliance will
| likely rapidly lead to the selection of drug resistant
| variants, rendering such a strategy short lived. _
|
| I could go on, but that fact is your comment is not a
| charitable or informed response to the statements I made.
|
| [1] Risk of rapid evolutionary escape from biomedical
| interventions targeting SARS-CoV-2 spike protein (April
| 2021) https://pubmed.ncbi.nlm.nih.gov/33909660/
|
| [2] Can we predict the limits of SARS-CoV-2 variants and
| their phenotypic consequences?
| https://www.gov.uk/government/publications/long-term-
| evoluti...
| civilized wrote:
| I stand by my post. None of this says anything remotely
| implying what you claimed, that the vaccines pose a
| serious public health risk. That is purely your
| speculation, vaguely inspired by the content of the
| papers.
|
| Your contention that it matters whether the campaign is
| compulsory or not only takes you further from your
| supposed evidence base. It's not even in the same
| universe as what the papers are talking about, and is
| purely your own invention.
|
| I understand that you're worried about vaccine escape,
| but to go from that to "the vaccines are a serious public
| health risk" is a completely unwarranted leap.
| fitzroy wrote:
| I'm curious to know how much the reaction to the second or
| subsequent jabs correlates to antibody/immunity level. I had
| no reaction to the first jab and a 12-hour flu-like reaction
| to the second jab the next day (both Moderna).
|
| NOT having a similar reaction to a third booster would be
| concerning, but I wonder how much the reaction actually
| correlates with protection for shots beyond the first.
| belter wrote:
| Good question. I think the consensus is that the two things
| are not related. That is the reason I argued for
| vaccination and testing for immunity as a single combined
| action for each individual.
|
| "No, vaccine side effects don't tell you how well your
| immune system will protect you from COVID-19"
|
| https://theconversation.com/no-vaccine-side-effects-dont-
| tel...
| red_trumpet wrote:
| It's not just antibodies though. Vaccines also trigger you to
| get memory cells, which have a longer life span. So even if
| your antibody levels go down after ~6 months, and you might
| get infected again, your immune system will have a faster and
| more precise reaction, preventing a more severe course of
| covid.
| loosescrews wrote:
| Note that it appears that it is still unknown how likely
| breakthrough infections are to result in long Covid. The very
| limited data that does exist indicates that the likelyhood is
| rather high (~20%).
|
| https://www.nytimes.com/2021/08/16/well/live/vaccine-long-co...
| phkahler wrote:
| Isn't long Covid caused by damage from the spike proteins? In
| that case, repeatedly giving people the vaccine might do
| damage as well since it gets you to produce those spike
| proteins right?
| red_trumpet wrote:
| What's your source that spike proteins cause long covid?
|
| This article[1] says the cause of long covid is still not
| clear.
|
| [1] https://www.bbc.com/news/health-57833394
| nradov wrote:
| Long COVID isn't a distinct disease, it's just a vague
| label for a set of non specific symptoms. There is evidence
| that some cases are caused by re-activation of dormant
| Epstein-Barr virus infections.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/
|
| If proven correct that wouldn't be at all surprising. We
| already know that major stresses can sometimes reactivate
| EBV. It might be a good idea to also test all COVID-19
| patients for EBV.
| eecc wrote:
| orders of magnitude less though.
| undersuit wrote:
| The spike proteins allow Covid to enter your cell where its
| actual RNA coopts the cellular machinery of the cell to
| reproduce. After enough copies of the virus are assembled
| the RNA coopted cell is made to kill itself by self-lysis
| releasing the new viruses.
|
| The spike protein itself is not dangerous.
| singingfish wrote:
| I think it kind of is because it's got a similar binding
| affinity to heparin. Heparin is a first responder
| chemical in the immune system. Coopting a low level part
| of the immune system like that is rather more dangerous
| than if it were getting entry via some other mechanism.
| On the other hand I could be wrong about this.
| foldr wrote:
| Hundreds of millions of people have received vaccines
| that (either directly or indirectly) expose them to the
| spike protein in question, so clearly it can't be
| dangerous.
| irthomasthomas wrote:
| Long Covid has the same symptoms as stress, anxiety and
| depression, which are to be expected after contracting a
| pandemic level virus and being forced to isolate. Is there
| any proof yet that it is any more than that?
| monoideism wrote:
| Long covid often includes easily quantifiable issues such
| as lung and heart issues.
| logicalmonster wrote:
| This is roughly my theory on long-covid too.
|
| The social isolation, stress, lack of sun and exercise, bad
| diets, and other side effects of the hypochondriac society
| we now live in are largely responsible for what is called
| long-covid.
|
| I think lung damage found in some cases is likely fairly
| typical post-covid, but my theory is that this is common
| after any harsh illness involving the respiratory system
| whether it's cold/flu/covid, we just weren't looking for it
| nearly as often before.
| amznthrwaway wrote:
| Long covid also shows itself in lung function, with
| decreased vo2max, visible lung damage, etc.
|
| I am unsurprised that this disinformation was posted by a
| user who posts right-wing extremist propaganda nearly
| exclusively.
| TeMPOraL wrote:
| Stress, anxiety and depression don't show up as lung damage
| on MRI scans.
| nitrogen wrote:
| What are the stats on that, especially vs. other severe
| respiratory diseases?
|
| Asking because I've had "long covid" since long before
| there was a COVID, so either everyone's making a bigger
| deal out of it than necessary, or I'm actually much worse
| off relative to normal than I thought and I should really
| be questioning my doctors.
| Closi wrote:
| > Asking because I've had "long covid" since long before
| there was a COVID
|
| Well that isn't "Long Covid" then. Symptoms can come from
| a variety of causes, and just because you suffered some
| of the same symptoms unrelated to a Covid infection
| doesn't mean that others won't experience similar
| symptoms after Covid.
| nitrogen wrote:
| So what are the percentages of people who will have long-
| term symptoms from Covid, how does that compare in
| severity and frequency to other respiratory diseases, and
| if it wasn't something people cared about before Covid,
| why do they care now?
| polote wrote:
| Almost none of the 20% people mentionned had a MRI scan.
| So you don't answer the question.
|
| The problem of long covid studies is they don't have a
| control group, so it is easy to say wrong things.
|
| Its probably closer to 1-4% than 20%
| stakkur wrote:
| Current breakthrough rate in the US is .004%, including Delta.
| In fact, vaccines are generally working as well or better than
| expected against _all_ known variants.
| tunesmith wrote:
| "Selective pressure". I find this phrase really confusing,
| because I think people use it differently. I'm still trying to
| nail down my own knowledge about this, but here's the gist I
| have so far.
|
| Viruses are not like bacteria. Bacteria can mutate in direct
| response to antibiotics. Viruses cannot mutate in direct
| response to vaccines. Some people use "selection pressure" to
| describe what happens with bacteria and antibiotics. Others use
| it in a looser sense.
|
| Viruses mutate purely randomly. Now, if a virus happens to
| mutate in a way that escapes vaccines, _and_ if vaccinated
| people are more likely to party because they are vaccinated,
| then yes, you could argue the mutation has an advantage against
| other variants the vaccine has protected against, in a social
| sense. Some people use "selection pressure" in this sense,
| which I think causes confusion.
|
| So the more relevant question is, if a virus mutates in an
| unvaccinated person, and that mutation happens to have the
| ability to escape all current vaccines, then, can the virus
| spread faster in a 50% vaccinated community than a 0%
| vaccinated community?
|
| Answers as far as I can tell:
|
| - Arguably yes, if the 0% vaccinated community is so sick from
| other variants that they aren't out and about to get exposed to
| the new variant. But I think this answer is cheating and
| doesn't get to the heart of the question. So, control for
| population activity and assume that both the 0% and 50%
| populations have the same chance of being exposed.
|
| - If the 0% vaccinated community is infected with variants that
| can "crowd out" the newer mutation, then it could grow faster
| in the 50% vaccinated community. But I don't know if this is
| actually possible - I do know it's possible to catch multiple
| variants at one time, and I'd expect that _usually_ a mutation
| that is more fit in terms of escapability might also have
| fitness advantages with transmissibility.
|
| - If the mutation responded _to_ the vaccine, in a direct
| biological sense, then it would clearly grow faster in the 50%
| population since it wouldn 't have existed otherwise. But this
| is the scenario that not possible as I understand it, since it
| is based on a misunderstanding of how viruses work.
|
| I welcome any corrections from those who are more familiar with
| this.
| undersuit wrote:
| >Bacteria can mutate in direct response to antibiotics.
| Viruses cannot mutate in direct response to vaccines.
|
| What do you mean by this? Are you a Lamarckian?
| tunesmith wrote:
| I don't know what that is. Put a bacteria and an antibiotic
| in a petri dish, and the bacteria can evolve in a way that
| has greater antibiotic resistance. Put a vaccine in a petri
| dish with a virus, and nothing happens. Bacteria are living
| organisms. Viruses are not.
| doubleunplussed wrote:
| Viruses are subject to selection, mutation, and heredity.
| These are the three necessary ingredients to be subject
| to Darwinian evolution.
|
| Whether they're defined as "life" or not isn't really
| relevant.
|
| (Personally, I have a pet definition of "life" that just
| equates it to being subject to Darwinian evolution.
| Viruses not being defined as life never sat well with me)
| bingohbangoh wrote:
| How long do you think we'll be keeping up the mask wearing
| given that "more variants are inevitably coming?"
| jmfldn wrote:
| No idea, this is a deeply complex question that I'm not
| qualified to answer. I'm merely wondering out loud as a
| member of the public if we have our policy around this
| calibrated quite right.
| jimmaswell wrote:
| It has to end at some point, and for me and most other people
| where I live in the US, it mostly has.
| bingohbangoh wrote:
| I thought the same last summer.
|
| It's always "almost over" yet there's chatter of Lockdown
| 3.0 here in the tristate area.
| code_duck wrote:
| > it does seem like this virus is bucking the trend and not
| necessarily becoming less potent despite increased
| tranmissability in some variants
|
| I would think causing more severe symptoms is a disadvantage
| for a Covid strain in terms of selection, because people
| affected by such an illness are more likely to go into
| quarantine or a hospital, reducing transmission.
| johnchristopher wrote:
| From what I understand: Not if symptoms appear many days
| after the infection. Covid easily transmits when it's still
| in the upper part of the body. Once it gets into the
| chest/pulmonary and you start manifesting symptoms and it
| inflicts long lasting damages it has already contaminated
| others. What happens after that doesn't apply pressure to the
| virus to be less virulent or lethal.
| code_duck wrote:
| True. A longer asymptomatic incubation period is also an
| evolutionary advantage.
| rolph wrote:
| when reproduction[X] occurs before a selective factor[y]
| is in play, the selective factor has no first order
| influence on reproductive success.
|
| the theory of inverse relationship between severity of
| symptoms and transmissibility, is based on the idea that
| sick individuals spend more time laying in convolesence
| than interacting with other individuals.
|
| this mechanism goes out the window when the infection is
| transmissible before symptoms appear.
|
| this is the case with covid, i wish it was other than
| wishfull hoping but it isnt.
| mynameishere wrote:
| _a bit more_
|
| A bit more until the virus decides to go away? Or a bit more
| until they invent a non-leaky vaccine? Or a bit more like when
| the cows come home? Because that's what you are talking about.
| A bit more forever.
| TeMPOraL wrote:
| A bit more until, by combination of the virus mutating to
| less dangerous forms and everyone's immune system being
| primed against it, it settles somewhere between common cold
| and the flu.
| jmfldn wrote:
| Yes someone thing like this. Exactly where we draw the line
| now is the hard question. I don't think we're massively off
| the mark but I feel we could be proceeding a bit more
| slowly is all. I'm not advocating the reverse gear or
| massively changing course. We're not quite out of the woods
| is the point.
| CheezeIt wrote:
| It's already well outside the top causes of death among the
| vaccinated.
| dragontamer wrote:
| Lets start with "Lets be precautious until hospitals stop
| triage of care". Maybe we should be precautious until
| hospitalization levels return to something looking like
| normal.
|
| https://www.washingtonpost.com/health/2021/08/16/joel-
| valdez...
|
| > Man shot 6 times waits more than a week for surgery after
| hospital is overwhelmed by covid
|
| ---------
|
| When our hospitals are full, we should be cautious. When our
| hospitals empty out, we can open up a bit more. This
| obviously is location-dependent (and higher-vaccinated areas
| can afford to open up more).
|
| But the absolute goal in every location is to keep hospitals
| functioning, and the relative stress levels of doctors /
| nurses at a reasonable level. I know in my state, we've been
| having to employ student nurses before they've graduated, so
| that there's enough staff around.
|
| As long as hospitals feel the need for emergency measures, we
| need to be precautious and doing what we can to clamp down on
| the sickness.
| tasogare wrote:
| > The point is that it does seem like this Delta variant breaks
| through regularly and it does seem (again, purely anecdotal)
| like it's v infectious. Of course the thing to emphasise is
| that, whilst it might break through, the vaccine still stops
| serious illness to a high degree.
|
| If numbers from IHU Mediterranee are to be believed, the Indian
| variant is about 6 times less dangerous than the English one.
| Way more infectious and less dangerous, the latter part helped
| mutating it to the former. And that's the numbers without
| taking vaccination into account.
|
| I wish medias would relay the information fully instead of
| spreading fear by only telling about the more infectious part.
| If indeed less dangerous this is a very good news that this
| strain is spreading more.
| pama wrote:
| Assuming that all of Florida has the delta variant, right now
| 53% of all adult ICU patients is with COVID-19, and the total
| people in hospitals with COVID is about 79 per 100K. So I
| don't understand why anyone thinks this variant is less
| dangerous. https://www.fha.org/covid-19.html
| johnchristopher wrote:
| > IHU Mediterranee
|
| I'd wait a bit for someone else to provide a second opinion
| considering Raoult track records regarding covid.
| hutzlibu wrote:
| I see the sentiment here expressed, that Covid is far from over.
| To be honest, I stopped following news since being fully
| vaccinated some time ago, so I am kind of ignorant here.
|
| Is the main problem, the unvaccinated, or that the Delta (and
| co.) variants are still, too dangerous for vaccinated people? Or
| is it the fear, that they will get more dangerous?
| Filligree wrote:
| > Is the main problem, the unvaccinated, or that the Delta (and
| co.) variants are still, too dangerous for vaccinated people?
| Or is it the fear, that they will get more dangerous?
|
| Lots of problems.
|
| - The virus causes serious sequela; people who have been
| infected may have life-long damage, and some of that damage
| looks really bad. There's little correlation between severity
| of the initial infection and severity of the damage, so we
| don't know if vaccines help either.
|
| - Not all people can be vaccinated. Young children can't be
| (their immune systems don't work the same way), people with
| some other underlying diseases can't be, etc. It's by no means
| just anti-vaxxers who are at risk.
|
| - People aren't dying enough. Historically, this sort of
| pandemic only ended once the people who were genetically at
| risk had all died, and we're not letting that happen. Now, to
| be _very clear_ : I'm not saying we should!
|
| - Having a vaccinated population intermingling with an
| infections population means there's immense pressure on the
| virus to evade those vaccines. Many of the means by which it
| might do so will make it far more deadly to anyone who _isn 't_
| vaccinated; Delta, for example, has adopted 'human wave
| tactics' to overwhelm the antibodies.
|
| However, this does mean that history is a poor guide to what
| might happen.
|
| Viruses don't generally have any reason to want their hosts
| dead, but there's also little evolutionary pressure for having
| that _not_ happen.
|
| We're helpfully adding pressure that's well suited to make it
| more deadly. Yay.
| red_trumpet wrote:
| Kind of a combination of Delta and unvaccinated. Delta is more
| infectious than previous variants., which means that we need
| more vaccinated people to reach herd immunity.
| sreque wrote:
| The main problem is that the U.S. federal government in
| particular has been pretending for a while that we can get to
| zero COVID, then blaming the unvaccinated when it doesn't
| happen. First, they said we need 50% vaccination to achieve,
| herd immunity. Then 60%. Then 70%. Then 80%. When things don't
| work out, they vilify and blame the unvaccinated.
|
| In reality, unvaccinated with natural immunity are likely more
| protected against the virus than the vaccinated. Israel's
| vaccination rates are among the highest in the world, and
| they've suffered the same delta outbreak as everyone else.
| Further, Israel has the most accurate and comprehensive data to
| date, and their numbers clearly show the naturally-immunized
| outperforming the vaccinated during their delta wave. They've
| since resorted to giving 3rd booster shots to the most
| vulnerable to compensate.
|
| https://arieh.substack.com/p/inside-israels-delta-outbreak-p...
|
| https://abcnews.go.com/Health/wireStory/israel-delivers-boos...
|
| The real issue is that COVID is likely going to become endemic,
| and at some point the world needs to face this and move on.
| Unfortunately, our politicians have been lying to us and using
| COVID as a tool to gain political power for so long, that they
| are unwilling to admit they were wrong and to steer us in the
| right direction. The best we can do is elect these people out.
| cmrdporcupine wrote:
| You were (legitimately) attacking my numbers elsewhere but
| here you are posting completely inaccurate information.
| Israel is nowhere close to "90%" vaccinated. Haaretz from 4
| days ago reports them at 78%: https://www.haaretz.com/israel-
| news/israel-vaccine-data-how-...
|
| Given the vaccine is not approved for people under 12,
| there's no way it could be 90%, as 28% of their population is
| 0-14 years old: https://en.wikipedia.org/wiki/Demographics_of
| _Israel#Age_str...
| sreque wrote:
| I misremembered. It was 90% of people over 50 that were
| vaccinated. It's in the article I linked. But I don't think
| that discredits my main point, that increased vaccination
| rates aren't going to eliminate the virus entirely and that
| natural immunity is actually doing better.
| cmrdporcupine wrote:
| Here in Canada "natural immunity" would only cover maybe
| 4-5% of the population. Official testing numbers of total
| cases in Ontario since the pandemic began put it at 3.7%
| here (though it's likely a bit higher because of bad
| testing during first wave.)
|
| Maybe in some US states where the disease was horribly
| mismanaged that number is much higher, but it's a) not
| reliably counted b) badly researched. Knowing whether
| someone is "naturally immune" is a big roll of the dice,
| whereas we know for sure when someone is vaccinated.
|
| And to get to a high "natural" immunity rate requires
| unnecessary death and suffering.
|
| But yes, half of the 18-29 year olds here seem to be
| rolling the dice and playing this "natural immunity"
| game; which is why they are now the vast majority of
| hospital admissions for this disease.
| sfink wrote:
| Your numbers are wrong (see other responses for why.)
|
| The herd immunity figure (1) legitimately changed with the
| variants, and (2) is always going to be a shot in the dark so
| personally I don't find much point in paying attention to
| government figures anyway. Government is providing figures to
| achieve an outcome; it's fundamentally a policy tool. If you
| want the science, listen to scientists.
|
| The delta variant is currently overwhelming a large number of
| hospitals, and it wouldn't have done so with higher
| vaccination rates. Whether or not you view that statement as
| vilifying unvaccinated people is beside the point.
|
| If it is going to become endemic, and there are very good
| arguments that it will, then I agree that we'll need to move
| on. But "moving on" != "ignoring". Flushing the existing
| vaccines down the toilet and letting the cards fall as they
| may is not a winning strategy, yet that's exactly what 40% of
| the US population is presently choosing.
|
| "Moving on" means treating it like chickenpox or at least the
| flu. Not like meteor strikes.
| sreque wrote:
| I misremembered the numbers but if you click to the linked
| analysis the numbers are correct there.
|
| As to the delta variant overwhelming hospitals, that's
| partially because hospitals are firing nurses that won't
| get vaccinated. The lack of beds is primarily a staffing
| problem and hospitals are shooting themselves in the foot.
| I've also heard they have been underpaying nurses and some
| are just quitting or switching to better-paying contract
| work.
|
| Second, the media and even some hospital administration
| officials are blatantly deceiving people on actual hospital
| status: https://www.dailysignal.com/2021/08/06/fact-
| checking-4-claim...
|
| There's a whole section there debunking the claims, for
| instance, that hospitals in Florida are overwhelmed.
|
| I don't think anyone thinks that "moving on" means
| forgetting, but I do think it does entail having the
| government get out of the business of mandating lockdowns,
| masks, or vaccines. The problem lies in the fact that the
| media were too successful in scaring people to death about
| COVID. It makes handling the virus in a sane way impossible
| without negative political fallout.
| criticaltinker wrote:
| > it wouldn't have done so with higher vaccination rates
|
| That is the rhetoric that Fauci and others have been
| pushing, but the scientific literature is accumulating
| mounting evidence that counters the claim. Not to mention
| the data out of Israel - which has one of the highest
| vaccination rates in the world - is also strong evidence
| against your claim. Israel is struggling with overwhelmed
| hospitals due to variants reducing the efficacy of
| vaccination and also naturally acquired immunity.
|
| FWIW I'm keeping an open mind, please cite primary sources
| to support your claim and I will happily consider them.
| tomrod wrote:
| Please share some scientific citations showing natural
| immunity gives better protection than vaccines. This runs
| counter to what I'm hearing from my virologist sources.
| kriskrunch wrote:
| Here are a couple of preprint studies that show naturally
| acquired immunity provides protection.
|
| https://pubmed.ncbi.nlm.nih.gov/33948610/
|
| https://pubmed.ncbi.nlm.nih.gov/33907755/
|
| Meanwhile the CDC published this study showing the
| opposite:
|
| https://www.cdc.gov/mmwr/volumes/70/wr/mm7032e1.htm?s_cid=m
| m...
|
| I can understand why people are confused.
|
| There appears to be two camps, one that believes that
| science can defeat this disease, and in the other camp
| people that believe we need to learn to adjust to our new
| reality.
|
| I don't understand how a man made vaccine can provide
| better protection to the virus better than my body after
| recovering, but I'm not specialist.
|
| Aren't the pharmaceutical companies financially
| incentivized to provide minimal protection, and annual
| booster shots? Why would they make something better?
|
| As long as fear navigates our course, we won't see an end
| to this.
| sreque wrote:
| It really depends on the virus. For some viruses, the
| vaccines are far more effective and less risky and have
| helped eliminate or mostly eliminate the virus entirely.
| For other viruses, vaccines are far less effective.
|
| The Israel data is clearly showing natural immunity doing
| better for COVID, and every other peer-reviewed study I
| have seen shows natural immunity doing "at least" as well
| as vaccinated immunity.
| criticaltinker wrote:
| There is no scientific consensus that naturally acquired
| immunity gives better protection than vaccines.
|
| Two facts that are trending toward consensus in the
| scientific literature:
|
| A) Naturally infected individuals who recover will acquire
| robust and durable immunity [1][2]
|
| B) Natural infection induces an immune response that is
| mostly similar but slightly different than the immune
| response induced by vaccination. The primary differences
| can be summarized as: naturally infected individuals have
| nucleocapsid protein antibodies whereas vaccinated
| individuals do not, and vaccinated individuals have an
| immune response highly targeted toward the spike protein
| RBD. [3][4][5]
|
| In summary many people hypothesize that natural infection
| is better because it induces a broader and more balance
| antibody response, but the literature has not established
| consensus that this is necessarily "better" in terms of
| health outcomes for individuals.
|
| [1] SARS-CoV-2 infection induces long-lived bone marrow
| plasma cells in humans
| https://www.nature.com/articles/s41586-021-03647-4.pdf
|
| [2] Longitudinal analysis shows durable and broad immune
| memory after SARS-CoV-2 infection with persisting antibody
| responses and memory B and T cells
| https://www.cell.com/cell-reports-
| medicine/fulltext/S2666-37...
|
| [3] Rapid induction of antigen-specific CD4+ T cells is
| associated with coordinated humoral and cellular immune
| responses to SARS-CoV-2 mRNA vaccination https://www.cell.c
| om/immunity/fulltext/S1074-7613(21)00308-3
|
| [4] Distinct SARS-CoV-2 Antibody Responses Elicited by
| Natural Infection and mRNA Vaccination
| https://www.biorxiv.org/content/10.1101/2021.04.15.440089v4
|
| [5] Antibodies elicited by mRNA-1273 vaccination bind more
| broadly to the receptor binding domain than do those from
| SARS-CoV-2 infection
| https://pubmed.ncbi.nlm.nih.gov/34103407/
| tunesmith wrote:
| That first paragraph really isn't fair because R0 has
| changed. So of course scientific opinion has changed. That's
| not same thing as pretending and then vilifying.
|
| Your second paragraph is eliding a lousy "therefore" -
| obviously, the cost of shooting for natural immunity versus
| vaccination is that you have to experience the actual disease
| and all its risks. Survivorship bias.
| rajin444 wrote:
| Scientists are allowed and should be allowed to say "the
| data changed, so our recommendation changed". Politicians
| and health leaders have a responsibility to interpret the
| data and develop communications and policies that build
| trust and inform the public. It's a failure on the part of
| the latter when they make promises to the public that they
| know are not guaranteed.
|
| They have made definitive statements that are wrong too
| many times in the past year and a half. That is a massive
| failure. The average joe has nowhere near the time nor
| expertise required to interpret the scientific data out
| there, so trust is everything for them. At some point, you
| run out of the good will required to say "ok, I'll trust
| you again". Maintaining trust is a leader's most important
| job.
| tshaddox wrote:
| Personally I think the real problem with COVID is that it is
| a disease which kills many people and harms many more, not
| that some people supposedly vilify unvaccinated people.
| kriskrunch wrote:
| Why not fight heart disease with this voracity, since it
| kills more people?
| tshaddox wrote:
| What fight, and what voracity?
| bonzini wrote:
| There's not a single heart disease, and a lot of
| cardiovascular issues are caused by bad habits rather
| than infectious pathogens.
| kriskrunch wrote:
| That's the reasoning used to vilify unvaccinated people,
| which is my point. Cheers
| Florin_Andrei wrote:
| > _I stopped following news since being fully vaccinated some
| time ago_
|
| You're mostly fine, but you should not get disconnected
| completely from the news.
|
| Vaccine efficacy seems to wane slowly (faster for old people).
| Probably before the 1 year mark you should get a booster shot.
|
| The Delta variant is skewing some of the initial estimates, for
| the worse.
|
| The odds that you will catch the virus but have no symptoms or
| repercussions are still rather substantial, but definitely less
| than 50% (estimates vary). So there is a chance that you can
| still transmit it. Please wear a mask indoors in public places.
| sfink wrote:
| I disagree.
|
| Before Delta, it was reasonable to resume almost all
| activities after being fully vaccinated.
|
| I don't believe that is true any longer. There are too many
| breakthrough cases, presumably driven by a much higher viral
| load that can overwhelm defenses. (The figures I have seen
| are 1000x _in the upper respiratory tract_ of infected
| people; I haven 't been following well enough to know what
| the increase is in actually expressed viruses. But it's going
| to be a lot, and viral load has proven to be a very
| significant factor for transmission.)
| Florin_Andrei wrote:
| Well, I made no predictions for the future. :)
|
| Vaccinated people are still mostly fine, even with Delta.
| You just don't get the close to 100% protection against
| severe disease, it's a little lower than that. It's still
| pretty good protection against severe cases (talking about
| mRNA vaccines).
|
| What's clearly disappointing is that the vaccines are not
| very good at preventing Delta from spreading. I have not
| seen good estimates, but the numbers floating around seem
| to indicate the vaccines (again, mRNA) are still at least
| 50% effective against spread, but nowhere near 100%. That's
| the biggest gap right now.
|
| It is true that viral loads are orders of magnitude higher
| with Delta. That is still compatible with all the
| statements above.
| sfink wrote:
| Sorry, I was only disagreeing with the summary "You're
| mostly fine [because you are fully vaccinated]". I agree
| with everything else you said. My only disagreement is
| that I read "you're mostly fine" implying that it's still
| ok to resume (or in this case continue) regular
| activities. In my opinion, that is definitely no longer
| true if you live in or near an area with overburdened
| hospitals, and at the very least changes your
| calculations in other areas because it's again important
| to reduce transmission.
|
| Before Delta, I felt like reducing transmission was good
| but not that important compared to the disadvantages of
| isolation. Delta shifted the tradeoff back in the other
| direction. How much is debatable, but personally I feel
| that quite a few activities that were ok, aren't anymore.
| I'm definitely still doing more than pre-vaccination,
| though.
| Covzire wrote:
| For most people I know, other than mask requirements when going
| out certain places and the constant fear mongering on TV,
| COVID-19 is completely over and their lives are back to normal,
| complete with in person graduation parties this summer, going
| to ball games, family gatherings like it doesn't exist, etc.
| Other than both my parents last year (who recovered, didn't
| need hospitalization but were very ill for 2 weeks) I don't
| know anyone who has gotten seriously ill from it since.
| Steltek wrote:
| For a balanced perspective and as a parent of ineligible
| children about to enter a new school year, Covid is far from
| over! We have no idea how long our school will be open or if
| we'll need to split attention between work and quarantined
| children at home. Similar to the evaporation of empathy for
| unvaxxed people who are admitted to the hospital, I'm
| concerned about a similar fatigue of tolerating working
| parents who are still partying like it's 2020, except we have
| no choice in the matter.
| bcrosby95 wrote:
| I have a friend that is an ER nurse that works at Cedars and
| she's ready to quit because of the attitude that "covid is
| over". She loves her job and helping people but the shitty
| attitudes of patients and people in general over this issue
| have caused her to rethink her life choices.
| tomrod wrote:
| (1) vaccinated people who get infected can infect others (this
| wasn't common before Delta)
|
| (2) Kids aren't being vaccinated, and masks have become
| political despite being the cheapest non-pharmaceutical
| intervention when most or all are masked (versus costs of
| shutting down, increasing ventilation, etc.). Some others also
| cannot be vaccinated due to health issues or availability (not
| in the US, it's widely available)
|
| (3) most, but not all, hospitalizations are among the
| unvaccinated.
| cmrdporcupine wrote:
| So here in Ontario where we're @ about 65% of the population
| totally vaccinated, today's new cases.
|
| Source: https://data.ontario.ca/dataset/covid-19-vaccine-data-
| in-ont...
|
| 10.25/100k among people who are unvaccinated. 6.5/100k among
| people who are partially vaccinated. 1.0/100k among people who
| are fully vaccinated.
|
| For hospitalization:
|
| 2.04/100k for unvaccinated, 1.11/100k for partially, 0.21/100k
| for vaccinated.
|
| For current ICU status:
|
| 1.6/100k for unvaccinated, 0.7/100k for partially, 0.05/100k
| for vaccinated.
|
| So basically the vaccines are really good, even against Delta.
| The disease is spreading primarily among the unvaccinated. And
| even those who get it who are vaccinated are on the whole not
| getting very sick.
|
| EDIT: For those wondering about natural immunity: only 3.67% of
| the Ontario population is counted as having had COVID, so I
| doubt it's a significant influence on those statistics.
| Granted, the first wave had poor testing, so I'm sure the
| number is a little higher, but I doubt it's more than 5%.
|
| _EDIT: disregard the below comment about 10% ending up ICU; is
| incorrect because I was comparing the incremental new case
| count against current ICU status. I 'll try to fix the # in a
| bit._
|
| But what's kind of crazy is seeing that those numbers seem to
| be saying that among the unvaccinated who get it that almost
| 10% of them are ending up in ICU. And when you consider that
| those are probably overwhelmingly _young people_ (here 92% of
| seniors are fully vaccinated and 95% at least one dose) that 's
| scary.
| seaman1921 wrote:
| thank you for the numbers!
|
| But i think you got them wrong > 10.25/100k among people who
| are unvaccinated that should be 10.25k - so your statement at
| the end about 10% ICU admissions does not hold.
| seaman1921 wrote:
| and honestly given this huge error in your statement, I
| have lost confidence in your entire comment unless you are
| willing to share the source.
| pfyon wrote:
| The source is provided in the second paragraph.
| sreque wrote:
| That should be a clue that something is wrong with your
| numbers. 10% of unvaccinated people getting COVID are
| absolutely not ending up in the ICU. It's not even remotely
| close.
|
| Also, as good as the vaccines are against delta, natural
| immunity is doing even better: https://www.msn.com/en-
| us/health/medical/dr-makary-says-natu...
|
| https://www.deseret.com/coronavirus/2021/7/20/22584134/whats.
| ..
|
| https://arieh.substack.com/p/inside-israels-delta-
| outbreak-p...
| [deleted]
| cmrdporcupine wrote:
| I'm counting ICU admissions among the unvaccinated
| separately, not against the population as a whole. When you
| consider that the majority of the population (65% total,
| 80% eligible) is vaccinated, then you have to separate the
| two groups because the outcomes are totally different.
|
| But I did spot something wrong with the way I'm counting,
| so yes the 10% is probably wrong. The reason is that the
| daily new case count given by the province is incremental,
| while the ICU count is current # of cases, not new
| admissions. So it's not possible to do the comparison in
| this way. I'd have to take a look at the current active
| case count by vaccination status, which is something I
| don't think the province is reporting.
| sreque wrote:
| Your biggest problem is that your data isn't accurate.
|
| The page notes that it's case count isn't necessarily
| correct. This page shows the total case delta at 650 for
| today versus yesterday:
| https://covid-19.ontario.ca/data/case-numbers-and-spread
|
| Whereas the spreadsheet from your page says 426. It's not
| even clear to me that the 650 number is accurate because
| not everyone may necessarily be reporting they have
| COVID. I know when my whole family got COVID we didn't
| report it to the government. I've seen estimates in the
| U.S. that actual case count is more than double reported
| case count: https://www.cidrap.umn.edu/news-
| perspective/2021/07/us-covid...
|
| Secondly, ICU case counts are based on people who are in
| the ICU and happen to have COVID, not people who are in
| the ICU primarily because of COVID. So for yesterday the
| delta in ICU COVID case count was 15, but we don't know
| how many of those net new 15 are actually in the ICU for
| COVID symptoms primarily.
|
| So taking the raw numbers for yesterday's delta, that's
| 15 / 650 as a rough estimate (dividing the deltas isn't
| really what we want but it's the best I can come up
| with), and that lands us at 2.3%. I also believe that
| number is far too high for the other reasons outlined
| above.
|
| For comparison, the numbers here seem to indicate a 5%
| chance of hospitalization for the unvaccinated:
| https://www.wbay.com/2021/08/19/covid-19-wisconsin-dhs-
| compa...
|
| They give no ICU numbers, so we can expect the ICU odds
| to be closer to 2% again, and their data suffers from the
| same problems.
| cmrdporcupine wrote:
| Not sure which spreadsheet you're talking about, the page
| I linked to has a series of feeds, and if you download
| today's CSV and sum all 4 case count columns it adds up
| to 650. 426 is the unvaccinated count. 650 is the count
| of all cases. Date covid19_cases_unvac
| covid19_cases_partial_vac covid19_cases_full_vac
| covid19_cases_vac_unknown 2021-08-20 426 64 103 57
|
| BTW, it's not "my page"; it's the official gov't of
| Ontario COVID data API. It's where the other link you
| pasted gets its data. There's another feed that provides
| just testing numbers, but doesn't break down by
| vaccination status. It also reports yesterday as 650. So
| the two accord.
|
| But please, go on. "Your biggest problem" is that you
| don't read. Just like the 90% in Israel stuff.
| tux1968 wrote:
| > The disease is spreading primarily among the unvaccinated.
|
| What is the evidence for this? Vaccinated people are capable
| of spreading the disease just as easily as those who aren't.
| And since they're much more likely to be asymptomatic, may be
| more likely to spread the disease unknowingly.
|
| Those without the vaccination are more likely to end up in
| hospital, but that says nothing about how the disease is
| actually being transmitted.
| cmrdporcupine wrote:
| I never said "spreading _from_ the unvaccinated " I said
| "spreading _among_ the unvaccinated " which is borne out by
| the fact that the unvaccinated (and partially vaccinated)
| here are only 35% of the population (25% of the eligible
| population) but are _75%_ of the daily new case count (and
| perhaps higher because there 's a % with unknown
| vaccination status)
| tux1968 wrote:
| How are case counts determined? Why would someone who has
| no symptoms go for testing? Case counts among the
| vaccinated are surely being under reported because
| they're asymptomatic.
| robertoandred wrote:
| The vaccinated may be just as capable of spreading covid,
| but they're less likely to be infected in the first place.
| tux1968 wrote:
| The vaccinated are not less likely to be infected. The
| vaccine can not stop infection, it can only help your
| body fight off the effects of infection.
| [deleted]
| tunesmith wrote:
| This is the best article I've recently read that describes what
| is currently going on:
| https://www.theatlantic.com/health/archive/2021/08/delta-has...
|
| (Pulitzer Prize winner for science communication)
| TeMPOraL wrote:
| Thanks for the link! Lots of interesting details in there.
| I'll attempt a TL;DR of points most relevant for non-
| Americans (but please check the article for context,
| particularly on numbers, and link to sources):
|
| - Delta variant has ridiculously high R0 - estimated to be
| between 5 and 9, where initial COVID-19 variants had it
| around 2 to 3.
|
| - Viruses spread nonuniformly. Old COVID-19 (R0 = 2-3) tended
| to spread through super-spreading events (few people
| infecting a lot more at a time). R0 of 5-9 implies Delta
| variant doesn't need super-spreading events.
|
| - This R0 value also means it's not possible to eradicate the
| virus through vaccination or herd immunity - it's going to
| become endemic (which was always seen as a likely outcome
| anyway).
|
| - Current vaccines have proven to be effective against the
| Delta variant, by significantly reducing infections (0.01% to
| 0.29% chance of breakthrough disease), such infections
| showing symptoms (~88% percent effective) and severity of
| those symptoms if they show up, as well as preventing
| hospitalization (~96% effective against Delta; >95% of all
| COVID patients in US hospitals are unvaccinated).
|
| - There is evidence that vaccinated people can still transmit
| Delta, even if themselves they don't show symptoms. As
| expected, the virus seems to live shorter in the airways of
| vaccinated people.
|
| - Above and high R0 mean Delta can spread even through
| highly-vaccinated communities.
|
| - Individually, for those who can get a shot, it's the best
| thing to do. Community-wise, we still need other precautions
| - like mask, widespread testing, hygiene, improvements in
| ventilation, to protect the vulnerable and slow the spread.
|
| - Vulnerable groups now include children under 12 - they're
| not eligible for vaccination, and there's a growing (though
| still small) amount of children suffering from long-COVID and
| MIS-C.
|
| - The end goal is still to slow the spread, to keep schools
| open and hospitals running, prevent healthcare personnel
| burnout, give time to develop better countermeasures and
| therapies, and let the economy slowly recover (instead of
| repeating 2020). Slowing the spread down also gives the virus
| less chances of mutating into a more problematic variant.
| colordrops wrote:
| What is the delta variant R0 in fully vaccinated
| communities though? Certainly it's not in the range of 5 to
| 9. If it's something like 2, then sure, a mask mandate
| makes sense for everyone. But if it's much lower than 1,
| then is it fair to force the vaccinated to wear masks? Is
| this sort of information hidden from the public because
| officials are too cowardly to force vaccine passports?
| There are so many information gaps like these that leave
| room for doubters.
| tunesmith wrote:
| You can figure it with math. Given a starting R0, a
| vaccination level, and an efficacy, you can figure
| effective Rt:
|
| Rt = R0 * (1 - (vacRate * effRate))
|
| So if Delta R0 is 6, a community is 65% vaccinated, and a
| vaccine is 80% effective against transmission, then
| effective Rt would be:
|
| Rt = 6 * ( 1 - (.65 * .8)) = 2.88
|
| Real effective Rt includes impact of mitigation levels
| and natural immunity. So for instance, in Portland OR, Rt
| is about 1.4. We didn't get hit as hard as surrounding
| states in the first few rounds, so we don't have as much
| natural immunity. In contrast, Seattle got hit harder
| early on; their effective Rt is a little lower - and
| Silicon Valley is actually pretty close to 1 right now.
| tunesmith wrote:
| One clarification - between 0.01% and 0.29% (actually 0.54%
| now) of fully vaccinated people are affected by
| breakthrough infection, while 88% effective means in a
| situation where an unvaccinated person would become
| infected, the vaccinated person would have an 88% chance of
| not being infected. So the difference between the two is
| exposure, which is a function of prevalence.
| walterbell wrote:
| Since the deadliest virus mutations kill their hosts, weaker
| virus mutations can spread (without killing their hosts) more
| quickly.
|
| US deaths peaked in January 2021, before Delta became prevalent
| in the US, _before_ substantial vaccination,
| https://www.worldometers.info/coronavirus/country/us/#graph-...
|
| US daily vaccines peaked in April 2021,
| https://ourworldindata.org/grapher/us-daily-covid-vaccine-do...
|
| India (origin of Delta) deaths peaked in May 2021, when their
| vaccination rate was less than 5%,
| https://www.worldometers.info/coronavirus/country/india/#gra...
| redisman wrote:
| Deaths are down because we vaccinated all the old people who
| were dying in the first waves
| monocasa wrote:
| Deaths are climbing again in the US and are expected to be
| above where they were the same time last year within a couple
| weeks.
| veemjeem wrote:
| It's still lower than the peak of 3300 (7-day average)
| during the winter season, and that's when we had 250k cases
| daily. We're almost at 150k daily cases, but with only 1k
| daily deaths. At least based purely on numbers, the CFR is
| lower. The CFR is lower because most of the infections are
| happening in younger people.
| shreddit wrote:
| Why would you vaccinate a dead person?
| bregma wrote:
| They're less likely to refuse on political grounds.
| RC_ITR wrote:
| We vaccinated all the old people, who were the population
| most at risk for death the first time.
| erokar wrote:
| Delta-infected patients seem to be 1.8 times more likely to be
| hospitalised, compared to Alpha-infected patients [1]. Since
| the covid virus takes two weeks plus to kill its host and also
| spreads while the host is asymptomatic, there really isn't much
| selective pressure to make it less deadly. So far
| infectiousness and severity of disease has gone hand in hand
| with this virus.
|
| 1. https://www.bloomberg.com/news/articles/2021-07-23/what-
| make...
| tandem5000 wrote:
| > 1.8
|
| What's the confidence interval?
| walterbell wrote:
| _> Early data from Scotland indicated that delta-infected
| Covid patients were 1.8 times more likely to be hospitalized
| than those with an alpha infection. Other U.K. data support
| the increased risk of hospitalization but do not provide
| clear evidence that delta patients experience more severe
| illness once in the hospital._
|
| How do hospitals identify individual patients infected by
| Alpha, Delta or other variant?
|
| Do they perform genetic sequencing of a virus sample from
| each patient, to determine what mutations are present? If
| they are doing statistical sampling, what percentage of
| patients are being sampled for variant identification?
|
| It would helpful to have variant-specific numbers of cases
| and deaths added to national data, so that accurate graphs
| can be drawn for each variant. More granular data would
| support data analytics of local, variant-specific, policy
| interventions, to evaluate cause-effect on local health
| metrics.
| jryb wrote:
| Last I checked the US was sequencing about 1% of patients.
| In the Houston Methodist hospital system, they sequenced
| the viral genomes of 56% of patients, which they estimate
| is about 4% of Covid cases in the Houston metropolitan
| area: https://www.sciencedirect.com/science/article/pii/S00
| 0294402...
|
| Of course, there is a sampling bias there for variants that
| result in hospitalizations.
|
| Variant-specific proportions can be found here:
| https://covid.cdc.gov/covid-data-
| tracker/?ACSTrackingID=USCD...
| mellavora wrote:
| genetic sequencing is pretty cheap these days.
| walterbell wrote:
| Is it to the price level (e.g. under $1K) where an
| individual patient could pay a lab to sequence their own
| virus sample?
|
| How about the cost of sequencing one drop of the vaccine
| vial they received, as a quality control sample of the
| distribution supply chain?
| bhickey wrote:
| > Is it to the price level (e.g. under $1K) where an
| individual patient could pay a lab to sequence their own
| virus sample?
|
| Sure. It'll run under $50 in bulk. Less, but not that
| much less, if you're only interested in sequencing the
| spike.
|
| > How about the cost of sequencing one drop of the
| vaccine vial they received, as a quality control sample
| of the distribution supply chain?
|
| This isn't a useful quality check. A negative result
| implicates your field assay rather than manufacturing.
| walterbell wrote:
| Thanks for the pricing.
|
| _> This isn 't a useful quality check. A negative result
| implicates your field assay rather than manufacturing._
|
| What if there were multiple samples of the same lot
| number, collected in different geographical regions at
| different times?
| nradov wrote:
| Generally hospitals don't test for specific variants.
| Instead they forward a sample subset of patient specimens
| to regional or national infectious disease centers which
| then perform genetic sequencing. That way we can monitor
| the spread and evolution of variants.
|
| https://covid.cdc.gov/covid-data-tracker/#monitoring-
| varaint...
| jamespwilliams wrote:
| See https://www.gov.uk/government/publications/covid-19-var
| iants...
| cogman10 wrote:
| Not every nation does this, mostly only the ones with
| socialized medicine are.
|
| For nations like the US, we are measuring the variant by
| looking at sewage. It doesn't tell us anything about who
| ends up hospitalized, but it does give us a good indication
| of what the is the common variant in a community (and
| inferences are drawn from there).
|
| The UK has been doing probably the most covid genome
| sequencing of any nation.
| walterbell wrote:
| Thanks, good to know. Would be interesting if the UK also
| measured variants via sewage, as a methodological
| comparison against their more expensive individual
| sequencing.
| quarterdime wrote:
| "Since the deadliest virus mutations kill their hosts, weaker
| virus mutations can spread (without killing their hosts) more
| quickly."
|
| The problem with the SARS-COV2 virus is that infected
| individuals are infected before they're symptomatic, let alone
| dead. Thus there is no evolutionary pressure that would make
| this virus less lethal, as is the case for viruses that kill
| their hosts early in the course of infection.
| walterbell wrote:
| What are some good references on asymptomatic transmission?
|
| Early 2020 reports of asymptomatic transmission from South
| Korea were later retracted. There was a contact tracing study
| of 10 million people in Wuhan which found no asymptomatic
| transmission.
| caddemon wrote:
| Unfortunately I think the media has really mixed up the
| words "presymptomatic" and "asymptomatic". You're right
| there is little evidence that people who never develop
| symptoms can spread COVID. But it seems likely that COVID
| can be spread up to 48 hours before symptoms develop, which
| still presents roughly the same problem.
|
| Here is a paper looking at viral shedding over time in
| COVID patients:
| https://www.nature.com/articles/s41591-020-0869-5
|
| I also anecdotally know a few different people who caught
| COVID from someone who felt fine at the time they
| interacted, so I'm quite confident it is possible, although
| I'm not sure I'd make a strong statement about the
| prevalence.
| FooHentai wrote:
| There are some confounding factors to that though, I think?
| Infectivity post mortem (as seen with plague) and time lag
| between infectivity and symptoms appearing allowing for longer
| periods of asymptomatic transmission. Both variables that mean
| the spread of a mutation and it's lethality need not be linked.
| walterbell wrote:
| Mass distribution of non-sterilizing vaccines which reduce
| symptoms (via blood/serum antibodies) but don't prevent
| infection and transmission (lack of nasal/mucous antibodies)
| can increase spread of variants that would otherwise cause
| symptoms and self-isolation of the infected person.
| bhickey wrote:
| This is not a credible concern.
|
| Vaccination reduces the infection rate. Among vaccinated
| individuals who suffer breakthrough infection the time at
| peak viral load is significantly reduced.
| walterbell wrote:
| Could you recommend a good reference on the time interval
| for peak viral load in infected vaccinated people?
|
| CDC recommends testing of vaccinated people, since they
| can be infected and the vaccine suppresses symptoms, so
| they won't know to self-isolate,
| https://www.webmd.com/lung/news/20210729/cdc-reverses-
| guidan... (July 29, 2021)
|
| _> Even if they're not showing symptoms, fully
| vaccinated people should "get tested 3-5 days after
| exposure to someone with suspected or confirmed COVID-19
| and wear a mask in public indoor settings for 14 days
| after exposure or until they receive a negative test
| result," ... "Our updated guidance recommends vaccinated
| people get tested upon exposure regardless of symptoms,"
| CDC Director Rochelle Walensky, MD, told The New York
| Times_
| tehjoker wrote:
| Is there any information on what the upper bound might be on the
| infectivity of SARS-CoV-2? I think a lot of people just assume
| one big jump consumes most of the range, but we've seen at least
| three big jumps so far ("Doug", "Alpha", and "Delta").
| toiletaccount wrote:
| i was wondering this the other day.
|
| the next big mutations may not be more infectious because they
| can survive outside the body longer, but because they get
| around existing immunity or theres a longer asympomatic-but-
| still-transmissible phase. theres a lot of different paths this
| could take to mass infection.
| tehjoker wrote:
| Receptor binding affinity can also increase too, or like
| Alpha did, further suppress interferon production. Lots of
| ways...
| T-A wrote:
| That reminds me of this scary preprint from January:
|
| https://www.biorxiv.org/content/10.1101/2021.01.06.425392v3
|
| "in vitro evolution enhancing binding by 600-fold provides
| guidelines towards potentially new evolving mutations with
| even higher infectivity" :/
| tehjoker wrote:
| I saw that yesterday and didn't post it because it was
| too scary lol
| bredren wrote:
| This is getting at "saying the quiet part out loud."
|
| For a variety of reasons media and influential organizations
| have avoided considering the upper bound on virility and
| mortality (? Not sure the right term) of covid.
|
| But to think delta is it would be some kind of miracle. It
| would mean we are going through the worst of it, and that after
| we handle delta globally, people can worry about other things.
|
| But it doesn't stand to reason that we are done here with
| covid. There are too many hotspots and I believe delta is older
| than most of the big ones right now.
|
| How likely is a nasty new variant not pop out of Iran or India,
| or Texas?
|
| What about variants created by non-human beings like rats? [1]
| Are we going to skate by on those? That would be great!
|
| I suspect the public is not ready to fully address the breadth
| and depth of covid's impact. I also speculate that the
| "booster" shot suddenly being prescribed is intended to help
| ward off future variants as much or more so than delta alone.
|
| [1] https://www.nbcnewyork.com/news/local/researchers-find-
| covid...
| nradov wrote:
| SARS-CoV-2 has multiple animal reservoirs, and that's one
| reason why it will be impossible to eradicate. But generally
| variants that evolve in animals will select for fitness in
| those different species. So those will probably have less
| impact on humans.
|
| This is one piece of circumstantial evidence why some
| virologists suspect the virus was produced in a lab doing
| gain of function research using transgenic mice with human
| like respiratory systems. When the virus first appeared in
| Wuhan it was already really good at infecting humans. That
| would be unlikely if it had evolved in wild bats or pangolins
| and then jumped straight to humans. But we don't know for
| sure, maybe it was just natural bad luck with no lab
| involved.
|
| https://pubmed.ncbi.nlm.nih.gov/25589660/
| tehjoker wrote:
| SARS-CoV-2 is a generalist that can infect many animals. I
| doubt it a "lab leak". Studies of genetic sequences from
| around the Wuhan fish market showed that it had been
| circulating and mutated a bit for some time before it was
| detected.
| DSMan195276 wrote:
| > When the virus first appeared in Wuhan it was already
| really good at infecting humans. That would be unlikely if
| it had evolved in wild bats or pangolins and then jumped
| straight to humans. But we don't know for sure.
|
| Just curious about this point - wouldn't this always be the
| case, since before it was good at infecting humans it would
| only be in a few if any of them? IE. My thinking is that
| even if it had existed for a while before that point, we'd
| be unlikely to know since it wasn't at that point good at
| infecting humans and thus not many had it.
| MatteoFrigo wrote:
| You probably mean "virulence", not "virility". The latter
| word denotes the masculine ability to procreate.
|
| The confusion arises because the Latin word "vir" means "man"
| (specifically of male sex, as opposed to human), and the
| similar word "virus" means poison.
| f38zf5vdt wrote:
| Measles is estimated to be about 300% more infectious than the
| delta variant, so if it surpassed measles it would be the most
| contagious viral disease known to man. It's already pretty
| close to what is assumed to be the "ceiling".
| tehjoker wrote:
| 300% is still a lot of room to grow. Delta is only about
| twice as bad as the wild type strain.
| marricks wrote:
| I'm not sure "only twice as bad" paints an accurate
| picture.
|
| - Herd immunity is much harder. Calculated as 1 - 1/r0
| where r0 is defined in relation to transmissibility. So if
| r0 = 3 that's ~66% need to be immune to stop the virus. If
| r0 = 6 that's 83% needed, much higher threshold.
|
| - The virus is only getting more deadly. A preprint study
| found delta has "120% greater risk of hospitalization, 287%
| greater risk of ICU admission and 137% greater risk of
| death"[1]
|
| Also 225% more transmissible is 3x more unless I'm doing my
| math wrong?[2]
|
| [1] https://en.wikipedia.org/wiki/SARS-
| CoV-2_Delta_variant#Virul...
|
| [2] https://en.wikipedia.org/wiki/SARS-
| CoV-2_Delta_variant#Trans...
| polynomial wrote:
| Do we have generally accepted R0 values for each of these
| 3 variants?
| marricks wrote:
| I think there's am R0 for initial strain and then ranges
| for the other variants. I thought it was in Wikipedia but
| either it's been edited out or I saw it elsewhere.
|
| What I recall (so huge grain of salt here) was R0 at 2.3
| for initial strain then around 2x for Alpha and another
| 2-3x for Delta. Not. Great.
| nradov wrote:
| Right which is why achieving any meaningful level of herd
| immunity is now effectively impossible. Thus we're all
| likely to get infected eventually.
|
| https://www.businessinsider.com/delta-variant-made-herd-
| immu...
|
| Fortunately the vaccines are very effective at preventing
| death for all variants.
| tunesmith wrote:
| Right, and that's where vaccine efficacy comes into play.
| If r0 is 6 and HIT is 83.3%, but efficacy is only 90%,
| then you actually need about 93% vaccinated.
|
| And for herd immunity, what matters is transmission, and
| the vaccine efficacies for asymptomatic infection are
| pretty low; 50-60%. So mathematically impossible without
| severe lockdowns and/or improved vaccines that are better
| at preventing transmission.
| Retric wrote:
| Herd immunity happens long before we are all infected.
| Less than 40% of the US population is completely
| unvaccinated, which means we can open up more without
| overwhelming hospitals. That does put the unvaccinated at
| increased risks, but the general public is seemingly
| unwilling to continue lockdowns to protect people
| choosing not to be vaccinated.
|
| If ~85% is needed for herd immunity then we could be
| rapidly approaching that point. Though specific locations
| would likely have outbreaks even if it was less of a
| concern nationally.
| chinathrow wrote:
| > Less than 40% of the US population is completely
| unvaccinated, which means we can open up more without
| overwhelming hospitals.
|
| Not sure where you get this about open up, but have you
| seen current ICU fill levels in various US states such as
| Alabamba etc?
| Retric wrote:
| That's quite regional. Nationwide there is still plenty
| of ICU beds available, and presumably if it gets bad
| enough hot spots will respond appropriately.
| chinathrow wrote:
| Huh? If you have a heart attack or a stroke or a grave
| accident you need a regional ER asap, not one 5h away.
| nradov wrote:
| With an R0 of about 6 for the Delta variant, herd
| immunity won't provide a meaningful level of protection
| for most people. Herd immunity works with less contagious
| diseases because susceptible individuals can go their
| whole lives without exposure. But with SARS-CoV-2 now
| being endemic worldwide we'll all eventually get exposed,
| it's just a question of when. So the smart move is for
| everyone to protect themselves by getting vaccinated and
| actively treating co-morbid conditions like obesity,
| diabetes, hypertension, and hypovitaminosis D.
|
| Any further lockdowns at this point cause far more harm
| than benefit.
| Retric wrote:
| They can prevent hospitals from being overwhelmed.
| Opening or not opening schools are one case where local
| communities are going to adjust based on the rates of
| hospitalization.
| tunesmith wrote:
| There's math you can do to roughly judge impact of
| partial vaccination. If R0 is six, and you're looking at
| hospitalization, estimate vaccine efficacy for Delta at
| around 90% (I've seen estimates above and below that).
|
| Taking your estimate of a 60% vaccination rate:
|
| 6 * (1 - (.6 * .9)) = 2.76
|
| 2.76 is the effective Rt, which is far above 1, so no,
| that is not enough to open up more without eventually
| overwhelming hospitals.
|
| Natural immunity from catching COVID, and other
| (inherently temporary) mitigation measures like
| masks/distancing/lockdowns would bring that Rt down
| further. But clearly what is best is more vaccination.
| Retric wrote:
| 2.76 assumes normal conditions, social distancing
| literally changes the equation.
|
| Mask use for example pushes that down. It's easier to get
| below 1 with a 50% vaccination rate than a 0% rate.
| Meaning we can open up _more_ without overwhelming
| hospitals.
| tunesmith wrote:
| That's pretty much what I said in my last line. The
| problem is, "opening up more" generally tends to mean
| things like less masking and less social distancing. So
| to the extent that Rt is pushed down by mitigation
| measures, Rt gets pushed back up when those mitigation
| measures end.
| Retric wrote:
| The advantage in my mind is you can avoid the most costly
| mitigation strategies.
|
| Unfortunately, vaccination rates are age dependent so
| opening schools is a very high risk activity. Children
| are at low risk for COVID but they would be a major
| vector for transmission as everyone under 12 is
| unvaccinated.
| Sohcahtoa82 wrote:
| All likely to be infected, I certainly believe.
|
| But I've been operating under the assumption that while
| vaccination won't prevent you from infection, it is still
| highly effective (90%+) at reducing symptoms, even with
| Delta. I'm certainly open to learning if this is false,
| however. I've just seen statistics that over 95% of
| people hospitalized are unvaccinated.
| kansface wrote:
| I believe that number is in the 80s for the mRNA vaccines
| and lower for the others (minus the one from Russia).
| tunesmith wrote:
| There are many efficacy numbers. mRNA does help against
| infection but efficacy is apparently low, like 50-60%.
| Makes sense because they weren't really developed with
| that in mind.
|
| Efficacy goes to 60-80% for symptomatic, over 80% for
| serious/hospitalization, and mid 90% for death. I think.
| johnchristopher wrote:
| > It may already be getting harder for SARS-CoV-2 to make big
| gains in infectiousness. "There are some fundamental limits to
| exactly how good a virus can get at transmitting and at some
| point SARS-CoV-2 will hit that plateau," says Jesse Bloom, an
| evolutionary biologist at the Fred Hutchinson Cancer Research
| Center. "I think it's very hard to say if this is already where
| we are, or is it still going to happen." Evolutionary
| virologist Kristian Andersen of Scripps Research guesses the
| virus still has space to evolve greater transmissibility. "The
| known limit in the viral universe is measles, which is about
| three times more transmissible than what we have now with
| Delta," he says.
|
| https://www.sciencemag.org/news/2021/08/new-sars-cov-2-varia...
| criticaltinker wrote:
| Here is a fantastic resource from the UK government that
| answers your question in great detail [1].
|
| _> As eradication of SARS-CoV-2 will be unlikely, we have high
| confidence in stating that there will always be variants. _
|
| _> We describe hypothetical scenarios by which SARS-CoV-2 could
| further evolve and acquire, through mutation, phenotypes of
| concern, which we assess according to possibility. _
|
| _> Scenario One: A variant that causes severe disease in a
| greater proportion of the population than has occurred to date.
| For example, with similar morbidity /mortality to other
| zoonotic coronaviruses such as SARS-CoV (~10% case fatality) or
| MERS-CoV (~35% case fatality). [...] Likelihood: Realistic
| possibility. Impact: High. _
|
| _> Scenario Two: A variant that evades current vaccines. [...]
| Likelihood: Realistic possibility. Impact: High._
|
| _> Scenario Three: Emergence of a drug resistant variant after
| anti-viral strategies. [...] Likelihood: Likely - unless the
| drugs are used correctly. Impact: medium. _
|
| _> Scenario Four: SARS-CoV-2 follows an evolutionary trajectory
| with decreased virulence. [...] Likelihood: Unlikely in the
| short term, realistic possibility in the long term. _
|
| And here is one very relevant quote:
|
| _> There is no historic precedent for the mass administration
| of antiviral medication in the community as prophylaxis, apart
| from the use of anti influenza Neuraminidase Inhibitors, which
| were used to a limited extent in this way in the early phases
| of Influenza Pandemic of 2009 in the UK. The safety and
| efficacy profile must be extremely well established for a mass
| administration strategy to work and poor compliance will likely
| rapidly lead to the selection of drug resistant variants,
| rendering such a strategy short lived. _
|
| [1] Can we predict the limits of SARS-CoV-2 variants and their
| phenotypic consequences?
|
| https://www.gov.uk/government/publications/long-term-evoluti...
|
| https://assets.publishing.service.gov.uk/government/uploads/...
| tehjoker wrote:
| Thank you!
| bredren wrote:
| Indeed, thank you for these links and quotes.
| softwaredoug wrote:
| There is a "Doug" variant?!? Asking for a friend...
|
| EDIT
|
| So there is! Ha
|
| > And you can imagine, it was quite a mouthful. So, we started
| to call this D to G mutation 'Doug', and then any of the other
| virus sequences that didn't have this mutation ... we called
| 'Douglas', so it was sort of a bit of a private joke within the
| lab," she said. "As more mutations came about, we'd come up
| with a person's name for them."
|
| https://www.theguardian.com/world/2021/feb/17/nicknames-emer...
| [deleted]
| [deleted]
| NullPrefix wrote:
| >One of the first mutations to go global is known as D614G,
| or Doug for short
| hahamrfunnyguy wrote:
| Also the Nelly and Eeek variants. They would have called it
| Erik, but they worked closely with someone named Erik
| already.
| tomrod wrote:
| It comes from the same family as SARS and MERS. Worst case,
| IMHO, would be that level of mortality combined with its
| current R0 of 6 to 9.
| sfink wrote:
| Do absolute R0 numbers have meaning without a specified
| environment?
|
| As in, shouldn't there be various values for R0 within a
| fully vaccinated community, R0 within an age group, R0
| relative to the prevalence of active infection in a
| community, etc.?
|
| I'm just wondering what complexity is concealed within an R0
| figure. After all, if every infected person _really_ infected
| 6 other people every 2 weeks or so, it would infect every
| person on Earth in about a year and a half.
|
| Which is probably why R0 is distinguished from R1. Since
| otherwise R1 would be R0**2, and I highly doubt it is. It
| could be higher if viral load was a large factor (you have x%
| chance of picking it up when around a single carrier, but >x%
| if surrounded by multiple). Far more likely, it would be
| lower as it burned out tightly-connected groups.
|
| Anyway, just thoughts triggered by seeing absolute R0 values.
| raphlinus wrote:
| It's best to think of R0 as a summary.
|
| For a detailed discussion, see TWiV [792] with
| epidemiologist Jeff Shaman. First link in this show notes
| is "A guide to R"[2].
|
| [792]: https://www.microbe.tv/twiv/twiv-792/
|
| [2]: https://www.nature.com/articles/d41586-020-02009-w
| tomrod wrote:
| Consider R0 a rough estimate of how many people each cade
| infects. It's an imperfect instrument but helps communicate
| the idea clearly that answers "how infectious is this
| virus?"
| chefkoch wrote:
| Can someone eli5 why some variants are substrains like Delta AY3
| and what or how much has to change to have it declared as a new
| strain?
| polynomial wrote:
| This is a really great question. Technically speaking, any
| single mutation defines a new strain. But that's not how we
| tend to talk about it either to the general public or amongst
| clinicians. Rather we use a more informal notion of a
| significant functional change. We do this because there is,
| somewhat surprisingly, no real term that reflects the category
| of "new strain with significant or interesting functional
| effects."
| chefkoch wrote:
| Thank you for the explanation.
| hncurious wrote:
| Covid is going to be endemic like the flu and cold. It's not
| going to be eradicated, unfortunately, and I don't think we've
| come to terms with this yet.
|
| Now what's our plan exactly? Get vaccinated every 6 - 12 months
| indefinitely and always wear masks? What's our goal and what's
| our new normal?
| sdze wrote:
| Too bad that the cold and influenza flu are not comparable with
| Covid-19.
| throwawaysea wrote:
| I certainly hope it isn't leading to a society where papers are
| checked and masks are always required. Although I am
| vaccinated, I feel vaccine mandates constitute a breach of
| bodily autonomy and medical privacy. As for masks - I find them
| stifling in more ways than one - it is hard to breathe, it fogs
| up glasses, it causes me to feel overheated, and it really
| diminishes human connection and exchange of emotions. I think
| the impact of masks on developing children who need natural
| socialization will be drastic and dangerous.
|
| So my take is that at some point, we just need to deal with it
| as a background event and move on. The infection fatality rate
| for COVID is incredibly low, particularly for those under 50.
| It is irrational to worry about it to the extent we are, since
| we don't typically worry about such rare possibilities. I am
| also betting that phenomenon like "long COVID" will either be
| found to be other conflating factors, or found to be a
| phenomenon associated with any illness. It's just that we're
| _so_ focused on COVID as an entire species, that we 're
| spotting all the little things we would normally ignore.
| schmichael wrote:
| I already get vaccinated every 12 months for the flu, so that
| seems like a fine plan to me.
| seunosewa wrote:
| Perhaps they could add it to the flu shot.
| xienze wrote:
| Why get the flu vaccine anymore? If you believe official
| reports, it's basically been eliminated by virtue of simple
| mask mandates that everyone swears no one is following.
| schmichael wrote:
| > Why get the flu vaccine anymore?
|
| Because it's safe and easy. I have immuno-compromised
| friends and elderly family members. Vaccines are almost
| literally the least I can do to help keep them safe. I have
| kids and taking care of sick kids is awful. Also I really
| really really hate having the flu personally. Bleh.
|
| > If you believe official reports, it's basically been
| eliminated by virtue of simple mask mandates that everyone
| swears no one is following.
|
| I have not seen official reports that determined the drop
| in flu was due to masks. I would assume the drop in flu was
| due to many factors combined: schools and businesses going
| remote, other physical distancing, more people getting the
| flu vaccine to avoid getting sick and potentially straining
| our strained healthcare system, masking, and who knows what
| else...
|
| ...at any rate I expect the flu will return as kids go back
| to school, workers return to offices, etc. I'll keep
| getting vaccinated for the flu as long as my doctor
| recommends it for my reasons stated above.
| vharuck wrote:
| I'm not surprised flu rates are crashing with the current
| social distancing, mask wearing, and higher skittishness
| around people with respiratory symptoms. Even if most
| people do them poorly, and others don't do them out of
| protest.
|
| The takeaway isn't that official reports are baseless
| propaganda. It's that we were _really bad_ about handling
| the flu before 2020. How many times did one of your
| coworkers show up with a persistent cough, running nose, or
| sneezing fits? How often did you see people with symptoms
| in grocery stores or buffets? I 'm not surprised even a
| modicum of care greatly outperforms our previous habits.
| walterbell wrote:
| We have many years of data on flu vaccine safety.
|
| Should the flu vaccine be combined with newer vaccines which
| have numerically less safety data?
| [deleted]
| delecti wrote:
| > Get vaccinated every 6 - 12 months indefinitely and always
| wear masks
|
| An annual Flu and COVID shot seems perfectly reasonable.
| Wearing masks in public is already normal (or at least not
| uncommon) in many places, and I don't have a problem with where
| I live being one of those places.
| baxtr wrote:
| Why indefinitely? If that was the case we would need shots for
| the other cold viruses as well, which we don't. As you say,
| Sars-2 will turn into an endemic virus and thus we will get
| used to it over time, death rates will drop and it will turn
| into a cold. There is absolutely no historic precedent to think
| it will turn out differently.
| tshaddox wrote:
| The only reason we don't "need" vaccines for other cold
| viruses is that they're very rarely severe, right? I'd
| certainly take the shot if they existed.
| baxtr wrote:
| Yes exactly. But how was it when they first appeared in the
| human population? We can't know for sure, but most likely
| they caused a heavy pandemic in the first years and then
| over time became "harmless".
|
| Just think about how bacteria/viruses which were not really
| dangerous for Europeans wiped out entire populations in
| Middle and South America.
| chinathrow wrote:
| If this is so clear, then my current question is how long
| would that take?
| baxtr wrote:
| I would say 3-5 years without vaccines. See for example the
| 1889 pandemic [1], which might have also been induced by a
| coronavirus. It's hard to say with a vaccine since there is
| no real precedent. If I had to guess I'd say 1-3 years?
|
| [1] https://en.wikipedia.org/wiki/1889-1890_pandemic
| insulanus wrote:
| We don't have vaccines for the 200+ viruses that cause "the
| common cold". The flu, which is usually a more serious
| disease, has a vaccine that is updated and offered yearly.
|
| 80% of US medical personnel already take the yearly flu shot.
| Trasmatta wrote:
| We get shots for the flu every year (or at least we should).
| That's the historical precedent.
| pengaru wrote:
| Influenza is a different virus which mutates aggressively
| (recombinant), I'm not under the impression sars-cov2 is
| similar in this regard.
| raphlinus wrote:
| Buckle up. Quoted tweet[1] below:
|
| Congrats to Ben Jackson, @maciekboni, @viralverity,
| @AineToole, @robertson_lab, @EvolveDotZoo, @arambaut et
| al for their recent Cell paper.
|
| Rock solid evidence of alpha/non-alpha recombination in
| #SARSCoV2 in the UK.
|
| https://www.cell.com/cell/fulltext/S0092-8674(21)00984-3
|
| [1]: https://twitter.com/MichaelWorobey/status/1428515836
| 62971699...
| Trasmatta wrote:
| Can somebody ELI5 what this means, and what the
| implications are?
| baxtr wrote:
| Yes, you are right. At the same time, flu viruses are very
| different from coronaviruses. We didn't get any shots
| against OC43 and the three other already endemic
| coronaviruses.
|
| Also, note that older people and immune-deficient people
| (who are most likely those needing a shot every year) have
| been dying from ordinary cases of flu before, too.
| tgsovlerkhgsel wrote:
| Due to COVID not mutating as quickly, I think the end game is
| everyone getting immune, through a combination of repeated
| vaccinations and infections.
| munk-a wrote:
| I am becoming more skeptical of that outcome unless we can
| kill it dead globally. It seems probable to me that this is
| going to go on in perpetuity like a much more deadly seasonal
| flu.
| chitowneats wrote:
| What evidence do we have that covid "doesn't mutate as
| quickly"?
|
| There have been at least 3 distinct variants, separate from
| the original strain, since the virus was detected in late
| 2019 / early 2020.
| bparsons wrote:
| Relative to perhaps, the seasonal flu.
| bonzini wrote:
| These variants have their most severe symptoms blocked by
| the same vaccine with very similar effectiveness. Influenza
| viruses, on the other hand, undergo recombination in such a
| way that the vaccine has to be engineered every year based
| on guesses of what the prevalent strain is going to be.
| avereveard wrote:
| immunization doesn't seem to last long enough for this plan,
| it will just increase the mutation pressure.
| ldjkfkdsjnv wrote:
| I got covid last march, and got it again one month ago. I was
| very sick for three weeks on my second covid infection. I
| think we are about to face the harsh reality that covid is
| never going away, and immunity and is never going to happen.
| The virus will mutate and find new ways to infect
| schmichael wrote:
| > I think we are about to face...
|
| I feel like this is what most experts were saying from near
| the beginning: this is not a few months problem. This is an
| ongoing problem that will require us to adapt just as it
| adapts. I remember many articles in 2020 projecting what
| the virus might look like 5 or 8 years out.
|
| Lockdowns and other extreme measures were about flattening
| infection curves to keep from overwhelming health systems,
| _not_ about eradicating the virus outright.
|
| Masks and distancing are about getting the virus to a
| manageable infection rate to minimize impact on our new
| normal lives.
|
| Vaccines are the only way out without high mortality and
| extreme pressure on our health systems. Whether it requires
| vaccines like polio (one or two and safe forever) or flu
| (annual) is yet to be determined AFAIK. It seems like
| somewhere in the middle is most likely at least for many
| years to come.
| munk-a wrote:
| > this is not a few months problem
|
| I agree that it was never a few months problem - but I
| think we had a window to stamp it out and low vaccination
| production and adoption rates have killed that window
| dead. I don't believe it's impossible that we beat this -
| but I would not be surprised if mutation rates simply
| outrun vaccination adaptation.
| theonething wrote:
| > I think we had a window to stamp it out
|
| What do you base that on? That seems highly unlikely to
| me. Even as the virus tapers down in one country, it or a
| variant surges back in five others and then it spreads to
| others. I haven't seen any chance of stamping that out.
| ldjkfkdsjnv wrote:
| I just dont see how getting a shot every year or six
| months for eternity is a viable solution. Not only that,
| vaccinated individuals can encourage new mutations (this
| is controversial, but I believe over time it will be
| realized)
| kaoD wrote:
| > I just dont see how getting a shot every year or six
| months for eternity is a viable solution
|
| What do you mean? We have yearly flu vaccinations.
| paganel wrote:
| > We have yearly flu vaccinations.
|
| Where I live (Eastern Europe) those are taken by a
| minority of the population.
| TurkishPoptart wrote:
| Yes, but flu shots are entirely voluntary. Meanwhile,
| there's legislation being considered in the U.S. to put
| people on Do Not Fly lists for not showing proof of being
| "fully" vaccinated. And who knows how far the goalposts
| can move when it comes to what "fully" vaccinated means.
| Next year, that might mean having had 4 shots, or more.
| munk-a wrote:
| In the 1970s the US required MMR shots for attendance in
| public schools and the disease quickly tapered off -
| we've done this before and, so long as the vaccinations
| aren't inducing a financial burden on individuals that
| are unable to afford it - I see no issue with requiring
| vaccination if you want to share a close space with
| others. A lot of potential partners will reject you if
| you're unable to provide negative STD results - this
| isn't all that different.
| grepfru_it wrote:
| What is your definition of very sick?
|
| I too had a similar series of events and my second
| infection was both worse and better than the first. My
| first bout was longer but consisted of just a mild cough
| with a tolerable shortness of breath but 9 months of long
| haul hell. My second was rife with congestion, headaches,
| and muscle pains but it came and went in the span of a
| week, no long covid this time around (so far).
| nradov wrote:
| Same as with what probably happened with HCoV-OC43, another
| betacoronavirus very similar to SARS-CoV-2. Evidence indicates
| that it caused a worldwide pandemic that killed a lot of people
| starting in 1889. Now it's endemic. Most of us catch it when
| we're young and healthy which gives us partial immunity later.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/
|
| https://sfamjournals.onlinelibrary.wiley.com/doi/10.1111/175...
|
| Eventually almost all of us will be infected by some variant of
| SARS-CoV-2. Fortunately the vaccines are very effective at
| preventing death.
| criticaltinker wrote:
| > Fortunately the vaccines are very effective at preventing
| death
|
| Yes individuals who have been vaccinated or recovered from
| natural infection will have durable immunity and
| significantly lower risk of severe outcomes like
| hospitalization and death. [5][6]
|
| The real question: is mass vaccination effective at
| preventing the spread and increasing trasmission/virulence of
| variants of concern? A growing body of the scientific
| literature and evidence suggests not. [1][2][3][4]
|
| This doesn't mean we shouldn't be using vaccines, rather we
| should use them in a highly targeted way, and supplemented by
| other therapeutic modalities.
|
| [1] Risk of rapid evolutionary escape from biomedical
| interventions targeting SARS-CoV-2 spike protein
| https://pubmed.ncbi.nlm.nih.gov/33909660/
|
| [2] Can we predict the limits of SARS-CoV-2 variants and
| their phenotypic consequences?
| https://www.gov.uk/government/publications/long-term-
| evoluti...
|
| [3] Imperfect Vaccination Can Enhance the Transmission of
| Highly Virulent Pathogens https://journals.plos.org/plosbiolo
| gy/article?id=10.1371%2Fj...
|
| [4] Why does drug resistance readily evolve but vaccine
| resistance does not? https://royalsocietypublishing.org/doi/p
| df/10.1098/rspb.2016...
|
| [5] Longitudinal analysis shows durable and broad immune
| memory after SARS-CoV-2 infection with persisting antibody
| responses and memory B and T cells https://www.cell.com/cell-
| reports-medicine/fulltext/S2666-37...
|
| [6] Rapid induction of antigen-specific CD4+ T cells is
| associated with coordinated humoral and cellular immune
| responses to SARS-CoV-2 mRNA vaccination
| https://www.cell.com/immunity/fulltext/S1074-7613(21)00308-3
| rileyphone wrote:
| [2] states: > The UK should continue to proactively support
| a strategy of worldwide effective vaccination in order to
| drive down global viral load reducing the likelihood of
| dangerous variants emerging in other parts of the world.
|
| In any case, even if vaccines lead to stronger variants (as
| some of the research you cited states is possible), a game
| theoretical situation is created where enough people are
| vaccinated that those who are not are just leaving
| themselves in greater danger. And in the case of a mutation
| breaking out of the vaccine, [2] suggests just to
| immediately start making a new one with the same
| technology.
| nawitus wrote:
| Why use vaccines in a highly targeted way instead of giving
| it to everyone?
| criticaltinker wrote:
| Because mass vaccination combined with a vaccine that
| does not necessarily prevent infection and transmission
| creates selective pressure that is likely to further
| enhance the fitness of the virus and will lead to
| variants that escape the immune response in both
| vaccinated and naturally infected individuals.
|
| Excerpts from [1]:
|
| - "The spike protein receptor-binding domain (RBD) of
| SARS-CoV-2 is the molecular target for many vaccines and
| antibody-based prophylactics aimed at bringing COVID-19
| under control."
|
| - "Such a narrow molecular focus raises the specter of
| viral immune evasion as a potential failure mode for
| these biomedical interventions. With the emergence of new
| strains of SARS-CoV-2 with altered transmissibility and
| immune evasion potential, a critical question is this:
| how easily can the virus escape neutralizing antibodies
| (nAbs) targeting the spike RBD?"
|
| - "Our modeling suggests that SARS-CoV-2 mutants with one
| or two mildly deleterious mutations are expected to exist
| in high numbers due to neutral genetic variation, and
| consequently resistance to vaccines or other
| prophylactics that rely on one or two antibodies for
| protection can develop quickly -and repeatedly- under
| positive selection."
|
| - "The speed at which nAb resistance develops in the
| population increases substantially as the number of
| infected individuals increases, suggesting that
| complementary strategies to prevent SARS-CoV-2
| transmission that exert specific pressure on other
| proteins (e.g., antiviral prophylactics) or that do not
| exert a specific selective pressure on the virus (e.g.,
| high-efficiency air filtration, masking, ultraviolet air
| purification) are key to reducing the risk of immune
| escape"
|
| - "Strategies for viral elimination should therefore be
| diversified across molecular targets and therapeutic
| modalities"
|
| [1] Risk of rapid evolutionary escape from biomedical
| interventions targeting SARS-CoV-2 spike protein (April
| 2021) https://pubmed.ncbi.nlm.nih.gov/33909660/
| HeroOfAges wrote:
| Glad to see you're not getting downvoted for this. This
| line of thought and information will be dismissed as a
| conspiracy theory and will follow the same arc as the lab
| leak hypothesis. Meaning there will be attempts to
| discredit it with no more than appeals to authority until
| the truth becomes impossible to ignore.
| vkou wrote:
| > Because mass vaccination combined with a vaccine that
| does not necessarily prevent infection and transmission
| creates selective pressure that is likely to further
| enhance the fitness of the virus and will lead to
| variants that escape the immune response in both
| vaccinated and naturally infected individuals.
|
| And yet, the Delta variant evolved in an 100%
| unvaccinated population - and is quite happily punching
| through some of the protections afforded by vaccines,
| despite not having any evolutionary pressure to do so.
|
| > "The speed at which nAb resistance develops in the
| population increases substantially as the number of
| infected individuals increases, suggesting that
| complementary strategies to prevent SARS-CoV-2
| transmission that exert specific pressure on other
| proteins (e.g., antiviral prophylactics) or that do not
| exert a specific selective pressure on the virus (e.g.,
| high-efficiency air filtration, masking, ultraviolet air
| purification) are key to reducing the risk of immune
| escape"
|
| Doesn't this mean that the problem is in _having_ a large
| number of infected individuals? Which is exactly what
| happens when a virus sweeps through the unvaccinated
| population - see, delta.
|
| Also, since Covid and its variants seems to happily re-
| infect people who have already had it, the same
| evolutionary pressures will still be present, as long as
| there's a large reservoir of sick people, regardless of
| whether they are rubbing shoulders with vaccinated
| individuals, or 'caught it eight months ago' individuals.
|
| We have two broad options for reducing the number of
| dangerous COVID mutations.
|
| 1. Harsh lockdowns, Australia/NZ/China style, to bring
| cases down. It works, but everyone hates it.
|
| 2. Mass vaccination, that gets us to herd immunity
| against the most prevalent strains of COVID, so that we
| no longer have millions of active cases. We're not there
| with 50% of the population vaccinated. We might be there
| if we were at 85%.
|
| Since you seem to think that #2 is not the solution, what
| is your plan for stopping the evolution of the virus? #1?
| walterbell wrote:
| Why should already-immune, recovered people be
| vaccinated?
| munk-a wrote:
| Vaccination has shown better health outcomes even in
| already infected persons[1] - getting both is the best
| protection and there is no rational reason to refuse the
| vaccine.
|
| 1.
| https://jamanetwork.com/journals/jama/fullarticle/2782139
| walterbell wrote:
| It is still very early in vaccine trials. There are
| anecdotal reports of an increase in non-Covid health
| problems in those who had already recovered from Covid,
| then got vaccinated. That's separate from the tens of
| thousands of reports in VAERS and non-public (HMO)
| adverse event reporting systems for all Covid-vaccinated
| people, whether or not they were previously recovered.
| vkou wrote:
| Because you don't become immune after surviving COVID,
| many people have caught it multiple times, now.
| walterbell wrote:
| The most recent UK data shows 137 confirmed cases of
| reinfection out of 5.2 million first-positive PCR tests,
| which works out to 0.003%, see the chart on page 18, http
| s://assets.publishing.service.gov.uk/government/uploads/.
| ..
| baxtr wrote:
| Yes, exactly.
|
| More info on the 1889 pandemic:
| https://en.wikipedia.org/wiki/1889-1890_pandemic
| 2OEH8eoCRo0 wrote:
| >Get vaccinated every 6 - 12 months
|
| So what I already do for influenza.
| BjoernKW wrote:
| I've been asking those questions for about 16 months now and
| hardly anyone of those in charge is willing to even consider an
| answer. They just botch and bumble their way through from one
| lockdown to the next.
|
| The COVID-19 vaccines are a boon and a vital component for
| ending this crisis. However, they're not the panacea those in
| charge made them out to be. Make no mistake, those vaccines,
| particularly those of the mRNA variety are more successful and
| have been available much more quickly than one could've
| reasonably hoped them to be.
|
| Still, it should have been clear right from the start that
| virus variants against which vaccines are not as effective
| anymore are a distinct possibility.
|
| Hence, my suggestions for a "new normal" (though I dislike that
| term because it implies both that the world in general is
| static and that on the other hand we have to accept the current
| situation as the new default indefinitely) for the time being
| (that is until COVID-19 has become endemic and most of the
| population has built up at least some level of immunity -
| through vaccines or by "natural" means) are these:
|
| 1. getting vaccinated, if possible
|
| 2. getting booster shots and / or updated vaccines regularly,
| in case that's proven to be useful (the jury still being out on
| both counts)
|
| 3. wearing masks in certain settings, e.g., on public transport
|
| 4. the most important one: having everyone - vaccinated or not
| - tested for indoor gatherings or large-scale events (rather
| than prohibiting those outright)
|
| Other than that, life has to continue as normal: No further
| lockdowns, no social distancing, no civil rights restrictions.
|
| Unfortunately, and totally incomprehensibly, #4 seems to be
| highly controversial, with some countries now even shutting
| down their previous - if perhaps not exemplary then at least
| adequate - testing schemes or implementing truly asinine
| measures such as mandating people to pay for tests and only
| requiring those not vaccinated to be tested at all.
|
| Yeah, right. What could possibly go wrong? I suppose the
| rationale behind that one is: "No tests. No problem."
| hartator wrote:
| Getting tested - have you? - is not neutral on your body. The
| nasal swab is sterilized by a carcinogen gas which exposure
| should be limited and you can't avoid wrong gesture by a
| nurse physically damaging your nose. It's fine time to time
| but not everyday.
| BjoernKW wrote:
| Regarding that claim about the carcinogen gas (ethylene
| oxide) see https://www.reuters.com/article/factcheck-
| coronavirus-swabs-... , for example
|
| That an object has been exposed to a compound during that
| object's lifetime doesn't necessarily mean that you'll be
| exposed to that compound upon touching the object.
| polote wrote:
| Why do 2, 3, 4 when people are already protected?
|
| I don't understand the fear the catch covid once your
| vaccinated, why not make the same measures for the flu for
| example?
| BjoernKW wrote:
| #2 because if the virus gets an update it might make sense
| to give the immune system an update, too (the same way we
| do with the flu, by the way).
|
| #3 because it further reduces the risk to get even mildly
| sick at little to no cost. I'll continue to wear a mask on
| public transport even after this pandemic is over. I don't
| need to catch the flu or even the common cold either, if I
| can avoid it.
|
| #4 because it enormously helps with keeping new infections
| at a minimum. Hence, further lockdowns neither required nor
| justifiable anymore.
| jdavis703 wrote:
| Yeah, as long as COVID-19 fills up hospitals we should do this.
| Not having hospitals seriously compromises quality of life.
|
| I had untreated kidney stones for about a week at the peak of
| the pandemic. When I was in the middle of an attack I could not
| work, the pain was too severe. I was missing several hours of
| work everyday just dealing with pain.
|
| I finally got to the emergency room which did basic imaging and
| gave me painkillers and muscle relaxers.
|
| I didn't get the actual stones removed until 6 months later!
|
| So yes, I'd rather vaccinate and mask up then be denied
| healthcare.
| walterbell wrote:
| _> Not having hospitals seriously compromises quality of
| life._
|
| A non-trivial percentage of healthcare workers were infected
| in 2020 and recovered with natural immunity to Covid. Some of
| those feel strongly enough about vaccine mandates that they
| are prepared to move jurisdictions or retire, which would
| exacerbate existing staffing shortages in some hospitals. If
| we don't want more hospital shortages, we should reconsider
| unnecessary vaccine mandates for those with hard-earned
| natural immunity, which includes nasal/mucosal immunity,
| unlike intramuscular vaccines that were developed for symptom
| reduction, https://www.statnews.com/2021/08/10/covid-
| intranasal-vaccine...
|
| _> Vaccines that are injected into the arm have done a
| spectacular job at preventing severe disease and death. But
| they do not generate the kind of protection in the nasal
| passages that would be needed to block all infection. That's
| called "sterilizing immunity." The fact that the vaccines
| don't block all infections and don't prevent vaccinated
| people from transmitting isn't a big surprise, said Kathryn
| Edwards, a vaccine expert at Vanderbilt School of Medicine._
|
| The UK's SAGE also commented on nasal (inhaler) vaccine
| development and the consequences of non-sterilizing
| intramuscular vaccines for variants,
| https://www.gov.uk/government/publications/long-term-
| evoluti...
|
| _> Whilst we feel that current vaccines are excellent for
| reducing the risk of hospital admission and disease, we
| propose that research be focused on vaccines that also induce
| high and durable levels of mucosal immunity in order to
| reduce infection of and transmission from vaccinated
| individuals. This could also reduce the possibility of
| variant selection in vaccinated individuals._
| rescripting wrote:
| A recent study showed having had COVID before offers less
| protection from reinfection than the vaccine [0].
|
| "The study of hundreds of Kentucky residents with previous
| infections through June 2021 found that those who were
| unvaccinated had 2.34 times the odds of reinfection
| compared with those who were fully vaccinated. The findings
| suggest that among people who have had COVID-19 previously,
| getting fully vaccinated provides additional protection
| against reinfection."
|
| [0]
| https://www.cdc.gov/media/releases/2021/s0806-vaccination-
| pr...
| walterbell wrote:
| Detailed response to that study,
| https://satyameva.medium.com/analysis-of-reduced-risk-of-
| rei...
|
| _> Also what should be obvious is this study doesn't
| really look at the relative strengths of naturally
| acquired immunity vs vaccination acquired immunity, it is
| looking at whether vaccination can add further to the
| robust protection elicited by covid infection._
|
| Latest UK data shows 137 confirmed cases of reinfection
| out of 5.2 million first-positive PCR tests, which works
| out to 0.003%, https://assets.publishing.service.gov.uk/g
| overnment/uploads/... (see chart on page 18)
| sreque wrote:
| This article completely destroy the CDC's report:
| https://www.powerlineblog.com/archives/2021/08/more-
| voodoo-e....
|
| The CDC's report is a fantastic example as to why the CDC
| don't deserve our trust. They are dishonest. They cherry
| pick data to fit their narrative. They are unburdened by
| the constraints of peer review. They admit in their own
| study that it can't apply causation and yet they remain
| silent as the media run wild and report the study as
| causative fact.
|
| This analysis has, to my knowledge, not been debunked at
| all: https://arieh.substack.com/p/inside-israels-delta-
| outbreak-p....
|
| It shows natural immunity far outclassing vaccine
| immunity in Israel.
|
| In terms of peer reviewed studies, they all show that
| natural immunity is fantastic:
|
| https://jamanetwork.com/journals/jama/fullarticle/2781112
|
| https://www.thelancet.com/action/showPdf?pii=S2589-5370(2
| 1)0...
|
| https://www.cell.com/cell-reports-
| medicine/fulltext/S2666-37...
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209951/pdf/
| RMV...
| walterbell wrote:
| https://arieh.substack.com/p/inside-israels-delta-
| outbreak-p...
|
| _> it looks like recovered people -- people who had
| tested positive for the coronavirus in a past PCR test --
| are massively under-represented. Recovered people are
| around 9% of Israel's population, but they're less than
| 1% of current cases.
|
| > That has led to speculation that recovery from past
| Covid is more protective against infection from the Delta
| Variant than vaccination. Known recovered people in
| Israel are mostly not vaccinated, though some chose to
| get a single booster dose ... From data I was passed last
| week, recovered people were testing at only 0.1%
| positivity, compared to more than 1% for vaccinated
| people.
|
| > I wouldn't be surprised if natural infection turned out
| to be more protective against variants than spike protein
| vaccination. It makes sense that the body's immune system
| would find more ways to attack the whole pathogen and
| would recognise different parts of it compared to the
| changing spike in variants._
| jjwiseman wrote:
| https://www.covid-datascience.com/post/israeli-data-how-
| can-... argues that people are misinterpreting the
| Israeli data due to Simpson's paradox: In
| the case of vaccine efficacy vs. severe disease, it is
| the fact that both vaccination status and risk of severe
| disease are systematically higher in the older age group
| that makes overall efficacy numbers if estimated without
| stratifying by age misleading, producing a paradoxical
| result that the overall efficacy (67.5%) is much lower
| than the efficacy for either of the age groups (91.8% and
| 85.2%).
| criticaltinker wrote:
| First off, I'm sorry you had to suffer like that - and I
| don't want anyone to be denied healthcare.
|
| > I'd rather vaccinate and mask up then be denied healthcare
|
| You've presented a false dichotomy here - mass vaccination
| and masking will not necessarily prevent overwhelmed
| hospitals.
|
| Israel is a prime example - with one of the highest
| vaccination rates in the world - their hospitals are being
| overwhelmed right now due to the variants. The CDC is
| reporting similar data from the U.S. [1][2][3]. There's no
| doubt that vaccination is saving some lives, but it also may
| be partly to blame for the increasing dominance of variants
| of concern. [4][5]
|
| And counterintuitively, compulsory masking is likely setting
| us up for a very bad winter in terms of endemic illnesses
| such as influenza and RSV - which poses an increased risk of
| overwhelming medical facilities even further.
|
| I only raise these counterpoints to help inform others and
| bring much needed nuance to these discussions.
|
| [1] https://www.cdc.gov/mmwr/volumes/70/wr/mm7034e3.htm
|
| [2] https://www.cdc.gov/vaccines/acip/meetings/downloads/slid
| es-...
|
| [3] https://www.cdc.gov/library/covid19/08132021_covidupdate.
| htm...
|
| [4] Risk of rapid evolutionary escape from biomedical
| interventions targeting SARS-CoV-2 spike protein
| https://pubmed.ncbi.nlm.nih.gov/33909660/
|
| [5] Can we predict the limits of SARS-CoV-2 variants and
| their phenotypic consequences?
| https://www.gov.uk/government/publications/long-term-
| evoluti...
|
| [6] The impact of COVID-19 nonpharmaceutical interventions on
| the future dynamics of endemic infections
| https://www.pnas.org/content/117/48/30547
| chefkoch wrote:
| > Israel is a prime example - with the highest vaccination
| rate in the world
|
| Israel has 60% of the population fully vacced, compared to
| iceland with 71%
|
| >Israel's ICUs overflow as unvaccinated patients fall
| severely ill
|
| https://www.ynetnews.com/health_science/article/sj1lzflgk
| eecc wrote:
| Only 66% of Israelis are fully vaccinated: there's a good 3
| million hard-core religious orthodox who won't let science
| interfere with their deity's will.
|
| 3 million of blissfully and deliberately ignorant
| individuals who won't adapt their social behavior to avoid
| viral spread is more than enough to overrun any health
| system.
| walterbell wrote:
| How many of those were infected and recovered in the last
| 18 months?
| undersuit wrote:
| How many were infected multiple times in the last 18
| months?
| walterbell wrote:
| I don't have the Israel numbers, but UK data shows 137
| confirmed cases of reinfection out of 5.2 million first-
| positive PCR tests, which works out to 0.003%, see charge
| on page 18, https://assets.publishing.service.gov.uk/gove
| rnment/uploads/...
| flyinglizard wrote:
| It's closer to 1 million than 3 million. There are about
| 6 million vaccinated out of a nation of 9 million, but
| that's also including kids 0-12. The number I know is
| about 1 million eligible who refuse the shot.
|
| It's not the ultra orthodox who really stand out. There's
| about 30% in the general 20-29 groups who haven't taken
| their shots (going down to about 20% in 30-39 and down to
| 10% in the 60+ group), and many Arabs who are reluctant
| to do so too.
| nazgulnarsil wrote:
| For people in a similar situation. Chanca Piedra might help.
| goodluckchuck wrote:
| Everything I've heard about how viruses evolve says that they
| get milder within the host population. The host's resistance
| keeps increasing as the virus mutates and the population is
| exposed to the new mutations, and over time this allows the
| virus to diverge from other populations... where the virus
| isn't spreading.
|
| E.g. diseases can evolve in Europe then spread to Native
| American populations. Evolve in bats, or apes, then spread to
| humans.
|
| Now that this virus has shown that humanity has become one
| population... and it will spread everywhere if we let it... we
| should let it.
|
| If we do strict testing, vaccination, etc. and prevent
| international travel, and otherwise fiercely prevent the virus
| from spreading across populations, then we'll have just created
| a situation where the virus could mutate to become harmful.
|
| As long as we do nothing we're safe.
| munk-a wrote:
| It's absolutely horrific to bring up Native American
| populations considering the estimates on population loss
| range from 25% to 90% with most folks erring toward the 90%
| end of the range. As terrible as COVID has been we're no
| where near the level where - as a middle aged person with
| kids and parents[1] - it's expected that you'll be the only
| one to survive out of your extended family.
|
| Estimates about the fatality of COVID put it way below the
| small pox epidemic in North America but that's an absolutely
| terrible example to draw on.
|
| 1. Assume your parents had two children - you both married
| and had two kids - that's ten people so choose one to survive
| (obviously epidemics don't actually work this way, but I've
| found it's the clearest way to demonstrate proportional
| mortality rates.
| polote wrote:
| Vaccinate all people greater than 40 years old, preferably
| anyone and resume a normal life.
|
| Even though the vaccine doesn't prevent to catch covid to high
| degree, it still prevent deaths and hospitalizations to more
| than 90% (whether Delta or not, and whether Aztrazaneca or
| Pfizer or Moderna)
|
| Long Covid seems to exists, but it is about 2-3% of cases so
| nothing to really worry about more than any other disease.
|
| Maybe at some point the vaccine won't protect from a new
| variant and things will change. But so far so good. And even at
| this point, Lockdowns and masks mania doesn't seem to be give a
| better output than asking citizen to be careful and try to
| limit meeting too many people (Sweden)
|
| Here for more details
| https://cspicenter.org/blog/waronscience/why-covid-19-is-her...
| aantix wrote:
| Take Vitamin D/C/Zinc/Niacin and build up natural immunity?
| johnbaker92 wrote:
| It's sad that this comment (and probably mine) downvoted
| despite being a reasonable long-term response to this virus.
|
| Instead of mandating this vaccine worldwide, why don't we
| focus on collectively building a better / stronger health
| that would prevent the large majority of severe cases?
| Florin_Andrei wrote:
| It is downvoted because it's pseudo-science.
| nradov wrote:
| At least in the case of vitamin D it's hardly
| pseudoscience. Multiple clinical studies have found that
| hypovitaminosis D is a serious risk factor for COVID-19.
|
| https://vitamin-d-covid.shotwell.ca/
| Florin_Andrei wrote:
| It is correlated, but I am not aware of even a single
| study that shows actual causal determination.
| nradov wrote:
| Are you claiming that you read all the studies linked
| above and none of them show actual causal determination?
| We can't really prove anything 100% in biology but the
| totality of evidence is very strong here.
| lambdaba wrote:
| I recall studies showing significant efficacy even in
| acute settings, which was slightly unexpected, at least
| to me.
| protein_lense wrote:
| This is not a study, but it does discuss the biochemistry
| of vitamin D and the role it plays in the immune system.
| It is left to the viewer to draw their own conclusions.
|
| COVID-19 and Vitamin D | Association Between Vitamin D
| Deficiency and COVID-19
|
| https://www.youtube.com/watch?v=cT1CaTv5-e4
| johnbaker92 wrote:
| According to "science":
|
| - Lockdowns should have stopped covid.
|
| - Masks should have stopped covid.
|
| - Vaccines should have stopped covid.
|
| - "Health" passports and those ridiculous mandates should
| have stopped covid.
|
| The fact is, we're two years down the road and we're
| still talking about this virus - so "true" science (that
| advocated by governments / media I imagine?) is obviously
| not working.
|
| Time to take a step back and think for ourselves perhaps?
| BugsJustFindMe wrote:
| > _- Lockdowns should have stopped covid._
|
| Maybe if people obeyed them, which they did not.
|
| > _- Masks should have stopped covid._
|
| Maybe if people wore them, which they did not.
|
| > _- Vaccines should have stopped covid._
|
| Maybe if people got them, which they did not.
|
| And now that there are new variants in the wild because
| of people not doing all of those things, the vaccines,
| lockdowns, and masks still keep ICU beds from
| overflowing. But you have to actually do them.
| johnbaker92 wrote:
| Have we perhaps forgotten about Sweden which:
|
| - Did not force lockdown / masks onto anybody
|
| - Has one of the least vaccinated population in Europe
| (around 40% afaik)
|
| - Has had 0 covid deaths in the last couple weeks.
|
| - Has not had it worse than countries with stricter
| mandates.
|
| Are we also forgetting about Iceland / Israel which are
| among the most vaccinated countries in the world (on top
| of having stringent mandates) and are basically
| experiencing their largest spike in cases since the
| beginning of this pandemic?
|
| At the end of the day, it's also good to realise so
| called experts do not seem to have all the answers even
| though it's "backed by science". Going back to common
| sense and taking a step back is what will get us all out
| of this.
| BugsJustFindMe wrote:
| > _Have we perhaps forgotten about Sweden: - Has not had
| it worse than countries with stricter mandates._
|
| Please explain this graph comparing Covid deaths in
| Sweden to its immediate neighbors that shows the opposite
| of what you're saying:
|
| https://ourworldindata.org/explorers/coronavirus-data-
| explor...
|
| > _- Has had 0 covid deaths in the last couple weeks._
|
| Deaths per week are a function of previous deaths and
| population distribution. If more people die at the
| beginning, then fewer are left to die later. That's how
| dying works. Sweden's weekly per capita deaths peaked
| much higher than in the US or EU overall, and they've
| lost more people per capita than their neighbors.
|
| A person who cares about numbers should be looking
| cumulatively, not just within some specific narrow
| window.
|
| > _Are we also forgetting about Iceland / Israel which
| are among the most vaccinated countries in the world_
|
| Israel isn't even in the top 30 and their vaccinations
| flatlined back in February, they prematurely declared
| victory, and people went back to licking doorknobs. But
| let's ignore all of that for now.
|
| Congratulations, people faffed around fighting against
| restrictions and vaccination for so long that now we have
| successfully developed a mutation that achieves viral
| escape. Go team! Yay! Mission accomplished!
|
| Vaccines and lockdowns and mask mandates still appear to
| prevent deaths and hospital overflow. How do we know?
| Because deaths and ICU bed percentages go down during
| lockdowns and go up when lockdowns end and because a tiny
| fraction of the people dying are vaccinated.
|
| Keep in mind also that Iceland still has one of the
| lowest total per capita COVID death rates of any place in
| the world. It's also a weird little volcanic island with
| everyone living in only a few places with a major
| international transit hub between Europe and North
| America. The few places in the world doing better than
| Iceland are places which also lock down quickly.
|
| > _Going back to common sense_
|
| Except that your "common sense" tells you that Sweden has
| done great and that Israel and Iceland are doing poorly
| when compared to other countries the opposite is true.
| How then should we assess the accuracy of your common
| sense?
|
| My common sense says that people who refuse the vaccine
| should just be refused access to hospital resources if
| they get sick. It would neatly address a lot of issues.
| ostrichlamb wrote:
| > Deaths per week are a function of previous deaths and
| population distribution. If more people die at the
| beginning, then fewer are left to die later. That's how
| dying works. Sweden's weekly per capita deaths peaked
| much higher than in the US or EU overall, and they've
| lost more people per capita than their neighbors.
|
| Is this necessarily an issue though? They've managed to
| keep a reasonable way of life through those times while
| building a natural immunity to this disease. They're also
| not implementing any inhumane / dystopian measures like
| "health passports" and the like. At some point we have to
| look beyond the number of cases / deaths as the only
| "success measure" for dealing with this thing. The level
| of humanity (although hard to assess with numbers but
| easy to _see_ for the humans among us) needs to be
| factored in here.
|
| > My common sense says that people who refuse the vaccine
| should just be refused access to hospital resources if
| they get sick. It would neatly address a lot of issues.
|
| Should we carry on with this logic and ban the [obese /
| overweight / inactive / drinkers / smokers / stressed /
| etc.] from the hospitals because they could have done
| something about their health that would ultimately have
| prevented them from getting sick? This is a slippery
| slope, but I'm sure you'll quickly understand why.
|
| That being said, if I also no longer have to pay taxes
| that fund these establishments (and get refund on
| previous contributions), I might take your deal .. That's
| another discussion though.
| Florin_Andrei wrote:
| > _so called experts do not seem to have all the answers_
|
| You are drinking misinformation from the firehose. That
| quote is a clear symptom of it.
| pacerwpg wrote:
| Have you been actually following how things have gone?
| Sweden has 1708% more deaths to covid vs Norway, but only
| 84% higher population. That doesn't sound that great to
| me.
| ostrichlamb wrote:
| Per Google stats, Sweden has had 14,664 COVID deaths to
| this day on a population of 10.23M people which is 0.1%,
| the vast majority being close to average age of death (82
| y/o) in this country. (It's also worth noting that ~24K
| people die of vascular disease in this country every year
| to put things in perspective.)
|
| Although death is always unfortunate, it seems to be a
| very foolish goal to try and prevent everyone from dying
| in this situation. Well, we might be able to do just
| that, but how much of your previous way of life /
| liberties are we willing to sacrifice _forever_?
| MatteoFrigo wrote:
| This comparison between two datapoints is not too useful.
| The graphs at https://euromomo.eu/graphs-and-maps/
| provide a more nuanced picture, with the caveat that
| those are graphs of excess mortality and not necessarily
| covid-specific.
| BugsJustFindMe wrote:
| Useful or not, I think it's more representative within
| that region than you let on and matches basically the
| activity causing this moment in the timeline from your
| link: https://imgur.com/a/G3D7AZ2
| volfied wrote:
| You're acting in bad faith and you know it. You can't
| just say "lockdowns/masks/vaccines should have stopped
| covid, but they didn't", when you know that a lot of
| people out there refused to mask up, refused to
| quarantine and refused to get the vaccine.
|
| People with your thinking are the reason we're still in
| this pandemic.
| tux1968 wrote:
| >People with your thinking are the reason we're still in
| this pandemic.
|
| If a proposed solution doesn't factor in non-compliance
| when considering its likelihood of success, it isn't a
| reasonable solution.
| smolder wrote:
| So you're aware it was noncompliance that reduced the
| effectiveness of those measures, and you think... those
| measures shouldn't have been taken at all? I'm not clear
| on what the alternative was, apart from that.
|
| There's a difference between what's reasonable and being
| perfect. I think they were absolutely reasonable
| solutions, since I haven't heard a peep about any better
| ones available, and even with noncompliance they are
| helpful.
| [deleted]
| ssklash wrote:
| > - Lockdowns should have stopped covid.
|
| Not everyone cooperated with lockdowns, rendering them
| less effective.
|
| > - Masks should have stopped covid.
|
| Not everyone wore masks, rendering them less effective.
|
| > - Vaccines should have stopped covid.
|
| Not everyone is getting vaccinated, rendering it less
| effective.
|
| I see a pattern here with an obvious solution, and it's
| not doubting the "true" science and declaring ourselves
| epidemiologists, virologists, and public health experts.
| travoc wrote:
| Each of these scenarios was predictable and in fact,
| predicted by many. Yet here we are, still pretending to
| be shocked at the intensity of human autonomy.
|
| If your plan requires everyone on earth to cooperate,
| it's not a good plan.
| ssklash wrote:
| You realize that the way other diseases were eradicated
| required the cooperation of everyone on earth? Or at
| least in most countries. The reason we don't get polio in
| virtually any country on earth is because of global
| cooperation in the face of a disease with a known
| mitigation. Barely 500 known cases _world-wide_ in 2019.
| Thanks to global cooperation. Too bad propaganda and
| social media probably ruined our chances of repeating
| such a feat...
| xienze wrote:
| > The reason we don't get polio in virtually any country
| on earth is because of global cooperation in the face of
| a disease with a known mitigation.
|
| The polio vaccine being a sterilizing one is certainly a
| _major_ reason for its success. The Covid vaccine, by
| contrast, does not confer sterilizing immunity. Polio
| also spreads through contaminated food and water, not the
| exhaled breath of the infected. So other than those minor
| things, great comparison.
| osigurdson wrote:
| Regular exercise should be a larger part of the
| conversation.
|
| https://www.health.harvard.edu/blog/does-exercise-help-
| prote...
| tcbawo wrote:
| I haven't seen an evidence that supplements would prevent
| the majority of severe cases, or the neurological damage
| done (in even mild cases). Is this something backed up by
| data?
| mrfusion wrote:
| Is neurological damage in mild cases backed up by data?
| The only study I saw was based on self reporting and an
| Internet based IQ test.
|
| Also considering perhaps 30% of the world has had covid
| now (anyone have the exact figure?) that would be an
| unbelievable amount of brain damage. I'd think we'd be
| aware of that if one in three people had recent brain
| damage.
| nradov wrote:
| The CDC estimates that 36% of Americans have been
| infected so far.
| lambdaba wrote:
| Anyything that makes your immune system work properly
| will help, the reason Covid is even a subject is that
| there is a silent epidemic of immunocompromised people, a
| large number of which are unaware that they are - the
| kind of people who routinely get sick in the winter, for
| instance. It's very strange that we are pretending that
| healthiness doesn't exist or can't be improved. It can,
| and rather easily and cheaply (yes, Vitamin D is one, but
| also, especially for Covid, anything that improves
| vascular function, as the etiology of Covid is closely
| linked to vascular health... which is where Niacin
| (vitamin B3), vitamin C, and reducing /eliminating sugar
| come in).
| johnbaker92 wrote:
| Health goes beyond taking nutrients (although they might
| help). Here we're talking about exercise, nutrition,
| mental health etc:
|
| - None of those were advocated by governments during this
| pandemic.
|
| - Some measures (lockdowns, etc.) were detrimental to
| individual health and (imo) contributed to complications
| we've been seeing.
|
| This is generally backed up by common sense (which - just
| like the flu - has mysteriously disappeared in the past 2
| years)
| BobbyJo wrote:
| What's mysterious about the flu disappearing? The
| precautions taken to reduce COVID were extremely
| effective against influenza. Given that it was much more
| broadly circulating, and therefore a large percentage of
| the population had antibodies to dominant strains (more
| than COVID even now), one would expect masks and
| isolation to basically destroy it's spread no?
| lambdaba wrote:
| It's also possible that viral disease dynamics are just
| like that, with one virus dominating at a time (amongst
| this class of highly contagious respiratory viruses).
| walterbell wrote:
| There's a social-acceptability phenomenon where people say
| one thing (e.g. in surveys) and do another (e.g. what they
| buy).
|
| Relatively early in 2020, some grocery and pharmacy shelves
| were completely emptied of Vit C/D/Zinc/Quercetin. When they
| were restocked, they would sell out again, even with per-
| customer quotas. This took place even with a complete news
| blackout on early treatments. As with HCQ/Ivermectin, we have
| decades of data showing very low risk of adverse effects from
| these early treatments. So the worst case is that people
| waste money on placebos. But there are studies showing that
| early treatment helps some (not all) patients to recover more
| quickly.
|
| Just as we don't know why some people are injured by
| vaccines, we don't know why some people are not helped by
| early intervention with supplements. More studies are need
| for both, including funding for autopsies of those who die
| and retroactive genomic sequencing of
| virus/vaccine/supplement samples collected from the most
| severely affected cases.
|
| India (origin of Delta) provides comparative data because
| some areas have rejected Ivermectin while other areas have
| embraced it. This is a ZH (sorry) article, but it uses data
| from Johns Hopkins,
| https://www.zerohedge.com/covid-19/indias-ivermectin-
| blackou...
|
| _> This data shows how Ivermectin knocked their COVID-19
| cases and deaths - which we know were Delta Variant - down to
| almost zero within weeks. A population comparable to the US
| went from about 35,000 cases and 350 deaths per day to nearly
| ZERO within weeks of adding Ivermectin to their protocol.
|
| > Let us look at the August 5 numbers from Uttar Pradesh with
| 2/3 of our population. Uttar Pradesh, using Ivermectin, had a
| total of 26 new cases and exactly THREE deaths. The US
| without Ivermectin has precisely 4889 times as many daily
| cases and 191 times as many deaths as Uttar Pradesh with
| Ivermectin._
|
| At present, there are billions of dollars of economic
| incentives for suppression of early treatment, because
| vaccines are still under EUA that could be questioned by the
| availability of therapeutics with decades of safety data. If
| the FDA fully approves one or more vaccines in September
| 2021, perhaps there will be more economic incentives to
| perform research and studies of therapeutics.
|
| Merck (original holder of the Ivermectin patent) is
| developing a new patented therapeutic for early treatment of
| Covid. Time will tell whether this is a genuinely new
| treatment or an "evergreen" variant of Ivermectin to obtain
| patent revenue. Either way, it would mean that at least one
| Big Pharma company has an economic incentive to promote early
| therapeutics for Covid, which could provide some balance to
| the currently polarized treatment landscape.
| MaxBarraclough wrote:
| Slightly off-topic: shouldn't the 'new normal' be to wear
| N95/N99 masks?
|
| We know they're far more effective, and there's been plenty of
| time to ramp up production. I don't see why the 'normal' option
| is to wear a non-medical mask.
|
| It's also surprising that societies are entirely incapable of
| doing a hard lockdown for 3 weeks with mandatory testing at the
| end. I imagine that would be enough to reduce the case count to
| near zero, but it seems this cannot be done at a national scale
| even with time to prepare.
|
| _edit_ Turns out I 'm not alone here, here's a Harvard
| professor pushing for mass use of N95 masks:
| https://www.washingtonpost.com/opinions/2021/01/26/n95-masks...
| rich_sasha wrote:
| Just asking: would they also be effective in a slightly
| clueless general public? Eg they only work when they are in
| your face, fitted, etc.
|
| It could be that cost/actual benefit looks worse when you
| factor poor usage.
| hncurious wrote:
| That's actually what Dr Fauci initially talked about with
| regard to the general public. With how masks are worn and
| used in practice, he was probably right.
|
| Fauci: There's no reason to be walking around with a mask.
| When you're in the middle of an outbreak, wearing a mask
| might make people feel a little bit better and it might
| even block a droplet, but it's not providing the perfect
| protection that people think that it is. And, often, there
| are unintended consequences -- people keep fiddling with
| the mask and they keep touching their face.
|
| LaPook: And can you get some schmutz, sort of staying
| inside there?
|
| Fauci: Of course, of course. But, when you think masks, you
| should think of health care providers needing them and
| people who are ill.
|
| https://www.youtube.com/watch?v=5gYAka7qSnM
| anonuser123456 wrote:
| This outlook ignores a critical factor.
|
| Intramuscular vaccine delivery did not confer high levels of
| mucosal immunity. However, subsequent infection of the
| vaccinated may provide excellent systemic protection while
| allowing mucosal immunity to naturally develop as a consequence
| of infection.
|
| If high levels of mucosal immunity develop as a result of
| breakthrough infection, that may go a long way towards reducing
| r0.
|
| Further, nasal delivery covid vaccines are underdevelopment.
| These may also provide mucosal immunity.
|
| So there is still a very plausible way out of the pandemic that
| includes the near eradication of the disease.
| xboxnolifes wrote:
| I'm not sure if this is technically feasible, but maybe a
| yearly covid shot just gets added to the flu shot routine.
| Either through the same shot, or two shots in one visit.
| pragmaticalien8 wrote:
| Just like any vaccine, I suppose better generation of vaccine
| will emerge. https://athometest.com/blog/a-next-generation-
| sars-cov-2-vac...
| nonbirithm wrote:
| Is it implausible to think that continued transmission and
| mutation at this rate will cause a catastrophic worsening of the
| pandemic to an extent several orders of magnitude above what it
| is now? Vaccination is effective in the current state of the
| pandemic, but what's to prevent the built-up immune response of
| humankind being wiped out if the virus adapts enough?
| slumdev wrote:
| SARS-CoV-2 has four antigens. The existing vaccines stimulate
| the production of antibodies against only one of them, the
| spike protein.
|
| The existing vaccines are proving ineffective against Delta
| because it has mutated significantly enough that its spike
| protein does not cause a neutralizing immune response. They may
| even be causing ADE, as evidenced by the most recent data
| comparing Israel and Palestine.
| bushbaba wrote:
| Palestine is ambiguous. I assume you mean Gaza or West Bank?
|
| To Palestinians the entire country of Israel is Palestine.
| Hence the chant from the river to the sea Palestine will be
| free.
| etc-hosts wrote:
| Obviously the OP is referring to West Bank and Gaza.
| bushbaba wrote:
| There are Palestinians living in east Jerusalem. There's
| Palestinians who are citizens of Israel. His use of
| wording was ambiguous.
| OneLeggedCat wrote:
| > existing vaccines stimulate the production of antibodies
| against only one of them
|
| Is this true for the J&J vax as well?
| desine wrote:
| Yes the J&J shot still works using only the spike protein.
| IIRC only Novavax uses traditional inoculation of using the
| weakened SARS-CoV-2 virus.
| raphlinus wrote:
| Novavax is a protein subunit vaccine, with the spike
| protein only. The Chinese CoronaVac and Indian Covaxin
| are traditional inactivated virus vaccines.
| polynomial wrote:
| weakened how?
| nradov wrote:
| Some of the current vaccines are produced by mixing
| batches of SARS-CoV-2 virions with beta-Propiolactone to
| make them inactive.
| selimthegrim wrote:
| Uh... citation? And as you know, neutralizing response is not
| the only type.
| slumdev wrote:
| A study demonstrating the mechanism for Delta ADE in vivo:
| https://pubmed.ncbi.nlm.nih.gov/34384810/
|
| Highly-vaccinated Israel's third-wave surge in both cases
| and deaths:
| https://www.worldometers.info/coronavirus/country/israel/
|
| Unvaccinated Palestine's lack of third wave deaths:
| https://www.worldometers.info/coronavirus/country/state-
| of-p...
| Mordisquitos wrote:
| > A study demonstrating the mechanism for Delta ADE in
| vivo: https://pubmed.ncbi.nlm.nih.gov/34384810/
|
| Not only is that article not a study but rather a letter
| to the editor, but also in their last paragraph they
| explicitly state that ADE in SARS-CoV-2 has never been
| demonstrated _in vivo_. Here is the relevant quote from
| the letter:
|
| > _[...] Although this potential risk has been cleverly
| anticipated before the massive use of Covid-19 vaccines6,
| the ability of SARS-CoV-2 antibodies to mediate infection
| enhancement_ in vivo _has never been formally
| demonstrated. [...]_
| [deleted]
| walterbell wrote:
| Thanks for the Israel-Palestine comparison.
| jdkuepper wrote:
| Here is a more in-depth counterpoint to that preprint:
|
| https://blogs.sciencemag.org/pipeline/archives/2021/08/16
| /a-...
| nemo44x wrote:
| A couple things though - the median age of Israel is
| higher than that of Palestine by a pretty large margin.
| Secondly, how can we be sure both places are testing at
| the same rate? For instance, the percentage of cases
| reported in Palestine VS Israel is smaller when adjusted
| for population size.
| [deleted]
| YPCrumble wrote:
| Do you have a source for the recent data on ADE? I searched
| and didn't find anything suggesting this. The only thing I
| see are studies that more vaccinated people are dying in
| Israel, but that is to be expected because the older people
| are, the more likely they are to be vaccinated and they have
| less immune response to the vaccine.
|
| Source https://twitter.com/rzioni/status/1426178482569109504
| slumdev wrote:
| See my reply to a sibling comment. The most damning
| evidence comes from the comparison between highly-
| vaccinated Israel, where there are many third-wave deaths,
| and mostly-unvaccinated Palestine, where there isn't a
| third-wave death spike at all. Having mostly-unvaccinated
| Palestine as a control group is showing us that we don't
| know what we thought we knew.
| rdedev wrote:
| The graphs you've mentioned in your sibling comment does
| not separate deaths based on vaccination. Here is another
| source that takes this into account. Vaccination does
| reduce chances of severe infections even in delta, though
| it's not as good as before:
|
| https://www.npr.org/sections/goatsandsoda/2021/08/20/1029
| 628...
|
| > The good news is that among Israel's serious infections
| on Thursday of this week, according to Health Ministry
| data, there were nine times more serious cases among
| unvaccinated people over age 60 (178.7 per 100,000) than
| among fully vaccinated people of the same age category,
| and a little more than double the number of serious
| infections among unvaccinated people in the under-60
| crowd (3.2 per 100,000) than among the vaccinated in that
| age bracket.
|
| Also do note that official numbers from Palestine could
| be undercounted because of the situation there
| naasking wrote:
| Not implausible at all. Mutation rate is proportional to the
| number of infected. Third world countries have barely even
| started vaccinating. There's a lot of room for nightmare
| scenarios.
|
| Which is why I think it was a bone-headed move to not suspend
| patent protection on the vaccines. Thanks Bill Gates!
| rudedogg wrote:
| The Bill Gates mention set off my conspiracy nut alarm bells,
| but after reading this entire article[0] the criticism seems
| fair.
|
| [0] https://www.devex.com/news/gates-foundation-reverses-
| course-...
| rdedev wrote:
| This. The Astra zenca vaccine, originally designed by the
| Oxford University, was supposed to be open licenced. But the
| gates foundation convinced them otherwise. The top priority
| should have been to get as many vaccine factories open as
| soon as possible but even functioning factories had trouble
| starting talks with bigshots like pfizer
|
| https://www.seattletimes.com/seattle-news/health/have-
| gates-...
|
| https://apnews.com/article/drug-companies-called-share-
| vacci...
|
| https://newrepublic.com/article/162000/bill-gates-impeded-
| gl...
| silicon2401 wrote:
| People believe what's comfortable/convenient, not what's true.
|
| In very early 2020, when I was following the news of the virus
| development in Wuhan, China, I felt like a conspiracy theorist
| pointing out to friends and coworkers that a bad epidemic
| spreading in one of the most crowded parts of the world. They
| thought it was ridiculous to say that hospitals were getting
| overwhelmed, people were being quarantined etc. Don't even
| think about suggesting it'll spread outside of China, or that
| the virus may have come from the lab that just so happened to
| also be in the origin of the epidemic, a lab which specialized
| in highly infectious diseases.
|
| Not even 2 years later and where are we now? The entire world
| got sick and pretty much every country has done
| lockdowns/quarantines/shutdowns. Not to mention the lab theory
| of the virus origin still can't be ruled out.
|
| Even after the pandemic started, people still had no problem
| sticking their head in the sand. It's not a big deal; it's
| 2020, we have technology and medicine and we'll just make a
| vaccine and get back to normal. Well now it's almost 2022 and
| somehow things just keep getting worse.
|
| We can reasonably say the Black Death killed 30% of Europe's
| population. We can't reasonably say covid won't do the same.
| All optimistic projections so far have been proven wrong, so
| all we can say for sure is that humans are terrible at
| predicting the future.
| desine wrote:
| >We can reasonably say the Black Death killed 30% of Europe's
| population. We can't reasonably say covid won't do the same.
| All optimistic projections so far have been proven wrong, so
| all we can say for sure is that humans are terrible at
| predicting the future.
|
| I think Black Death had quite a bit higher mortality than any
| version of covid we will see
| OneLeggedCat wrote:
| > We can reasonably say the Black Death killed 30% of
| Europe's population. We can't reasonably say covid won't do
| the same
|
| I was going along, nodding my head in agreement until this.
| Do you realize how bad medical care was during that era?
| Hygiene? Knowledge of how to slow transmission in a community
| (we Americans have not yet even BEGUN to _really_ take COVID
| seriously)? Do you realize how vastly _more_ deadly than
| Black Death that COVID will have to become to cause a 30%
| death rate among the general population? It 's absurd.
| silicon2401 wrote:
| > It's absurd.
|
| People said that about the idea that covid would become a
| pandemic too, you just proved my point.
| jstanley wrote:
| That doesn't prove your point at all. The fact that
| someone disagrees with you doesn't prove you're right.
| nradov wrote:
| That's just fear mongering nonsense, like claiming that we
| can't reasonably say that aliens won't invade the Earth
| tomorrow. I mean I can't prove it's impossible but come on.
| There's no scientific evidence that a coronavirus can be both
| highly contagious _and_ have a 30% fatality rate. CDC data
| clearly shows that the fatality rate in the US has been 0.6%,
| largely because we have a lot of vulnerable elderly people
| with serious co-morbid conditions. The fatality rate in
| countries with younger, healthier populations is far lower.
| And for vaccinated people of all ages the death rate is close
| to 0.
| silicon2401 wrote:
| Yes I'm aware of what today is like, now tell me what
| tomorrow will bring, because not many people have been able
| to do that so far. Instead, as I said, optimism is proven
| wrong as things just keep getting worse. But I'm sure
| you're right, all the other mis-steps to this point were
| flukes, this time you know for sure what the future holds.
| cjfd wrote:
| Both the worst-case and the best-case scenario are on the
| table. Only time will tell what happens. As you seem to be
| focusing on the worst-case scenario I will talk about the best-
| case scenario. The best-case scenario is that the human immune
| system is getting used to corona with even vaccinated people
| spreading the delta variant with little chance of getting very
| ill. This will turn covid-19 into something like the common
| cold or possibly the flu. Who knows what will actually happen?
| Both my best-case scenario and your worst-case scenario can
| happen. I think, though, that one should not only focus on the
| adaptability of the virus. The immune system also has been
| doing defense against various pathogens for many millions of
| years.
| achenatx wrote:
| The likely scenario is that it turns into cold/flu.
|
| Everyone either gets the vaccine or the virus and we are all
| mostly immune. It mutates a little and once it mutates just
| enough to spread substantially everyone who gets it gets
| immune. Only a fraction of the population will get any
| particular mutation.
|
| I remember having the debate that herd immunity has never
| happened without a vaccine. Which is just BS. Every disease
| throughout history has eventually reached equilibrium with
| humans which is essentially herd immunity.
|
| Most mutations are point mutations. Once enough point
| mutations accumulate that give the virus superior ability to
| spread, it will. It is unlikely that any point mutation will
| suddenly make the virus orders of magnitude more deadly.
| empthought wrote:
| You don't understand what "herd immunity" means. Herd
| immunity means eliminating a disease within a community
| ("herd"). It does not mean endemic case incidence with
| socially tolerable outcomes, or whatever loosey-goosey idea
| you mean by "equilibrium."
|
| Herd immunity means the contagion is eliminated. It has
| never happened worldwide without a vaccine, and I'm unaware
| of any virus where it has been sustained within a community
| without a vaccine. How could it? The only paths to immunity
| are vaccine or exposure, and exposure depends on the virus
| actually circulating.
| dannyz wrote:
| At some point this is just arguing semantics, but my
| understanding is that the herd immunity threshold is
| defined when Reff < 1. You could have Reff=0.99999999,
| which counts as herd immunity being reached, but it would
| take a very long time for the virus to actually
| disappear. Even if we do momentarily hit Reff < 1 for the
| delta variant, there could be mutations/waning immunity
| that causes it to stay around 1 becoming endemic.
| chinathrow wrote:
| > Every disease throughout history has eventually reached
| equilibrium with humans which is essentially herd immunity.
|
| Not a biologist here but can you elaborate on this? Do you
| consider all circulating diseases such as HIV, yellow
| fever, malaria, hepatitis etc. having reached
| "equilibrium"?
| wizzwizz4 wrote:
| Well, humanity still exists, therefore no disease wiped
| out all humans. That's a form of equilibrium, and it's a
| lot better than some other species.
|
| And now we have decent medicine, we can properly turn the
| tables on diseases. mRNA vaccines are literally sci-fi
| stuff, and now they're here! Antibiotics weren't even
| _in_ sci-fi, and we 've got them (though they're no
| longer panaceas).
| Mordisquitos wrote:
| No, it is not implausible in the sense that "it could never
| happen". However, neither was it implausible for this to have
| happened with the myriad of other viruses which have jumped
| into our species across our natural history--and yet here we
| are.
|
| Remember there is no motivation behind the virus to adapt, nor
| such thing as "wiping out" the immune response. At most, there
| are random mutations which, if they are more successful than
| the previous ones, will become more widespread than their
| alternatives.
|
| Are mutations that are less sensitive to current populations'
| immune responses more likely to succeed? Yes, of course! But
| there is a practical limitation to how much a virus can
| accumulate mutations which evade immunity to previous variants:
| it must not break its ability to infect (human) cells.
| Eventually an equilibrium is reached, as it has thousands of
| times previously.
| christkv wrote:
| I'm following the studies around nasal covid vaccines.
| https://www.voanews.com/east-asia-pacific/researchers-begin-...
|
| The theory is that they will create a better early response in
| the cells where the virus makes first contact making it more
| likely to stop replication early.
|
| If it works it would seem this could be a more effective way to
| vaccine for respiratory viruses.
| nikkinana wrote:
| I love staying home. Get paid and spend nothing. Thanks Cuba for
| pioneering that concept!
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