2019-2020 coronavirus pandemic (Vaccination 2021 Edition)

[tstorm823]

Firstly, we weren't discussing the probability of a second wave. We were discussing, specifically, whether the increase is explicable as a product of increased testing. That question remains whether we're in the first or second wave, or whether loosening restrictions is a good idea or not.

And on that point, about whether it's a good idea to loosen restrictions, I'm going to be taking advice from scientists and epidemiologists. Y'know, the people with expertise in the subject. For what it's worth, the W.H.O. recommends against considering loosening restrictions until positivity has been below 5 for 14+ days; researchers and experts seem pretty unanimous in arguing for extreme caution and that a second wave remains very much on the cards.

So what would you do if you were Texas or California? They weren't having their case loads decrease, quite the opposite, the trend was perpetually slowly increasing. Other states, those that had been through their part of the pandemic, have had their rates plummet and are reopening without major incident. Despite the reopenings, despite the holiday celebrations, despite the weeks of protests, and the frequently chastised disregard for social distancing, the whole northeast continues to trend downwards in basically the same way that other countries around the world have. And these generally southern states are looking at their trends and thinking "crap, we're not going to be on the other side of this pandemic for years at this rate." The CDC recommended two weeks of decreasing numbers of cases before opening up. That's basically not going to happen if you never have the major outbreak. At some point ~10% of everyone is going to get this, and if the fears that people won't be immune long term are justified, locking the spread down to a crawl is going to backfire and put places on a perpetual treadmill where the pandemic spread is never actually contained.

 

[Silvanus]

So what would you do if you were Texas or California? They weren't having their case loads decrease, quite the opposite, the trend was perpetually slowly increasing. Other states, those that had been through their part of the pandemic, have had their rates plummet and are reopening without major incident. Despite the reopenings, despite the holiday celebrations, despite the weeks of protests, and the frequently chastised disregard for social distancing, the whole northeast continues to trend downwards in basically the same way that other countries around the world have.

Do you genuinely believe that because there hasn't yet been some massive spike in these places, they're out of the woods? That a couple of good weeks is enough to declare us in the clear?

And these generally southern states are looking at their trends and thinking "crap, we're not going to be on the other side of this pandemic for years at this rate." The CDC recommended two weeks of decreasing numbers of cases before opening up. That's basically not going to happen if you never have the major outbreak. At some point ~10% of everyone is going to get this, and if the fears that people won't be immune long term are justified, locking the spread down to a crawl is going to backfire and put places on a perpetual treadmill where the pandemic spread is never actually contained.

Why should I give more credence to what you say than the CDC & W.H.O.? I don't believe that you are more authoritative than them, or that you better know what's probable or advisable.

 

[tstorm823]

Do you genuinely believe that because there hasn't yet been some massive spike in these places, they're out of the woods? That a couple of good weeks is enough to declare us in the clear?

Are you talking about the Northeast? Yes. Absolutely yes. Not because there hasn't been a massive spike, but rather because there has been a massive spike. That's how this works. You don't get normal back until X amount of people get infected. When that X amount of people have been infected, the epidemic spread recedes.

Why should I give more credence to what you say than the CDC & W.H.O.? I don't believe that you are more authoritative than them, or that you better know what's probable or advisable.

You're welcome to determine credibility by accuracy of predictions. You can find me on the old forums claiming 10% of everyone would get infected, and now we're looking at places like Germany on the other side of the curve doing serology tests and finding 5-15% of the population with antibodies depending on location.

 

[Silvanus]

Are you talking about the Northeast? Yes. Absolutely yes. Not because there hasn't been a massive spike, but rather because there has been a massive spike. That's how this works. You don't get normal back until X amount of people get infected. When that X amount of people have been infected, the epidemic spread recedes.

The herd immunity canard, widely discredited by the experts actually working on this. You'll notice that the UK and Sweden, two of the very few countries to incorporate a herd immunity approach into public policy, have fared terribly.

You're welcome to determine credibility by accuracy of predictions. You can find me on the old forums claiming 10% of everyone would get infected, and now we're looking at places like Germany on the other side of the curve doing serology tests and finding 5-15% of the population with antibodies depending on location.

I can find you on the old forums claiming all sorts of stuff. I can also find experts with a far more reliable track record and a wealth of experience in the field.

 

[tstorm823]

The herd immunity canard, widely discredited by the experts actually working on this. You'll notice that the UK and Sweden, two of the very few countries to incorporate a herd immunity approach into public policy, have fared terribly.

Your imaginary experts discrediting the concept of immunity are idiots.

 

[Eacaraxe]

Read it again. More testing leads to a higher absolute number of confirmed cases; that's the truism. That's not the same as attributing the rise in number to the level of testing. The latter ignores that other factors are also driving that number, and that the rate of positive-cases-per-test is also high.

I mean, that's it. That's the post. Statistics in this situation don't mean a whole lot in a contextual vacuum. If one just looked at numbers of raw tests and tests per capita, and positivity rate, you'd think South Korea would be a Fallout hellscape by now dominated by COVID super mutants. Clearly that is not the case.

 

[Agema]

I mean, that's it. That's the post. Statistics in this situation don't mean a whole lot in a contextual vacuum. If one just looked at numbers of raw tests and tests per capita, and positivity rate, you'd think South Korea would be a Fallout hellscape by now dominated by COVID super mutants. Clearly that is not the case.

Well, I dunno. Have you actually been there recently? Maybe the lamestream librul media are just being crap and or pushing their agenda. Samsung could be using their last warehouse stocks as we speak.

 

[Generals]

Your imaginary experts discrediting the concept of immunity are idiots.

But it has been widely discredited. Not because the concept is considered false but because of the cost of achieving it through infections rather than vaccination.
If you need to reach an infection rate of 60-70% the costs would be huge, not only in the amount of deaths but also complications for those who had to face severe symptoms. That it is why it is widely discredited. You only need to look at Sweden where infection rates are still not decreasing and is faring much worse than its neighboring countries.

https://www.sciencedirect.com/science/article/pii/S1074761320301709
https://www.mayoclinic.org/diseases...th/herd-immunity-and-coronavirus/art-20486808

 

[tstorm823]

But it has been widely discredited. Not because the concept is considered false but because of the cost of achieving it through infections rather than vaccination.
If you need to reach an infection rate of 60-70% the costs would be huge, not only in the amount of deaths but also complications for those who had to face severe symptoms. That it is why it is widely discredited. You only need to look at Sweden where infection rates are still not decreasing and is faring much worse than its neighboring countries.

https://www.sciencedirect.com/science/article/pii/S1074761320301709
https://www.mayoclinic.org/diseases...th/herd-immunity-and-coronavirus/art-20486808

You don't need to reach an infection rate of 60-70%. In fact, you would never reach an infection rate of 60-70%. Too high a percentage of people already don't get infected when exposed.

You can't say the infection rates are increasing in Sweden. Their testing wasn't ever great, and the increase in cases recently coincides exactly with them starting to test far more aggressively. Looking at deaths as a proxy variable for infections, Sweden is decreasing in severity just like the rest of Europe. And the neighboring countries wouldn't be going down if the population wasn't developing immunity to the virus.

https://www.medrxiv.org/content/10.1101/2020.04.27.20081893v1.full.pdf

 

[Baffle]

All aboard the good ship COVID! We're inexplicable bound for the pub!

(I'm not going to the pub.)

 

[Silvanus]

Your imaginary experts discrediting the concept of immunity are idiots.

Not the idea of immunity. The idea of herd immunity forming a public strategy for this virus. There are so many unknowns for a novel coronavirus (keyword: novel) that it represents just about the least cautious approach possible. Estimates for the percentage of people required to develop immunity in order for herd immunity to act as an effective bulwark vary hugely, but are usually around 60 - 65% (and no, I'm not going to listen to what you think the immunity rate would need to be; I'm going to be taking numbers from the experts).

We don't know the mortality rate of the virus for certain, but early studies put it around 2 - 3%, making use of the limited data available. So, an intentional herd immunity strategy in the US could therefore be aiming for 60 infection (about 196 million people), with 2 or 3% dying, coming to... just under 4 million deaths. Only, it would probably end up being a great deal higher, because such a rush would inevitably overwhelm the health services.

The enormous and unnecessary death toll involved in pursuing herd immunity as public policy is almost certainly the reason the UK government abandoned that doomed avenue.

I mean, that's it. That's the post. Statistics in this situation don't mean a whole lot in a contextual vacuum. If one just looked at numbers of raw tests and tests per capita, and positivity rate, you'd think South Korea would be a Fallout hellscape by now dominated by COVID super mutants. Clearly that is not the case.

Thankfully, we do have some context.

The context being that I was promoting the use of the positivity rate specifically to judge whether the rise is primarily attributable to increased testing, as V.P. Pence argued. For that purpose, it's not perfect, but it's about the most apt metric we have.

 

[tstorm823]

Not the idea of immunity. The idea of herd immunity forming a public strategy for this virus. There are so many unknowns for a novel coronavirus (keyword: novel) that it represents just about the least cautious approach possible. Estimates for the percentage of people required to develop immunity in order for herd immunity to act as an effective bulwark vary hugely, but are usually around 60 - 65% (and no, I'm not going to listen to what you think the immunity rate would need to be; I'm going to be taking numbers from the experts).

We don't know the mortality rate of the virus for certain, but early studies put it around 2 - 3%, making use of the limited data available. So, an intentional herd immunity strategy in the US could therefore be aiming for 60 infection (about 196 million people), with 2 or 3% dying, coming to... just under 4 million deaths. Only, it would probably end up being a great deal higher, because such a rush would inevitably overwhelm the health services.

The enormous and unnecessary death toll involved in pursuing herd immunity as public policy is almost certainly the reason the UK government abandoned that doomed avenue.

I'm not talking about herd immunity as a strategy. I'm talking about it as an inevitability. Did Italy choose a herd immunity strategy? No. Did New York choose a herd immunity strategy? No. That's why choosing it as a strategy is dumb, and also why pretending you can avoid it is dumb. That situation is coming one way or another, the policy needs to be keeping as many people alive as you can along the way. Trying to get lots of people sick really fast isn't doing that, but neither is turning off large aspects of the healthcare system and hiding and expecting the virus to just disappear because you social distanced. That's what the old "flatten the curve" graph was saying months ago, everyone understood it then: you don't social distance because fewer people will get sick in the long run, you social distance to keep the caseload at any one time manageable.

Listening to experts is one thing, understanding them is another. If you recall back to the early times, they did exactly the math you just did, but with an IFR of 1%. 60% of the US population getting infected with 1% mortality, it's about 2 million dead. That was an early forecast of the pandemic. Then the expected deaths got revised way, way down, barely a tenth of those low estimates based on the little initial data. Why? In part because serology studies have shown a lower fatality rate than the case fatality ratio you're bringing up, but in large part because the experts know exactly the things that I do, and are using much less simplistic assumptions to make their models than just Herd Immunity = 1 - 1/R0.

 

[Silvanus]

I'm not talking about herd immunity as a strategy. I'm talking about it as an inevitability. Did Italy choose a herd immunity strategy? No. Did New York choose a herd immunity strategy? No. That's why choosing it as a strategy is dumb, and also why pretending you can avoid it is dumb. That situation is coming one way or another, the policy needs to be keeping as many people alive as you can along the way. Trying to get lots of people sick really fast isn't doing that, but neither is turning off large aspects of the healthcare system and hiding and expecting the virus to just disappear because you social distanced. That's what the old "flatten the curve" graph was saying months ago, everyone understood it then: you don't social distance because fewer people will get sick in the long run, you social distance to keep the caseload at any one time manageable.

It'd be desirable, but it's fairly unrealistic in the short term. We don't have anywhere near the infection & immunity rates required anywhere, and nor has it proved necessary.

The idea behind social distancing is primarily but not exclusively to spread the same number of infections over a longer period. Countries which implemented lockdown more immediately, and stuck to it, have also experienced overall fewer infections. Not just deferred infections; the rate overall is also lower.

Experts have pointed out that an earlier response in countries like the UK could have dramatically cut the number of cases. Not deferred them; cut them. That's understood quite well.

 

[Eacaraxe]

Not the idea of immunity. The idea of herd immunity forming a public strategy for this virus. There are so many unknowns for a novel coronavirus (keyword: novel) that it represents just about the least cautious approach possible...

Not just that, but deciding upon a herd immunity strategy when the question of how long immunity lasts, and how quickly can individuals be re-infected, was (and still is) very much in the air, for a pandemic of this magnitude was genocidally ignorant and reckless. There really is no other way to describe it at this juncture.

The context being that I was promoting the use of the positivity rate specifically to judge whether the rise is primarily attributable to increased testing, as V.P. Pence argued. For that purpose, it's not perfect, but it's about the most apt metric we have.

For the case of countries that ignored the problem until it blew up in their faces, sure shotgun testing at immense cost in time, money, and resources is about the only approach that can be taken now. But, I was referring more to South Korea's testing metrics having the appearance of poor performance, but being indicative of their success through diligent and proactive contact tracing, targeted testing, and containment. If anything, discussions about the magnitude of US testing are based on the premise the US has already catastrophically failed in its response to the pandemic.

 

[Generals]

You don't need to reach an infection rate of 60-70%. In fact, you would never reach an infection rate of 60-70%. Too high a percentage of people already don't get infected when exposed.

You can't say the infection rates are increasing in Sweden. Their testing wasn't ever great, and the increase in cases recently coincides exactly with them starting to test far more aggressively. Looking at deaths as a proxy variable for infections, Sweden is decreasing in severity just like the rest of Europe. And the neighboring countries wouldn't be going down if the population wasn't developing immunity to the virus.

https://www.medrxiv.org/content/10.1101/2020.04.27.20081893v1.full.pdf

While the study you linked does suggest a lower required infection rate (which seems suspiciously low) even if we assume around 10-20% of the population has to be infected that's potentially huge. Deaths decreasing is not necessarily surprising as the first wave usually kills the "weakest" (against the virus) but it is still higher than its neighboring countries.

Now many other posters have made most of the points that can be made about the problem with relying on herd immunity but one I would like to add is that your rationale is based on a medical standstill. If we make the safe assumption we will find treatmens which reduce the death rate and/or come up with a vaccine we do not need to achieve such a high infection rate or death rate. Delaying infections allows to have more infections which can be treated better than they are now or even to never occur due to vaccination.

 

[Silvanus]

Not just that, but deciding upon a herd immunity strategy when the question of how long immunity lasts, and how quickly can individuals be re-infected, was (and still is) very much in the air, for a pandemic of this magnitude was genocidally ignorant and reckless. There really is no other way to describe it at this juncture.

I would tend to agree. If private citizens operated with the level of dismissiveness and lack of preparation that the UK and US governments have with regards to this outbreak, they would be charged with criminal negligence.

 

[tstorm823]

While the study you linked does suggest a lower required infection rate (which seems suspiciously low) even if we assume around 10-20% of the population has to be infected that's potentially huge. Deaths decreasing is not necessarily surprising as the first wave usually kills the "weakest" (against the virus) but it is still higher than its neighboring countries.

It is huge, but it's already accomplished in places. That's why when asked earlier about whether I thought the US northeast was out of the woods, I said yes, because New York City and the surrounding mega-city that is the eastern seaboard has had some numbers as high as that 10-20% range.

Now many other posters have made most of the points that can be made about the problem with relying on herd immunity but one I would like to add is that your rationale is based on a medical standstill. If we make the safe assumption we will find treatments which reduce the death rate and/or come up with a vaccine we do not need to achieve such a high infection rate or death rate. Delaying infections allows to have more infections which can be treated better than they are now or even to never occur due to vaccination.

I don't disagree with this. That's a valid point. But people are acting like we're gonna hold off in perpetuity, and are also brutally, brutally pessimistic when presented with hope for treatments.

 

[Avnger]

I don't disagree with this. That's a valid point. But people are acting like we're gonna hold off in perpetuity, and are also brutally, brutally pessimistic when presented with hope for treatments.

Hope for "treatments" like injecting bleach and shoving UV lights up our bums? I wonder why anyone could possibly think those would be problematic...

 

[Generals]

Hope for "treatments" like injecting bleach and shoving UV lights up our bums? I wonder why anyone could possibly think those would be problematic...

I'm willing to bet people who drink loads of bleach are much less likely die from the corona virus...

 

[Agema]

I don't disagree with this. That's a valid point. But people are acting like we're gonna hold off in perpetuity, and are also brutally, brutally pessimistic when presented with hope for treatments.

I'm pretty confident there will be a vaccine before this time next year. If we're lucky, before the end of this year - although odds are still early 2021.

If we mean drugs, I think there's not a lot of huge use from the existing pharmacopeia, or we'd know all about it by now. And given what it takes to design and test drugs, it'll take significantly longer to develop one than it will to develop a vaccine.