2019-2020 coronavirus pandemic (Vaccination 2021 Edition)

[Silvanus]

Correct. It does not tell you about trajectory. It tells you about scale. Tests, death rate, hospitalizations, etc. Those do an alright job with plotting trajectory when done consistently (which they didn't do the tests in Sweden consistently, so deaths and hospitalizations are better proxy variables for trajectory there). You do serology studies to establish scale. When the question is "what percentage of people have been infected and recovered", that isn't a question of trajectory, that is a question of scale.

You were arguing that the infection rate has "come back down" (i.e., trended downwards); that's the central claim about Sweden used to support your hypothesis in post #465 which sparked this whole discussion.

And the whole reason antibody tests were brought up in the first place was that you disputed the usefulness of positivity rate when I showed that it doesn't support the idea of a downward trend. So now, when I make the argument that antibody tests are an even worse metric for studying trends, suddenly it's not about trends at all? Trends are what you were initially talking about! The supposed trend was your supportive evidence!

 

[tstorm823]

You were arguing that the infection rate has "come back down" (i.e., trended downwards); that's the central claim about Sweden used to support your hypothesis in post #465 which sparked this whole discussion.

And the whole reason antibody tests were brought up in the first place was that you disputed the usefulness of positivity rate when I showed that it doesn't support the idea of a downward trend. So now, when I make the argument that antibody tests are an even worse metric for studying trends, suddenly it's not about trends at all? Trends are what you were initially talking about! The supposed trend was your supportive evidence!

To quote myself:

"So deaths and hospitalizations are better proxy variables for trajectory there."

 

[Silvanus]

To quote myself:

"So deaths and hospitalizations are better proxy variables for trajectory there."

Yes, deaths and hospitalisations would indeed be the third and fourth metrics you came to rest on. I kind of feel that if I start addressing deaths and hospitalisations, in three or four posts' time you'll be talking about how we shouldn't be using them.


But assuming the downward trend: what convinces you to attribute this to herd immunity? With the immunity rate so low, far lower than experts in the field say is necessary, and even Swedish scientific authorities now admitting they were aiming for much higher numbers developing antibodies. And there are concurrent downward trends in plenty of countries which did lock down.

Sweden experiencing a reduction in deaths (from an extraordinarily high peak, relatively speaking), broadly alongside the rest of Europe which did lock down, would be no vindication of the notion that <10% of people having antibodies constitutes herd immunity.

 

[lil devils x]

Yes, deaths and hospitalisations would indeed be the third and fourth metrics you came to rest on. I kind of feel that if I start addressing deaths and hospitalisations, in three or four posts' time you'll be talking about how we shouldn't be using them.

We hopefully should see a reduction in deaths regardless though as we are more equipped to treat it now than before. Initially, they didn't even realize that all of these heart attacks and strokes were actually from COVID-19 because they thought it was just a respiratory virus, which actually means we likely have more deaths than were recorded and when this is reviewed later, the deaths that were disregarded in states like Alabama and Florida will be returned to the proper count. Although we definitely still need more resources to help treat this, we at least have a better of understanding of how to approach treatment and what to expect in the short term. Of course none of that matters if people do not actually have access to these resources, either due to existing financial barriers in the US, or overwhelming the system, both of which are a serious issue in the US due to the horrid state of healthcare distribution and ease of access.

 

[tstorm823]

Yes, deaths and hospitalisations would indeed be the third and fourth metrics you came to rest on. I kind of feel that if I start addressing deaths and hospitalisations, in three or four posts' time you'll be talking about how we shouldn't be using them.

I mean, if you take a number to a conclusion that you cannot reasonably reach with that statistic, I will be telling you not to use that number in that way.

But assuming the downward trend: what convinces you to attribute this to herd immunity? With the immunity rate so low, far lower than experts in the field say is necessary, and even Swedish scientific authorities now admitting they were aiming for much higher numbers developing antibodies. And there are concurrent downward trends in plenty of countries which did lock down.

Don't get me wrong. I'm not, by any stretch of the imagination, suggesting that Sweden took the right course of action. They put people at additional risk early in the pandemic, leading to a lot of death all at once, for little to no gain. They just also made themselves a case study to evidence my point. I think the experts expecting a much higher immunity rate to establish herd immunity, including the ones in Sweden, were and are wrong. The timeline of Sweden was that they figured they wouldn't quarantine as much as everyone else and weather the storm until the virus burnt itself out. They waited until the deaths and hospitalizations were dropping, those things dropping was meant to be evidence that it was factually burning itself out. Then they went to measure antibodies, they expected like half the population to be immune. Because theoretically, if you're maintaining the same behavior, and the rate of transmission is dropping, it's because parts of the population are no longer susceptible. That's what you expect. They did not expect to do antibody testing and see a single digit number. My suggestion here is that their theory is right, except they just still think they need way more immunity than they do.

But also, they thought their results would be different than everyone else's. They thought they were dealing with a virus that's roughly as infectious as the common cold. But it clearly spreads more easily than that. And because of that, Sweden couldn't protect its vulnerable population while everyone else was free to move about, where other nations avoided that, even while having the virus move similarly through the essential workers of the world. Based on antibody studies, Sweden's rate of infection wasn't particularly high. Nearby countries in Europe also have had results in the mid-to-high single digits for antibodies, and hard hit cities everywhere seem to line up in that 10-20% range. Sweden doesn't seem to have any gotten closer to herd immunity than other places that avoided a lot of death in that big wave. And that's ultimately my point here: all the places that got hit and brought back down seem to approach an antibody rate of 10% overall and 20% in dense cities, regardless of behavior. Which is exactly what the "flatten the curve" message early on was meant to describe. It's not over until a certain amount of people are immune, roughly the same number of people will get infected regardless of what you do, but you social distance to slow the infection rate so that the health system can handle it. But that pattern only fits if places are experiencing the effects of herd immunity, and they are even with single digit percentages of infection, and I happen to have a theory that makes that make sense.

 

[Agema]

But assuming the downward trend: what convinces you to attribute this to herd immunity?

Herd immunity is a long, long way off.

But there are ways that infection spread can be vastly reduced with a relatively small number of immune. The basic idea is that people have differing levels of contact. At one end you have hermits, and at the other ultra-tactile conference organisers who spend all their days travelling around the county and interacting with large groups of people who they kiss on the cheeks. Obviously, the latter are a disease spreading disaster.

So if each infected person infects an average of 3 other people, that might be ~0 for hermits, ~1.2 for most of the population, and ~20 for conference organisers. But what that means is when the conference organisers have all had it and are theoretically immune, that's pretty much the end of major risks of overwhelming the health service. Might need the odd local lockdown if the disease gets a bit frisky in some areas, but nothing too huge. Covid-19 will gently roll around the country killing people at a "tolerable" rate that the health service can cope with. After a few years of this herd immunity will build up* and the spread will die off. I mean, ~0.5% of the population may have died of it by then, but such is the way of the world.

On the other hand, doing a "Germany" would have been better anyway. Ultimately, they've had the same lockdown, and they will also have to have a few more lockdowns, but chances are they will still end up having far fewer deaths than the UK did. What's not to prefer about that?

* Assuming long-term immunity. If we're unlucky, covid-19 immunity might, like several other diseases, turn out to only last a few months

 

[Phoenixmgs]

You can have places go over the 20% because it's not a random, evenly spaced group. The concept you're missing is innate immunity. Antibodies are not the human body's only response to viral infection, we have non-specific bodily responses as well. Different people are going to have different levels of innate immune response to different pathogens. In particular with sars-cov-2, children seem to avoid the virus altogether at a relatively high rate.It's not because they have some magical forcefield protecting them, it's because their bodies are axing the virus before it can start reproducing inside of them. If you take like a choir of middle-aged people of similar backgrounds, you don't expect a random 20% of them to be susceptible. It isn't random, they might all have similar results. We know some of who gets sick at higher rates than others, but we don't know the exact mechanism of why.

It's not like there's only been 1 or 2 incidents where a large portion of people have gotten infected from a single gathering, there's been many of them. There's no concrete data on any children being immune to the virus. Some studies have found the infection rate in children are the same as adults, some have found children are harder to get infected. I'd be guessing that children need a larger viral load to get infected than adults. The biggest question with regards to children is how much they can spread the virus to determine if schools should go back to normal. It's definitely safer for children themselves to be in school, the question is if it's safe enough for adults to be with them. Anyway, there's been literally no one that has even suggested that anyone, let alone 80% of the population, is immune to the virus. And yes, the reason why some people get mild symptoms vs serious symptoms is because of their immune responses and why it seems very likely that Vitamin D deficiency is a key reason that leads to serious symptoms, hospitalizations, and deaths. Vitamin D directly impacts the immune system and even the ACE2 receptor.

 

[tstorm823]

There's no concrete data on any children being immune to the virus.

Nor will there ever be, as ethics get in the way of that experiment.

Anyway, there's been literally no one that has even suggested that anyone, let alone 80% of the population, is immune to the virus.

I wouldn't say literally no one. At least one person has suggested that.

 

[Worgen]

I miss the days when this was parody.

 

[Phoenixmgs]

Nor will there ever be, as ethics get in the way of that experiment.

I wouldn't say literally no one. At least one person has suggested that.

There's no data even pointing to the idea that some kids could be immune.

Nobody in the medical profession.

 

[Kwak]

I wouldn't say literally no one. At least one person has suggested that.

You?

 

[Fieldy409]

I just realised over 500k are dead. They shut down the whole world to stop this and half a million people are still dead.

This is crazy, anyone else think this is crazy? This virus dies from soap, barriers stop it and it only lasts hours outside the body. It should be way easier to make this thing extinct.

 

[Agema]

I just realised over 500k are dead. They shut down the whole world to stop this and half a million people are still dead.

It's undoubtedly far worse than that. I'm extremely skeptical lots of countries outside the West are accurately reporting covid-19 deaths - I suspect that people are dying of covid-19 and it doesn't get reported, and even that some countries are deliberately manipulating their figures.

This is crazy, anyone else think this is crazy? This virus dies from soap, barriers stop it and it only lasts hours outside the body. It should be way easier to make this thing extinct.

Well, that's the thing with infectious diseases. It's very hard to prevent spread. But most of Europe and the USA did a particularly terrible job, so much is evident.

 

[tstorm823]

You?

Bingo!

 

[tstorm823]

It should be way easier to make this thing extinct.

It isn't easy. But it's also worth mentioning, even if you could eradicate a virus from every human being on the planet, animals can still act as a reservoir and start a brand new outbreak anyway. It's a pandemic, it's a natural disaster; if people die to nature, the correct response is humility rather than indignance.

 

[Specter Von Baren]

I just realised over 500k are dead. They shut down the whole world to stop this and half a million people are still dead.

This is crazy, anyone else think this is crazy? This virus dies from soap, barriers stop it and it only lasts hours outside the body. It should be way easier to make this thing extinct.

Perhaps it's just because I listen to Hardcore History and Dan Carlin made an episode on how easy it was for this to happen over 15 years ago, so I'm not surprised by that.

We're still doing far better than we did with the Spanish Influenza, so it's a bit comforting for me to know that we've at least improved our ability to deal with this, but it still hasn't run its course so we'll see if that continues in the long run.

 

[Fieldy409]

It isn't easy. But it's also worth mentioning, even if you could eradicate a virus from every human being on the planet, animals can still act as a reservoir and start a brand new outbreak anyway. It's a pandemic, it's a natural disaster; if people die to nature, the correct response is humility rather than indignance.

Nah fuck humility honestly. We've wiped out diseases before like Smallpox we can do it again. Extinction is what the Anthropocene era is all about humans have caused the Earths sixth major exctintion event. We can surely wipe out a virus that is killed by soap. Even those animals can develop immunity.

 

[Buyetyen]

We're still doing far better than we did with the Spanish Influenza, so it's a bit comforting for me to know that we've at least improved our ability to deal with this, but it still hasn't run its course so we'll see if that continues in the long run.

Imagine how much better we could have done if Trump didn't put his dick in it. That we're doing better than the 1918 pandemic is a very cold comfort.

 

[Silvanus]

Don't get me wrong. I'm not, by any stretch of the imagination, suggesting that Sweden took the right course of action. They put people at additional risk early in the pandemic, leading to a lot of death all at once, for little to no gain. They just also made themselves a case study to evidence my point. I think the experts expecting a much higher immunity rate to establish herd immunity, including the ones in Sweden, were and are wrong. The timeline of Sweden was that they figured they wouldn't quarantine as much as everyone else and weather the storm until the virus burnt itself out. They waited until the deaths and hospitalizations were dropping, those things dropping was meant to be evidence that it was factually burning itself out. Then they went to measure antibodies, they expected like half the population to be immune. Because theoretically, if you're maintaining the same behavior, and the rate of transmission is dropping, it's because parts of the population are no longer susceptible. That's what you expect. They did not expect to do antibody testing and see a single digit number. My suggestion here is that their theory is right, except they just still think they need way more immunity than they do.

I understand that, but the data doesn't support it. There's no indication at all that the antibody numbers they've reached actually constitute herd immunity. Pretty much the entire scientific community agrees it needs to be significantly higher. And Sweden's drop in deaths and hospitalisations doesn't provide any strong supporting evidence at all, coming as it does alongside similar drops across Europe in countries with vastly different situations.

All we've got here is a rough percentage for those who have antibodies, based largely on self-selecting data and data with a dozen other confounding variables; a positivity rate that doesn't show any meaningful drop recently; and a rate of deaths and hospitalisations that's dropping a little bit at the moment, but is broadly alongside Europe in general (but from a much higher starting point, meaning we would expect their drop to be more pronounced anyway).

Herd immunity is a long, long way off.

But there are ways that infection spread can be vastly reduced with a relatively small number of immune. The basic idea is that people have differing levels of contact. At one end you have hermits, and at the other ultra-tactile conference organisers who spend all their days travelling around the county and interacting with large groups of people who they kiss on the cheeks. Obviously, the latter are a disease spreading disaster.

So if each infected person infects an average of 3 other people, that might be ~0 for hermits, ~1.2 for most of the population, and ~20 for conference organisers. But what that means is when the conference organisers have all had it and are theoretically immune, that's pretty much the end of major risks of overwhelming the health service. Might need the odd local lockdown if the disease gets a bit frisky in some areas, but nothing too huge. Covid-19 will gently roll around the country killing people at a "tolerable" rate that the health service can cope with. After a few years of this herd immunity will build up* and the spread will die off. I mean, ~0.5% of the population may have died of it by then, but such is the way of the world.

On the other hand, doing a "Germany" would have been better anyway. Ultimately, they've had the same lockdown, and they will also have to have a few more lockdowns, but chances are they will still end up having far fewer deaths than the UK did. What's not to prefer about that?

* Assuming long-term immunity. If we're unlucky, covid-19 immunity might, like several other diseases, turn out to only last a few months

I get that the levels of immunity (or near-immunity) we do have, concentrated as it'll be on those who experience more frequent & widespread contact, will have a slowing or "flattening" effect. But peoples' habits have been affected so drastically by lockdown that people are likely to be switching between those two categories in the months after restrictions loosen. And as it rests on untracked personal behaviour, it's almost impossible to quantify.

 

[tstorm823]

I understand that, but the data doesn't support it. There's no indication at all that the antibody numbers they've reached actually constitute herd immunity. Pretty much the entire scientific community agrees it needs to be significantly higher. And Sweden's drop in deaths and hospitalisations doesn't provide any strong supporting evidence at all, coming as it does alongside similar drops across Europe in countries with vastly different situations.

The indication that the antibody numbers they've reached are meaningful toward herd immunity IS that it comes alongside similar drops across Europe. All of western Europe and the US northeast are experiencing the effects of herd immunity. That is why there's a bell curve at all. If you look at the graph of new cases, the graph in the flatten the curve image, the slope of the graph is an illustration of of the changing R value of the virus. When it's going up, R >1, when it's flat R=1, when it's going down R<1. R depends on a combination of factors: the natural qualities of the virus, the behavior of the population, the immunity of the population, etc. If your measures to stop the virus are sufficient to drive R below 1, you'd still see a short term increase because of the lag from the incubation period, but after a week or so the number of new cases would immediately start dropping. Look at South Korea for that, they started responding near the end of February and cases dropped precipitously about 1 incubation period later. If your measures are insufficient, you continue increasing. Europe did that. European countries had policies that slowed the rate of spread but did not push the rate of growth below 1, the number of cases continued to rise for a month or more after measures were put in place. So why did the number of new cases come back down? Either the people in every hotspot all decided to behave more responsibly over time to slowly drive down the rate of growth in exactly the pattern you'd expect to be caused by herd immunity, or the obvious explanation that there were fewer people available to infect.

If people's behavior is constant, you expect a bell curve as people become increasingly immune. Better control measures don't give you a smaller peak of the same duration, it either gives you a smaller peak with a much shorter duration because you've cut the virus off (but your population remains susceptible to outbreaks indefinitely sans vaccine), or it gives you a shorter peak with a longer duration that the total number of infections is the same but spread out. Nowhere in Western Europe is the pandemic behaving as though the virus was suppressed without the effects of herd immunity. They are all approaching herd immunity.