This post is a reaction to this post by Cheryl Rofer to which she linked in the comments thread of this post by James Joyner. The particular passage to which I am reacting is this paragraph:
People who are not vaccinated will become sick and die. Those who recover will be immune to the disease. Either way, they will be removed from the susceptible pool. People are being vaccinated every day. They are removed from the susceptible pool after the appropriate number of shots and waiting period. The numbers of the susceptible decrease every day.
With all due respect I think that Cheryl is mistaken in almost every particular in that statement. The population is not divided into two groups (the vaccinated and the unvaccinated). There are many groups. We do not know whether those who do not elect to be vaccinated will become sick but we can be pretty confident that most who contract COVID-19 will not die because that has been the experience to date. We do not know whether some proportion of the population is simply not susceptible to the disease without either previous contracting of the disease or vaccination. We can be pretty confident, again based on present experience, that people who have been vaccinated can, in fact, contract the disease. At this time we cannot say with confidence whether vaccinated individuals who nonetheless contract COVID-19 are able to spread it to others. We are hopeful that they cannot but we do not actually know. We do not know whether those who have been fully vaccinated and nonetheless contract COVID-19 may die of the disease. We have fair confidence they will not but we do not actually know.
All of these reasons point to why my view differs dramatically from Cheryl’s. I don’t believe that the pandemic will ever be “over” in the sense that we will return to the status quo ante September 2019. The pandemic will technically be over but it will be endemic. “Zero COVID” is not an achievable goal. It probably was not an achievable goal as early as December 2019 and it may never be achievable. People will contract COVID-19, spread it to others, and some will die of it and all of those will be true regardless of how many people are vaccinated.
Just for the record I am fully vaccinated, I believe it is prudent to do so, and I wear a facemask when entering stores or other buildings in which I encounter the public. I do not see my self as either a “anti-vaxxer” or even as a pessimist. I think I am a realist and an empiricist.
To answer Ms. Rofer’s question, at least 85% of the Yankees players and staff have been fully vaccinated since fairly early in the season. This is their second outbreak this season. And yet they still test positive for the virus. I think MLB protocols are that if a team reaches that 85% threshold then those fully vaccinated don’t have to do regular testing, wear masks, and can congregate with others inside. The unvaccinated still do regular testing and if they test positive, then contact-tracing which can lead to vaccinated people getting tested and forced to isolate even though they have mild or no symptoms.
I think what baseball is doing is kind of nuts, but with so much testing going on, it should be clear that people don’t become immune to the disease. Their immune system becomes more effective, rendering COVID-19 to something like the flu.
One thing I wish was mentioned more is the number of people who appear to have received one shot of a two shot regiment. The lag seems persistent enough that there appear to be quite a lot of people that are getting one shot, but choosing not to get the second. I’ve read claims that people hear that the second dose creates symptoms and are avoiding it.
Unfortunately, I think the second dose is probably very valuable for optimizing the response to the inevitable mutations. A boost increases the effectiveness, speed and duration of the immune response. Maybe a single dose might be sufficient to prevent severe illness, particularly among the younger, it probably does not do much in terms of suppressing viral shedding. Seems like there should be messaging directed to people who clearly aren’t anti-vax to get fully vaccinated.
The ability of fully vaccinated people to transmit the virus has been documented. I also think that Cheryl makes it clear she understands not everyone dies from Covid since in her next sentence she mentions survivors. There are plenty of case reports and summations showing that the fully vaccinated can still die. Not many but it still happens.
At one point maybe it was realistic to think we could make this like measles. It would still be around but very rare. The anti-vaxxers have made sure that wont happen.
https://medical.mit.edu/covid-19-updates/2021/07/deltas-here
Steve
Internal contradictions are not particularly good proof of understanding.
The title of her post is “The Pandemic Will End”. I don’t think that either experience or the present evidence supports that in anything but a technical sense—as I said it will change from a pandemic to endemic. What are the policy implications of that difference and only that difference? I doubt there are any.
After delta there are likely to be epsilon, kappa, and so on until they run out of Greek letters. At some point they’ll just number them.
The descendent of the Spanish Flu is still circulating once the pandemic ended and the virus became endemic.
The “This Week in Virology” podcast has started moving away from COVID-19, but I believe they still remain skeptical of “variants of concern” because lack of supporting data. Also, the “transmissibility” analysis apparently is not in the traditional virology tool kit, and the studies using this framework generally fail to consider social phenomena, founder-effects and relative fitness in imputing rate of spread to new features of a virus:
“Why do variants out-compete and displace other viruses? It is because the variants have increased fitness, the ability of a virus to reproduce in the host. Fitness can be altered in many ways, including evasion of antibody responses, increased particle stability, and even person to person transmission. No experiments have been done to explain the increased fitness of variants. Fitness is not the same as transmission.
“Variants of influenza virus arise frequently, and these variants displace existing viruses because they have a fitness advantage. For influenza virus, a fitness advantage is often conferred by HA amino acid changes that allow escape from antibody neutralization. Antigenic variants can infect a slightly larger number of hosts and that is enough natural selection advantage for the new variants to outcompete the older ones. No one ever says that these influenza virus variants have increased transmission.
“Unfortunately the narrative that the variants have increased transmission is dominating the media. This situation has arisen because virologists, epidemiologists, and evolutionary biologists are not talking to one another. In addition, what we know about other viruses, as illustrated here for influenza virus, is also ignored.”
https://www.virology.ws/2021/06/10/holiday-travel-explains-spread-of-a-sars-cov-2-variant/
I was born in 1968 and almost died in the 1968 pandemic. Supposedly that virus is still around today and part of the annual flu shot.
To me, it was always pretty clear that this virus would never be eliminated. At my sister’s memory care facility two vaccinated staff members tested positive. They were asymptomatic and it was only caught because the state health department mandates regular testing for employees in elder care facilities. Who knows how many vaccinated people are infected and none the wiser?
Considering vaccine efficacy will diminish over time, I would expect booster shots to be a big deal soon, particularly for vulnerable groups since it appears the current vaccines don’t completely prevent spread.
Now they find SARS-COV2 can infect deer.
https://arstechnica.com/science/2021/07/over-half-the-deer-in-michigan-seem-to-have-been-exposed-to-sars-cov-2/
And that’s on top of cats, mink. With multiple animal reservoirs I don’t see how it’s realistic to go to zero-COVID.
Also — my interpretation is the finding raises the likelihood of zoonotic origins; but may make it impossible to prove so.
Agreed.
“Internal contradictions are not particularly good proof of understanding.”
I try to be a bit more understanding since people are often making fast responses on a blog. I think if you want to know if they really understand you can just ask them.
Steve
“Now they find SARS-COV2 can infect deer.”
Has the Biden Administration implemented an order to make the deer wear masks yet?
What is clear, and has been clear for quite some time, is that the data is suspect, the response to viral infection varies widely among people, the public policy responses are often misguided, contradictory or inefficacious, and fail any sort of rudimentary cost/benefit analysis. Zero risk/zero cost simply is not the way the world works.
Of all that has transpired, few actions seem truly wise. Vaccination appears prudent, but in no way a guarantee. High risk individuals should take their own reasonable precautions. Say, limiting public exposure or hand washing. That’s pretty much it. Oh……….
One of the few aspects of this whole sorry chapter that should be crystal clear is that allowing large numbers of immigrants into the country runs absolutely counter to any serious expressed concern about spread of the virus. It almost makes one think this is largely a political issue, not a scientifically based public health issue.
And of course the biggest of all. We might want to rethink funding gain of function research in a country known for a complete lack of transparency and which we have no control whatsoever. What could go wrong?
“Vaccination appears prudent, but in no way a guarantee.”
Not much is guaranteed in life, but 97% effective against severe disease is pretty good. So in fact, there were a lot of errors at first. We had politicians making recommendations about what drugs to use and they were recommending drugs that didnt work. We have never, that I can recall, had any politician making such inappropriate recommendations out of their field of expertise. Initial testing was botched. Initial messaging was botched. It was not just the flu. The recommendation against masks so they could be saved for the medical community was a mistake. They work pretty well and should have been advocated for sooner. So overall, leadership was very poor early on, but it did get better. ( Hand washing is generally good but not a major issue for Covid. )
Immigrants have not been a significant source of Covid. What counts now is vaccinations. States are reporting that 99.5% of those dying are the unvaccinated.
https://www.texastribune.org/2021/07/21/coronavirus-texas-vaccinated-deaths/
Steve
“Not much is guaranteed in life, but 97% effective against severe disease is pretty good. So in fact, there were a lot of errors at first. We had politicians making recommendations about what drugs to use and they were recommending drugs that didnt work.”
You are simply reiterating my points. First, there is no risk free world and the ready, fire, aim measures taken were horrible policy, with essentially no consideration of costs. Second, the whole thing was made a political issue, with footballs tossed both ways, for obvious reasons. It was shameful. It still is.
That immigrants are statistically not a large spreader issue is a red herring. (Provided that’s true. How would we really know? All of the statistics in this saga have been a mess.) The number should be zero. We put travel restrictions all over the place for citizens. We are now talking about vaccine passports for legal residents (simply amazing). “Well, you know, illegal immigrants aren’t that big a spreader” is a nonsense argument. These are not political refugees. They have no inherent right to come here. They put downward pressure on wages, when we supposedly care about income inequality. Why invite any increased covid risk. No one should should take anyone professing covid concerns seriously when they are fine with an immigration flow like a broken fire hydrant.
In1968, I was 16, that fall during football season I came down with a fever. Lasted three days of delirium.
Went from 160 lbs to 130 lbs in three days.
When the fever broke I knew it was done, but man , so weak.
Maybe I had that too.
Never forget that leaders must act, and act without foreknowledge.
To be judged when the facts are in, if ever.
Fauci should have explained to President Trump how it was that he knew everything about the unfamiliar virus, having financed the research that spawned it.
But that’s now the past and we face a new, more dangerous variant.
Profligate public service education is the best and least divisive method I know of to help people protect themselves.
One thing to bear in mind is that there are now around 500,000 vulnerable Americans who will not contract the virus as they are gone.
“(Provided that’s true. How would we really know? All of the statistics in this saga have been a mess.)”
We actually study this stuff. Look at all of our big surges. They occurred when immigration rates, illegals especially, were low. The increase going on now is among the unvaccinated. The problem is people not being vaccinated and immigrants are a distraction.
“ready, fire, aim measures taken were horrible policy”
As I Ahv repeatedly pointed out, the early actions of the CDC/FDA were pretty bad. We didnt get testing early like we should. We had horrible leadership from Trump. He stopped travel into the US by foreigners bout he let Americans keep traveling back and forth. Most spread is by family members. It was a pure performative measure. They want tis save masks for hospitals so they discouraged their use. All mistakes. But we did a lot of good. The masks were actually pretty effective. Lockdowns helped at peaks. Distancing and banning large gatherings helped.
We even have out own natural experiment. Look at Sweden and its neighbors. Sweden did lockdown-lite. Neighbors had stricter lockdowns. Similar climates, cultures, lifestyles, diets etc. Sweden had about 5 times as many deaths as neighbors.
Steve