Uhh, I'm gonna need to see a source on this. That's a hell of a generalization to try to apply to a virus that people are still scrambling to gather more data on. Especially with regards to immune...
Vaccine-induced immunity, though, tends to be weaker than immunity that arises after an infection.
Uhh, I'm gonna need to see a source on this. That's a hell of a generalization to try to apply to a virus that people are still scrambling to gather more data on. Especially with regards to immune response. There have been suspected cases of reinfection, there are large numbers of "long-haulers", and there has been very little data collected about long term immunity because it simply hasn't been around long enough to understand how various people's immune systems are responding to it.
The Oxford vaccine recently published their phase 2 results, and showed the presence of T-cell immunity. Antibodies tend to clear out within the course of a few months (they're supposed to; failure to do so can result in some pretty awful long term complications when your system just accumulates antibodies against every little thing it encounters). T-cell immunity involves the memory response. They're hoping that it will be capable of yielding some decently long term immunity. But with the number of asymptomatic carriers who don't seem to be building up either antibodies or T-cell memory because of the non-severity of the infection, it's absolutely possible that vaccine immune response will be more robust than average sars-cov2 infection immune response.
But respiratory viruses don’t normally fling themselves into muscle. They infect respiratory systems, after all, and they usually sneak in through the mucous membranes of the nose and throat. Although vaccine shots induce antibodies in the blood, they don’t induce many in the mucous membranes, meaning they’re unlikely to prevent the virus from entering the body.
I'm sorry but I'm kinda questioning whether this author understands what vaccines are and the variety of different ways in which they can work. The things they are trying to pass off as -- I dunno, I feel like based on the headline I'm supposed to find these things deeply concerning in tone... But there are a pretty huge variety of approaches being attempted in parallel right now, on a pretty massive scale, and with absolutely unprecedented budget. This could likely be the single largest peer review in history, with the scientific eyes of the world over focused on finding the solution. So the tone of this article is kinda rubbing me the wrong way. I'm sorry if they come to a decent conclusion eventually, but to me this feels like someone's sloppy attempt to prematurely wrap their head around something they were ill prepared to comprehend.
Edit: finished reading it. I kinda get what they're trying to get at. People need to to hedge their optimism. That isn't always immediately apparent to me because I kinda take that as a given. I guess what rubs me wrong about it the most is that I feel like this vaccine effort is absolutely jaw-dropping in pace, scale, breadth, all of it. People have been working on it for all of 7 months, and they could possibly be 5 months away from having the first batches ready. That's... that's absolutely astounding.
So instead of belaboring what could possibly go wrong, how about focusing on the different ways we could keep things from going wrong? How about talking about the fact that if the best of humanity has stepped up to the plate and is accomplishing some incredible things, we could try and keep that ball rolling? And I know that the former nitpicking is a necessary first step for the latter solution, but I think it's just the tone and delivery of the messaging that irks me.
Like, I'm not in medicine. I'm not in journalism. It's not my job to either understand these concepts nor to explain them, yet I've devoted a hell of a lot of my time and energy to understanding the concepts at play here. I don't feel like this author did more than some cursory interviews, thought up some seemingly clever explanations to fit into the narrative they wanted to tell, and bowed out when it came down to the nuts and bolts of actually understanding it before trying to pass it on.
Sorry again for going on at length. I'll leave my rant at that.
I believe they are referring to vaccine induced immunity in general, not specifically Covid-19. So there is likely plenty of data regarding this. This article seem to dig into the topic a bit.
Vaccine-induced immunity, though, tends to be weaker than immunity that arises after an infection.
Uhh, I'm gonna need to see a source on this. That's a hell of a generalization to try to apply to a virus that people are still scrambling to gather more data on.
I believe they are referring to vaccine induced immunity in general, not specifically Covid-19. So there is likely plenty of data regarding this. This article seem to dig into the topic a bit.
Thanks, I'm giving it a read. I have some issues with it already (mostly in the simplification of the nature of immunity, the very topic that the article is claiming to be insufficiently...
Thanks, I'm giving it a read. I have some issues with it already (mostly in the simplification of the nature of immunity, the very topic that the article is claiming to be insufficiently understood and yet they are trying to simplify what is understood), but despite that it reinforces my point of contention. There are many vaccines that do give long term immunity. There are even vaccines that give long term immunity against cases when unvaccinated infection rarely gives immunity. So I'm wondering where the author of OP's article got the concept and why they believe it's applicable.
At this point I'm tempted to go through and gather a list of primary sources for vaccines that give robust long term immunity. But that's belaboring the wrong point. This is a sidetrack off of my overall objection to this article based solely off the first sentence I wrote. Maybe I've spent too long with my nose buried in medical studies lately, but I can't even begin to relate how frustrating it is to me that journalism in general seems to be making a hash of wrapping their heads around the concepts they're attempted to explain. Maybe they just don't have the time to devote and have impending deadlines that must be met. But that's still a problem, not merely an excuse.
These articles bear the weight of influence. They inform people. But to be able to teach something, one must first understand it. And in my experience of teaching, I need to understand things at a decently higher level than that of which I'm teaching in order to do a proper job of it. I think this article is punching above its class to be honest. They skipped the understanding part (let alone understanding at a higher level) and went straight towards teaching. That fails to inform, it misinforms. And we have enough problems with misinformation about science right now without adding to that pile.
Eh, okay I'm reading through the article you grabbed a bit more. So I might as well keep this going...
The growing understanding of the speed at which vaccine-trained immune systems can lose their muscle has raised concerns about some recent public health decisions. In 2016, the World Health Organization (WHO) in Geneva, Switzerland, changed its legally binding regulations about use of the yellow fever vaccine... so WHO shifted from requiring booster shots every 10 years to a single, lifetime shot. ... "The yellow fever vaccine–induced immunity is long-lived, but only in 80% of people," Slifka says.
So what happened with the yellow fever vaccine is that they were seeing good long term immunity responses so they stopped recommending boosters. Then some people stopped having long term immunity and there were some cases that popped up. Now that's certainly a problem for those who caught it. But it's also notable that this didn't result in an epidemic. Why? Because herd immunity did its job. The statistical factor of long term immunity kicked into play and limited the effective rate of transmission. So they came to the conclusion that boosters should still be given to those who live in areas that aren't regularly exposed to yellow fever and who thereby lose their immune response over time. None of this indicates that the vaccine doesn't do its job. It only indicates that variables must be accounted for in order for it to do its job to maximum efficacy.
A WHO spokesperson for the expert committee that evaluates vaccines says it continues to review new data on breakthrough cases of yellow fever, closely monitoring the duration of immunity in people who received a single dose. "The evidence provided does not support the need for [a] booster dose," the spokesperson says, noting that WHO cautions against "overinterpretation" of antibody data.
This kinda drives it home for me. When talking about vaccines, it seems like a lot of journalism leans heavily on solely antibody immune response. That's only one factor in a complex network of immune response. They're cautioning against interpreting the results of the correlation of decreased antibody in some of the vaccine recipients and the resurgence of cases. Because the resurgence may have nothing to do with a decrease in antibody response. There are other factors involved.
With SARS-Cov2, we're unlikely to get a vaccine that will give robust antibody results. At least from what I understand. Antibody response seems to be dropping off within a few months of recovery. However, there are other branches of immune response, and what we need to understand specifically with this is how effective T-cell memory response will be. There are already anecdotal cases of reinfection popping up, but we don't have data on these cases. Did they develop memory response and lose it? Did they never develop memory response in the first place? What conditions of infection must be met in order to develop robust immunity?
If there was a way to provide even short term immunity to the population in a safer way than infection, even if it only provides that short term immunity to 51% of that population, would you find it a worthwhile endeavor to administer it?
I'd emphatically answer yes for three reasons.
Saving lives is a worthwhile endeavor that I wonder if people have forgotten. "Don't let perfect be the enemy of the good" is a good phrase that's been floating around lately that responds nicely to this lack of regard, in my opinion.
Among those hit with symptoms of COVID (so ignoring the asymptomatic carriers for a moment), those who survive still high I high likelyhood of retaining symptoms for a long time after initial recovery. These "long haulers" are having to endure some pretty significant decrease in quality of life due to the damage inflicted by the virus.
The R effective is already heavily influenced by precautions. This virus is not so infectious that it bypasses all of our efforts. The more precautions we've been taking, the more the R effective goes down. The less precautions we take, the more infection we get. Even if a vaccine can only provide short term immunity for 51% (minimum efficacy for approval), that will still have the capacity to impact the R effective, especially if we exercise other precautions in tandem.
Alright, that's my core dump for the day. Haha thanks again for the article. Sorry if I come off as a grump or anything. I'm also trying not to punch above my own weight with this and unwittingly spread misinformation, so apologies if I've done so at any point.
The T-cell memory from the original SARS has lasted 17 years, so I think there's some room for optimism that similar immunity is possible with C19 given they are very similar viruses. It's not...
The T-cell memory from the original SARS has lasted 17 years, so I think there's some room for optimism that similar immunity is possible with C19 given they are very similar viruses.
It's not immunity, really. It's a zero-lag antibody response, since your body has the blueprints for the proper antibodies and doesn't have to discover them on its own. You can still get sick, just a lot less sick unless you manage to snuff a massive viral load somehow and let it get on top of your antibody response, or have other issues hampering that response.
The article is right about one thing - Covid isn't going away. It'll learn to mutate, it'll recombine with leftover coronaviruses in the infected and take a seat right alongside the flu and the common cold as part of the seasonal fun.
I wonder if this entire situation is just going to end with the calculated number of people dying, no matter what we do (~1% of the world population). I can't imagine people doing this for much...
I wonder if this entire situation is just going to end with the calculated number of people dying, no matter what we do (~1% of the world population). I can't imagine people doing this for much longer, I mean we can barely get Americans to wear masks, it kind of works here in Europe because of our social safety nets, but my country reintroduced masks, just in a really weird way, which is getting the rural population fairly mad because they don't have many covid cases and thus they see the measures as redundant.
Here in the US, I've begun trying to internalize and accept the fact that we're already screwed. We had basically one opportunity to keep the virus in a controlled state and then get back to...
Here in the US, I've begun trying to internalize and accept the fact that we're already screwed. We had basically one opportunity to keep the virus in a controlled state and then get back to somewhat "normal" while maintaining contact tracing and selective quarantine. That time is long past now. People are tired, angry, and burnt out. I know I am. And the longer this goes on, the more tired, fed up, and numb people are going to get. The more people will go out into public because "fuck it, why not". And the more people will die.
So I'm left sitting here isolated in my house, waiting for a vaccine. And it's a race between the vaccine, and enough people dying that we achieve herd immunity. I'm just trying to not be one of the dead ones.
We've had two outliers over here: Sweden and Belgium. Sweden has remained mostly open with voluntary quarantines and Which they did, which is why Belgium sits squarely at 2nd place in deaths/1M...
Here in the US, I've begun trying to internalize and accept the fact that we're already screwed. We had basically one opportunity to keep the virus in a controlled state and then get back to somewhat "normal" while maintaining contact tracing and selective quarantine. That time is long past now. People are tired, angry, and burnt out. I know I am. And the longer this goes on, the more tired, fed up, and numb people are going to get. The more people will go out into public because "fuck it, why not". And the more people will die.
We've had two outliers over here: Sweden and Belgium. Sweden has remained mostly open with voluntary quarantines and Belgium, from the beginning, went fuck it mode and said that they were reserving hospital beds for young people only and that old people can go die. Which they did, which is why Belgium sits squarely at 2nd place in deaths/1M population statistics, only after San Marino, which is only in first place because of statistics fuckery.
As time passes I wonder if just ripping the band aid off wasn't the better choice. The specialist handling Sweden's response has said that the entire thing is going to even out in the next few years and we'll end up with said ~1% of the world population dead. If so, are all these measures even doing anything?
Also, I wouldn't get my hopes up about a vaccine. Just like influenza, corona mutates quickly. Even if we get a vaccine, it won't be very effective, just like the various influenza vaccines we have.
EDIT: My info about Belgium is wrong, please see @Adys' comment for correction.
Tim Harford (economist, FT, BBC) has been, quite rightly IMO, pegging COVID-19 not as the disaster but the warning. It is just bad enough to cause real pain (and death), but not the horror of...
Tim Harford (economist, FT, BBC) has been, quite rightly IMO, pegging COVID-19 not as the disaster but the warning.
It is just bad enough to cause real pain (and death), but not the horror of mediaeval plagues with 10-50% mortality. At the same time, COVID has shut down the global economy and shaken political systems worldwide. Institutional and social responses are largely dysfunctional.
Harford's "Cautionary Tales" podcast has been brilliant from the start (November 2019, amazing timing).
Oh entirely. And that may be the most scary part. If we can't handle the fire drill, the actual fire is going to be truly horrifying. Sure maybe we'll get more cooperation if the threat of death...
As callous as it sounds, COVID-19 isn't all that bad of a pandemic.
Oh entirely. And that may be the most scary part. If we can't handle the fire drill, the actual fire is going to be truly horrifying. Sure maybe we'll get more cooperation if the threat of death is higher, but that seems overly optimistic.
Our species isn't very good at calculating risk, but even so there's no reason to believe that a serious pandemic wouldn't result in better cooperation with restrictions. I'm speaking anecdotally...
Our species isn't very good at calculating risk, but even so there's no reason to believe that a serious pandemic wouldn't result in better cooperation with restrictions. I'm speaking anecdotally here, but people ignore social distancing guidelines because they believe that the risk of them getting and dying from the disease is too low to warrant changes to their lifestyle. Humans are selfish creatures and do not act "rationally" (whatever that's supposed to mean). They certainly don't act altruistically unless they 1) have very strong morals or 2) doing so doesn't inconvenience them. Which, in the case of COVID-19, it very much does. Convenience and perception are the measures that should be used to judge compliance rates, not the "severity" of the disease outright (that word has no unified meaning to a population decidedly not comprised of virologists). This is especially true in a country like the United States, where "freedom" is ingrained in our very souls. But everyone knows that death is an awfully bad inconvenience.
Americans do not care that 2,000 people died on 9/11 in New York; they care that every time they board a flight, they could be the ones whose plane is being hijacked, or that they could die whenever they're at the office. Likewise, 25,000 people dying from some "Chinese virus" in New York state has literally zero significance to a potato farmer in rural Idaho. Distance turns news into an abstraction, and any number pressing beyond the three-digit range becomes increasingly difficult for us to conceptualize. "Oh, how unfortunate. I hope they figure it out. Good thing I don't live in Manhattan." Only because a virus can spread to other people does that potato farmer recognize that it has any bearing on her life. Someone contracting the disease in Boise might raise an eyebrow, and 100 dying from it is potentially more concerning. But 10,000 dying in a week will ring massive alarm bells in her and everyone else's head. With distance accounted for, such a figure is well past the "BIG NUMBER" threshold that signifies fear and loathing.
The death rate for COVID-19 in the United States is almost 0% for anyone under the age of 40. Thinking about this from an individualized standpoint, a sickly 25-year old who also has pneumonia will recognize that they'd be seriously putting their life in danger by not quarantining, so they'd go ahead and do it. A healthy 25-year old will comply with the regulations that are convenient for them because they care about their public image, but will ignore the ones that are inconvenient—as far as they're concerned, there is no substantial threat to their life by doing so. A 65-year old might see "5% death rate" for their age group and take it seriously. They also might not; that's not really a big number. Even 30% for 85-year olds is low enough that I can see why they might dismiss it. I have no interest in pedantic arguments about precise numbers (they're subjective), but my point is that people are ignoring the coronavirus because the death rates just aren't that high, not because they don't fear viruses or death in general. If the death rate were substantially higher, and/or the side effects of surviving the disease were more severe, fear would set in.
Imagine that an Ebola outbreak were to occur in the United States, a virus with an average death rate of about 50% (but up to 90%). That's a big enough number to strike fear into any sane person's heart! Perhaps more importantly, Ebola is an absolutely terrifying disease. Here's an excerpt from Richard Preston's The Hot Zone, which I read some years ago:
On the third day after his headache started, he became nauseated, spiked a fever, and began to vomit. His vomiting grew intense and turned into dry heaves. At the same time, he became strangely passive. His face lost all appearance of life and set itself into an expressionless mask, with the eyeballs fixed, paralytic, and staring. The eyelids were slightly droopy, which gave him a peculiar appearance, as if his eyes were popping out of his head and half closed at the same time. The eyeballs themselves seemed almost frozen in their sockets, and they turned bright red. The skin of his face turned yellowish, with a brilliant starlike red speckles. He began to look like a zombie. His appearance frightened the temporary housekeeper. She didn’t understand the transformation in this man. His personality changed. He became sullen, resentful, angry, and his memory seemed to be blown away.
[...]
He is holding an airsickness bag over his mouth. He coughs a deep cough and regurgitates something into the bag. The bag swells up. Perhaps he glances around, and then you see that his lips are smeared with something slippery and red, mixed with black specks, as if he has been chewing coffee grounds. His eyes are the color of rubies, and his face is an expressionless mass of bruises. The red spots, which a few days before had started out as star-like speckles, have expanded and merged into huge, spontaneous purple shadows: his whole head is turning black-and-blue. The muscles of his face droop. The connective tissue in his face is dissolving, and his face appears to hang from the underlying bone, as if the face is detaching itself from the skull. He opens his mouth and gasps into the bag, and the vomiting goes on endlessly. It will not stop, and he keeps bringing up liquid, long after his stomach should have been empty. The airsickness bag fills up to the brim with a substance know as the vomito negro, or the black vomit. The black vomit is not really black; it is a speckled liquid of two colors, black and red, a stew of tarry granules mixed with fresh red arterial blood. It is hemorrhage, and it smells like a slaughterhouse. The black vomit is loaded with virus. It is highly infective, lethally hot, a liquid that would scare the daylights out of a military biohazard specialist. The smell of the vomito negro fills the passenger cabin. The airsickness bag is brimming with black vomit, so Monet closes the bag and rolls up the top. The bag is bulging and softening threatening to leak, and he hands it to a flight attendant.
[...]
He appears to be holding himself rigid, as if any movement would rupture something inside him. His blood is clotting up and his bloodstream is throwing clots, and the clots are lodging everywhere. His liver, kidneys, lungs, hands, feet, and head are becoming jammed with blood clots. In effect, he is having a stroke through the whole body. Clots are accumulating in his intestinal muscles, cutting off the blood supply to his intestines. The intestinal muscles are beginning to die, and the intestines are starting to go slack. He doesn’t seem to be fully aware of pain any longer because the blood clots lodged in his brain are cutting off blood flow. His personality is being wiped away by brain damage. This is called depersonalization, in which the liveliness and details of character seem to vanish. He is becoming an automaton. Tiny spots in his brain are liquefying. The higher functions of consciousness are winking out first, leaving the deeper parts of the brain stem (the primitive rat brain, the lizard brain) still alive and functioning. It could be said that the who of Charles Monet has already died while the what of Charles Monet continues to live.
[...]
He becomes dizzy and utterly weak, and his spine goes limp and nerveless and he loses all sense of balance. The room is turning around and around. He is going into shock. He leans over, head on his knees, and brings up an incredible quantity of blood from his stomach and spills it onto the floor with a gasping groan. He loses consciousness and pitches forward onto the floor. The only sound is a choking in his throat as he continues to vomit while unconscious. Then comes a sound like a bedsheet being torn in half, which is the sound of his bowels opening and venting blood from the anus. The blood is mixed with intestinal lining. He has sloughed his gut. The linings of his intestines have come off and are being expelled along with huge amounts of blood. Monet has crashed and is bleeding out.
There exists no possibility in my mind whatsoever that any human being capable of any level of coherent thought would be able to read about those symptoms in the context of an Ebola pandemic literally happening around them and then continue on to say, "I don't care if I get the disease. I'll be fine." There is no world where they could laugh it off with the words "it's probably a hoax" and not simultaneously feel a cold, invisible grip squeezing their heart, subsuming them in a dark cloud of revulsion and fear that lurks in the back of their mind at all times; the very real threat that they, too, will die in this horrific, disgusting, repulsive way. It's the very embodiment of pestilence, all but riding in on a white horse. No doubt some group of evangelical loonies would begin preaching about the Apocalyptic End Times and the Great Bloodletting to Come (for the bad people, that is), but I have a seriously hard time believing that this would keep up once the actual process of death becomes clear to them. They wouldn't be taken seriously anyway; this country isn't as religious as it pretends to be. There's also a very real possibility that a potentially catastrophic plague on this level would prompt governments to declare martial law and enforce it with military strength. The populace might complain about fascism or liberals or whatever from their homes, but they wouldn't come outside to protest in crowds like they do right now. Self-interest outweighs any fledgling moral quandaries they might have. They don't want to die, and that's the end of the story. I can predict any number of nightmarish, dystopian characteristics and effects of a modern-day plague, but people just ignoring the disease and letting it take its course is definitely not one of them.
Edit: that excerpt from Preston's book actually doesn't seem to include the most frightening part of the Monet case. Good thing I have a copy on-hand. I've added the fourth and most gruesome paragraph for extra emphasis.
Okay I just had to chime in there… I live in Brussels, my best friend is a nurse at a hospital close by, and this is way off-mark. Belgium did say "prioritize younger people for hospital beds"....
Exemplary
Belgium, from the beginning, went fuck it mode and said that they were reserving hospital beds for young people only and that old people can go die. Which they did, which is why Belgium sits squarely at 2nd place in deaths/1M population statistics
Okay I just had to chime in there… I live in Brussels, my best friend is a nurse at a hospital close by, and this is way off-mark.
Belgium did say "prioritize younger people for hospital beds". During the first peak, it was standard procedure to take old people off a respirator if a younger, healthier person needed it. It never said "don't give beds to old people" or whatever version of this you heard though. This is also not in any way exceptional: It's standard triage procedure and most countries have this protocol (of course I have no idea how many apply it in practice).
Death statistics are warped because of two data gathering oddities: The first one is that anyone who tested positive for COVID and subsequently died is counted as a COVID death. This is actually super controversial here because it prevents people from seeing their loved ones during their last days and what not. The second oddity is the government ordering tests of every single resident in every single nursing home; so we had a surge of recorded positive COVID cases in the elderly population; this is amplified by point 1.
Belgium has been pretty pragmatic about the whole thing in my experience. Right now the second wave is beginning and we are tightening security measures again, making face masks mandatory in certain public areas (they're already mandatory in many places such as supermarkets, public transports, etc). Standard stuff. Personally I never felt like Belgium was doing "too much", but also never felt like it was doing too little either; and this is an extremely central country (geographically) in Europe we're talking about.
Anyway, I also do think this will even out, but remember the measures are supposed to "flatten the curve" and reduce the spread, not abolish it. New Zealand is the outlier IMO.
Citation needed. My source (Christian Drosten) says mutation is no concern for the foreseeable future. It's barely enough to be able to do phylogenetic tracing.
Also, I wouldn't get my hopes up about a vaccine. Just like influenza, corona mutates quickly.
Citation needed. My source (Christian Drosten) says mutation is no concern for the foreseeable future. It's barely enough to be able to do phylogenetic tracing.
Uhh, I'm gonna need to see a source on this. That's a hell of a generalization to try to apply to a virus that people are still scrambling to gather more data on. Especially with regards to immune response. There have been suspected cases of reinfection, there are large numbers of "long-haulers", and there has been very little data collected about long term immunity because it simply hasn't been around long enough to understand how various people's immune systems are responding to it.
The Oxford vaccine recently published their phase 2 results, and showed the presence of T-cell immunity. Antibodies tend to clear out within the course of a few months (they're supposed to; failure to do so can result in some pretty awful long term complications when your system just accumulates antibodies against every little thing it encounters). T-cell immunity involves the memory response. They're hoping that it will be capable of yielding some decently long term immunity. But with the number of asymptomatic carriers who don't seem to be building up either antibodies or T-cell memory because of the non-severity of the infection, it's absolutely possible that vaccine immune response will be more robust than average sars-cov2 infection immune response.
I'm sorry but I'm kinda questioning whether this author understands what vaccines are and the variety of different ways in which they can work. The things they are trying to pass off as -- I dunno, I feel like based on the headline I'm supposed to find these things deeply concerning in tone... But there are a pretty huge variety of approaches being attempted in parallel right now, on a pretty massive scale, and with absolutely unprecedented budget. This could likely be the single largest peer review in history, with the scientific eyes of the world over focused on finding the solution. So the tone of this article is kinda rubbing me the wrong way. I'm sorry if they come to a decent conclusion eventually, but to me this feels like someone's sloppy attempt to prematurely wrap their head around something they were ill prepared to comprehend.
Edit: finished reading it. I kinda get what they're trying to get at. People need to to hedge their optimism. That isn't always immediately apparent to me because I kinda take that as a given. I guess what rubs me wrong about it the most is that I feel like this vaccine effort is absolutely jaw-dropping in pace, scale, breadth, all of it. People have been working on it for all of 7 months, and they could possibly be 5 months away from having the first batches ready. That's... that's absolutely astounding.
So instead of belaboring what could possibly go wrong, how about focusing on the different ways we could keep things from going wrong? How about talking about the fact that if the best of humanity has stepped up to the plate and is accomplishing some incredible things, we could try and keep that ball rolling? And I know that the former nitpicking is a necessary first step for the latter solution, but I think it's just the tone and delivery of the messaging that irks me.
Like, I'm not in medicine. I'm not in journalism. It's not my job to either understand these concepts nor to explain them, yet I've devoted a hell of a lot of my time and energy to understanding the concepts at play here. I don't feel like this author did more than some cursory interviews, thought up some seemingly clever explanations to fit into the narrative they wanted to tell, and bowed out when it came down to the nuts and bolts of actually understanding it before trying to pass it on.
Sorry again for going on at length. I'll leave my rant at that.
I believe they are referring to vaccine induced immunity in general, not specifically Covid-19. So there is likely plenty of data regarding this. This article seem to dig into the topic a bit.
Thanks, I'm giving it a read. I have some issues with it already (mostly in the simplification of the nature of immunity, the very topic that the article is claiming to be insufficiently understood and yet they are trying to simplify what is understood), but despite that it reinforces my point of contention. There are many vaccines that do give long term immunity. There are even vaccines that give long term immunity against cases when unvaccinated infection rarely gives immunity. So I'm wondering where the author of OP's article got the concept and why they believe it's applicable.
At this point I'm tempted to go through and gather a list of primary sources for vaccines that give robust long term immunity. But that's belaboring the wrong point. This is a sidetrack off of my overall objection to this article based solely off the first sentence I wrote. Maybe I've spent too long with my nose buried in medical studies lately, but I can't even begin to relate how frustrating it is to me that journalism in general seems to be making a hash of wrapping their heads around the concepts they're attempted to explain. Maybe they just don't have the time to devote and have impending deadlines that must be met. But that's still a problem, not merely an excuse.
These articles bear the weight of influence. They inform people. But to be able to teach something, one must first understand it. And in my experience of teaching, I need to understand things at a decently higher level than that of which I'm teaching in order to do a proper job of it. I think this article is punching above its class to be honest. They skipped the understanding part (let alone understanding at a higher level) and went straight towards teaching. That fails to inform, it misinforms. And we have enough problems with misinformation about science right now without adding to that pile.
Eh, okay I'm reading through the article you grabbed a bit more. So I might as well keep this going...
So what happened with the yellow fever vaccine is that they were seeing good long term immunity responses so they stopped recommending boosters. Then some people stopped having long term immunity and there were some cases that popped up. Now that's certainly a problem for those who caught it. But it's also notable that this didn't result in an epidemic. Why? Because herd immunity did its job. The statistical factor of long term immunity kicked into play and limited the effective rate of transmission. So they came to the conclusion that boosters should still be given to those who live in areas that aren't regularly exposed to yellow fever and who thereby lose their immune response over time. None of this indicates that the vaccine doesn't do its job. It only indicates that variables must be accounted for in order for it to do its job to maximum efficacy.
This kinda drives it home for me. When talking about vaccines, it seems like a lot of journalism leans heavily on solely antibody immune response. That's only one factor in a complex network of immune response. They're cautioning against interpreting the results of the correlation of decreased antibody in some of the vaccine recipients and the resurgence of cases. Because the resurgence may have nothing to do with a decrease in antibody response. There are other factors involved.
With SARS-Cov2, we're unlikely to get a vaccine that will give robust antibody results. At least from what I understand. Antibody response seems to be dropping off within a few months of recovery. However, there are other branches of immune response, and what we need to understand specifically with this is how effective T-cell memory response will be. There are already anecdotal cases of reinfection popping up, but we don't have data on these cases. Did they develop memory response and lose it? Did they never develop memory response in the first place? What conditions of infection must be met in order to develop robust immunity?
If there was a way to provide even short term immunity to the population in a safer way than infection, even if it only provides that short term immunity to 51% of that population, would you find it a worthwhile endeavor to administer it?
I'd emphatically answer yes for three reasons.
Alright, that's my core dump for the day. Haha thanks again for the article. Sorry if I come off as a grump or anything. I'm also trying not to punch above my own weight with this and unwittingly spread misinformation, so apologies if I've done so at any point.
The T-cell memory from the original SARS has lasted 17 years, so I think there's some room for optimism that similar immunity is possible with C19 given they are very similar viruses.
It's not immunity, really. It's a zero-lag antibody response, since your body has the blueprints for the proper antibodies and doesn't have to discover them on its own. You can still get sick, just a lot less sick unless you manage to snuff a massive viral load somehow and let it get on top of your antibody response, or have other issues hampering that response.
The article is right about one thing - Covid isn't going away. It'll learn to mutate, it'll recombine with leftover coronaviruses in the infected and take a seat right alongside the flu and the common cold as part of the seasonal fun.
I wonder if this entire situation is just going to end with the calculated number of people dying, no matter what we do (~1% of the world population). I can't imagine people doing this for much longer, I mean we can barely get Americans to wear masks, it kind of works here in Europe because of our social safety nets, but my country reintroduced masks, just in a really weird way, which is getting the rural population fairly mad because they don't have many covid cases and thus they see the measures as redundant.
Here in the US, I've begun trying to internalize and accept the fact that we're already screwed. We had basically one opportunity to keep the virus in a controlled state and then get back to somewhat "normal" while maintaining contact tracing and selective quarantine. That time is long past now. People are tired, angry, and burnt out. I know I am. And the longer this goes on, the more tired, fed up, and numb people are going to get. The more people will go out into public because "fuck it, why not". And the more people will die.
So I'm left sitting here isolated in my house, waiting for a vaccine. And it's a race between the vaccine, and enough people dying that we achieve herd immunity. I'm just trying to not be one of the dead ones.
We've had two outliers over here: Sweden and Belgium. Sweden has remained mostly open with voluntary quarantines and
Belgium, from the beginning, went fuck it mode and said that they were reserving hospital beds for young people only and that old people can go die.Which they did, which is why Belgium sits squarely at 2nd place in deaths/1M population statistics, only after San Marino, which is only in first place because of statistics fuckery.As time passes I wonder if just ripping the band aid off wasn't the better choice. The specialist handling Sweden's response has said that the entire thing is going to even out in the next few years and we'll end up with said ~1% of the world population dead. If so, are all these measures even doing anything?
Also, I wouldn't get my hopes up about a vaccine. Just like influenza, corona mutates quickly. Even if we get a vaccine, it won't be very effective, just like the various influenza vaccines we have.
EDIT: My info about Belgium is wrong, please see @Adys' comment for correction.
Tim Harford (economist, FT, BBC) has been, quite rightly IMO, pegging COVID-19 not as the disaster but the warning.
It is just bad enough to cause real pain (and death), but not the horror of mediaeval plagues with 10-50% mortality. At the same time, COVID has shut down the global economy and shaken political systems worldwide. Institutional and social responses are largely dysfunctional.
Harford's "Cautionary Tales" podcast has been brilliant from the start (November 2019, amazing timing).
Oh entirely. And that may be the most scary part. If we can't handle the fire drill, the actual fire is going to be truly horrifying. Sure maybe we'll get more cooperation if the threat of death is higher, but that seems overly optimistic.
Our species isn't very good at calculating risk, but even so there's no reason to believe that a serious pandemic wouldn't result in better cooperation with restrictions. I'm speaking anecdotally here, but people ignore social distancing guidelines because they believe that the risk of them getting and dying from the disease is too low to warrant changes to their lifestyle. Humans are selfish creatures and do not act "rationally" (whatever that's supposed to mean). They certainly don't act altruistically unless they 1) have very strong morals or 2) doing so doesn't inconvenience them. Which, in the case of COVID-19, it very much does. Convenience and perception are the measures that should be used to judge compliance rates, not the "severity" of the disease outright (that word has no unified meaning to a population decidedly not comprised of virologists). This is especially true in a country like the United States, where "freedom" is ingrained in our very souls. But everyone knows that death is an awfully bad inconvenience.
Americans do not care that 2,000 people died on 9/11 in New York; they care that every time they board a flight, they could be the ones whose plane is being hijacked, or that they could die whenever they're at the office. Likewise, 25,000 people dying from some "Chinese virus" in New York state has literally zero significance to a potato farmer in rural Idaho. Distance turns news into an abstraction, and any number pressing beyond the three-digit range becomes increasingly difficult for us to conceptualize. "Oh, how unfortunate. I hope they figure it out. Good thing I don't live in Manhattan." Only because a virus can spread to other people does that potato farmer recognize that it has any bearing on her life. Someone contracting the disease in Boise might raise an eyebrow, and 100 dying from it is potentially more concerning. But 10,000 dying in a week will ring massive alarm bells in her and everyone else's head. With distance accounted for, such a figure is well past the "BIG NUMBER" threshold that signifies fear and loathing.
The death rate for COVID-19 in the United States is almost 0% for anyone under the age of 40. Thinking about this from an individualized standpoint, a sickly 25-year old who also has pneumonia will recognize that they'd be seriously putting their life in danger by not quarantining, so they'd go ahead and do it. A healthy 25-year old will comply with the regulations that are convenient for them because they care about their public image, but will ignore the ones that are inconvenient—as far as they're concerned, there is no substantial threat to their life by doing so. A 65-year old might see "5% death rate" for their age group and take it seriously. They also might not; that's not really a big number. Even 30% for 85-year olds is low enough that I can see why they might dismiss it. I have no interest in pedantic arguments about precise numbers (they're subjective), but my point is that people are ignoring the coronavirus because the death rates just aren't that high, not because they don't fear viruses or death in general. If the death rate were substantially higher, and/or the side effects of surviving the disease were more severe, fear would set in.
Imagine that an Ebola outbreak were to occur in the United States, a virus with an average death rate of about 50% (but up to 90%). That's a big enough number to strike fear into any sane person's heart! Perhaps more importantly, Ebola is an absolutely terrifying disease. Here's an excerpt from Richard Preston's The Hot Zone, which I read some years ago:
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There exists no possibility in my mind whatsoever that any human being capable of any level of coherent thought would be able to read about those symptoms in the context of an Ebola pandemic literally happening around them and then continue on to say, "I don't care if I get the disease. I'll be fine." There is no world where they could laugh it off with the words "it's probably a hoax" and not simultaneously feel a cold, invisible grip squeezing their heart, subsuming them in a dark cloud of revulsion and fear that lurks in the back of their mind at all times; the very real threat that they, too, will die in this horrific, disgusting, repulsive way. It's the very embodiment of pestilence, all but riding in on a white horse. No doubt some group of evangelical loonies would begin preaching about the Apocalyptic End Times and the Great Bloodletting to Come (for the bad people, that is), but I have a seriously hard time believing that this would keep up once the actual process of death becomes clear to them. They wouldn't be taken seriously anyway; this country isn't as religious as it pretends to be. There's also a very real possibility that a potentially catastrophic plague on this level would prompt governments to declare martial law and enforce it with military strength. The populace might complain about fascism or liberals or whatever from their homes, but they wouldn't come outside to protest in crowds like they do right now. Self-interest outweighs any fledgling moral quandaries they might have. They don't want to die, and that's the end of the story. I can predict any number of nightmarish, dystopian characteristics and effects of a modern-day plague, but people just ignoring the disease and letting it take its course is definitely not one of them.
Edit: that excerpt from Preston's book actually doesn't seem to include the most frightening part of the Monet case. Good thing I have a copy on-hand. I've added the fourth and most gruesome paragraph for extra emphasis.
Okay I just had to chime in there… I live in Brussels, my best friend is a nurse at a hospital close by, and this is way off-mark.
Anyway, I also do think this will even out, but remember the measures are supposed to "flatten the curve" and reduce the spread, not abolish it. New Zealand is the outlier IMO.
Citation needed. My source (Christian Drosten) says mutation is no concern for the foreseeable future. It's barely enough to be able to do phylogenetic tracing.