Cont: The One Covid-19 Science and Medicine Thread Part 3

[The Atheist]

There is no doubt that Delta is more difficult to stop than the original version of SARS-CoV-2 or even the Alpha variant, but your argument seems to be that since it hasn't (yet) been stopped, it can't be stopped, and in order to strengthen the validity your suspicion, you would have to argue that all measures have been employed to no avail.

I don't see vaccines able to stop the disease. Too many people won't be vaccinated, and there's a significant breakthrough rate in the vaccines as well.

We can mitigate it, but that's all.

 

[Planigale]

Interesting study on Covid-19's transition into endemicity.

Immunological characteristics govern the transition of COVID-19 to endemicity

https://www.science.org/doi/full/10.1126/science.abe6522



Also explores how other, more virulent SARS-CoV's would be best handled.

The interesting observation is that we may be better with a vaccine that does not prevent infection, but prevents people becoming seriously ill. They suggest that for the long term, adenovirus vaccines may be the best option, to minimise long term mortality. It is important in this model to keep the infection circulating and so maintain immunity.

 

[Planigale]

Covid News: C.D.C. Study Shows Pfizer Vaccine’s Protection Wanes (NY Times)



What could account for the difference between Pfizer's vaccine and Moderna's?

I seem to recall that the Moderna vaccine contains 100 µg of the mRNA active ingredient, compared to 30 µg in Pfizer. That's more than a 3-fold difference. Also, the timing between doses is 4 weeks for Moderna and 3 weeks for Pfizer. Could either of those things be relevant?

There is good evidence extending the interval between first and second doses improves magnitude and duration of protection. This has been shown for Pfizzer in the UK comparing 3 week to 8-12 week interval, the latter produces three times greater antibody levels with greater apparent duration of protection. Any earlier than weeks for a booster may weaken immunity.

https://www.birmingham.ac.uk/news/l...r-vaccination-interval-antibody-response.aspx

 

[dann]

I don't see vaccines able to stop the disease. Too many people won't be vaccinated, and there's a significant breakthrough rate in the vaccines as well.

We can mitigate it, but that's all.

Vaccines seem to be able to slow it down considerably. In Denmark, a high level of vaccinations alone seems to have been able to make the R₀ drop to below 1 in recent weeks. I was very skeptical of the reopening, but so far it doesn't appear to have made the numbers rise. My only concern now is that the apparent success may also have contributed to making the yet unvaccinated young people more reluctant to go ahead and get the shot.

You talk of the vaccines as the one and only remedy against the pandemic. They aren't. Restrictions still work, face masks still work, and New Zealand still has far fewer cases than Denmark in spite of the relatively low level of vaccinations. I think that New Zealand would have reached ZeroCovid (again) if the vaccination level were as high as in Denmark (which it will be very soon with the current rate of vaccinations), which is why it annoys me that Denmark didn't wait a couple of weeks more before opening up. Like I said, the numbers are decreasing, but we would have had far fewer cases now, maybe even zero, if the reopening had been postponed.

How Denmark returns to pre-pandemic life thanks to high vaccination rates (DW, Sep 17, 2021)


Share of people vaccinated against COVID-19: DNK~USA~GBR~NZL~AUS (Our World in Data)

By the way, the high degree of TTI in Denmark is also very important. The vaccines alone wouldn't have got us where we are now.

 

[dann]

We haven't yet stopped it.

No, we haven't. That is pretty obvious.

The wider it spreads, the harder it is to stop it.

If your only tool is lockdowns, then yes, otherwise no.

So "we're not going to stop it" is a reasonable conclusion.

No, it's not. It's like saying that because a fire is easier to put out when it is small than when it has grown large, there is nothing we can do to stop it, so we might as well stop trying and let the whole town burn down.

The virus will have paths through many areas of partial immunity, ocassionally running rampant in isolated pockets as boosters wane and children without prior exposure grow into young adults, travelling and taking risks as they do.

Yes, it will have many paths if we let those paths remain open, let boosters wane, let children remain unvaccinated and unprotected, if we don't maintain the necessary level of border control etc. You pretend that difficulties can't be overcome. I.e. any and all difficulties to you are arguments for the impossibly of ZeroCovid, but all of them imply the solutions to the problem.

The only thing that prevents SARS-CoV-2 from being eradicated is the political will to do so.

 

[dann]

They were right then, so just maybe they're right now....

They were wrong then, which doesn't in itself make them wrong now, but they are. Throughout the pandemic, Swedish epidemiologists have been as wrong about everything as they could possibly be. When their state epidemiologist was told about New Zealand having eliminated the virus, he exclaimed: "Impossible!"
He was embarrassed by the fact instead of seeing it as encouragement: 'What I thought could not be done has actually been done.'
Instead, he did his utmost to make sure that the virus always had ways to spread in Sweden, and he was deeply offended when the other Nordic countries closed their borders to his infected compatriots.

 

[Dr.Sid]

The only thing that prevents SARS-CoV-2 from being eradicated is the political will to do so.

There is no political will be cause there is no common will. People don't want lockdowns. People don't want border control. And enough people don't want vaccines.
Zero Covid is impossible not because there isn't a way. But because exactly everyone in the world would have to cooperate. Which will never happen.

 

[Skeptic Ginger]

...

The only thing that prevents SARS-CoV-2 from being eradicated is the political will to do so.

Does that include rich countries going all out to stop the pandemic in poor countries?

Whose political will is needed in countries like Brazil, their's or our's?

And what about the most rural areas of the world where the vaccine cold chain is challenging to say the least?

I think claiming it is political will seriously over-generalizes the problem.

 

[Planigale]

No, we haven't. That is pretty obvious.




If your only tool is lockdowns, then yes, otherwise no.




No, it's not. It's like saying that because a fire is easier to put out when it is small than when it has grown large, there is nothing we can do to stop it, so we might as well stop trying and let the whole town burn down.




Yes, it will have many paths if we let those paths remain open, let boosters wane, let children remain unvaccinated and unprotected, if we don't maintain the necessary level of border control etc. You pretend that difficulties can't be overcome. I.e. any and all difficulties to you are arguments for the impossibly of ZeroCovid, but all of them imply the solutions to the problem.

The only thing that prevents SARS-CoV-2 from being eradicated is the political will to do so.

Eradicating it may be more dangerous than letting it become endemic. In the model infection occurs before 5 years in the vast majority, when the risk is very low, immunity develops and subsequent infections are mild but relatively frequent as occurs with the corona viruses that cause the common cold. Vaccination is used to emulate the immunity of natural infection in the older age groups. Covid becomes a nuisance rather than a danger. In eradicating (which given the need to do so globally) you will continue to maintain a susceptible population with a constant need to maintain vaccination, there will continue to be deaths associated with outbreaks until you achieve global eradication. Vaccines are much more effective against polio and smallpox than they are against covid, and it has taken decades to approach or achieve eradication. I cannot see the campaign to eradicate covid being quicker. The model suggests endemicity could be achieved in twenty years, at which point vaccination would no longer be needed and covid is no longer a threat. Eradication is likely to take longer and is not clearly safer.

 

[marting]

Here's a good reason to get a mRNA vax if you already had Covid-19:

High genetic barrier to SARS-CoV-2 polyclonal neutralizing antibody escape
https://www.nature.com/articles/s41586-021-04005-0

By aggregating VOC-associated and antibody-selected spike substitutions into a single polymutant spike protein, we show that 20 naturally occurring mutations in SARS-CoV-2 spike are sufficient to generate pseudotypes with near-complete resistance to the polyclonal neutralizing antibodies generated by convalescents or mRNA vaccine recipients. Strikingly, however, plasma from individuals who had been infected and subsequently received mRNA vaccination, neutralized pseudotypes bearing this highly resistant SARS-CoV-2 polymutant spike, or diverse sarbecovirus spike proteins.

 

[The Atheist]

Vaccines seem to be able to slow it down considerably. In Denmark, a high level of vaccinations alone seems to have been able to make the R₀ drop to below 1 in recent weeks. I was very skeptical of the reopening, but so far it doesn't appear to have made the numbers rise.

Yeah, the news coming from highly vaccinated countries is very encouraging, but it's not going to eliminate it. There will always be targets for the virus.

You talk of the vaccines as the one and only remedy against the pandemic. They aren't. Restrictions still work, face masks still work,...

I'm picking that while compliance was high in the early stages, once countries reach the point of very low death rates, I don't believe the political or societal will to wear them will exist. I believe you now have no mask rules in Denmark?

... and New Zealand still has far fewer cases than Denmark in spite of the relatively low level of vaccinations.

Only because we had the luxury of raising the drawbridge. But we still let it back in again...

I think that New Zealand would have reached ZeroCovid (again) if the vaccination level were as high as in Denmark (which it will be very soon with the current rate of vaccinations),...

Depends on how you see "very soon".

By my calculations, with vaccines given six weeks apart, we're not going to hit 70% until at least 8 November.

Now that I can see the collateral damage of lockdowns, I think more of them is an extremely bad idea.

 

[Orphia Nay]

Oxford and Oracle partner to speed identification of COVID-19 variants

https://www.ox.ac.uk/news/2021-09-2...artner-speed-identification-covid-19-variants

"The fast spread of the highly infectious Delta variant underscores the need for faster identification of COVID-19 mutations. Uniting governments and medical communities in this challenge, the University of Oxford and Oracle’s Global Pathogen Analysis System (GPAS) is now being used by organizations on nearly every continent.

"Built using Oxford’s Scalable Pathogen Pipeline Platform (SP3), Oracle APEX, and Oracle Cloud Infrastructure (OCI), the Global Pathogen Analysis System is a cloud platform that provides a unified, standardized system for analyzing and comparing the annotated genomic sequence data of SARS-CoV-2."

I hope a lot of facilities jump onto this so we stay on top of variants.

 

[dann]

Yeah, the news coming from highly vaccinated countries is very encouraging, but it's not going to eliminate it. There will always be targets for the virus.

But that's the point of herd immunity: spreading out those targets so the rest of us will act as buffers - in addition to PPE and other measures until it's gone.

I'm picking that while compliance was high in the early stages, once countries reach the point of very low death rates, I don't believe the political or societal will to wear them will exist. I believe you now have no mask rules in Denmark?

I am not sure. Nobody wears face masks when shopping, but I see some people on public transport wearing them even though it is no longer mandatory.

Only because we had the luxury of raising the drawbridge. But we still let it back in again...

That was the argument used by Swedes from the very beginning: 'But New Zealand is an island! That's easy!'
Nothing prevented the countries in the EU from having border control.

Depends on how you see "very soon".

By my calculations, with vaccines given six weeks apart, we're not going to hit 70% until at least 8 November.

Now that I can see the collateral damage of lockdowns, I think more of them is an extremely bad idea.

Every jab helps. And the numbers are decreasing in NZ. 325 active cases today is amazing. Denmark has 5,452 and still considers the pandemic to be over.
I would prefer the (sometimes only alleged) collateral damage of lockdowns to the actual damage of the pandemic.

 

[dann]

Eradicating it may be more dangerous than letting it become endemic. In the model infection occurs before 5 years in the vast majority, when the risk is very low, immunity develops and subsequent infections are mild but relatively frequent as occurs with the corona viruses that cause the common cold. Vaccination is used to emulate the immunity of natural infection in the older age groups. Covid becomes a nuisance rather than a danger. In eradicating (which given the need to do so globally) you will continue to maintain a susceptible population with a constant need to maintain vaccination, there will continue to be deaths associated with outbreaks until you achieve global eradication. Vaccines are much more effective against polio and smallpox than they are against covid, and it has taken decades to approach or achieve eradication. I cannot see the campaign to eradicate covid being quicker. The model suggests endemicity could be achieved in twenty years, at which point vaccination would no longer be needed and covid is no longer a threat. Eradication is likely to take longer and is not clearly safer.

You don't seem to take into account what it will take for SARS-CoV-2 to become endemic the same way the common cold is: I don't see anybody getting 'long Cold' - neither children nor adults.

 

[dann]

Does that include rich countries going all out to stop the pandemic in poor countries?

Whose political will is needed in countries like Brazil, their's or our's?

And what about the most rural areas of the world where the vaccine cold chain is challenging to say the least?

I think claiming it is political will seriously over-generalizes the problem.

The most rural areas are not the problem. The virus doesn't spread fast in those areas. A sparsely populated area works much like herd immunity. Besides, it is still a question of the will to get the job done, even is those areas. They can get vaccinated against polio and smallpox. Vaccinating them against SARS-CoV-2 isn't any different.

And yes, that includes rich countries and countries like Cuba going all out to stop it everywhere.

 

[dann]

There is no political will be cause there is no common will. People don't want lockdowns. People don't want border control. And enough people don't want vaccines.
Zero Covid is impossible not because there isn't a way. But because exactly everyone in the world would have to cooperate. Which will never happen.

There is no "people don't want". Nobody implements lockdowns or border control for fun.
If the ways of the pandemic are explained to people, there aren't many objections. Nobody seriously objected to the Danish border control - except Swedish politicians, but **** them.
The protests against the Danish lockdowns were few and far between and of no consequence. And when the point of the vaccines are explained properly to people, they want them.

The main problem is with special interest groups like the people who own restaurants and concert venues. In Denmark, they received state subsidies, which helped dampen their opposition to the restrictions. The clever ones were aware that a raging pandemic makes an awful lot of people stay away from discos, bars and movie theaters anyway. Only complete idiots believed in the delusion that no restrictions = business as usual. (Not that those idiots don't exist.)

Border controls take care of your problem that "everyone in the world would have to cooperate." No they wouldn't. You could close your borders to countries unwilling to cooperate. It's a very obvious part of quarantine measures. Then the covidiots could all go there to celebrate their freedom. The conditions for returning would have to be worked out in detail.

 

[Planigale]

You don't seem to take into account what it will take for SARS-CoV-2 to become endemic the same way the common cold is: I don't see anybody getting 'long Cold' - neither children nor adults.

But you cannot assume that elimination is the best option. Both will result in decades of infection, in the former (endemicity), one does not need high level surveillance, travel restrictions and intermittent lock downs for decades. Both options have to be looked at. The former is achievable, the latter (eradication) may not be.

How do you know people do not get long colds? We do not know the trigger for chronic fatigue syndrome. What we do know is 'long covid' is probably less common than was originally feared, the majority seem to recover, and it is less common in children (or may not even exist as a separate entity from 'pandemic syndrome' caused by lock down stress).

https://journals.lww.com/pidj/Abstract/9000/How_Common_Is_Long_COVID_in_Children_and.95677.aspx

Of the 5 studies which included children and adolescents without SARS-CoV-2 infection as controls, 2 did not find persistent symptoms to be more prevalent in children and adolescents with evidence of SARS-CoV-2 infection.

However, in the majority of studies, symptoms did not persist longer than 12 weeks. Consistent with this, 1 study that did find a difference between cases and controls in persisting symptoms (at 4 weeks post COVID) reported that by 8 weeks, most symptoms had resolved, suggesting long COVID might be less of a concern in children and adolescents than in adults.

ETA and vaccination seems to protect against long covid in adults if they subsequently have a natural infection.

 

[Skeptic Ginger]

The most rural areas are not the problem. The virus doesn't spread fast in those areas. A sparsely populated area works much like herd immunity. Besides, it is still a question of the will to get the job done, even is those areas. They can get vaccinated against polio and smallpox. Vaccinating them against SARS-CoV-2 isn't any different.

And yes, that includes rich countries and countries like Cuba going all out to stop it everywhere.

I think you underestimate the population size in countries in Africa that have poor access to refrigeration.

 

[The Atheist]

Every jab helps. And the numbers are decreasing in NZ. 325 active cases today is amazing. Denmark has 5,452 and still considers the pandemic to be over.

I wouldn't be hanging your hat on NZ's figures. We're about to go NSW with the virus, and if we don't have over 1000 active cases by the end of this month, with 100+ cases a day I have several hats I'll gladly eat.

I would prefer the (sometimes only alleged) collateral damage of lockdowns to the actual damage of the pandemic.

We proved with the 2020 lockdowns that as long as you eradicate the disease, the economic and other collateral damage is very limited.

Letting it back in is a very real mistake, as NZ is about to find out, to the cost of many lives and more billions of dollars.

 

[Puppycow]

There is no "people don't want". Nobody implements lockdowns or border control for fun.

I agree, but apparently a lot people on the internet argue that it's all because they want to control people and take away their freedumbs.