How do we know a pandemic's over?

[icerat]

But interestingly, not other coronaviruses, that can also be deadly.

I agree that would be a worthy goal, but I am curious as to why flu is not on the list.

The degree of difficulty vs the benefit.

And if this mean that seasonal flu cant be realistically eradicated, doesn't the same argument apply to Covid?

I'd argue quite a few diseases on that list can't be "realistically" eradicated. It's pretty damn unlikely car accident fatalities can be either, but I've never once seen anyone argue against "Vision Zero" car safety measures because "zero" is unrealistic.

 

[icerat]

The animal reservoir of SARS-CoV-2 makes eradication of COVID-19 impossible.

the number of animal-human transmissions has been negligible. Proven cases are in single digits. In many places - including Australia - at times virtually every single transmission was traced. Not once was it traced to an animal.

And I'd note one of the diseases on the list for eradication ... rabies.

I also return to the Walt Dowdle quote -

"Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control. The basic question is whether these goals are to be achieved in the present or some future generation"

But I really

 

[icerat]

We didn't know covid existed before it had already been shipped to all parts of the globe.

Codswallop

NZ couldn't keep it out in spite of spending ~$50B trying to.

Utterly false.

Tanzania and Turkmenistan.

I'll take your word for it. Simple - quarantine them.

Two diseases which conveniently aren't contagious pre-symptoms.

Yup, makes it easier. But guess what we know for a fact that elimination of Sars-CoV-2 is possible.

Because it was done.

You really struggle with this, don't you?

Nope. You however struggle with facts.

The measles vaccine is incredibly efficacious at stopping the disease, with an extremely stable virus and no need for vaccine boosters over half a century of use.

As you're fully aware, none of the covid vaccines are anything like the efficacy of MMR and the virus is constantly mutating. We've already been through 3 or 4 new vaccines in 3 years and current versions have been highly ineffective against infection.

Maybe you need to put down the rose-tinted spectacles and look at reality for a while.

You know what's even more effective than the measle vaccine at stopping measles transmissions?

FFP2 masks.

Maybe you need to put down the doom and gloom spectacles and look at the reality of what is possible.

I'm fairly convinced that widespread adoption of HEPA, Ventilation, and associated CO2 monitoring is enough to get R_eff<1 in most places. Throw in UVA and masks and it's almost certain. And that's before even talking about better vaccines, which are being worked on.

 

[jt512]

the number of animal-human transmissions has been negligible.

It doesn't matter. Eradication means completely eliminating the pathogen in nature. Pathogens with non-human reservoirs are considered uneradicable.

 

[icerat]

It doesn't matter. Eradication means completely eliminating the pathogen in nature. Pathogens with non-human reservoirs are considered uneradicable.

For some reason I thought lyssaviruses and plasmodium existed in non-humans. My mistake

Eradication has been used both to mean no infection as well as no disease. So you might eradicate Covid-19, but not SARS-CoV-2 even in humans. It's only in the last 4 years that "eradication" of a disease suddenly only means extinction of the pathogen causing the disease. Just like "herd immunity" now means something completely different to what it meant until sometime in 2020, and "immunity debt" manifested out of nowhere in 2021.

It's practically Orwellian.

Walt Dowdle again, from The principles of disease elimination and eradication -

"Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control. The basic question is whether these goals are to be achieved in the present or some future generation"​

The goal is to minimise disease, all disease, and ultimately get rid of all disease. This neo-public health of "we can't get rid of it completely, even in animals, so why bother trying to minimise it" is just bizarre.

 

[jt512]

For some reason I thought lyssaviruses and plasmodium existed in non-humans. My mistake

Eradication has been used both to mean no infection as well as no disease. So you might eradicate Covid-19, but not SARS-CoV-2 even in humans. It's only in the last 4 years that "eradication" of a disease suddenly only means extinction of the pathogen causing the disease.

Like many terms in epidemiology, definitions vary, but a 1961 paper in Science defined eradication as "the extinction of the pathogen that causes the infectious disease in question."[1] Nowadays that definition is usually modified to permit the pathogen to exist in the laboratory.

Even the WHO definition of zero incidence worldwide in the absence of control efforts implies extinction of the pathogen except in the lab, because they don't consider the disease extinct until zero incidence has been observed for many years, suggesting that the pathogen is indeed extinct in nature. If even a single case were to occur, it would indicate that the pathogen still existed and thus had never actually been eradicated.

The goal is to minimise disease, all disease, and ultimately get rid of all disease. This neo-public health of "we can't get rid of it completely, even in animals, so why bother trying to minimise it" is just bizarre.

What is bizarre is that straw man.


1. Cockburn, T. A. (1961). Eradication of Infectious Diseases. Science, 133(3458), 1050–1058. http://www.jstor.org/stable/1706940

 

[icerat]

Like many terms in epidemiology, definitions vary, but a 1961 paper in Science defined eradication as "the extinction of the pathogen that causes the infectious disease in question." Nowadays that definition is usually modified to permit the pathogen to exist in the laboratory.

Cockburn literally said in that paper "the meaning of the term varies with the user" and "in my definition"

Which kind of supports my point, right?

Even the WHO definition of zero incidence worldwide in the absence of control efforts implies extinction of the pathogen except in the lab

Not at all, because WHO's (usual) definition talks about *disease*, not pathogens.

, because they don't consider the disease extinct until zero incidence has been observed for many years, suggesting that the pathogen is indeed extinct in nature. If even a single case were to occur, it would indicate that the pathogen still existed and thus had never actually been eradicated.

And in practical terms, what would that mean? If we failed and only almost eradicated Covid-19 and every few years there was a deer-induced outbreak.

How would that compare to the current situation?

What is bizarre is that straw man.

If you think that's a straw man, then you need to get out more. "It can't be stopped so there's no point trying" is the essential thinking behind Sweden's response to SARS-CoV-2 since day 1.

 

[dann]

It doesn't matter. Eradication means completely eliminating the pathogen in nature. Pathogens with non-human reservoirs are considered uneradicable.

No, it doesn't mean "completely eliminating the pathogen in nature." Ebola has been eradicated a couple of times. So has Marburg virus.
They are still out there in nature.
However,

What lessons can we learn from these successive but separate epidemics [of Ebola]?
(...)
When a new Ebola outbreak was detected in Mweka in 2008, the community got involved at the first signs of the disease, helping to detect and quickly eradicate the epidemic.
Community involvement is key to eradicating ebola (blogs.Worldbank, Feb 27, 2019)

To avoid confusion between the two words eradicate and eliminate, I found another article. It describes Ebola, not as eradicated, but as 'eradicatable' in the sense of immunizing people in areas where zoonotic transmission of the virus may occur:

In conclusion, the answer to “Will Ebola ever become eradicated?” is simply yes. It has only been a few years since the Ervebo vaccine was released. There hasn’t been too much time for many people to become vaccinated.
Will Ebola ever be eradicated (YS Journal)

It is obvious that we are dealing with two different definitions of eradication, but it is also obvious that they don't pretend that eradicating Ebola requires immunizing each and every African bat (or even each and every human being) to achieve eradication of Ebola. (Or each and every bat and green monkey, in the case of Marburg virus.)

Are you hoping that Ebola and Marburg virus will become 'endemic'?
There actually are alternatives to We Want Them Infected. (New episode about the GBD!)

It remains to be seen if it will ever become possible to immunize people against all the variants of the SARS-CoV-2 virus. In the meantime, mitigation measures would limit the number of people who are infected with this deadly and debilitating virus every day.


ETA:

The combination of precautions
Face masks (at least FFP2/N95) limit transmission of the virus. They always did and they still do.
Ventilation/air filtration limits transmission of the virus. It always did and it still does.
Vaccination limits transmission of the virus.
Working from home limits transmission of the virus.
Isolating when infected (not merely sick) limits transmission of the virus.
And for this reason, testing limits transmission of the virus by letting you know when your are infectious in spite of being presymptomatic or asymptomatic.
Staying away from (particularly crowded) indoor places limits transmission of the virus.

Finally, making people understand all of this, i.e. proper information about the ways of the virus, limits transmission of the virus, but as we have seen in the Californian example recently, many public health agencies promote disinformation, which helps spread the virus.
The idea that spreading this disease as fast as possible is somehow the way to make it go over sooner and even help save lives was insane in 2020 once we learned how virulent it is, and it hasn't become any saner since then.

 

[dann]

The goal is to minimise disease, all disease, and ultimately get rid of all disease.

There's another word the minimizers don't understand!

 

[jt512]

Cockburn literally said in that paper "the meaning of the term varies with the user" and "in my definition"

Which kind of supports my point, right?

No, but it supports mine that (1) the definition varies and (2) the stronger definition has existed since at least 1961.

If you think that's a straw man, then you need to get out more. "It can't be stopped so there's no point trying" is the essential thinking behind Sweden's response to SARS-CoV-2 since day 1.

"It can't be stopped so there's no point trying to stop it" is different from "It can't be stopped so there's no point in trying to minimize it." Your straw man was the latter.

 

[jt512]

Ebola has been eradicated a couple of times.

That's a contradiction. You really don't get definitions, do you?

 

[icerat]

No, but it supports mine that (1) the definition varies and (2) the stronger definition has existed since at least 1961.

yes, and a "not stronger" definition exists to this day. See also your point (1)

"It can't be stopped so there's no point trying to stop it" is different from "It can't be stopped so there's no point in trying to minimize it." Your straw man was the latter.

Again, you need to get out more. It is absolutely not a straw man. I get it on Xitter almost daily. And as I mentioned, it was the entire basis of the Swedish pandemic response - It couldn't be stopped, everyone will get infected, so let's just try and spread out the infections ("flatten the curve") to decrease pressure on healthcare.

I would also point out that in practice trying to minimise infections and trying to stop all infections are essentially the same thing, it's just a debate over how successful it may or may not be.

 

[jt512]

I would also point out that in practice trying to minimise infections and trying to stop all infections are essentially the same thing, it's just a debate over how successful it may or may not be.

That's obviously wrong. We can't prevent all cases of almost any disease and therefore we don't try to; instead, we aim to minimize cases.

 

[icerat]

That's obviously wrong. We can't prevent all cases of almost any disease and therefore we don't try to; instead, we aim to minimize cases.

Good grief. Pick a disease. Any disease. What's the minimum possible number of cases? In your house? In your town? In your country?

 

[dann]

Ebola has been eradicated a couple of times.

That's a contradiction. You really don't get definitions, do you?

You really don't get texts, do you?

From post 648:

What lessons can we learn from these successive but separate epidemics [of Ebola]?
(...)
When a new Ebola outbreak was detected in Mweka in 2008, the community got involved at the first signs of the disease, helping to detect and quickly eradicate the epidemic.
Community involvement is key to eradicating ebola (blogs.Worldbank, Feb 27, 2019)

In conclusion, the answer to “Will Ebola ever become eradicated?” is simply yes. It has only been a few years since the Ervebo vaccine was released. There hasn’t been too much time for many people to become vaccinated.
Will Ebola ever be eradicated (YS Journal)

 

[Chanakya]

Cockburn? Really?

*ducks down*

 

[jt512]

Three nonsensical posts in a row. I must have won the argument!

 

[The Atheist]

Codswallop

Oh, this is going to be fun!

I said:

We didn't know covid existed before it had already been shipped to all parts of the globe.

Which is demonstrably correct: https://www.who.int/news/item/27-04-2020-who-timeline---covid-19

Covid virus was identified 12 January 2020 - first Thai case 13 January 2020. Given that case had covid prior to 12 January, your call of codswallop is laughable and wrong.

Fact: The virus had long escaped China when it was identified as a novel coronavirus.

Utterly false.

Fact: Despite the expenditure of billions of dollars and the instigating of lockdowns causing extreme hardship, along with 100% quarantine of arrivals, the virus re-entered NZ every time it was suppressed.

Ergo, your claim of my statement being false is yet again, incorrect.

I'll take your word for it. Simple - quarantine them.

That's gold.

Tanzania alone has land borders with 8 countries, none of which have anything like the wherewithal to stop cross-border incursions.

You really should give up now while you're behind, because you're just digging a deeper hole. Saying "quarantine them" is way beyond absurd.

Yup, makes it easier. But guess what we know for a fact that elimination of Sars-CoV-2 is possible.

Because it was done.

Show me a single country or territory that is still covid-free and I'll give up. Turkmenistan won't cut it, sorry, because I think they're lying.

Nope. You however struggle with facts.

Irony.

First off, you're using my old pal's playbook in trying to cast something back at me; secondly, I just threw all of your prior statements in the garbage, where they belong.

You know what's even more effective than the measle vaccine at stopping measles transmissions?

FFP2 masks.

It's lucky children don't get measles then, because can you imagine the impossibility of keeping babies and toddlers in FFP2 masks all day, every day, forever?

Idiotic.

Maybe you need to put down the doom and gloom spectacles and look at the reality of what is possible.

No doom or gloom involved, I don't spend any time not on this forum thinking about covid. It is what it is, and from here on, pretty much always will be. People will catch it, a few oldies will croak and a fair few people will develop a mental condition called long covid. Along with that, a very small number of people will develop a known post-viral syndrome that may impact their lives negatively for 6 months or more.

I'd lay odds that the people in that last group are far outweighed by people injured in car crashes.

I'm fairly convinced that widespread adoption of HEPA, Ventilation, and associated CO2 monitoring is enough to get R_eff<1 in most places. Throw in UVA and masks and it's almost certain. And that's before even talking about better vaccines, which are being worked on.

Proving you have zero understanding of economics or human behaviour, which is quite common around here.

If you hadn't grasped the enormously simple fact that people will not wear masks by now, you never will.

Good luck with your fantasy world, I'm sticking with the real one.

 

[theprestige]

I suppose it depends what you mean by "we". Probably some folks in a lab in China knew what it was. But it would be very weird for a westerner to include himself in a collective "we" with Chinese lab workers.

If you believe the rumors that one or more western governments were funding gain of function research in Chinese labs, you might at a stretch include yourself in a collective "we" that includes one such government that you (overly?) identify with. Maybe that's what icerat means be "we"? He thinks Fauci and the CDC knew, and he feels kinship with them?

 

[icerat]

Covid virus was identified 12 January 2020 - first Thai case 13 January 2020. Given that case had covid prior to 12 January, your call of codswallop is laughable and wrong.

Why do I even bother engaging with someone who thinks that a case in Thailand is evidence the virus had spread to "all parts of the globe".

Good grief

Fact: Despite the expenditure of billions of dollars and the instigating of lockdowns causing extreme hardship, along with 100% quarantine of arrivals, the virus re-entered NZ every time it was suppressed.

You very words here confirm I was correct - if it was successfully supressed it was, by definition "kept out". Permanently, no. But that's expected. You eliminate locally then handle introduced outbreaks. That's how elimination works.

Ergo, your claim of my statement being false is yet again, incorrect.

That's gold.

I said simple, not easy. And yes, I was being somewhat facetious.

Show me a single country or territory that is still covid-free and I'll give up.

Nobody is trying to be covid-free as far as I'm aware. In a "game" like this, the costs increase with every other "player" who gives up. Understandably - especially given the dishonest "scientific" advice - those places who were successfully pursuing elimination decided to change strategy.

It's lucky children don't get measles then, because can you imagine the impossibility of keeping babies and toddlers in FFP2 masks all day, every day, forever?

Idiotic.

Yes, implying anyone has suggested that is indeed idiotic.

Along with that, a very small number of people will develop a known post-viral syndrome that may impact their lives negatively for 6 months or more.

I'd lay odds that the people in that last group are far outweighed by people injured in car crashes.

I'll take that bet. How much do you want to wager?

But perhaps more importantly - do we, or do we not, spend a lot of time, money, and effort trying to minimise car crash injuries?

If you hadn't grasped the enormously simple fact that people will not wear masks by now, you never will.

Such a statement proves you know nothing about human behaviour - and also apparently struggle with reading comprehension, since, as I made clear, I consider masking to be a relatively low priority intervention. I rarely do it myself. But I'm used to that kind of response -

"We need good ventilation and HEPA filters!"

"WAAHHHH!!! WAHHHH!!!! butIdonwannawearamask!!!! WAAAHHHHH!!!!!"