Corona Virus: It's a Marathon, Not a Sprint

[LordMortis]

There was a small newslet on CNBC this morning that an anitdepressant... that acts as ans anti inflammatory... is showing promise in treating COVID...

Of course, here I am with a billion chronic symptoms mirroring long COVID that all seem to go into remission when on a good anti inflammatory and I'm like "I want that" knowing absolutely nothing about it.

https://apnews.com/article/coronavirus- ... a64a394802

Researchers tested the pill used for depression and obsessive-compulsive disorder because it was known to reduce inflammation and looked promising in smaller studies.

They’ve shared the results with the U.S. National Institutes of Health, which publishes treatment guidelines, and they hope for a World Health Organization recommendation.

“If WHO recommends this, you will see it widely taken up,” said study co-author Dr. Edward Mills of McMaster University in Hamilton, Ontario, adding that many poor nations have the drug readily available. “We hope it will lead to a lot of lives saved.”

The pill, called fluvoxamine, would cost $4 for a course of COVID-19 treatment. By comparison, antibody IV treatments cost about $2,000 and Merck’s experimental antiviral pill for COVID-19 is about $700 per course. Some experts predict various treatments eventually will be used in combination to fight the coronavirus.

[stessier]

This is what a real breakthrough infection report should look like. Thanks Oregon. People < age 60 are not "immune" from hospitalizations and deaths
J&J>Pfizer>Moderna
Currently ~1/4 of cases
We still do not have this for the US, let alone most states

I assume the > symbols here mean more deaths/hospitalizations with that vaccine and not that JJ is more effective than the other vaccines, which it seemed like he was saying at first glance.

From the data in the bottom left, I think he means total cases per 100k. So J&J has more breakthrough cases than Pfizer who has more cases than Moderna. The data doesn't show the same per 100k for hospitalizations and deaths (although I guess you could calculate it relatively easily).

[Smoove_B]

https://twitter.com/kylegriffin1/status ... 6761323521

NBC News: The U.S. has exceeded 46 million COVID cases since the start of the pandemic.

One million new cases in 14 days.

It's like...a vaccine doesn't exist.

[Max Peck]

I still don't understand how people are coming into close enough contact with deer out in the wild to be able to infect them in the first place.

New study suggests SARS-CoV-2 spreading widely within wild deer population

Earlier this year, researchers found that many wild deer in Michigan had antibodies that suggested the animals had been exposed to SARS-CoV-2, the virus that causes COVID-19. It was a significant cause for concern, as a large population of susceptible animals could act as a reservoir that allows the virus to spread back to humans.

At the time, however, uncertainties abounded. The study looked at only a small sample of the deer population of one state—we didn't know how the animals were exposed, and we didn't know whether the virus was actually spreading among wild deer. Since then, a few of the blanks have been filled in. Critically, deer-to-deer transmission has been observed in captivity. On Monday, a preprint of a new paper answered some more questions, showing that infection is widespread in a second state, driven both by its spread from humans and deer-to-deer transmission.

[Isgrimnur]

[LordMortis]

I still don't understand how people are coming into close enough contact with deer out in the wild to be able to infect them in the first place.

I can give two speculations.

1) Our suburban sprawl is such that large populations of deer live adjacent to most suburbs in protected nature preserves or speculative development areas.
2) In areas that aren't suburb adjacent, hunting is everything and hunters basically create bait known rubs. While they may try to disguise their scent from daily trips to hunting stands they can't disguise viral shed.
Bonus:
3) In 2020 and now 2021, communing in nature was up up up across the whole of the US, to the point parks were turning people away. Michigan is communing with nature state.

Although this does suggest to me that virus lingers more in the out doors than I was hoping.

[Freyland]

Plus there is a lot of vaccine misinformation being spread among the deer population.



And they are more likely than not going to just eat their masks.

[Zaxxon]

New very much not-Ed-Yong piece at The Atlantic this morning: It's Time to Contemplate the End of the Crisis.

On the one hand, provocative. On the other, obvious given what our country has demonstrated over 1.5 years it's [not] willing to do. I'm curious to hear Smoove's (and others') thoughts.

By now, Americans should realize that there isn’t a magic solution that will make COVID go away. Many restrictions, such as indoor mask mandates, remain in place to protect the vulnerable and unvaccinated in states following updated CDC COVID-prevention guidance. But within two or three months of introducing vaccines for 5-to-11-year-olds, the U.S. should be able to begin winding down most of the formal and informal limits to which Americans have become accustomed—office closures, masking mandates, educational interruptions, six-foot distancing, and more. (Data should be available soon on whether vaccines are safe for children ages 6 months to 4 years and how much of an immune response they provoke in this group. But children of this age are already at very low risk of COVID-19, and because most are not yet in school, their lack of access to vaccination is less disruptive to their family’s routines.)

COVID-19 is still causing more than 1,000 deaths a day in the United States; by comparison, influenza causes about 100 deaths a day on average, and most experts will feel uncomfortable declaring the coronavirus emergency phase over until COVID deaths settle down to a similar level. Yet infection, hospitalization, and death rates have begun to shrink since the peak of the Delta surge, and it’s not premature to begin planning for an end to the crisis phase. Once the emergency is over, Americans can focus on rebuilding their lives and think more clearly about how to accelerate COVID-19 vaccination abroad—a moral imperative that would also do far more than masks or booster shots for healthy, vaccinated U.S. adults would to end the global pandemic.

I recognize the apparent irony in my table-pounding for vaccine approval for 5-11, and now my posting of this piece ~16 hours after that approval came. I'm not advocating for the article's thesis, but rather wondering, now that one of the final pieces of the vaccination roll-out is in place: what does the end of the pandemic phase look like?

It's crystal clear that we are not ever going to get enough uptake in behavioral changes to stamp out the virus in the USA, so there will come a time when we return to 'normal' even with COVID circulating. That's unfortunate, but it's a given, and IMO that changes the calculus for how long fully-vaxxed families should continue to make sacrifices in the name of protecting others.

What is the 'right' time for folks who have been doing their part up to this point? 'Once vaccines are available for all age groups' seems like a solid starting point to me, but I am but a layman.

[Smoove_B]

What is the 'right' time for folks who have been doing their part up to this point? 'Once vaccines are available for all age groups' seems like a solid starting point to me, but I am but a layman.

I haven't read that one yet, but I need to. I think I'm still pondering another Atlantic article that was posted on Monday about how we've lost the plot:

“We need to come to some sort of agreement as to what it is we're trying to prevent,” says Céline Gounder, an infectious-disease expert at New York University. “Are we trying to prevent hospitalization? Are we trying to prevent death? Are we trying to prevent transmission?” Different goals would require prioritizing different strategies. The booster-shot rollout has been roiled with confusion for this precise reason: The goal kept shifting. First, the Biden administration floated boosters for everyone to combat breakthroughs, then a CDC advisory panel restricted them to the elderly and immunocompromised most at risk for hospitalizations, then the CDC director overruled the panel to include people with jobs that put them at risk of infection.

But really:

On the ground, the U.S. is now running an uncontrolled experiment with every strategy all at once. COVID-19 policies differ wildly by state, county, university, workplace, and school district. And because of polarization, they have also settled into the most illogical pattern possible: The least vaccinated communities have some of the laxest restrictions, while highly vaccinated communities—which is to say those most protected from COVID-19—tend to have some of the most aggressive measures aimed at driving down cases. “We’re sleepwalking into policy because we’re not setting goals,” says Joseph Allen, a Harvard professor of public health. We will never get the risk of COVID-19 down to absolute zero, and we need to define a level of risk we can live with.

We have absolutely lost control of this in terms of bigger-picture. The idea that we're at the point of just settling into an acceptable number of annual deaths is short-circuiting my brain, especially in light of the fact that we still don't fully understand chronic COVID-19 in adults or children. I don't want to believe that's what we're going to do, but the overwhelming evidence everywhere suggests otherwise. Even now as NJ sits on the precipice of a new governor, he's already declared no vaccination mandates for adults or kids. To me, that is just saying NJ is going to accept a new level of death and suffering, because freedom.

As much as we've learned about SARS-CoV-2, there's still more we don't know. The idea that we're blindly stumbling around with policy...it's just too much. Feeling low and overwhelmed again, quite honestly but I will look at that article too.

[Zaxxon]

Absolutely we've lost the plot. Which is what has me vacillating on 'proper' next steps. Clearly, in a rational, look-out-for-each-other world, we would not be talking about going back to 'normal' at this point. We'd be working together to eliminate or at least gain drastically better control of the virus before opening up fully.

But we don't live in that world, and we're not going to do that. It's not among our possible options. So we can't pretend as though this is something we should have done 'instead.' <commodus>This vexes me. I'm terribly vexed.</commodus> Yet it remains fact.

So, given this thing that vexes you and me greatly, now what?

[El Guapo]

We have absolutely lost control of this in terms of bigger-picture. The idea that we're at the point of just settling into an acceptable number of annual deaths is short-circuiting my brain, especially in light of the fact that we still don't fully understand chronic COVID-19 in adults or children. I don't want to believe that's what we're going to do, but the overwhelming evidence everywhere suggests otherwise. Even now as NJ sits on the precipice of a new governor, he's already declared no vaccination mandates for adults or kids. To me, that is just saying NJ is going to accept a new level of death and suffering, because freedom.

Just to be clear though Murphy is very likely to win at this point, so NJ isn't actually on the precipice of a new governor. If that helps.

[Smoove_B]

Just to be clear though Murphy is very likely to win at this point, so NJ isn't actually on the precipice of a new governor. If that helps.

I need the challenger to concede and for it to be officially declared. Basically I need to hear the lamentations of the local GOP cultists in order to believe it.

So, given this thing that vexes you and me greatly, now what?

I'm very torn because lately I'm having a harder and harder time separating my various functions in life - parent, husband, public health dude, local/county official. Prior to 2020, I didn't consider my profession/vocation as part of my self identity. Now its driving my behaviors and choices in every day life, every single day for (checks watch) almost two years now. I mean, it influenced decisions before, but not on a constant, daily basis like it's doing right now. Add in the political/policy elements coming into place nationally / regionally (thankfully not in my own state, currently) and it's adding another dimension. I cannot describe what it feels like to have your chosen profession suddenly reviled in parts of America.

To get back to your question, I'm torn because I am struggling with coming to an answer that satisfies me as a human being and as a person that is (ideally) supposed to be advocating for public health measures.

[LordMortis]

So, given this thing that vexes you and me greatly, now what?

I'm clearly in the minority but I will isolate reasonably and mask and immunize for as long as it takes. I will treat social "hygiene" as a lifelong practice, even if/when COVID wanes. If that's the new life we lead, it's the new life we lead. People gonna do what people gonna do. The freedom to travel and act people have just expanded because everyone wants what they think is good for themselves. I still sit in the golden rule populace. "I wouldn't want you to get me sick. I don't want to be the one who gets you sick." As long as it takes. Even as I am beyond weary of mask wearing and never doing, well, anything.

[Zaxxon]

To get back to your question, I'm torn because I am struggling with coming to an answer that satisfies me as a human being and as a person that is (ideally) supposed to be advocating for public health measures.

Yeah, there's no easy answer (that I can determine).

I'm clearly in the minority but I will isolate reasonably and mask and immunize for as long as it takes.

As long as it takes for what, specifically? 'The rest of your life' is the answer if we're talking 'get rid of COVID.'

I will treat social "hygiene" as a lifelong practice, even if/when COVID wanes. If that's the new life we lead, it's the new life we lead. People gonna do what people gonna do. The freedom to travel and act people have just expanded because everyone wants what they think is good for themselves. I still sit in the golden rule populace. "I wouldn't want you to get me sick. I don't want to be the one who gets you sick." As long as it takes. Even as I am beyond weary of mask wearing and never doing, well, anything.

Absolutely. To be more precise in my question/framing--I'm not talking about 'moving on' from things like wearing masks in high-risk, crowded areas. I think that's going to be a thing (for a small but significant subset of the population) for some time to come. And it should have been a thing long before COVID. I'm referring specifically to restrictions on activity--choosing not to fly, not attending concerts/sporting events, mitigations at schools, etc.

[Smoove_B]

I'm referring specifically to restrictions on activity--choosing not to fly, not attending concerts/sporting events, mitigations at schools, etc.

This is where I'm falling to pieces. I really miss going to restaurants and concerts. I cannot imagine doing either of them any time soon - not while the levels of circulating virus are high. But that might never change in the big picture - virus levels might always be elevated and depending on location and time of year, risk might be higher or lower based on local conditions. I didn't spend my life worried I'd catch the measles or chicken pox as an adult, but now I am concerned that I could catch COVID-19 because we've lost the plot.

Schools, workplaces, indoor environments should all likely have reconfigured indoor air systems. But our water/sewer/road/tunnel/bridge infrastructure is literally falling apart and we can't be bothered to address that. Do I think we're going to invest in air treatment and purification systems in schools and public buildings? Nope.

The issue is that the pressure to just "endure" and ignore all this is so overwhelming at this point.

Meanwhile I have family members that have.not.stopped doing anything (vacation travel by car and plane, vacationing, indoor dining) since May of 2020. I don't know how they do it; I cannot mentally get there. And while I've not asked them to stop, they're asking me to join them and making me feel less than when I push back.

I just don't know anymore. I need more coffee.

[Smoove_B]

New very much not-Ed-Yong piece at The Atlantic this morning: It's Time to Contemplate the End of the Crisis.

Oh..wow. I didn't realize who wrote this article until now. Not good. She's a "not helper" actor during our COVID times. The reason is that she's using her experiences in HIV/AIDS as a way to frame COVID response. On the surface, that might seem like a great idea but the viruses don't spread the same way and they're not seen in the same populations of people. Just because something worked for HIV/AIDS (policy/protocol), doesn't mean we should be taking the same approach ("harm reduction") during a pandemic that spreads via airborne aerosols.

This is really the core issue right now with vaccinations for 5-11 year olds (to circle back), yes kids are going to die from COVID-19 but the push to vaccinate them isn't largely focused on preventing death - it's to stop community spread. So the tool is the same (vaccine) as for elders, but the strategy is different (in the short term). Her argument from a few months ago that kids should be back in school unencumbered was based on the reality that largely kids are not dying at the same level as grandparents from COVID-19, so in her mind sending them back to school is a net better benefit for kids. And yes, to a degree, that's true but only if you completely ignore the role kids play in transmission of the disease (and just accept the non-zero number that will die and additional number that will have chronic illnesses).

So her current argument here about "getting back to normal" doesn't completely work as we still have even younger kids that are unvaccinated as well as a significant portion of eligible adults. She also seems to be pushing the narrative of the One True Vaccine - that's all we need - and now that its here, masking, distancing, ventilation, etc... aren't viable tools anymore, which is absolutely untrue.

In summary, not a fan.

[Zaxxon]

That's helpful; thanks.

[LordMortis]

I'm referring specifically to restrictions on activity--choosing not to fly, not attending concerts/sporting events, mitigations at schools, etc.

Understood. I'm still in the as long as it takes minority. I'm willing to go in public and demask long enough eat at a demonstrably non crowded restaurant, wherein I will not drink and I will not linger. That's it. I don't yet see the timeline to change tolerance, even as I hope for one every day. Anything past the rare eating out occasion is putting myself at a known risk of becoming a carrier who may infect someone, so I can have a fleeting good time. If I were 20, I'd have a different attitude about life a wastin' and I can understand that. I'm not 20. I live by the golden rule. Even as I can't and won't force you to make a decision not put yourself in a situation where you become a carrier, it is my desire that you don't and I would treat you with that same level of respect, whether or not it is asked of me. Both the mass of vaccinated and the mass of unvaccinated disagree with me but for entirely different reasons. Though we all want to be free. Though we all don't want to be inconvenienced. We all want to do more than just exist. We all to experience. To enjoy. Still, I don't want to get your loved ones perilously sick and that is rooted in my desire that you don't get my loved ones perilously sick. And that desire and resulting actions will last for as long at it takes.

[Paingod]

The issue is that the pressure to just "endure" and ignore all this is so overwhelming at this point.

I think it's gone beyond overwhelming and right into unavoidable. My vaccinated, masked self has been sitting at my desk following the schizophrenic rules we have in place while 20-30% of the local population flouts the concerns and concepts and walks around like it's life as normal. I have co-workers who'd rather have regular COVID testing instead of getting a vaccination. These same people walk around with their masks down below their noses and management has gotten tired of reminding them to pull it up. Masks become almost pointless theatrics.

I feel like a portion of the population just doesn't care about whether or not they live or die, nor whether or not you and your family lives or dies. I don't care if it's driven by cognitive dissonance or willful ignorance or subliminal probes from space. I sincerely feel like we have all the options on the table and the means to overcome this and force it back down towards being little more than a "potent flu" each year in terms of hospitalizations and deaths. So. Let them. Let's all get back to life as normal.

It's cold and hard, but when 30% of a population can't change, that makes it 100% impossible to fix a problem that impacts everyone. The 70% doing it right can't even carry the 30% to success. They're just running in circles.

[Blackhawk]

I still don't understand how people are coming into close enough contact with deer out in the wild to be able to infect them in the first place.

Deer get in human trash.

[Max Peck]

I still don't understand how people are coming into close enough contact with deer out in the wild to be able to infect them in the first place.

Deer get in human trash.

But that's not now the virus propagates from one host to the next, is it? My understanding is that it is airborne and that fomites don't play a significant role in transmission. That's why we don't do things like wipe down the groceries with disinfectant anymore (germophobes excepted, of course).

[Kraken]

Last week, my only local friend's son died accidentally (I think it was an opioid OD, but not sure). I haven't seen this guy since the pandemic started. On Sunday, he's having a two-hour memorial service, followed by a two-hour reception at his ex-wife's house, and finally an open-ended reception at his own house. He would really like me to be there for parts 1 and 3, so I am obligated. Wife made it clear that my social anxiety and fear of Covid are not excuses -- my only friend needs me to be there for him. Since he lives 45 minutes away, it would be silly to drive home and then back out there again in between, so I'm going to attend all three events...about six hours altogether.

IDK what Covid precautions are in place, but I'm assuming it's "none," or close to none. I'll stay masked thru the service; that part's easy. The receptions are going to be harder. There will be numerous 20-somethings there (the dead son's friends), and we all know how seriously the young take Covid. I'm likely to be indoors for extended periods with potentially unvaxxed and almost certainly unmasked strangers. I'll be as careful as possible under the circumstances, but these long social events are going to be my worst exposure since the pandemic started, and I can't wiggle out of them without ending a friendship.

[Zarathud]

Funerals are important.

It’s about mitigating risks. Your friend’s mental health you can help a lot. The young people will likely steer clear of the old man in a mask, so your exposure will likely be more limited than you fear. If you pop outside a few times for air and calm, your friend will know you were there for him. That’s a big net benefit IMO.

[Alefroth]

I just don't know anymore. I need more coffee.

Drink up while you can still get it.

[Blackhawk]

[El Guapo]

Last week, my only local friend's son died accidentally (I think it was an opioid OD, but not sure). I haven't seen this guy since the pandemic started. On Sunday, he's having a two-hour memorial service, followed by a two-hour reception at his ex-wife's house, and finally an open-ended reception at his own house. He would really like me to be there for parts 1 and 3, so I am obligated. Wife made it clear that my social anxiety and fear of Covid are not excuses -- my only friend needs me to be there for him. Since he lives 45 minutes away, it would be silly to drive home and then back out there again in between, so I'm going to attend all three events...about six hours altogether.

IDK what Covid precautions are in place, but I'm assuming it's "none," or close to none. I'll stay masked thru the service; that part's easy. The receptions are going to be harder. There will be numerous 20-somethings there (the dead son's friends), and we all know how seriously the young take Covid. I'm likely to be indoors for extended periods with potentially unvaxxed and almost certainly unmasked strangers. I'll be as careful as possible under the circumstances, but these long social events are going to be my worst exposure since the pandemic started, and I can't wiggle out of them without ending a friendship.

Can't you skip part 2? Doesn't mean you have to drive all the way back home, but you could just go for a walk in a local park or something.

As for part 3, does your friend have a deck / yard / etc.? Seems like you could spend much / most of your time outside.

[Formix]

Not to be Debbie Downer, but the part that I am personally struggling with, is that if this virus is endemic now, and it continues to mutate, and if there is a significant percentage that continues to ignore it, how do we avoid what I see as the only 2 scenarios? A) eventually a more deadly mutation/one that ignores the vaccine, so we're back where we started, (wash, rinse, repeat until it all falls apart) or B) just accepting that we will lose the elderly, immunocompromised and ~1% of the population for the rest of our lives (The Randian Logan's Run scenario)? Honestly, if it wasn't for wanting some kind of future for my kids, I'd just say "screw it, we're a stupid species, and we're reaping what we've sown."

[noxiousdog]

Not to be Debbie Downer, but the part that I am personally struggling with, is that if this virus is endemic now, and it continues to mutate, and if there is a significant percentage that continues to ignore it, how do we avoid what I see as the only 2 scenarios? A) eventually a more deadly mutation/one that ignores the vaccine, so we're back where we started, (wash, rinse, repeat until it all falls apart) or B) just accepting that we will lose the elderly, immunocompromised and ~1% of the population for the rest of our lives (The Randian Logan's Run scenario)? Honestly, if it wasn't for wanting some kind of future for my kids, I'd just say "screw it, we're a stupid species, and we're reaping what we've sown."

The percentage of people that die will continue to fall as a) we get better treatments, and b) COVID survivors will be better attuned to COVID.

2) There will likely be a variant booster vaccine that will allow the vaccinated to significantly reduce the 1%-2% case mortality rates.

[Pyperkub]

Will probably see a winter bump amongst the unvaccinated during the holidays, I expect.

[Smoove_B]

The percentage of people that die will continue to fall as a) we get better treatments, and b) COVID survivors will be better attuned to COVID.

2) There will likely be a variant booster vaccine that will allow the vaccinated to significantly reduce the 1%-2% case mortality rates.

At some point I'm going to get you to stop focusing on deaths - that really is but a fraction of the bigger picture here. Early on? Absolutely a major concern. And to be clear, we're still trying to prevent deaths. But we're not going to get 5-11 year olds vaccinated by suggesting it's to prevent them from dying.

[LordMortis]

The percentage of people that die will continue to fall as a) we get better treatments, and b) COVID survivors will be better attuned to COVID.

2) There will likely be a variant booster vaccine that will allow the vaccinated to significantly reduce the 1%-2% case mortality rates.

At some point I'm going to get you to stop focusing on deaths - that really is but a fraction of the bigger picture here. Early on? Absolutely a major concern. And to be clear, we're still trying to prevent deaths. But we're not going to get 5-11 year olds vaccinated by suggesting it's to prevent them from dying.

As someone who wipes out after 10 minutes of reasonable physical work, without ever having suffered from COVID, ayup. We really don't want any percentage of the nation or of the world be a me.

[noxiousdog]

I'm not sure what either of your responses have to do with answering Formix.

[LordMortis]

Point taken. You should not be singling out ND but just the general "why is it the collective 'we' are hyperfocused only on deaths"? when there are hosts of people not getting early warning five to six figure treatments that aren't dying but aren't fully recovering either and the only ones we pay attention to are the ones we personally know (or which I'm now up to three)

[LordMortis]

Pfizer set to emergency release their antiviral. Claim 89% effective is given within 3 days of showing symptoms.


https://www.nbcnews.com/health/health-n ... t-rcna4593

CNBC was reporting in an interview with the head of the company that they have 5 million treatments (a course of 10 pills) in the hopper at an estimated cost of $700 per round of treatment.

Add that to the Merck progress and as long as it takes may be around the corner for me. Spring? Is it too much to hope for earlier?

[Zaxxon]

Add that to the Merck progress and as long as it takes may be around the corner for me. Spring? Is it too much to hope for earlier?

I don't dare hope, but I'm with you in wondering.

[malchior]

This legitimately looks like good news but we need to see it in widespread action, right? Also, it is a little sad that a super expensive pharmaceutical that treats the consequences instead of being adults might be the answer. But it is what it is.

[Smoove_B]

I'm not sure what either of your responses have to do with answering Formix.

I'm sorry, it's probably my reflex as you've historically voiced opinions (non-COVID) that we spend too much energy focused on regulating things for all based on minimal death experienced by few. Your post (to me) suggested you believed that COVID-19 will eventually move into some level of acceptable death and we shouldn't be worried about it anymore. Apologies if that is a mis-read.

Not to be Debbie Downer, but the part that I am personally struggling with, is that if this virus is endemic now, and it continues to mutate, and if there is a significant percentage that continues to ignore it, how do we avoid what I see as the only 2 scenarios? A) eventually a more deadly mutation/one that ignores the vaccine, so we're back where we started, (wash, rinse, repeat until it all falls apart) or B) just accepting that we will lose the elderly, immunocompromised and ~1% of the population for the rest of our lives (The Randian Logan's Run scenario)? Honestly, if it wasn't for wanting some kind of future for my kids, I'd just say "screw it, we're a stupid species, and we're reaping what we've sown."

Your two scenarios aren't the only scenarios. At the risk of being told I'm a broken record, we have no idea what's going to happen. I've seen virologists arguing online over the "likely" outcome over the last year - will we see a more virulent version? Will a less virulent strain emerge and "settle" into the human population. I think that is the only message - we don't know; everything is still a guess.

And to clarify, the virus is absolutely not endemic now; we're still in the throes of a global pandemic despite what people might want to believe (or tell you is true). The virus is still circulating globally and there is uncontrolled spread pretty much everywhere at this point - that is what defines a pandemic.

This is terrible for all the death and suffering its causing right now; thinking about future scenarios isn't nearly as useful (to me) as we're not even close to being out of this one. And with that, your (A) is absolutely a concern to the degree that the more it spreads the more there's a chance of a mutation that does *something* not good. But there could also be a mutation that somehow makes it even more likely to spread but causes less illness - this goes back to what virologists have been arguing about. We've never seen anything like this so everyone is still guessing.

And to get to my own point, death isn't the only outcome here. I think once we start to get a better handle on what chronic COVID is actually doing to people and to what degree people are suffering it's also going to change how we look at this. At least, I hope it's going to change how we look at this. While death is obviously terrible, I fear we're going to get to a point where uncontrolled spread is acceptable because death is largely manageable. And so instead of people dying, there's going to be some new baseline level of people living with chronic impacts for a generation or so until the virus reaches some new equilibrium. To me,that's depressing as hell - that collectively as a society we would just accept some level of trauma, because freedom.

[Smoove_B]

From last night:

https://twitter.com/EricTopol/status/14 ... 6469407747

[noxiousdog]

I'm sorry, it's probably my reflex as you've historically voiced opinions (non-COVID) that we spend too much energy focused on regulating things for all based on minimal death experienced by few. Your post (to me) suggested you believed that COVID-19 will eventually move into some level of acceptable death and we shouldn't be worried about it anymore. Apologies if that is a mis-read.

Unless we have the stomach for forced vaccination, it absolutely will move into some level acceptable death, and I'll be more and more angry at the anti-vaxxer's every year.

But to the broader point, I do care when the risks affect everybody; and I understand when regulations are shared by everybody (say... seatbelts). I take a contrary opinion when one person regulates someone else's vices but doesn't really experience harm. Ergo, banning smoking in restaurants? Fine. Banning it in a home? Not so much.

[malchior]

While death is obviously terrible, I fear we're going to get to a point where uncontrolled spread is acceptable because death is largely manageable.

I unfortunately expect this because we're already at a point where we went from it's as bad as the flu to ok it's worse but still acceptable. I can't help that if we get the numbers to be steady especially with therapeutics that people will accept it because it'll still largely be other people. I might also only be saying that because I've spent this involuntary travel week trapped amongst a large group of people who seem to believe that.