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

[Smoove_B]

It's really been sinking in for me over the last 5 days or so, that this is going to be life now - all time is going to be measured between variants and we'll see what happens as each new one emerges. Why? Because of (1) how long it's going to take to vaccinate the planet to some important unknown base level and more critically, (2) the general population is not interested in lowering circulating virus levels via masking (or any other strategy).

If we know a significant number of people aren't vaccinated and that even vaccinated people can spread the virus under the right conditions, I'm struggling to understand the lack of masking, ventilation improvements, encouraging crowded indoor activities with strangers etc... while an airborne virus continues to spread.

This is beyond giving up. It makes me question whether or not we'll be able to do anything requiring social cooperation anymore.

[LawBeefaroni]

It's really been sinking in for me over the last 5 days or so, that this is going to be life now - all time is going to be measured between variants and we'll see what happens as each new one emerges. Why? Because of (1) how long it's going to take to vaccinate the planet to some important unknown base level and more critically, (2) the general population is not interested in lowering circulating virus levels via masking (or any other strategy).

If we know a significant number of people aren't vaccinated and that even vaccinated people can spread the virus under the right conditions, I'm struggling to understand the lack of masking, ventilation improvements, encouraging crowded indoor activities with strangers etc... while an airborne virus continues to spread.

This is beyond giving up. It makes me question whether or not we'll be able to do anything requiring social cooperation anymore.

Hey, we got rid of buffets, what more do you want?


*Touches earpiece*

Wait, we didn't get rid of buffets? Well, I guess that makes sense, how else can you serve that many people indoors with labor shortages?


We gave up buffets for months and months. What more do you want?

[El Guapo]

It's really been sinking in for me over the last 5 days or so, that this is going to be life now - all time is going to be measured between variants and we'll see what happens as each new one emerges. Why? Because of (1) how long it's going to take to vaccinate the planet to some important unknown base level and more critically, (2) the general population is not interested in lowering circulating virus levels via masking (or any other strategy).

If we know a significant number of people aren't vaccinated and that even vaccinated people can spread the virus under the right conditions, I'm struggling to understand the lack of masking, ventilation improvements, encouraging crowded indoor activities with strangers etc... while an airborne virus continues to spread.

This is beyond giving up. It makes me question whether or not we'll be able to do anything requiring social cooperation anymore.

There is a natural time limit to how long the pandemic will last due to natural immunity (supplemented by vaccines) and by the evolutionary pressure towards less lethality in the virus (as killing fewer hosts helps the virus spread), right? Our collective response, shitty though it is, is probably on the whole better than the response to 1918 Spanish Flu pandemic, and the heart of that was "only" 1.5 years or so. So like, even with the GOP being shit bags, seems like this can't go on forever, right?

Right???

[noxiousdog]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

[Smoove_B]

There is a natural time limit to how long the pandemic will last due to natural immunity (supplemented by vaccines) and by the evolutionary pressure towards less lethality in the virus (as killing fewer hosts helps the virus spread), right? Our collective response, shitty though it is, is probably on the whole better than the response to 1918 Spanish Flu pandemic, and the heart of that was "only" 1.5 years or so. So like, even with the GOP being shit bags, seems like this can't go on forever, right?
Right???

Oh, it most certainly can. So much arguing between virologists online this year about which way SARS-CoV-2 will evolve. As I said somewhere here, there's now like 8 layers of people for the virus to move through - all different levels of vaccination + prior exposures. That's an environment filled with all kinds of variables for the virus to explore. I've seen some suggesting this Omnicron variant might have come from someone with a weakened immune system and/or partial protection. The number of mutations this new strain exhibits (according to their theories) suggest it was in lengthy back and forth battle where the person's body couldn't eliminate it and so the virus just continued to try new combinations until it found one that worked.

I'd always thought (like you) that a virus wants to get into a state of equilibrium with the host, and while that might be true for some it's not a requirement or a "final state". Ebola liquefies~70% of the people it infects and it still manages to keep coming back to cause epidemics.

We have no idea why the 1918 pandemic ended. As quickly as it arrived, it was gone. The strain (for whatever reason) burned through the people it could and then disappeared. Maybe it would have gone on for longer if they had modern technology zipping people around the globe or there were just more people back then.

So I don't think it will go on forever, for all practical purposes it will start to feel like it...at least, in my mind. I'm still a little hopeful we'll get through this winter, but all bets are off if Omicron can really breakthrough vaccinated populations. It feels (to me) like the pandemic is going to continue a few more years at our current rate. I guess we'll see how many more Greek letters we get to learn.

EDIT: Not a transformer

[Smoove_B]

I've never quite heard 0.1% as important, but I guess it's perspective.

Say it with me - at scale, rare events aren't rare.

In terms of reducing circulating virus levels, masks are absolutely important - especially now that we know the virus is airborne and can be transmitted by vaccinated people.

[stessier]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

Where do you get 0.1%? This is from the MWRA graphs right? It looks like unmasked areas see 30% more cases starting in September.

[Defiant]

There is a natural time limit to how long the pandemic will last due to natural immunity (supplemented by vaccines)

The Black death lasted ~5 years and returned every couple of decades or so on a regular basis for centuries. Of course, it took longer for spread (so it could be mopping up here while it only started elsewhere and managed to revisit down the line), but then there were fewer people back then.

and by the evolutionary pressure towards less lethality in the virus (as killing fewer hosts helps the virus spread), right?

I would say quick deaths are bad for a virus spread, but slow deaths aren't necessarily bad or good for spread. (the best would be if it's infectious before visible symptoms). And even if that's the end result, evolution doesn't necessarily have to go the most direct path - it could take the scenic route.

[El Guapo]

There is a natural time limit to how long the pandemic will last due to natural immunity (supplemented by vaccines) and by the evolutionary pressure towards less lethality in the virus (as killing fewer hosts helps the virus spread), right? Our collective response, shitty though it is, is probably on the whole better than the response to 1918 Spanish Flu pandemic, and the heart of that was "only" 1.5 years or so. So like, even with the GOP being shit bags, seems like this can't go on forever, right?
Right???

Oh, it most certainly can. So much arguing between virologists online this year about which way SARS-CoV-2 will evolve. As I said somewhere here, there's now like 8 layers of people for the virus to move through - all different levels of vaccination + prior exposures. That's an environment filled with all kinds of variables for the virus to explore. I've seen some suggesting this Omnicron variant might have come from someone with a weakened immune system and/or partial protection. The number of mutations this new strain exhibits (according to their theories) suggest it was in lengthy back and forth battle where the person's body couldn't eliminate it and so the virus just continued to try new combinations until it found one that worked.

I'd always thought (like you) that a virus wants to get into a state of equilibrium with the host, and while that might be true for some it's not a requirement or a "final state". Ebola liquefies~70% of the people it infects and it still manages to keep coming back to cause epidemics.

We have no idea why the 1918 pandemic ended. As quickly as it arrived, it was gone. The strain (for whatever reason) burned through the people it could and then disappeared. Maybe it would have gone on for longer if they had modern technology zipping people around the globe or there were just more people back then.

So I don't think it will go on forever, for all practical purposes it will start to feel like it...at least, in my mind. I'm still a little hopeful we'll get through this winter, but all bets are off if Omnicron can really breakthrough vaccinated populations. It feels (to me) like the pandemic is going to continue a few more years at our current rate. I guess we'll see how many more Greek letters we get to learn.

One thing I wrestle with is that as a budding internet expert that's read two whole books on the 1918 pandemic (and listened to some podcasts!), is that my understanding is that the flu virus is freakishly good (relative to other viruses) at mutating. Hence why we need flu vaccines every year, and why the flu vaccines (while doing a lot of good) don't have as good efficacy rates as other vaccines.

So given that COVID doesn't mutate as well, that our response overall is better than in 1918, that our medical establishments are light years ahead of where we were in 1918...shouldn't this thing have a natural end, even if that end is badly extended by incompetence and cynical malice? I guess the counter-points are more travel than in 1918 and a broader spectrum of immunity than in 1918, but seems like that shouldn't be enough to overcome the other side of the equation?

I guess we'll find out.

[Smoove_B]

One thing I wrestle with is that as a budding internet expert that's read two whole books on the 1918 pandemic (and listened to some podcasts!), is that my understanding is that the flu virus is freakishly good (relative to other viruses) at mutating. Hence why we need flu vaccines every year, and why the flu vaccines (while doing a lot of good) don't have as good efficacy rates as other vaccines.

The thing with influenza (as you're aware as an expert) is that it's primarily a disease of aquatic waterfowl. And every year, the variants we are hit with are passing through birds, into pigs and then into humans. So while it's really good at shuffling genes around it's always coming from a different set of host species, mixing things up, and then impacting humans. But the virus isn't really looking for human fuel, it just so happens that it can infect us and cause disease.

So given that COVID doesn't mutate as well, that our response overall is better than in 1918, that our medical establishments are light years ahead of where we were in 1918...shouldn't this thing have a natural end, even if that end is badly extended by incompetence and cynical malice? I guess the counter-points are more travel than in 1918 and a broader spectrum of immunity than in 1918, but seems like that shouldn't be enough to overcome the other side of the equation?

I guess we'll find out.

Right now, humans seem to be the ones driving the spread and mutation - so the lifecycle is very different than what we see for influenza. That's also why it was quite interesting (SEE: frightening) that so many deer were discovered to be carrying the virus (link I posted a few weeks ago) because it could mean the etiology could change. Namely, if deer can act as a viral reservoir (they experience no symptoms but allow the virus to survive), deer could end up passing it back to humans with changes the virus picked up from hanging out in deer - in the same way that we get influenza by way of aquatic water fowl and pigs.

Regardless, the issue is that when there's a significant number of people that (1) refuse to vaccinate and (2) refuse to wear masks, we're always going to have the ingredients to fuel another outbreak. If we could drive circulating virus levels down and then get more people vaccinated things *could* theoretically change rather quickly - going back to "flattening the curve in two weeks" - remember that chestnut? As I've been saying all along, we're always ~2 weeks away from dramatically lowering cases. All it would take is political and social will (and support). Until then, a slow-burn where we just accept ~7K deaths a week is apparently the new norm.

[Blackhawk]

I'm struggling to understand the lack of masking, ventilation improvements, encouraging crowded indoor activities with strangers etc... while an airborne virus continues to spread.

That's surprisingly easy to understand.

1. Doing those things affects the income of people with influence (and that's really the short explanation right there, the rest is just dominoes.)
2. Those people used that influence to make sure that those things were turned into us-vs-them political issues, as doing so kept them from losing money.*
3. As a result of #2, the people influenced were forced to fight against any hint of the things you mentioned, or else they would lose power.
4. We have a system of 'checks and balances', and it has evolved in a way that all of the pieces of government have to work together for major changes to occur.
5. Due to #s 3 and 4, it was relatively simple (and inevitable) that any attempt by the non-influenced to create change could be, and was, either blocked by the influenced, or else it was enacted and then eliminated.

1+2+3+4+5 - We, collectively, consider our own interests more important than the interests - including the lives - of any number of others, and will take any action to protect them.


*We're not talking about not eating here, we're talking about three yachts instead of four.

[Blackhawk]

I guess we'll see how many more Greek letters we get to learn.

There aren't many left. Another six months and COVID start joining fraternities.

[gilraen]

One thing I wrestle with is that as a budding internet expert that's read two whole books on the 1918 pandemic (and listened to some podcasts!), is that my understanding is that the flu virus is freakishly good (relative to other viruses) at mutating. Hence why we need flu vaccines every year, and why the flu vaccines (while doing a lot of good) don't have as good efficacy rates as other vaccines.

The 1918 virus was not capable of mutating as quickly, simply due to its structure. It was exceptionally virulent but too good at killing its hosts to sustain itself.

[noxiousdog]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

Where do you get 0.1%? This is from the MWRA graphs right? It looks like unmasked areas see 30% more cases starting in September.

Or 250 people out of 100,000 vs 150 people out of 100,000. So, perspective.

[noxiousdog]

I've never quite heard 0.1% as important, but I guess it's perspective.

Say it with me - at scale, rare events aren't rare.

In terms of reducing circulating virus levels, masks are absolutely important - especially now that we know the virus is airborne and can be transmitted by vaccinated people.

If you could get mask compliance you're right. But we've been at this for close to two years now. I'm sure now they'll listen.

[Defiant]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

Where do you get 0.1%? This is from the MWRA graphs right? It looks like unmasked areas see 30% more cases starting in September.

Or 250 people out of 100,000 vs 150 people out of 100,000. So, perspective.

Is 0.25% important? Surely, 0.5% is important, since that was the height of the pandemic.

If a single step reduces new cases by 40%, that's pretty significant.

[Smoove_B]

If you could get mask compliance you're right. But we've been at this for close to two years now. I'm sure now they'll listen.

They won't, which is why I'm back to day-drinking.

[Zaxxon]

If you could get mask compliance you're right. But we've been at this for close to two years now. I'm sure now they'll listen.

They won't, which is why I'm back to day-drinking.

Kudos for ever having stopped.

[stessier]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

Where do you get 0.1%? This is from the MWRA graphs right? It looks like unmasked areas see 30% more cases starting in September.

Or 250 people out of 100,000 vs 150 people out of 100,000. So, perspective.

So what do you think is important using that perspective? Nothing short of World Wars make the cut using that metric.

[Kraken]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

Where do you get 0.1%? This is from the MWRA graphs right? It looks like unmasked areas see 30% more cases starting in September.

Or 250 people out of 100,000 vs 150 people out of 100,000. So, perspective.

There are nearly 5 million people in the MWRA region, so 0.1% potentially represents around 5,000 weekly cases.

[Drazzil]

More visualization from MA showing how important masks are

I've never quite heard 0.1% as important, but I guess it's perspective.

Where do you get 0.1%? This is from the MWRA graphs right? It looks like unmasked areas see 30% more cases starting in September.

Or 250 people out of 100,000 vs 150 people out of 100,000. So, perspective.

There are nearly 5 million people in the MWRA region, so 0.1% potentially represents around 5,000 weekly cases.

A few of my co workers are stupid enough to be unvaccinated.

[Smoove_B]

A few of my co workers are stupid enough to be unvaccinated.

I cannot even process working high-volume retail and not being vaccinated. Or that corporate is allowing it?

Also, in a discovery that should surprise no one:

https://twitter.com/CBSNews/status/1465662492525404162

JUST IN: Omicron COVID variant was in Europe before South African scientists detected and flagged it to the world

So travel ban...pointless. I wonder if there's anything else we could consider that might genuinely impact circulating virus levels?

[malchior]

So travel ban...pointless.

It was purely political pandering and following the herd. I don't expect much more from him or other leaders. A lot of leaders in the West all chasing the needle on the gauge and are just hoping it'll resolve on its own.

[Smoove_B]

It also reinforces the idea that when a country finds something like this, sharing it to the world actually has immediate negative impacts for them. Disincentivizing the sharing of information during a global pandemic is not a winning move. That's why cynical me isn't surprised at all that the United States isn't doing nearly as much as other countries to test and genetically monitor strains. Oh, we're really good at verifying it's Delta ripping through our population, but magically we have no idea about other strains? C'mon.

[Defiant]

So travel ban...pointless. I wonder if there's anything else we could consider that might genuinely impact circulating virus levels?

I don't know if it's pointless - it wouldn't put a stop to it, but if there are a lot more infections there than there are here, then more people were to come in with the variant it would increase the numbers here more quickly. Of course, there are other reasons why we might not want to impose a ban. If countries that detect a new variant get a travel ban as a reward, it might disincentivize looking for new variants.

[Smoove_B]

If we were all on the bleeding edge of testing or we were a nation that was isolated and had very controlled travel to begin with, the travel bans *might* be justified. But in America? Europe? Pointless. It was also discovered in Germany yesterday as well - in people with no travel history. The travel bans are theater and reactionary. Almost two years later we need to shift our focus on proactive measures.

[Zaxxon]

The travel bans are theater and reactionary.

To be fair, we've been doing reactionary theater with our air travel security actions for decades.

[Smoove_B]

Exactly! It's a core defining characteristic of our culture.

Someone the other day on the Internets pointed out that the entire purpose of public health is to create and advocate for policies that promote the health and well being for hundreds of thousands (millions) of people. If we can't do that now in a time of crisis, then what the f are we ever going to realistically do, ever?

[Zaxxon]

For Smoove, and replace 'Dutch' with your choice of locale.

https://twitter.com/MaartenvSmeden/stat ... 32288?s=20

[El Guapo]

Sometimes I feel like we should have a day where we give Smoove a ton of uppers and get the most optimistic take that he has buried somewhere in his soul. Though I'm sure that take is probably still pretty grim.

[Smoove_B]

That Tweet is 100% perfect.

RE: My take -- I was never popular at parties, but now I'm extra not popular. I had to catch myself multiple times during Thanksgiving. Not that it was a big event (it was only 6 of us), but I was trying not to interject all that much. But family in attendance would keep asking questions. I'm like a human car wreck apparently - you just can't help yourself and need to know, even though you're clear it's not a good idea.

I think what we're seeing now is where we will be. There will be some level of death we'll come to accept and it might be a disease that is always around, always causing localized outbreaks with higher and lower rates based on the time of year and where you are. So more present than influenza and something we're all more aware of because we'll need to do more monitoring for new variants of concern. But unless those variants are (1) more deadly (2) more transmissible and most importantly (3) are able to bypass vaccinated populations, I'm not sure much will change. We might see certain cities and communities embracing the idea of seasonal/temporary voluntary mask usage, but my feeling is that it will eventually become weird to see people in masks. There will be random deaths we'll bemoan as tragic ("He was so young"; I can't believe how fast it happened?") but in a practical sense, nothing is going to change. That is what I'm currently soaking in.

[malchior]

I think what we're seeing now is where we will be. There will be some level of death we'll come to accept and it might be a disease that is always around, always causing localized outbreaks with higher and lower rates based on the time of year and where you are.

Where this falls apart is that we are where we are now with a certain level of vigilance. As the vigilance wanes we will see all sorts of related systemic risks rise up. Maybe people will accept a certain amount of illness/death but that isn't the end of the chain.

The all important economy is at risk here. Part of our supply chain disruptions that people don't really understand is that there are deep, networks of sick pockets of people at any given time and they have widespread economic impacts. Maybe grandpa died (it was his time!) but his son is out of work for 2-4 weeks perhaps without pay or any safety net.

Also, the healthcare system is constantly under risk of breaking. Do outbreaks overwhelm systems and tax the system over time? It sure as shit looks like it. We're seeing chaos there and it's been under two years. What does it look like in year three or four or five?

So maybe we'll stop being vigilant on the root cause but the cumulative secondary effects might end up being more dangerous to us in the long run. Economic distress like we see over long periods of time is risky to stability. That's where my mind goes when I see this reckless behavior. Everyone is out of ideas. It really looks like everyone is just hoping the ride stops in a way where we don't end up starting to kill each other or end up under reactionary authoritarian regimes. It's all a real risk right now and I don't think people are seeing that risk for what it is.

[Smoove_B]

Yeah, all that is true. I just assumed we'd be leaning into the chaos and just start accepting the changes in healthcare and logistics as the new normal - in the same way that we accept the need to tell 6 year olds to learn how to hide in a supply closet because a crazed gunman might come in and start blasting or how it's normal to expect to take off your shoes and get screened for flying on a plane now. Oh, I can't schedule my hernia surgery because there's a surge in COVID-19 cases right now? Ok, hope nothing happens. We tried to help your husband after his heart attack, but unfortunately we were understaffed and overwhelmed with an early Fall COVID-19 surge; sorry. Going to be a tough Xmas season as an outbreak of COVID-19 among unvaccinated dock workers has the ports backed up again.

Where it all flies to pieces (for me) is if a more deadly variant emerges. Then it's true chaos. Now? Most people are just inconvenienced. Marginalized populations are feeling the brunt and will continue to do so as they're forced into situations where they need to interact with the unvaccinated / high risk masses. I've truly come to appreciate that so many of my decisions during the pandemic (then and now) are from a position of of status. My wife is getting ready to walk away from a employer that is pretty much actively encouraging spread at work, starting tomorrow. Being able to quit a job right now is a privilege - I totally get that. I'm trying to advocate for those that aren't in similar positions (jobs, money, health insurance, age) but there are politicians that are actively working against it all; it's untenable.

[malchior]

Yeah, all that is true. I just assumed we'd be leaning into the chaos and just start accepting the changes in healthcare and logistics as the new normal - in the same way that we accept the need to tell 6 year olds to learn how to hide in a supply closet because a crazed gunman might come in and start blasting or how it's normal to expect to take off your shoes and get screened for flying on a plane now.

Yeah. We are seeing that starting to happen but it actually probably adds in more risk short-term. The transition from warehousing to just-in-time manufacturing/logistic practices took years and years to become the norm. It is now very baked into modern corporate cash management, valuation, etc. (All the financial C-suite strategic financial considerations). I expect it'll take years to move to some theoretical stable manufacturing/logistical hybrid model. All the while the transition will probably be exacerbating the current situation as manufacturers build reserves of critical parts where they can. Those who can't build reserves because it is high-change like high-tech? I guess they might have to figure out some hedge against this. In the meantime we just have to hope the whole thing doesn't implode on us.

[malchior]

What'd Trump do that didn't work? Some meaningless border stuff? Well we need to look like we did something. Just do that. Then the GOP can't complain...

https://twitter.com/nytimes/status/1465863244669722624

[Smoove_B]

If only there was something we could require in order to fly on both domestic and international flights. Like...some kind of documentation proving that you're not likely going to be a threat to the health and safety of others. I'm sure it'll come to me.

[Blackhawk]

Guy standing neck deep in water: "Need to make sure there are no leaks..."

[Kraken]

If only there was something we could require in order to fly on both domestic and international flights. Like...some kind of documentation proving that you're not likely going to be a threat to the health and safety of others. I'm sure it'll come to me.

Charlie Baker is on board with up to 20 other governors who are developing a standard vaccine passport, which is basically an app with a QR code. I'd venture out in public again if I could be sure that the unvaxxed were excluded.

[Smoove_B]

This is a really long Tweet (like 40 posts), but it's a also a great overview from a trusted voice - one that apparently emerged to drop knowledge after being in a self imposed exile related to the Internet being a dumpster fire for scientists.

https://twitter.com/K_G_Andersen/status ... 6629821442

If it's too long (and I get it) the summary is - we don't know; we need to wait and see. We can guess, but that's all we're doing now. Time will tell, however we should be acting accordingly - including promoting masking and ventilation (not just vaccination).

[Drazzil]

Guy standing neck deep in water: "Need to make sure there are no leaks..."

Its almost like the bags out of the cat.