If it does become endemic, the question is, what disease would it cause? The deadly Spanish and Hong Kong flu viruses didn't disappear, but rather evolved to cause yet-another seasonal flu after a few seasons.
If the Covid virus does the same and causes yet-another-cold, who cares? Whereas if we're fighting Covid-the-disease for decades to come, well, God help us!
There is plenty of evidence to support the idea that as it becomes endemic, it will evolve toward yet-another-cold. There is no evidence in all of history for an endemic coronavirus that is not yet-another-cold.
I am clueless but I'd like to ask: when you say "it will evolve toward yet-another-cold"... does it mean it'll be as harmless as the common cold or as common as the common cold but as dangerous as covid19 ?
we do fight colds already, it just wouldn't be news anymore.
In recent history we haven’t bothered fighting colds at all and this attitude has not served us well. Up until March 2020 it was socially acceptable to roll into your office, church, or school coughing and sneezing everywhere. In 2020 we even had to produce public health videos to teach people how to wash their hands and why it was a good idea to do so! This was taking place in high income, well educated countries that would consider themselves technologically advanced and socially sophisticated.
That casual posture is obviously gone for a generation, but what underpinned it was our collective delusion that we had conquered infectious disease while all visibly ill from all the infectious disease circulating in the population every year.
The research efforts are interesting because it seems to be a very tough vaccine candidate due in part to the sheer number of viruses and strains you’re dealing with. I’ve not seen the financials, but I’d be surprised if we were spending anything like the estimated costs of tens of billions of dollars on finding a solution. I guess it’s a case where the costs are borne in a very diffuse way but the solutions have to come out of specific research budgets. Why bother researching and getting approval for a vaccine, when you can just sell people over the counter snake oil like cough medicine?
We don’t have to shrug when our low baseline expectations for life get even worse. We can and must do better if we believe in progress.
Then there's the counter-argument that within reason having a low level of infectious diseases hanging around isn't such a bad thing. It trains our immune systems, preparing them for more serious attacks. I honestly don't know how good an idea that is, but it seems plausible and Ive heard it from medical professionals.
At the medical science level, we absolutely do investigate common cold pathogens and others, and have developed a battery of techniques, all of which were very rapidly brought to bear on Covid-19.
Where I think we do need to do a lot better is in international co-operation and co-ordination. In the USA the CDC needs competent leadership again, they need their seat back at the US national Security Council and they need their international outreach budget back. Europe needs to develop their own equivalent to the CDC that's well funded and effective.
The WHO also needs thoroughly upgrading. I think given the way national governments have ensured the WHO stays a political football, they actually overall do a lot of good. A lot of nations are thoroughly reliant on them for advice and technical assistance, but clearly their chronic dependence on the good will of nation states has severely compromised their ability to act as an independent and effective organisation. They need more funding and more independence, not bullying by China and the USA to serve domestic agendas.
Please don't make that argument your making? Please don't make your argument in that way? Please don't argue at all? Please don't ask questions?
Literally, all the comment you responded to did what ask a question to invite further discussion of an idea they were interested in.
When I hear "please don't do that" I picture kids pulling up flowers in someone's yard and they yell out "please don't do that!" It seems aggressive and unspecific for a civilized discussion among equals.
If we had invested more in developing vaccines and treatments for the common cold, then maybe we would have tricks that would have helped us beat covid faster.
I think that's a common misconception here. Common cold viruses are very frequent targets of research - not with the end goal of creating an actual vaccine for a specific cold virus but for covering blind spots in our insight and processes that can be weaponized to create a vaccine when an outbreak happens. I'd say that our system is working - developing several working vaccines for a novel virus in under a year is pretty darn impressive.
Especially considering several of the actual vaccine candidates were developed in low single digit months, it's the evaluation production and testing that's taking most of the time.
I'm not aware of a single working Covid-19 vaccine, which ones would that be? There are promising candidates, sure, but I don't think any have already been shown to be both effective and safe, which I'd say is required for one to be working, on the timescales that are needed, and I wouldn't know how one might do that so quickly. The current forerunners might well not work out, though I hope at least one of them will work, but my understanding is that anything immunity-related is fiendishly hard.
The one constant in all reporting and discussion about potential SARS-CoV-2 vaccines is wishful thinking. I don't blame the pharma execs for that; talking up their stocks is their job. Everyone else, though, could do with a great deal more skepticism. We'll be lucky to have a commonly-available, somewhat-effective vaccine next year. If you had listened to the cheerleaders in June, you would be shocked to learn we don't have multiple such vaccines now.
Regular mask wearing and careful avoidance of problematic public situations is already more effective than any vaccine for this virus will ever be.
Lockdowns absolutely not: the costs outweigh the benefits, and there’s no potential vaccine on the horizon.
Quarantines, maybe. The vulnerable already have to shield themselves as protection, and the economic losses are pretty steep before you factor in the human cost of suffering.
I wonder why we never hear serious talk of trying to cure the common cold. It reminds me of how people who talk about curing aging are seen as crackpots. Unlike cancer, aging and colds are seen as inevitable by people, and any attempt to cure them, or even talk about the fact that we should, is seen as fanciful.
Can't remember where I read it, but the idea was that using existing vaccine tech to knock out pretty much any virus is a major financial undertaking. Now multiply that by 100x, or however many common-cold-causing viruses exist.
Keyword being existing. Future advances may change the landscape significantly, and not just for colds. For that, we need a stable society, competent governance, and investment in foundational science.
> Can't remember where I read it, but the idea was that using existing vaccine tech to knock out pretty much any virus is a major financial undertaking. Now multiply that by 100x, or however many common-cold-causing viruses exist.
It seems quite strange to me that this should be multiplicative. There should be some economics of scale, especially for viruses from the same family.
(It is also quite strange to me that the SARS-2 vaccine takes some long, as if we have to invent the vaccine technology from scratch. But granted, I don't know much about this field. Maybe it is not a technology problem but mostly testing and approval)
There are no coronavirus vaccines; prior to the year 2002 that’s because coronaviruses were relatively harmless in humans and thus not deemed a threat. Post 2002 it is because we didn’t heed the warning of SARS and invest seriously in creating one (and it’s hard to develop a vaccine for a disease that isn’t around anymore).
For the “common cold” vaccine, you’re looking at hundreds of strains across about nine types of virus, so a pretty tall order using traditional approaches.
> For the “common cold” vaccine, you’re looking at hundreds of strains across about nine types of virus, so a pretty tall order using traditional approaches.
A couple of hundred does seems tall at all, especially when it is basically just 9 different types. It seems to me that this is easy to scale once a general approach is found.
But since there is basically no progress on the common cold, I assume it is just not solved for any of these families, so the total number of strains or families doesnt matter anyway. Or it is mutating faster than we do anything. But I dont get how a small number like couple of hundred should matter - at least from the technogical perspective.
By all means, keep the vaccine research, incentive people to wear masks when sick, stop the worst hygienic practices (like hand pushers on public restroom doors), keep WFH where it works, etc.
But nobody will accept a full quarantine, commerce restrictions, or any of the other heavy actions for fighting a normal cold. And with a lot of reason. It's best if people don't even propose carrying those practices after the disease gets less lethal, because even proposing them can bring bad consequences right now.
Eh.. this will cost me some reputation points on HN, but I have to say this.
Why "Spanish flu" and not H1N1-A-18? That flu is called "Spanish" only because Spain's newspapers openly talked about the epidemic. The actual origin, according to wikipedia, was "likely Kansas".
I think roughly this, but it is a bit more complex.
Basically, mutations of the virus that cause it to spread more make it more likely for the strain to persist. Usually this means, virus becomes more benign, doesn’t kill people quickly and instead causes some minor illness, which gives the patient more opportunities to spread it.
But it’s not a given. It could for example mutate to become more deadly, but with a longer infectious period. This is what happened to myxomatosis in rabbits in Australia.
Fortunately HIV isn't communicable by sharing air. Despite that truvada costs $2000/month[] in the us. And, unless I'm mistaken, it needs to be taken for life, or until a proper cure is found and hopefully that doesn't cost $2,000,000. Truvada costs more than the median us salary. I'd rather risk covid19. Death would come much faster than an agonising death from untreated aids.
While your points about the obscene cost of Truvada are spot on, your point about US incomes is not.
For 2019 the median US income was $36,000 [1] (not ~$20,000). The median US full-time income was around $52,000 [2]. The median family income was $86,011 [3] and the median household income was $68,703 [4].
I believe that HIV is still considered an epidemic, and in fact a pandemic, which is not the same as being endemic.
Edit: This comment is being downvoted for some mysterious reason so I'll add a reference: "HIV/AIDS is considered by some authors a global pandemic. However, the WHO currently uses the term 'global epidemic' to describe HIV." [1]. There may some confusion as to what 'endemic' means by some commenters here...
Medication exists that can prevent HIV from causing AIDS and from passing the infection to others and also medication exists that can prevent the user from becoming infected.
If that drops r below 1 long enough it would have to right?
This seems especially hard to do though, since compliance would need to be nearly universal. You could potentially wipe out influenza and the common cold at the same time too though potentially.
Some individuals may stay infectious forever. E.g. Typhoid Mary[1] was quarantined twice, and the second time she remained isolated until death. (Thypoid fever is a bacterial infection, but I assume something similar can happen with a virus.)
In addition to the others, there'd be a long tail of few infections before it's actually wiped out, and during that period I expect too many people to just stop caring about masks for it to actually get eradicated.
It really doesn’t. Poor quality masks are questionable at an individual level but even if everybody just wore knickers on their head, that would have a gigantic effect on the spread on the virus overall.
That would be great if true, we'd be able to scale down the social distancing, among other things. That said I'm not nearly as confident that the effect will be that great, do you have any references you're basing this on?
Masks work by physically filtering viruses out of the air. How do you propose shall a virus adapt to that? The thing's packed with DNA, it can't easily evolve to be 1/10th the diameter (and 1/1000th the volume) to get through filters.
Except that's exactly how most masks people wear do NOT work; they serve simply to prevent large particles (spittle) to move too far from their origin. Yeah there are better masks/SCBAs, but even common use and enforcement of something that actually stops a virus is impossible so long as people keep chanting the "empathy" mantra.
I suppose the virus could adapt to spread more easily via surfaces. Or, it could become more virulent, such that fewer particles have to get through the mask to cause infection.
> I'm not sure why no one's saying this, but the virus is adapting to masks
Based on what? Countries that are supposedly “taking it seriously” experiencing recent rising case counts? This assumes a couple of things:
1. That there exists a place on earth where everyone practices perfect mask usage.
2. That said people are using ideal masks. And no, that cotton mask you carry around in your pocket all day and wash once a week doesn’t count.
I think the problem is people are ascribing magical properties to the kind of masks that most people are using, which are generally cheap, not N95, and reused over and over.
HIV is not asymptomatic though. If you have it you know it, and thus you can protect yourself and those around you. If we had an indication of who's a covid carrier we could have fought the pandemic a lot better.
With the common cold and flu they mutate a lot more than Covid, the chance is that it will be around for a long period of time then fizzle off because of the advance of meds together with low rate significant of mutations.
As I understand it, influenza mutates much faster than coronaviruses do. "The" common cold is really a whole bunch of unrelated viruses lumped together, and I haven't heard anything about the other coronaviruses that cause common colds mutating any faster than Covid.
The answer seems to be :shrug: which is what I would think the answer would be right now.
From the middle of the article:
"Should reinfection prove commonplace, and barring a highly effective vaccine delivered to most of the world’s population, SARS-CoV-2 will likely become endemic"
And the closing sentence:
"A duration of immunity similar to that of the other betacoronaviruses (~40 weeks) could lead to yearly outbreaks of SARS-CoV-2, whereas a longer immunity profile, coupled with a small degree of protective cross-immunity from other betacoronaviruses, could lead to apparent elimination of the virus followed by resurgence after a few years. Other scenarios are, of course, possible, because there are many processes at play and much that remains unresolved."
At the moment we are going through a pandemic caused by a first contact with the virus. This is not an endemic state.
Once this is over, if the virus remains in some sort of steady state in a given area, i.e. person to person transmission never stops so that a least a few cases always exist, then it will have become endemic in that area.
Globally it might become endemic, or it might not, or a large-scale vaccination program might kill it off anyway. We don't know.
With so many people ignorant of the science, believing in wild conspiracy theories, being antivaxers and antimakers, of course it's going to become endemic.
It remains to be seen if most people will even get vaccinated if/when a safe and effective vaccine becomes available.
Even if people got vaccinated once, to actually eradicate COVID-19 they might have to get revaccinated multiple times, possibly over a span of years. We can't even get everyone to get flu shots. Getting everyone to get a new vaccine to a disease towards which there's so much disbelief will be even more difficult.
We eradicated smallpox, but that was a fluke. Take a look at the eradication efforts towards HIV, measles, and polio. Much more progress could be made on these fronts, but paranoia, ignorance, and long-held beliefs and behavior patterns stand in the way.
Even if COVID-19 itself is eradicated, something else to consider, that virologists have been pointing out, is that there are plenty of other coronaviruses in various animal species that could make the jump to infect humans, possibly causing another pandemic which is just as bad or even worse.
A major shift in thinking and priorites has to happen globally, on many different fronts to make humans less vulnerable to this kind of disease in the long-run.
You can’t just put all the “many” people in the same bucket. I hate this so much now in various circles. I also saw someone else with a similar idea: “why is there a second wave, are so many people anti maskers and non COVID believers?”. No, people had enough of the fumbling and incoherent messages, people are tired and the world is made up not just of developers that can work from home and see this pandemic from their windows while ordering food online, most of the people can’t afford to lose their jobs or stay at home. The whole world adopted this toxic US us vs. they model where everyone who doesn’t agree with you on everything is an ignorant fool and your enemy.
Instead of acting with compassion and trying to convince people of the dangers of this disease, but also providing some sort of perspective of where we are going, we’re just calling everyone who has a different opinion an anti-* and be done with it.
There's also the issue that while it's deadlier than the flu, it's not that much deadlier, so people are genuinely looking at death rates and making different value judgements on if various restrictions are worth it.
There's also the issue that cases of flu are remarkably low this year because of all the mask wearing, social distancing &c. Comparing apples to apples, coronaplague is about 10 times as deadly as annual flu.
"cases of flu are remarkably low this year because of all the mask wearing, social distancing &c."
And yet if COVID-19 was no more dangerous than the flu you'd expect to see equal result form those mask wearing and social distancing measures.. but you don't.
COVID-19 is just way more deadly than the typical flu might be true, but it is telling not much more than claiming COVID-19 is way more deadly than the common cold.
Less than 217000 people died of COVID-19 during the epidemic in the USA while some 1.5 million people died from other causes in the same time frame. Why the obsession with COVID-19?
Right, especially with the huge variability by age. Telling 25 year olds that they shouldn't socialize because they might infect someone who might infect someone who might infect someone who might infect a nursing home is nowhere near as persuasive as "if you get infected there's a significant chance it will kill you".
I felt this was a really interesting piece explaining how covid deaths are reported deaths versus flu deaths are just estimated and how the two are very different numbers to base comparisons off.
I also kind of liked how the article was written with the narrative of the eureka moment in realising how the stats were not comparable.
> I decided to call colleagues around the country who work in other emergency departments and in intensive care units to ask a simple question: how many patients could they remember dying from the flu? Most of the physicians I surveyed couldn’t remember a single one over their careers. Some said they recalled a few. All of them seemed to be having the same light bulb moment I had already experienced: For too long, we have blindly accepted a statistic that does not match our clinical experience.
> The 25,000 to 69,000 numbers that Trump cited do not represent counted flu deaths per year; they are estimates that the CDC produces by multiplying the number of flu death counts reported by various coefficients produced through complicated algorithms. These coefficients are based on assumptions of how many cases, hospitalizations, and deaths they believe went unreported. In the last six flu seasons, the CDC’s reported number of actual confirmed flu deaths—that is, counting flu deaths the way we are currently counting deaths from the coronavirus—has ranged from 3,448 to 15,620, which far lower than the numbers commonly repeated by public officials and even public health experts.
Rough order of magnitude estimates suggest that corona will kill ten or so times as many people as a typical flu season by the spring of 2021. We have however spent hundreds of times as much on coronavirus mitigation than we ever did on flu mitigation in one year. This would imply that society places well over ten times the value on a life lost to covid than on a life lost to influenza.
"Instead of acting with compassion and trying to convince people of the dangers of this disease"
Like that hasn't been done non-stop since the world heard the term "coronavirus"?
A significant percentage of the population prefer not to listen to the science and instead believe in conspiracy theories. Science literacy in the general population is abysmal. That's just a fact.
Many people prefer to listen to what their morning talk show tells them than listen to the CDC.
This kind of ignorance could be overcome to some extent through massive information campaigns, but so far the US government at least is incapable or unwilling to do that. If anything, on some of the highest levels it's doing quite the opposite.
That kind of obviously harmful attitude is not just ignorant, it's borderline malicious.
People certainly have and will probably continue to die because of it.
> This kind of ignorance could be overcome to some extent through massive information campaigns, but so far the US government at least is incapable or unwilling to do that. If anything, on some of the highest levels it's doing quite the opposite.
I think at this point we have enough data to understand what happens when we try to force people to think or believe things on a massive scale. Its not great.
> A major shift in thinking and priorites has to happen globally, on many different fronts to make humans less vulnerable to this kind of disease in the long-run.
I don't necessarily disagree with this, but I don't think the current mitigations can reasonably be long-term solutions. Think about how the lockdowns have caused small businesses to close down, people to lose their jobs, etc. We count deaths caused by COVID-19, but do we count the deaths and quantify the damage caused by our mitigation strategies?
Anecdotally: in my years on this planet, I've never known anyone who committed suicide (thankfully).
However in the last 3 months, I've had both a friend and a relative kill themselves unexpectedly, both laid off since March, unable to work, financial issues, no hope and one just recently in an area just gone back into lockdown.
It is very much easier for those of us who are able to WFH taking Zoom meetings in PJs with Amazon Fresh delivering groceries to the door. But for a big chunk of the populace, these are really hard times.
I do not know what the right answer is, but you have a very good point.
If the Covid virus does the same and causes yet-another-cold, who cares? Whereas if we're fighting Covid-the-disease for decades to come, well, God help us!