Tuesday, October 12, 2021

In which I am - fair warning- exceedingly pessimistic

So immunity for everything - even for the very most effective vaccines - wanes over time, right? And covid vaccine immunity /protection will, inevitably, wane over time (yes, even with boosters), and also everyone's numbers are nonsense

At some point, vaccines will be approved for all ages; there will be a lag until they are required for school, and even then, there will be highly variable enforcement. We're hovering around roughly 30% for 12-18 year olds now; if you really think 90% of parents are going to rush out and get their elementary schoolers vaccinated right away, I have a bridge to sell you.

Let's say the US finally does something effective and 60% of adults and children alike end up vaccinated... by next summer.  That's two and a half years of raging pandemic.  Right now, testing is free, so worried and/or quarantined people go get tested all the time while anti-vaxxers ignore the whole thing.  60% is not enough to stop transmission, though it slows it somewhat.  Go look at the month of September and tell me this isn't going to go on, and on, and on.  This is not working.  This is not preventing hospitals from being overwhelmed (though vaccination has helped) and this is not 'stopping the spread' in any meaningful way.

Right now we are, as a society, still acting like preventive measures might make a difference: like we can get transmission down to a level where ordinary people won't have to worry about being infected.  That's not going well.  So when will life 'return to normal'?  Well, once children are eligible to be vaccinated, maybe people will worry less about going out and doing things, but there will continue to be transmission for... forever.  When will people stop wearing masks?  Because my employer required vaccination, 98% of people are vaccinated, and that's as immune as most of us are going to get (barring a really good delta booster, which, hah, maybe winter 2022.)   I don't think now is necessarily the time, but also, what exactly are we waiting for?  Vaccine approval down to 6 month olds?  See above.  I make the cynical prediction that many interventions will stop when insurers stop covering coronavirus tests.  And yet!  None of this is a good idea.  None of it is good policy.  When even Australia gives up, you know it's bad news.

How does the pandemic end?  It doesn't.  I predict that eventually, everyone who wants to be vaccinated (and our children!) will be vaccinated, and most people will just give up on preventive measures.  Even if there are boosters every 12 months, if they lose even 5% effectiveness against all disease per month, that means by the next year, people will have 40% immunity (probably less).  Will everyone wear masks forever?  No, of course not.  They wouldn't even wear masks last winter when 3000 people a day were dying.  This winter?  Good luck.  And boosters for all?  In the US?  Good luck with that too.

12 comments:

  1. Socal Dendrite4:52 PM

    Here in CA, I think vaccine availability for 5+ yr olds will make a difference. Not necessarily that there will be huge uptake (though certainly more than in many places) but at that point all families with school-aged children will have the choice to get all family members vaccinated if they wish. I am also hopeful that getting through the winter will make a difference. While I 100% agree with the masking and testing we have in place in schools now (and I am grateful that my workplace has mandatory vaccination), I don't think we should keep doing it forever.

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    1. I think many people feel like, once everyone, or at least school aged children, *can* be vaccinated, maybe we're all gonna give up.

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    2. Socal Dendrite12:29 AM

      Yes, that is definitely what it feels like.

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  2. After raging covid 19 where about 7% of the student body in our district has reported having covid since mid-August (so not including everyone who got it last year), we've had over a week of single digit reports for the entire district. I'm hopeful that a combination of vaccines and natural immunity will tamp the spread down in the longer term. Still waiting for DC2 to get vaccinated before sending her back, though if these low numbers keep up...

    After several weeks in the multiple hundreds range, we're back down to double digits for the county as well. Now, some of that could be under-reporting because the uni isn't doing required testing anymore.

    That said, my (uni) class this morning sounded like a flu ward. Constant wet sneezes, sniffles, and coughs, mostly sneezes and sniffles. One woman would not keep her mask on. They can zoom in if they're sick, but they're choosing not to. Do they have covid? Do they have flu? I'm not allowed to ask!

    It's sad that once DC2 is vaccinated I will probably show as much care for the 0-4 year olds as other groups are showing for my 9 year old. Which is to say only when reminded.

    We get flu shots every year, I assume they'll be bundled with covid boosters at some point. At what point does a person become selfish and just throw up their hands about everyone else?

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    1. That's basically what it boils down to for me: at some point, you know, if people didn't choose to be vaccinated then I don't see why I should have to mitigate for them FOREVER.

      I think vaccines and recovery *will* take it down some, just not enough!

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  3. I don't think this is exceedingly pessimistic.

    Especially the "what exactly are we waiting for?". It's not going to get much better than now. (With the possible exception of someone finding a miracly drug to quickly and efficiently treat COVID patients. Oh, I just found some optimism!)

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    1. Right? We can hope for a miracle antiviral for coronaviruses in general, BUT... I'm not gonna hold my breath.

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    2. I mean, there's molnupiravir: https://www.nature.com/articles/d41586-021-02783-1. I especially like how it causes the virus to mutate itself to extinction. WHAT COULD GO WRONG?! Though, short periods of treatment will probably be fine. Humans are around carcinogens constantly.

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    3. And! The NNT (to prevent one hospitalization) is 14 in a population 5-10 times as likely as the general public to need hospitalization. You would generally expect the NNT in the general population to be disproportionate...
      This is not a miracle drug. It will cost a bare minimum of $45,000 of this drug to prevent one hospitalization in the general population.

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  4. Ugh I try not to think too much about this and just focus on what I can control which is just me. We'll see when I stop wearing a mask but it's not anytime soon. But I do like that Novavax is testing combining covid vaxx with the flu shot and getting good results. Since I annually get my flu vaxx I like the idea of my routine not necessarily changing and just being able to get a two in one.

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    1. You can already get them on the same day! I'm sure 'just mixed together' is next. That was always a stupid rule, because, you know, we don't get any OTHER vaccines together, right???

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  5. I am waiting for my youngest to be vaccinated. Although the data you showed the other day and the data in the recent NYTimes article showing that unvaccinated 5-10 year olds are significantly less likely to be hospitalized than vaccinated 70 year olds make me wonder if I should see it through (meaning keep minimizing our activities until vaccination) or not. But I will. Everyone else in my family was vaccinated at the first opportunity. My partner has had the booster already. Once the youngest is vaccinated, I may feel that we've done all we can to protect ourselves and loosen up a bit. That said, I plan to keep wearing a mask in crowded areas. I don't know if I'll ever fly without one again. I'll keep the kids wearing masks at school until caseloads in my area are down significantly (down to what? I don't know). Life is never going back to exactly the way it was. Which is OK. But I do hope to be eating in restaurants again in the spring.

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