I really want to understand how “two weeks to slow the spread” became “white collar workers should shelter in place for the foreseeable future and blue collar folks should wear masks.” Im still dumbfounded by why healthy young and middle aged people were willing to give up so much for so long to avoid such a small risk. Vaccines were developed faster and proved more effective than was expected. Last years risk calculations would look really silly if the vaccines had been 60% effective and the curve had exploded after delta came along. They would look equally silly if delta had hit five months earlier.
Why were young and middle aged people willing to live bleak and austere lives for a year or more to avoid a 1 in 2000 chance of death. Do they never drink alcohol or smoke pot? Do they have a scientifically ideal BMI? Do they always drive the speed limit? The extreme risk aversion was a collective mental illness.
I can totally understand why retirees might have chosen to stay home for a year, I can even understand why school districts might have let 60 year old teachers work from home and hired young people to monitor classrooms. I can also understand why grandparents might have avoided their grandchildren during Christmas 2020, though I can also understand taking a small risk of infection and a 3% chance of dying if infected to have a normal Christmas if you only have 10 or 15 Christmases left in you. Reasonable people can disagree on that one.
America was not built by timid men, it was built by people who threw up railroads and bridges and dug mines fully aware that some of the workers would die. The idea that life can be completely safe until old age, with the consequence that many peoples’ bodies outlast their brains and they spend years as senescent morons, is the essence of modern decadence.
This does seem to have some relevance for the masks in schools debate doesn’t it? And just for covid prevention among young people in general. If my daughter is going to get variations on this virus dozens of times in her life why am I trying to prevent her from getting it now? Especially since, past the first year of life, it seems like the younger you get this thing the better.
I also know a few parents who are now saying “why don’t kids always wear masks” to prevent spread of flu and ‘common colds’. Which I do understand as it’s a big pain when your kid is sick! But if the common cold is not serious in mid life because we’ve all had it ten times while we were young then we’re not doing kids much of a favor by reducing their exposure to these coronaviruses and rino viruses at a time when their bodies seem most able to handle first exposure.
First cent: Regarding flu vs cold, we're generally pretty sloppy with language. I mean, we call it the "stomach flu." (Some people even misuse the term "flywheel.")
Second cent: Man, Matt must have been demon good at writing term papers the day before the deadline back in college.
I am so excited for the trials of Moderna’s new cold and flu vaccines. Even if it just stops four cold viruses, four flu viruses, and Covid, that’s a significant improvement on past flu vaccines.
The question is whether the hospital system can handle ‘a little worse than usual because of a new virus’ for a decade. Here in LA, vaccine rates are better than they will likely get in a lot of states (80 percent of adults) and there was a large wave over the winter. But hospitalizations are still up enough to stress the system some, in a way that will cause nurses to quit. System didn’t have slack to begin with. If the 1889 theory is correct we need to find a way to raise the line.
While poorly (deceptively?) communicated, flatten the curve is never a single time point strategy. It may need to be maintained or repeated until some immunity threshold is reached and the susceptible population remaining is unlikely to overwhelm a local healthcare system. Overall I think the public would have responded well to more mechanistic and transparent explanations throughout this pandemic.
For me the takeaway is that we just need more vaccines. More vaccines for covid, more vaccines for the flu and maybe vaccines for the common cold. And the more we suppress the prevalence of the virus in the population, the more we need vaccines to keep our immune system sharp because covid, the flu and the common cold all include a set of viruses for which elimination is not possible. But we can reduce the human cost with regular and varied vaccination.
But along these lines, we need vaccines that have fewer side effects, and not just deadly ones. I would be fine with taking a cocktail of 5-6 vaccines every year, but the symptoms should be mild not, you're going to spend next day in bed. So I think more research is needed and dosing needs to be experimented with.
There is enormous economic value here in improving daily human health if we can improve vaccine regimens - on the order of a large fraction of a percent or even a full percent of GDP. It would be great if we could actually unlock it.
I wonder if the coronavirus Matt writes about — or other, similar coranaviruses that cause common cold — are truly globally endemic in the main, or some are and some aren't, or do they exhibit regional differences in terms of endemicity.
Relatedly, I've wondered if certain populations — I'm thinking primarily in terms of East Asia — might possess a modicum of immunity (I know there's a more technical way to describe this but no time to research at the moment) vis-à-vis Covid19. I'm not even suggesting we have epidemiological evidence for this, although we may, in that China, Taiwan, Japan and Korea all have suffered a lot less sickness during this pandemic than most of the Americas or Europe.
One personal anecdote that got me thinking along these lines was that, during my first sting in Asia — I arrived in 2013 — I got slammed on a regular basis with nasty colds for the first eighteen months or so. I rarely suffered from them back in the States. And yes, these were quite unpleasant. At one point I was absolutely convinced my neighbor's cat's dander was blowing through the building ventilation and affecting me (the cold wouldn't let up for weeks). But he kept his cat and I eventually recovered.
I have zero idea whether or not these colds were caused by coronaviruses. My guess is that this is statistically not all that likely (non-coranavirus cold viruses outnumber coranaviruses by something like 4 to 1, if memory serves). But who knows?
The Covid period has given me a lot of conversations where I’ve said “I’ve never heard that before.” This was the best of the batch.
Now… to be fair. MattY was competing with a cohort of mostly “COVID IS A PLOT BY THE ELITES TO DISTRACT AND DIVIDE US WHILE THEY POISON THE WATER SUPPLY!!!” and its homeomorphisms
But this would likely be the best novel take even if he wasn’t.
Frankly on the topic of covid policy I have no clue what anyone is doing anymore. it seems like the government is running in circles right now. we should have gone harder with mandates than we did, why do people have such a problem with vaccines anyway? I don't get it.
Off-topic: Matt, you've tweeted a lot recently about the crucial role played by the NYT's editorial judgment regarding *which news stories to promote with what angle*. First the Afghanistan editorializing, today the TX abortion decision:
"Always interesting to see which stories are seen as equally newsworthy as "new copies of old emails found on a laptop." Virtually nothing meets that high bar."
I've seen this argument laid out elsewhere and I agree that it's persuasive. But (even though I know this wasn't Matt's intention), I'm going to have to quibble with the "take the L" take home at the end. Assuming the COVID-1889 theory is true, you could logically argue that this is the mostly likely outcome for SARS-CoV2 IN THE LONG RUN. But when do we get there? If the world was still seeing serious issues with the disease 5-10 years later, that's a pretty long time! Moreover, giving as many people as possible (including "lower risk (but not no risk)" children) gives their immune systems a first exposure to this coronavirus, meaning they won't have to suffer the debilitating effects that much of the world has seen. Remember, again -- death is not the only negative endpoint... Long COVID and serious long-term respiratory effects are nothing to dismiss.
It's also worth raising again that Pfizer (and probably pretty much every other large pharmaceutical company) are working on a drug (NOT a vaccine) that will protect against not only SARS-CoV2 but also other future coronavirus threats.
"The oral antiviral clinical candidate PF-07321332, a SARS-CoV2-3CL protease inhibitor, has demonstrated potent in vitro anti-viral activity against SARS-CoV-2, as well as activity against other coronaviruses, suggesting potential for use in the treatment of COVID-19 as well as potential use to address future coronavirus threats."
I really want to understand how “two weeks to slow the spread” became “white collar workers should shelter in place for the foreseeable future and blue collar folks should wear masks.” Im still dumbfounded by why healthy young and middle aged people were willing to give up so much for so long to avoid such a small risk. Vaccines were developed faster and proved more effective than was expected. Last years risk calculations would look really silly if the vaccines had been 60% effective and the curve had exploded after delta came along. They would look equally silly if delta had hit five months earlier.
Why were young and middle aged people willing to live bleak and austere lives for a year or more to avoid a 1 in 2000 chance of death. Do they never drink alcohol or smoke pot? Do they have a scientifically ideal BMI? Do they always drive the speed limit? The extreme risk aversion was a collective mental illness.
I can totally understand why retirees might have chosen to stay home for a year, I can even understand why school districts might have let 60 year old teachers work from home and hired young people to monitor classrooms. I can also understand why grandparents might have avoided their grandchildren during Christmas 2020, though I can also understand taking a small risk of infection and a 3% chance of dying if infected to have a normal Christmas if you only have 10 or 15 Christmases left in you. Reasonable people can disagree on that one.
America was not built by timid men, it was built by people who threw up railroads and bridges and dug mines fully aware that some of the workers would die. The idea that life can be completely safe until old age, with the consequence that many peoples’ bodies outlast their brains and they spend years as senescent morons, is the essence of modern decadence.
This does seem to have some relevance for the masks in schools debate doesn’t it? And just for covid prevention among young people in general. If my daughter is going to get variations on this virus dozens of times in her life why am I trying to prevent her from getting it now? Especially since, past the first year of life, it seems like the younger you get this thing the better.
I also know a few parents who are now saying “why don’t kids always wear masks” to prevent spread of flu and ‘common colds’. Which I do understand as it’s a big pain when your kid is sick! But if the common cold is not serious in mid life because we’ve all had it ten times while we were young then we’re not doing kids much of a favor by reducing their exposure to these coronaviruses and rino viruses at a time when their bodies seem most able to handle first exposure.
So, we all agree the Uzbeks didn’t have a lab leak, right?
My two cents:
First cent: Regarding flu vs cold, we're generally pretty sloppy with language. I mean, we call it the "stomach flu." (Some people even misuse the term "flywheel.")
Second cent: Man, Matt must have been demon good at writing term papers the day before the deadline back in college.
I am so excited for the trials of Moderna’s new cold and flu vaccines. Even if it just stops four cold viruses, four flu viruses, and Covid, that’s a significant improvement on past flu vaccines.
The question is whether the hospital system can handle ‘a little worse than usual because of a new virus’ for a decade. Here in LA, vaccine rates are better than they will likely get in a lot of states (80 percent of adults) and there was a large wave over the winter. But hospitalizations are still up enough to stress the system some, in a way that will cause nurses to quit. System didn’t have slack to begin with. If the 1889 theory is correct we need to find a way to raise the line.
There are a couple of cases in this article of writing 1899 when you meant 1889.
While poorly (deceptively?) communicated, flatten the curve is never a single time point strategy. It may need to be maintained or repeated until some immunity threshold is reached and the susceptible population remaining is unlikely to overwhelm a local healthcare system. Overall I think the public would have responded well to more mechanistic and transparent explanations throughout this pandemic.
For me the takeaway is that we just need more vaccines. More vaccines for covid, more vaccines for the flu and maybe vaccines for the common cold. And the more we suppress the prevalence of the virus in the population, the more we need vaccines to keep our immune system sharp because covid, the flu and the common cold all include a set of viruses for which elimination is not possible. But we can reduce the human cost with regular and varied vaccination.
But along these lines, we need vaccines that have fewer side effects, and not just deadly ones. I would be fine with taking a cocktail of 5-6 vaccines every year, but the symptoms should be mild not, you're going to spend next day in bed. So I think more research is needed and dosing needs to be experimented with.
There is enormous economic value here in improving daily human health if we can improve vaccine regimens - on the order of a large fraction of a percent or even a full percent of GDP. It would be great if we could actually unlock it.
I wonder if the coronavirus Matt writes about — or other, similar coranaviruses that cause common cold — are truly globally endemic in the main, or some are and some aren't, or do they exhibit regional differences in terms of endemicity.
Relatedly, I've wondered if certain populations — I'm thinking primarily in terms of East Asia — might possess a modicum of immunity (I know there's a more technical way to describe this but no time to research at the moment) vis-à-vis Covid19. I'm not even suggesting we have epidemiological evidence for this, although we may, in that China, Taiwan, Japan and Korea all have suffered a lot less sickness during this pandemic than most of the Americas or Europe.
One personal anecdote that got me thinking along these lines was that, during my first sting in Asia — I arrived in 2013 — I got slammed on a regular basis with nasty colds for the first eighteen months or so. I rarely suffered from them back in the States. And yes, these were quite unpleasant. At one point I was absolutely convinced my neighbor's cat's dander was blowing through the building ventilation and affecting me (the cold wouldn't let up for weeks). But he kept his cat and I eventually recovered.
I have zero idea whether or not these colds were caused by coronaviruses. My guess is that this is statistically not all that likely (non-coranavirus cold viruses outnumber coranaviruses by something like 4 to 1, if memory serves). But who knows?
Now all we need to do is find some Russian who died from Covid-1889 and was buried in the Siberian permafrost, just as the 1918 flu was accurately identified from a burial in Alaska: https://www.cdc.gov/flu/pandemic-resources/reconstruction-1918-virus.html
The Covid period has given me a lot of conversations where I’ve said “I’ve never heard that before.” This was the best of the batch.
Now… to be fair. MattY was competing with a cohort of mostly “COVID IS A PLOT BY THE ELITES TO DISTRACT AND DIVIDE US WHILE THEY POISON THE WATER SUPPLY!!!” and its homeomorphisms
But this would likely be the best novel take even if he wasn’t.
So can we get a HCoV-OC43 vaccine, and have 5% less colds? I'd take that.
Frankly on the topic of covid policy I have no clue what anyone is doing anymore. it seems like the government is running in circles right now. we should have gone harder with mandates than we did, why do people have such a problem with vaccines anyway? I don't get it.
Off-topic: Matt, you've tweeted a lot recently about the crucial role played by the NYT's editorial judgment regarding *which news stories to promote with what angle*. First the Afghanistan editorializing, today the TX abortion decision:
"Always interesting to see which stories are seen as equally newsworthy as "new copies of old emails found on a laptop." Virtually nothing meets that high bar."
Will you write an essay on it?
I've seen this argument laid out elsewhere and I agree that it's persuasive. But (even though I know this wasn't Matt's intention), I'm going to have to quibble with the "take the L" take home at the end. Assuming the COVID-1889 theory is true, you could logically argue that this is the mostly likely outcome for SARS-CoV2 IN THE LONG RUN. But when do we get there? If the world was still seeing serious issues with the disease 5-10 years later, that's a pretty long time! Moreover, giving as many people as possible (including "lower risk (but not no risk)" children) gives their immune systems a first exposure to this coronavirus, meaning they won't have to suffer the debilitating effects that much of the world has seen. Remember, again -- death is not the only negative endpoint... Long COVID and serious long-term respiratory effects are nothing to dismiss.
It's also worth raising again that Pfizer (and probably pretty much every other large pharmaceutical company) are working on a drug (NOT a vaccine) that will protect against not only SARS-CoV2 but also other future coronavirus threats.
https://www.pfizer.com/news/press-release/press-release-detail/pfizer-initiates-phase-1-study-novel-oral-antiviral
"The oral antiviral clinical candidate PF-07321332, a SARS-CoV2-3CL protease inhibitor, has demonstrated potent in vitro anti-viral activity against SARS-CoV-2, as well as activity against other coronaviruses, suggesting potential for use in the treatment of COVID-19 as well as potential use to address future coronavirus threats."