"Live with" means low cost of minimizing serious infection. "Public health" means finding and communicating those low cost ways as an ongoing mission. Pubic health officials failed miserably in failing to reduce the costs of the pandemic, but hopefully lessons will be learned.
we could 'take the L on this' or we could say screw it lets eradicate all these pesky coronaviruses at once. Pack all their spike protein mRNA into one vaccine and give it all at once. I'd take it.
There seems to be a category error where people believe that Covid will behave like a bacteria and create a completely untreatable superbug, whereas my understanding is that the way viruses usually work is the vaccines and body retains some immunity though somewhat decreased against them so even if the mutations are somewhat worse the first wave is basically inevitably the worst.
What would be great to study is why some states had waves (with different policies in place) and others did not at various points. Florida is getting hit hard now after slagging on California for its bad patch last year. The Dakotas looks pretty good right now while Oregon is hitting its highest rates after being in the bottom 10 states in 2020.
Is it masks or not? Is it masks in certain places but not others? Is it that some states avoided a wave by pure random chance but then later got hit because enough of their population avoided it the first time around? If people are being lax about precautions but got lucky because other people near them got lucky, can that skew the conclusions about masks or social distancing in their areas?
Some seasonal patterns seem to be coming into focus. The summer wave of 2020 was concentrated in southern / very hot summer states, too, then slowly spread north into central states, but all but skipped the northern half of the country.
In Europe the late summer into early fall wave began in Spain 12 months ago, and Spain is the European country with the highest rate of excess death today; https://www.euromomo.eu/graphs-and-maps/
Going out on a limb a bit, I'm guessing changes in humidity and / or air conditioner usage is a big driver of these relative differences.
Also, what type of mask? If a surgical mask protects only you but an N-95 protects you AND me, then can that make all the difference? I bought a supply of N-95s in 2018 after watching the movie "Contagion" on Netflix. I flew between Oregon and California every few weeks in 2020 wearing my N-95 and never got sick. I also wore it going to the grocery store. Would that have been true if I'd only been wearing a cloth mask?
My guess is that it's more likely something like: a cloth mask protects both me and you by a factor of 10%, a surgical mask protects both me and you by a factor of 30%, and an N95 protects both me and you by a factor of 95%.
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?
"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."
It appears, in fact, that the descendants of the southern Chinese population circa 20,000 years ago did have immunity.
But also, everything I've read about colds suggests that we know four coronaviruses, some number of rhinoviruses, syncytial viruses, and influenza viruses, but every time someone does a systematic study of several hundred people with colds, they find some new viruses that they hadn't cataloged before. We should try to learn more about that, and maybe do more surveillance to understand when and where a new one is emerging.
It would be very surprising to me if there's something that spreads easily from human to human, but isn't globally endemic (other than the things like measles and polio that we've eliminated from some places through vaccination). There are bacterial (cholera) or other parasite (malaria) diseases that are endemic only in some regions, but it's because those don't spread directly from one human to another, but go through some environmental factor that varies in different parts of the world.
However, if there are animal viruses that frequently get spread to individual humans, but only rarely spread from human to human, those could be endemic in the animal populations of some region. (You mentioned a cat, and covid is known to infect cats - maybe there are other animal coronaviruses endemic to East Asia that get to humans the way that covid gets to cats?)
Well, I guess specifically what I was wondering about was the regional *variance* in the frequency that a given virus causes illness, ie, perhaps a certain coronavirus causes (say) 1.3% of all colds in one region, but 14.8% of all colds in another. And so on. But maybe there are no substantive differences from region to region on this score. I haven't looked into it. But commenter Elm provides a link to an interesting NYT article about a study conducted by University of Arizona scientists that concludes a large-scale, long in duration (centuries) outbreak of coronavirus disease in China millennia ago has resulted in changes to the DNA of people in that region (actually my region) to this day — the implication being people here on average enjoy a greater degree of genetic protection from coronaviruses.
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.
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 should have been clearer. I, too, wrote terms papers in the last few hours before the deadline. Unlike Matt's though, they were terrible as a result.
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."
This is a good summary with historical context. I think we've known (or at least experts have) for a long time now that Covid is going to be endemic. We're going to have to learn to live with it which likely means regular booster shots, at least for vulnerable populations.
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.
I don't see those vax numbers reported for LA? The NYTs has the 18+ in LA county at 67%, with overall rates of vaccination lower in LA than in Miami or Harris (Houston) county, Texas. But to the larger point, why wouldn't each subsequent year get a little better, with more and more people building up their immunity through infection or vaccination as time moves on?
For first dose - it's 80% statewide, 74% in LA County as of a day or two ago, and increasing since the mandates are coming. But the point is that if 1889 led to a decade of increased stress on the public health system, even if the vaccine cuts that to five you still have doctors and nurses quitting, especially in places like Mississippi. Not clear how you solve for that.
Where are you seeing data on nurses and doctors quitting? I've seen a lot of retirement-age folks quit in my extended family and friend network for reasons loosely connected to covid. In other words, they were probably going to quit in a few years anyways, and the covid disruptions kind of pushed them over the edge. But that was as much about the huge amount of baby boomers in the generation that is now reaching retirement as it was about anything else, and not limited to those working in a medical environment.
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.
The issue is that the systems aren't designed for that. Indoor dining is really bad for curve flattening, but repeated restaurant closures will just kill the industry. Claustrophobic close-in clubbing is horrible for curve flattening, but again, you can't open/close/open/close on industries like that. PPP and CARES help a lot, but the dimmer switch approach can't continue indefinitely. Red States have already decided they are done with it.
I wonder if there are economic structures that would help with this. Water parks and ski resorts have to deal with unexpected weather closures all the time - do they have insurance against that? If so, could we create a social insurance program for restaurants and nightclubs and occasional disease-related closures?
It's not just red states. I was up in Minneapolis last week and the world was capital-N Normal again. A few business had mask mandate signs posted, and people generally complied in a your-roof-your-rules framework, but that was it.
With exceptions, continued enthusiasm for NPI seems to be a coastal thing in a way that doesn't map very neatly onto red and blue.
"You probably don’t spend a lot of time thinking about the virus HCoV-OC43"
1) Good work guy! Original reporting! Shoeleather! Down with the pajamas and the cheetos!
2) I haven't spent a lot of time thinking about HCoV-OC43, but I have thought a lot about the onset of new diseases in the population.
"It could be the case that a quarter of colds caused by coronaviruses today are what we might call Covid-1899, the modern-day symptomatic manifestation of what used to be a much more serious illness — one that’s simply not a big deal now due to a mix of evolution and acquired immunity."
Covid-1889, dude. The basic problem with herd immunity (and this is the herd immunity argument) is that it takes eternity (in Twitter time) to acquire it and a lot of people. In this case, the newspapers of the day were likely underreporting the death count.
The model is: 1) a disease makes the jump from another mammal, 2) it starts spreading like crazy, 3) a lot of people get it and get better, 4) a lot of people get it and die, 5) over a decade.
That likely describes a lot of (maybe most!) diseases, it's not unique as it has happened a lot, and it means Covid-19 is actually pretty average as these things go. Things could be a lot worse.
"Some Russian Flu sufferers reported long-term neurological symptoms, while others doubted the connection was real or thought it might be psychosomatic."
Doctors tend to jump to invoking 'psychosomatic' when they have no hard diagnostic tests to show evidence of disease. The medical profession doesn't do well with ailments where they can't just jump in and fix or explain the problem immediately - where they can be heroes, another words.
Lyme disease exists - it has specific symptoms, as does chronic fatigue. On the other hand, carpal tunnel appears to exist, but it's proximate cause is stress. We tend to treat psychosomatic as synonymous with 'imaginary' but it's precisely that psychosomatic symptoms are *real* symptoms, that really exist, and that the sufferers really don't have any kind of direct control over, but may not have a direct physical cause.
"we would say the most parsimonious explanation is that molecular analysis strongly suggests it was caused by the breakthrough of a new coronavirus from cows to humans, possibly in the Bukhara area."
I think, given the symptomology, that calling it a likely coronavirus outbreak should be the default, rather than defaulting to calling it the flu. Even if it possibly might not be a coronavirus.
"Very possibly, it’s still with us, and we’re now so adapted that we barely notice. And these days we do have vaccines that we know accelerate that process of rendering Covid-19 less harmful; booster shots could further speed that process."
HCoV-OC43 is almost certainly with us in a descendent and highly mutated form.
"But to some extent, we’ve probably got to just take the L on this. The common cold is not a huge deal and neither is seasonal flu, but they’re both not nothing. If you could reduce cold incidence by 5% by eliminating HCoV-OC43, that would be pretty awesome."
If we got the vaccines for Covid-19 that quickly, making an mRNA vaccine should be a snap. So let's fund that shit. It might provide additional wide protection against other forms of coronavirus. (Basically, a vaccine for the common cold.)
"And even if SARS-Cov-2 does calm down and becomes just another cold virus, that’s still not great. But it’s something we’re going to have to learn to live with on some level."
I believe that's the argument I made to Josh Marshall that I maybe cc:ed to you. It's basically a paradigm for ANY new respiratory diseases. So we should be researching the fuck out of it.
It also implies that the Covid-19 is a zoonotic outbreak - that intelligence report (from the NSA) that Biden got basically confirms that the Chinese had no idea there was an outbreak coming, so it's not a bioweapon. The lab slip-up has a dwindling likelihood, given that Covid-19 was detected in the sewage in Europe twice before November 2019.
elm
so we really just need to be shipping vaccines all over the planet and i dunno what the holdup is
“although H. Franklin Parsons, the medical investigator for England's Local Government Board, completed his final report on the ‘1889–92 epidemic’ in 1893, further severe recrudescences were observed in 1893, 1895, 1898, and 1899–1900.”
I'm glad that vaccines will shorten this. 11 years for general, random exposures to turn a virus into something we generally ignore is a long time (for me! Maybe it's a blink of an eye for humanity)
"Live with" means low cost of minimizing serious infection. "Public health" means finding and communicating those low cost ways as an ongoing mission. Pubic health officials failed miserably in failing to reduce the costs of the pandemic, but hopefully lessons will be learned.
we could 'take the L on this' or we could say screw it lets eradicate all these pesky coronaviruses at once. Pack all their spike protein mRNA into one vaccine and give it all at once. I'd take it.
Legitimately tough call on whether matt should write about Texas abortion law or Joe Manchin tomorrow.
There seems to be a category error where people believe that Covid will behave like a bacteria and create a completely untreatable superbug, whereas my understanding is that the way viruses usually work is the vaccines and body retains some immunity though somewhat decreased against them so even if the mutations are somewhat worse the first wave is basically inevitably the worst.
What would be great to study is why some states had waves (with different policies in place) and others did not at various points. Florida is getting hit hard now after slagging on California for its bad patch last year. The Dakotas looks pretty good right now while Oregon is hitting its highest rates after being in the bottom 10 states in 2020.
Is it masks or not? Is it masks in certain places but not others? Is it that some states avoided a wave by pure random chance but then later got hit because enough of their population avoided it the first time around? If people are being lax about precautions but got lucky because other people near them got lucky, can that skew the conclusions about masks or social distancing in their areas?
It’s not “masks or not,” it’s unvaccinated people acting as though they are not in danger.
Some seasonal patterns seem to be coming into focus. The summer wave of 2020 was concentrated in southern / very hot summer states, too, then slowly spread north into central states, but all but skipped the northern half of the country.
In Europe the late summer into early fall wave began in Spain 12 months ago, and Spain is the European country with the highest rate of excess death today; https://www.euromomo.eu/graphs-and-maps/
Going out on a limb a bit, I'm guessing changes in humidity and / or air conditioner usage is a big driver of these relative differences.
Also, what type of mask? If a surgical mask protects only you but an N-95 protects you AND me, then can that make all the difference? I bought a supply of N-95s in 2018 after watching the movie "Contagion" on Netflix. I flew between Oregon and California every few weeks in 2020 wearing my N-95 and never got sick. I also wore it going to the grocery store. Would that have been true if I'd only been wearing a cloth mask?
My guess is that it's more likely something like: a cloth mask protects both me and you by a factor of 10%, a surgical mask protects both me and you by a factor of 30%, and an N95 protects both me and you by a factor of 95%.
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.
"but the symptoms should be mild not, you're going to spend next day in bed."
If said vaccines can really prevent common colds, I'd much rather spend one day in bed rather than a couple weeks with a cold.
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?
"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."
It appears, in fact, that the descendants of the southern Chinese population circa 20,000 years ago did have immunity.
https://www.nytimes.com/2021/06/24/science/ancient-coronavirus-epidemic.html
elm
keeping in mind that's based on a genetic clock so it could be off by orders of 2-4, maybe more
That's interesting. Thanks.
But also, everything I've read about colds suggests that we know four coronaviruses, some number of rhinoviruses, syncytial viruses, and influenza viruses, but every time someone does a systematic study of several hundred people with colds, they find some new viruses that they hadn't cataloged before. We should try to learn more about that, and maybe do more surveillance to understand when and where a new one is emerging.
It would be very surprising to me if there's something that spreads easily from human to human, but isn't globally endemic (other than the things like measles and polio that we've eliminated from some places through vaccination). There are bacterial (cholera) or other parasite (malaria) diseases that are endemic only in some regions, but it's because those don't spread directly from one human to another, but go through some environmental factor that varies in different parts of the world.
However, if there are animal viruses that frequently get spread to individual humans, but only rarely spread from human to human, those could be endemic in the animal populations of some region. (You mentioned a cat, and covid is known to infect cats - maybe there are other animal coronaviruses endemic to East Asia that get to humans the way that covid gets to cats?)
Well, I guess specifically what I was wondering about was the regional *variance* in the frequency that a given virus causes illness, ie, perhaps a certain coronavirus causes (say) 1.3% of all colds in one region, but 14.8% of all colds in another. And so on. But maybe there are no substantive differences from region to region on this score. I haven't looked into it. But commenter Elm provides a link to an interesting NYT article about a study conducted by University of Arizona scientists that concludes a large-scale, long in duration (centuries) outbreak of coronavirus disease in China millennia ago has resulted in changes to the DNA of people in that region (actually my region) to this day — the implication being people here on average enjoy a greater degree of genetic protection from coronaviruses.
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.
That will be interesting.
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.
How else would you write them?
I should have been clearer. I, too, wrote terms papers in the last few hours before the deadline. Unlike Matt's though, they were terrible as a result.
"(Some people even misuse the term "flywheel.")"
Unpossible.
No one could be that callously indifferent to the English language and basic mechanics, all at once!
So can we get a HCoV-OC43 vaccine, and have 5% less colds? I'd take that.
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?
This is a good summary with historical context. I think we've known (or at least experts have) for a long time now that Covid is going to be endemic. We're going to have to learn to live with it which likely means regular booster shots, at least for vulnerable populations.
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.
I don't see those vax numbers reported for LA? The NYTs has the 18+ in LA county at 67%, with overall rates of vaccination lower in LA than in Miami or Harris (Houston) county, Texas. But to the larger point, why wouldn't each subsequent year get a little better, with more and more people building up their immunity through infection or vaccination as time moves on?
For first dose - it's 80% statewide, 74% in LA County as of a day or two ago, and increasing since the mandates are coming. But the point is that if 1889 led to a decade of increased stress on the public health system, even if the vaccine cuts that to five you still have doctors and nurses quitting, especially in places like Mississippi. Not clear how you solve for that.
Where are you seeing data on nurses and doctors quitting? I've seen a lot of retirement-age folks quit in my extended family and friend network for reasons loosely connected to covid. In other words, they were probably going to quit in a few years anyways, and the covid disruptions kind of pushed them over the edge. But that was as much about the huge amount of baby boomers in the generation that is now reaching retirement as it was about anything else, and not limited to those working in a medical environment.
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.
The issue is that the systems aren't designed for that. Indoor dining is really bad for curve flattening, but repeated restaurant closures will just kill the industry. Claustrophobic close-in clubbing is horrible for curve flattening, but again, you can't open/close/open/close on industries like that. PPP and CARES help a lot, but the dimmer switch approach can't continue indefinitely. Red States have already decided they are done with it.
I wonder if there are economic structures that would help with this. Water parks and ski resorts have to deal with unexpected weather closures all the time - do they have insurance against that? If so, could we create a social insurance program for restaurants and nightclubs and occasional disease-related closures?
There is business interruption insurance, but I can’t see anyone underwriting affordable policies for COVID lockdowns.
That's a good point, I didn't mean to imply the earliest interventions should be repeated. Interventions can and should be optimized over time
It's not just red states. I was up in Minneapolis last week and the world was capital-N Normal again. A few business had mask mandate signs posted, and people generally complied in a your-roof-your-rules framework, but that was it.
With exceptions, continued enthusiasm for NPI seems to be a coastal thing in a way that doesn't map very neatly onto red and blue.
"You probably don’t spend a lot of time thinking about the virus HCoV-OC43"
1) Good work guy! Original reporting! Shoeleather! Down with the pajamas and the cheetos!
2) I haven't spent a lot of time thinking about HCoV-OC43, but I have thought a lot about the onset of new diseases in the population.
"It could be the case that a quarter of colds caused by coronaviruses today are what we might call Covid-1899, the modern-day symptomatic manifestation of what used to be a much more serious illness — one that’s simply not a big deal now due to a mix of evolution and acquired immunity."
Covid-1889, dude. The basic problem with herd immunity (and this is the herd immunity argument) is that it takes eternity (in Twitter time) to acquire it and a lot of people. In this case, the newspapers of the day were likely underreporting the death count.
The model is: 1) a disease makes the jump from another mammal, 2) it starts spreading like crazy, 3) a lot of people get it and get better, 4) a lot of people get it and die, 5) over a decade.
That likely describes a lot of (maybe most!) diseases, it's not unique as it has happened a lot, and it means Covid-19 is actually pretty average as these things go. Things could be a lot worse.
"Some Russian Flu sufferers reported long-term neurological symptoms, while others doubted the connection was real or thought it might be psychosomatic."
Doctors tend to jump to invoking 'psychosomatic' when they have no hard diagnostic tests to show evidence of disease. The medical profession doesn't do well with ailments where they can't just jump in and fix or explain the problem immediately - where they can be heroes, another words.
Lyme disease exists - it has specific symptoms, as does chronic fatigue. On the other hand, carpal tunnel appears to exist, but it's proximate cause is stress. We tend to treat psychosomatic as synonymous with 'imaginary' but it's precisely that psychosomatic symptoms are *real* symptoms, that really exist, and that the sufferers really don't have any kind of direct control over, but may not have a direct physical cause.
"we would say the most parsimonious explanation is that molecular analysis strongly suggests it was caused by the breakthrough of a new coronavirus from cows to humans, possibly in the Bukhara area."
I think, given the symptomology, that calling it a likely coronavirus outbreak should be the default, rather than defaulting to calling it the flu. Even if it possibly might not be a coronavirus.
"Very possibly, it’s still with us, and we’re now so adapted that we barely notice. And these days we do have vaccines that we know accelerate that process of rendering Covid-19 less harmful; booster shots could further speed that process."
HCoV-OC43 is almost certainly with us in a descendent and highly mutated form.
"But to some extent, we’ve probably got to just take the L on this. The common cold is not a huge deal and neither is seasonal flu, but they’re both not nothing. If you could reduce cold incidence by 5% by eliminating HCoV-OC43, that would be pretty awesome."
If we got the vaccines for Covid-19 that quickly, making an mRNA vaccine should be a snap. So let's fund that shit. It might provide additional wide protection against other forms of coronavirus. (Basically, a vaccine for the common cold.)
"And even if SARS-Cov-2 does calm down and becomes just another cold virus, that’s still not great. But it’s something we’re going to have to learn to live with on some level."
I believe that's the argument I made to Josh Marshall that I maybe cc:ed to you. It's basically a paradigm for ANY new respiratory diseases. So we should be researching the fuck out of it.
It also implies that the Covid-19 is a zoonotic outbreak - that intelligence report (from the NSA) that Biden got basically confirms that the Chinese had no idea there was an outbreak coming, so it's not a bioweapon. The lab slip-up has a dwindling likelihood, given that Covid-19 was detected in the sewage in Europe twice before November 2019.
elm
so we really just need to be shipping vaccines all over the planet and i dunno what the holdup is
“although H. Franklin Parsons, the medical investigator for England's Local Government Board, completed his final report on the ‘1889–92 epidemic’ in 1893, further severe recrudescences were observed in 1893, 1895, 1898, and 1899–1900.”
I'm glad that vaccines will shorten this. 11 years for general, random exposures to turn a virus into something we generally ignore is a long time (for me! Maybe it's a blink of an eye for humanity)