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Re: What endemic Covid will be like

Posted: Sun Jan 16, 2022 5:16 pm
by jdc
Bird on a Fire wrote:
Sun Jan 16, 2022 5:08 pm
Would we describe flu as endemic? That seems to be the closest analague for future-covid, though covid is even epidemickier.
I'm not sure we would (I'd have to consult an epidemiologist), and I'm not sure it's close enough an analogue for future covid. The R0 for the variants is 5+ so it's more in the pertussis and polio range, whereas flu's 1-2 ish.

Re: What endemic Covid will be like

Posted: Sun Jan 16, 2022 5:33 pm
by lpm
I don't think we know what R is for variants in vaccine-world. Omicron has behaved so strangely.

Omicron first presented as something mad like R=8 with doubling time of 1.6 days, but now looks like a R=2 which has been reduced to an effective R=0.7 due to Plan B lockdownicity. Hospital numbers have peaked at a fraction under 20,000 and have begun to fall.

We don't test for flu. It comes in a wave in December, say, and we notice it from hospitalisations and surveys and models. The NHS comes under stress in January.

Imagine if we'd stopped testing for Covid in November. Would we have noticed the cases? A lot of young people getting ill in December might have been noticeable. But would there have been any news stories, any more than the news stories about flu waves in the pre-pandemic era? I doubt it.

I suspect flu is epidemickier than Covid. There's less seasonality to Covid. Waves will come and go across the whole year, unnoticed if we stop wasting resources on testing. It will become a permanent backdrop of hospitalisations and deaths, with flu waves then coming in on top each winter.

For me, endemic means annual vaccination for over 50s and no more attention paid to it by the general public, with health services tasked with trying to predict when the pressure will become too great and hence routine operations need to be cancelled.

Re: What endemic Covid will be like

Posted: Mon Jan 17, 2022 12:01 am
by Herainestold
Covid being (primarily) a respiratory disease, is definitely seasonal. You could see it two months ago as northern Europe was being overwhelmed by Delta as winter closed in. Why is it always so bad around Christmas?

There is a strong overprint from new vaccine evading variants (hello Omichron!), and rapidly declining vaccine immunity.

We are going to see at least two waves per annum, the winter covid/flu/ etc. wave around Christmas and a summer wave as new variants develop and immunity from the last wave declines.

How hard these waves impact the NHS depends much on what measures we choose to take. Targeted booster vaccination, FFP3 mask mandates, distancing, lockdowns, will all help to ameliorate the consequences of these inevitable surges.

It is up to us what kind of future we want.

Re: What endemic Covid will be like

Posted: Mon Jan 17, 2022 2:16 am
by Millennie Al
Herainestold wrote:
Mon Jan 17, 2022 12:01 am
... depends much on what measures we choose to take. Targeted booster vaccination, FFP3 mask mandates, distancing, lockdowns, will all help to ameliorate the consequences of these inevitable surges.

It is up to us what kind of future we want.
It is. And I don't think very many people would agree to all those precautions for the rest of their lives.

And I think it is a mistake to contrast "endemic" with "pandemic" and then try to analyse exactly what "endemic" means. There are already diseases, such as the common cold, which are widespread and we cope with them. In the past we coped with more severe diseases by dying, leaving only survivors who coud resist them. That always remains an option for Covid.

Re: What endemic Covid will be like

Posted: Mon Jan 17, 2022 2:53 am
by Herainestold
Millennie Al wrote:
Mon Jan 17, 2022 2:16 am
In the past we coped with more severe diseases by dying, leaving only survivors who coud resist them. That always remains an option for Covid.
That appears to be what you are suggesting.