Five years of COVID

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sTeamTraen
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Five years of COVID

Post by sTeamTraen » Sat Aug 29, 2020 12:57 pm

Suppose you knew that something like the current COVID-19 situation was likely to last at least five years. No particularly effective vaccine will be forthcoming (or people refuse to take it because kemikulz), no substantial breakthrough in anti-viral treatment is made that reduces the chances of someone who catches it either dying or becoming chronically ill by two orders of magnitude, which I think is roughly what we would need to see before governments, and cautious people over 50, would agree that we "just have to live with it".

I don't think that's an unreasonable scenario. We can hope for things to be better than that, we can even sincerely believe that it will be all over within one or two years (Bill Gates seems to think so), but it doesn't seem unreasonable for governments, businesses, organisations (such as schools and universities), or individuals to start planning for the possibility that it might not be.

What does that world look like? At a policy level, do we plan for a never-ending stream of local lockdowns? Should businesses be hedging against this? What does this mean for insurance companies (who we might not like, but on whom a lot of us depend)? Do we decide that after a year or two we'll say "f.ck it, I'm going to make that trip to Australia to see my brother anyway"?

And how should we model (meta-model?) the evolution of the virus, and its spread, and how people react to it? It seems we're at the start of a big second wave, led by younger people (or, perhaps, "with older people less affected" as they are sheltering more, for now) --- is this actually qualitatively different from the first wave, or will those kids eventually infect their grandparents anyway? Does the fact that we hopefully won't get caught without PPE now change anything?

Has anyone here started to think about that, professionally or personally, in a way that they can share?
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Martin Y
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Re: Five years of COVID

Post by Martin Y » Sat Aug 29, 2020 3:00 pm

I wonder how long the outbreak could continue at roughly its present level before herd immunity overcame it. In the longer term, even without any vaccine, it might become something like chickenpox; a nuisance illness you get in childhood but rarely serious, though much more serious if you didn't get it till you were older.

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Martin_B
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Re: Five years of COVID

Post by Martin_B » Sun Aug 30, 2020 1:27 am

sTeamTraen wrote:
Sat Aug 29, 2020 12:57 pm
... Do we decide that after a year or two we'll say "f.ck it, I'm going to make that trip to Australia to see my brother anyway"? ...
That you, sis?
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lpm
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Re: Five years of COVID

Post by lpm » Sun Aug 30, 2020 9:13 am

Also to consider is a different pandemic in the next 5 years. A flu, or another SARS, or an ebola. The coming decades might well be the age of pandemics.
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Re: Five years of COVID

Post by AMS » Sun Aug 30, 2020 9:31 am

lpm wrote:
Sun Aug 30, 2020 9:13 am
Also to consider is a different pandemic in the next 5 years. A flu, or another SARS, or an ebola. The coming decades might well be the age of pandemics.
On the positive side, we have a clearer idea of what to do when the next one emerges, and you'd hope, the political will to do what's needed.

If it's a new flu strain, we have the structures in place to roll out a vaccine quickly.

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Re: Five years of COVID

Post by shpalman » Sun Aug 30, 2020 10:46 am

Martin Y wrote:
Sat Aug 29, 2020 3:00 pm
I wonder how long the outbreak could continue at roughly its present level before herd immunity overcame it. In the longer term, even without any vaccine, it might become something like chickenpox; a nuisance illness you get in childhood but rarely serious, though much more serious if you didn't get it till you were older.
You'd need at least half the population to have had it to have herd immunity. That would mean an infected person be more likely to meet a person who was immune rather than susceptible, in the limit of R_0 being 1. We've seen the human cost of just a few percent of the population getting it and we've seen the economic and social cost of trying to get R down to 1.

This ignores the possibility that the virus could mutate in ways which evade natural immunity from previous infections, which gets more likely if it continues to circulate as a long-term nuisance in the human population, so we would need to get better at spotting and stamping out serious outbreaks.
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Woodchopper
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Re: Five years of COVID

Post by Woodchopper » Mon Aug 31, 2020 9:54 am

shpalman wrote:
Sun Aug 30, 2020 10:46 am
Martin Y wrote:
Sat Aug 29, 2020 3:00 pm
I wonder how long the outbreak could continue at roughly its present level before herd immunity overcame it. In the longer term, even without any vaccine, it might become something like chickenpox; a nuisance illness you get in childhood but rarely serious, though much more serious if you didn't get it till you were older.
You'd need at least half the population to have had it to have herd immunity. That would mean an infected person be more likely to meet a person who was immune rather than susceptible, in the limit of R_0 being 1. We've seen the human cost of just a few percent of the population getting it and we've seen the economic and social cost of trying to get R down to 1.

This ignores the possibility that the virus could mutate in ways which evade natural immunity from previous infections, which gets more likely if it continues to circulate as a long-term nuisance in the human population, so we would need to get better at spotting and stamping out serious outbreaks.
Yes. There is some evidence that SARS-COVID-2 has already mutated to become more contagious. Even if it were to become less of a risk to human health, that might take decades.

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shpalman
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Re: Five years of COVID

Post by shpalman » Mon Aug 31, 2020 11:50 am

Woodchopper wrote:
Mon Aug 31, 2020 9:54 am
shpalman wrote:
Sun Aug 30, 2020 10:46 am
Martin Y wrote:
Sat Aug 29, 2020 3:00 pm
I wonder how long the outbreak could continue at roughly its present level before herd immunity overcame it. In the longer term, even without any vaccine, it might become something like chickenpox; a nuisance illness you get in childhood but rarely serious, though much more serious if you didn't get it till you were older.
You'd need at least half the population to have had it to have herd immunity. That would mean an infected person be more likely to meet a person who was immune rather than susceptible, in the limit of R_0 being 1. We've seen the human cost of just a few percent of the population getting it and we've seen the economic and social cost of trying to get R down to 1.

This ignores the possibility that the virus could mutate in ways which evade natural immunity from previous infections, which gets more likely if it continues to circulate as a long-term nuisance in the human population, so we would need to get better at spotting and stamping out serious outbreaks.
Yes. There is some evidence that SARS-COVID-2 has already mutated to become more contagious. Even if it were to become less of a risk to human health, that might take decades.
Mutations in the spike protein are especially concerning since there are vaccines targeting exactly that.
molto tricky

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Woodchopper
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Re: Five years of COVID

Post by Woodchopper » Mon Aug 31, 2020 12:09 pm

sTeamTraen wrote:
Sat Aug 29, 2020 12:57 pm

What does that world look like? At a policy level, do we plan for a never-ending stream of local lockdowns? Should businesses be hedging against this? What does this mean for insurance companies (who we might not like, but on whom a lot of us depend)? Do we decide that after a year or two we'll say "f.ck it, I'm going to make that trip to Australia to see my brother anyway"?

And how should we model (meta-model?) the evolution of the virus, and its spread, and how people react to it? It seems we're at the start of a big second wave, led by younger people (or, perhaps, "with older people less affected" as they are sheltering more, for now) --- is this actually qualitatively different from the first wave, or will those kids eventually infect their grandparents anyway? Does the fact that we hopefully won't get caught without PPE now change anything?

Has anyone here started to think about that, professionally or personally, in a way that they can share?
If there's no vaccine I'll also assume that a natural immune response isn't long lasting. So as with influenza much of the population will be at risk of being infected every year.

In that case for most people we are looking at a permanent reduction in life expectancy. That'll have a major effect upon all aspects of society. People will want to retire earlier, they'll have kids earlier, they'll want to travel earlier.

It might be possible to permanently shield groups over 60s who are rich enough. Other people could be kept out of a compound and goods coming in could be disinfected. They could keep in touch with the rest of the world via video links. But who would actually choose to live in that kind of isolation for decades?

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