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Is COVID strategy moving towards herd-immunity?!

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Vasr

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Please explain an alternative mechanism for how countries that 'let the epidemic rip' end up with a Gompertz curve, other than herd immunity.

Another example of false logic via false dichotomy. Herd immunity cannot be established by absence of theories/evidence for other mechanisms. It needs to be established by positive testing results that there is actual immunity let alone conflate amount of infections with amount of immunity. It is a simple concept and part of what doing science requires.

Necessarily positing herd immunity isn't any more valid otherwise than positing divine intervention.

Occam's razor suggests alternate posits such as a combination of growing awareness and self-quarantining and self-isolation of vulnerable segments (it takes a certain amount of immediate effects for people to take it more seriously "it is a depression only when you lose your job"), combined with hitting current limits of contact tracing and in some case amount of testing or reporting for the gathered numbers to plateau out and even subside. This could also be used to advance a thesis of very strict period of prophylactic measures. Mandated lockdowns are necessary only because people don't want to be responsible.

All of these are hypotheses and it is perfectly fine to have such hypotheses. But using such a hypotheses to advance a policy is irresponsible unless there is positive proof of developing immunity and an understanding of secondary effects for survivors. All because of some nebulous and un-quantified posit of the effects of a lockdown whose validity is not subjected to the same level of scrutiny or precision.
 

onofno

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France and UK have roughly the same population...
Number of deaths in hospitals from covid 19 from 27 July til 4 August : UK 451 FR 85
 

onofno

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UK deaths in hospital actually 52 over that time period. This from UK hospital deaths

There is a big discrepancy between this number and the government stats reported here

Numbers are coming from WIKI, they post everyday the numbers of deaths in UK, France and some countries....

This is a copy for UK (from Wiki)

Capture d’écran 2020-08-06 à 22.11.46.png


Deaths in France (from WIKI)
Number of deaths, in hospitals only until March 31, 2020. From April 1, 2020, the number of deaths includes deaths in social or medico-social establishments...

-Capture d’écran 2020-08-06 à 22.22.15.png
 
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A Surfer

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What makes you say that? Some viruses (e.g. the Spanish Flu) show up, cause a bit of trouble, then vanish again. Others (e.g. the swine flu of 2009) stay around for a long time. Both of those examples are an influenza A(H1N1) virus. I don't know what factors decide the long-term outcome, much less how they apply to covid-19. Do you?
Covid is from the same family as brings us the common cold and I haven't noticed that going away. Call me guilty of simply repeating what I have heard, but this was exactly what several infectious disease experts were saying about covid that it is now endemic and we need to accept that. Nobody knows for sure yet so we will all have to wait and see.
 

North_Sky

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I think Singapore has the best strategy to combat COVID-19. ...Hong Kong too.
And those two countries are not into herd immunity, zero.
New Zealand is also one the safest places to be right now.

This COVID-19 pandemic is like . . . a game of RISK; except it's real, serious real.
No game here.

* This week it took me over an hour (almost 1:30) in waiting my turn to the bank teller.
I've waited about an hour outside in line (roughly 15 people ahead of me and another 6 behind me). The other half hour wait was inside.
Not even 10% of the people wear masks (the two tellers; one yes, the other no).
Self distancing (2 meters) yes. Hand sanitizer yes (in all the public stores...everywhere).
A very good business also for plexiglass (it's everywhere).

Life is different, you can tell over all...it's like a slow paste, like everyone's is on vacation no matter where...it feels eerie sort of. Some folks are relaxed and others aren't thinking properly, not adapting well, still stuck in the other life (past one) with the stress of money and all. Some people are relentless, not knowing where to go what to do.
Some they know exactly what they're doing but it is much slower...for me, in public.
I'm good with that as I'm in no rush. Some are though, and they're the ones I like to stay far far away from. Not healthy for my balance, for my peaceful equilibrium.

I like to follow the rhythm of nature best.

Yes, if giving the choice I'd go with Singapore's strategy instead of Sweden.
...And away from major cities, in the country side...in the mountains or a quiet place by the ocean. Like here where I live on Vancouver Island for example.

Best time to hit towns; early in the mornings...over all in general. ...Here anyway.
 

A Surfer

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Sorry North_Sky, that isn't at all reasonable to say just wait and wait and wait and wait in hopes that magically all the risk will disappear. That isn't going to happen. Maybe for people on Vancouver Island which has a much slower way of life can afford such patience, but for millions of others the current and impending financial crisis from being too risk adverse is catastrophic. I will not presume to know your particular situation, but I have known several people from Vancouver Island and they all tend to be pretty financially well insulated. If that doesn't describe you my apology, but if it does try to put yourself in the shoes of others who have had not only their social lives put on hold, but also their current and economic future put at risk. The risk of serious illness and death is only one of the impacts of covid, but it is not the only risk. People are suffering serious economic hardships, our governments are spending decades worth of budgets now.

When they start rolling out austerity measures down the road to pay for these bills it won't be the old and retired people who will have problems finding jobs, their pensions will generally be ok and the infrastructure to look after them while they age will be seriously improved. It will be the young people who will be asked to foot all of the austerity measures and having to live with even greater uncertainty than they already face, and young people today are screwed compared to past generations. So if you are an older adult sitting pretty, which again I do not know if you are, but if you are, really try to see that there are lives being damaged and destroyed without even contracting the disease.
 
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A Surfer

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And to be fair, I do realize that in some cases austerity measures also affect pensioners and older people as well, but in Canada that is not normally the case. Usually big tax bills are footed by those still in the work force. I know how bleak and difficult an economic future the young people today face. Each generation has less to work with than the generation that proceeded them, plus more and more competition as the worlds population increases relentlessly.
 

North_Sky

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I simply described briefly my own experience going in town for day-to-day life here in my own surroundings recently...that is all. That's real as real it can be.

I perfectly know how much harder it is for the poor, the vulnerables, the elders, etc.
...For the people living with elevators. ...For the people living like sardines. ...For the people depending on public transportation. ...For the people stressed by finances. ...For the people looking for water and food ...

The economy and school system is taking a beating. They are printing new money...brand new bills.

The rich and the smart people are leading ... it's all up to us, and them.
This is my first universal war; I've never been to war before.
I have to fight like everyone else...for survival, for the human race, for universal health.
I do the very best I can, everything I can really do. If I was younger I would go assist where they need help the most...in hospitals. But I'm not young and have a very bad heart condition.

Money? That won't cure. A vaccine? ...Hope.
Can we live in hope, or do what's best to do?
So I keep a safe distance, wash my hands, and always carry a mask with me...for those times ...

Money? That helps but that doesn't resurrect the dead.
 

Vasr

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I like that the pandemic appears to have brought out an outpouring of empathy for the poor and the economically vulnerable from those advocating an end to the lock-down as a shared goal.

I just hope that such empathy doesn't end with the end of the lock-down.

The reality is that the same poor and economically vulnerable have been at risk of any catastrophic event for a long time. While this is widespread and more visible, such calamities have occurred individually every year, every month, every day. If the empathy ends with the lock-downs replaced by a continuation of support for the policies that maintain that vulnerability and inequalities, then the unfortunate might think it was more opportunism than empathy.

I do think the pandemic has made people (at least more than a few) start to think of social responsibilities and inequalities and who is more important for a society to appreciate - sports figures and celebrities or nurses and teachers, for example. For many of the fortunate, the shut-down was a forced pause in their daily routine which kept them too busy before to think of those things earlier. That is one silver lining in this tragic event.
 

Racheski

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I simply described briefly my own experience going in town for day-to-day life here in my own surroundings recently...that is all. That's real as real it can be.

I perfectly know how much harder it is for the poor, the vulnerables, the elders, etc.
...For the people living with elevators. ...For the people living like sardines. ...For the people depending on public transportation. ...For the people stressed by finances. ...For the people looking for water and food ...

The economy and school system is taking a beating. They are printing new money...brand new bills.

The rich and the smart people are leading ... it's all up to us, and them.
This is my first universal war; I've never been to war before.
I have to fight like everyone else...for survival, for the human race, for universal health.
I do the very best I can, everything I can really do. If I was younger I would go assist where they need help the most...in hospitals. But I'm not young and have a very bad heart condition.

Money? That won't cure. A vaccine? ...Hope.
Can we live in hope, or do what's best to do?
So I keep a safe distance, wash my hands, and always carry a mask with me...for those times ...

Money? That helps but that doesn't resurrect the dead.
Agreed, eating or rubbing money on yourself will not cure disease nor resurrect the dead.

I'd like to challenge the notion that an effective vaccine is just a "hope" which some on this thread seem to think. Please note that I'm saying an effective vaccine, which the FDA said would have to protect at least 50% of vaccinated people to be labeled "effective." I hope by now that we all understand that a vaccine does not need to be a cure for everyone that receives a dose, nor has to be given to 100% of the population for herd immunity. It is also of note that the FDA and other experts have recently stated it is unlikely we will have an effective vaccine produced in mass quantities by the end of this year.

Reasons to be optimistic for an effective vaccine to be available in mass quantities before the end of next year:
  • The NY Times COVID Vaccine Tracker shows 6 vaccines in Phase III trials. The 1 approved vaccine was one China approved after only Phase II trials, and I think it's going to be limited to military personnel only (would appreciate comments from those with more insight).
    1596777184665.png
  • Governments are handing out billions of dollars to companies to develop vaccines with relatively lax scrutiny, resulting in a more diverse number of solutions for an effective vaccine . Recent example is the $1.6B Novavax received from Operation Warp Speed, despite never bringing a single vaccine to market during its 30 year history. While I certainly wouldn't bet on Novavax, I do like that companies outside of big-pharma are given a chance, which may bring an effective vaccine to market faster than traditional approaches.
  • Pfizer has claimed they can crank out over a billion doses of their vaccine by the end of 2021, if approved. Other companies are building factories in order to ramp up production if their vaccine is approved - the world has the infrastructure to ramp up vaccine production to massive levels in short periods of time.
  • Although a SARS-COV2 is a RNA-based virus with therefore a very high rate of mutation compared to DNA-based viruses, a recent study shows 7 major strains with a variability rate half of the common flu. It is therefore likely that a COVID vaccine will be effective for all major strains of the virus.
Reasons not to be optimistic for an effective vaccine to be available in mass quantities before the end of next year:
  • An effective vaccine for previous COVID-related viruses (SARS, MERS) has never been produced before.
  • We currently do not precisely know the re-infection rate of COVID19.
  • Just because we can manufacture a vaccine in large quantities does not necessarily mean we can distribute the vaccine quickly to a large number of people. There are going to be challenges due to infrastructure in less wealthy nations (especially if the vaccine has to be refrigerated), and if governments do not effectively subsidize the cost of the vaccine, some people may not be able to afford a dose.
  • The virus could evolve into a new strain not protected by the first round of vaccines.
  • All of the Phase III trials could fail.

For all of the anti-vaxxers out there, we know where you stand and I don't want this to turn into a political debate.
 

Thomas_A

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A Surfer

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Nobody here can claim to have any knowledge of these new vaccines efficacy, nor whether or not the protection lasts. Even the researchers behind the vaccines can only speculate how effective the vaccines will be once used in mass immunization programs. There are far more unknowns than there are facts as of yet. This virus is so new and can still shift and change so much. At this point it is all speculation and conjecture where vaccine efficacy is concerned. How effective are these vaccines? How is the efficacy being determined?

I am not against vaccinations (I have had all of mine recently boosted) but I am against selling what may amount to false hope. In the end I will bet that the majority of the effective treatment will come from organic herd immunity working it's way through the worlds population. I am not an expert, but I have read that naturally acquired immunity tends to be more robust than artificial immunity.

Regardless, I have little doubt that vaccines will help and I fully support their use if safe, but I have very little belief that they will be the silver bullet either. Thankfully that doesn't really matter because no matter what we do, clearly the virus is making it's way across the globe so to whatever unknown extent herd immunity is beneficial with this pathogen, it is building.
 

Vasr

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  • Pfizer has claimed they can crank out over a billion doses of their vaccine by the end of 2021, if approved. Other companies are building factories in order to ramp up production if their vaccine is approved - the world has the infrastructure to ramp up vaccine production to massive levels in short periods of time.
It would be better if we don't have to rely on the people who develop the vaccine to also have to manufacture it in large scale themselves. They are likely to over-promise and under-deliver or distribute preferentially to nations that bid the most and likely start a black market for hoarding.

There is a considerable existing capacity in all the generic manufacturers that can be deployed as well. They have a much better cost structure and experience with making drugs available at affordable prices in poorer parts of the world than Pfizers of the World.

If I was handing out that much money, I would have put clauses that any developed vaccine using that money even in part is not patent protected and can be manufactured by any generic manufacturer that is approved.

There is expert opinion (and some consensus) that any vaccine would likely have to be multiple doses which also complicates availability and distribution. You need to guarantee follow-up doses for whoever receives it first to prevent that initial dose from being wasted otherwise.

We will have to wait and see if the agreements turn out to be pharma-friendly or world population friendly. It might look like feeding time for a bunch of sharks fighting over a school of fish.
 

Racheski

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Nobody here can claim to have any knowledge of these new vaccines efficacy, nor whether or not the protection lasts. Even the researchers behind the vaccines can only speculate how effective the vaccines will be once used in mass immunization programs. There are far more unknowns than there are facts as of yet. This virus is so new and can still shift and change so much. At this point it is all speculation and conjecture where vaccine efficacy is concerned. How effective are these vaccines? How is the efficacy being determined?

I am not against vaccinations (I have had all of mine recently boosted) but I am against selling what may amount to false hope. In the end I will bet that the majority of the effective treatment will come from organic herd immunity working it's way through the worlds population. I am not an expert, but I have read that naturally acquired immunity tends to be more robust than artificial immunity.

Regardless, I have little doubt that vaccines will help and I fully support their use if safe, but I have very little belief that they will be the silver bullet either. Thankfully that doesn't really matter because no matter what we do, clearly the virus is making it's way across the globe so to whatever unknown extent herd immunity is beneficial with this pathogen, it is building.
How can a vaccine go from Phase 1 to Phase III trials if it has not shown to be effective?
I keep hearing the term "silver bullet" in these threads. I still don't understand what folks are referring to.
 

Veri

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Racheski

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The fear-mongering I hear is that the case fatality rate for Covid-19 is 1%. Pakistan has a population of 212m. It has recorded 5865 deaths so far. How many deaths has it truly had? It certainly cannot be 2m dead as there would have been visual evidence that would play on our news 24/7. I could imagine that they have undercounted deaths by up to a factor of 10. This would still leave Pakistan with a vastly better survival rate than the UK.



For western countries, this completely underestimates the costs of lockdown and social distancing. In the UK for example, there have been around 15000 excess deaths with Covid-19 not on the death certificate. Of the 47k Covid-19 deaths, some died with Covid-19 rather than due to it. The deaths from cancer will be a national disaster for the next two years to come. A large minority of the population are scared to leave the house. The effects of home confinement on physical health and mental well-being are only just beginning to play out. And this is before the economic impacts are truly felt. Most about-to-be-made-redundant furloughed workers are unaware of the certain joblessness they will face.

For children, they have missed so much schooling and social interaction. Their social interactions are now governed by fear of the virus. They are not seeing people's faces due to masks. Again I am certain this is storing up tremendous psychological harms for the future.

If the virus is less deadly now, absolutely none of these immense harms are justified. Just because you don't see something doesn't mean it isn't there.
Take another look at your first paragraph. CFR is not the same as mortality rate; the denominator is the number of cases, not the entire population.
 

mansr

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How can a vaccine go from Phase 1 to Phase III trials if it has not shown to be effective?
Phase III is where effectiveness is determined. The earlier phases ensure that it is safe and generates an immune response.

I keep hearing the term "silver bullet" in these threads. I still don't understand what folks are referring to.
Those are for werewolves. Not relevant now. Maybe next year.
 

onion

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Take another look at your first paragraph. CFR is not the same as mortality rate; the denominator is the number of cases, not the entire population.

Yeah I understand that. The point still stands. Fear stems from a CFR of 1%. And that fear is premised on the fact that there remains a large susceptible population. The purpose of using the Pakistan figures (5865 deaths, 212m population) is to illustrate that in countries that let the infection rip, there were not deaths running into the hundred thousands/ millions. That means either the susceptible population was far smaller than modelled; or it does not have a 1% CFR; or both.

Practically no country (except maybe Iceland and South Korea) can arrive at a reliable estimate of CFR because they were not adequately testing patients when the epidemic took hold. So relying on their confirmed cases count will shrink the denominator and boost CFR. The UK has a CFR of 15% if calculated this way which is absurdly high. In recent testimony the UK Chief Medical Officer stated that the epidemic peaked in mid-March. Any form of community testing for symptomatic patients did not begin until near the end of April. They almost entirely missed the community caseload of Covid-19 patients.
 
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lashto

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Other than a heavy dose of fatalism or a vested need to push herd-immunity as a solution, I don't see a justifiable case for herd-immunity as a solution.. yet.
..
There is no "justifiable case" for anything at the moment and we are all quoting partial stats, half-baked theories, etc. Nobody has any better and there is no point getting too emotional about any of those. We are all just speculating and waiting.

If I was to bet right now, I will probably choose the herd-strategy. Not because I like it or think it's best but because it looks inevitable. I did not have it in mind when starting this thread but the 'argument' of +3billion people who can't do anything else is pretty strong. By far the strongest I seen here or anywhere else. And pretty much implacable.
 
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