With so many people and local and state governments refusing to take even the most basic precautions against COVID-19, I shudder to think how badly we’ll fuck up the next big thing.
This is the fifth pandemic I can recall. Not the last. Won’t be the worst.
SARS did not effect most Canadians, but it was the first time I had to “don and doff” space suit clothing at work for many months. It was generally handled in a competent way and in Ontario led to proper funding for decontamination and negative pressure rooms, improved patient transfer standards and a sensible stockpile of necessary items. I was pleased to be a part of these decisions in my small way.
By Covid, the sensible stockpiles and respected Canadian international surveillance had apparently and gradually been deemed too costly and cumbersome to keep up to date. This mistake was to prove enormously expensive in every respect.
Interventions which greatly lengthen life are not always medical breakthroughs. Things like clean water, garbage collection, nutrition and hydration, plumbing, sterile hospital procedures, education, seat belts, antibiotics and insulin make a real difference. So do immunizations. It is disturbing to see this progress undermined by those who often choose to be poorly informed. As a medical student, I went to India. There I saw many diseases long vanquished in Canada. I hope I never see them again, not least because someone ignorant of our Constitution thinks themself expert on public health policy.
There will likely be more because of increased vectors for the spread of disease.
I’ve read a number of articles saying that it’s a harbinger of deadlier pandemics.
This from the NY Times one is paywalled so here’s an excerpt:
"The challenges won’t go away, and they won’t get smaller. The coronavirus was a shock, but a pandemic was long predicted. There is every reason to think that this one will not be a one-off. Whether the disease originated in zoonotic mutation or in a lab, there is more and worse where it came from. And it is not just viruses that we have to worry about, but also the mounting destabilization of the climate, collapsing biodiversity, large-scale desertification and pollution across the globe. https://www.nytimes.com/2021/09/01/opinion/covid-pandemic-global-economy-politics.html?searchResultPosition=72
Here are other articles about the inevitability of future pandemics, fuelled by climate change, loss of animal habitat and biodiversity
When you refer to SARS-CoV-2 as possibly originating “in a lab” do you mean the virus being studied in a lab and then accidentally released, or that it was manufactured in a lab and then released, on purpose or by accident?
Because these a very different things. If you mean the latter then of course there’s a LOT more and a LOT worse and deadlier “where it came from”. Smallpox, Ebola, Marburg, plague just to start with. We already know all about that potential catastrophe. It’s like potential nuclear war: horrible, but not a very interesting “what if”.
That’s not my own reference to zoonotic mutation or lab, it’s a quote from the NYT article. The way I understood it, though, was “Wherever the disease originated”, and not an argument for either provenance.
I personally don’t believe that there’s enough evidence to show a lab connection, and it didn’t seem to me that the NYT article was arguing that the pandemic did originate in a lab.
Since college football season started the stadiums have been packed with maskless fans and that’s when the case numbers started declining rapidly in the south. We should keep that in mind for any future pandemics. Lockdowns don’t accomplish anything.
You can compare the percentage of the world’s population killed by each epidemic using this table:
Interesting article about other potential threats out there:
I dunno – I think masking has been normalized to an unprecedented degree in the USA. Next big outbreak, the masks will go up pretty fast and with decent adoption rates.
Compare with asian countries in the last decade (they wear masks constantly) and the difference is stark. So that’s one positive outcome.
I think that depends on where you are:
…et cetera, ad nauseam.
The wearing of masks has been normalized among rational people (although I think there is still a lot of education to be done about the appropriate use of effective surgical or respirator grade masks versus using cloth wraps, gators, or ‘chin hammocks’) but there are a thundering herd of non-rational people out there, and not all of them are in Florida or Texas.
Stranger
Sure, it’ll vary area by area.
But every area is > than it used to be. I NEVER EVER saw an American wear a mask during flu season in my entire life until now.
Anything greater than zero is an infinite increase, technically, and I think we did much better than 1 or 2 percent here.
I’d see it, on occasion, in downtown Chicago, or at airports, but I’d say that 95+% of the people I saw wearing them were Asian (or Asian Americans).
Yeah, by American I sorta-kinda meant the typical schlumpy fat white people. Of which I am absolutely one, though I’m not as fat as I used to be, in all fairness.
This really isn’t true. A thread a while back about the political response to the pandemic showed a dynamic graph of case numbers per state, along with their vote breakdown in 2020. By December of 2020, the states were nearly perfectly sorted: Every blue state had lower per capita case counts than every red state. And this is despite the fact that cities are inherently more vulnerable to contagion than rural areas are.
In other words, all of the things that sane communities were doing, even before the vaccine, worked, in aggregate. They didn’t completely stop the disease, of course, but they did significantly slow it. The difference wasn’t because of N95 masks (which most folks haven’t been using even in blue states): Even just homemade cloth masks, or drugstore paper filter masks, worn imperfectly, make a huge difference. As do all of the other imperfect measures taken.
Masking of any type has made a difference, despite the fact masks differ a lot, no mask is perfect, and people do not always wear them correctly or everywhere or at all.
Social distancing has made a difference too. Early thoughts that the disease spread due to fomites or surface contact led to some policies more “hygiene theatre” than helpful. A future pandemic might use more than one modality?
Immunization has been helpful at keeping people out of hospitals and the ICUs but was never a magic bullet. Scientists have been working on RNA vaccines for over twenty years and the science is safe and understood. However, more people than ever seem to be questioning the science and their right to choose what treatments they undergo regardless of circumstance - and it is an important right, but also an important circumstance. It may make future immunizations more difficult, which is more than a pity. Covid will continue to mutate - hopefully to less virulent forms. The ACE factor does not guarantee the vaccine will always be effective for several reasons, but it should hold for most small mutations and hopefully most of the bigger ones.
It has been interesting to see there are very few cases of flu thus far.
There is a real risk of overreaction to future pandemics less serious than Covid - at further economic cost and scapegoating - and of underreaction to a more serious epidemic like Covid with a higher R, more modalities of spread, and where a majority of affected children and adults get seriously ill. We need to draw the right lessons now.
Well, I wouldn’t go that far. In the effort to get people to wear masks there has been a lot of what is frankly bad science and worse statistics to try to assert that any mask worn any way is has significant effect on transmission when common sense and laboratory filtration efficacy experiments show that to be nonsense. The epidemiological studies supposedly demonstrating the effectiveness of improvised or ‘partial’ masking make the elementary mistake of attributing all data supporting rejection of the null hypothesis is due to the effectiveness of mask-wearing instead of considering that populations in which mask-wearing is high also likely have additional factors such as following physical distancing guidelines, ensuring good ventilation, imposing indoor gathering restrictions, et cetera that also reduce the spread of contagion.
In fact, if you are wearing your mask under your chin, or wearing a two layer gator providing essentially no filtration, or some other physically ineffectual barrier, there is really no non-magical mechanism by which such ‘masking’ would or could reduce viral spread, and such use is pure theater without real evidence. Authorities should really be ensuring the availability and encouraging the wearing of correctly fitted respirator masks (N95 or similar) in any confined conditions, and also supporting the development masks fitted to child/smaller faces, but little attention was paid to this in order to promulgate the message that any mask is okay in order to justify reopening as fast as possible. Of course, the fact that most people do not wear masks correctly even when they are wearing an N95 or KN94 mask largely negates the effectiveness, but again, so much emphasis has been placed on masks so that little effort is made in other measures equally or more effective such as switching to updraft ventilation in buildings, ensuring physical distancing measures, maintaining rapid test & trace capability, et cetera. Basically, masks are the cheapest and most visible solution even if cloth masks are at best marginally effective and many people don’t wear masks correctly, and prevent having to spend money and effort on more expensive and complicated measures to limit spread.
Stranger
Even N95 masks do not offer full protection. Of course, a mask not covering the nose and mouth is useless, and we now know cloth is inferior to filters and proper medical masks. They still made a difference to the people who wore them, helped by other policies. If you refuse to wear a mask, and talk to someone who has one - the mask helps you too since it imperfectly reduces spread compared to no mask. When I say not worn correctly or at all I was speaking of this global effect, which is no substitute for wearing a proper mask properly. That said, masks are imperfect. Hospital staff wearing fitted N95 masks still got sick by times. They still do something, and a big reduction is better than none.
I don’t really disagree with what you say but think masks did make a real difference, even though improperly emphasized (due to cost or convenience) at the expense of other effective measures.
TL;DR Masks are an important part of a balanced breakfast. Get vaccinated!
Here is a two part scientific commentary that just came out about masking and aerosol transmission.
Part 1
Part 2
This table provides a quick summary, but they are just estimates. They are the best estimates we can do right now, but in the article they say “These numbers are just estimates based on the CDC’s 15-minute contact tracing time, which has no scientific basis. And the more transmissible Delta variant (lineage B.1.617.2) may require an adjustment to a shorter contact time.” So, none of this TV tropes countdown timer “I got out of the room in 19.6 minutes so I’m safe!” but the relative ratios are probably accurate.
https://www.cidrap.umn.edu/sites/default/files/public/mask_table_1-final.jpg
Reading through the articles I see a few things:
- Masks are an easy, if not completely effective, action
- Compliance is easy to determine
- Easier to enforce than other things like vaccination or quarantining
- Needs to be combined with other interventions such as ventilation and distancing
- Multiple interventions increase protection
- Not all scientific findings hold equal weight [it can often take an expert to evaluate this, and another expert to disagree with valid arguments, as opposed to non-experts kibitzing]
- Doing a good mask study is hard
- It is vitally important that good science is used to conduct and evaluate studies
- A well fitting N95 respirator will protect you much more than nothing
- Other masks probably protect more than nothing, especially when everybody is wearing them
Other news:
Colorado reports that school districts with a mask mandate show lower COVID rates among students than districts without a mask mandate. Masks work! IIRC the difference was about 20%, but I can’t find the reference now. My opinion is they are probably helping, but it is not a single degree of freedom test. Districts with a mask mandate also have higher vaccination rates among the public, and maybe take other interventions more seriously, too.
Colorado college campus with high vaccination rates have far lower rates of COVID than the surrounding communities. Compare that to this time last year when were just coming off lots of college based outbreaks.
The campus I’m on has about 45,000 people with 95%+ vaccination rates. Last year by this time there were 3800 cases, this year there’s been 93.
Guys guys guys… we basically FUCKING DEFEATED THE FLU. That’s INCREDIBLE.
Except that this past year, things were different: During the 2020–21 flu season, the United States recorded only about 2,000 cases, 17,000 times fewer than the 35 million it recorded the season before. That season, the flu killed 199 children; this past season, as far as we know, it killed one.
One child died. ONE! OOONNEEE!
Good lord, masking, social distancing, and washing your hands really does work. Just add the new layer of “it’s like smoke, not dirt” to handle HVAC and air filtration and it could be a whole new era post COVID.