Here’s an excellent article that compares and explains the different challenges of Covid, influenza (flu), and various other common viruses that are currently “under control”, but not entirely eradicated:
I think that “live with it” is the most likely outcome in our immediate future.
We won’t be able to eradicate it. There are animal reservoirs, and human immunity appears to wane over time, as well.
I hope we will be able to eliminate it, or reduce it to something that we can mostly ignore, but sometimes there are local outbreaks and locally we need to take precautions for a while. If everyone got vaccinated, i think that would be realistic.
Given that we have vast swaths of people who don’t want to be vaccinated, I’m not sure what the end game is. Especially if immunity is short-lived, we’re not going to be able to make everyone stay current in vaccination.
I don’t think it’s defeatism, it’s just reality that it’s become an endemic disease. Now, luckily there are many many endemic respiratory viruses (including many other coronaviruses) that afflict the human population and it’s not that big of a deal. What is bad about the coronavirus is that it is novel, having made the jump from animals to humans for the first time ever in late 2019, and we have minimal population reservoirs of immune resistance to it. If it follows the same course as other similar viruses in the past, it is likely over the years it becomes less and less virulent. The refrain of the covid deniers of “it’s just a flu”, that’s honestly sort of the end goal. Influenza is a respiratory virus with relatively low mortality, that we can help tamp down during flu season by getting seasonal vaccines, that is essentially “well managed.”
In the here and now though and for the foreseeable future it remains significantly more virulent than a number of other common human respiratory viruses, and should be treated with greater caution and vaccination should be encouraged much more aggressively than it is for seasonal influenza. But eventually, hopefully it does become “just a flu.” It being completely stamped out unfortunately was never likely, even from day one, because it simply spreads too easily and has too long a period of asymptomatic contagiousness. By the time even the Chinese realized it was a problem, it was arguably too late. Other outbreaks in the past like SARS and MERS that have much higher virulence don’t spread nearly as covertly, and were able to be contained in their initial outbreak by aggressive contact tracing until the virus went extinct in the human population (both viruses are assumed to still exist in their original animal carriers.)
There was a chance early on, and then we moved into mitigating the damage to the healthcare system. By that point it was everywhere so we’re not about to get rid of it. With vaccinated populations it does, finally, become the bad flu that we’re likely just going to have to manage. In Canada influenza (and associated pneumonia) kill 7000 a year - we don’t take too many heroic actions to reduce that so I guess covid can rage at that level unmolested.
It’s not going to go away, but that doesn’t mean it’s “just a bad flu.” Even if we could get the whole world vaccinated, there’s the matter of immunocompromised people who are unlikely to completely clear the virus, at least in a short time frame. As far as animal reservoirs go, I think the jury is still out on that one. Sure, the original reservoir is still there, but other than cats, I haven’t heard of COVID-19 being a major issue among other domestic animals.
ETA: For practical purposes, we’ll never come close to having the whole world vaccinated. Not even close. That’s going to be the biggest contributor to COVID-19 being endemic.
I don’t think the expectation was that it would be “eradicated” like smallpox.
What I’d always heard was that the long-term expectation was that it would end up much like the flu- something that is always present at a low level, but due to immunity acquired through vaccinations and actually having had the disease, it would mostly stay at a low level, mostly catching people who don’t get their vaccinations. Much like the flu in that sense, although COVID is more severe, but the vaccines are more effective as well, and the mutation rate is considerably slower.
The trick is getting to that state. Right now, there are still huge numbers of people who have neither been vaccinated nor had the virus. So they’re still catching it and spreading it like crazy among themselves, and raising the chances of breakthrough cases among the vaccinated. That’s why masks are still in play, and they’re still encouraging vaccination.
But give it a while, and the current surge will burn out and the people left will mostly be immune one way or another, and if they’re not, they’re probably not in a position to be exposed much in the first place. We’ll be back where we were in April or so, except without as much likelihood of such a large flare-up. And hopefully it’ll trail down from there.
…the “we just gotta live with it” mentality has been there since the beginning. Look to Sweden and the nature of their pandemic response, look to the UK that initially were planning on “herd immunity” until there was a public outcry and they pretended that wasn’t the plan after all.
Or look to how people have reacted to our strategy in New Zealand, which has been subject to this sort of critique since the early days of the pandemic back in early 2020.
This is the sort of thing the “experts” are saying about what we are doing here.
I mean…what kind of nonsense is this? Abstinence only? If you read (or listen) to what Dr Adalja has to say it should become clear that he is both ignorant of our actual strategy, AND using information that is well out of date.
Learning to live with Covid actually means learning to die from Covid. We are watching as the world burns and we have decided that we don’t want that here. We’ve got a plan to reopen. We aren’t going to rush it. We’ve taken a science-lead public health centric response here, and by keeping people both out of hospital and out of the cemetery we’ve found that is a good thing for the economy actually.
I don’t think they are. I think the biggest problem is you’ve got power structures (at the government level, social media giants, and the media) who are both intentionally and unintentionally sabotaging the pandemic response.
New Zealand originally looked to “flatten the curve” but quickly abandoned that when the Prime Minister looked at what those numbers meant.
For context: NZ journalist Matt Nippert spoke to the modellers who work on our elimination strategy, and he said that (during our current outbreak) if we hadn’t locked down, our hospitals would have been overwhelmed Monday last week. Flatten the curve can (and has) work if you have the ICU capacity. But NZ doesn’t.
Eradication is an epidemiological term that is distinct from Elimination, which is the strategy that New Zealand is perusing. And we aren’t abandoning elimination here. And even as we go into 2022, the intention is still to ringfence/stamp-out outbreaks as they happen, even as we gradually open things up.
I do admit that while it may not be so much to live with it, but to ease the transition it to a childhood disease in its ‘deadly to mostly adults’ form, and that takes at least a generation or 2. Not that adults won’t get it, but the immune system of a baby/child will be growing up with it, fight it along the way when infected, perhaps some passive immunity from mothers milk, and be better prepared for new variants that will crop up over time. I would not call that exactly learning to live with it, but preparing to live with it.
We also will develop better treatments, which do take time, which will lessen it’s sting.
However right now I think there is a balancing act to try to keep it under control but still allow as much normality in life. That however is not to allow COVID to spread, but to stave off the damage of a lockdown society faced from being locked down.
What I have noticed is an obvious attempt by a certain side to say things that discredit the efforts to limit the spread, or at least tried to spread doubt. People with a obvious agenda will often jump into covid support groups for the first time and spread their easily disprovable disinformation as fact or posing as a question. Stuff like ‘I and my relatives were all fully vaccinated and everyone got Covid, anyone else had that happen to them?’ With a note that this person is new to the group. Or a post that more vaxed are being admitted to their hospital than unvaxed, but someone else posted a link showing that hospital admissions for COVID were running 90% unvaxed in their state (discrediting their attempt at disinformation).
That is the situation that will prevail, Is is pretty much inevitable now.
However, Here is an interesting snippet of data from the UK that gives a flavour of what high vaccination levels of vulnerable people can do to death rates in a country where the virus is able to freely spread.
In a nutshell. Just 0.5 - 0.8% of the deaths seen in the January-July window were of fully vaccinated people (the lower figure appears to be for people who we know were second jabbed well before their positive test). Of that small percent, three quarters were of people who were clinically extremely vulnerable.
That is an incredible degree of protection and gives an idea of the degree of control that can be exerted over the virus by suitable vaccination efforts and it is a figure that is only likely to get better with boosters. new vaccines, new treatment regimes and targeted care for the vulnerable. It is indeed approaching a flu-like scale, even if the virus itself is a nastier piece of work.
So that will be the calculus that will ultimately need to be made. Are countries willing to trade that level of death (in a well-vaccinated country) in return to pretty much normal life of pre-2020 style?
I suspect that most countries will, sooner or later, take that approach. It would be hard to make a case for continuing with draconian restrictive measures when presented with the figures above.
Of course, various countries have made sterling efforts at keeping the virus out but even under the strictest controls it has not proved possible to do so, the data above gives hope that even when the virus does get through you minimise the effect it will have.
I don’t know if it’s a case of taking that approach, as much as it’s going to happen, regardless of what they do, short of continual rather draconian procedures against it. The big question is how they go about it - most sane places are trying to mute the spikes through masking, social distancing and vaccinations, but some places are just letting it burn through their unvaccinated populations, either because they have no vaccinations, or because they apparently don’t care.
I think you are broadly right. Though numbers can be kept low with stringent restrictions, all countries that wish to return to a time without such restrictions and to return to more open borders will find that the virus will get through.
And yes, when, (not if) that happens it becomes a question of balancing freedoms against health outcomes and what each country is willing to bear for each of those criteria.
Current evidence suggests not. Countries with very high levels are still seeing the virus spread.
The current variant still infects vaccinated people and they pass it on.
Even if you could reach the unheard of 90% vaccination rate it’ll still spread (and that doesn’t even touch upon further variants arising)
What high vaccination levels will do (and are showing they can do) is to prevent huge numbers of deaths.
Agreed - there’s no way to eradicate it now because of the speed at which it mutates and its transmissibility between humans and animals.
I think that over time we will eventually, through a combination of widespread exposure and vaccination, live with it as a flu-like disease. If I recall correctly, something like 95% of UK adults have antibodies already, resulting from a combination of vaccines and natural infection. Our bodies will become more familiar with it. We will vaccinate ourselves. We will have COVID infections and deaths every year, with some years being worse than others.
The key, whether living in NZ or the US, is to get people vaccinated, to give them that initial body armor of protection that can, if nothing else, reduce the chance of hospitalization. I think we will indeed have to live with the virus, but if the unvaccinated are taking that as their cue to avoid vaccination, that is a mistake that may well cost them their lives.
The virus is now probably going to evolve to get around the vaccine’s protection. The vaccine is acting as an evolutionary pressure of the virus. COVID will eventually make our current vaccines less effective in terms of symptomatic infection but they are likely to remain mostly effective in terms of preventing the worst outcomes. But for those who are unvaccinated, their immune systems are going to get overwhelmed.
It’s worth noting that the flu virus in the 1918 flu pandemic was never eradicated. It circled the globe until everyone who contracted it either died or gained immunity. Then it mutated to a less lethal strain and is the ancestor of many human flu viruses circulating today.
The same thing doesn’t need to happen with COVID if we get enough people vaccinated, but there seem to be too many obstacles in the way to getting that critical mass. I’m just praying that this partially-protected posture doesn’t drive the emergence of even worse variants. Ones that are more deadly, or more transmissible, or deadly to children, or has more lingering symptoms.
The vaccine resistance is so frustrating. It’s partly political contrarianism to be sure, but there are so many other people who are afraid of needles, or skeptical of the medical establishment, or afraid of the unknown, or just don’t understand what’s at stake enough to weigh it against the inconvenience of getting a shot. Such a goddamn shame.
Absolutely. No matter where you live in the world it now seems inevitable that the virus will find you. The vaccines offer far better protection than we could have ever reasonably hoped for but enough people have to step forward to keep those death rates low.
Indeed they are. Any evolution to avoid the current vaccine will certainly keep infections rumbling on but there is no certainty that the virus will be any more deadly. There’s no real benefit to it in incapacitating the host and a mildly affected, walking virus factory may indeed be preferable.
I’d anticipate the current vaccines will continue to provide strong protection against death for many variants and of course the great news is that the now proven technology for the vaccines is very much a “plug and play” system where changes can be made very rapidly.
I kind of figured that by 2019, it’s just a routine illness. You get it as a kid, it’s likely not that serious, maybe you get it again as a young adult, a more mild case, and by the time you’re old, you have had it a half dozen times, your immune system is up to the task, and it’s no big deal. Maybe you do get it bad and die, but old people are always at risk of dying from any serious disease, the flu, pneumonia, etc. because they’re old, and that’s what being old is like.
The problem right now is that we’re all getting it for the first time, nobody has resistance to it (until the vaccine) and it’s pretty dangerous for older folks to get hit by it fresh. Eventually, we get to this situation, it’s endemic, everyone has either been vaccinated or has gotten sick with it at some point. I’d prefer if everyone took the vaccine and didn’t wait to randomly get sick and risk death, but if they’re hellbent on taking the risk, I cant stop them.
I read a story about a school district where 5 teachers died of Covid and thought it was a tragedy until I read one particular comment “how many of these teachers were vaxxed?” I’m guessing zero, and is it really a tragedy when someone chooses to share a room 8 hours a day with 25 unvaccinated plague rats children, and chooses to deliberately avoid a vaccination to protect themselves from this dangerous pandemic?
i always find these stories were a cluster of people (family, bunch of coworkers, etc) all infect each other and die of covid. Because the disease has a 99%* survival rate. So did 500 teachers catch covid at the same time? Were these particular teachers old, suffering from some other issue, or just unlucky?
But to the OP’s point, if there are covid vaccines that are 95% at preventing the disease and 99% of the people who catch covid survive (more if they are vaccinated), To me it would seem it is quickly becoming live with it-able.
Which is not to minimize the disease. If 1% of 100 million people catch covid in a year, that’s still a huge number of dead people.