When does it end?

The Quarantine Zone
21

What reports from what source? How was “reinfection” verified? Were people verified to be infected, then virus free for longer than a possible dormancy period, and then reinfected by an identifiable different strain?

First of all, there is zero evidence that warmer conditions will attenuate the spread of this virus. It has spread just as rapidly in tropical areas and temperate areas experiencing warm weather as it has in cold areas. So, expecting that a warm summer will defeat the virus is just hopeful pleading with no basis in evidence.

Second, because of the unpredictability of the progress of the SARS-CoV-2 virus in people across demographic spectra, deliberately exposing a “random sample of people” just isn’t useful and it certainly isn’t ethical. Even many immunologists who normally work on “challenge trials” where volunteers are vaccinated and then deliberately exposed to accelerate efficacy testing of the virus are cautioning against using challenge trials for a SARS-CoV-2 vaccine because it just isn’t possible to tell who may have a severe response to the illness. And frankly, given how contagious this virus is, it probably isn’t necessary to run a challenge trial; researchers can just vaccinate a suitable population of likely exposed people like police or medical workers with a statistical expectation of how many will be infected with high confidence. Indeed, the problem with human vaccine trials is more likely to be finding a group of uninfected people who are not at-risk for serious complications.

This plan of deliberate infection and expecting to “continue to get hot spots” while we are in the midst of this epidemic is beyond foolish; it is futile. Because of how interconnected we are as a society and how contagious the virus is, essentially every place is or will shortly be a “hot spot”. The purpose of “social distancing” (which some authorities are now rebranding as “physical distancing” to reinforce the principle that maintaining at least the 6 foot minimum distance in all contacts with people outside the home is necessary) isn’t to cause the virus to “die out”; it is to blunt the peak of severe COVID-19 cases such that medical personnel have some hope of treating at least the people who may be saved through intervention and possibly slowing the progress of contagion through the at-risk population such that effective treatments may be developed. This deliberate exposure plan is basically saying, “Let’s just get it over with,” even if doing it in a systematic way, which again, does nothing worthwhile.

What is needed is broadly available antibody testing so people who have been exposed and are immunized can return to work with assurance that they will neither contract the disease nor spread the virus to others, and so epidemiologists have highly representative data of the spread of the virus instead of small sample size testing which only gives rough estimates through a population that is not homogenous.

Stranger

22

R0 is an average measure. If you have nearly all infected quarantined, the few who aren’t, wouldn’t bring it over 1. If there are 100 infected, and of those 94 are quarantined, and those 6 loose ones infect 30 others, the average rate is 0.3. Of course, if you don’t address those 30, or most of them, things get wonky. The whole point is to identify the infected and so the infectious, by testing. This requires many, many tests. But it’s been done many times before. The scale is larger, but the principle isn’t different. In Korea, and Singapore, they appear to have done exactly that.

23

This is an incorrect assumption. Transferring plasma containing antigen-presenting cells acts as a therapeutic to fight viruses in the patient’s body but does not convey immunity, which requires the patient’s own plasma B cells to recognize and start producing antibodies. Given that the SARS-CoV-2 virus appears to be highly localized in the respiratory system, it isn’t even clear how effective plasma therapies may be in fighting an advanced presentation COVID-19. This may provide an effective prophylactic but even that is unknown at this time until actual trials are run.

Stranger

24

Ah. Still useful but, yes, not quite what I was thinking it was.

25

We are saying the same thing. I was pointing out the reports previously were spurious and uncontrolled. I was disputing the claim the people don’t have immunity because of reports of reinfection.

Yep. Totally on board with that. That is why I was saying we would have to get really luck for that to happen. I’m proposing we don’t bank on that at all. It isn’t likely.

This is where you and I usually end up differing, I’m afraid. I never said a random sample of people. I said those least vulnerable. This is an important distinction. I know of several people living in assisted living quarters that are now in lock down. Guess who is delivering their food every day, three times a day. 20 somethings who have no idea if they have been exposed or are vectors. Instead, expose those 20 somethings NOW, isolate them for 3 weeks, and then have them start delivering food after they have been cleared. When the virus then starts to really take off in that area, the elderly in those facilities have an even bigger buffer between them and the virus because the only people they are exposed to, really, are ones that we know are no longer vectors. Waiting like we are now, those people could be vectors and we don’t even know it. We need to find people that are no longer vectors and have them interacting with the most vulnerable. Otherwise, we are leaving this up to random chance.

We know, factually, that people under 40 (even 50) are far less vulnerable to the worst of this virus. Exposing those people now, then quarantining them, means some percentage of them will need critical care which we can provide because in many areas the critical care facilities have capacity. If we wait, those same people who need critical care will need it at the same time the much more vulnerable will need it, and we run out of capacity.

I can’t stress this enough. We cannot wait out this virus. It just isn’t feasible. As you’ve said many, many times, we need to reduce the peak of the critical care needs and spread it out over time. Waiting around for it to reach an area where it will spike is insane. This will, realistically, only go away when we have gotten 50% or more of the population exposed. We can do that with a huge spike at a given time or we can do that more slowly. If I had exposed myself 3 weeks ago I’d be immune and able to help out at assisted living places instead of sitting on my ass at home. There is a very small chance I’d have gotten critically ill, but in the end, I have that same chance just waiting around. I don’t want to be critically ill when hundreds of others in the same area are also critically ill.

Even if you had the antibody testing, you would still only be able to return those to work that were exposed. YOU STILL NEED TO GET PEOPLE EXPOSED. Expose the least vulnerable now, when we have resources, and you don’t need to wait around for antibody test. They can go help NOW.

26

Having to get revaccinated for Covid-19 because immunity wanes isn’t that different from having to get your pets revaccinated for rabies, or getting DPT boosters.

It isn’t impossible there could be a vaccine for Covid-19 that conferred immunity for a few years, the same as having the virus would, and then you would need another vaccine.

27

We are not “saying the same thing”, and please answer the questions:
[ul]
[li]What reports from what source? [/li][li]How was “reinfection” verified? [/li][li]Were people verified to be infected, then virus free for longer than a possible dormancy period, and then reinfected by an identifiable different strain?[/li][/ul]

Stranger

28

That’s not what I said. To be more specific, tho, your assertions that

are baseless.

China enacted much more draconian measures than the US has and it has taken them over 60 days to even hint that things are flattening out.

And we have reports that people have been re-infected, so IMO “spreading immunity” is still a baseless assumption at this point in time.

29

[ul]
[li]What reports from what source? [/li][li]How was “reinfection” verified? [/li][li]Were people verified to be infected, then virus free for longer than a possible dormancy period, and then reinfected by an identifiable different strain?[/li][/ul]
Stranger

30

I’ll answer that, I promise, if you’ll answer this direct question for me.

Are you saying the reports of reinfection are spurious, at best, and not verified and are trying to call me out for saying it has happened?

31

Here is one report of someone being reinfected.
Reinfection was verified by testing the person again after having tested negative.
The article itself raises many questions about the testing and results. WHICH IS EXACTLY WHAT I WAS DOING. I wanted to short circuit that argument that reports had been made of reinfection by saying upfront that I’m aware of these reports, BUT THEY ARE DUBIOUS.

Unless you are saying these reports have any merit, we are, once again, SAYING THE SAME DAMN THING.

32

I would be willing to permit a voluntary scheme where people such as yourselves could waive their right to ventilator treatment and submit to 3-week quarantine. But if anybody comes at me with a needle full of COVID viruses, they’ll be the ones who end up with holes in their bodies, not me.

I say this as someone who donates O-negative on a regular basis. Exposure to COVID-19 is a high-risk medical procedure and would be criminal to force it on anyone.

33

I’m not proposing forced exposure. It would all be voluntary. I don’t see the need to restrict medical care because, quite honestly, this is a risk the volunteer is taking for the benefit of society as a whole. They should be offered free medical care it they take the offer now.

People somehow have the idea that somehow they’ll completely avoid getting this because of social distancing. You have a 50% chance of getting this. Do you want to take that chance when the medical system is overloaded? I don’t. I’m lowish risk. Mid 50s and in perfect health. But there is a risk if I get it, and I’d rather do that now than in a month when this thing comes ripping through my area.

If I get sick now, I’d be taking a ventilator no one presently needs. If I die, I would have die when I got the virus a month from now and would have been taking a ventilator someone else who might have survived needed. If I survive, it was because I had access to a ventilator and now I’m immune and no longer a vector.

34

It will never end. All public gatherings and sports will end, and people will be allowed to go out only for groceries and we will all be happy and healthy

35

We don’t need to wait out the virus. We need to wait out the availability of sufficient tests for the virus, so we can isolate carriers. And wait out the availability of tests for antibodies so we can identify the presumed immunized, and get enough ppe so susceptible personnel is effectively insusceptible when caring for carriers.

The idea that this only goes away once 50% of the population is exposed is profoundly wrong and is dangerous to boot. We don’t need 50% exposed to Covid19 anymore than we need 50% exposed to Ebola or Marburg. We need a humongous amount of tests. Like a metric shitton of tests, like at least tens, possibly hundreds of millions of tests for the US. alone. But in the end, this is a viral outbreak, and needs to be dealt with like a viral outbreak. Not like a “measles party”.

36

What is your timeline for all this testing?

What is your proposed plan once you have that testing? How are you going to get 330,000,000 people tested?
How were Ebola and Marburg contained? Contact tracing and isolation? I really don’t know.

Let’s say, magically, you have the antibody testing you need tomorrow. What do you propose we do with that? I’d go and get tested and find out I haven’t had the virus, along with million upon millions of others. Then what? We’ll find some that are immune who never knew they had it, and some that are presently active. And now?? Those that are active will be asked to self quarantine. We are trying that now. It isn’t working. So the virus will continue to spread. How many rounds of antibody testing will I need to go through? When does that testing end?

37

I’m not Stranger, but I’d say the reports are unconfirmed, and that if it were the case this virus would be VERY atypical to the point where I think it would rewrite the books. While life long immunity might not happen, getting it that fast again? :dubious: That just isn’t how things work, so there would need to be extraordinary evidence to this extraordinary claim.

38

This is what I said:

If you are right and that is what he was saying, I WAS SAYING THE SAME THING. I was trying to indicate these types of arguments are basically without merit. I truly, honestly, have no idea how to be more clear about this.

How am I not being completely clear that reports of reinfection are basically bunk??

39

Time line: when we get the tests. Probably much longer than we’d like, but no an infinite wait.
What do with the tests? Use them. On those with symptoms, and those they came in contact with. Like we did with other viruses. Like Korea did with this one.
The assertion that quarantine isn’t working is flat wrong. We cannot know indisputably yet, because it hasn’t been in place long enough. But early signs point to it working very well: the curve seems to be flattening in the SF bay area, and the stark difference between Northern and Southern Italy show it’s working. Again, Korea shows how it can work.

Your plan, on the other hand, seems to be: ignore how we have always dealt, successfully, with outbreaks, I can’t fuckin’ wait that long. Let’s just infect a bunch of people, and see what happens. We’ll pick the “right” candidates, of course. Well, I don’t like that plan.

40

Look, let’s say the curve flattens, they open up bars, restaurants, cinemas, etc. Your best bet is to not participate in any activities involving socialization for at least another month. Or two, or ten. We simply don’t know yet.

What about if new strains come around? Ones that affect those ages 6-16 more than the original one?

We have to wait.