The Coronavirus Is Here Forever. This Is How We Live With It.

[Celerity]

We can’t avoid the virus for the rest of our lives, but we can minimize its impact.

https://www.theatlantic.com/science/archive/2021/08/how-we-live-coronavirus-forever/619783/



In the 1980s, doctors at an English hospital deliberately tried to infect 15 volunteers with a coronavirus. COVID-19 did not yet exist—what interested those doctors was a coronavirus in the same family called 229E, which causes the common cold. 229E is both ubiquitous and obscure. Most of us have had it, probably first as children, but the resulting colds were so mild as to be unremarkable. And indeed, of the 15 adult volunteers who got 229E misted up their nose, only 10 became infected, and of those, only eight actually developed cold symptoms. The following year, the doctors repeated their experiment. They tracked down all but one of the original volunteers and sprayed 229E up their nose again. Six of the previously infected became reinfected, but the second time, none developed symptoms. From this, the doctors surmised that immunity against coronavirus infection wanes quickly and reinfections are common. But subsequent infections are milder—even asymptomatic. Not only have most of us likely been infected with 229E before, but we’ve probably been infected more than once.

This tiny study made little impression at the time. In the ’80s and ’90s, coronaviruses still belonged to the backwater of viral research, because the colds they caused seemed trivial in the grand scheme of human health. Then, in the spring of 2020, scientists urgently searching for clues to immunity against a novel coronavirus rediscovered this decades-old research. Before the emergence of SARS-CoV-2, which causes COVID-19, only four known coronaviruses were circulating among humans, including 229E. All four of these coronaviruses cause common colds, and in the most optimistic scenario, experts have told me, our newest coronavirus will end up as the fifth. In that case, COVID-19 might look a lot like a cold from 229E—recurrent but largely unremarkable. That future may be hard to imagine with intensive-care units filling up yet again during this Delta surge. But the pandemic will end. One way or another, it will end. The current spikes in cases and deaths are the result of a novel coronavirus meeting naïve immune systems. When enough people have gained some immunity through either vaccination or infection—preferably vaccination—the coronavirus will transition to what epidemiologists call “endemic.” It won’t be eliminated, but it won’t upend our lives anymore.

With that blanket of initial immunity laid down, there will be fewer hospitalizations and fewer deaths from COVID-19. Boosters can periodically re-up immunity too. Cases may continue to rise and fall in this scenario, perhaps seasonally, but the worst outcomes will be avoided. We don’t know exactly how the four common-cold coronaviruses first came to infect humans, but some have speculated that at least one also began with a pandemic. If immunity to the new coronavirus wanes like it does with these others, then it will keep causing reinfections and breakthrough infections, more and more of them over time, but still mild enough. We’ll have to adjust our thinking about COVID-19 too. The coronavirus is not something we can avoid forever; we have to prepare for the possibility that we will all get exposed one way or another. “This is something we’re going to have to live with,” says Richard Webby, an infectious-disease researcher at St. Jude. “And so long as it’s not impacting health care as a whole, then I think we can.” The coronavirus will no longer be novel—to our immune systems or our society.

Endemicity as the COVID-19 endgame seems quite clear, but how we get there is less so. In part, that is because the path depends on us. As my colleague Ed Yong has written, the eventuality of endemic COVID-19 does not mean we should drop all precautions. The more we can flatten the curve now, the less hospitals will become overwhelmed and the more time we buy to vaccinate the unvaccinated, including children. Letting the virus rip through unvaccinated people may get us to endemicity quickest, but it will also kill the most people along the way. The path to endemic COVID-19 will also depend on how much the virus itself continues to mutate. Delta has already derailed summer reopening plans in the U.S. And with so much of the world still vulnerable to infection, the virus has many, many opportunities to luck into new variants that may yet enhance its ability to spread and reinfect. The good news is this virus is unlikely to evolve so much that it sets our immunity back to zero. “Our immune responses are so complex, it’s basically impossible for a virus to escape them all,” says Sarah Cobey, an evolutionary biologist at the University of Chicago. For example, levels of antibodies that quickly neutralize SARS-CoV-2 do indeed drop over time, as happens against most pathogens, but reserves of B cells and T cells that also recognize the virus lie in wait. This means that immunity against infection may wane first, but the protection against severe illness and death are much more durable.

snip

[secondwind]

1. We were talking about this tonight... because of the anti-vaxxers, Covid will be around forever.

We will have to get shots once a year, just like a flu shot. What irks me is the infections, how do we travel from now on?

Will we have a normal rest of our lives, or will Covid always BE THERE, lurking... It's really a bit depressing..

[madville]

3. The US is really ahead of most of the world

If 58% of the total US population is vaxxed, that's actually pretty good considering that about 25% of our population isn't even allowed to be vaxxed yet (those 12 and under). That's just 17% unvaccinated here, compare that to the billions of people that will never be vaccinated around the world and it's a pretty small number. COVID and new variants of it are gonna be here and circulating the globe for years, decades, maybe the rest of our lives. There is no way many new variants don't originate from Africa, South America, and Asia in the coming years, this is really the new normal.

[Ms. Toad]

5. 0-11 is 15%, not 25%. n/t

[Celerity]

9. Only around 51% of the US population is fully vaxxed. The US trails multiple nations now.

https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-population-vaccinated-march-15.html

As of 6 a.m. EDT Aug. 17, a total of 168,897,604 Americans had been fully vaccinated, or 50.9 percent of the country's population, according to the CDC's data.

The US has far too many anti-vaxxers to get anywhere near herd immunity via vaccination.

White nationalist MAGA funts/'baby jeebus' blood is my vax' christofascists and then Africans Americans (especially the younger cohorts) overall are the two hardcore vax refusenik groups. Latinx are also lagging overall, partially because many of the undocumented ones are terrified of being deported or fucked up by MAGAts, both copper's and civilian Johnny Reb types looking for a kickabout.

It's a tripartite COVID Clusterfuck of Shitbaggery.

[Zeitghost]

4. It has nothing to do with anti-vaxers (and yes, they're still morons)

The minute this thing went global it was here to stay. You can't have a novel virus that spreads that quickly run amok for almost a year and then vaccinate 7.5+ billion people quick enough to snuff it out globally. We need to manage it's spread to maintain functioning healthcare systems (flatten the curve) and vaccinate to ensure more mild cases are the norm, but like it's predecessors, it's here to stay and future generations will know it as just another seasonal cold virus. Zero Covid is unrealistic.

[Ms. Toad]

6. 1. It's no more a cold than it is the flu.

2. Smallpox, Measles, polio - these are all viruses which were eliminated, or substantially so, by vaccination.

[Calculating]

7. None of those mutate as quick as covid

It's the same reason why we can't wipe out the cold. Eventually COVID-19 will become yet another endemic cold that periodically troubles us, everyone will have either developed a durable resistance to it or died if they're particularly vulnerable.

[Ms. Toad]

10. That is one of the reasons why we can't eradicate the cold with traditional vaccines

The mRNA vaccines are different - rather than generate recognition of a very specific enemy (a particular strain of flu, for example), the mRNA vaccines generate recognition of the spike proteins (which are a common component in all strains of COVID.

With the Dela variant, I'm not sure whether we have determined why the Delta variant is evading the immunity - but part of it is not that our bodies don't recognize it, but that it creates a significantly higher viral load.

(And the cold comes from multiple viruses - coronaviruses and others. Same thing with infuenza. Both of those, and the lower virulence, are more significant reasons we have not eradicated them.)

[womanofthehills]

8. Unlike Covid 19, animals do not get smallpox & polio

Making Covid 19 even harder to eradicate. Polio is usually spread thru feces, water, contaminated food - not so much thru the air.

[Ms. Toad]

11. There is not enough animal to human transmission around

to prevent eradication.

And both measles and smallpox (at least theoretically0 are spread through the air.

[Zeitghost]

14. I understand that

But there are vast differences between Corona virii and Polio, smallpox, etc. For someone who appears to do a lot of research, I'm surprised you even made such an ignorant argument. The ones you mention do not mutate as quickly. Yes, the mrna vaccines are game changers, but look at how quickly they have been compromised, with a few more mutations they will be even less effective. Trying to keep up with 80-90%+ effective vaccines on a global scale is impossible. 30% of our population is already vaccine hesitant, how many do you think will sign up for boosters every 6-12 months for the latest Omega Varient?

Zero Covid is not practical or possible and continuing to chase that goal is dangerous and expensive. We need to vax everyone who is willing and move on with only enough precautions to keep the healthcare system from collapsing.

[Ms. Toad]

15. It is (so far) unclear whether the mutations are directly or indirectly responsible

for the reduced efficiency.

The mRNA vaccines work, including against mutations, because instead of training the body to recognize a very specific strain or variant, they train the body to recognize a common element across the variants (the spike protein).

It is too early to tell that the reduction in efficiency is because the spike protein has changed significantly enough that the body no longer recognizes it (that would be a direct reduction in efficiency) - in which case we are chasing mutations the same way we chase flu strains.

The other possiblity is that the virus has fundamentally changed in other ways (such as becoming dramatically more efficient at transmssion) that mean we need a better immune response to the same spike protein in order to fight it off. That requires boosters like polio, smallpox, DtP - and other diseases that can be defeated, but not with a single innoculation.

We will know that eventually - but we don't know which is the issue yet, and which one it is will dictate whether we can virtually eliminate it through vaccination - or will be chasing it annually like influenza.

[live love laugh]

2. That's good news and bad. I hope we can avoid the death spikes. nt

[Initech]

12. Well the biggest road block to that problem is anti-vaxxers.

Which we are finding out right now just how many of them there are. And these idiots are digging their own graves because they bought into the lies being sold on Facebook. Mark Zuckerberg needs to be hauled before a Senate committee to answer for this.

[GusBob]

13. Endemic for the 'Rona, fine. But then what?

What’s next?
Hopefully we’ve learned something. Huh CDC?

Hope some reality TV star isn’t in charge. And we know now about the scourge of ant-vaxxers

I can’t get over it , how a public health care issue became a political football game