I thought the point of the vaccines wasn't to provide an absolute block against the virus but to reduce the incidence of severe symptoms and hospitalisations? Rather than running rampant and killing hundreds of thousands, it'll be pushed down to mild flu or common cold kind of levels?
I feel like attacking a virus this aggressively worldwide with a vaccine was a mistake since it will make the virus more resilient and resistant and spark thousands of new variants or in another words speed up its evolution and possibly cause and make a super virus.
Masks, social distancing and washing hands was and is enough.
Maybe vaccine should've been rolled out more slowly not everywhere at once.
This is missing the last step of calculations as any degree of lower r0 doesn’t necessarily prevent endemic disease. My understanding is that at this point, vaccines are about keeping symptoms mild and ICUs at low capacity through reduced spread and more effective immune responses. This seems compatible with the view that we will have to live with this disease for a long time.
Why doesn't this solve the whole problem? I would intuitively assume almost any given person has already been either vaccinated or infected or both by today so severe cases should be rare.
Partially effective vaccines are good enough to basically eradicate the virus if everybody gets them. No country will continue pandemic measures after a sufficient number of people are vaccinated.
The first and primary public focus was always to prevent severe illness and death and alleviate the load on hospitals. Messaging on that has been fairly consistent.
Some countries pursued an eradication goal early on and some public health officials publicly spoke about their hope to achieve that, but while that was possible with the wild type it no longer is with the variants and animal reservoirs. It was a reasonable, rational strategy at the time, later undermined by the nature of new mutations.
You’re attempting to redefine the baseline of what’s considered acceptable for a vaccine, beyond what has ever been the case. In fact the vaccine most people would be aware of and have come into contact with, the flu vaccine, only partially protects against severe illness.
We have only been able to eradicate two viruses in human history through vaccination. In all other cases it’s a tool used to prevent worse outcomes and control the disease’s severity and spread.
Nonetheless, new vaccines that better target variants like Delta and Omicron, and hopefully any new ones that may emerge, are already in active development and trials. So we will see improvements in our ability to protect people against COVID-19.
Don’t get me wrong. The vaccines are great at preventing severe disease. But they won’t prevent an outbreak of 20-30% of your population is unvaccinated.
Data seem to point at keeping some level of restrictions until everyone who is vulnerable has an opportunity to get the vaccine. Otherwise you’ll be dealing with outbreaks - smaller in scale, but outbreaks none the less.
I agree with most everything, except I'm not quite sold on vaccines as the a silver bullet:
1) We don't quite understand the impact of a new disease on the vaccinated. /Many/ diseases have debilitating long-term effects. Some vaccines -- for example rabies -- prevent that. Others don't.
2) We don't know how well vaccines will work for future disease.
I view them more as part of a comprehensive solution. What I would have liked to see with COVID, and with future diseases, is a sufficient zero-COVID policy everywhere to stop the disease, as happened with smaller outbreaks in recent years.
My general conclusion is that we ought to have:
- Enough manufacturing capacity to provide everyone in the world with high-filtration masks, disinfecting wipes, plastic gloves, and similar basic supplies
- Enough vaccine manufacturing capacity to be able to roll out an mRNA vaccine to 7 billion people in a few months at most
- Enough manufacturing capacity to be able to spin out things like antigen and PCR tests quickly
- Some plan for supply chains to get everyone food if we need another lockdown
- Plans for contact tracing, ideally with practice drills.
- Perhaps, some plan for how our economy doesn't implode on a lockdown. This went surprisingly well with covid19, but I feel a little bit by fluke.
To be fair, the vaccines we have today were literally the first ones out of the gate, and they should be considered a stopgap solution that only serves to mitigate the problems caused by the global pandemic, but they patently don't work in eliminating it or even reach herd immunity.
Basically the current batch of vaccines (the best ones, to boot) just train the immune system for it to have a fighting chance at not being overwhelmed by covid. But that's it.
Some vaccination locations even make it their point to distribute pamphlets stating quite clear that the vaccine is not a silver bullet, and all basic health and higiene precautions in place should continue to be followed.
It's far too early to talk about preventing mutations or any scenario where the current vaccines making covid is a thing of the past. If anything, the economical gains from the vaccines illustrate that much needs to be done to get a better, long-term solution.
Preventing severe infection is a fine endpoint though. A vaccine or treatment that does that is a minimum viable tool for moving forward.
Reduces deaths, reduces utilization of medical resources, etc, and then when it's a vaccine, it's pretty likely that it also reduces transmission. But it doesn't need to reduce transmission to be worth an awful lot.
Mortality is going to be dramatically reduced once nearly everyone has T-cells+B-cells that recognize the virus. If everyone got vaccinated we'd be out of the pandemic phase and into the endemic phase with a virus that looked more like just a flu/cold.
Vaccines are a 10x or 20x improvement in death and hospitalization rates. That's just a fact. All these antivirals won't have that kind of impact and are closing the barn doors after the horse has escaped. Which is not to say we don't research both, but vaccination is the simple easy and effective answer. There's a considerable technological fetish with antivirals while boring vaccines are now treated with skepticism, which is backwards. Antivirals should be used after vaccines have failed in vulnerable populations, the major weapon against viruses is vaccines, and they work.
If the vaccines are so fantastic at preventing hospitalizations and deaths, and they've been taken up by the vast majority of the elderly who are most at risk, then why are we still trying to slow the spread of an endemic respiratory virus?
Seems we've forgotten all about how viruses work over the last couple of years.
Without a vaccine, viruses will still evolve to be less virulent and more transmissible, leading to endemic status. Within this a large number of the population gain natural immunity also reducing spread.
Vaccines, done poorly and too frequently, cause vaccine escape where the immune system actually does a worse job fighting infection and you get more virus (aside other immune system issues). Which is exactly what we're seeing now where a lot of places have more hospitalisation and death per capita in the vaccinated...two years into the pandemic
The most ignorant thing to think at the moment is 'just need more jabbing.'
The problem with that sort of thinking is if you let the virus circulate and multiply you are risking mutations that are resistant to the vaccines. There already are two mutations that are already somewhat resistant to the vaccines according to initial anecdotal evidence.
But practically speaking most nations are taking this approach and have been reducing social distancing measures when hospitalization rates go down. (Often with negative results.)
Mass vaccination isn't expected to stop the disease from spreading. I know some regions have made plans under the assumption that vaccines will eradicate the virus, but no experts that I'm aware of think that's likely. (Other countries have said that they're just going to be okay with whatever level of disease burden exists after a vaccine, which I think is a defensible plan.)
The plan was always iterative lockdowns, followed by loosening of restrictions, as the virus is much more deadly when hospitals are overwhelmed. The earliest studies and models clearly recommend this as widespread natural immunity is a guaranteed way though and a successful vaccine is not.
Human nature and politics have played their role, from both directions, for better or worse. So we’re all just betting on a vaccine, now.
What worries me is that there doesn't seem to be some global coordination in the distribution of the vaccines. It looks more like an individual race, than a synchronized collective effort.
In the scenario where only the old accept to get vaccinated, and the vaccine doesn't reach the required threshold to stomp the virus. The virus become manageable, the economy reopen but the virus run rampant in the asymptotic population slowly mutating over-time until it finds a variant that is resistant to the vaccine by successfully infecting a vaccinated person.
And it just needs for this to happen in a large population cluster where the vaccination doesn't reach the threshold, either because they do not have access to the vaccine yet or because some fraction of the population decide to not get vaccinated, for everyone to get screwed-up again.
There are far, far too many of them compared to the number of vaccination treatments currently available. It wouldn't make a dent. Better to treat the much smaller number of people in high risk groups.
I have been assuming the idea of these vaccines was to buy time until a new one gets developed that also stops transmission. Ie, I assume we will all get a second vaccine one day that’s better that can have a shot at wiping Covid out, if we get really lucky and everyone takes it
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