Response from Alex Altair to a social media post I wrote containing some of the claims above:
I feel quite strongly confused about why someone would think that future COVID risk might be permanently as high as it currently is. (You didn’t say literally this, but you’ve said/shared a bunch of things that make me think that’s what you believe; please correct me if I’m wrong!)
I will grant that it is physically possible; like, I’m not laboring under the illusion that there is some natural baseline risk that reality equilibrates to. The world could at any time become permanently more dangerous.
But like… that basically just doesn’t seem to happen with diseases? Over the bazillion years of human history, a lot of pandemics have occurred, and none of them proceeded to continuously exist at the risk level that COVID is currently occurring. The flu did mutate and stick around mightily, but annual flu deaths are an order of magnitude lower than COVID.
I do fully expect COVID to become endemic at this point, and I don’t think I ever believed we were going to eradicate it. But almost all diseases somehow end up receding to a very low level of daily risk, and I have no reason to think that COVID is different. So to me, the current case rates are clearly a spike of risk worth changing my behavior for, and worth waiting out. Not going to indoor unmasked parties is one of the easiest ways to reduce that risk.
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I could imagine that the amortized case rates don’t go down much over the next few years, but I do expect it to continue having these exponential rises and falls, such that one can efficiently reduce most of the risk (the current spike being one of those times).
I feel like the “diseases just naturally become not-dangerous” perspective neglects smallpox and other extremely deadly endemic viruses which we have used vaccination to control or eradicate.
The flu did mutate and stick around mightily, but annual flu deaths are an order of magnitude lower than COVID.
Maybe this is what you’re already saying, but I want to highlight something specific:
My understanding is this isn’t about the virus mutating to become less deadly, but more because endemic viruses encounter non-naive immune systems, which is true for flus but not for sars-ncov-2 (so far). T-cells have basically lifetime memory I think (longer than antibodies?). This is similar to how european diseases were so devastating to indigenous folk (and I think vice versa in one case?) because of naive immune systems.
And this prepared defense effect might be stronger for people who actually got sick than folks who got the vaccine (I feel like I saw this somewhere but am very unsure) but in either case the odds of this being worse than the flu are now pretty low and it seems to me vaccinated folks should at this point treat covid roughly like the flu—get a shot now and then, and don’t visit your grandparents if you think you might have it, but otherwise don’t worry about it.
Hold on. That seems to be very wrong. The world became permanently more dangerous when smallpox, cholera, typhoid, measles, mumps, and the flu jumped to humans. That only stopped being true when vaccines were developed. I think it bodes pretty well for the outlook of COVID, if we keep vaccinating. But so far as I know, it’s definitely not the case that smallpox ever became less deadly on its own.
I agree with Alex’s first points, but it’s not clear to me that this part follows:
So to me, the current case rates are clearly a spike of risk worth changing my behavior for, and worth waiting out.
It seems likely that there will be a spike this winter, but then by next summer (and the following winter) COVID will have faded to just being a flu-like minor consideration.
In which case, yeah this is not the new normal forever, but also it’ll probably get worse one more time before it gets better.
Maybe call this the “bouncing ball” model. Each bounce lower than the last. At some point the bounces are too low to care about. We probably have one non-trivial bounce left.
Response from Alex Altair to a social media post I wrote containing some of the claims above:
I feel like the “diseases just naturally become not-dangerous” perspective neglects smallpox and other extremely deadly endemic viruses which we have used vaccination to control or eradicate.
Maybe this is what you’re already saying, but I want to highlight something specific:
My understanding is this isn’t about the virus mutating to become less deadly, but more because endemic viruses encounter non-naive immune systems, which is true for flus but not for sars-ncov-2 (so far). T-cells have basically lifetime memory I think (longer than antibodies?). This is similar to how european diseases were so devastating to indigenous folk (and I think vice versa in one case?) because of naive immune systems.
And this prepared defense effect might be stronger for people who actually got sick than folks who got the vaccine (I feel like I saw this somewhere but am very unsure) but in either case the odds of this being worse than the flu are now pretty low and it seems to me vaccinated folks should at this point treat covid roughly like the flu—get a shot now and then, and don’t visit your grandparents if you think you might have it, but otherwise don’t worry about it.
I’m getting much of this from this source, which bases its reasoning on various claims I’m not qualified to assess. Would love to hear others thoughts: Why COVID-19 Is Here to Stay, and Why You Shouldn’t Worry About It
Hold on. That seems to be very wrong. The world became permanently more dangerous when smallpox, cholera, typhoid, measles, mumps, and the flu jumped to humans. That only stopped being true when vaccines were developed. I think it bodes pretty well for the outlook of COVID, if we keep vaccinating. But so far as I know, it’s definitely not the case that smallpox ever became less deadly on its own.
I agree with Alex’s first points, but it’s not clear to me that this part follows:
It seems likely that there will be a spike this winter, but then by next summer (and the following winter) COVID will have faded to just being a flu-like minor consideration.
In which case, yeah this is not the new normal forever, but also it’ll probably get worse one more time before it gets better.
Maybe call this the “bouncing ball” model. Each bounce lower than the last. At some point the bounces are too low to care about. We probably have one non-trivial bounce left.