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Cliff note: wait and see. Transmissibility and/or ability to punch through immunity may be higher. Severity may be lower. We don’t know by how much overall.
We should all be hoping that severity takes a hit.
I've seen the theory that the only real endgame for COVID in the face of variants, hesitancy, etc. is a variant that outcompetes others but causes only mild symptoms. This would follow the pattern of the 1918 ("Spanish" but should really be "Kansas") flu. I don't want to downplay it, but it almost seems like omicron is a step in that direction. Keeping my fingers crossed, for sure.
Do they know how many years from 1918 it took before it got to be the normal (still quite lethal for compromised immune systems) flu?
The main part of the pandemic included three waves over almost exactly two years, starting in April 1917. There were "aftershocks" in 1920-21 but those were clearly less virulent strains. OTOH, similar/related H1N1 strains continue to reach concerning levels every few years even today.
Wasn't there news about how as a virus mutates over time it becomes less severe, but more transmissible? Something about where the virus just wants its host to live long enough to transmit the virus to someone else so it can continue passing its genetic data over. It seems like Omicron could be following this pattern.
If you have too severe of a virus, then all its hosts are killed and it can't live on. Too weak of a virus and the host's immune systems will kill it before it has a chance to transmit.
> Wasn't there news about how as a virus mutates over time it becomes less severe, but more transmissible?
That's sort of a rule-of-thumb, not a fixed law. In the case of covid there's a relatively long period of time (up to several days) in which people can spread the virus without yet showing symptoms. As such there isn't a lot of evolutionary pressure for it to become less virulent.
True, there's no selective pressure for it to become less lethal.
But I wonder: isn't a random mutation unlikely to improve on any of its profiles (transmissibility or lethality)? If so a more transmissible virus is unlikely to also be more lethal.
What if (not sure) a random mutation actually tends to do slightly worse? Then more transmissible viruses tend to be less lethal over time.
Sure we still get more lethal mutations from time to time, but the more transmissible ones are the ones which win out.
The people have dramatically altered their behavior on a global scale (on average anyways) because of COVID’s lethality. There is absolutely selective pressure in that dimension.
If the lethality of Covid were to drop to seasonal flu levels there wouldn’t be anywhere near the amount of research into medical interventions nor would we feasibly maintain our current levels of public health interventions.
I'm no expert but my understanding is that unfortunately there is some correlation between transmissibility and severity of disease, because one of the ways it can become more transmissible is to reproduce in your cells faster so that you shed more virus particles. This also means it takes over quicker and your immune system has less time to respond before it does lots of damage.
Whether that outweighs the randomness you describe I don't know. Maybe nobody knows for this virus?
Well if the two events (improved transimissibility and improved lethality) are not independent as I assumed then it's certainly bad news.
I also heard the opposite thesis btw, higher transimissibility might sacrifice something in terms of lethality. Like you can't really add much as I'm not an expert.
> random mutation unlikely to improve
indeed, but subsequent success or failure does. Mutation and selection. Mutation prepares the pool to sieve the successful ones.
Yes my point is, when you do improve one (transimissibility) you probably did not improve the other one (or even got worse at it).
With delta and asymptomatic transmission this wasn’t totally the case iirc.
Increased viral load in the asymptomatic phase increased virality, but also increased deadliness once the symptoms started. At least that’s what I recall reading. Normally you’re correct, but it doesn’t necessarily need to be that way.
Hopefully we’re lucky and it’s both way more transmissible and way less deadly, but no one knows yet.
Delta was more severe than the original strain, but there was some evidence indicating it was slightly less severe than Alpha (and much more transmissible than Alpha).
In order for this to occur, there needs to be a selection pressure. It doesn't just magically happen.
The virus behind Marek's disease in chickens hasn't gotten less severe over time, it's gotten much, much more severe, as an example. HIV does not seem to have gotten less severe, nor smallpox.
The virus behind Marek's disease in chickens got much more severe because of the leaky vaccine used on chickens.
Here's some introductory material:
https://www.pbs.org/newshour/science/tthis-chicken-vaccine-makes-virus-dangerous
https://www.nationalgeographic.com/science/article/leaky-vaccines-enhance-spread-of-deadlier-chicken-viruses
https://www.youtube.com/watch?v=haRMKsI-jKY
And here are a couple of papers:
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002198
https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002236
This is true (and hopefully so w/ Omicron) when looked at a long enough time scale.
The real concern is if we're currently in the "still getting worse before it gets better" part of the timeline.
We're all waiting to see how many severe hospitalizations occur w/ a large enough population.
That's the theory behind spanish flu mutating into the less severe seasonal flu strains we learned to live with.
>If you have too severe of a virus, then all its hosts are killed and it can't live on.
Ever played "Plague Inc" ?
Its a fascicle way to show how this model is unlikely to play itself out in todays hyper mobile population.
Is COVID going to continuously mutate worse and worse forever? What’s our end-game here?
It’s not getting worse. The treatments are now good enough that your chance of dying is extremely low if you’re vaccinated. Honestly starting to wonder why people are so worried.
My understanding is that the potential for long lasting Covid symptoms is not insignificant, vaccinated or not, and from what I’ve read of long covid, it should be avoided.
The idea of facing issues with exhaustion and worsened mental health for months on end sounds like a nightmare.
My whole family caught covid around 5-6 weeks ago. Kids had super-mild symptoms (way less than the flu). I had pretty mild symptoms, but have had a persistent cough (I've had that with some other colds though).
My wife got hit pretty hard (no hospital though). She would up with a cough too, but the worst part has been headaches. Worst headaches of her life for almost 3 weeks. Thankfully, they seem to be getting more intermittent and less intense.
From what I’ve read long lasting symptoms are very rare too, but the longer this goes on the more we’ll know about the long term effects of both COVID and vaccines. It’s kind of like a chronic lyme disease thing though, it’s really hard to prove whats going on with some people.
You can't avoid it. We'll all eventually be exposed.
https://www.medpagetoday.com/opinion/vinay-prasad/94646
I'm worried about being in a traffic accident and not getting timely treatment because all nearby ICUs are already filled beyond capacity with Covid patients.
The media makes money, the drug companies make money, and politicians get political benefits if people are afraid.
People are still dying at a rate of about a thousand a day due to Covid in the U.S.. The vast majority of those people are unvaccinated, but still a death is a death, and a thousand deaths a day is definitely newsworthy even if (or even especially if) it was avoidable.
That happens without covid to
This is definitely true, but the world is still in emergency mode. This we can’t maintain forever.
I’m all for vaccines and safety measures, but feel really burnt out by the situation.
Two years conditioning from the media also "taking it seriously" is tribe and class affiliation signaling.
Very unclear.
In spite of some propaganda trying to instil the epistemological blasphemy that called anecdotal phenomena irrelevant, "some of us know people directly" to have the notion that consequences should not be taken lightly. And this is valid for the bad-lottery tickets in both infection and vaccination. The risk averse have material for concern.
> What’s our end-game here?
Get to >90% population immunity. For now, it seems that's around the level that hospitalizations and deaths are manageable.
It'll mutate to be better. Virus does not want to kill its host. Virus wants its host to be alive and well and just sneeze all the time, spreading virus around. That's the long time game, though, of course in the short time there could be worse kinds. Omicron seems like a step in right direction.
> Virus wants its host to be alive and well
A virus doesn't want anything. It just exists and, if the environment is amenable, reproduces with mutations.
I don't understand the downvotes.
My comment is in response to a 100% scientifically false statement. It's like saying that heat flows from cold to hot. Saying that viruses "want" is as false as that, if not worse.
The correction I posted is 100% scientifically correct, does not personally attack anyone and isn't even pedantic. Are we in favor of misinformation now?
To be fair, articles like this one [0], don't help when they get loose with language and say things like "SARS-CoV-2 is one smart virus". Ironic, when the site's tagline includes the term "academic rigor".
At one point in the article they say:
"Of course, viruses and bacteria don’t have brains so they don’t “think,” per se. But like all life forms, these particular living creatures are trying to maximize their chances of reproducing and having their offspring survive and reproduce."
That starts out well. The first sentence is accurate. The second sentence is false as can be. A sad failure for a publication that claims to have "academic rigor".
Viruses don't "try" --which implies a directed objective, thought, intent, goals-- to do anything. Evolution is brutally simple and ridiculously stupid. It has no intent. It has no objectives. I doesn't say "let's make an eye" for a million years until done. It just happens. I know this is hard for some to understand, yet this is the truth.
I can understand how people who have not studied and understood the scientific theory of evolution by natural selection can develop false ideas about how it works, particularly when exposed to material, such as this article, that mix false statements with accurate information.
That second word, understood, is important. Every high school student learns about evolution. I don't think I can say most of them understand it.
SARS-CoV-2 is as smart as a key with 30,000 teeth. Evolution is a process with stochastic mutation that cuts the teeth in different configurations. If a given configuration happens to be effective at penetrating human defenses and do damage, it can be serious. Other configurations could penetrate and have little to mild effects (this, so far, appears to be the case with Omicron). And yet others could be completely ineffective. The mutation isn't directed, it's stochastic.
Above all, I think rigor is important because, without it, crazy ideas like "intelligent design" can find footholds that can be used or further distorted to support them.
[0]
https://theconversation.com/think-like-a-virus-to-understand...
Lockdowns (and masks?) have shown that the spread of COVID and the 'flu can be slowed down. If governments can implement lockdowns and not cause too much harm to the population, I reckon we can beat these diseases.
Edit: add masks
Lockdowns by definition harm the population psychologically and economically. For merely slowing it down when it won't stop it from circulating or mutating, I don't see what the point would be by now unless we get a variant that is dramatically more dangerous than Delta and renders vaccines utterly useless which doesn't seem to be the case with this one (and even then it's a last recourse that isn't to be taken lightly).
> Is COVID going to continuously mutate worse and worse forever?
Evolution does not have objectives like "let's make an eye" or "let's get worse". Organisms mutate and either thrive and reproduce (with mutations) or die off over time.
Because of this, I think the answer to your question is: There is no way to know.
There might be epidemiologists or researchers on HN who could offer a different perspective. I am sure there are other mechanisms at play. There's also understanding the statistical behavior of mass infections.
Judging by how long other viruses have been around, we will not see the end game within our lifetimes assuming no dramatic advances in life extension occur. So don’t worry about it, this is our life now.
They buried the lead somewhat
Omicron can infect 3 to 6 times as many people as Delta, over the same time period
That's ominous if true
Is it really though, if it's less lethal?
With covid we need to move beyond infection rates and just focus on deaths and really start getting ready for the long haul as its not going anywhere and we will never beat covid. Every year will see a new variant, as much the same as every flu virus before it.
If you want to have the same ratio of deaths then it has to be much much milder. But furin cleavage and all that. Not happening apparently.
And then you have long debilitating covid. If it's not gone - unlikely - then it's most likely worse.
Warning, I just follow some Twitter accounts. But some scientists who have a good track record with their comments on covid since it started are very much concerned.
I think this was meant as "Omicron can infect 3 to 6 times as many people as Delta [considering that a lot of people already have immunity to Delta]", this chart was enlightening for me:
>Under a scenario of 90% population immunity against previous variants, we get the following picture where Omicron could lie anywhere along the dashed line ranging from an intrinsic R0 of 3 and 83% immune escape to an intrinsic R0 of 9 and 20% immune escape.
https://twitter.com/trvrb/status/1466076797670363140
*lede
According to "Tom Wenseleers, an evolutionary biologist at KU-Leuven in Belgium [who like all people is trying to make a name and reputation for themselves, and reluctantly recognizes the competitive nature of academia and the need for using hyperbole to stay competitive in that marketplace of ideas]" (Emphasis mine).
Bring on the downvotes, folks. I know we all want to take part in the "sky is falling narrative" but hopefully this will help you wake up, especially if what I said has you triggered.
Following that German minister's line of thinking that stated "by the end of this winter pretty much everyone in Germany will be vaccinated, recovered or dead" it's a really good news to expend quickly the second category. The sooner everyone will have antibodies, be it from natural immunity or paid one, the sooner society can stop revolving around saving a few months of life of a bunch of elderly at the expense of everything else.
Maybe you missed the news that naturally acquired antibodies aren't necessarily effective against further variants.[0] I wouldn't be so glib about hoping that millions get infected. If it turns out that Omicron is decidedly less deadly than the prior mutations, that of itself will shape policy decisions toward fewer restrictions. But if it's as deadly or more deadly, our best option is for a slow spread so we have time to revise our treatments as needed without unnecessary loss of life.
[0]
https://www.nytimes.com/2021/12/02/world/africa/virus-omicro...
I follow medcram on youtube, he's a doctor and dives into COVID related topics. He gives his opinion, and provides sources on the papers he references. Generally the research presented made a case that getting COVID provided better protection than the vaccines, until Delta.
Similarly Omicron seems to have a higher breakthrough rate for vaccinated folks than the previous variants.
_Prior Infection Is Little Defense Against Virus Variant, Scientists Say_ claims the NYT based on a study that found thet 2.7% of subjects might have been reinfected.
From where does NYT derive that conclusion?
Predictable downvotes, but you are right that the sooner we lose the unwinnable war the better.
Predictable uninformed comment.
The more infections there are the more variants and more fit variants there are. Only a zero COVID policy with global technology sharing will realistically end this.
Plenty of pandemics have come and gone, this one will pass too, and global technology sharing or not will probably have a negligible impact on that timeline. How many times have we seen a region or country held up as a model for success for whatever reason (lockdowns, vaccines, etc.) only to be a hotspot months later?
Just get vaccinated, avoid crowded poorly ventilated places, stop trying to herd 7 billion cats, and move on with your life.
> Plenty of pandemics have come and gone, this one will pass too
A lot of them lasted for centuries. People would get it and play the lottery, maybe 3 in 10 would die, the rest develop immunity for example.
Most pandemics either end because too many people die, and you're only left with the immune survivors, like the plague. Or they end because of improvement to public health and sanitary practices. Vaccines ended smallpox, condoms and awareness reduced AIDS impact, better water sanitization ended cholera, even the plague ended with help by quarantine and lockdowns.
I'm not sure how this one will end, but they almost never "just end" magically. Either some level of herd immunity is achieved, for example by having everyone have it very quickly, and being left with only immune survivors, or the spread is contained through public measures, or immunity is achieved through vaccination, or a drug to cure it is found.
>Plenty of pandemics have come and gone
Honest question, how does this one go away on the timescale of a few years to a decade (or, worst case in what truly interests us, a generation)? Couldn't seem to find an answer on pubmed or scholar when I looked, I'm jabbed and have been mindful this whole time but my logic tells me that is not happening. We'd have to get it's R0 low enough that it disappears before mutating a variant that escapes immunity (if that is even necessary given the likelihood of impermanent immunity, at least partial). Is that possible barring a new type of vaccine that entirely prevents infection and reinfection for which we'd have to get full planetary coverage of in time?
SARS-CoV-2 will never disappear. While the vaccines are pretty good at preventing deaths they don't reliably prevent infection or transmission. Even if we had more effective vaccines, the virus stll spreads and mutates in other animal species.
There is no real risk that a new variant will completely evade immunity from previous infections. Nothing is 100%. Over the long run it will probably play out similar to the previous coronavirus pandemic. Fortunately this time we have vaccines and other treatments which can prevent most deaths.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252012/
A zero COVID policy is impossible. While the vaccines a pretty good at preventing deaths they don't reliably prevent infection or transmission. The virus is also spread by animals.
No. Also it's kinda over already, save for the media fearmongering. It's ridiculous to expect 0 death worldwide for any disease. We have to accept a few people will die of it from times to times, just like it is with the flu (which is targeting the same population anyway so nothing really changed).
I never understand these comments. We try are prevent deaths for all diseases. Infectious diseases are probably the easiest ones to prevent. Yet, we have these odd comments that we should allow people to die just as we allow people to die with the flu. We don't just allow people to die of the flu either, we try and vaccinate vulnerable groups. But ignorant comments such as this stand in the way of these effects. Just as it stands in the way of effectively dealing with Covid.
The issue is this disease is killing younger people than those who typically die of the flu. There number of general hospitalizations is significantly higher, with more longer lasting after infection effects.
Nearly all my friends who have had Covid can't taste or smell. That alone should scare you. I have not had it, because I am vaccinated and wear a mask while I do my normal social activities here in South Africa.
How's our track record at preventing influenza or the common cold, both of which are transmitted as airborne viruses?
The problem is that most of the things that governments around the world have been doing to try to combat corona are completely useless, and carry a huge cost for society. We're killing people with lockdowns and school closures and by limiting medical procedures. Suicides among children and teenagers are up. Deaths of despair are up. Cancer screenings are down. The future healthcare debt is just piling up. If our strategy is killing more people than we're saving, we should stop and re-think the strategy!
The hubris is enormous. Countries _think_ they can eradicate sars-cov-2, and every single attempt has been an abysmal failure. Omicron has been detected in Australia. How? They have incredibly strict border controls, quarantine camps, vaccine requirements and testing requirements for travelers, and yet the virus slipped through.
OP isn't saying we should throw our hands in the air and just ignore the virus, but we also shouldn't double down on useless measures that do more harm than good, and we shouldn't succumb to wishful thinking that the virus can be magically erased if only everyone did X.
Your comments about Australia are incorrect. We have one "quarantine camp", Howard Springs in Darwin, and it is only for incoming travellers. Two are being constructed and will be used longer term, and not just for COVID, remembering that Asia has been through a number of equivalent pandemics (SARS, MERS) over the last 20 years.
Those that arrive through other locations (eg Melbourne, Sydney) etc were quarantined through hotel quarantine, which had/has leaks.
Our infection rate from COVID is substantially lower than other countries of similar size and economy, our hospitalization and death rates are substantially lower as well.
We have achieved 80-90+% vaccination rates for the majority of the population (ie 12+) and have started rolling out the 3rd shot/booster as well as planning for vaccination of 5+ starting early next year, hopefully getting 5+ kids vaccinated early in the school term.
The people protesting and complaining are a very small but noisy minority, and their arguments are becoming less and less relevant. In the two largest states, Victoria and NSW, we are "living with" COVID, with minimal restrictions (masks in internal retail spaces, hospitals and other vulnerable population locations, requirement for double vaccination in most businesses etc).
We're not trying (anymore) to "eradicate" covid, we're adapting to it, but in a way that maximizes safety and minimizes risk.
> How's our track record at preventing influenza or the common cold, both of which are transmitted as airborne viruses
Anecdotally, me and my family have not been sick with the cold or flu ounce since all the Covid measures started. Normally we all get sick with the cold or flu at least ounce a year if not more, but now for over 2 years not sick ounce.
So it does seem like the measures do work to contain the spread of airborne disease to some extent. Will it be enough to eradicate Covid, probably not, that I can concess.
There's still more than "a few" people dying "from time to time", so even by your metric, it is not over, or anywhere near over.
Yes, about 300,000 americans (taking us over 1 million deaths) will probably die in the next four-five months given the current numbers.
Definitely not a few.
We were on the downslide of the third big bump of COVID deaths per worldometers, but let's face it, there's going to be a big fourth even without Omicron from the infections from far less restrained Xmas/Thanksgiving get togethers.
I hope I'm wrong...
A large chunk of those deaths is due to the lack of urgency to get people vaccinated, as well as, somehow, your _political_ allegiance deciding whether you get vaccinated, stop spreading disease by mask usage etc.
The US is one of the worst examples of COVID response, both during Trump's era and the post-Trump/QAnon/Fox/OAN/etc spread of bullshit propaganda.
It's not Xmas/Thanksgiving that's the issue, it's the lack of following logical safety and vaccination measures, somehow tied to "freedom" without considering the "general welfare".
ICU nurses would strongly disagree with it being "kinda over already", at least where I live.
Assuming you live in the US, that is the kind of thing a person living in the country with the most deaths in the world would say.
> Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith.
> Eschew flamebait. Avoid unrelated controversies and generic tangents.
Tone policing someone protesting a call for millions of deaths is really something.
A doctor mentioned to me that it's not known in the history of viruses, that a virus mutates this much and stays as deadly.
So let's hope!
Historically speaking, it isn't really deadly. Never before has a virus had a host population composed of so many people who are living despite old age, immunocompromising medical conditions, and diabetes.
Even the present death rate for the untreated (at ~3%) would historically be quite weak for an epidemic. I'm not sure it would even make history books (as a "bad flu") pre-enlightenment.
People die, it's deadly.
The statement remains.
By that measure, the flu is deadly.
"deadly" is not the same statement as "as deadly".
I'm not replying on my own comment. I'm replying on his definition of deadly.
The statement used as deadly and indeed wasn't affected by it. Statement remains valid ;)
A doctor that hasn't heard of the flu?
The short answer: as bad as Pfizer–BioNtech say it is.
Travelers. Do not click. They have no answers and are baiting with fear.
Thanks, postponed some travel plans to SEAsia today because I don't want to get stuck there again amid lockdowns / travel bans.
Thank you, father. The stars are right. Let us proceed to the reef tonight.