An Indictment of US Covid Policy

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Reader GM, who has an aura-of-burning-rubber resume (membership of several elite scientific institutions) and hangs with scientists who have published dozens of cutting-edge immunology papers, including on topics directly relevant to the intricacies of Covid pathogenesis, has provided, through a series of e-mails, a damning critique of US Covid policy. Thanks to America’s status in the global economy, it is well nigh impossible for other countries to pursue a markedly different path. As he described in a recent e-mail:

The question that I have no answer to is when exactly was it decided to not contain it. If you remember, some information came out about early and mid-February 2020 closed Senate meetings, after which senators were selling their shares in hotels and airlines, i.e. what was going to happen in late March was known at that time. But it was not in fact too late to contain it in early February, it could have been done with test-trace-isolate. So maybe it was perceived at the time that it could not be, assuming the decision was made as late as possible within that timeline. But the earlier that decision happened, the more nefarious motivations one would have to suspect were involved, because why would you not at least try to contain it when it was eminently doable? After all SARS-1 was contained even though it reached hundreds of cases in Canada and the US. And then what followed was the outright sabotage of testing and detection by the CDC,1 the CDC allowing strongly suspected to be infected people to just get off their flight and walk right back into the community, and a rather long list of other such absurd actions. Maybe one day internal information will leak and we will learn the truth, who knows…

Also, this all becomes even more gruesome when one realizes that the decision of the US to allow it to become endemic meant the same decision was imposed on most of the rest of the world, as the US controls it. As I said above, Eastern Europe (except for Belarus and Russia) took it very seriously early on and locked down before it had gotten out of hand, and was in fact very close to elimination. Montenegro, which eventually ended up being one of the worst affected countries, actually did eliminate it in May 2020.

But once it became clear the US will not eliminate and the EU will not eliminate, those countries had no choice, although they could have at least held out for vaccines instead of letting it rip. There was never going to be a world in which the EU and Latin America have indefinitely banned travel out of the US, not with US military bases stationed all over Europe. And there was never going to be a world in which Bulgaria and Romania ban travel from Germany.

The really sad part is that a country like Russia supposedly does have that independence, and could have gone for elimination and closed borders and a bubble with China. But modern Russia is not the USSR, it’s just as, if not more neoliberal than the US, so they let it rip too, for the same reasons as in the US…

And now some the countries that did the right thing — Taiwan, Vietnam, and Laos — are encircled and battling their worst outbreaks since the start, which is heartbreaking to watch.

Even this site, early on, inferred that both the Trump and Biden Administrations were relying on magic Covid vaccines as pretty much their only Covid strategy. Policy-makers and public health officials were unwilling and/or unable to pursue a path of eradication, which in practice is aggressive minimization: hard lockdowns, followed up by opening only areas where new infections are effectively nil, testing at-risk populations often, and engaging in contact tracing and quarantines. Our rejection of quarantines was a tell that the chosen path instead was simply to keep hospitalizations to a manageable level.2 And bugger any consideration of morbidity.

Quite a few of those who are neither in the Biden-aligned PMC bubble nor anti-vaxxers/anti-maskers, like the biggest nurses unions in America, are upset and confused by the Biden Administration’s Covid “Mission Accomplished” directive of “ditch masks and social distancing if you are among the fully vaccinated ‘cool kids’ group.”3 Even if you buy the proposition vaccines alone can vanquish Covid, this was utterly irresponsible messaging. Where was the warning that the vaccinated will need another shot by early-mid fall?

So far, the main propagator of the notion that boosters are coming has been the drug companies themselves, rather than public health officials. But my impression is that even then, no one has been willing to suggest more than an annual shot.

By contrast, former Harvard Medical School/Harvard School of Public Health professor William Haseltine in Forbes warned that booster jabs for mRNA vaccines to combat variants were probably needed six months after the second shot .

Haseltine recaps new research from Moderna, whose vaccine confers the best immunity. It shows that immunity to new variants, as shown by antibody levels, is likely to last only 6 months from the initial shots, and for The Original Covid, eight months. Some researchers argue that T cell and memory B cell immunity could last longer; Haseltine isn’t willing to bet the farm on that.

This finding is consistent with our uninformed layperson best guess. We repeatedly pointed out that experts estimated that immunity after having contracted Covid lasts six to eight months. Even though we accepted the notion that vaccine-conferred immunity would be more robust (as in would enable the recipient to combat higher viral loads and might also offer more protection against variants), that didn’t amount to proof that vaccine-conferred immunity was longer-lived.4

From Haseltine:

The majority of new infections in the US, Europe, and most other countries are now driven by variants….

A new preprint study conducted by Moderna describes both the hope and challenge of booster vaccines as an approach to the solution to the problem of variants. Their booster shots appear to be effective at neutralizing at least two of the new variants, B.1.351 and P.1. But importantly, their preprint study also revealed the first-generation Moderna vaccine doesn’t protect against the variants for as long as we initially hoped…

When tested for its ability to neutralize the P.1 and B.1.351 strains, the antibodies generated by the Moderna vaccine against the original strain dropped to low or undetectable levels six to eight months after the second dose…If two doses of the Moderna vaccine amount to six months of protection against the variants, other vaccines are likely to guarantee less.

So not only is the Biden Administration failing to prepare the public that those who’ve gotten their shots will need to take another in a few months, they’ve also effectively trash-talked what proved to be pretty effective public health strategies of masking and social distancing. Look at how New York City went from being a Covid disaster area to a good performer before vaccinations were readily available. Yet Team Biden has effectively endorsed the Covid-denier line that wearing masks is oppressive.

GM warned where the combination of infection level and vaccine effectiveness lead:

Unfortunately, with many respected scientists jumping on board of the optimism hype train (it was quite noticeable how the mood shifted on purely scientific matters that had absolutely nothing to do with politics a few months ago), the wrong message has already been once again sent to the public, and we can expect disaster in the future.

Non-sterilizing vaccines mean the virus will not only get the chance to evolve complete escape but will be channeled in that direction. But it also may be channeled in the direction of being much more virulent as a side effect of its fight with the vaccines (this can get quite detailed on a molecular level so I will not go into it right now).

The math does not look good — the unmitigated-spread R_0 in February 2020 was much closer to 6.0 than to the usually cited 2.0. But the current variants have undergone adaptation and are much more contagious. Let’s say we have R_0 = 6. And let’s say we reach 70% vaccination (it’s hard to see how we will get higher), and that transmission is cut by 80% (this, however, is simplistic — it is quite likely that transmission is cut by 80% in the first couple months after vaccination, but then the first thing that will wear off is protection from infection, with protection from severe disease going away last). That’s 56% effective vaccination. But the herd immunity threshold for R_0=6 is 85%, a lot higher, i.e. it will continue to spread. It might in fact continue to spread even with 100% vaccination with a full return to 2019 in terms of lack of social distancing.

So we should absolutely never have gone down the path of “solving” this crisis with vaccines and not doing anything to stop transmission. The vaccines should have been used as one of the tools to eliminate the virus, but in combination with NPIs.

If evolution featured in the thinking of our overlords, they would not have settled on this as the “solution” to the problem. But either it does not, or they just don’t care.

P.S. Some more sobering simple math. Let’s say the vaccine is 90% protective against severe disease over a period of two years. Then one can expect to have on average three serious COVID episodes by the time he is 60 even if he is always up-to-date with his biannual vaccinations (and there is no knowing how much more virulent to young people it will have become in the future with all the serial passaging). We now see what round #1 of mass reinfections looks like in India. So that is the “solution” being offered right now. However, it will probably not happen as one giant apocalyptic wave so it can be pushed to the background as a non-problem.

Mind you (and GM has discussed these on other threads), there is a promising nasal vaccine under development that should be able to achieve sterilizing immunity, and that could even start being distributed if everything goes right by end of 2022. That sort of vaccine could be a game-changer. The current ones are enablers of “life with Covid” and not “life after Covid”.

IM Doc has pointed out that past great pandemics had a first wave, then a more acute second wave, and somehow the virus and humans reached an accommodation. So it’s possible Mother Nature will bail us out after we go through some more collective pain.

Another avenue the US has not taken all that seriously is treatments. We reported yesterday, for instance, of a retroviral treatment developed in Queensland that reduced Covid viral loads in mice by 99.9%. IM Doc is a bit leery since he’s seen retroviral based treatments go spectacularly south in some cancer and autoimmune disease patients. But biomedical professor KLG had speculated earlier that ivermectin and another (one or two) antivirals that attack other parts of the viral replication pathway will be one answer to COVID-19, each given at a relatively low dose and working synergistically: “This is how AIDS was turned into a manageable chronic infection in most HIV/AIDS patients.”

So there is hope of eventually getting off the inertial path, but make no mistake, the one our putative leaders have put us on is not pretty. GM made this call on May 8, the week before the “Mission Accomplished” reversal:

GM made this call on May 8:

….the path forward …. “personal choice” on how much you can protect yourself, but nothing will be done to stop transmission aside from vaccination. The US will easily tolerate 100-200K deaths a year, probably even more, as long as hospitals do not collapse. And the truth is that while they were close to collapsing on several occasions, at no point did it become an India-like situation.

And that is fine as far as the powers that be are concerned – the only real constraint there ever was was that there should be no people dying on the street outside of hospitals because that is very bad PR and it runs the risk of the public waking up and demanding that an elimination program be implemented (which is fundamentally impossible without the absolutely abominable idea of taking from the rich and giving to the poor). How many people die overall does not matter (especially given that we know very well which people will be doing the dying and which people will be living comfortable secluded from it all lives). BTW, this has a corollary – expanding hospital capacity is something that we do not want in the West, because what it means is a lot more people dying and becoming disabled for life in absolute terms, as it raises that tolerance limit. This is one reason the late-2020 wave was met with a lot less restrictions than the Spring 2020 one. Even though it killed 2-3X as many people. Hospitals were “prepared”. Again, this perverse logic works in the West. In less privileged places people will be left to die on the streets.

This also highlights the more generally perverted logic of Western medicine and healthcare systems – we only care about “treatment”, not about the actual health of people.

Of course nobody wants to listen, so a lot of suffering lies ahead.

Yes, we’ll get through Covid collectively, but many people and families will suffer unnecessarily due to weak and incompetent leadership and lack of concern for the general good. This is yet another product of neoliberal cognitive capture.

____

1 From GM in a different thread:

For the record, to those of us in the molecular biology world, what the CDC was doing in January and February 2020, when it simultaneously could not put together a working test for the six to eight long crucial weeks of silent undetected spread, while preventing others from developing their own, looked like deliberate sabotage of containment. It was hard to explain in any other way — I’ve mentored high school students who were successfully doing much more complex designs of molecular biology reagents in 9th grade, it is not rocket science, plus there were already working designs from other countries, and it was quite literally a copy-paste matter to adapt those. And then there is the question of why would you possibly not allow others from working out their own tests and also demanding that samples be sent across the country to Atlanta, when literally every minute was of the utmost importance?

2 Please do not present New York’s quarantine as a counterexample. I went in and out of New York City several times while it was on (to see doctors). It was a joke. I did not have to change a single thing I had planned, for example.

3 The plural of anecdote is not data, but I am seeing even some resistance among my tiny sample here. I saw an older but fit looking woman at the drugstore wearing a serious-looking mask and thanked her for doing so. She said she was fully vaccinated but thought it was way too soon to stop masking. I assume her logic was to model appropriate behavior.

4 Mind you, getting Covid is a really bad idea; we are simply leery of the over-hyping of the vaccines.

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90 comments

  1. Isotope_C14

    Great summary – thanks much Yves, IMDoc, GM, and Haseltine!

    I knew this was going to be a train-wreck right when they started testing in the US and were getting an incredible number of cases compared to China. I thought it looked like community spread far earlier than what was being suggested in the media.

    My sister’s kids and family almost certainly had it around Thanksgiving 2019, and her kids bring every single possible pathogen they possibly can from school. I think they also had hand, foot, and mouth disease. Their house is pretty much plague central during the school year. I had 3 more siblings than they do, and we were never ever that constantly sick. I’m reasonably sure my parents had it in February 2020, they even gave my dad some super strong cough syrup. I’m quite sure I had it in March 2020 – and probably the long version as well.

    I’m posting what follows here as a thought experiment. I know that people are polarized to think that any questioning of our benevolent billionaires are “C Theoris t” – I’m sorry I can’t type this completely – it’s just too overused, and I’m just tired of reading it.

    Utterly fascinating thought experiment:

    https://www.youtube.com/watch?v=i45rfuZN1ig

    I wanted to put this up here before it gets taken down, I suspect this will be removed within the next 18 or so hours.

    1. QuicksilverMessenger

      A lot of us don’t have an hour to watch a video without at least some lead in that it may be worth the time. Can you tell us the thesis of this video? Thx

      1. SurCone

        Sadly, I do have too much time on my hands. And thank goodness for YouTube’s ‘speed’ function — Kim Iverson is much more tolerable at 1.75x speed.
        The TL;dr is this (and I make no claims and offer no opinion on this conspiracy theory): Jeffrey Epstein was in the business of collecting assets for Israeli security, through kompromat or otherwise; Bill Gates, whose life was falling apart desperately wanted a Nobel Prize and believed JE could help deliver it; Bill & Melinda Gates Foundation invested heavily in vaccine companies (BioNTech & Pfizer) and (heroic) vaccine narrative; BioNTech/Pfizer opted out of sharing schemes (COVAX, Operation Warp Speed); BMGF (heroically) funded WHO efforts at unprecedented level; WHO abandons initial commitments to NMIs, diagnostics, treatments in favor of vaccine narrative; Israel gets priority access to Pfizer vaccines.

        Just for fun, I have a yarn diagram (Freeplane Mindmap) of this if I can figure out how to post it.

        1. SurCone

          The ‘yarn diagram’ (haha) of the conspiracy theory. ( BTW, FreePlane is a free, open-source program for creating mind maps. It’s good for much more than conspiracy theories! )

      2. Isotope_C14

        Yes. The summary is hysterical.

        1.) Essentially the Gates/Gates-French divorce is opening up all kinds of information.

        2.) Gates-French, a devout Catholic was none too happy about husband palling around with Epstein. (I know she’s a devout Catholic, [Unrelated to video] and found out she dumped all kinds of money into a Dallas/Fort Worth Catholic school, I was told not to say anything by someone in-the-know)

        2b.) Graham Elwood has been reporting extensively [Not in this video] that one of Gates’ senior guys was the executor of the Epstein estate, upon his death…

        3.) Gates-French was going for divorce already in 2019.

        4.) According to staffers, Gates desperately wants a Nobel Prize.

        4b) Gates thought the social connections with Epstein might make it happen.

        5.) The whole plan is to be the vaccine hero. It’s why all discussion of ivermectin, and/or the Russian/Chinese vaccines are baloney. (in the frame that they don’t work, I’m sure they are at least in the ballpark of the mRNA ones)

        6.) Now what was the first country with huge vaccination rates? I’ll tell you with this current conflict, it’s not the Palestinian part of the country. IIRC the US and UK are still lagging somewhat behind.

        7.) Creating Microscoft didn’t get the prize, 10 years ago he was the champion of new types of schooling, now he’s the BioTech czar. It’s like he’s throwing spaghetti at a wall, and doesn’t care what harm it does.

        8.) I will not go into the “rabbit hole” as it is not relevant to the video but really, this script couldn’t be easier:

        Bored billionaire thinks everyone should worship him
        Bored billionaire tries Tech – fails.
        Bored billionaire tries Education – fails.
        Bored billionaire says 3rd world can’t safely make vaccine (this is super offensive because with a couple weeks training, I could explain to you how to do it in a garage, as I’m a microbiologist) – fails.

        Perhaps next he’ll try to out-do Musk and Bezos on space flight, it’s really all he has next.

  2. Taurus

    When I look at major screwups that have transpired recently- the US Federal government response to Covid-19 or the UK government handling of Brexit – I wonder if it is strictly a matter of lack of leadership or if the bureaucracy has atrophied to such an extent that it is impossible to do anything at scale within the context of a contemporary Western democracy.

    Leadership is critical when time is of the essence. This was demonstrated over and over again during the pandemic early stages – the CDC testing fiasco, the half-measures to lock down, dithering in invoking the war powers production act, groping for “market” solutions to the PPP shortages, etc. The leadership that we had at the time was a combination of magical thinkers (Trump and cabinet), spineless figureheads who knew better yet repeatedly lied to the public (Dr Fauci and friends) and the logistics nepotism squadron (Kush and company).

    Yet, before I attribute it all to leadership, I look at small scale disasters that are very easy to fix within the context of the vast government resources that can be brought to bear on them. The Flint, Michigan water pipe replacement posed an insurmountable problem to competence poster boy Obama. California – a one party state by most definitions – cannot keep the power on when the wind blows. Etc.

    No one else in the West covered themselves in glory either – it wasn’t just the US. Juxtapose this to the Chinese building the field hospital in Wuhan.

    It seems that our ability to do marshal logistics on a larger scale has diminished dramatically- to the point that I wonder if it will ever come back.

      1. flora

        adding: it’s hard to see how shutting down and essentially destroying the world economy for a year helps most people’s economic position. It’s great for the world’s biggest monopolies the billionaire owners, though. Not that I’m foily. / ;)

    1. Temporarily Sane

      I wonder if it is strictly a matter of lack of leadership or if the bureaucracy has atrophied to such an extent that it is impossible to do anything at scale within the context of a contemporary Western democracy.

      I think it’s closer to the latter but it’s not just bureaucracy that’s atrophied.

      The west is so out-of-touch with reality and so convinced of its own ideological superiority that it is not only unable to respond quickly and effectively to unexpected challenges, it is unable even to admit that it family blogged up and needs to do things differently. Self-reflection and humility are anathema to the neoliberal western democracies.

      From outsourcing its manufacturing capabilities to elevating the rights of banks and corporations over the people’s to its obsession with dominating the world, the west is broken at a fundamental level but due to its immense hubris and ideological blinders it is unable to to reflect honestly on its shortcomings, let alone learn from history or from how other countries do things.

      Effectively fighting the COVID19 pandemic (and climate change for that matter) requires an assertive and competent state that has the resources and the ability to lay down the law and put capital in its place.

      But the west has been working for over half a century to weaken the state vis a vis capital and when a situation that falls outside of the neoliberal profit über alles framework arises, such as a public health emergency, the system simply isn’t equipped to handle it.

  3. Jackiebass63

    I think it was political. Trump feared that it would negatively reflect on him. He therefore tried to impose efforts to even acknowledge there was a serious threat from COVID. I believe in the long term this actually hurt his popularity. If he had come out swinging against the threat he would be considered a hero. Instead the crisis spiraled out of control. It probably resulted in Trump not being re-elected.

  4. PlutoniumKun

    Outstanding overview, as usual, NC produces something more succinct and to the point than anything I’ve read in the supposed main stream media.

    I find it deeply upsetting that so many very good doctors and scientists have bought into the whole idea that vaccines are some sort of triumph of humanity and will save us all. I’m taking my vaccine, and I’m glad its available, but the reality is that it is an expensive and high risk sticking plaster over a problem that could have been prevented. And the science/medical establishment is as responsible for the terrible decision making as our politicians, maybe in some cases more so.

  5. The Rev Kev

    Maybe the decision was made just to let it sweep through the country so that coming out the other end, they would be able to recover their economy quicker and therefore have an advantage over the other countries that were still being hit by this virus. Such seems to have been the plan in the UK-

    https://www.youtube.com/watch?v=SQDXmipIYF8 (1:10 mins)

  6. Adrian D.

    Interesting post, but it would benefit from at least passing consideration of the potential costs of the NPIs he recommends. Without this, i’m afraid to say this analysis is very limited.

    Furthermore, how could any such virus successfully ever have ben ‘contained’ given these facts:
    1. The relative ease of it’s transmission.
    2. The huge overlap of symptoms with many other respiratory conditions.
    3. The possibility/likelihood of reservoirs of the virus in non-human populations (we know cats get it and we all know it came from bats) – how would we prevent re-infection from these reservoirs given 1&2 above?

    .

    1. Mark

      By acting quickly and decisively. Limiting travel, social distancing and testing and tracing. Countries that did that quickly pretty much eliminated COVID. Had this been done by the major western powers we might have had a chance at worldwide containment and elimination.

      It wouldn’t have been easy. But it would have been easier than the alternative that we have lived through and are still yet to live through. Many asian countries have seen initial success or continue success. Their biggest challenges have been from the rest of the world having not behaved in a similar manner.

      In Australia and NZ life continues and is almost back to normal and has eliminated COVID. The end game is not easy as ultimate they will have to open up their borders. That said, even with vaccines, the watch and wait scenario is looking like the safer approach for Australia and NZ.

      1. Adrian D.

        @Mark – sure an unprecedented, global response may have worked, but would have required huge, global restrictions swiftly and immediately in a very small time-window for a virus about which people knew little at the time. Just how serious was that given the geopolitics of early 2020? Literally anything Trump might have done with the Chinese & Russians would have been castigated from one side or another – probably both.

        GM’s ‘could have, should have’ commentary seems to gloss over the fact that back then pandemic recommendations were for responses more akin to targeted protection than complete lockdown – a response previously dismissed for all sorts of reasons. In the UK in April & May we had prominent members of SAGE – the UK gov’s advisory committee – cautioning against LDs. They’ve all backflipped into line now, but you can’t pretend anyone really knew what to do back then.

        As for Australia & NZ they’re not yet into their usual respiratory virus seasons so we’ll see how well they’re performing in a few months shall we? Taiwan now are and they’re locking down (see my other comment).

        1. Mark

          I agree that it would have require an unprecedented global response. But that is what the world has done regardless with FAR more cost than if it had tried containment.

          but you can’t pretend anyone really knew what to do back then

          We did know. Quarantining has been used for at least half a millennium. Testing and tracing is a standard practice for controlling epidemics. If the world needed reminding about restricting travel then China did that for us at the start.


          As for Australia & NZ they’re not yet into their usual respiratory virus seasons so we’ll see how well they’re performing in a few months shall we? Taiwan now are and they’re locking down (see my other comment).

          Huh? It seems like you don’t quite understand what has happened over in Australia and NZ.

          NZ has been essentially COVID free for over a year. Australia has been largely COVID free with the exception of one state which through tough measures managed to eliminate it.

          Australia and NZ have had various tiny COVID outbreaks every second month from incoming travellers but the virus continues to be eradicated.

              1. Adrian D.

                The point is that test & trace etc was supposed to stop ANY spikes. They don’t.

                1. Cuibono

                  What part of the data do you not understand? A spike in Taiwan right now means 6 cases per MILLION! show me one person who said that test trace and isolate would COMPLETELY shut this down

          1. Adrian D.

            @Mark again – you state that ‘we knew’ about quarantines, but that’s a huge amount of hindsight in play. In the UK we’d got the likes of Prof John Edmunds – one of the UK Gov’s SAGE advisors dismissing serious measures as ‘late’ as March 11. He’s completely changed his mind now – as has Neil Fergusson of Imperial – as of course has your Dr Fauccci (on all sorts of things).

            You can read a transcript of Prof Edmunds dismissals here:

            https://duncanlaw.wordpress.com/2020/06/11/john-edmunds-on-herd-immunity-full-transcript/

    2. Adrian D.

      I’d add to my comments regarding the ability of any country to contain the virus to ask GM what he thinks of the goings on currently in Taiwan. It’s a country with everything going for it as far as potential containment measures are concerned – an island nation with effective border controls, high compliance to government advice, indoor mask wearing and – crucially effective test-and-trace – the combination of which we are led to believe is sufficient to contain the virus.

      But now we have the introduction of more serious, restrictive measures in response to a rapid increase in the rates of transmission. Yes the absolute numbers are low, but what this shows is that even with everything in their favour, this virus is very, very hard to contain without shutting businesses and locking people down/away.

      1. GM

        Taiwan lowered their guard — they never locked down because they controlled their borders from the beginning, but then apparently they gradually relaxed some of the border control measures and that’s how it inevitably leaked back into local transmission (3 days quarantine for airline pilots is absurd).

        What I don’t like is that they are not already under total lockdown with the current case counts — what is happening right now is very similar to what European countries were doing in March 2020, i.e. gradual imposition of restrictions instead of dropping the hammer immediately as Australia and NZ do. This has usually gone spectacularly bad. Once you get above a couple hundred cases a day it becomes very hard to trace all clusters and the only thing that can solve the problem is total lockdown (as in Victoria), and if you don’t impose it, COVID becomes endemic.

        The question is whether this is a sign that they are giving up or they just want to preserve for as long as possible the distinction that they controlled it successfully without “authoritarian” measures, in contrast to the mainland, but despite that public health considerations will eventually prevail.

        The list of ZeroCOVID countries is very very short now — Thailand, Cambodia and Mongolia have given up, so we are left with China, Taiwan, Hong Kong, Singapore, Vietnam, Laos, Australia and NZ (and a bunch of tiny Pacific Island countries), with Taiwan, Vietnam, Laos, and Singapore battling serious outbreaks now, the most serious ever for the first three.

        China will be able to resist the longest, but the others are already under tremendous pressure to open up their borders (the flurry of articles calling them “hermit” countries and decrying the loss of their cosmopolitan values has already started), and it will be increasingly harder to keep the virus out.

        In Taiwan there is an added complication — the computer chip factories, on which the whole world depends. Can you control the virus without hurting production there in some way? Probably not. But there is a very serious shortage right now worldwide, and thus an immense pressure to keep those open at all costs.

        1. Adrian D.

          @GM thanks for your informed comment. It rather serves to highlight the issues I have with the nature of the NC piece as a whole. Taiwan slips slightly under pressure of the numerous other costs of its measures and the virus cannot be contained. But the US, with a more open & diverse society, no particular COV1 experience, numerous hub airports, 51 different States etc. is indicted here for not achieving the same a year ago in all the panic, all the uncertainty and in the midst of its typical respiratory virus season.

          It’s also notable that the countries you identify as the ones having the big problems now are the ones that would be predicted to be having their biggest problems right about now under Robert Hope-Simpson’s theories of influenza seasonality from the 80s. Under his thories, Australia and NZ will be getting theirs around about the end of June. I hope the next few months prove me wrong, I really do, but I think they’re in for a bumpy ride.

          You can see a copy of one of his graphs in this piece (written by a sceptic I’m afraid, but the graph is all you need if you don’t want to read the lot:

          https://richardlyon.substack.com/p/a-summer-third-wave

          1. Paua Fritter

            NZ didn’t have a COVID outbreak in June 2020, so it’s certainly not inevitable.

            But it’s important to note that NZ is not in the situation (common elsewhere) of having a small prevalence of COVID that they need to continually suppress, and which might bounce back in response to changes in community behaviour. Seasonal effects (i.e. the virus spreading more readily while people are shut up inside against the cold) can only come into play if the virus is actually present in the community in the first place, which it isn’t.

            Currently, therefore, what stops NZ getting a major outbreak is not the implementation of NPIs such as social distancing, mask-wearing, etc, which are actually minimal in NZ. Instead, NZ is primarily protected by its quarantine system (including the vaccination of everyone working in it), and secondarily by testing and contact tracing.

    3. praxis

      Taiwan? China? How much has the failure to contain virus cost? Cost/benefit calculations do not measure into complete ruin scenarios. Costs to contain the virus were a red herring.

      Also I do believe Yves mentions containment would likely of required serious redistribution policies to support the disruption of vulnerable populations.

    4. grayslady

      and we all know it came from bats

      No, we don’t all know it came from bats. So far, not a single bat has been located with Covid-19. The fact that the virus can be transmitted to certain animals does not mean that it originated with a non-human.

      1. Adrian D.

        @grayslady: I was being a touch sarcastic with the bat comment – apologies for not making this clearer.

    5. Adrian D.

      I’ve read GM’s comments again and I’m more baffled now. He’s talking about test-trace-isolate in ‘early February’, but how were these tests to be performed? The (in)famous Corman Drosten paper was only published on 23rd January – how could anyone expect an effective system to be in place in a fortnight? It was months before the infrastructure was available. We’re talking about symptoms common to all sorts of respiratory conditions in the months when those were at or around their peak anyway – and yes, it’s more serious than flu, but for the majority of people they’ll likely suffer no more than what appears to be a heavy one.

      The most obvious response then – backed up by the established pandemic plans – was to tell everyone with symptoms to isolate. That the US & UK didn’t follow this up with immediate reassurance that whoever did wouldn’t lose their job or income was the criminal mistake then (along with kicking the sick elderly back out into care-homes & probably too lax border monitoring). That they didnt magically impose a functioning test&trace system has to be seen in the context of that time.

        1. Adrian D.

          @GM Yes, well done them for that in their for-all-intents–and-purposes Island state, with COV1 experience, arguably culturally compliant, tech-enabled, wealthy, quite urban population. Can you comment on Taiwan’s need for lockdowns now though? Effective T&T hasn’t stopped them needing that has it?

          1. GM

            So Seattle, New York and the SF Bay Area are not wealthy, tech-enabled and urban?

            Even better examples — what is Vietnam? I don’t think they even used phone apps as in South Korea, just did it the old fashioned way. And they did it several times, not just once.

            I commented on Taiwan elsewhere in the thread but it has not gotten past moderation.

            P.S. Also, we need to keep in mind that governments, especially the US government, do not get their information from the media. If random regular people knew we have a very serious problem on our hands in mid-January, and then the events circa January 24th, when the cordon sanitaire was established around Wuhan, dispelled all remaining doubts, it is a safe bet to assume that the US government was aware of what is happening much earlier than those regular people.

            1. Yves Smith Post author

              Jerri-Lynn described at length how it was done in Hong Kong. Interviews. As in humans.

              Apps are no good, they capture only distance, not distance + duration, and so no matter how you set them, they identify too many or too few. And that assumes others are carrying a phone. I don’t.

        2. Left in Wisconsin

          If the claim is that an effective test-trace-isolate system could have been up and running in the U.S. in two weeks from late Jan – early Feb, then I’m with Adrian D – no way. I’m not sure it could have been done even if one is considering this as strictly an engineering problem but, and this is perhaps the one useful thing that social science has taught us, the social is part of every human activity. Does the two-week scenario account for rioting in the streets? Fox News? Having to do this over the opposition of the sitting President and most politicians? How many new public health workers would have needed to be hired? And trained? In a (pseudo) democratic country at a time when most of us knew virtually nothing? Talk about faith in science. Given what we have learned from this episode, I would not confidently claim we could do such a thing if a future, more virulent virus appears. But I do think we would do better than we did this time. (In this case, I think “we” is the correct subject.)

          There is another thing I don’t understand about the eradication argument. As far as I know, everyone agrees that COVID seems to have an original single source. Is the argument really that isolation could lead to the complete eradication/die off of the virus, such that another single case at some point in the future couldn’t kick off another round of global pandemic? Skepticism about this is not an argument for doing nothing – just the opposite – but aren’t we ultimately going to be reliant on vaccines for beating this, in the same way that we are reliant on vaccines for beating polio, measles, TB, etc.?

          1. GM

            The US government probably knew about the virus in December the latest. They don’t get their information from the media, the media gets its information from them, and even according to the official version of events that has been released, they were informed very early in January.

            We are not talking two weeks to set up TTI, but two months to both close borders and set up TTI.

            Under both the direct zoonosis transfer and the lab leak hypotheses, the virus underwent major changes on its way from bats to humans and does not have an external reservoir. Thus the smallpox model does apply.

            Bats will still harbor a lot of SARS-type coronaviruses as well as a very large zoo of other nasties, but those SARS-type coronaviruses are probably more like the original SARS, i.e. not as transmissible as this one (again, it underwent major changes to make it adapted to humans). We eradicated SARS-1 and will almost certainly have to eradicate SARS-3, SARS-4, etc. in the future. But will we even try after the precedent established with SARS-2?

            1. Adrian D.

              @GM I bow to your knowledge regarding animal reservoirs.

              Regarding when the US knew about COV2 I’d first wonder whether they alone, apart from the Chinese would have this knowledge. If not just them, then why weren’t other countries taking more immediate steps then? I’d also suggest that there’s a rather large gulf between knowing about a virus and understanding it – I’m not sure we do now even a year and a half later. Yes the responses were slow, yes they were likely corrupt, but they were also (mostly) in line with what was then received wisdom regarding how to deal with such threats.

              1. GM

                Presumably other countries knew too, that is correct.

                As I said above, I have no idea who acted when based on what knowledge, and, most importantly, what motivation.

                The events after March 2020 are easy to explain with basic political economy.

                Those from January and February are full of unknowns.

  7. Northeaster

    This post is yet another reason to get healthy if you’re not. The government, and the corporate lobbyists (i.e. sugar, potato) that want Americans unhealthy are not going to help you.

    1. Arizona Slim

      Northeaster, you read my mind. And, thanks to Naked Capitalism, I put myself on a daily supplementation program. Vitamins C, D, and E, our very good friend, zinc, and some other good guys as well.

      I also took a good, hard look at the ole bod. Had to have a talk with myself last summer. Seemed that the midriff was no longer living up to my slender reputation. ‘Twas a combination of many factors, er, excuses.

      So, it was time to lower the quantity of food eaten — this wasn’t a diet. It was nothing more than ceasing the feeding of my face when I felt full.

      As for exercise, that was the fun part. What’s not to like about taking more bicycle rides and long walks around the neighborhood?

      The excess weight didn’t come off right away, but, over time, it has.

    2. PHLDenizen

      To be fair, neither are most physicians. Almost all of them know fsck all about nutrition, aside from the guidelines they dutifully regurgitate from their trade associations. “Eat less. Exercise more. Avoid fats and eat carbs. No, actually, carbs are now the enemy and fats are good. Low sodium! Well, maybe sodium isn’t quite as bad as we thought…cardio! Weights are dangerous for your joints! Squats kill your knees! Deadlifts destroy your spinal column!” There is so much contradictory and just plain wrong information bandied about it that it’s hard to take doctors seriously. Even my dad, renowned invasive cardiologist, doesn’t get it right and he’s always surprised when I prove that out.

      Myth: younger people need more protein than older folks. Wrong! Amino insensitivity INCREASES with age, so it takes the more protein to provoke the same anabolic response. Part of the reason you lose muscle mass with age.

      Myth: all proteins are interchangeable. Eat all the plants you want and it’s as good as beef! Wrong again. Animal proteins are much higher in leucine — the amino acid that directly stimulates muscle protein synthesis. Chicken is less calorically dense than nuts — which are super fatty. So you’d need to eat a ton more calories in nuts than you would chicken to get equivalent protein. And animal proteins are complete. Cats, for instance, are obligate carnivores for a reason.

      Myth: high carb is better than low carb or vice versa or intermittent fasting is better. Again, not true. If you hold calories, fiber, and protein constant across different diet modalities, the outcomes are the same. Changes in body weight are near equal. Intermittent fasting also interferes with muscle protein synthesis. Your body can store excess fat, your body can convert excess glucose to glycogen and dump it into your liver and muscle tissue. Excess aminos end up in your urine and proteins aren’t zero calorie, so they can still make you fat, but it’s much harder to eat 3500 calories of baked chicken than it is peanuts.

      And so on.

      Cardio is good, as it helps with fat oxidation and glucose disposal.

      Squats, deadlifts, bench press, standing shoulder press are also all very important as you age. If your form isn’t garbage and you progressively overload with weight you can control, you are not going to wreck your body. If you have pre-existing musculoskeletal problems that preclude you from them, then they’re probably a bad idea without modification.

      But in terms of fighting off sarcopenia, fixing back pain, and increasing strength so you don’t injure yourself shoveling snow or moving boxes, you should consider lifting a mandatory intervention. You’ll surprise yourself with how quickly back pain and knee pain disappear. You can keep adding muscle to your frame as you age. It doesn’t magically stop when you turn 40. The key is managing fatigue and adhering to minimum effective volume.

      Committing to that requires habitation and buy-in, but I actually enjoy lifting and ducking unnecessary back operations is a positive, as is not feeling hostage to the frailties of the aging process.

      Just my two cents.

      1. Mantid

        Hi PHL, Your two cents became a nickel – in a positive way. I’d add eggs. We have chickens and I eat about 10 eggs a week and give away the excess. Remember the egg/choelesterol argument? Oh my, kinda ticky tack.

        And to (Raising) Arizona, My sentiments exactly. General health and strengthening one’s immune system are the first line of defense. Of course add Ivermectin as one of the “good guys”. I started hearing about IVM in about April via Chris Martenson and the FLCCC. By October the evidence was mounting and now there’s a mountain of positive studies on preventatives such as IVM, vitamins, zink, and a few more being discovered as I type.

        Of course the CDC et al have no mention of any of these preventative measures on their website or in their public communication. In conjunction, the US system, or lack thereof, of a nationwide health care totality (there is no system to it) ensures that the rich can and will “cull the herd”. That’s the largest difference between Taiwan, NZ, Austrailia and a few of the other, more successful countries. Reminds me of the sarcastic phrase “Eat the Rich”. Seems that reality is just the inverse.

        So, take a walk, plant a garden, preserve your food, limit interaction to friends and family (if they limit theirs) and bon courage! Of course many people don’t have the where with all to do these things. Sad but true.

  8. nv

    February 26, 2020 was the day I was certain we were going down the wrong path irrevocably. Twice during a panel at New York University Law School Laurie Garrett turned to the representative of the state health department for his point of view. Instead of outlining plans
    he instructed the audience to get a flu shot. No plans? Panic.

    (And why was the illustrious New York City health department not represented on the panel?
    Much later I discovered that a few days later the state health department disengaged or
    stopped talking to, the city’s.)

    1. Telee

      Yes, we know that bats are involved but it is also possible that it was a bat virus that manipulated by gain of function laboratory techniques that resulted in a virus that was virulent to humans. The Wuhan laboratory was receiving monies which came from NIH and routed through the non-profit EcoHealth. Dr. Fauci recently denied that funding of gain of function occurred while testifying in the senate. There are eleven of these labs in the US and safety breaches have occurred. This testimony in spite of the fact that the Wuhan lab had published papers on gain of function research thanking Dr. Fauci for his financial support. Of course, this sounded like another of Fauci’s lies such as proclaiming early on that masks were not necessary. Keep in mind that Fauci is a very important supporter of gain of function research. Bottom line is we really don’t know what the truth is.

      1. Mantid

        Telee, Testify! I find it beyond amazing that the US press have not “called” Fauchi on that specific lie. He should be interviewed by the BBC or some one who will ask follow up questions and not just ask Q after Q of unrelated drivel. The BBC is not perfect, but they often have that wonderful Brit attitude that’s so much on display in Parlimentary debates. Bloody ‘ell.

  9. nv

    From the above: ‘ This is one reason the late-2020 wave was met with a lot less restrictions than the Spring 2020 one. ‘ (By the way, its ‘fewer’.)

    Which is something I had wondered about, but wish for a bit more elucidation, or clarity,
    than in GM’s statement of May 8th.

  10. The Historian

    Great article. Thank you.

    I think it is important to keep in mind that as bad as things are in India right now, more people have died from Covid-19 in the US than in India. The Johns Hopkins site says that there have been 283,248 deaths so far in India, while there have been 587,225 deaths in the US. And India has about 4X the population of the US.

    I don’t want to hear anyone bragging about how well the US has done with Covid-19.

    1. CallMeTeach

      But those are the “official” numbers and even NPR states that the case numbers are hopelessly wrong, both through lack of testing and willful manipulation my Modi. The US isn’t a shining star by any means, but India is undercounting its death toll.

      1. The Historian

        I don’t doubt that India is under reporting deaths. I truly wonder if the US is too! But do you realize that India will have to have over 2 million deaths to reach parity with the US wrt population? I have no doubt that given Modi’s response that will probably happen in the future.

        I think I am just tired of the tsk-tsking about India in the press these days when the US hasn’t done any better in protecting its population.

      2. Pat

        And America isn’t?

        Just call me cynical but I always add at least half again as much to the official total.

      3. Mantid

        Hi Teach, “even NPR states”. Oh my, NPR is soggy milque toast. You won’t hear any cutting edge journalism via them.

    2. Shom

      The data out of India is unfortunately being heavily censored, so this 283k number is a drastic (~10x) undercount. This article shows that Gujarat (a state with 4.5% of India’s population) saw ~67k excess deaths in the crucial 40-day period run-up to this wave, while the state officially only recorded ~4k deaths as COVID related. Reporters had to tally up issued death-certificates (needed to proceed with any transfer of estate etc.) in each municipality and city corporation. This is still an undercount since rural (unincorporated villages) death certificates take a lot longer to register. Oh, this is also the state that beset us with the millstone that is the current Prime Minister.

      Personally (I’m from this benighted land but currently in the US), it feels like I could tally up the deaths in my personal circles and those of my Indian-origin friends in the US and can come up with more than 283k.

  11. William Hunter Duncan

    “If evolution featured in the thinking of our overlords, they would not have settled on this as the “solution” to the problem. But either it does not, or they just don’t care.”

    It think the thinking goes, such as it is, we have put checks on evolution, or rather, the weeding out of the weak, so this is just letting evolution do it’s thing. With automation and AI, we simply don’t need so many people, anyway. So many people are ruining the earth, so let’s reduce the numbers, release a lot of capital tied up in retirement, and meanwhile set up a Pharma/Health Care gravy train indefinitely.

    1. rowlf

      Evolution or eugenics? What happens if people find out that there were treatments that were not used or investigated?

  12. CanChemist

    Important question about immunity duration:

    The 6-8 month estimate on vaccines is I’m guessing based on getting the 2nd dose within a few weeks as recommended. What about countries like here in Canada where they are delaying the 2nd dose by 3-4 months? Does the clock start ticking on immunity wearing off after the 1st dose, the 2nd dose, or some other equation? And that’s assuming of course that there isn’t some huge displacement by a new variant with different properties.

  13. Jason Boxman

    Minor typo that changes the meaning:

    IM Doc has pointed out that past great pandemics had a first wave, then a more acute second wave, and somehow the vaccine and humans reached an accommodation. So it’s possible Mother Nature will bail us out after we go through some more collective pain.

    Probably meant virus here.

  14. Andre Cresset

    Why is it that STILL practically no body mentions treatments of which there are many?
    Why is it that STILL all the boobs unthinkingly follow the other boobs and mouth to each other knowingly details of ongoing “boosters” for “variants” The cash register is going ka-ching ka-ching. Can’t you hear it?
    I’m not going to bother with the dozens of links to treatment studies.. The boobs have their masks securely fastened over eyes ears nose and throat. It’s tragic.

  15. DJG, Reality Czar

    One of the great mysteries (or great obfuscations) to me is that only a few weeks back, reliable commentators and commenters noted that the U S of A had no flu season to speak of this year.

    The cause? Masks, better hand washing, observance of the safety distance.

    How do we know? Because there have been flu seasons each year in the past–in spite of vaccination.

    Yet the same logic that the flu virus has kindly pointed out to us can’t be applied to COVID? We couldn’t have had a campaign?: “We defeated one virus, and now let’s defeat the other virus. Wear your mask.”

    Further, we had evidence from countries like Japan (less so) and Taiwan (much more so) that masks are successful, historically. More recently, I am seeing the success of mask wearing in Italy, where the wearing of masks is enforced, has social support, and even the general in charge of the vaccination program doesn’t seem to allow himself to be photographed without his mask on.

    I am hesitant to follow GM, above, in the main and notes to use the word “sabotage.” I can only offer the word “belief.” Americans and their beliefs, the endless thundering fundamentalisms, the puritanism.

    It would help if Americans stopped believing (things).

    1. Arizona Slim

      Here in Tucson, we conduct an epidemiological experiment every year. It’s officially known as the Tucson Gem, Mineral & Fossil Showcase. Informally it’s called the Gem Show.

      I’ve also heard referred to as the Germ Show. Why? Because it attracts crowds of people from all four corners of the earth, and, uh-oh. They bring their germs with them.

      A lot of people talk about coming down with something-or-the-other that correlates with their attendance at the Germ Show. In other words, if you got sick in Tucson during February, guess where you got it. Likewise, if you were fine in Tucson, but fell ill after arriving home, well, the Germ Show provided you with a souvenir.

      In 2020, the Germ Show was suspected of being a super spreader event, but officialdom said no, that didn’t happen. However, I have heard local friends and acquaintances tell me that they were horribly ill with something-or-the-other during February 2020.

      This year, no Germ Show in Tucson. And, wouldn’t you know it, the winter flu season was a non-event here.

      Likewise, COVID. Cases have been declining since early January.

    2. Henry Moon Pie

      “It would help if Americans stopped believing (things).”

      Stop being holy, forget being prudent,
      it’ll be a hundred times better for everyone.
      Stop being altruistic, forget being righteous,
      people will remember what family feeling is.
      Stop planning, forget making a profit,
      there won’t be any thieves and robbers.

      Tao te Ching #19 (UK Le Guin, trans.)

  16. Basil Pesto

    the problem with GM’s ‘rest-of-the-world’ thesis is the counterexamples of Australia and New Zealand – hardly bulwarks of anti-neoliberalism. And my perception has always been that Australian politics is usually hopelessly imitative of the US. And yet, I was in a packed nightclub with friends on Saturday night with no fear of getting sick. Which was really lovely. Perhaps Horne’s ‘Lucky Country’ thesis applies (I have yet to read it, but I increasingly think I should).

    1. Cuibono

      GM’s case is strengthened not weakened by AU and NZ (unless i mistake your meaning)

  17. Mikel

    With regards to protection via vaccine, the experiments are to see what happens in 6-8 months.
    Gives a whole new meaning to 4th of July fireworks.

    And about to have expiration of all kinds of benefits and eviction moratoriums.

    And thoughts about this:

    “And that is fine as far as the powers that be are concerned – the only real constraint there ever was was that there should be no people dying on the street outside of hospitals because that is very bad PR and it runs the risk of the public waking up and demanding that an elimination program be implemented…”

    There are cameras on phones now and people can take pictures of their dead loved ones. Something to think about.
    Of course social media platforms are censored to all get out, but there are other ways of getting pics out.
    Just musings…

  18. Synoia

    Was the policy driven by incompetence or Malice?

    Was there perhaps decision to use the pandemic to kill off as many as possible?

    As I recall, the flu epidemics in the late ’50s came back in the UK came back in the new year.

    My memories are more like snapshots than a continuous thread, and I can only place the approximate date by the content of the memory.

  19. Susan the other

    Lockdowns and Neoliberalism are antithetical. What’s a modern leader to do? Protect the system? Or protect the living? It has been said that climate change will change epidemiology. The big factor in that equation is the sun. Direct sunlight. Even though the planet is warming under its blankie of CO2, the direct sunlight is lessened by the same CO2. That might be the biggest factor of change. We can’t rid ourselves of this CO2 cover too aggressively or profits will crash and the planet will cool too rapidly. But it might well be healthier. We don’t know what we are messing with. If Covid is here to stay every winter, we need good medicines for treating it. That has been the biggest sin of remission. Nobody made those medicines a priority. Because profits. The only good thing that will come out of this is the revelation about the tar-pit of neoliberalism and the growing perception that it must be eliminated.

    1. GM

      Lockdowns and Neoliberalism are antithetical

      That’s what it comes down to.

      There is no question the former Soviet bloc would have locked down Wuhan-style and eliminated it in a couple months, then forgotten about the whole thing.

      But even Western democracies would have probably done it too in the 1950s through the 1970s.

      I doubt we even do what we did to eradicate SARS-1 in 2003 from now on.

  20. sam

    Excellent summary of the COVID farce but should be read with the “Counterlife of COVID” article in today’s Links. Both US political parties were equally at fault. During Feb and March 2020 blue state medical authorities often exceeded Trump in their denialism. I think I’ve posted here before about LA County public health heroine Barbara Ferrer announcing on the last day of Feb that “there is no risk from COVID”. And don’t forget Cuomo’s outrage when Trump suggested travel restrictions.

    Our neoliberal system incentivizes kicking the can behavior. Whether it’s COVID, financial speculation or climate change, future negative outcomes can be very clear but those with the power to influence events think that with sufficient resources they can insulate themselves and their loved ones so why not keep the good times going as long as possible. By the end of 2006 everyone on the CDO desks knew the game was up and an enormous crash was imminent but they kept churning out deals anyway, assuring themselves that with one more multi million $ bonus they wouldn’t need a functioning economy. Or like the upper classes in Latin America who know their rent extraction will inevitably result in social upheaval but plan to be on the last plane to Miami. Maybe for our upper classes the escape scenario is the last rocketship to Mars.

    1. Lambert Strether

      > And don’t forget Cuomo’s outrage when Trump suggested travel restrictions.

      And liberal Democrats screaming racism when Trump tried a travel ban from China.

      1. Mantid

        Lambert, Small scale I know, but my left leaning friends calling me a right wing conspiracy theorist for mentioning Ivermectin? Right wing? I was a Jimi Hendrix fan for Christ sake.

      1. Cuibono

        this is not the first article to show robust immunity after natural infection as you know. Out of my 800 patients with covid we have had 2 reinfections!

      2. Yves Smith Post author

        I had to run and so didn’t go into further detail.

        Multiple experts have looked at the best large-scale data in the world, which is the Imperial College regular testing of 100,000. We already have a baseline of the falloff in antibodies. Experts argued as to whether it implied 6 or 8 months of immunity, but they pretty much all agreed on somewhere in that range.

        Some argued T cells and memory B cells might produce long-lived immunity but Haseltine and others are dubious.

        As to your anecdata, you have no idea how well they were social distancing and practicing other NPIs. And you also don’t know if they got asymptomatic cases.

        1. Nick Alcock

          > Some argued T cells and memory B cells might produce long-lived immunity

          Well, yes, because they are the only things that produce long-lived immunity to anything. Antibody fall-off happens in *every* disease, including ones with known lifelong immunity like measles: it’s not some special thing unique to coronaviruses. The numerous non-expert sources over the last year that were going oh doom and gloom antibody responses don’t last therefore immune responses will fade fast didn’t know what they were talking about (and were mostly misreading what the experts were saying, which is that antibody levels were fading fast *and this tells us nothing about the long-term immune response*, though it has implications for people using antibody tests to tell if they’ve already been infected).

          Haseltine knows what he’s talking about, but here he’s being cautious simply because so very little is known about coronaviruses and what is known suggests that current human coronaviruses don’t produce long-lived immunity: but all those coronaviruses also produce relatively mild immune responses because they are mild diseases. We just don’t know (but frankly to me it seems unlikely that the immune response will be mild, if just for the strictly personal reason that I caught covid nine months ago ago, and my response to my first AZ jab this month was *fierce*: I definitely had a *lot* of immunity persisting. Which was not pleasant, but was oddly reassuring nonetheless.)

  21. Cuibono

    Don’t forget to add:
    1) Failure on Airborne spread precautions
    2) Failure on basic health measures; better diet, sleep, exercise, etc
    3) failure to properly investigate and implement treatment outside of the hospital

  22. GM

    IM Doc has pointed out that past great pandemics had a first wave, then a more acute second wave, and somehow the vaccine and humans reached an accommodation. So it’s possible Mother Nature will bail us out after we go through some more collective pain.

    This will probably be different from 1918 though. This is not the flu. Flu pandemics come and go, because immunity against individual flu strains is actually more durable, the problem there is antigenic drift, plus there are hundreds of different flu strains in fierce competition with each other, and they displace each other rapidly.

    What we have here is the establishment of a completely new disease in the population — this virus has no competition with other less virulent versions of itself, and immunity against it is much more short lived, plus it does do a lot of antigenic drift, but none of the virulence properties are associated with the regions of the S protein that are relevant to that antigenic drift, so it will not lose them (moreover, they are actually important for viral fitness and thus maintained by selection).

    So this is here to stay indefinitely. Which should have never been allowed.

    There is a reason why smallpox was eradicated — it is a deadly pathogen with a respiratory mode of transmission, i.e. a very big problem. Once it was eradicated, there was nothing else left of similar severity and ease of spread. TB is still a big problem too, but TB is not an acute infection, it can take decades to kill you. HIV had 100% mortality initially, but it can be controlled with simple behavioral modifications as it is rather hard to catch. Etc.

    Now we are likely back to where we were with smallpox. Keep in mind that so far the virus has been evolving towards worse, not better — we now have widespread variants that are probably twice as deadly as the original, and we have seen on at least one occasions the appearance of something even worse than those (B.1.616 seems to be 2.5x-3X deadlier than the regular strains). Thankfully that did not take hold, but it’s simply a matter of time that something else does. The original SARS-1 killed 5-10% of the infected, and SARS-CoV-2 likely does have the potential to eventually return to that level with enough passaging and selection.

    1. Cuibono

      “this virus has no competition with other less virulent versions of itself,”
      not necessarily true i think. The corona family is likely competing with itself all the time. And with other URIs. we saw it decimate the competition this past year to be sure. But the other strains are down but not out.

  23. Kevin Carhart

    Is vaccine-wearoff underaddressed by the CDC? I was apprehensive about the mission-accomplished cessations already and now I really have a problem with it. Because what can they really purport to be saying about the safety of the “fully vaccinated” when some of those people are approaching wearoff and continuing to run around in the time interval between wearoff and a new shot? Especially given a maelstrom of ameliorating factors back and forth like
    procrastinating going back again
    when it gets somewhat close, forgetting all about it and continuing to do everything during the interval between the actual wearoff and when it may dawn on you that it’s been a while
    scheduling a new appointment but continuing to do everything during the interval between setting it up and going in
    the uneven and unclear nature of how long protection lasts
    the inconsistency in advice towards frequency of revaccination between the gov and companies
    the rolling nature of when different people need a new shot based on when they last got one
    variants just basically making a muddy timeframe muddy; we don’t know anyhow and with variants, we don’t know

    I don’t see how they can advise the cessation of masks and distancing if you incorporate unfolding wearoff.

  24. LawnDart

    To a fair degree, I believe that Hanlon’s Razor may apply to much of the overall political response to Covid-19:

    Never attribute to malice that which is adequately explained by stupidity.

    I hope that there is intelligent life somewhere in this universe and that they do maintain an intergalactic version of the Darwin Awards; it’d be a shame for us having to go through all of this for naught, not even to serve as a warning to others.

    Thank you for a most excellent post.

  25. VietnamVet

    Thanks. This post lets me know that I am not going bonkers. This does all go back to George W Bush’s “Mission Accomplished”. Since then government has ceased to work for Americans. Restoration of a functional national public health campaign to eliminate coronavirus is impossible within the current neoliberal/plutocratic system. mRNA jabs are corporate money makers. To keep the status quo, Americans are marketed with Public Relations (PR = Propaganda). But January 6th shows that PR and divide and rule identity politics are not working.

    The CDC is isolated in its ivory bubble. Its experts deny to themselves that aerosol transmission by super-spreaders indoors is real. The contagiousness of endemic SARS-2 virus in the USA, variants, open borders, breakthrough infections, no masks or social distancing, and 30 to 40% unvaccinated Americans make a fourth COVID-19 wave this winter inevitable. PR won’t be able to cover it up. Without the restoration of democracy, a working public health system, and trust; the succession of states will be inevitable.

  26. vlade

    I believe that the most important thing here is that with vaccine (and all other) is what GM calls ignoring evolution by the powers-that-be.

    It stares them in their faces via variants, but they still seem to see it only as a “it just evolves”. With our actions (including vaccine), we’re effectively closing some, and supporting others, venues of the virus evolution. And we have NOT a whiff of an idea where it can go (well, some people do, but..), and most don’t seem to even care.

    It’s also depressing that an informed layman like me can come to similar (broad-brush) conculsions but the governments can’t.

    1. Pat

      It isn’t that the government can’t, it is that our system has been so corrupted that the people in it are constantly competing for lucrative sinecures outside of their jobs. So much so that they only think of the public good when cornered by that public. While there is a possibility that Biden cannot keep enough facts straight to be able to understand, the rest certainly do. See the dumping of hospitality business stocks. They have weighed the costs and a healthy public does little or nothing for those able to offer the board seats and speaking engagements and book deals. Those valued citizens want expensive And liability immune vaccines and full stores and cheap compliant labor, now they even want expensive hospital stays.

      Also keeping the public healthy means giving money to the great unwashed with no sinecures for the bureaucrats and we just can’t have that. I mean they might get the idea that they should get things from government. Ongoing Covid threats is their best, their only means to guarantee the status quo. But we should never forget that this is not the result of a monolith called “government”. That while government does contain concerned people trying to push the system to do right by the people of this country far too often they are outdone by hundreds even thousands of greedy, callous and bubbled individuals who see that public as commodities to trade.

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