SARS-COV-2 Post-Delta: Andy Slavitt Says “Let ‘Er Rip” 2.0

By Lambert Strether of Corrente.

I’ve loathed Andy Slavitt and his progress up the greasy pole — Penn/Wharton > Harvard MBA > Goldman Sachs > McKinsey > UnitedHealth > CMS > Obama and Biden administrations (various) — for some time, because as Founder of the so-called United States of Care (NC here and here) Slavitt worked hard to help achieve the liberal Democrats’ #1 policy goal: Shoring up the the private health insurance “industry” and making sure Medicare for All “never, ever” came to pass. (Since Medicare for All would, according to The Lancet, save 68,000 lives and $450 billion a year, it’s hard to see Slavitt’s actions as anything other than sociopathic servility to whoever’s pocketing those billions. And sure, 68,000 lives a year might not seem like much in these days of a pandemic, but over a decade or so, those little numbers can really add up!)

Recently, Slavitt tweeted out a thread that most likely indicates the future preferred policy path for the Covid pandemic, as determined by the Penn/Wharton-Harvard-Goldman-McKinsey-UnitedHealth-CMS-Democrat hive mind currently dominant at the Federal level and in Coastal states[1]. I’m not going to quote the whole thread, because I might stroke out. Instead, I’m going to quote and comment on the central tweet. Slavitt’s thread begins:

And here is Slavitt’s central tweet:

So, (1) “Everyone will get the virus,” (the “Let ‘er rip” part[2]) but (2) vaccinate as many as possible (the 2.0 part). Well… The public mind doesn’t seem prepared for the former. And the fact that the vaccines we have today are not sterilizing means some will come down Covid (the disease), even if not as many as catch SARS-Cov-2 (the virus). I’m not sure the public mind is prepared for that either. So I asked alert reader GM to do some back-of-the-envelope math[3] on what Slavitt’s modest proposal would mean for the population as a whole, in practice. Here is GM’s response:

If we have a vaccine that needs to be taken annually and is over the period of that one year on average 95% efficient against symptoms, that means one symptomatic infection every 20 years. Or 3 such infections by the time one is 60. Assuming a Poisson distribution, 17% of people will get it 4 times, 10% 5 times, etc.

If the vaccine is 90% efficient, that is on average 6 such infections by age 60, for 10% of people it is >=9 infections.

If the vaccine is 80% efficient, we have on average 12 infections by age 60.

This is all simplified, of course, in reality vaccines are waning and it is not a linear function of time, so I am not sure whether it even makes sense to be talking about an average efficiency over a year, a lot depends on when one was vaccinated relative to the timing of whatever waves the population is subjected to.

Also, this assumes no future evolution towards worse — 10% breakthrough on Wuhan-2019 is different from 10% breakthrough on current B.1.617.2, which in turn is very different from 10% breakthrough for 2003 SARS-1 and any hypothetical future SARS-CoV-2 evolution products that might be much more lethal that the present strains.

In terms of damage, it is easy to think about the cumulative cell damage — you get bad COVID once, you lose, say, 30% of your lungs, next time you lose another 30%, and you are now extremely vulnerable to any subsequent infections because there is not much left. Same for kidney failure, etc.

But then there is the immune system damage aspect which is much more murky, but could be potentially even more serious. The virus has a super-antigen[4], and we have actually never dealt with a virus that reinfects and has a super-antigen. This means a potential downwards spiral of T-cell exhaustion with each subsequent reinfection, which in turn means increased susceptibility to other pathogens, high rates of any autoimmune issue you can think of, and all sorts of other very bad things. In fact SARS-1, even though it did not have a super-antigen, still wrecked people’s immune systems even on the first infection — many of the survivors were hit hard repeatedly after that by otherwise minor to regular people infections.

We will see whether the people who are worried about this will turn out to be correct (there are very good reasons to fear it), the problem is that whether they are correct will only become apparent in the rearview mirror. And by then the frog will not only have been boiled, but the water in the pot will have boiled off too and the frog’s carcass will have been charred on the bottom of it.

So I guess the #ZeroCovid people have a point[5]. Slavitt’s policy recommendations:

Refusing to accept “preventable deaths” is rather rich, coming from a high-level political operative whose goal is to keep pumping $450 billion a year into the private health insurance industry while — so that? — 68,000 people die[6]. More central, however, Slavitt is pushing a modified version of the conservative line: That Covid is just like the flu, albeit a bad flu. So, yes, “Let ‘er rip!” Get vaccinated, however, and you’ll only catch this flu 3-12 times a year before the age of 60. A sophisticated, PMC-style “Let ‘er rip”!

But as GM points out, this is a flu that could rip out 30% of your lung capacity each time you catch it[7]. That’s a pretty bad flu. Is a public that avoids medical treatment because our health care system is so horrific going to “lead their lives” like this? Has the public mind been prepared for “everyone will get the virus”? Will yet more noble lies be told?

NOTE

[1] I do not wish to imply that the PMC hive mind is principled or consistent in any way; just that Slavitt, by virtue of his position, is a good indicator of where the PMC is today.

[2] BoJo thought herd immunity was a thing.

[3] GM notes: “The calculations assume 100% attack rates under conditions of completely unmitigated epidemics. This has not been the case so far but that is because people have been cautious even without formal restrictions. But it is a reasonable assumption under a full “return to normal”. It is what happens with regular coronaviruses, against which seropositivity is 95-100% at any given moment and people serorevert within 18 months. And those are not in the same league as B.1.617.2 in terms of contagiousness.”

[4] On super-antigens, see e.g. PNAS, “Superantigenic character of an insert unique to SARS-CoV-2 spike supported by skewed TCR repertoire in patients with hyperinflammation“: “A hyperinflammatory syndrome reminiscent of toxic shock syndrome (TSS) is observed in severe COVID-19 patients, including children with Multisystem Inflammatory Syndrome in Children (MIS-C). TSS is typically caused by pathogenic superantigens stimulating excessive activation of the adaptive immune system. We show that SARS-CoV-2 spike contains sequence and structure motifs highly similar to those of a bacterial superantigen and may directly bind T cell receptors. We further report a skewed T cell receptor repertoire in COVID-19 patients with severe hyperinflammation, in support of such a superantigenic effect. Notably, the superantigen-like motif is not present in other SARS family coronaviruses, which may explain the unique potential for SARS-CoV-2 to cause both MIS-C and the cytokine storm observed in adult COVID-19.”

[5] Among whom Slavitt was once numbered.

[6] How do these people sleep at night?

[7] Go long oxygen tanks.

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

135 comments

  1. Mikel

    Let ‘er rip:
    “I’m not sure the public mind is prepared for that…”

    Neither is the public’s pocketbook. Can people send this &*&%$ their medical bills for long Covid?
    Is he even going to pay for a bowl of soup for any sick person?

  2. Converger

    Wait a second. I’m not arguing with the central arguments here at all. But I do think your calculation is uncharacteristically sloppy. Getting COVID confers some immunity, just like vaccines do. Breakthrough cases if you are vaccinated/recently sick have nothing like 30% lung damage rates. And assuming that we get off the systemic vaccine-only shtick, we’re going to see things like nasal sprays that dramatically reduce vas infection outcomes.

    Slavitt is horrifying. The US response is horrifying. The nightmare scenario outlined here is horrifying, especially because it’s a not completely implausible worst case given where we are. But I don’t have to tweak the numbers and assumptions very hard to do much, much better than this.

    1. GM

      I said 95%-90%-80% efficiency against symptoms, the asymptomatic breakthroughs do not count at all.

      Vaccine efficiency fell down below 80% in Israel and also in some parts of the US too against hospitalization. Against symptoms it was down to 16% in Israel for those vaccinated in January.

      Which is why they are now giving 3rd doses to everyone over 40…

      So I am not sure why you think breakthroughs are always mild, but they most definitely are not always mild. Reinfections aren’t either — plenty of people died of reinfections in Manaus, South Africa, India, etc.

        1. allan

          Zeno’s herd immunity. As Anatole France almost said,

          In its majestic equality, the market allows rich and poor alike to sleep under bridges,
          beg in the streets and go long PFE and MRNA.

        2. William Hunter Duncan

          I’ve had the Phizer, both “jabs”. Based on everything I am reading, I am inclined to not get a booster, especially if people like Slavitt are saying I have to if I want to make any money or eat, especially if boosters have to come on the regular, ongoing. I am 48 and in quite good health. Increasingly I feel less freaked out by the virus than I am by the elite response to the virus. What is your opinion about taking your chances on Covid?

          1. Alex

            Just a comment: the effectiveness is significantly worse among >60 years old, so an average person would get infected less before getting to 60 yo or so (and more afterwards).

            Btw, can lung capacity be restored? Is it fair to sum up these percenages?

      1. Wisdom Seeker

        The most serious flaw in the math as presented in the OP above is the apparent assumption that all individuals will be infected every year in the absence of vaccine protection.

        COVID’s been around for 1.5 years and only about 10% of the population has had a “confirmed case”, of which many were asymptomatic. Absent a vaccine maybe 15-20% might have been infected, not 100%. Similarly, flu is endemic and the vaccine is of low effectiveness and yet most people don’t get flu in a given year.

        If it becomes clear that COVID is an endemic threat and that vaccine protection won’t be strong, people will adapt to reduce transmission risk by other means.

        The other factor which isn’t discussed in the article is the potential of treatments other than vaccines to reduce the risk of extreme outcomes.

        P.S. For Lambert and Yves – It’s been a while since I came here to NC and frankly I’m disappointed at the hyperbole and self-righteous vitriol that seems to pervade all the articles now.

        1. Yves Smith

          Let’s start with the last. In Lambert’s and my collective experience of moderating over 1.5 million comments, concern trolling is never done in good faith. And as to your assertion that we’ve changed our tone, that’s false. Go look at our work after the financial crisis bailout or the mortgage/foreclosure crisis, or CalPERS. We’ve called out bad actors in similarly unvarnished terms starting in 2008, if not sooner. Our writing hasn’t changed, it’s that unlike perps or enabler of financial bad conduct, you don’t like criticism of our Covid misleadership class.

        2. GM

          This was already addressed in the original post.

          What is missed here is that we never went fully back to 2019. Even in June 2021 in the US, that was still not the case, there are still quite a few sensible people who are being cautious with their behavior.

          But we have plenty of examples around the world of very high attack rates. Manaus was at 75% in 6 months, Iquitos at 70%, many cities in Colombia were above 50% already in late 2020, and Colombia had the bulk of its cases and deaths AFTER that, in 2021 (i.e. there were rampant reinfections). We have no proper serosurvey from Mexico, but we know that CDMX (the central area in Mexico City, with a population close to 10M) lost more than 1% of its population. And that in less than a year — they stopped releasing excess death statistics in February 2021 in order to hide the scale of the damage. A 1% PFR is way above any IFR estimate for a population with those demographic characteristics, i.e. most likely it was both the case that most people got infected and that many got infected more than once.

          India itself as a whole was at 70% seropositivity in early June 2020 after the second wave, but there were many individual cities above 50% already in late 2020.

          High attack rates happened in Europe too.

          There was a serosurvey from St. Petersburg in Russia a month ago, that showed 45% infected, but again, this was not a full let-it-rip-like-it’s-2019 scenario.

          Then there was the original outbreak in Bergamo — quite a few cities lost more than 1% of the population as a result of the virus infecting more than half of it. In a couple months. And that was original Wuhan virus, not Delta. Because life was normal back then.

          So very high attack rates during each antibody waning cycle are not at all an unreasonable assumption

  3. Converger

    Wait a second. I’m not arguing with the central arguments here at all. But I do think your calculation is uncharacteristically sloppy. Getting COVID confers some immunity, just like vaccines do. Breakthrough cases if you are vaccinated/recently sick have nothing like 30% lung damage rates. And assuming that we get off the systemic vaccine-only shtick, we’re going to see things like nasal sprays that dramatically reduce bad infection outcomes.

    Slavitt is horrifying. The US response is horrifying. The nightmare scenario outlined here is horrifying, especially because it’s a not completely implausible worst case given where we are. But I don’t have to tweak the numbers and assumptions very hard to do much, much better than this.

  4. Lost in OR

    Does this sentence need editing?

    “Get vaccinated, however, and you’ll only catch this flu 3-12 times a year before the age of 60. A sophisticated, PMC-style “Let ‘er rip”!”

  5. TBellT

    Is there anything an individual can do when the national policy makers admit this is the policy? Besides become a complete anti-social hermit?

      1. ChiGal in Carolina

        My quite ordinary doc gave me 8 doses of Ivermectin when I asked at my annual physical last week. I do the rest of the FLCCC prophylaxis regularly so I wanted it in case of possible exposure. I showed him the protocol on my phone and he had no problem with it; he had obviously heard of it before.

        I was looking for povidine but the stuff at CVS is a liquid, not a spray, and warns against internal application.

        1. Lambert Strether Post author

          > I was looking for povidine but the stuff at CVS is a liquid, not a spray,

          Somewhere, Yves has a recipe for this which I think includes spray; you would need the right sort of bottle.

          Good job by your doc. Harmless at the very worst; the hysteria is utterly in bad faith.

          1. Skip Intro

            The recipe in a paper linked here was for a 0.4% solution which meant a 30:1 dilution of the 10% PI commonly available. I have no idea where to get a nose sprayer.

            1. Richard Needleman

              It hurts to say this…But Amazon or preferably your local pharmacy. Though why I think better of CVS, Rite Aid etc. I do not care to think about.

            2. Yves Smith

              Take any nose spray bottle, like for saline spray. Empty it and fill it with the povidone iodine (diluted).

              Studies generally done on 0.45% to 0.5%. 30:1 dilution is too weak. Studies indicate up to 2.5% is safe for a gargle or nose spray. I am using a 1% solution.

              1. skippy

                Here in Oz we have an over the counter povidine – lodine gargle at 1% w/v povidone and .1% lodine w/v called Betadine – cheap as chips too.

      2. TBellT

        No prophylaxis works 100% and if the strategy is leave a permanent reservoir for the virus than even these won’t prevent you from getting virus if you abandon the other protocols, i.e. masks/social distancing.

      3. Howard Beale IV

        When I see the number of. doctors they have listed there say thier practice name with the word “integrative” in it, my spinchter tightens up.

          1. Terry Flynn

            “integrative” can be a good thing, reflecting a “join the dots”/patient-centred approach to medicine. In practice, certainly in the UK and Australia (where my experience comes from) it is a dog whistle term to indicate a doctor who incorporates woo.

            Now, to be fair to “woo”, a lot of it is simply having a doctor give you TIME to fully describe the problem and context. As well as time to suggest realistic solutions that might not be “traditional medicine” but are all about adjusting your routine to better integrate things like CBT and mindfulness exercises.

            But CERTAINLY in posh postcodes in Sydney, integrative medicine means “are you a middle class twat? Come here for ridiculous solutions and give us all your money”. They infested Mosman, centre of power of a certain Tony Abbott, former PM and nutjob.

      4. B flat

        My doctor gave me a prescription for ivermectin last week – fulfilment was delayed by a day because the pharmacy had run out.

    1. urblintz

      they are pyrrhic victories and terribly immature gestures but… I joined twitter just to respond to idiots like this. I won’t link to the one i sent slavitt, but it had to do with repairing the cranial/rectal inversion on display.

    2. Amfortas the hippie

      don’t knock it til you’ve tried it(complete antisocial hermit).

      especially given the unhinged, spittle flying lunacy from so many of our righty neighbors.
      i’m hoping that the right finds the fall of kabul/all biden’s fault narrative more delicious, and the hyperpoliticisation of anti-covid measures, in aggregate, fades away.
      i’ve been thinking about my experience as an iconoclast antiimperialist out here, circa 2001-2009…and think i prefer that to my more recent experience with the “itaintreal”-ers.
      with the latter, i haven’t been yelled at, called a traitor, or strangled…but the forever wars weren’t right on my doorstep, either.
      this is, of course, a sad calculation.

      1. kareninca

        “don’t knock it til you’ve tried it(complete antisocial hermit)”

        Have you ever actually been a complete antisocial hermit? I thought you lived in a family group, and have done so for many years. That is quite the opposite of being an antisocial hermit. Imagine being one of the many people I know who live with no-one else at all. Each social interaction requires an actual effort; they have to go out into the (perilous) world. Relatives, if any, are typically 2,000-3,000 miles away. They were in agony early in the epidemic and they are going to be in agony again. It is easy for people who live with family members to not be able to picture this. Living in a family group and avoiding annoying neighbors is not being a “complete antisocial hermit.”

        1. Amfortas the hippie

          yeah.
          i even lived in a cave, once.
          and then in the depths of the atchefalaya wilderness….then again in the davey crocket forest..
          and under el capitan….
          and an hundred other places.
          wherever the cops couldn’t find me.
          i’ve done the whole wild man, alone-thing, many times.
          have you?

          1. Amfortas the hippie

            my crazy ass life sounds unbelievable to you BECAUSE you haven’t been there.
            my life, i admit, is a little bit more than weird, but still.
            i strive for total honesty in this space.

            i sincerely hope that that’s come across in the tellings.

            1. CanCyn

              Amfortas – your truth comes across loud and clear to this reader. I respect and admire your views and your life choices.

          2. kareninca

            No, I haven’t. I’m sorry if this seemed like an attack; it wasn’t meant as one. I like your posts. I just thought that you spent your time with your relatives.

        2. CanCyn

          Kareninca – not sure why the attack on Amfortas? You ask him if ever really was a hermit but the people you describe as living alone are not hermits either. Living alone doesn’t make you an antisocial hermit in and of itself. No doubt people have suffered from loneliness and anxiety and many other psychological woes during the pandemic. What is your point?

        3. Yves Smith

          You don’t get to talk to Amfortas this way.

          In general, you abuse regular other readers as if you have the right to do so. I’m rapidly losing patience.

          You are already in moderation for your unwarranted nastiness. One more incident like this and you will be banned.

          1. kareninca

            Thanks for explaining why I’m in moderation. I thought it was for a totally and completely different reason. I like Amfortas a lot and enjoy his posts, so clearly I’m not getting my tone right. I doubt my personal anecdotes about Silicon Valley are much use, so between that and my apparent tone-deafness I definitely think it would be best if I stepped back.

            1. Amfortas the hippie

              for whatever its worth, consider yerself forgiven.
              for my part, i was at wits end with stepdad’s debacle with va contractor “specialty hospitals”, being on the road far too much for my skeletal health, and being well into my Decompression Protocol, after such a trip.
              all next day in the damned bed, watching tv.
              my whole summer has been like this.
              sorry for being snappy.

  6. Jason Boxman

    No mention that we also condemn some people, even vaccinated, to long-COVID, the implications of which we don’t entirely understand yet, but appear with over a year of data to be quite serious. Granted we know even less about long-COVID in vaccinated people, but it’s beginning to emerge that this is a possible outcome of infection, and a deeply disturbing one.

    Slavitt makes no mention of paid income support or similar mechanisms to prevent spread, for those that do become infected. This is consistent with his ideology, but a noteworthy exclusion. Nothing fundamental must change.

    1. Lambert Strether Post author

      Ha, I was trying to come up with an appropriate term of abuse for the headline and this is very good. (The best I could do was “Weathervane Andy,” but I didn’t have time go into how his views kept changing; this is only the latest.

  7. MonkeyBusiness

    Don’t viruses mutate to be less lethal at the same time they become more contagious? Look, I am not saying I agree with this guy, but at the same time I don’t see all of humanity suffering from the effects of Covid. I mean from last year, we know plenty of people got Covid while being asymptomatic. Yes, we don’t know who will win the “lottery”, but at the same time it’s not hard to imagine that there will be people who will get this 20 times and still be fine.

    1. John Zelnicker

      @MonkeyBusiness
      August 16, 2021 at 7:52 pm
      ——-

      Viruses frequently mutate into less lethal forms. However, they can also mutate into more lethal forms as they learn to escape the vaccines with various changes in their make-up.

      The emergence of the Delta strain for which the existing vaccines are not as efficacious is proof of this possibility.

      Other strains have been identified since Delta, but because their incidence is still low, we don’t know if they are more lethal or less. We also don’t know if they can escape the vaccines we now have.

      1. MonkeyBusiness

        Yes, viruses can become more lethal, but then they usually would peter out because they will run out of hosts to infect soon enough. Let’s say the virus grows to be as lethal as Ebola, there’s a reason why Ebola outbreaks in the past didn’t spread to the rest of the world.

        1. Skunk

          Highly pathogenic influenza viruses have not “petered out” in bird populations. When it comes to people, this is a world of over 7 billion people. A more lethal variant would not necessarily run out of hosts in an interlinked, globalized world.

          1. David

            Thanks Skunk. “Running out of hosts” is the only evolutionary pressure for a less lethal variant, and modern human civilization presents no shortage of hosts or vectors for global spread. Massive human depopulation is the only way to teach the virus not to bite the hand that feeds it, so until that becomes a realistic threat any talk of the virus naturally preferring to mutate towards less lethality has no basis in fact or theory.

    2. BlakeFelix

      They often tend to, but COVID is already not very lethal by those standards. The incentive for a virus to get less deadly is it killing people before they have a chance to spread it hampering its spread. COVID already kills rarely and usually slowly, so it’s not under much pressure in that direction I fear.

  8. Carolinian

    As I understand it the earlier “let it rip” was based on the idea that the most vulnerable–those prone to that 30 percent loss of lung function–would be protected and quarantined and that others would be given therapeutics like ivermectin to suppress the symptoms of the more than the flu. The base assumption behind this line of thought is that we can’t conquer Covid with hasty science but that disease exists and has always existed and you have to seek out the best treatments to deal with it. The end goal of the earlier let it rip was herd immunity.

    Not that I’m championing that earlier point of view because I don’t know anything about medicine and have no qualifications to make any argument one way or the other. But that was their point, as I got it.

    1. Objective Ace

      I, too, thought his suggestion to use Ivermectin in conjunction with quarantines/vaxxination/etc was refreshing. I’m not sure he realized that’s what he was suggesting.. or if Pfizer and Bill Gates will let the CDC/WHO recommend it though

    2. Amfortas the hippie

      “…“let it rip” was based on the idea that the most vulnerable–those prone to that 30 percent loss of lung function–would be protected and quarantined…”

      as a poor person who has sought healthcare from programs explicitly enacted to provide it to people just like me…it seems clear that it is, and has been, and will continue to be, the de facto policy of the USA to do the exact opposite of “protect the vulnerable”.
      at least the bottom half of the income/wealth distribution is regarded as expendable, if not eradicable.
      the people this guy runs with hate us.
      that this demonstrable fact is so rarely mentioned in these discussions is why the actions and statement discussed seem so mystifying.

      1. Nce

        Yep! You know it’s almost funny, they blow off 68000 deaths as the necessary price of doing business, but if someone was to suggest that we the people should off the wealthiest 68000 on the planet to greatly improve the quality of our lives, well… I’m probably on some potential DVE list for just posing this scenario.

  9. JTMcPhee

    I guess Slavitt, that skink, takes it as a give that HE will not have repeating infections by various variants of the coronavirus. Must be nice to be so special.

    Is it bad to hope that maybe he gets a taste of his own medicine? The news is carrying lots of stories about anti-vaxxers and Covid deniers making deathbed pleas to the rest of us to “just get the shot”? Carrying the presumption that they would not be on their deathbeds if they had just gotten the shot? Looking for reporting on people who dutifully got both shots per the EUA text, but are dying from the disease anyway? Or the vaxxed who have developed long-hauler permanent disabilities?

    TBellT may well have it right: the only way to avoid the disease is to become a complete anti-social hermit. Good luck with that in a political economy that forces us to labor for pittance pay without a national health service, living in our cars or in Hoovervilles (“Reagan Resorts”?) because the MFers who have figured out how to mark the deck have priced us out of places to live, or evicted us from even property we owned but could not pay the taxes increased by the MFers’ bidding up the price of real estate leading to ever higher real property taxes…

        1. Daniel LaRusso

          9xxx% were surviving before the vaccine. Hospitals/deaths were a very small percentage of reported cases/tested cases. Unless I mis-read something.

        2. jefemt

          166 million Americans? How FEW global citizens have been vaxxed?

          The data is really lacking. The lack of rigor is mind boggling. The way its been managed as it evolves should get deep study and attention.

          I’d like to see correlation data of equity ownership portfolios of the various policymakers to the policies (and Brands) they endorse.

          B A U

    1. Daniel LaRusso

      no one wants to hear that the people dying of covid “may” have died if vaccinated. Or we so close to the edge that a dry throat could have pushed them over.

      That thinking always meets with “callous” or excess deaths gymnastics.

      I don’t know wether I’m fascinated by “statistics” or peoples “interpretations”. But I find it amazing how we can all look at the same thing but see something different.

  10. The Rev Kev

    After reading his Wikipedia entry, I think that the sobriquet “Ratface Andy” is wasted on Cuomo. Anyway. I’m not that crash-hot on statistical analysis so I will defer to the calculations of GM here and I find the implications of them very disturbing. So let’s go with this and I hope that GM will correct me on any obvious errors here. So in the lifetime of a person, a person may be expected to be infected by this virus several times with each time having a worse effect on your health. People may not survive even the third or fourth infection due too cumulative damage too. Can you imagine the effects on the health care systems of countries around the world dealing with permanent Covid sufferers with them getting worse each and every time? It’s a budget breaker that.

    And as for these vaccines, the figures out of Israel would suggest perhaps a bi-annual shot rather than an annual one will be needed. If your body can tolerate it. I seem to recall IM Doc (?) talking about how some people have been so roughly treated by their third dose of vaccine that they are swearing that they will not have a fourth. This may indicate that mRNA vaccines are not an option in thinking in terms of having take them like an annual flu vaccine. In fact, they may be a dead end. A profitable dead-end but still a dead-end. And if that is generally realized, where does that leave us? About in 2019 I would reckon as far as vaccines are concerned to a large extent.

    And this virus may be like that Russian Coronavirus from over a century ago that lasted in several waves over the course of a decade. Or it may just stick around like AIDS has. And then again, since the Delta strain is now the dominant strain, it is now also the base strain of this virus with the potential to get even worse. I doubt that it will just disappear like Trump said a coupla times. I see that they reckon that about 208 million people have been infected so far but I would at the very least triple that figure. So that means that there are well over 7 billion people that have yet to be infected by this virus so we may still be sitting at the ground floor of a very tall building in terms of infections. Long term? The implication could be that this virus will be just as destructive as the Black Death but that it will do so in slow motion instead of a violent three years.

    1. JTMcPhee

      Maybe if the rulers stop shoveling wealth into the furnaces of imperial wars and the belly of Moloch (the relatively tiny “vampire squid” bunch that already “owns” most of everything and has a direct line into the central banks,) that notion of “budget busting” might evaporate like morning mist over the lake…

      https://en.wikipedia.org/wiki/Moloch (includes child sacrifice, like Abraham was happy to do at YHWH’s with his only son Isaac… fitting analogy, I think.)

      Haw, haw, as effing if…

  11. Dave R

    So what is your argument? Are you arguing that we should avoid taking the vaccine since it’s not “perfect” (you can get a breakthrough case) AND was developed by a large pharmaceutical company? It’s our best tool to fight this virus (that and N95 masks). The alternative, never going outside the house, is not an option for most of us. His recommendations sound very reasonable. We are learning more about this virus every day and it’s true that the mRNA vaccines do not seem to provide perfect protection. But reports from around the country state that >90% of hospitalizations and deaths are among the unvaccinated.

    The vaccine does not always prevent infection (thus his comment that we will all “catch” the virus since the Delta variant seems to be extremely contagious); the way the vaccine works is that in case you do get infected, your immune system is primed with antibodies to fight it in the best way possible. And this does not guarantee against sickness and long Covid. But certainly much better than no vaccine.

    1. Darius

      The argument is zero COVID, not the herd immunity that Slavitt is going for. Herd immunity is mass slaughter. Of course, people who matter will be OK, probably. Most of them.

      1. Dave R

        I don’t see where Slavitt is arguing for herd immunity by “letting it rip” through the population. Talk about over the top! He is taking a very realistic stance by just saying that for maximum safety, we must be vaccinated and take other precautions since in the long run, it is likely that most of us will “catch” Covid, even if vaccinated, due to the extreme contagiousness of the Delta and future possibly more contagious variants. The vaccine will help us fight it by working as designed; many will be asymptomatic, others will have mild symptoms, and a small percentage will get sick with very few hospitalized (This will NOT be the experience of the unvaccinated). You and the author’s extreme dislike for Slavitt are reading something into his tweets that really aren’t there. In the real world, where most of us cannot sequester away from people forever, we must do what we must to lower the risk: get vaccinated and mask up (with N95) when necessary. His precautions are very reasonable. Do you (or Mr. Strether) have any better (realistic) ideas?

        1. Darius

          Ventilation standards. Occupancy standards. A nationwide systematic testing and tracing program. Quarantines for positives. Mask requirements in public buildings. I may be leaving out a few things but we actually know how to crush this. Our leaders choose not to. Why should they? The most powerful people in society are making a killing on it. And going on vanity subspace rocket rides.

          1. Dave R

            Yes, all good things to do. But secondary to vaccines, our most powerful tool, which you left off of your list.

            1. bsun

              Yes, all good things to do.

              But not mentioned in Slavitt’s tweets (at least not the ones featured in this write up). The things that Slavitt is recommending, along with the vaccines, are all cheap and require little action on the part of the state. That’s the point: aside from maybe getting and distributing vaccines, people with power aren’t going to actually do anything to make this pandemic less dangerous for people. I’m not sure if zero COVID is possible but we have a lot of tools that NEVER GET MENTIONED by the learn-to-live-with-it folks.

          2. Nce

            And checks for people who must quarantine, along with adequate shelter to quarantine in- oh, and medical care, too would be helpful. Naw, endless wars are far more important, hmmm.

        2. GM

          I don’t see where Slavitt is arguing for herd immunity by “letting it rip” through the population.

          What do you think “this will infect everyone and we will not do anything to stop it” is? if not letting it rip?

    2. curlydan

      I don’t think that avoiding the vaccine is the suggestion here. But from my perspective, Slavitt offers (like many in this country) a very tunnel vision view of our choices, i.e. lets put mRNA vaccines on a 90-day production line and pump out shots to match each major mutation. In my mind, an effective strategy does not rely on tunnel vision or lack of a Plan B.

      I’ll admit he does fleetingly speak of anti-virals in one of his 26 part thread. But what about mucosal vaccines? Sterilizing vaccines? Non-mRNA vaccines like Novovax? Where is the push for alternative therapies and treatments. I really didn’t see it. His solution also seems very U.S.-centric. I’m not sure how Moderna or Pfizer are going to set up production plants across the globe, charging IP protected prices to the rest of the world, and get an ongoing green light from the FDA for each new iteration domestically.

      To defeat a menace, I think going down “one line” of thought (mRNA will largely protect us) is not wise. Better to branch off perpendicularly on other lines of thought to give us multi-dimensional protection.

    3. Lambert Strether Post author

      > So what is your argument?

      I thought it was quite clear: At the very minimum, prepare the public mind for what is to come. I mean, this is a democracy, right? Not some sort of utopia run by philosopher kings?

      1. Pate

        “this is a democracy, right?“
        IMO and quite literally, I don’t think so (and apologies if im wrong but I don’t think you really do either). Isn’t it a moneyocracy? More specifically, mostly a corporatemoneyocracy? Has not unlimited amounts of mostly corporate money whether to fund lobbying or elections captured the state? Has not the corporate media monopoly largely captured what we think and talk about (except here at NC of course). Is not democracy merely a facade? I guess im in hedges camp. What say you Lambert?

            1. JBird4049

              Yes, that is a much more accurate term. The robber barons and captains of industry of the Gilded Age don’t seem as stupid or incompetent as today’s ruling class.

              1. JTMcPhee

                The political economy the Robber Barons and Gilded Agers preyed upon was a lot deeper in the stability well. After another 150 years, it’s become apparent that the looting of the planetary system of life has exceeded the homeostatic corrective and balancing capacities that once existed.

                I would not give Jay Gould or Rockefeller or Rothschild or Krupp even a tiny bit of credit for being in any way less bad than our current class of Uberparasites.

    4. Daniel LaRusso

      but this “imperfect” vaccine is having bad side effects on people (A small % I know) and there are no studies into “long vaccine” that I have read … becasue it’s still experimental and only a year old.

      It’s a lottery if the vaccine will help you AND not hurt you in later life. For most healthy people how is that different to the lottery of not taking the vaccine, when COVID is a cold to them?

      1. Joe Well

        Seriously? In August 2021? Almost two years in?

        A cold does not scar your lungs, cause neurological damage, myocarditis, damage to sense of smell, and on and on…and neither do the vaccines.

        1. Daniel LaRusso

          Yes seroulsy … For a small % those things may be an issue. But not for many, myself included. I tested positive for covid twice – no lasting effects as far as I can tell or my GP.

          We don’t know what the long term effects of the vaccine are. I’m not saying there are bad effects … although some are producing anecdotal evidence. I’m saying it’s too early to tell.

  12. CloverBee

    Are there not other vaccines in development, that might do a better job? Are we stuck with these just because they were first?

    Stuck as in the powers that be are choosing that the first in class is the only option?

    1. Michaelmas

      Yes, there are other vaccines in development.

      More significantly, at least a dozen mucosal-nasal prophylactic-type sprays are being developed that I know of, which will be a less invasive method of resisting the virus than the high-tech tinkering with the immune system we’re doing with both the mRNA and adenovirus vector vaccines.

      I believe this kind of modality translates into about a year to clear the FDA (somebody correct me if I’m wrong). Faster of course with emergency authorization.

    2. polar donkey

      The Cubans may have a good vaccine. I read a few weeks ago they were developing 4 vaccines and 1 seemed very good. Wasn’t mRNA or like J&j.

      1. MonkeyBusiness

        Cuban vaccines will never get approved here. Heck say the Chinese or the Russian were to come up with a 100% guaranteed to be working vaccine, America would still go with a “homegrown” solution that would not work as well, I suspect.

        1. JTMcPhee

          Unless “our” Western Empire supranational corporations could find a way to own and monetize those Commie Pinko vaccines— then you would see a very different vista.

    3. chris

      So, there were originally about 10 vaccines in development. The ones we got to EUA were the best of the first concepts we had. You don’t hear much about the Merck or Sanofi vaccines anymore, right?

      There are others in development now using different concepts than the spike protein. However…as Yves and others have repeatedly stated on this site, and as studies have shown for years, you can’t get sterilizing immunity against a coronavirus from a vaccine based on everything we’ve tried so far.

      Maybe we’ll get something new and amazing and it will fix things. Most likely not. I’d be satisfied with OTC prophylaxis.

      1. CloverBee

        We don’t hear much about the other contenders anymore at all, and that concerns me. There is the push to get the current contenders approved for kids, and as a parent of young, school age kids, I have concerns. I am more interested in the Nasal spray ones, but I am very interested in other options that are maybe slower to develop.

        I had hoped that these vaccines would be used as a stop-gap until we had better options, but the official narrative starting with “take off your mask if you have been vaccinated” indicated that was not the approach they were taking. With the way the narrative is going now, I see vaccine mandates for little ones coming if you want to send them to school.

        Fauci held up AIDS therapeutics for years, and would he delay access to better COVID treatments or preventatives for profit and image?

          1. Eric377

            High quarantine isn’t necessarily the same as major outbreaks. The Green Bay parochial schools came under tremendous pressure last fall from the local heavyweight healthcare providers – particularly Prevea – to shift to virtual instruction because the quarantine rules were tying up many staff members who had kids in the system. But there actually were no major school outbreaks (or frankly minor ones for that matter). They were trying to recover from backlog from heavy restrictions on elective and lower priority care in spring and early summer plus some real community COVID pressure and they were losing days from professionals because the school needed household level isolation until classmate Billy’s test came back. Nearly always negative. Basically the healthcare community hated the consequences of the exceptionally stringent policies they pushed at the schools and decide that having all the kids sit home pretending to learn helped them somehow. The system caved for a week, then went back.

      2. Beth

        Two new vaccines that rely on protein subunit recombinant DNA technology (long in use, for instance Hep B, but admittedly not using insect viruses and army worm ovarian cells!) are Novavax and GSK/Sanofi. I had high hopes for Novavax which had great VE in Phase 3, but they cannot get their s**t together at global production facilities (despite over a billion in public dollars) and have now pushed back FDA EUA to maybe 4th quarter 2021. Same for GSK, but they may just ditch the US entirely as they seem to be going for EU approval. Very discouraging. I am not happy about my young adult children getting a third mRNA. Am giving them that new Israeli made nose spray Enovid.

          1. Yves Smith

            Please stop from making comments that are so incomplete as to be misleading. The way the Novavax vaccine works is vastly less problematic than the mRNA or adenovirus vaccines. From Science:

            Word came yesterday that Novavax had very good safety and efficacy in the trial of their recombinant protein vaccine. This is good news. By this point, the vaccine is much less needed here in the US, but it could be a very important part of getting many other countries vaccinated, due to its less demanding storage requirements and (relatively) straightforward production process. The company does intend to file for FDA approval, and is in the last stages of getting all of its manufacturing and quality control procedures ready for that. I hope that this opens up to worldwide usage of this one, and that the company really is ready for large-scale production.

            As many readers are well aware, this is a recombinant protein vaccine, not a viral vector (like J&J or the Oxford/AZ vaccines), and not an mRNA one like Moderna or Pfizer/BioNTech. I also hope that this allays some of the worries that many people still have about those two platforms: recombinant protein vaccines have been around for longer, so this one would (presumably) be less of a concern for some potential users….

            Remember, the Novavax vaccine does not cause cells to produce the Spike protein. It is the Spike protein, injected directly into a person’s body, along with an adjuvant to make the immune reaction that much more vigorous. It does not get cleaved to make S1 protein, because that cleavage site has been mutated to keep that from happening, but it does bind to human ACE2 receptors just like the wild-type protein. If such an injection were causing harm to patients, that would have set off a strong safety signal in the human trials, but no such problems have been seen. Not in the animal studies, not in first dose-finding studies in humans, not in the first efficacy trial, and not in the one whose results were just announced.

            https://blogs.sciencemag.org/pipeline/archives/2021/06/15/the-novavax-vaccine-data-and-spike-proteins-in-general

            1. Ian Perkins

              My apologies; I had no intention of implying there’s something dangerous about Novavax or GSK/Sanofi.

  13. WhatdoIknow

    We could get this pandemic under control if more focus is done on testing rather than vaccination.
    Find a quick and easy way to test and send each family enough free tests so they can test daily at no cost.
    You can be sure that 99% of people will stay home if they test positive and this will go a long way to prevent contaminations.

    1. Keith

      I have to disagree with you. People will not get tested if it means affecting their pay and/or careers. People won`t take leave or no pay dues if they have a xaee of the sniffles that may be contagious. Heck, a neighbor of mine continued going to work despite his wife, in the same household, being quarenteened for confirmed covid case. In my household, we are not considering it unless forced, such as daycare. Even the doctors dont seem all that enthused about getting them done. Our pediatrition said if we have are heart set on a test for our kid, we could get one. Anecdotal from me, but i suspect it is a common sentiment.

    2. chris

      No, we can’t be sure that 99% of people would stay home if they test positive. Plenty can’t afford to stay home. Plenty more are going to be thrown out of what homes they have. A good number do not have paid medical leave or sick time. Our leaders are very interested in pushing people back to working the crappy jobs so that we lose the idea that workers could ever have a say in their working conditions and pay. Your typical American bank account can’t handle the shock of being denied income. Most people rely on just in time finances and credit. So without further federal support, and mechanisms for the states to distribute that support effectively, I see no reason why any of what you assumed could be true.

      As for rapid testing, we have had options like that for well over a year now. Our leaders decided that won’t be what we do. We have refused to follow the guidance from people like Dr. Mina. We have refused to make rapid testing cheap and readily available. I don’t know why. Dr. Mina hasnt said much about it lately either.

      So…we’re kind of stuck. The only options were being given is to get vaccinated and then go back to work. And if vaccinated, depending on many factors, you may not receive a test to verify whether you have COVID and are infectious.

      1. Whatdoiknow

        I don’t know, I had to vaccinate my 12 year daughter so she can go to school. They make life impossible otherwise for her. However, if they required testing for kids every day in the morning before going to school and such testing was free , quick and easy, most parents will comply. This is far better than vaccinating kids as they can still carry the virus and contaminate others despite the vaccination. Plus, while I got the vaccine for myself, having to vaccinate my 12 year daughter makes me uneasy, I feel violated.

    3. Skunk

      We should be doing much more testing, but the virus is often contagious before symptoms appear. So you would need to test everyone, not just those with symptoms. Testing has often yielded inconsistent results. A person can test negative, then positive, then negative again within days. Cruise ships show that trying to test everyone prior to embarking is not completely effective. The virus slips through. Also, while not a pleasant topic, the virus can be carried in the intestinal tract even if the nasal passages test negative. China was performing anal swabs at one time. You can imagine the outcry if such testing practices were tried in the western world.

    4. GM

      Testing is useless without supported isolation.

      And nobody has absolutely any intention to provide financial support for self-isolation.

      States are doing exactly the opposite, by cutting off unemployment benefits to force people back to work.

      This is why investment in new testing technologies ended in the middle of last year when the decision to make it endemic was made.

      It is also why several European countries are ending free testing (something that most US states did a long time ago).

  14. chris

    I wonder if Slavitt’s statements are another foaming the runway moment for our leadership class… We had some discussions two weeks ago about what was common knowledge if you had read background papers on the vaccines and what was being advertised. “The vaccines are designed to protect against hospitalization and death” vs. “The vaccines prevent infection and will guarantee an end to the pandemic.” So I have to wonder if the same issue is here. How common is the knowledge that a virus like this could become endemic? How many of my fellow citizens understand that the likely scenario we have for the next long while is a 5th corona virus cycling through our population but instead of a nasty cold it gives you COVID?

    I don’t know whether that will result in much direct action by the people in the US. I expected a lot more violence and rebellion based on so many things last year and we didn’t see anything. So I have no idea what millions of people who have been told to be very afraid would do if they discover that now the killer is inside the house and isn’t going to be leaving anytime soon.

    The only thing I’m certain of is that the passport holding professionals of the F*ck-Up class will never admit that their decisions lead us to this point.

    1. GM

      The elites learned their lessons from the first half of the 20th century and have spent heavily on propaganda to make sure any potential real resistance is neutered before it gains any ground.

      Which is how we ended up in the current situation — the elites are committing premeditated mass murder on the masses yet the masses are not only not aware that this is happening but much of them have been successfully convinced it is in their best interest…

        1. Nce

          Is it still neoliberalism with the nicely obscured #2 directive, or techno-feudalism, which I assume just nakedly carries out the agenda?

  15. VietnamVet

    The coronavirus pandemic cannot be separated from the other catastrophes hitting the West; 1) the debacle in Kabul worse than Saigon 1975, 2) climate change enhanced wildfires, hurricanes, tornadoes and floods destroying American towns, 3) gone missing workers, 4) shortages from failed just in time global logistic system, and 5) evil incompetent leadership.

    “Let ‘er rip” booster shots are the ultimate version of the corporate state profiting from disasters. Either good governance is restored, coronavirus eradicated by using all of the public health tools available, the 1% globalists crooks jailed, or the USA will simply fall apart. Surviving Americans will be too sick from obesity, addictions and long-COVID to work for what few service jobs that are accessible. Portland OR is a glimpse at the future:
    https://katu.com/news/homeless-crisis/portlands-off-to-a-slow-start-with-homeless-sweeps

  16. Pat

    I really love his things we should tolerate list including “staying home when sick – always.”
    Something that could only be said by someone who has never worked two jobs and still struggle to have enough money to have a home and food to eat.

    We are facing a homeless explosion with a lot of the same parasites he has worked with for decades determined to make housing as “affordable” as healthcare in the age of ACA and private equity owned hospitals and medical practices.

    We have spent decades watching multitudes of good paying jobs become minimum wage and the gap between minimum wage and living wage become an abyss. And jobs come with fewer benefits, like paid sick leave. If you don’t work, you don’t get paid, and if you don’t get paid you don’t eat or have a place to live.

    How many people do not have a home to stay in, Andy? How many have to work 60+ hours a week to have a home and food for themselves and their kids and don’t get paid at one or every job they have if they don’t come in? And how many do not have enough paid sick days for one bout of flu or Covid much less multiple illnesses due to reinfection or long Covid?

    That he wasn’t struck by lightning for that piece of stupidity alone…

    1. Eclair

      My reaction exactly, Pat. Or you take time off because you’re sick, or your kids are sick, and you’re fired from your job. Sophie’s choice.

  17. drumlin woodchuckles

    We have another problem in this country, namely lots of people like the subject of this video. I will not write real nasty stuff about it. I will let the video speak for itself.

    https://www.reddit.com/r/facepalm/comments/p5kge3/i_respect_freedom_toofrom_asshat_like_you/

    I will also not state a wish that this person live for a hundred more years with long tail covid for all hundred of those years, because we have been informed that would go against the spirit of this blog. So I won’t state any such a wish.

  18. PlutoniumKun

    The ‘let it rip’ movement has been chuntering away in the background since the very beginning of the epidemic. There is no question but that there is an ideological, libertarian side to it, but I also don’t doubt that its funded from a wide variety of interests. I wonder if some of those interests (such as the airline industry) have really thought it through. Its been interesting in my own little corner of the world to see the stupidity of some business pressure groups who have repeatedly and loudly called for early ends to lockdowns, and then their members have suffered the inevitable consequences when Covid came back with predictable speed, wiping out much of the hospitality industry. I may be wrong, but I can’t think of any example of a business group apologising to their members for getting things so badly wrong.

    One problem though with countering the ‘let it rip’ narrative is that to my knowledge very few people have been giving a clear outline for alternatives – and this includes those people who are paid to do it, like WHO and all the national public health authorities. Most strategies have been built on unspoken but implied ethical choices – most commonly a strategy based on ‘keep infections down to a left that health services can cope with’. i.e. a purely hospital capacity based strategy. This can be clearly seen in Europe where the level of lockdowns have been closely corrolated with available hospital bedspaces.

    For me, the only intellectually and ethically coherent alternative to ‘let it rip’ has been Zero Covid. The problem is that we may have long missed the boat. There were, I think, opportunities in the last 16 months when it was a realistic target, in developed countries at least (and assuming our Leaders were willing to grasp the nettle of shutting down the airline industry). But with the multiplicity of varients now getting lose it may no longer be achievable (I have no opinion on this, I just don’t know enough about what would be needed). Even China seems to be having second thoughts.

    Some European countries such as Germany and Denmark now seem to be banking on a combination of constant testing, vaccines, plus low level public health controls to try to achieve ‘low covid’. Essentially, they seem to hope that Covid can be tolerated and managed by maintaining an R0 number hovering each side of 1 in the long term.

    The missing feature in all this is democracy. Without being provided a coherent menu list of choices, we are left with technocrats, elites, and financial interests arguing among themselves, and giving post hoc justifications for whatever emerges. This isn’t just a matter of fairness, without clarity on the underlying strategies at work, we can never know what is working and what is not working. We are muddling through in the vague hope that a really nasty and lethal variant doesn’t arrive. Maybe we’ll get lucky, maybe not.

    A few writers have made the point early on with the epidemic that historically, autocracies often react more decisively and effectively to out of the blue emergencies, but in the longer term democracies adopt better, albeit in an often messy fashion. I’d like to believe this is true with Covid, but increasingly I think the neoliberal infestation everywhere has weakened so many western socieities to the point where they are combining the worst features of democracies with the worst features of centralised autocracies. Covid may be the stress test that proves this point.

    1. GM

      One problem though with countering the ‘let it rip’ narrative is that to my knowledge very few people have been giving a clear outline for alternatives – and this includes those people who are paid to do it, like WHO and all the national public health authorities

      If you are not for elimination, you are for “let it rip”

      There is no middle ground in this case, this is very much a binary choice in the long run.

      This is not HIV where if you catch it through means other than blood transfusion, it is very much on you for being a careless moron, it’s a highly contagious airborne virus, there is no escaping it without becoming a hermit.

      Thus the unmentionable truth being that most public health authorities have implicitly been backing “let it rip” from the beginning…

        1. Ian Perkins

          Some have argued that animal reservoirs are irrelevant, but their arguments look extremely weak to me.

      1. PlutoniumKun

        I agree that this is probably correct (although it does seem that the Danes and others seem to think they can keep a cap on existing infections, although they may be overestimating their capacity).

        What I would like to see is someone put forward a coherent national and international strategy(s) for zero covid, at least so the public can see what is required. My suspicion is that the absence of published plans is quite deliberate – the current situation suits technocratic bodies and politicians who like to be seen to be in charge.

          1. Ian Perkins

            I haven’t looked through it all, but the Lancet article it mentions says
            There are three elements to their plan, based on the twin objectives of No-COVID and the creation of virusfree green zones. First, a rapid reduction in numbers of infections to zero. Second, avoidance of further virus transmission or reintroduction through rigorous test, trace, and isolate systems, together with local travel restrictions. Third, rapid outbreak management if new cases of COVID-19 occur sporadically.
            Which doesn’t look like it’s going to happen on a global scale, and until it does, even ‘virusfree green zones’ like New Zealand can suddenly become non-virusfree again – see NO-COVID IN LANCET

            And the list of COUNTRIES BEATING COVID-19 is mostly pretty tiny island nations. Elsewhere, the chances of reaching zero COVID aren’t looking so bright. As Plutonium Kun says, we may have missed the boat, if there ever was one.

            1. GM

              On a global scale rich countries will have to help poor countries, with testing and staffing resources to track and isolate the infected, and also with direct material assistance for supported isolation.

              That was done for smallpox and polio, and it worked.

              Yes, it is never going to happen in the current climate, but it is not for reasons of technical infeasibility.

              1. Ian Perkins

                I don’t think polio or smallpox were as prevalent as COVID has become. While we were tracking and isolating the infected and so on (in nearly two hundred countries simultaneously?), new outbreaks would likely pop up elsewhere. Even in a different climate, would the world have the resources to eliminate a highly infectious virus that is almost everywhere? Perhaps with a sterilising vaccine that breaks transmission, but we don’t have one yet, and there’s nothing to say such a thing is definitely possible, though attempts are underway.

      2. JBird4049

        T>>>his means a potential downwards spiral of T-cell exhaustion with each subsequent reinfection, which in turn means increased susceptibility to other pathogens, high rates of any autoimmune issue you can think of, and all sorts of other very bad things.

        >>>This is not HIV where if you catch it through means other than blood transfusion, it is very much on you for being a careless moron, it’s a highly contagious airborne virus, there is no escaping it without becoming a hermit.

        Well, it is like AIDS in that the declining T-cell counts means goodbye immune system. AIDS kills by getting everything else to kill you. Long COVID might equal AIDS in that you oh so slowly fall apart and die, which is a really fun experience to just see.

        Just like with AIDS, the epidemic showed who were real, and who were the psychopaths. Too many people then, brushed off the disease because most of the early victims were gays and later addicts, the then disposables. Today, it is the poor who are the most likely to get the disease and then be disposed of.

        History is just rhyming again. How f—— fabulous!

      3. Ian Perkins

        If you are not for elimination, you are for “let it rip”

        I don’t see why. The latter sounds to me like doing nothing, which isn’t what Slavitt is recommending –
        – Accelerate global vax effort. Instead of 70% by Dec 2022, we need 70% by March 22. The difference in giving the virus less time as we attack it is critical. A slow attack means more time for it to find ways to adapt.14/
        The development of an oral anti-viral is an essential tool. Along with better ventilated buildings, we can keep transmission low & make infections shorter & milder. 16/
        Research & development of treatments for long COVID must begin now & there is reason for hope that we will find both symptom relief & clues to better treatment quickly if we put our minds to it. 17/
        But there is something we can decide not to tolerate:

        Preventable deaths.

        We haven’t eliminated AIDS, but we’ve managed to do a lot to tame it. It looks increasingly unlikely to me that we’ll eliminate COVID, but that doesn’t mean we should just let it rip.

        1. GM

          Things like “developing an oral anti-viral” are a classic example of “assume a can opener” thinking. There is no guarantee anything like that will ever work. We got very lucky the vaccines work even as well as they do, few people expected it given past experience with coronaviruses, do we want to press our luck even further?

          There is also no guarantee long COVID can be treated. Lung fibrosis is forever, so is the brain damage, and many other aspects of it. We might be able to help a bit with the autoimmune issues, but again, there is no guarantee.

          And yes, Slavitt is very much recommending doing nothing other than vaccination. Which may well end up not just being not much better than doing nothing, but actively making things worse, depending on what effect the vaccines have on viral evolution.

          There is literally a public health algorithm for stopping epidemics like the current ones, saving the maximum number of lives, and restoring “normality”. The Chinese, NZ and Australia (minus NSW) run it very successfully every time.

          The US, UK, etc. governments blatantly refuse to follow it.

          And in the US the very concept of “public health” has now been completely discarded, which will have disastrous ramifications for decades to come even if COVID was to somehow magically disappear

          1. Acacia

            Thank you for this very helpful clarification.

            > The US, UK, etc. governments blatantly refuse to follow it.

            Not to sound too foily, but would it be too far a leap to infer that they are well aware of this public health algorithm, but have as a matter of policy chosen not to implement it, simply because that would involve “too much” public spending and such spending is counter to their general goal of privatizing all aspects of health care?

        2. Yves Smith

          This is bad faith argumentation, which is a violation of our written site Policies. You are already in moderation for previous violations. I suggest you quit accumulating troll points if you want to continue to comment here.

          GM explained why Slavitt’s position was tantamount to “Let it rip” and you have shifted grounds to say maybe somehow we can contain it, which is not what Slavitt is arguing for and there’s no public health policy designed to achieve that end.

    2. Olivier

      FYI Germany is closing many testing centers and ending the provision of free tests. The politicians there are also rabid about reopening schools. So I think Germany has given up, too, although it’s unwilling to come out and just say it.

      Don’t forget Germany is the land of financial repression, where wages have been kept low for decades and the social safety net whittled down to preserve the competitivity of the export sector, on which the german economy is crazily dependent. So giving up on COVID and telling workers to go die is perfectly in character.

    3. eg

      If Zero is unattainable (I really don’t have a clue about this) the next best strategy appears to be public health measures (testing, tracing, masking, lockdowns) to prevent healthcare system collapse while research on better treatment options and prophylactic regimens (including vaccines) continue.

      Anything else strikes me as more dangerous.

      Now, if Zero can be achieved, then that would be preferable — again, I don’t know whether or not that ship has already sailed.

  19. Olivier

    As a side note I don’t find it a coincidence that the same elites that think they can manage inflation levels also think they can manage COVID infection levels. Both beliefs are foolish but fit their managerial mindset so well.

  20. JTMcPhee

    Interesting that measles, an aerosol-transmitted virus, has an R0 of maybe 13, Delta maybe 6 or 7. Measles is pretty rare, though there must be reservoirs in our population since it’s still seen. https://onlinepublichealth.gwu.edu/resources/measles-history-in-the-united-states/ But I believe the measles vaccine is “sterilizing,” as opposed to “let her rip” “ neutralizing” COVID vaccines. Wonder why there’s not much seen on developing a true “sterilizing” vaccine for COVID. Or maybe I am missing something?

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