Yes, escape from circulating neutralizing antibodies (so the virus is able to infect you and replicate) is one thing.

Escape from CD4+ T-cells is another thing (the dreaded "reset to 2019" fear).

And the 1918 H1N1 influenza circulated as the only form of seasonal influenza until 1957 (when it was displaced by H2N2 which later became H2N3). From 1957 to 2009 H1N1 mutated in swine. After 50 years of mutating in probably billions of pigs the H1 envelope protein jumped back to humans in 2009. Since old people had pretty universally been exposed to pre-1957 H1N1 they had cross reactive partial immunity from T-cells that still recognized the H1 envelope protein and that pandemic fizzled.

If you can't escape CD4+ T-cells after 50 years of mutating in pigs, I don't think that this coronavirus is going to be able to escape them in a year or two.

Also at some point to achieve escape from neutralizing antibodies this virus is likely going to have to start making "choices" which make it less virulent.

A decline in vaccine efficacy against delta could also indicate that the enhanced transmissibility of delta comes through partial vaccine/immune escape and not through ratcheting up R0/Rt (which would be more consistent with reports that it isn't more lethal / doesn't have higher viral loads, since those switches are all likely to move together).

yep, it may be that these new variants are not attempting any kind of immune escape against vaccines. They might just replicate faster or may be more transmissive and we are seeing the inevitable outcome of a non-sterilizing vaccine: you still get an infection, it just usually isn't a bad one.

Ironically in NZ they have nether vaccine nor any remaining covid. Because they solved it as a community.

Instead we created a global persistent pandemic.

Cool.

Unlike New Zealand, most countries don’t think indefinite draconian restrictions on travel and ever-present risk of being locked down with little notice are an acceptable price to pay for a small increase in life expectancy. I share that viewpoint, and am very happy not to live in New Zealand.

Describing the covid pandemic as simply a small decrease in life expectancy is a little on the nose.

Also, as a vaccinated New Zealander who after spending 5 months at home is now traveling again, I can assure you people there are happy and mostly oblivious to what has gone on overseas.

The travel restrictions whilst draconian, aren’t absolute and are being eased when needed. The travel bubble with Australia being a good example of this.

Sounds worse than many places, ie Switzerland which is completely landlocked with diverse neighbors and open borders.

Very few travel restrictions, mostly in spring 2020, just do your part and do the right choices in ie hygiene and travel destinations.

Switzerland has had just under 11,000 people die, NZ 26 (twenty-six).

Not to mention, NZ had complete lockdown for all of two months. The rest of the time peoples daily lives were unchanged. No masks (generally), concerts with 10,000+ people no problem. Summer holidays etc etc.

New Zealand was exceptionally successful, and other areas which tried that strategy weren't so lucky. Some parts of Australia were shut down for something like 9 of the past 18 months. (Sydney is under lockdown orders today!) And I think it's hard to find fault with the strength of lockdowns in France, Spain, or Italy - their lockdowns just didn't fully eliminate transition, so we put them in the "weak lockdown" bucket, even though as a matter of government policy they were doing the same thing.

> Describing the covid pandemic as simply a small decrease in life expectancy is a little on the nose.

How so? The first result I could find[1] estimates that life expectancy decreased by 1.18 years in the US due to the pandemic, which doesn't strike me as extreme.

1: https://www.pnas.org/content/118/5/e2014746118

Life expectancy is a long term trend. Why would you use it to measure the impact of a pandemic?

Answer: Because you can hide the one bad year with the last 100 good years of data and trending.

Maybe you should use population growth projections from 1970 to 2070 to show that this isn't even a pandemic?

That's 1.18 years despite all the countermeasures the US has implemented.

Are you aware how hard it is to move the needle by any significant percentage when you are dealing with sets of millions? Life expectancy is essentially an average of when people die.

Not to mention life expectancy was going up. So it not only stopped whatever gains we had, but reversed it by a substantial amount.

We were expected to gain 2 years from 2017 to 2030. That's 13 years to go up 2 years.

About 2.8 million people die in the US each year. The current life expectancy is about 80 years. To make that 80 become 78.8 is the equivalent of 1.5% of the people or 42,000 babies dying as soon as they were born.

Anything that can move the needle that much in such a short time is pretty extreme.

Yea, statistics can make a case for anything.

Life expectancy went down, but the average age of a covid death was 82 years old, meaning half were older than 82.

These octogenarians and older are pulling the average life expectancy up every year they continue living.

It would be a way different story to have the average life expectancy go down because a bunch of, say, 20 year olds died.

Yes, old people living longer pulls up the average life expectancy. That's how it works.

And that's been happening every year by a little bit every year (about 0.15 years). Until this year.

When it decreased by 0.1/year for three years in a row, it was a big deal.

Having it drop by 1.2 in just a single year is effectively astronomical. It is a significant event.

It depends on how it drops by 1.2

If all you care about is the numbers, then a drop of 1.2 is a horrible terrible outcome and we should all recoil in horror, no matter how it happens.

To me and almost every other human, having a bunch of 80 year olds die, losing out on say, 1-5 quality-adjusted years of life, is not great, but it is nowhere near a tragedy.

Having a bunch of young healthy people with say 50-70 quality-adjusted years of life left, is an absolute horrific nightmarish cosmic-scale terrible outcome.

But to you, it's 1.2 either way.

> nowhere near a tragedy

It might be useful to tone down any highly idiomatic usage of English here, because this sounds very weird.

edit: sort of has this vibe. me: "I was sad when my grandmother died" hn: "WAAAAYYY off there, buddy."

If half are over 82, what does that make the other half?

I'll wait for you to figure that one out.

1.2 is major, no way to slice it. Because either we've been lucky for decades with all of the slight increases or something major just happened.

Now you're trying to color the discussion by projecting things onto me. I never used the words "horrific" or "nightmarish" or even "terrible".

I used the words significant and astronomical. Because they apply. When we've been slowly gaining by 0.1 years/year, a drop of 1.2 years is a -1.3 change. That's a 1300% decrease compared to previous years. Those sorts of scales of difference are typically found in astronomy.

Why do you have a vested interest in downplaying what happened over the past year?

> if every country simply locked down for 3-4 weeks

This is an absurd fantasy that couldn’t have been possible in the real world.

> But no, muh freedom, and but the economy!

Your mocking tone is out of place. I do in fact think freedom and the economy are both important. Don’t you?

I'll try with a different tone.

The intention of keeping freedom and not harming the economy was IMNSHO not matched by that effect and the discrepancy wasn't really surprising.

The authorities where I live decided to keep more open than I considered wise, and not much later closed a lot of sports, for example. The effective choice was freedom now against freedom later, even if the intention was to choose more freedom rather than less.

Yes, my freedom over the course of almost 1.5 years was adversely affected because we couldn't handle a month without it.

And yes, the economy was adversely affected because most small businesses were shuttered for half a year and swaths of them went out of business since we could not bear closing everything down for a sixth of that time period.

Edit: Please explain to me how swallowing real estate, employee, and supply chain expenses for 30 days would have been more difficult or less preferable to the splintered schedule of mandated closings over a far longer time period.

The importance of freedom and the economy are not in dispute. The point is that both would have suffered less in the long term if "draconian" lockdowns had been implemented in the short term. It's game theory, and NZ chose the winning strategy while much of the world chose the losing one.

>This is an absurd fantasy that couldn’t have been possible in the real world.

China and the countries of Oceania did just this and have largely suppressed COVID without MRNA vaccines. China has a massive, porous land border. They've protected themselves from inbound infection by quarantining all visitors on arrival.

> every single country

The pandemic is estimated to have cost the world >$16 trillion already. Now politicians are telling us we will have to live with it forever.

For that price, we literally could have paid every human on earth $2,000 to shelter in place for 4 weeks.

What others did is not fantasy but possibility. If your leaders cannot deliver that, replace them.

It's a little more complicated than that.

When you live on islands thousands of miles away from anywhere with a fairly homogenous population and diversified economy, it's easier both physically and politically to take isolation action against a pandemic.

I think the crux of the matter is that I speak with the benefit of hindsight whereas governments had no such luxury. I think, perhaps, if we truly knew with certainty that the pandemic was a more prolonged situation than one could hope for (despite being warned of such), that a more organized and simultaneous effort to shutter economies and travel for a temporary short-term would have been an easier position to argue politically.

Perhaps. In the United States, the Federal government lacks the power or manpower to make such a decisions, and given that there are 50 states, you’ll always have exceptions.

Valid point. That's a whole extra tier of cooperation necessary. I suppose in this case it would not be unfair to treat each state similarly to a country on the global level, but it does complicate the path to the success condition.

The very fact you’re suggesting every country locks down for 3-4 weeks” as a solution shows youre ignoring reality.

All it would take is for 1 person to travel for the epidemic to continue. Maybe developed nations could do it but developing nations are still dealing with illegal border crossers even 1 year into the epidemic.

So great theory but it falls flat in reality.

In my scenario travel in both directions would be disallowed for the time period. This also requires neighboring nations to do the same, as well as farther off countries to implement checks at the airport. All this was somewhat done regardless but in a haphazard manner devoid of full international cooperation.

So we suffered the major drawbacks anyway all while reaping a partial reward.

Just because something is disallowed doesn't mean people stop doing it.

The insinuation is that in such a scenario there would be a strong enough disincentive.

And perhaps also the incentive of not having a years long pandemic.

Yeah the farmer in SE Asia whose family is starving because he can’t get to market will certainly not try and break any rules.

Love these solution designed by people who work from home.

Food distribution certainly falls under essential services. Pharmacies, too. But not much else is absolutely necessary.

What is a strong enough disincentive? Would you recommend building physical walls along our borders and using violence against people who attempt to cross without authorization?

No, I wouldn't. Gosh, and if I didn't respond it would almost look like I did support that wouldn't it? Toss out these cheap tactics...

There are obviously many levels on the spectrum of what could be done to sufficiently increase compliance without falling back on martial law and giving the governments more reason to erode our freedoms.

And if we banned all drugs, all drug use would stop too?

That's a strawman for an entirely separate discussion.

But I'll bite. No, it wouldn't. However that's not only why we shouldn't. It is most effectively and altruistically addressed as a medical and humanitarian issue.

They solved it as long as they can live without contact with anyone else.

As much as it shows what could be done with drastic measures, NZ is an island with small population, in the middle of nowhere so it can easily lock its borders compared to say, pretty much any European country.

They certainly handled it better, but I'm not sure that they will actually be ready to live in a COVID world any time toon without a strong and thorough vaccination rollout like everybody else.

Wanting to keep zero case as all cost is going to be increasingly difficult and expensive to maintain: how long will the population accept that they can't travel? Can an economy partially dependent on tourism afford not to be open? Wouldn't NZ be penalized at some point if business people/athletes/students/engineers/scientists can't fly to or from it?

Even if all western countries had been exemplary -ignoring that it would probably be impossible anyway- as long as we don't ensure that even poorer countries are able to stamp out the virus, there will always remain sources of variants that will continue to spread across the world.

Look at Australia. Small population, big country, huge barriers to entrance (even for residents), extreme quarantine measures, and yet, you only need a single infected person to start spreading again.[1] As long as the population won't reach the minimum vaccination level required, they will continue to be barred from travelling and get lockdowns.

Looks like the only hope we have is to accept it's there and ensure that the impact remains manageable through vaccination and targetted health control measures.

[1]:https://www.nytimes.com/2021/06/26/world/sydney-lockdown-cov...

Just to be clear, Australians are barred from leaving the country whilst NZers are free to come and go, provided when they return they do a 14 day quarantine at their own expense.

Getting a spot in the quarantine hotels is difficult but possible on a 3 month time frame.

As for the tourism thing, I’ve heard that it’s actually a net positive for the country(~1.5%). Whilst we have no foreign tourists, we’re also not heading overseas spending money.

Are children free to play team sports?

The lack of that really hurt here.

In NZ? NZ currently has no community covid cases so sports continue. Daily life is largely uninterrupted aside from having less international tourists.

That's what I though. Considerably more freedom than many other countries, IMNSHO, including those whose leaders chose policies with emphasis on maintaining liberty.

NZ already has vaccinations rolling out. They do not plan to have restricted borders forever. Last I heard 1.5m doses had been distributed and govt expects everyone to be vaccinated by end of year.

People can travel but on return would face a quarantine process so most do not bother (except for recent travel bubble destinations). Athletes travel.

Most people have been supportive of the NZ govt as the healthcare infrastructure may not hold up with large numbers of sick COVID patients, hence the vaccine being helpful in reducing those critical cases requiring hospitalisation.

Meanwhile we've spent pathetically small sums on making vaccines and expanding production.

NZ's strategy only makes sense with eventual vaccines. There is no chance that this disease would ever not become endemic. The world is too large, and too many countries don't have the advantages NZ does (comparitavely wealthy, isolated, low population density). They deserve props for keeping their population healthy until this point, but the idea that it can continue indefinitely, or that it was ever feasible for a large proportion of the world to replicate it is pure fantasy.

NZ's strategy (and all lockdown strategies) never made any sense and it was obvious from the get-go.

Very early into the pandemic, we learned three crucial facts:

1) Covid is non-transmissible outside. 2) Vitamin D is a potent inhibitor of respiratory illness in general and covid in particular. 3) Obesity is the greatest risk-factor associated with covid.

With these taken into account (and all are very well-supported by many of those peer-reviewed studies everyone seems to need in order to take any action), the best course of action is to encourage everyone to go outside, hang out with friends, don't wear masks outside (because this discourages going outside), exercise, and soak up lots of sun.

The next "big wave" of covid in the northern hemisphere is going to come in the winter, just as all "seasonal illnesses" do. In fact, there's at least one study out lately that indicate that there's nothing seasonal about illnesses, but that vitamin D deficiency, brought on by staying inside during the cold months lowers group immunity and causes increased illness.

1) might not be true with Delta. There are cases of "passing" transmission of <30s contact. Too soon to tell, but what we learned early in the pandemic pre-delta may not apply now.

2) is still up in the air with studies going both ways (but get your vitamin D still, it has multiple benefits outside of this)

3) is somewhat true, but there are other big comorbidities as well (Diabetes, Downs Syndrome, etc), it's just that it's one that's highly visible in Western society and hypertension is very common in obese people.

It seems like you're of the mind that every new novel virus that enters the biosphere requires several months worth of randomized control trials to determine best paths forward.

The precautionary principle would tell us that it's best to ensure your immune system is as strong and healthy as it can possibly be, which requires going outside, getting fresh air and sunshine, visiting with family and friends, and getting fit.

The way your reply is phrased, it makes it seem like every time a new variant or whatever is announced, we should all default to locking down, staying inside, and slowly killing our immune systems.

That doesn't seem to make sense. We know what makes humans healthy, and we should be constantly reminding people to do the daily things to build their natural immunity, which is an amazing and effective defense against covid and myriad other ailments.

Imagine if we'd spent the past 1.5 years collectively working to lower the BMI of the USA and getting everyone a little more tanned. We'd be far better off along basically every metric and the pandemic would've been far less impactful.

That our Public Health Professionals know all these things work and never ever talk about them and instead seem to always recommend staying inside and spiking cortisol levels, we shouldn't really pay them any mind whatsoever.

Your attempt at reading my internal mindstate was wrong, I'm afraid. I was simply correcting your assertions that have not been backed up by real data, and the fact that you've glossed over the changes in the virus that have been observed in the wild over the last few months.

But let's talk about this: having an immune system be as strong as possible is not a good thing. Weak immune systems are bad. Overly "strong" immune systems result in auto-immune disease.

"Natural immunity" to COVID is no different ($) than vaccine immunity, and our vaccine-given immunity comes with far less risk. We've been given a miraculous vaccine technology, tested it at scale and found that it's safe. If you want to make some real change, focus on changing the minds of the anti-vaxxers that are extending the pandemic through their lack of action.

Sure, getting everyone fitter would help. Getting people more vitamin D will help with other things (but again, probably not to a great extent with COVID). But that doesn't change the fact that we were grappling with a deadly virus that can quickly overwhelm health care systems and cause long-term "long-COVID" damage that we are still not completely understanding.

($) I don't have the numbers at hand, but the last study I read suggested that getting COVID was slightly better at preventing future COVID than a single Pfizer dose, but worse than two Pfizer doses. Will look for this again.

EDIT: https://www.gov.uk/government/news/past-covid-19-infection-p... is the study.

> "Natural immunity" to COVID is no different ($) than vaccine immunity

You can't find any studies to back this up, can you?

It'll be hard without clarification at first, because it's not clear what you mean--do you mean "natural immunity" as in somebody who, when encountering the virus for the first time, has an immune system which fights off the infection without any symptoms and low/no transmission to other hosts? If that's what you mean, then no, natural immunity, present in basically everyone sub-40 who's not fat, is far superior to vaccines, because it comes with zero long-term risk and from what everyone can tell has a death rate too small to measure: https://www.thelancet.com/journals/landia/article/PIIS2213-8...

If you're talking about someone who has fought off covid and has naturally-produced antibodies, then you have I presume no citation to say it's "as good as vaccines". Natural immunity in every case it's been studied has been shown to be robust, long-lasting, and superior to vaccines. In fact, the survivors of Sars-Cov-1 from back in 2005 still have robust immunity against sars-cov-2. In fact, some large percentage of the population had t-cell reactivity to sars-cov-2 without ever having contact with the virus: https://www.bmj.com/content/370/bmj.m3563

It's also super-weird to have people like hold the bar as "vaccine-level immunity". The human body is a genius achievement of evolution, and THAT is the bar.

Zero studies have ever shown any way in which vaccine-based immunity is superior.

And now we have all this talk of boosters. LOL!

Don't need no booster for natural immunity. But there sure are some people who want you to have 'em anyway!

> You can't find any studies to back this up, can you?

The "($)" which you quoted indicates a reference at the bottom of my comment, where I linked a study that explicitly showed that natural immunity from COVID and vaccine immunity are similar (but fully-vaccinated with an mRNA vaccine is best).

I don't believe you're willing to have a conversation in good faith, as you are clearly anti-vaccine. Good day.

Well NZ can enjoy their isolation and constant threat of outbreak while the rest of the world goes back to normal.