If the forever-COVID reality for 95+% of the population is "you really, really ought to get that annual booster shot" (instead of "get the flu shot iff it's convenient"), that's not actually so terrible.

If it becomes century-long endemic in the population, kids are exposed to it, likely creating a productive exposure-related immune reaction until they're old enough to get an mRNA vaccine.

Definitely. I don't think it's terrible at all given the alternative is tens or hundreds of thousands of additional people dying from Covid per year in the US. I guess we'll soon see the extent to which the public can be convinced to get booster shots every year. The governments of the world will have their jobs cut out for them, there will be a lot of resistance to forever Covid vaccinations as time goes on (and very lucrative for big pharma; Pfizer, BioNTech and Moderna are going to make a stupid amount of money over the next few years).

What will be interesting to find out in the near future, is if high vaccination rates + prior infections reduce Covid deaths below, say, 50k people in the US every year, or whether we're forever stuck with a sizable population killer no matter what (short of implementing elaborate forever cultural systems of lockdown; as in, those counter measures will have to become ingrained deeply into the culture, accepted and automatic). The next decade is going to be very weird and interesting on that front.

Vaccination is great but in addition to that we could also cut the ongoing death toll through public health campaigns to eliminate hypovitaminosis D. This could be done relatively cheaply.

https://vitamin-d-covid.shotwell.ca/

From a public health perspective, the total number of deaths in a pandemic is less important than the timing of the case load. Too many cases in too short a period of time causes havoc in the health care system, and then helps lead to deaths from conditions unrelated to the pandemic (because hospital care is unavailable).

It may sound callous, but in terms of first priorities, reducing the total number of deaths from COVID19 has never been our #1 priority (to the extent that we've had any clearly formulated priorities at all). The implicit goal, as we were all saying in the spring of 2020, was/is "flatten the curve".

The actions of my local government align with that. Keep the hospitals from being overwhelmed, but if you die because you didn’t get vaccinated, too bad so sad. Which seems the right way to handle it. Allow folks their individual freedom as much as possible, but don’t break the health care system.

> Allow folks their individual freedom as much as possible, but don’t break the health care system.

Unfortunately, these two goals, when combined with an infectious agent with a good-sized R0, are really in opposition to each other.

I don't think they need to be. At least not within reasonable bounds.

There's certainly an interesting discussion to be had surrounding individual freedoms vs the common good in a pandemic, but I'm not sure as to what extent we can even have those discussions while an embarrassing number of people feel that just being asked to wear a covering over their face in public spaces is an intolerable violation of their personal freedoms. When even the smallest requirements intended to protect the public's health are treated as if they were the harshest forms of oppression imaginable there simply isn't any room left for debate.

Still, for the population that believes a degree of concession can be reasonable and appropriate under such extreme conditions as a global pandemic I think it is possible to strike a good balance between individual freedom and individual and collective responsibility. I think we can work to protect freedoms while also insisting on some measures to help reduce the spread of a virus.

It doesn't have to be an either-or situation at least.

It's probably going to end end up the same as the Spanish Flu influenza variant, occasional localized outbreaks which are much less severe than the original pandemic.

U.S. is only at 50% fully-vaccinated, with several states in the high 30s to 40s. I could believe 70% with at least one shot but haven't seen any statistics to that effect; it doesn't matter much since Delta is still pretty dangerous to partially-vaccinated people. We had 35M recorded COVID cases; I'd believe about a 2:1 undercount, so about 70M total cases (~22%). Vaccines + previous cases was likely past herd immunity for the original variant (hence why cases dropped dramatically after vaccines came out), but with Delta's increased herd immunity threshold we should expect another 50-70M cases within the next few weeks.

> I could believe 70% with at least one shot but haven't seen any statistics to that effect

Good guess. As of today, that's the exact number:

https://www.usnews.com/news/health-news/articles/2021-08-02/...

Just for clarity, that's "70% of American adults".

18% of Americans are 15 or younger [1], below the youngest approved vaccine age (the Pfizer vaccine is approved for teenagers as young as 16), so that's (0.18 + (1-0.18) * (1-0.7) = ) ~42% of Americans who haven't even received 1 shot, and 58% who have.

(There may be some error in that, if far more or far less than 70% of non-adult vaccine-eligible people (teenagers aged 16 or 17) have gotten at least one shot, but it probably doesn't change the overall percentage that much.)

[1] https://www.cia.gov/the-world-factbook/field/age-structure

Need to redo some numbers, Pfizer has been approved for ages 12 & up for a couple of months now [1]. Our World In Data lists that ~50% of American population is already fully vaccinated.

[1] https://www.fda.gov/news-events/press-announcements/coronavi...

I found:

https://www.mayoclinic.org/coronavirus-covid-19/vaccine-trac...

...to be quite interesting for covid-19 vaccination information. For example, the state with the lowest rate of at-least-one-dose vaccinations for people 65 and up is West Virginia, at 83.1%. Most states are 90+% or better for that age group.

It's 70% adult vaccination at one shot or more (I specified adult in my comment). That's all over US news today. The US is at 165m fully vaccinated (or 50%), most of which are of course in the adult segment.

A very large number of those adults also aren't going to need two doses to reach high levels of protection (against severe outcomes), due to prior infections. One mRNA vaccine dose + prior infection will get you there.

Combined with the recent surge in vaccinations due to Delta concerns, the US will probably see the same drop-off that Britain has by late August - early September.

> The great lie still [...] is that Covid is going to go away courtesy of vaccinations. The authorities have pitched that to the public from the early days of the vaccines

That is (1) outrageously hyperbolized and (2) completely wrong. Delta wasn't known to have this level of transmissibility until the last three weeks. People, experts, doctors, "authorities", whatever, you want to label them 100% believed sincerely that we were on a path to the elimination of the outbreak.

Cut the bullshit, basically. Yeah, yeah, I know it's HN and everyone wants to think they're smarter than everyone else. But you aren't. You're retconning brand new science to make prior understanding into a "big lie". That's really awful.

> Delta wasn't known to have this level of transmissibility until the last three weeks.

Delta was formerly known as the India(n) variant. We've known it had high transmissibility since April or May.

The relevant experts - virologists, epidemiologists, etc. - neither believed nor claimed that we were on a path to the elimination of the outbreak. They've consistently stated that the virus will be around for at least years, probably decades, possibly forever.

To be clear, I meant "elimination of the outbreak" in the sense of an endemic virus that produces a steady case rate. Clearly no, no one expected this disease to be eradicated.

Well, you and I didn't. I know quite a few people who've been talking since June about how they're comfortable doing suchandsuch "as soon as Covid is gone", and I'm not sure what they could mean by that other than eradication. It would seem to me that by an endemic standard, the Covid outbreak was gone from the US between May and July and has only just recently made a resurgence.

That seems nitpicky. There are lots of non-eradicated endemic diseases (ebola, malaria...) that are objectively much scarier than covid. But we don't freak out about them because they are well-controlled and rare. A covid mitigation regime that keeps its R0 under 1 and its outbreaks local and non-spreading would be very much the goal here.

> It would seem to me that by an endemic standard, the Covid outbreak was gone from the US between May and July and has only just recently made a resurgence.

Pffft. Yeah, not even close. At its lowest, the covid death rate was 5x higher than average deaths from influenza over the past decade.

At what specific death rate would you be comfortable saying "okay cool" and treating Covid the same way as other diseases?

I don't mean for this to be a trick question. 5x the flu is within my comfort zone, but 2x or 1x or even 0.5x could all be reasonable answers. The answer that's not reasonable, but is by far the most common answer I've gotten, is that no Covid deaths are acceptable and we should never stop taking extreme measures to suppress them.

Gah. Influenza kills more people in the US than any other infectious disease, and frankly it isn't even close. You aren't making any sense here. I cited that number, clearly, as an UPPER bound beyond which we couldn't possibly view an outbreak as acceptable.

I don't view a statement that puts 100k deaths/year as within your "comfort zone" as a serious attempt to engage, sorry.

I dunno. I'm not gonna browbeat you with more arguments for my risk tolerance if you're not interested in them, but I think you're avoiding looking reality in the face here; there's a lot of people an order of magnitude more risk tolerant than me who wanted to open crowded bars in February or earlier. A policy that expects restrictions will remain in place as Covid deaths fall, but can't offer any explanation for why they should remain in place or when they'll no longer be needed, seems doomed to the same kind of mass defection we saw in mid-2020.

People aren't necessarily risk tolerant they largely are utterly incapable of grasping relative magnitude of risk and largely believe that gains in freedom will accrue to them and costs will accrue to other people.

Yeah, but a politician can’t say that…so the experts close to the politicians tend to follow the political narrative instead. The ugly result is a lack of trust in the experts, the science, and the politicians when there are setbacks to that political narrative.

Yeah. This has been my impression, too. I’m not aware of anyone who thought vaccines were a path to total elimination. But then, my only news source is HN and some science YouTube channels.

The vaccines are/were a path out of a pandemic.

That's something to strive for, but extremely different from "elimination"

IMO users who push flat-out lies like that should be banned. HN should not be a source of disinformation.

Where are you getting 100M confirmed infections?

I can't speak to what the parent comment might have been referencing, but the CDC estimates 120MM infections through May 2021.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd...

Thank you