> Long term plan in my mind was to get enough people vaccinated that community spread stops being a thing. We were almost there in late spring prior to delta variant showing up

Was this your plan back in March 2020 or did it become your plan somewhere down the line? What I remember from March 2020 is that the plan was to "flatten the curve" with temporary restrictions. The possibility of a vaccine was theorized to be between 18 months away to possibly never.

My plan in March 2020 was to wait it out and do whatever I could not to get infected myself. I think at the time I said something to the effect of "I can't imagine this lockdown lasting less than six months." At first I think I expected most people to get it eventually, and the main concern was to keep the hospitals from being overwhelmed all at once. Then after awhile it became apparent that it could be kept under control or not depending on how well people adhered to social distancing and masking. The vaccines arrived, which were supposed to be the thing to end the pandemic. It almost worked.

Now we have Delta variant which is far more contagious. Looks like we may be over the hump in the current wave (speaking from a U.S. centric point of view). What happens next depends on whether we can achieve a level of immunity that prevents the virus from spreading.

> What happens next depends on whether we can achieve a level of immunity that prevents the virus from spreading.

Sir Andrew Pollard, the head of the Oxford Vaccine Group that developed the AZ vaccine, does not think this is possible because vaccinated people can still get and spread the virus.

https://www.cnbc.com/2021/08/12/herd-immunity-is-mythical-wi...

> “The problem with this virus is [it is] not measles. If 95% of people were vaccinated against measles, the virus cannot transmit in the population,” he told the U.K.’s All-Party Parliamentary Group on the coronavirus.

> Pollard said that while Covid vaccines might slow the spread of the virus — because fully vaccinated but infected people appeared, in studies, to shed less virus, giving the virus less opportunity to spread — new variants were likely to emerge that would also spread.

> “I suspect that what the virus will throw up next is a variant which is perhaps even better at transmitting among vaccinated populations and so that’s even more of a reason not to be making a vaccine program around herd immunity.”

It is increasingly obvious that we are going to have to find ways to live with this virus. It will be (and basically already is) endemic. Hopefully over time it will become more and more like a cold but until then, aiming for the impossible is only going to make the situation worse because more and more people are seeing that the narrative and claims presented by politicians and technocrats don't add up.

Living with the virus means people getting vaccinated. We will continue to have mass death so long as there are segments of the population that are unvaccinated. Vaccines are still the answer.

people say that delta is more contagious but they don't provide hard data to support that. any calculation of r naught is synthetic and there has been little effort to share such models. also, the idea that every new infection is delta isnt based on any randomized testing of samples, but some outdated surveys in the past.

I think, like I've consistently done, you have lost a year. It's 2021, and parent's post (and plan) makes sense to me.

The virus is now endemic and can never be eradicated. The Delta variant is so contagious that there will be no significant herd immunity effect to protect unvaccinated people. All of us can expect to be exposed occasionally no matter what we do.

https://www.businessinsider.com/delta-variant-made-herd-immu...

In the US, adults who want to be vaccinated have been vaccinated. Children aren't at significant risk. So the best approach is to drop all restrictions and accept the risk.

Nonsense.

1. Many diseases have been considered endemic but were eradicated. Don't be a doomer.

2. The whole schtick about anyone who wants to get the vaccine can get it, so it should be a personal choice makes this common but very much mistaken assumption that a vaccinated individual is safe from harm. It just isn't so. Your personal risk is not affected only by your acquired immunity, but the acquired immunity of everyone around you. Vaccines fundamentally require a communal, cooperative endeavor to succeed.

We eradicated smallpox and (almost) polio because we had highly sterilizing vaccines and no animal hosts. That situation doesn't obtain with SARS-CoV-2.

Vaccines are highly effective at preventing deaths and I do encourage vaccination, but vaccinated people can still catch and spread the virus. They are probably less contagious on average, but unfortunately that isn't enough to control community spread.

https://www.nature.com/articles/d41586-021-02187-1

https://www.nature.com/articles/s41586-021-03944-y

Acknowledging reality isn't being a doomer. Don't engage in magical thinking.

Delta variant has an R0 of about 7-8. Measles 12-18. And yet, measles is nearly eradicated in the US.

You are overstating the extent to which vaccinated individuals are likely to be infectious. But more importantly, you are ignoring the importance of the network effects involved.

For x to get to z through y, x has to infect y, and y has to infect z. If probability of infectious breaktrhough and a contact event is 20%, the probability of it getting to z from x, is .2^3 = 0.008. And yet, a 20% is really high-end estimate of that likelihood. You need to both have a breakthrough infection and be in the vicinity of others for potential transmission.

Two doses of the measles vaccine (MMR or MMRV) are highly sterilizing and 97% effective. That's far better than any COVID-19 vaccine, so measles isn't a valid comparison.

https://www.cdc.gov/measles/vaccination.html

Your other numbers are just made up and not worth discussing.

1. We're not done making COVID-19 vaccines. For you to declare defeat so early is purely anti-vaxx bias.

2. The measles is way more contagious. It's dreadful for you to simply ignore that when it matters so much to the calculations.

The thing about these results is that its mostly in people who show symptoms, and it isn't clear to me that symptomatic covid infections in vaccinated people are associated with similar viral loads as when asymptomatic.

I think this study tries to address this. But haven't had time to read through

https://spiral.imperial.ac.uk/bitstream/10044/1/90800/2/reac...

> 1. Many diseases have been considered endemic but were eradicated.

Name two (and also, how long did it take for each one? Is that a reasonable amount of time to wait?)

I don't need to. Wikipedia does it for me.

https://en.wikipedia.org/wiki/Eradication_of_infectious_dise...

The first two sentences of your article are

> Eradication is the reduction of an infectious disease's prevalence in the global host population to zero.[1]

> Two infectious diseases have successfully been eradicated: smallpox in humans and rinderpest in ruminants.

There is exactly one disease that has been eradicated in humans: smallpox, which took somewhere between 19 years and 27 years depending on when you consider the eradication effort to have started in earnest. We've gotten close with polio (after 40 years) and guinea worm (37 years). There are also a bunch of other diseases on that list where elimination efforts are in progress, but have not yet been completed.

Regardless, "eliminate COVID", should we decide to go down that path, is going to be a multi-decade project at best. It's also likely to be much harder than eradicating smallpox given the asymptomatic transmission and animal reservoirs. It might still be worth doing, in the same way that our eradication effort for measles is worth doing, but it's not worth holding up anything important until the effort completes considering that "until the effort completes" is likely to be a couple generations at the earliest.

You're arguing semantics now. Measles is effectively eradicated. Sure, if we all stopped getting the vaccine, there would be outbreaks. The important thing is that it can be controlled to an extent that it no longer poses a substantial burden on people's lives --- and the reason it isn't eradicated is less than full vaccination.

The point I was responding to was this idea that we should just settle for covid being endemic. So I'm really not sure why you are going on at about semantics.

My understanding is that you are advocating for continuing to wear masks, restrict gatherings, and push for vaccination until COVID is eradicated or close to it, and are also under the impression that "until COVID is eradicated or close to it" could be a matter of just a few months if everyone would just work together.

My point is it will not be just a few months. It will be decades. Even in the case of measles, it took almost 10 years to get from 250,000 cases / year in the Americas to 100, and we're starting from a lot more than 250,000 cases a year in the Americas this time.

If the alternative is 10 or 20 more years of restrictions, I think "settle for covid being endemic for now, with vaccines available for anyone who wants them, and maybe push eradication at a later date when most everyone has either natural or vaccine immunity and that job is easier" is in fact a better solution.

Are you ready for another 5 years of partial restrictions over a virus that's as deadly as the flu (after vaccination) for the chance we develop a vaccine that's even more effective than what we have today?

Bingo. It's wild to me that with these simple and undisputed facts, so many people are still unwilling to operate within that reality.

We have these "rules" to play by: Vaccines don't stop transmission, vaccines majorly help prevent major complications, kids at zero risk, overwhelming majority of adults at zero risk, unvaccinated people are unlikely to convert for whatever reason (political, fear, friends won't, etc), and natural immunity after infection is very helpful.

If given these "rules" - aka reality - what would you do? The dumb people are like, "Durrr, we need more vaccinated people, those evil bastards they are" even though it blatantly ignores reality and will therefore accomplish nothing, besides being an illogical fear since they're protected anyhow. But if you just accept this is how reality is, there's no other logical option but to drop restrictions and move on. It's a relief that at least a couple countries in Scandinavia are normal enough to recognize this. We're too stupid, too broken with fear.

> get enough people vaccinated that community spread stops being a thing

The problem with this plan is that vaccinated people still catch and spread the virus. The available vaccines do not create "herd immunity" in the traditional sense.

I think the best argument for getting a vaccine now is you will be much less likely to get hospitalized (and/or die) if you catch COVID after being vaccinated. But that argument may not apply to people who already caught it, recovered and now have some natural immunity.

Don't they have a lower probability of catching it so it does have a serious impact

Right. Also a lower chance of hospitalization and death, therefore preventing hospitals from clogging up.

Yes but it even one vaccinated person gets COVID it means the whole vaccine is useless!!!11!

Ugh. The antivax stance on HN makes me think wbole of the banned Reddit antivaxx subs moved here.

That's a good point. I suspect that being vaccinated reduces the likelihood of spreading it to other people somewhat, but I don't know if the data supports that.

> So now the long term plan is for the holdouts to either change their minds and get vaccinated (and many of them have)

This makes the huge assumption that the variants stop. The Mu variant, which appears to be vaccine resistant, is here already: https://www.newsweek.com/mu-variant-which-may-vaccine-resist...

My question is, have we ever mass distributed a non-sterilizing vaccine before?

I'd assume that new variants arise roughly in proportion to the number of people who are infected at a given point in time. Each infection is like a lottery ticket for developing a new variant. Covid might be around for a very long time, but if we can keep the pandemic under control to the point where we have thousands rather than millions of people getting infected every day, then I'd expect the risk of variants to go way down. (Maybe this is completely right, and the mutations accumulate over time, but either way fewer infections would mean lower risk, even if it isn't exactly a linear relationship.)

The question then is can we get new infection under control all around the world? Maybe it'll happen naturally due to herd immunity in places where vaccination is rare, but I'd rather we exported more vaccines to those places. We're all in this together.

Interesting thing from that article you link is that just over 99 percent of Covid cases in the U.S. are delta variant.

I'm inclined to be skeptical of claims that any variant is bypassing vaccine protections unless we have pretty solid evidence. It's just the nature of news to speculate about worst-case scenarios.

Yeah, every flu vaccine ever made.

The Mu variant isn't competing very well against the Delta variant.

https://covid.cdc.gov/covid-data-tracker/#variant-proportion...

The seasonal influenza vaccine that is mass distributed every year isn't very sterilizing. But it has a good safety profile and some protection is better than nothing.

https://www.cdc.gov/flu/vaccines-work/effectiveness-studies....

> The Mu variant isn't competing very well against the Delta variant.

I think this logic only works if a Delta variant infection provides strong protections against Mu, and a large part of the unvaccinated and vaccinated population first gets exposed to delta variant (assuming it can spread easily...can't find R estimates for some reason, which seems crazy). After all, the same was said about delta before it was prolific, and this whole thing started with one person. "It's not very present, so it won't be present" doesn't make sense, only R numbers do.

I doubt Mu is especially resistant. It was first detected in Colombia in January. The strains that will surface in 6 months will actually be resistant.

Your assumption is that vaccine production has stopped.

No, I question if the vaccines that are currently being produced will remain effective through later strains, requiring new vaccines to be developed, produced, and then redistributed to the populations of the world, in a global game of cat and mouse. Vaccinated people getting and spreading delta show a crack in the armor [1]. More than that, it goes against what was communicated to the public, about these vaccines:

> People infected with the Delta variant, including fully vaccinated people with symptomatic breakthrough infections, can transmit the virus to others.

1: https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-var...

I think the current wave is going to drift Northwards as the weather turns colder and people spend more time socializing inside.