A Quite Possibly Wonderful Summer
February 19, 2021 10:38 AM   Subscribe

Families will gather. Restaurants will reopen. People will travel. The pandemic may feel like it’s behind us—even if it’s not. Variant strains that increase the transmissibility of the virus could also throw these estimates off, Shaman noted. As the virus mutates, the reliability of immunity from prior infections also changes. The recent outbreak in Manaus, Brazil, suggested that even high levels of past infection didn’t necessarily protect a population for long. Fundamentally, we still do not know how herd immunity will work—if it even does. “The most important thing to remind ourselves of is that herd immunity is only relevant to consider if we have a vaccine that blocks transmission,” says Shweta Bansal, a biologist at Georgetown University. If it turns out that vaccinated people can still carry and spread the virus, then a group cannot assume that they are protected because people around them are vaccinated. It would mean that the finish line is not 70 percent, but 100.
posted by folklore724 (70 comments total) 18 users marked this as a favorite
 
Apropos, from what I hear, the authorities (for values thereof encompassing pretty much all responsible adults working in this space) say that they do not know that the existing vaccines block transmission.

That doesn't mean that they don't. It means that answering that question will take a lot more time and data than answering whether they protect the vaccinated, and in the meantime, the authorities have to err on the side of caution.
posted by ocschwar at 10:42 AM on February 19 [1 favorite]


It appears from (admittedly limited) data on persons vaccinated so far that the infection rate is reduced but the incidence of severe infections is reduced still further. That is, in a vaccinated population, new variants will arise but are more likely to cause milder disease with reduced fatality rates. Thus, the situation may ultimately be of a virus with low but continuous transmission in the (predominantly immune after vaccine or infection) population causing milder disease, like the human coronaviruses already present. Further, if prevalence and transmission are reduced, emergence of variants will also be reduced.
posted by sudogeek at 10:47 AM on February 19 [3 favorites]


Also worth noting that vaccination does not, strictly speaking, have to completely block transmission to allow for herd immunity, just reduce it (enough, given a contact model and a vaccination rate).

Herd immunity essentially depends on pushing expected new infections per infection under one.

It requires a higher percentage of vaccinated people the less effective the vaccine is at preventing infection, and also the less effective it is at preventing transmission, but neither of those have to be 100% to allow herd immunity to develop, from a dynamical systems/S(E)IR(D) modeling perspective.
posted by SaltySalticid at 10:53 AM on February 19 [1 favorite]


A couple of months ago my family was thinking that maybe by the summer we'd be vaccinated and would be able to visit family in Japan without having to spend more time in quarantine than on the actual trip. That is looking less likely now as our vaccine rollout is going slower than we'd hoped and Japan's restrictions don't seem to have changed yet. I would imagine the latter will still happen in time for the Olympics but the whole thing has gone from something we could plan and dream about ahead of time to something that we'll likely decide on with fairly short notice as circumstances change. Not going isn't a big hardship but I haven't been back since 2015 and have a niece and nephew that I've never met.
posted by any portmanteau in a storm at 11:13 AM on February 19 [2 favorites]


Hope is nice, I guess, but my life is on hold until there is an approved pediatric vaccine available. I saw Fauci out there throwing around summer/fall dates for such an event, but I will fucking believe it when I see it.
posted by Maarika at 11:24 AM on February 19 [13 favorites]


our vaccine rollout is going slower than we'd hoped and Japan's restrictions don't seem to have changed yet

And sadly Japan is doing even worse on the vaccine, although they are still doing dramatically better on deaths (by about 20x adjusted for population). [My wife has not seen her family in a few years now, we were scheduled to go for one of our regular trips in... March 2020]. We doubt we'll be able to go in 2021, so hopefully by 2022 things will be better [we are not planning to do any family visits until everyone is vaccinated, and that seems unlikely. Technically she could have gone anytime during the pandemic, as she is a citizen, but between the personal risk and the possibility of spreading it further it's not a real option].

The vaccine estimates from the US government seem... pretty optimistic, considering the actual vaccination rate around me (LA isn't even doing first doses for anyone this week b/c of a lack of vaccine).

I don't expect to be doing anything different this year than last year, but maybe I'll be surprised.
posted by thefoxgod at 11:32 AM on February 19 [1 favorite]


Thus, the situation may ultimately be of a virus with low but continuous transmission in the (predominantly immune after vaccine or infection) population causing milder disease, like the human coronaviruses already present.

Right. If nigh-universal vaccination means that SARS-CoV-2 becomes akin to a common cold like many other human coronaviruses, then that's good enough.

I don't expect to be doing anything different this year than last year, but maybe I'll be surprised.

For what it's worth, Pfizer has determined that its vaccine can be stored for two weeks at normal freezer temperatures and has asked FDA for approval for that, which could make distribution substantially easier. I would not be surprised if the same turned out to be true of Moderna's vaccine, since it's a similar design.

J&J has had production problems and will be a relatively small player to start, with only single digit millions of doses ready at the outset, but that's better than nothing, especially since it only requires a single dose. Novavax expects to be producing 150 million doses per month by May or June and ultimately expects to produce 2 billion doses per year.

The bigger looming issue in the US is that voluntary vaccine uptake is only at about 50-70%, even among healthcare workers and the military. On the one hand, that means those of us who want the vaccine will be able to get it sooner, but it means that herd immunity will be impossible unless the vaccine becomes mandatory.
posted by jedicus at 11:48 AM on February 19 [3 favorites]


The vaccine estimates from the US government seem... pretty optimistic, considering the actual vaccination rate around me (LA isn't even doing first doses for anyone this week b/c of a lack of vaccine).

That is how it seems here, too. At least from the perspective of sitting in a state that isn't exactly knocking the vaccine effort out of the park, it feels like a huge lift to go from the current pace of vaccinations to where we would need to be. At least at the moment, the reported vaccination rates in places I thought would be way ahead of the US (eg, Canada, many EU nations) are way behind what I was expecting, too. So returning to a "normal" for travel especially is feeling like a long way off.
posted by Dip Flash at 11:52 AM on February 19 [1 favorite]


Until very recently, Anthony Fauci had been citing August as the month by which the U.S. could vaccinate 70 to 80 percent of the population and reach herd immunity. Last week, he suddenly threw out May or early June as a window for when most Americans could have access to vaccines.

Dr. Makary (professor, Johns Hopkins School of Medicine and Bloomberg School of Public Health) argues for herd immunity by April. Not a STEM guy me, hell if I know.

As to Post Spanish Flu Fever - 1920 was the honeymoon summer at Westport CT for Scott and Zelda, under circs that ring interestingly of Gatsby. Worth watching.

1921 was Little Depression.
posted by BWA at 11:55 AM on February 19 [1 favorite]


Re: vaccines blocking transmission, I thought that there was a spectrum that goes from "sterilizing immunity which completely blocks retransmission" down to "does nothing". Most vaccines are somewhere in the middle, with the extremes being very rare; for example of common vaccines, pretty much only the measles vaccine gives sterilizing immunity.

This means that it is entirely possible, or even likely that covid vaccines will provide some protection against retransmission, even if that protection is not total.

I found the first hour or so of the recent episode 720 of the This Week in Virology podcast to be very informative and reassuring on the subject of covid vaccines. (Covid discussion begins, I dunno, maybe 20 minutes in?)
posted by surlyben at 12:02 PM on February 19 [2 favorites]


Re: vaccines blocking transmission, I thought that there was a spectrum that goes from "sterilizing immunity which completely blocks retransmission" down to "does nothing". Most vaccines are somewhere in the middle, with the extremes being very rare; for example of common vaccines, pretty much only the measles vaccine gives sterilizing immunity.

The data from the mRNA vaccines have been promising with 0 deaths and 0 hospitalizations from the vaccine during wide scale trials for both. So if it's not sterilizing immunity it's pretty damn close.
posted by Your Childhood Pet Rock at 12:09 PM on February 19 [2 favorites]


"...but I will fucking believe it when I see it."

Same here. Ontario has fully vaccinated $215K people, out of a population of 14.5M, so we're at a pathetic 1.5%. I've not seen the slightest hint of a plan of how a grand rollout will work, and the authorities are pretty cagey on giving any ETDs (which they will surely not meet). Our super-vaccination site (with a capacity for 250 people a day, and how many times does 250 go into 14.5M?) lasted a mere two days. So, will we in Ontario be freely-roaming this summer? Come the fuck on.

Last May, deep in the first lockdown, I rescheduled a big trip (which was two years in the making and got Covid-canceled) for September of this year, to catch a genuine once-in-a-lifetime event. A year and a half out -- I'd be fine, right? Things would surely have cleared up by then? And from having that light on the horizon, I'm now facing the possibility of having to cancel that trip as well -- and from the trickier spot of ME canceling, instead of having the trip canceled ON me.

Trying to be patient, but there's not much to be patient about.

posted by Capt. Renault at 12:12 PM on February 19 [12 favorites]


The data from the mRNA vaccines have been promising with 0 deaths and 0 hospitalizations from the vaccine during wide scale trials for both.

Yeah I guess the question is tho, of those people who were vaccinated in those trials, did they infect anyone?
posted by MisantropicPainforest at 12:17 PM on February 19 [4 favorites]


The rollout hasn't been fantastic, but if you told me last summer that 20% of the US adult population would be partially vaccinated by March I would have thought that was amazing. By late May I think every adult in the US who wants it will be able to get it.

I think there are still big potential challenges: We don't really have a lot of data on the new mutations. We don't know how many people will avoid getting vaccinated. We need to get the vaccine to other countries. There's a good chance Covid will become a perennial problem. But overall I'm a lot more optimistic than I was six months ago.
posted by justkevin at 12:24 PM on February 19 [7 favorites]


I am a bit frustrated with the messaging about the likelihood of transmission through vaccinated individuals. We don't know everything yet, but there are a few things we know. First, almost all vaccines reduce transmission by a huge factor (even completely). Also, the transmission of this coronavirus by asymptomatic individuals is notably lower than that of symptomatic individuals (although, of course, not zero, which is the source of how dangerous and devastating these things are).

I think it is a failure of scientific communication that we are focusing on the possibility that transmission could still happen from vaccinated individuals. I really think this messaging is likely to do more harm than good in encouraging people to get the vaccine.

Also, vaccination rates are low-seeming now (and have seemed low for quite some time), but all the evidence suggests that (1) vaccine production is ramping up, (2) states/provinces/municipalities are working out the kinks of their distribution models, and (3) at least in the US, there are finally adults supervising things at the national level.

I am pretty conservative, careful, and pessimistic when it comes to all things Coronavirus, but I think there is a real cause for optimism in the next few months and the pessimistic, hand-wringing articles are likely to do more harm then good.
posted by Betelgeuse at 12:28 PM on February 19 [30 favorites]


Dr. Makary (professor, Johns Hopkins School of Medicine and Bloomberg School of Public Health) argues for herd immunity by April.

Unfortunately he is just making up a conclusion based on faith, not data. He's assuming that there is a natural immunity in the population far exceeding what is actually measured by antibody tests. Typically you measure antibodies to determine who has been exposed and recovered. But even if antibodies gradually disappear, you can still have the T-cells that can produce new antibodies if infected again. But this T-cell response is difficult to measure.

So he's just making it up.
posted by JackFlash at 12:33 PM on February 19 [6 favorites]


This op-ed is contested, as are most WSJ Opinion pieces in recent years.
posted by RobotVoodooPower at 12:36 PM on February 19 [3 favorites]


There is a long record of these claims of invisible herd immunity going back almost a year. They have been proven wrong over and over again. At this point it is safe to assume that extraordinary claims require extraordinary evidence, but there is none. Just a faith argument dishonestly used to protest distancing and lockdown policies.
posted by JackFlash at 12:42 PM on February 19 [5 favorites]


I intensely dislike the framing of these types of articles, that [good thing] will happen in [the near future], when it's dependent on a lot of a lot of factors that we have no control over (virus mutations, extent of immunity) or limited control (population behavior, vaccine manufacturing and distribution).

It wasn't good when the last President of the United States did it for short-term gain. It's still not good when health authorities prepare optimistic scenarios based on a bunch of assumptions that are hidden in the body of the article, if they're listed at all. It's not surprising anymore to see someone say "beginning of summer" and then a day later, in response to a similar question but worded differently, say "end of summer". People starting believing that all these "smart scientists" are full of it. This isn't something that we can make a six-month schedule and at the end it says "Mission Accomplished". It's not like a marathon, where you can take a step and know that you're one step closer to the finish.
posted by meowzilla at 12:44 PM on February 19 [6 favorites]


I really like Hamblin, but this article is bullshit, for the reasons meowzilla states. The cone of uncertainty is still much too wide to be offering predictions like this.
posted by PhineasGage at 12:50 PM on February 19


I remember when this all started, the messaging was about flattening the curve to prevent the healthcare system from getting overwhelmed by severe COVID cases. This is why we’re vaccinating the older population first—to eliminate the vast majority of severe and deadly cases. Early evidence shows that if the vaccines don’t prevent infection by 100 percent, they do largely eliminate severe cases and almost completely eliminate death.

So, that said, once the vulnerable population and a significant population of adults are protected, what’s the big deal if vaccinated people can still catch and transmit it? By that time, severe cases requiring hospitalization should be a tiny fraction of what they are now, and the vaccinations will keep chipping away at the potential number of hosts. I don’t think that eliminating COVID is a realistic end game. Getting it to the point where we manage it like it’s like influenza is what I think is most likely to happen.
posted by TrialByMedia at 12:50 PM on February 19 [10 favorites]


Based on the lingering side effects that seems fairly common, I am not personally going to change anything until I am vaccinated. Over half the people I know who caught it and were symptomatic have not 100% recovered (for example, still no smell/taste). Even for those who don't die, it seems MUCH worse than flu or cold.
posted by thefoxgod at 1:07 PM on February 19 [29 favorites]


Does anyone know when we should have sufficient information on how long vaccine immunity will last?
posted by Selena777 at 1:40 PM on February 19


At the moment, we have to assume that tackling the virus moving forward will need to be a combination of vaccines (which may need updating regularly or irregularly), better behaviour when in crowded environments (particularly routine ones, ie; masks on trains), and a reduction of unnecessary contact (ie; regularly working from home for at least some of the time). We may also see periodic requirements to check in to venues for contract tracing, or reduce movements to just essential tasks whenever a nasty variant springs up to give the vaccines time to be tuned and rolled out.

Getting and keeping R0 down is all that matters, and we need to take a Moneyball approach to it -- whatever gets the job done, not just things that feel right. Also, we need to push back against any narrative that promises the unpromisable in an effort to make people think they can do nothing now because the end of the tunnel is near. No one knows where the end of this tunnel is, least of all a politician.

The most dangerous thing at the moment is thinking that things will go back to the old normal, so no planning needs to be done for a new normal. Whether we're talking about quarantine villas, or universal income, we need to consider all the old ways of getting through life that might be permanently broken, and we need to regularly review how to help people survive, not just in a ventilator kind of way, but in a paying rent kind of way too - even more so when a job is so bad that it risks both things simultaneously.
posted by krisjohn at 3:19 PM on February 19 [12 favorites]


I remember when this all started, the messaging was about flattening the curve to prevent the healthcare system from getting overwhelmed by severe COVID cases. This is why we’re vaccinating the older population first—to eliminate the vast majority of severe and deadly cases. Early evidence shows that if the vaccines don’t prevent infection by 100 percent, they do largely eliminate severe cases and almost completely eliminate death.

So, that said, once the vulnerable population and a significant population of adults are protected, what’s the big deal if vaccinated people can still catch and transmit it? By that time, severe cases requiring hospitalization should be a tiny fraction of what they are now, and the vaccinations will keep chipping away at the potential number of hosts. I don’t think that eliminating COVID is a realistic end game. Getting it to the point where we manage it like it’s like influenza is what I think is most likely to happen.


Just as a reality check regarding this blase approach to COVID, as long as most people aren't getting severe cases (never mind that a tiny fraction of severe cases multiplied by millions quickly becomes thousands and thousands of people):

You ever hear a story about someone who spent six weeks unable to get out of bed due to COVID (and likely faced employment and financial consequences)? Or someone who still can't taste or smell months later? Or someone with long term lung capacity reductions? None of those stories describe people with severe cases. The line between severe case and non-severe case is literally being able to breathe on your own.
posted by Superilla at 3:53 PM on February 19 [23 favorites]


Annnnnd NO ONE should be blase about getting a virus that is STILL causing weird symptoms in people who have "recovered" from initial infection. We don't know enough yet.
posted by tiny frying pan at 4:10 PM on February 19 [8 favorites]


Timely article I just saw pop up:

Almost a third of people with 'mild' Covid-19 still battle symptoms months later, study finds

The first priority was indeed the hospital crowding (which reached super bad levels here in Los Angeles earlier this year), which was clearly the primary initial danger due to deaths, but thats not the only priority.

While it's true COVID is probably going to be endemic, I think there is clearly value in reopening slowly, continuing to practice masks/distancing, and waiting on large scale vaccination, as this is not the same as getting the flu (much less a cold). The more people who can avoid getting it at all, the better.
posted by thefoxgod at 4:50 PM on February 19 [2 favorites]


Let me clarify, I’m not for wide, early reopening like my governor did a few weeks ago. I just think it’s incredibly unrealistic to expect people to continue with lockdowns and distancing after the vaccine is plentiful enough that any adult that wanted it received it. We’re going to be there in a few months, and people are simply not going to comply at some point. There are enormous costs to continuing lockdowns. Subpar education for children. Mental health impact. Scores of people in the dining and entertainment industries haven’t been able to work for a year now.
posted by TrialByMedia at 5:09 PM on February 19 [6 favorites]


Getting and keeping R0 down is all that matters

Like, it isn't, though. A whole lot of shit actually matters, and some of that shit is not compatible with an optimal reduction. We blew our chance for perfect FULLY A YEAR AGO, it's gone, blown, ain't comin back. We're stuck with mediocre-to-maybe-in-a-decade-OK.
posted by We put our faith in Blast Hardcheese at 6:12 PM on February 19 [1 favorite]


Just as a reality check regarding this blase approach to COVID, as long as most people aren't getting severe cases (never mind that a tiny fraction of severe cases multiplied by millions quickly becomes thousands and thousands of people):

You ever hear a story about someone who spent six weeks unable to get out of bed due to COVID (and likely faced employment and financial consequences)? Or someone who still can't taste or smell months later? Or someone with long term lung capacity reductions? None of those stories describe people with severe cases. The line between severe case and non-severe case is literally being able to breathe on your own.


This argument feels very anti-vaxxey to me. What is the proposition here? That a significant number of people who are vaccinated will get long covid? There's no obvious reason to believe that over the likelihood that they won't.

We all live with some risk all the time. We might get bitten by a tick and get lyme disease. We might get a bad flu that takes months to fully recover from. The question is: how much does widespread vaccination reduce the risk of COVID from some percent fatality and a larger percent risk of serious or lingering disease to an almost zero rate of fatality, a small chance of infection at all, and some fractional risk of that small chance of infection turning into serious or lingering disease? We don't know the answers but most scientists who study this are optimistic that we will in fact drastically reduce the risks of even infection and illness, not just death. And at some point, it's worth the tradeoff of going outside and living our lives as normal.
posted by ch1x0r at 7:20 PM on February 19 [6 favorites]


And at some point, it's worth the tradeoff of going outside and living our lives as normal.

Yes. The messaging on this has been so inconsistent and flawed, and so frustratingly without nuance or optimism (except for this kind of occasional, Twitter-contested op-eds).

On a personal note, I live in an a very low-risk area, with high levels of mask compliance, and I'm starting to get frustrated with friends who still feel apprehensive about meeting up at a park or for a walk. Friends who are in their 20s-30s, with no preexisting conditions, no regular contact with high-risk people, and we're living in an area with plentiful healthcare and non-overloaded ICUs. I'm just not seeing what the concern is in these particular circumstances. Sorry, but I'm not. In a normal year, I could eat some bad lettuce and lose kidney function from e.coli. I could become disabled from meningitis. This year, I could maybe suffer some long-term effects from Covid.

This Atlantic article really seemed sound to me, and I understand if you're in North Dakota in December 2020 and things are as dire as they were then there, but that's not always going to be the case everywhere. And when you look at teen suicide rates, increases in intimate partner violence, etc. etc., you wonder what we're trading all of this misery for.
posted by knotty knots at 8:00 PM on February 19 [5 favorites]


Anti-vaxxey? What on earth are you talking about? I and others in this thread have been questioning the optimistic projections for how soon most people will be able to resume what feels close to normal life without taking a big risk of full blown COVID. We have been pointing out that significant numbers of people who didn't need hospitalization nevertheless are suffering from significant, ongoing health problems.

I have spent much of the past year doing COVID ontact tracing, and I can't count the number of people I have spoken to who were still at home but nevertheless devastated by this disease.

This shit is real. Yes, we make trade-offs about risks all the time. But blithe arguments that we're all ok to go out again if the ICUs are not overwhelmed any longer is simply ignorant of the realities of this pandemic.
posted by PhineasGage at 8:01 PM on February 19 [26 favorites]


I'm starting to get frustrated with friends who still feel apprehensive about meeting up at a park or for a walk. Friends who are in their 20s-30s, with no preexisting conditions, no regular contact with high-risk people, and we're living in an area with plentiful healthcare and non-overloaded ICUs. I'm just not seeing what the concern is in these particular circumstances. Sorry, but I'm not. In a normal year, I could eat some bad lettuce and lose kidney function from e.coli. I could become disabled from meningitis. This year, I could maybe suffer some long-term effects from Covid.

Look, I feel you. This is tough on everyone and sometimes "common sense" and one's personal preferences are enough to say okay, are we sacrificing more in return than we're getting?

But your argument is flawed as soon as you compare to things that happen in a normal year, because due to the fact that this year is so ABRNORMAL, we just don't know enough to fully assess risks with covid, even wearing masks in areas with low ICU rates. So, even though things look okay to maybe meet socially distanced in the park, people are still ok to think "even if there's a .01% chance I contact this disease and even then I'll survive, I still don't want to risk it." And that has to be okay, because we really. just. know. enough yet. The ICU rate is low, so okay we should risk it going up? And take a bed away from someone who might need it and now can't go to the hospital so they die at home?

I understand saying you have to weigh the risks and make common sense decisions, but I do not understand getting frustrated with people who are simply being safe and making no demands of others. Even if you think "hey you'll be fine, look at these great stats" we just don't know. This is not eating contaminated lettuce in a normal year, b/c in a normal year you could probably get easier access to care. The saturated health care system now cannot deal with any more cases, so it's pretty fair to be as safe as possible if you can. If the risk of suicide/mental health issues means someone needs to make different choices so be it, but the general health guidelines are cautious for a reason: we don't know enough to protect all the people, so that's why people are playing it safe.
posted by andruwjones26 at 8:21 PM on February 19 [23 favorites]


The saturated health care system now cannot deal with any more cases,

OK so if we're not supposed to be blithe about the possibility of ever doing anything worth doing again, can other folks not be blithe about the current conditions in any given location? Not everywhere is, as said above, North Dakota in December. Not every place is downtown Los Angeles. In many places the health care systems are not, in fact, overwhelmed anymore.

Now sure just because there's an ICU bed doesn't mean you necessarily want to end up IN it. Is there any point in being frustrated with anyone about not wanting to take any level of risk? Not really, but only because there's just no point in being frustrated with anyone, or really doing anything...where was I going with this? I have forgotten, but it was probably back to bed, for the next two years.

Everyone just...go back to bed.
posted by We put our faith in Blast Hardcheese at 8:32 PM on February 19 [2 favorites]


people are still ok to think "even if there's a .01% chance I contact this disease and even then I'll survive, I still don't want to risk it." And that has to be okay, because we really. just. know. enough yet.

i get the impression the majority of mefites here are on board with the above sentiment and... i totally get it.

the super frustrating thing here in LA is that this same viewpoint--those who ostensibly took covid most seriously and were most in favor of restrictions--are now moving the goalposts for us. most notably, with schools. the same folks who 4 weeks ago said "dont even think of leaving the house! wear 2 masks to the market!" are now telling teachers, "hey, stop whining, the CDC says being in a room with 6 year olds all day is totally fine!"

taking it back to the article-- a lovely summer. this will depend on whether governments start being straight with us. if you open one sector of the economy but not another, just TELL US you think A is more important than B. tell us you think restaurant workers should stay out of work, but that kids need to go to summer school. dont bullshit us and say school is safe because "science" based on preposterous assumptions about PPE compliance (esp elementary schools, which parents know are notorious for spreading illnesses), yet stores and restaurants are closed for indoor use indefinitely.

ok. sorry. rant over. i've been in calif. lockdown for a fucking year.
posted by wibari at 8:55 PM on February 19 [4 favorites]


I don't think anyone here, at least, is saying "Even when everyone is vaccinated I don't ever want to leave the house".

Personally, if we hit that 75-80% vaccination rate (or whatever it is calculated at by the time we hit it --- target may move as we get more info) I'd feel comfortable going back to more-or-less normal life.

My point was we're a long way off from that, and I do not believe we will hit it by end of summer (both due to vaccine availability and anti-vax/"vaccine hesitancy")

Until then, I hope at least LA will keep strict mask requirements (even if they are completely unenforced, sigh) and distancing. At the very least I'll be doing it myself as much as possible (but I still have to go out once in a while). And certainly not going to be meeting up with anyone before then.
posted by thefoxgod at 9:20 PM on February 19 [3 favorites]


I think the last half of 2021 is going to be a new Roaring Twenties. We're surviving a global pandemic, we've been shut up for a year, and w're ready do rumble. Dare I say some people will be down to clown?
posted by kirkaracha at 11:50 PM on February 19 [2 favorites]


Friends who are in their 20s-30s, with no preexisting conditions, no regular contact with high-risk people, and we're living in an area with plentiful healthcare and non-overloaded ICUs. I'm just not seeing what the concern is in these particular circumstances. Sorry, but I'm not.

And I think that's absolutely bonkers. Perfectly healthy people have DIED. Long covid can strike anyone. And many of us DO have people we love who have preexisting conditions (or even people we don't know! I don't want to kill anyone!), so even if we caught it asymptomatic, we don't want to pass it on. If you're NOT still concerned about getting covid, I am afraid of YOU. A little bit. Because I really wouldn't meet up even in a park with someone who is letting their guard down now.
posted by tiny frying pan at 5:09 AM on February 20 [25 favorites]


I only say this to try to share the perspective of why people you know are probably still scared. Your type of comments are all I see in comment sections on covid (I know, I know, don't read the comments) and it terrifies me that people want to just give up and have us all be more vulnerable to infection with this nasty, still largely unknown disease.
posted by tiny frying pan at 5:26 AM on February 20 [3 favorites]


I don't think anyone here, at least, is saying "Even when everyone is vaccinated I don't ever want to leave the house".


But the tricky part is that we're going to be dealing with a spectrum of people, all the way from COVID deniers to the people who are not going to leave the house until COVID is eradicated.

Because of vaccine hesitancy, we're never going to get everyone vaccinated-- in my (unexpert) understanding the best case scenario is around 75%. We may never eradicate covid.

We are going to have to navigate a lot of discussions about personal and societal risk benefit analysis with a nuance that I am not seeing in this discussion so far.
posted by ambulanceambiance at 5:59 AM on February 20 [6 favorites]


I can discuss this with nuance once I am vaccinated. Until then, absolutely nothing has changed for me. I am grateful my parents got a 1st vaccination. But we're a long way from feeling like we can change our behaviors without fear. I am a VERY long way from not feeling pure incredulousness at anyone saying what's the big deal with getting covid, no matter the time frame or circumstance or how less crowded the hospitals are.
posted by tiny frying pan at 6:05 AM on February 20 [5 favorites]


The NY Times has an interactive article looking at when "herd immunity" (at the 70-90% level) might be reached in the US under different scenarios, and what the implications for each are in terms of potential deaths. As discussed in the article, there are a lot of assumptions built into the modeling, but it gives a sense of the range of dates when things might tip towards "normal" for many people whether or not things are fully safe at that time.

Dare I say some people will be down to clown?

I am remembering the first two weeks of college, where the brakes came off at that first taste of freedom. I am betting that this fall will be a slow-rolling version of that for a lot of people who are starved for touch and contact.
posted by Dip Flash at 7:14 AM on February 20 [1 favorite]


Nuance is a dangerous thing when it comes to public health during a pandemic.

States that tried to have nuanced discussions about shared risk and collective responsibility with the public ended up with a lot of confused people who then started ignoring restrictions. States that tried to tailor the level of restrictions too granularly or too often got the same result.

Until the bulk of the public is vaccinated you have to keep the message simple and consistent and tell people to stay home where possible.
posted by zymil at 7:16 AM on February 20 [1 favorite]


States that tried to have nuanced discussions about shared risk and collective responsibility with the public ended up with a lot of confused people who then started ignoring restrictions. States that tried to tailor the level of restrictions too granularly or too often got the same result.


People ignored restrictions because the response to the pandemic was politicized and disastrously executed, and because many, many people were not sufficiently supported financially and otherwise to follow restrictions.

Nuance and context have to be part of public health. Harm reduction has to be part of public health.
posted by ambulanceambiance at 7:30 AM on February 20 [8 favorites]


I've noticed my risk perceptions shifting now that I'm vaccinated, and not only of my own risk but of the risks of others who are not yet, to some extent. The current sharp drop in cases is part of it, but more I think it's a matter of empathy and of exhaustion.

And I guess there are a lot of people who have never considered themselves at much risk of covid, but who have been very careful in order to protect others. (Contrast with people with the same risk estimation who don't care about others, who we all know exist in large numbers.) So whether you agree with that risk estimate or not, it seems likely the behavior will change once the more vulnerable people are perceived as safe.

Whether this leads to a third wave certainly TBD.
posted by joeyh at 8:26 AM on February 20 [1 favorite]


If you're NOT still concerned about getting covid, I am afraid of YOU. A little bit. Because I really wouldn't meet up even in a park with someone who is letting their guard down now

What constitutes letting one's guard down? Literally the only thing that person described doing was meeting in the park, the thing that a hundred Mefites a day remind the rest of us is the only thing we should ever do, even when it's negative 15 degrees and the park is under 2 feet of snow. Someone who won't go to an outdoor park has always been a far outlier in safety precautions, frankly. It has always been on the list of approved activities, even in the worst parts of the pandemic.

The poster wasn't like, "I don't get why someone won't meet me in the park now that I stopped wearing masks and started licking strangers and letting an ICU nurse breathe into my face daily."

Not being afraid does not constitute, in itself, a risk to others. I have not been afraid of catching COVID at any point in this whole nightmare. I even posted a question to Ask because I was starting to wonder why the hell not. But the fact remains, I'm not concerned and I can't make myself be afraid. I nonetheless follow all of the guidelines and mandates, because i am a rule-follower at heart and have a basic understanding of public health.

Once I have any reassurance that my moving about the world doesn't constitute a public health crisis, you can be sure I'll never ever be awake in my house for more than a few minutes AGAIN.
posted by We put our faith in Blast Hardcheese at 9:05 AM on February 20 [7 favorites]


I'm starting to get frustrated with friends who still feel apprehensive about meeting up at a park or for a walk. Friends who are in their 20s-30s, with no preexisting conditions, no regular contact with high-risk people, and we're living in an area with plentiful healthcare and non-overloaded ICUs. I'm just not seeing what the concern is in these particular circumstances. Sorry, but I'm not.

Hi. I'm someone who's in my 30s, with no preexisting conditions, and able to limit my contact with high-risk people, I too live in an area with plentiful healthcare and non-overloaded ICUs. Heck it doesn't even matter about the ICU, because I didn't need to go in when I was sick. I'm one of the people who have what we are dubbing ultra-long haul COVID.

Let me tell you about my last 11 months since I had COVID, hopefully this will make you a little more aware of what the hell your friends are afraid of.

They were the worst 11 months of my life. Any single one of them would be in the running for worst month of my life, and that includes the really bad case of shingles I had directly before getting COVID.

I'm at the best I've felt since March of 2020. Today I feel like I would have before if I had gotten 4-5 hours of sleep last night, even with a full 8. I assume the low energy is because of all the work I did 2 days ago. I did about 30 minutes of working on re-assembling a washing machine and about an hour of shopping. That was enough to need 2 days of recovery. Every day, even good energy days, some time right around lunch (after if I'm lucky), I hit a wall where I JUST CAN'T do any more of anything until I've had about an hour of lying down.

Then there's Brain fog, I've forgotten 4 words since I've started writing this, I'll update as needed. I'm also a professional musician, and ever since the brain fog set in, making sense of music is HARD. I'm currently working my way up to 10 minutes of being able to do deep and active listening. My own I playing is just flat and lacking in something (5 words).

I've also constantly had an irritation in my chest that ranges from painful to really bad itch (6 words). I don't know if you've ever had like an itch that just won't go away, but imagine that, for 11 months, and with enough variation in intensity that your brain can never filter it out. Sometimes my lungs just decide that breathing should be hard work. Oh, and the adrenaline rushes. They're awful, my whole body's on edge, my heart feels like it's pounding in my chest, and I'm just in a mode of "There's something about to eat me" for about 30 min. and then I crash hard and am extra useless that day.

Here is a sampler (7 words) of some of the other lesser things: I didn't get to enjoy the roast I made for Christmas dinner because meat smelled like it was spoiled that week, andI'd occasionally just smell non-existent dog poop. My hair's falling out. My joints occasionally just hurt. Sometimes my fingers turn purple. My body's temperature regulation will just goes away for a bit.

I've gone to a specialist about this, and after a bunch of tests, here's the prognosis: It's going to take a long time to recover. That's it (8 words). The goal is that by July I'll be able to take 30 minute walks. I can't even begin to express how gutted (9) I am that I'm looking at another summer without hiking or fishing.

The kicker is that, as bad as all that is, I'm actually one of the lucky ones in the support group I'm in. There are people who were like your friends before COVID, and are now jealous of my 12 minute walks. So, maybe cut your friends a little slack if they're nervous, maybe they know me or someone like me.
posted by Gygesringtone at 9:10 AM on February 20 [39 favorites]


Not being afraid does not constitute, in itself, a risk to others. I have not been afraid of catching COVID at any point in this whole nightmare. I even posted a question to Ask because I was starting to wonder why the hell not. But the fact remains, I'm not concerned and I can't make myself be afraid. I nonetheless follow all of the guidelines and mandates, because i am a rule-follower at heart and have a basic understanding of public health.

Well then congrats, I am not and have never been worried about people such as yourself.
posted by tiny frying pan at 9:24 AM on February 20


Well then congrats, I am not and have never been worried about people such as yourself.

Well then I feel like you owe that original poster a bit of an apology; there's no indication that they are any different from myself.

(Though reading gygesringtone's description of their last 11 months now I'm wondering if I didn't actually just get COVID at some point and never recover, because that...is almost identical to my last 11 months, except that at no time did I ever have a period of active illness.)
posted by We put our faith in Blast Hardcheese at 9:35 AM on February 20 [2 favorites]


Well then I feel like you owe that original poster a bit of an apology; there's no indication that they are any different from myself.

The post being criticized expressed frustration with what other people were doing to keep themselves (and their own loved ones) safe during Covid, With an undercurrent of "I'm bored, they should adopt my risk model so I can have more fun." Then expressed incomprehension how anyone in their 30s could look at this differently.

This isn't a personal view, it's a prescriptive one. It's going to trigger some pushback.

You don't seem to have said anything like that, so I'd say there are indications of difference.
posted by mark k at 10:15 AM on February 20 [10 favorites]


I had a handicapped parent, who at one point was on a ventilator for 18 months. Dear God, I don't want to take the risk of getting this. Don't blow me off by saying that I'm young and healthy--that may literally not mean ANYTHING if I'm exposed to it. I can't say any better than Gygesringtone above as to why you don't want it. Literally no fun out of my house activity appeals to me enough to take the risk of death or possibly being permanently handicapped from Covid. I am completely baffled as to the people I know who are traveling and seeing family and doing fun activities and doing high risk things. Hell, walking outside down my street and having to cross the street to avoid someone else doesn't sound fun any more.

But here's the thing about "meeting up in a park," said from someone who has only done it a few times (I finally caved in a few times in fall) and still has Reservations about it.

It's inhuman and unnatural to stay six feet apart or farther from another human being that you like. I despise being forced to treat someone like they have the death cooties. I despise having to be AFRAID of another human being that I like being in my vicinity. Also, if you're moving around at all (I've insisted that for outside activities people have chairs and STAY STILL IN THEM or otherwise someone remains stationary) you will inevitably move closer and closer to someone. I hate having to tell someone over and over again to stay away and to keep/put their mask on and to not touch me or get near me. And that's not even covering "I can't hear you in that mask," which tempts someone to take it off, or speak up louder (which you should not be doing because more aerosols and whatnot either). I've suggested we talk on the phone while outdoors or through a screen door and so far, no takers.

Being in person with someone, even outdoors, even masked, supposedly at six feet, is a lot of work. It's depressing to ALWAYS HAVE TO REMEMBER THERE IS VIRUS AND WE CAN'T ACT NORMAL around each other. I have to always be thinking about the DEATH COOTIES and I can't relax and enjoy seeing someone live and in person. I don't want to leave my house because while I'm in my house I can have moments where I forget about The Virus. I absolutely can't do that if I go outside. I really can't relax if I see another human being within eyeshot.

And I can't even keep six feet apart from anyone in an indoor building, period. Not if you have to come up to a counter and get helped/waited on/buy something/get medical care.

I'd really, really, really rather just see people over Zoom. At least that way I don't have to fucking worry about it so hard and so much.
posted by jenfullmoon at 10:30 AM on February 20 [11 favorites]


The phrasing "the response was politicized" as a way of criticizing public health efforts sets off huge warning bells for me. Suggestions and outright requirements for masking or closing public facilities were made for public health reasons. They may have been correctly implemented or not, and that is a vital conversation to have and learn from. But the only 'politicizing' was from people who denied this pandemic was real and dangerous.
posted by PhineasGage at 10:46 AM on February 20 [2 favorites]


The phrasing "the response was politicized" as a way of criticizing public health efforts sets off huge warning bells for me. Suggestions and outright requirements for masking or closing public facilities were made for public health reasons. They may have been correctly implemented or not, and that is a vital conversation to have and learn from. But the only 'politicizing' was from people who denied this pandemic was real and dangerous.

It sets off "alarm bells" for you when someone says that the response to the pandemic in the US was politicized and therefore less effective? Really? Because from where I sit, that's a very hard viewpoint to dispute.

If you're taking my comment to be making any kind of excuses for leaders who were covid deniers, that is purely a bad faith reading on your part.
posted by ambulanceambiance at 11:09 AM on February 20 [2 favorites]


The phrasing "the response was politicized" as a way of criticizing public health efforts sets off huge warning bells for me. Suggestions and outright requirements for masking or closing public facilities were made for public health reasons.

Sorry, but I really don't think public health as a field is anywhere near beyond reproach here. The past year has seen a massive bipartisan political project to keep capital in wealthy people's bank accounts at the expense of human lives and livelihoods, and while public health authorities may have spoken out about hard Covid denialism, they have aided and abetted soft anti-health policies all across the country, in every state. I'm certainly not saying public health practitioners are evil-- those whom I have personal experience with are among the smarter and more caring people I've encountered-- but I think seeing the public health field as somehow unsmirchable and inherently politically neutral is very dangerous and incorrect.
posted by dusty potato at 11:35 AM on February 20 [2 favorites]


Someone who won't go to an outdoor park has always been a far outlier in safety precautions, frankly. It has always been on the list of approved activities, even in the worst parts of the pandemic.

In the US, meeting up with people outdoors, with limitations, has always been allowed, I believe. But some other countries have had more severe lockdowns that discouraged or prohibited people from different households meeting up, even outdoors.

It's also important to acknowledge how privileged it is to be in a situation where meeting up with someone in a park counts as one of your riskier activities. I think about this every time I have to go do something in-person -- I am mostly able to pick and choose those encounters, but there's someone else who has to stand behind that counter all day long facing a stream of people coming in.
posted by Dip Flash at 11:36 AM on February 20 [8 favorites]


Maybe I'm not understanding what y'all mean by "politicized" then - could you say more and clarify?
posted by PhineasGage at 11:50 AM on February 20


To try to advance the discussion, I'm just not understanding how the nearly universal advice from public health professionals - we need to all wear masks, not socialize with people outside our households, and shut local enterprises down when transmission rates are high and hospital capacity is about to run out - can be accurately labeled as "politicizing." I am sincerely curious how you are intending that label.
posted by PhineasGage at 12:15 PM on February 20


... and letting an ICU nurse breathe into my face daily.

I’m a operating room RN. I work in a Level I trauma center. I’m not an ICU nurse, but I take care of ICU patients every shift.

I’ve been working at the bedside for the entirety of this pandemic so I’d like to think I’m pretty hardened, but your comment gave me that weird throat tickle that means I might cry.

The truth is, I already feel like a fucking leper every goddamn day. People are actively afraid to be anywhere near me because sometimes I work with covid patients. Causing fear in others when my life’s work is caring for them, reassuring them, assuaging their fears, is genuinely one of the worst things I’ve ever felt.

I’m absolutely sure it wasn’t your intention, but being used as an example of something dangerous feels really, really shitty.
posted by jesourie at 12:23 PM on February 20 [25 favorites]


Maybe I'm not understanding what y'all mean by "politicized" then - could you say more and clarify?

We didn't have a unified national response or communication strategy because covid turned into a partisan issue.

Red states had a different response than blue states.

We didn't release enough aid or services for all people to have the ability to socially distance long term.

I'm not trying to both-sides here, it was by and large politicized by Trump. But that wasn't the point of my comment. The comment I was replying to was claiming that nuance was dangerous in public health, and that our national response failed because it was too nuanced for people to understand. Like, no, our national response failed because it was a clusterfuck, not because we brought too much thoughtful nuance to it.
posted by ambulanceambiance at 12:23 PM on February 20 [4 favorites]


Sorry, that is both-sides-ism. It was Trump and his allies who did everything they could to try to minimize belief in the seriousness of the pandemic and the seriousness of the measures needed to combat it. Criticizing public health officials for not having a single, unchanging set of recommendations over the course of nearly a year of emerging scientific insights, and while Scott Atlas, Fox News, and Trump himself were blowing BS all over the planet, is like criticizing the sailboat captain for not sticking to a perfectly straight course in the midst of a goddamned hurricane.
posted by PhineasGage at 12:53 PM on February 20 [2 favorites]


I’m absolutely sure it wasn’t your intention, but being used as an example of something dangerous feels really, really shitty.

I really do apologize for that. I was myself responding harshly to being perceived as a plague rat just for feeling a way, regardless of my actions, and definitely needed to be more careful in how I responded to that. I completely retract that example.

I don't get the fear, I wish I did, but I just honestly don't. The best I can do is offer to be the person who goes to the grocery and the pharmacy for the people who don't want to do it, since it doesn't distress me. As Dip Flash noted above, the folks who work in those stores and pharmacies don't have the luxury of being afraid; why should I?
posted by We put our faith in Blast Hardcheese at 12:55 PM on February 20 [2 favorites]


Well then I feel like you owe that original poster a bit of an apology; there's no indication that they are any different from myself.

I disagree, what you said was very different. And I don't really care what you think I owe another poster. I think you're being somewhat rude to me - I assume you don't care about that either so all is even.
posted by tiny frying pan at 1:14 PM on February 20


A lot of people who work in stores are very scared. Just because they have to show up for work does not mean they aren't afraid of getting sick. Here is one recent article.
posted by RobinofFrocksley at 1:50 PM on February 20 [10 favorites]


I'm not trying to both-sides here, it was by and large politicized by Trump. But that wasn't the point of my comment. The comment I was replying to was claiming that nuance was dangerous in public health,
Absolutely.
and that our national response failed because it was too nuanced for people to understand.
This is not what I said. I admit my post was terse but I don't think this was a charitable reading of it.

The American response to covid has been an utter disaster on every level, and in that context sure, nuance is less important. When half the country refuses to implement meaningful covid restrictions and nobody is getting paid to stay home there are limits to what anyone can accomplish with messaging.

But there are states outside America, and in the ones where I've seen nuance do the most harm (Britain, the EU), what nuanced public discussions have done is give cover to politicians who were reluctant to use hard lockdowns because of the political cost. As hard lockdowns are the only public health intervention that can actually end an outbreak delaying them is usually a disaster. The severity of the disaster depends on the current local climate and fraction of the population that already has some form of immunity, but its a situation every country is going to keep running into until they have most of the population vaccinated against the strains currently circulating.

If you decide to implement a hard lockdown in a western democracy its success will heavily depend on public compliance, as there are nowhere near enough police to actually keep most people home. The public has a limited ability to tolerate lockdown, and civil libertarians and anti-masker types who ignore restrictions erode that ability further because the public needs to see that everybody else is complying or their morale collapses. Public discussion of the lockdown emboldens these people and increases their number because they convince some other people who haven't made their minds up yet.

If you decide not to implement a hard lockdown and try to manage the severity of the outbreak via measures like mask mandates and closing schools and businesses you're still going to be burning through public morale, and public discussions have an additional problem in that people will often start pointing out inconsistencies in the restrictions. One example that comes to mind is the restaurant owner who filmed a movie production's outdoor catering in active use next to her closed outdoor dining area in California. This just destroys morale.

If you've gone with limited restrictions, you're also going to be tempted to change them every few weeks to match the current severity of the outbreak and as I mentioned in the earlier post this leads to parts of the public not knowing what they are currently required to do. At this point a lot of people just stop listening.

You can and should have nuanced discussions of public health measures at the governmental level during a pandemic, but having them in public erodes the effectiveness of the same measures and will kill people.
posted by zymil at 5:29 PM on February 20 [6 favorites]


In the US, meeting up with people outdoors, with limitations, has always been allowed

The California regional stay at home order in December / January prohibited this.
posted by mark k at 6:17 PM on February 20 [4 favorites]


There we go:
The Pfizer Inc. and BioNTech SE Covid-19 vaccine appeared to stop the vast majority of recipients in Israel becoming infected, providing the first real-world indication that the immunization will curb transmission of the coronavirus.

The vaccine, which was rolled out in a national immunization program that began Dec. 20, was 89.4% effective at preventing laboratory-confirmed infections
Studies will have to done, but it seems reasonable to assume that Moderna and other highly effective vaccines will also be effective at stopping transmission.
posted by jedicus at 7:13 AM on February 21 [5 favorites]


I don't get the fear, I wish I did, but I just honestly don't.

You don't have to understand and/or share someone's feelings to accept and respect them, that's OK; just like it's OK if you don't share this very common and widespread current fear. We are all entitled to our feelings but responsible for our actions.

You can and should have nuanced discussions of public health measures at the governmental level during a pandemic, but having them in public erodes the effectiveness of the same measures and will kill people.

I'm confident that health officials all over the world will be better prepared and will respond more consistently to the next active global pandemic. Comments like this seem like so much Monday-morning quarterbacking: looking back over what's already happened and noting what could have been done better while acting as if we all had perfect clarity and omniscient perspective as it was unfolding.

Health officials' responses were/are many and varied, but let's point blame (at least in the U.S.) very clearly where it belongs: many of those running governments at all levels were simply uninterested in this problem, and wanted it to just go away or work itself out. In that context, there was no good set of responses or actions for public health officials. In my region, for instance, I saw administrators of, e.g., schools and school systems being forced to make decisions far beyond their expertise, experience and job descriptions, decisions that impacted the health and well-being of thousands of people in immediate ways--and they were receiving little to no guidance from state and federal government for months. People were simply left on their own to make decisions that they were neither prepared nor qualified to make (including many local- and county-level health officials), and did the best they could. Some were maybe more thoughtful and responsible than others, but let's not just--in any version--glide past the fact that most of us were simply left alone to deal with the onset of this pandemic, especially those who were in some kind of decision-making roles, all over the place.
posted by LooseFilter at 7:22 AM on February 21 [7 favorites]






Data from the UK this morning shows that four weeks after the first doses, hospitalisations were reduced by 85% and 94% for the Pfizer and AstraZeneca vaccines respectively. (those confidence intervals probably overlap so I wouldn't read too much into the difference)

Among the over 80s there was an 81% reduction between the two vaccines.

This is Scottish data, England + Wales data expected later today but certain to show the same effect (since this data was available to the government over the weekend while it was making lockdown lifting decisions and they wouldn't be messaging the way they are this morning if it was different).

Given the similarity of the Moderna vaccine to the Pfizer and the J&J to AZ, plus the fact that these two vaccines from very different "families" both work very well, I think we can shift out Bayesian prior for all the vaccines in the direction of: they will all massively reduce hospitalisation even in the oldest groups.

There have also been initial results, due to be updated this week, that both the Pfizer and AZ vaccines are 2/3s or more effective in reducing transmission after a single shot.
posted by atrazine at 2:44 AM on February 22 [3 favorites]


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