[topspin]

"eliminating or eradicating the virus in the U.S."

I sincerely didn't imagine anyone still thought this was feasible. Is this really still an aspiration that can be offered with a straight face?

I want to point and laugh, but this is NPR so I know that's not allowed...

[jmopp]

There's a difference between elimination and eradication. Elimination means getting cases close to 0 as possible, and then - any outbreaks that do occur, tracking them and stamping them out before they can spread.

A good analogy is that of TB in most of Europe. When I moved from South Africa to the Netherlands, I had to have a chest X-ray every 6 months for 2 years to make sure I'm not infectious with TB. The disease has not been eradicated, but there are measures in place to make sure people don't die of consumption like it's the 1800s. We can do the same with covid, there is just a supreme lack of will to do so.

[wk_end]

> There's a difference between elimination and eradication. Elimination means getting cases close to 0 as possible, and then - any outbreaks that do occur, tracking them and stamping them out before they can spread.

Is that...true? I'm a native English speaker, and "elimination" and "eradication" are completely synonymous to me, at least in terms of denotation. That is to say, both of these mean "absolutely no SARS-CoV-2 remains." The dictionary agrees with this, too: eliminate is defined as "completely remove or get rid of (something)". What you're describing sounds a lot more like "containment"

I'd certainly accept that epidemiologists have their own lingo that differs from natural English, but it also...kinda sounds like you might be mistaken.

[cannabis_sam]

I think the terms have more narrow and specific meanings in the context of fighting disease.

From https://www.cdc.gov/mmwr/preview/mmwrhtml/su48a7.htm

>Control: The reduction of disease incidence, prevalence, morbidity or mortality to a locally acceptable level as a result of deliberate efforts; continued intervention measures are required to maintain the reduction. Example: diarrhoeal diseases.

>Elimination of disease: Reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts; continued intervention measures are required. Example: neonatal tetanus.

>Elimination of infections: Reduction to zero of the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate efforts; continued measures to prevent re-establishment of transmission are required. Example: measles, poliomyelitis.

>Eradication: Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed. Example: smallpox.

>Extinction: The specific infectious agent no longer exists in nature or in the laboratory. Example: none

[topspin]

"We can do the same with covid"

Do you have any evidence for this claim? It shouldn't need to be pointed out that COVID is vastly more contagious than TB. What sort of tracing system do you imagine implementing to achieve containment? You'd probably need a video record of every waking moment of every soul, subject to instantaneous remote analysis by authorities. And now the deer as well...

[jmopp]

Right now, track and trace is ineffective because cases are high. In the Netherlands, we can only trace the source of a quarter of infections. [1] If cases are brought down, track and trace has an easier workload and thus can be more effective.

We don't need draconian restrictions, just sensible ones. Wear a mask, get vaccinated, test yourself regularly. Many small measures combined have a big effect in aggregate. The only reason we have to resort to the draconian measures is because people are unwilling to do the basic measures.

[1] https://www.rivm.nl/coronavirus-covid-19/actueel/wekelijkse-... (In Dutch, the linked PDF has a table of track and trace for this past week on page 27)

[makomk]

Test and trace never worked nearly as effectively against Covid as the media claimed. I don't know about the Netherlands, but here in the UK the media coverage was pretty much outright lying about how well it worked in South Korea to convince us our government was incompetent and had failed, saying it let them achieve things like lifting social distancing restrictions and reopening bars and clubs pre-vaccine when in reality every time they tried that cases immediately went exponential and they had to reimpose the restrictions. Even the countries which were pursuing zero covid with some success had to rely on repeated, strict lockdowns to achieve that (and most of them have given up on that now).

And it's been much more effective pretty much everywhere at preventing Covid getting in than it has once it's endemic in a country - reducing the number of cases doesn't help much if there are undetected infections, and the difficulty of finding those doesn't really scale down much with the number of cases or infections since they could be almost anywhere in the population.

[nradov]

We don't have to resort to draconian measures. Those are purely a political choice.

[yorwba]

> What sort of tracing system do you imagine implementing to achieve containment?

Ask Taiwan? They had 39 cases in the past week, only two of which were local, and the latest of those was six days ago. https://www.cdc.gov.tw/Bulletin/List/MmgtpeidAR5Ooai4-fgHzQ

Of course they've never had more than 554 cases in a day, so it was a bit easier to get down from the peak. In most other countries people don't seem to have the patience to keep up countermeasures for long enough to achieve local elimination.

[topspin]

> Ask Taiwan?

I don't need to. I'm well aware of how Taiwan achieves this; near absolute control of travel to and from the island, implemented early and with no meaningful political opposition. That window closed for the US by Jan. 2019 while certain parties were still screaming "Xenophobe!" at modest and insufficient travel restrictions.

The question at hand is how NPR -- or anyone else for that matter -- imagines this happening in the US. Large numbers of people literally sneak into this country on foot every day and impeding them (for any reason at all, never mind COVID) is a monumental political issue, as just one example of what separates the US from Taiwan.

[danbruc]

I assume "Xenophobe!" is a reference to this [1].

[1] https://www.politifact.com/factchecks/2020/oct/23/donald-tru...

[LurkingPenguin]

I live in Taiwan and while there's much to be lauded about the way the government here has handled the pandemic, the current situation is not sustainable.

Taiwan's case numbers are low because the borders are effectively sealed shut. With few exceptions, only citizens and residents can enter the country. Upon return, everyone is required to do 14 days of quarantine in a centralized quarantine facility or in a quarantine hotel at their own expense. When I did it, I paid close to $2,000 USD for the 14 days.

Chinese New Year is coming up and there isn't enough quarantine hotel capacity, so the government is preparing to announce some loosening of the restrictions, like 7 days of quarantine in a centralized facility plus 7 at home for the fully vaccinated.

Economically, many local businesses have been hurt by almost 2 years of closed borders. Some have gone out of business. Save for the quarantine hotels, which are making a killing, tourism has been devastated at a time when it would be really helpful for Taiwan to be not isolated from the rest of the world.

The big problem is that, looking at highly-vaccinated countries like Singapore and Israel, it's clear that once the borders open, the virus will get in. Fully vaccinated people will get and spread the virus and some percentage of individuals in high-risk groups are likely to get very sick and die even if they've been vaccinated. Taiwan had a very high CFR when it had its mini outbreak in May, which reflects the fact that there are a lot of old, not so healthy people here for the virus to run through.

I wouldn't suggest that Taiwan should have just thrown caution to the wind and opened the borders before vaccination rates were higher, but at some point, continuing with a 0 COVID strategy is just delaying the inevitable at a higher and higher cost.

[throwaway894345]

Shakes fist. Why can't my government be as good as those of $ISLAND_NATION?!

Seriously though, we went over this with Australia and New Zealand. It's much easier to control your borders and keep cases low when there are fewer points of entry with existing screening infrastructure.

[GaryTang]

At this point, as conspiratorially as it sounds, I think this is exactly what the powers that be intend.

[Jansen312]

That is basically zero covid strategy. You need to be lucky that 1. Virus don't change like smallpox and polio (not true for covid). 2. Vaccines stop infection or herd immunity is a thing (not true for covid) 3. Virus evolves into less virulent form and less transmissive (at this moment it is the reverse for covid). Next year we will see how well zero covid strategy plays out in China.

[pvaldes]

An to remove the virus just in a country would be useless. Specially in a country that receives millions of international tourists. It would return again and again. At this point is either vaccines or more people killed and more money to the sink.

And as in the Ebola case we really didn't have a good picture of what is happening with pets until late. Cats can pick it and ferrets most probably.

[encryptluks2]

But people not getting vaccines are the reason we're here!!! /s

Seriously, can't we just accept reality and get back to normal. Those that want the vaccine should get it and those that don't shouldn't. I think the harm being caused by the ridiculous mandates at this point have done equal harm.

[dessant]

> Seriously, can't we just accept reality and get back to normal. Those that want the vaccine should get it and those that don't shouldn't.

No, we can't, because in most places in the world people who have nothing to do with COVID can't get into hospitals or be seen by doctors, when there is an infection wave, which at the moment is fueled by the unvaccinated. Deers won't take up hospital beds, but the unvaccinated will continue to strain health care systems.

[encryptluks2]

One explanation for hospitals filling up is that there was a major fear campaign happening in the media, and many people use the ER as a doctors office. Many doctors office at the beginning of COVID were refusing to see patients that exhibiting any cold like symptoms, so people had no choice but to go to the ER, which undoubtedly would have increased the spread.

2nd, there is a mental component to sickness that is apparent when looking at placebo effects in studies. If a patient is deathly afraid of COVID and catches COVID, they can in fact worsen their symptoms and sickness based on that alone. If media is convincing people that COVID-19 is incredibly deadly, it can become deadlier than if you are not someone who worried a lot. This is nothing new as there has always been a component of care for cancer patients that involved mental health. Watch Patch Adams to see what I'm talking about.

[taylodl]

ICUs around the world at full capacity aren't a result of the media or people having negative thoughts about Covid.

[DoingIsLearning]

> Seriously, can't we just accept reality and get back to normal.

Some countries have, some haven't been able to yet. I'm not going to start ideological arguments just want to bring you a new perspective.

The main criteria is your healthcare capacity.

In the Netherlands facemasks are only mandatory in public transit at this point. But you need a vaccine or test certificate to go to a restaurant/bar. The number of infections went up with everybody going back to the offices, but the hospitalizations and deaths are still on the low numbers.

In Germany you have regions like Saxony with extremely low numbers of vaccinated people, infection numbers also went up, but the hospitalizations are equally high, and the healthcare system is now strained with beds being repurposed for covid wards and surgeries cancelled.

My point is that _if_ we have unlimited healthcare resources and capacity then yes, theoretically, everything could go back to normal. But irrespective of where you sit ideologically our resources are finite, so our decisions have consequences.

[LurkingPenguin]

In the US, even before the pandemic, ICUs were typically run at very close to capacity. From Becker's Hospital Review[1]:

> For most level 1 trauma centers and tertiary care facilities, operating intensive care units at 80 percent to 90 percent capacity is standard — even before the COVID-19 pandemic hit.

In bad flu years, ERs are commonly overwhelmed[2] even though we obviously have vaccines that provide so-so protection:

https://time.com/5107984/hospitals-handling-burden-flu-patie...

I suspect that the situation in Europe is much the same.

Even if the vaccines continue to provide good protection against hospitalization, that doesn't mean that breakthrough infections won't have any impact on the healthcare system. As an anecdote, I just learned that a friend, who is a super fit collegiate athlete, just had a breakthrough infection and almost went to the ER because her symptoms were quite bad. She decided against it and the symptoms subsided within a couple of days, but if you hear about and read enough reports about breakthrough infections, it's pretty clear that it's not rare for "mild" cases to be pretty rough -- rough enough to have some people thinking about a visit to the hospital.

SARS-CoV-2 is well on its way to being endemic (it basically already is) so if we're being honest about getting back to normal, it's time for public health decision makers to be more realistic about the impact the virus will have on the healthcare system. Practically speaking, that means being prepared for high utilization and expanding capacity.

[1] https://www.beckershospitalreview.com/patient-flow/2-healthc...

[2] https://time.com/5107984/hospitals-handling-burden-flu-patie...

[topspin]

"but if you hear about and read enough reports about breakthrough infections, it's pretty clear that it's not rare for "mild" cases to be pretty rough"

That's me to a tee. Full vax by mid May, the worse fever of my life in Sept. Lasted five days and it felt like my brain was swelled.

The variants are way ahead of the vaccines. Perhaps the vaccines reduce symptoms -- I had no respiratory symptoms, for which I'm very grateful -- but not getting this is pretty much not an option; you are going to get it.

Eliminating or eradicating this is not feasible near term. I'm just astonished the official mainstream narrative is still indulging that concept.

[Clampower]

This is partially untrue.

Numbers are back up in the Netherlands, hospitals intensive care units are largely at capacity, and facemasks were reintroduced in public spaces such as all shops, doctors offices, etc last week.

[DoingIsLearning]

Indeed, fair correction on the masks being brought back.

But the intensive care units in the Netherlands are only at capacity in Brabant.

Everywhere else things are still ok and are likely to receive transfers from Brabant to balance resources.

[tromp]

There is a facemask mandate in public spaces, but enforcement is often lacking. I'd say 5-10% of shoppers don't wear masks. And no shop seems to refuse them. In my local mall, I've seen the mall manager walking around unmasked.

[hef19898]

I would agree if it wasn't for all those people that cannot get vaccinated. Young children, people with auto-immune diseases, transplant patients, certain kinds of cancer... I just guess taking one for the team went out of fashion a while ago.

[encryptluks2]

Studies have shown that deaths from COVID among children are incredibly rare, and more kids die from the flu than from COVID. People with auto-immune diseases, transplant patients and certain kinds of cancer have always been more susceptible to illness. Never have we mandated flu vaccines before, and those people would be equally as susceptible. However, I think you should be asking yourself.. if an mRNA vaccine presents auto-immune response, who is to say that isn't harming those being forced to be vaccinated? There is little to be understood about many auto-immune diseases, just look at fibromyalgia, which has often been labeled as a psychological condition and not a physical one. Many doctors still don't believe it is real, and if you use it for a disability claim it is difficult to prove.

If what you're saying is to be considered, then it must also be considered that the vaccine could have subtle side effects that may not be immediately known and later exhibit themselves as incredibly hard to diagnose and nearly impossible to detect illnesses.

[tpm]

Or those who can get the vaccine but it won't help them much.

But, as you say, homo homini lupus.

[ulfw]

Erm why do you think those can NOT get vaccinated?

Quite the opposite. They need more boosters as the vaccines don't generate enough immune response.

[mach1ne]

Honestly, there could be a malicious actor deliberately creating division among the populace. As with so many other topics, vaccination and COVID has been politicised to fanaticism.

Then again, the more probable explanation is that what we're seeing is the result of social media changing the dynamics of the society.

[saiya-jin]

> But people not getting vaccines are the reason we're here!!! /s

> Seriously, can't we just accept reality and get back to normal. Those that want the vaccine should get it and those that don't shouldn't. I think the harm being caused by the ridiculous mandates at this point have done equal harm.

People seem to forget all those folks who can't get their surgeries, early cancer screening, undiagnosed chest pain etc. Those are deaths and suffering that won't ever appear in official covid mortality stats but they are out there, everywhere. During Spring 2021 in India outbreak alone, officially there was 500k deaths, but heightened mortality for that period was more like 5 millions (that covers undetected covid and everything else).

A more general rant - it pains me to no end see how covid crisis brutally highlighted the fact that large part of population is utterly irrational, emotional, believes all kinds of lies very easily and is, is selfish, arrogant, self-centered, and for the lack of better word, plain dumb. You can't win with dumb. We saw it earlier with elections, we saw it on football stadiums etc. but this is worse. And I don't see a way out.

[gspr]

No. The ones that don't want the vaccine (and don't have a real medical reason not to) have to take the goddamn vaccine. Their beliefs are objectively wrong, and if they want to live in society, they have to do their part.

Bodily autonomy is very important to me, but it does not mean that you are allowed to cause real harm to others' bodies.

The antivaxxers have nothing. They're ridiculous morons who try to undermine society. Meet fire with fire, marginalize these idiots if they refuse to get their shit together.

[LurkingPenguin]

What do you say to people who eagerly took the initial 2-dose vaccine series but aren't interested in perpetual boosters every 6 months? Are they antivaxxers? Do they need to be marginalized?

The neutralizing antibodies generated after vaccination wane very quickly and the vaccines do not prevent infection or transmission. There are even breakthrough cases happening in people who are just 2-3 months out from their second dose.

I flew halfway around the world to get vaccinated and when I was in the US earlier this year, observed that the people who were most confident and even cavalier about forgoing preventative measures like mask wearing and social distancing were people who were fully vaccinated.

If vaccinated people who harbor objectively wrong beliefs about what the vaccines actually do engage in behavior that causes "real harm to other's bodies", do they need fire and brimstone too?

[gspr]

> What do you say to people who eagerly took the initial 2-dose vaccine series but aren't interested in perpetual boosters every 6 months? Are they antivaxxers? Do they need to be marginalized?

I don't know. It's difficult. So let's focus on the easy one: the idiots who won't get their first dose.

> The neutralizing antibodies generated after vaccination wane very quickly and the vaccines do not prevent infection or transmission. There are even breakthrough cases happening in people who are just 2-3 months out from their second dose.

Of course there are breakthrough cases. The vaccines aren't 100% effective. That's not the point.