SARS-CoV-2-specific immunity in Covid-19 and SARS cases, and uninfected controls(nature.com)
nature.com
SARS-CoV-2-specific immunity in Covid-19 and SARS cases, and uninfected controls
https://www.nature.com/articles/s41586-020-2550-z
23 comments
Derek Lowe's blog (linked by jhayward, thanks) has a good rundown of the recent T Cell research and what it means in general: https://blogs.sciencemag.org/pipeline/archives/2020/07/15/ne...
But, he (and the paper authors!) seem to skim right over what might be the most important conclusion:
> Recognition of the nsp7 and nsp13 proteins is prominent, ~as well as the N protein~. And when they looked at that nsp7 response, it turns out that the T cells are recognizing particular protein regions that have low homology to those found in the “common cold” coronaviruses – but do have very high homology to various animal coronaviruses.
This "NP" or "nucleocapsid protein" has high homology to "common cold" human betacoronaviruses (OC43 and HKU1), so this basically means that previous exposure to these colds should confer some degree of immunity to SARS-CoV-2. The novel result that everyone seems to be dwelling on is interesting too, it raises the possibility that coronaviruses are transmitted from animals to humans more often than had been previously thought.
But, he (and the paper authors!) seem to skim right over what might be the most important conclusion:
> Recognition of the nsp7 and nsp13 proteins is prominent, ~as well as the N protein~. And when they looked at that nsp7 response, it turns out that the T cells are recognizing particular protein regions that have low homology to those found in the “common cold” coronaviruses – but do have very high homology to various animal coronaviruses.
This "NP" or "nucleocapsid protein" has high homology to "common cold" human betacoronaviruses (OC43 and HKU1), so this basically means that previous exposure to these colds should confer some degree of immunity to SARS-CoV-2. The novel result that everyone seems to be dwelling on is interesting too, it raises the possibility that coronaviruses are transmitted from animals to humans more often than had been previously thought.
I remember at the start of this an infectious diseases professor commented how if you had the antibodies already against CoV you'd be fine, but if you had only half, you were at a significantly higher risk of death.
I guess the immune system can misidentify as well--I bet we haven't taxonomized everything fully yet so eventually we'll have a new name for what immunity is required.
I guess the immune system can misidentify as well--I bet we haven't taxonomized everything fully yet so eventually we'll have a new name for what immunity is required.
What a blatantly false statement. There is no sound scientific definition of "half" the antibodies.
Sorry can you rephrase?
What do you mean by half?
What do you mean by half?
I have no clue! I just heard this a while back on some random video three months ago from an infectious diseases professor. My knowledge of biology is very low, I really shouldn't be speculating publically, I thought it was less controversial knowledge. I've probably just phrased it badly or remembered it in too simple of a manner due to my lack of background here.
I think half is a simplification, it must mean that if you have the wrong type or quantity or some combination thereof, but again I'm guessing and not an expert or even a professional.
I think half is a simplification, it must mean that if you have the wrong type or quantity or some combination thereof, but again I'm guessing and not an expert or even a professional.
The closest thing I can think of is https://en.wikipedia.org/wiki/Antibody-dependent_enhancement....
There's no way in which having real antibodies, but a reduced amount of them, would be worse than not having antibodies, but the following is very possible:
> It is likely that in older people the production of antibodies is slower and by the time the antibodies are developed in the titer that is sufficient to neutralize the virus, the virus changes its antigenic determinants. In this case, immuno-dominant neutralizing antibodies might start forming unstable complexes with the new form of the virus and start to infect monocytes/macrophages causing ADE. This process can trigger generalized infection of immune cells in multiple organs and cytokine storm
There's no way in which having real antibodies, but a reduced amount of them, would be worse than not having antibodies, but the following is very possible:
> It is likely that in older people the production of antibodies is slower and by the time the antibodies are developed in the titer that is sufficient to neutralize the virus, the virus changes its antigenic determinants. In this case, immuno-dominant neutralizing antibodies might start forming unstable complexes with the new form of the virus and start to infect monocytes/macrophages causing ADE. This process can trigger generalized infection of immune cells in multiple organs and cytokine storm
It's possibly by type and not mass, ie, one of each type of antibody versus various strains of COVID. I think that would make the most sense to me given the conclusion--if you don't have the right antibodies but have some you may be more susceptible to some strains and less susceptible to other strains. I will see if I get the time to find the original source.
Yeah that still doesn't make sense haha. It's not really a different strains thing. But if you read about ADE you'll see that, I don't understand it perfectly but more or less you have a partial match which seems to make the immune system turn on itself. (I butchered that but it's been a long day...)
Well it could be based on ADE--certain strains of coronavirus antibodies will help other strains replicate. In any case, I do remember quite clearly "half" but it was towards a very lay audience.
This statement as said is almost certainly false, it's too overly simplistic - half of what? Half of peak? Or do you mean only IgG but not IgM, etc?
But, related, and maybe what the professor was talking about:
https://en.wikipedia.org/wiki/Antibody-dependent_enhancement
^ This should be mandatory reading for anyone. Especially people that are obsessed with the idea that all vaccine candidates are inherently safe. (Unfortunately the term "anti-vaxxer" now gets thrown around for any actual legitimate discussion of the risks of untested vaccine candidates).
I'd note that ADE literally happens in Coronaviruses, so it's extra relevant. It can even happen outside the context of a vaccine, and may play a role in the pathology of severe SARS-CoV-2 infection.
But, related, and maybe what the professor was talking about:
https://en.wikipedia.org/wiki/Antibody-dependent_enhancement
^ This should be mandatory reading for anyone. Especially people that are obsessed with the idea that all vaccine candidates are inherently safe. (Unfortunately the term "anti-vaxxer" now gets thrown around for any actual legitimate discussion of the risks of untested vaccine candidates).
I'd note that ADE literally happens in Coronaviruses, so it's extra relevant. It can even happen outside the context of a vaccine, and may play a role in the pathology of severe SARS-CoV-2 infection.
First of all, here's the full text in-case anyone isn't aware:
https://www.nature.com/articles/s41586-020-2550-z_reference....
Before the actual paper, some review.
REVIEW SECTION 1
Coronavirus is a family of viruses, viruses being basically pieces of genetic material that swim around, inject their DNA into other cells, which makes the cells produce more copies of themselves until thousands of baby viruses explode out of the cell, killing it and moving on to the next cell.
COVID-19 is the condition that results from infection with SARS-CoV-2, which is a novel coronavirus that almost certainly emerged sometime in 2019. Think HIV/AIDS: HIV is the virus, AIDS is the disease, same with SARS-2 vs COVID-19.
SARS-CoV-2 while technically novel, is incredibly close related to what we now call SARS-CoV-1, which we used to just call "SARS". SARS-1 was incredibly deadly, but the pandemic fizzled out, presumably because it is quite deadly/quite symptomatic and AFAIK there isn't pre-symptomatic transmission.
SARS-CoV-2 structurally is very similar, sharing the same characteristic spike protein, and targetting the same ACE2 receptor which is expressed differentially in different tissue types. But SARS-CoV-2 is like a refined version of SARS-1, it "learned" from SARS-1's mistakes. So, it appears to be adapted to spread quite well, possibly because of cool things it does with interferon-mediated early course immunosuppression, which lets it spread for a few days before you show symptoms. It's also much less deadly than SARS-1.
Now, to craft the "optimal" pandemic virus, you want something that spreads easily, has a long incubation time, and isn't too deadly (otherwise it fizzles out by killing its hosts before they spread sufficiently). So in that sense, SARS-2 is perfectly crafted to kill a bunch of people. But please don't fall into fear-mongering, it doesn't kill nearly as many people as most have been led to believe. In my opinion it's really quite a mild virus overall, but some people can have severe COVID-19 which presents very similarly to a more run-of-the-mill SARS-1 infection (remember the original SARS is very deadly, so run-of-the-mill != no-big-deal).
REVIEW SECTION 2
We've talked about SARS-1 and SARS-2, but let me briefly butcher the immune system (I can already hear the immunologists stampeding towards me in the distance).
Your immune system's job is to distinguish self from non-self, (or more accurately, "non-self that is actually a threat" since you can have bacteria/etc that are not pathogenic/pathological). When it identifies a target, it has a lot of cool ways to kill it, but the specifics of neutrophils and antibodies, etc are out of scope.
For now, take it as given that your immune system can detect and kill pathogens.
Once it has fought off an infection, you will likely have antibodies, which are little heat-seeker-missiles that are primed to detect and neutralize the pathogen in question. (Note there's also T-Cell immunity which operates perhaps orthogonally to antibody immunity. This paper talks about T-Cell immunity).
Assuming you produced antibodies, eventually your active circulating antibodies will fade. This takes several weeks-a few months for SARS-1, and seems to hold for SARS-2, although I believe antibody prevalence is correlated with disease severity.
So eventually you have no more circulating antibodies. Contrary to what doomers will tell you, that's not a bad thing, it's inefficient to perpetually maintain antibodies. So instead your body maintains a living library of the pathogens it has previously encountered.
I'd encourage anyone to read about https://en.wikipedia.org/wiki/Immunological_memory. I'll summarize briefly.
(1) After infection, even when antibodies fade, you still have circulating Memory B Cells which persist across decades, waiting for exposure to the previously-fought-off pathogen at which they ramp up antibody production, leading to a faster, more strong response that results in lower peak viral load, presumably lower transmissibility/symptoms/etc. So, eventually it's possible to get reinfected as far as antibody immunity is concerned, but it takes quite awhile and when it does happen it's not nearly as bad.
(2) There's also memory T Cells, which are similar except instead of relying on antibodies, they work with T cells, with basically directly kill pathogens rather than indirectly produce the antibodies with neutralize the pathogen.
Okay, now it's time for
THE ACTUAL PAPER
The first finding is not surprising at all to anyone who has been reading research, but probably surprising to everyone else (read: almost everybody): if you've been previously exposed to SARS-1, you have memory T cells which persist long-term and will happily attack SARS-2.
Remember when I said SARS-CoV-2 was a novel virus? Well, it was, but it was also incredibly similar to SARS-CoV-1. So, technically it's novel but in real terms it's only a little bit novel, so previous SARS-1 infection is protective.
Well, that's cool, but most of us have never been exposed to SARS-1. But many of us have been exposed to one of the handful of other human coronaviruses that we know about.
The somewhat shocking (maybe not shocking to those who have been reading about immunology for years) revelation in this paper is this:
> Surprisingly, we also frequently detected SARS-CoV-2 specific T cells in individuals with no history of SARS, COVID-19 or contact with SARS/COVID-19 patients (n=37).
In other words, people never exposed to either of the two SARS viruses showed immune activation against SARS-2, meaning that they are either completely or partially immune to SARS-2.
Why? Because they've almost certainly been exposed to some of the other human coronaviruses, which basically cause common colds. (Side note: For almost everybody SARS-2 is not any different from the common cold. It's quite rare to have severe SARS-2, but those that do get it experience very bad effects, since their immune system is basically ravaging their entire body)
---
So the TL;DR: any model that has assumed that everyone can get infected is completely wrong and will massively overestimate the ultimate death of letting SARS-2 rip through the population.
Many people will never be able to get SARS-2 because they've already fought off similar-enough human coronaviruses. (BTW, coronaviruses are very distinctive in structure so that is likely why our immune systems exhibit this cross-reactivity)
Implications: (Warning: Strong opinion) As a result any cost/benefit tradeoffs of, say, lockdown, based off those models was off by a huge factor. The good news is, that even with the assumption that everyone was susceptible (capable of being infected), it was still really obvious to anyone with the capacity for rational thinking that containment/lockdown was a terrible idea, so these findings don't really change too much on that front, it just makes it even more overwhelmingly obvious that we collectively lost our shit and chopped off a limb in response to a papercut. So, instead of us (meaning, everywhere except Sweden) being super duper wrong, we now have good evidence that we were actually unimaginably, insanely wrong, to a degree that will be studied by subsequent scientists for decades as an example of where social contagion, groupthink and censorship led to one of the most damaging events in modern human history. Woot!
https://www.nature.com/articles/s41586-020-2550-z_reference....
Before the actual paper, some review.
REVIEW SECTION 1
Coronavirus is a family of viruses, viruses being basically pieces of genetic material that swim around, inject their DNA into other cells, which makes the cells produce more copies of themselves until thousands of baby viruses explode out of the cell, killing it and moving on to the next cell.
COVID-19 is the condition that results from infection with SARS-CoV-2, which is a novel coronavirus that almost certainly emerged sometime in 2019. Think HIV/AIDS: HIV is the virus, AIDS is the disease, same with SARS-2 vs COVID-19.
SARS-CoV-2 while technically novel, is incredibly close related to what we now call SARS-CoV-1, which we used to just call "SARS". SARS-1 was incredibly deadly, but the pandemic fizzled out, presumably because it is quite deadly/quite symptomatic and AFAIK there isn't pre-symptomatic transmission.
SARS-CoV-2 structurally is very similar, sharing the same characteristic spike protein, and targetting the same ACE2 receptor which is expressed differentially in different tissue types. But SARS-CoV-2 is like a refined version of SARS-1, it "learned" from SARS-1's mistakes. So, it appears to be adapted to spread quite well, possibly because of cool things it does with interferon-mediated early course immunosuppression, which lets it spread for a few days before you show symptoms. It's also much less deadly than SARS-1.
Now, to craft the "optimal" pandemic virus, you want something that spreads easily, has a long incubation time, and isn't too deadly (otherwise it fizzles out by killing its hosts before they spread sufficiently). So in that sense, SARS-2 is perfectly crafted to kill a bunch of people. But please don't fall into fear-mongering, it doesn't kill nearly as many people as most have been led to believe. In my opinion it's really quite a mild virus overall, but some people can have severe COVID-19 which presents very similarly to a more run-of-the-mill SARS-1 infection (remember the original SARS is very deadly, so run-of-the-mill != no-big-deal).
REVIEW SECTION 2
We've talked about SARS-1 and SARS-2, but let me briefly butcher the immune system (I can already hear the immunologists stampeding towards me in the distance).
Your immune system's job is to distinguish self from non-self, (or more accurately, "non-self that is actually a threat" since you can have bacteria/etc that are not pathogenic/pathological). When it identifies a target, it has a lot of cool ways to kill it, but the specifics of neutrophils and antibodies, etc are out of scope.
For now, take it as given that your immune system can detect and kill pathogens.
Once it has fought off an infection, you will likely have antibodies, which are little heat-seeker-missiles that are primed to detect and neutralize the pathogen in question. (Note there's also T-Cell immunity which operates perhaps orthogonally to antibody immunity. This paper talks about T-Cell immunity).
Assuming you produced antibodies, eventually your active circulating antibodies will fade. This takes several weeks-a few months for SARS-1, and seems to hold for SARS-2, although I believe antibody prevalence is correlated with disease severity.
So eventually you have no more circulating antibodies. Contrary to what doomers will tell you, that's not a bad thing, it's inefficient to perpetually maintain antibodies. So instead your body maintains a living library of the pathogens it has previously encountered.
I'd encourage anyone to read about https://en.wikipedia.org/wiki/Immunological_memory. I'll summarize briefly.
(1) After infection, even when antibodies fade, you still have circulating Memory B Cells which persist across decades, waiting for exposure to the previously-fought-off pathogen at which they ramp up antibody production, leading to a faster, more strong response that results in lower peak viral load, presumably lower transmissibility/symptoms/etc. So, eventually it's possible to get reinfected as far as antibody immunity is concerned, but it takes quite awhile and when it does happen it's not nearly as bad.
(2) There's also memory T Cells, which are similar except instead of relying on antibodies, they work with T cells, with basically directly kill pathogens rather than indirectly produce the antibodies with neutralize the pathogen.
Okay, now it's time for
THE ACTUAL PAPER
The first finding is not surprising at all to anyone who has been reading research, but probably surprising to everyone else (read: almost everybody): if you've been previously exposed to SARS-1, you have memory T cells which persist long-term and will happily attack SARS-2.
Remember when I said SARS-CoV-2 was a novel virus? Well, it was, but it was also incredibly similar to SARS-CoV-1. So, technically it's novel but in real terms it's only a little bit novel, so previous SARS-1 infection is protective.
Well, that's cool, but most of us have never been exposed to SARS-1. But many of us have been exposed to one of the handful of other human coronaviruses that we know about.
The somewhat shocking (maybe not shocking to those who have been reading about immunology for years) revelation in this paper is this:
> Surprisingly, we also frequently detected SARS-CoV-2 specific T cells in individuals with no history of SARS, COVID-19 or contact with SARS/COVID-19 patients (n=37).
In other words, people never exposed to either of the two SARS viruses showed immune activation against SARS-2, meaning that they are either completely or partially immune to SARS-2.
Why? Because they've almost certainly been exposed to some of the other human coronaviruses, which basically cause common colds. (Side note: For almost everybody SARS-2 is not any different from the common cold. It's quite rare to have severe SARS-2, but those that do get it experience very bad effects, since their immune system is basically ravaging their entire body)
---
So the TL;DR: any model that has assumed that everyone can get infected is completely wrong and will massively overestimate the ultimate death of letting SARS-2 rip through the population.
Many people will never be able to get SARS-2 because they've already fought off similar-enough human coronaviruses. (BTW, coronaviruses are very distinctive in structure so that is likely why our immune systems exhibit this cross-reactivity)
Implications: (Warning: Strong opinion) As a result any cost/benefit tradeoffs of, say, lockdown, based off those models was off by a huge factor. The good news is, that even with the assumption that everyone was susceptible (capable of being infected), it was still really obvious to anyone with the capacity for rational thinking that containment/lockdown was a terrible idea, so these findings don't really change too much on that front, it just makes it even more overwhelmingly obvious that we collectively lost our shit and chopped off a limb in response to a papercut. So, instead of us (meaning, everywhere except Sweden) being super duper wrong, we now have good evidence that we were actually unimaginably, insanely wrong, to a degree that will be studied by subsequent scientists for decades as an example of where social contagion, groupthink and censorship led to one of the most damaging events in modern human history. Woot!
The rest of your comments aside, which I don't have evidence to address, "it was still really obvious to anyone with the capacity for rational thinking that containment/lockdown was a terrible idea" is just absolutely, patently untrue (if taken at face value and not just as a snipe). In fact, I'd say that most people I know with the "capacity for rational thinking" — including scientists, doctors, and amateur COVID researchers who dig through the scientific literature every day — would strongly agree with some form of lockdown.
I am immediately suspicious of "everyone has gone mad except me" arguments, and I'd posit that "worldwide hysteria" just isn't a thing that happens without good reason.
I am immediately suspicious of "everyone has gone mad except me" arguments, and I'd posit that "worldwide hysteria" just isn't a thing that happens without good reason.
> I'd posit that "worldwide hysteria" just isn't a thing that happens.
Well, we have well-understood cases of more localized hysteria, like https://en.wikipedia.org/wiki/Tulip_mania.
Worldwide mania is just an extension of that. Since I believe that literally social media / the internet / other aspects of modern technology have allowed the propagation of mind-viruses to a degree never seen before, I truly believe that it is simply a state of mass collective delusion.
> "it was still really obvious to anyone with the capacity for rational thinking that containment/lockdown was a terrible idea" is just absolutely, patently untrue (if taken at face value and not just as a snipe).
Okay, you are right and I let my frustration be visible there, I agree that it is not a fair characterization. More accurately, I feel that people who came down on the pro-lockdown side have the capacity for rational thinking and yet were/are not using that capacity insofar as COVID-19 is concerned.
> I am immediately suspicious of "everyone has gone mad except me" arguments
You should know that I am too. I spent quite some time trying to figure out what obvious thing I was missing.
Well, I think enough evidence is in at this point, if you're willing to look at it. The truth is that otherwise intelligent and knowledgeable people can very easily fall into states of delusion. It's no secret that as humans we are endowed with an incredible set of cognitive distortions, that presumably had adaptive value at one point, but now hamper efforts towards rationality.
If you've ever taken the time to synthesize a body of research into a coherent whole - not necessarily writing an actual paper etc, but just trying to iterate and construct a really good mental model - then you know what an enormous amount of careful thought, effort, and intelligence it requires. It's simply not easy to do, thus I think that the majority of doctors really just regurgitate the things they learned in med school, the majority of scientists do their version of that, the majority of software engineers just make whatever hacky change they need to get their feature out without thinking about the whole system (often because the system is crushingly complex, etc).
So when I look at what our "leaders" and public health officials have done, I see a total failure to take that mentality, a total failure to see what was really there in front of them. And I don't necessarily blame them; it's well known that an environment of sleep deprivation and stress cripples the capacity for cognitive flexibility.
Anyway, to conclude, you are right that my characterization was unfair. I do stand by the notion that they behaved irrationally, but not because of some fundamental lack of ability to be rational, but simply because truly being rational takes an incredible amount of careful attention. (And obviously, none of us, myself included, are truly rational, but what I mean is, are you near that asymptote or are you off in the woods somewhere ranting about how it's too unsafe to open up our schools, etc)
Well, we have well-understood cases of more localized hysteria, like https://en.wikipedia.org/wiki/Tulip_mania.
Worldwide mania is just an extension of that. Since I believe that literally social media / the internet / other aspects of modern technology have allowed the propagation of mind-viruses to a degree never seen before, I truly believe that it is simply a state of mass collective delusion.
> "it was still really obvious to anyone with the capacity for rational thinking that containment/lockdown was a terrible idea" is just absolutely, patently untrue (if taken at face value and not just as a snipe).
Okay, you are right and I let my frustration be visible there, I agree that it is not a fair characterization. More accurately, I feel that people who came down on the pro-lockdown side have the capacity for rational thinking and yet were/are not using that capacity insofar as COVID-19 is concerned.
> I am immediately suspicious of "everyone has gone mad except me" arguments
You should know that I am too. I spent quite some time trying to figure out what obvious thing I was missing.
Well, I think enough evidence is in at this point, if you're willing to look at it. The truth is that otherwise intelligent and knowledgeable people can very easily fall into states of delusion. It's no secret that as humans we are endowed with an incredible set of cognitive distortions, that presumably had adaptive value at one point, but now hamper efforts towards rationality.
If you've ever taken the time to synthesize a body of research into a coherent whole - not necessarily writing an actual paper etc, but just trying to iterate and construct a really good mental model - then you know what an enormous amount of careful thought, effort, and intelligence it requires. It's simply not easy to do, thus I think that the majority of doctors really just regurgitate the things they learned in med school, the majority of scientists do their version of that, the majority of software engineers just make whatever hacky change they need to get their feature out without thinking about the whole system (often because the system is crushingly complex, etc).
So when I look at what our "leaders" and public health officials have done, I see a total failure to take that mentality, a total failure to see what was really there in front of them. And I don't necessarily blame them; it's well known that an environment of sleep deprivation and stress cripples the capacity for cognitive flexibility.
Anyway, to conclude, you are right that my characterization was unfair. I do stand by the notion that they behaved irrationally, but not because of some fundamental lack of ability to be rational, but simply because truly being rational takes an incredible amount of careful attention. (And obviously, none of us, myself included, are truly rational, but what I mean is, are you near that asymptote or are you off in the woods somewhere ranting about how it's too unsafe to open up our schools, etc)
You might find this interesting:
> IFR takes into account both symptomatic and asymptomatic cases and may therefore be a more directly measurable parameter for disease severity for COVID-19.
The latest CDC estimates an IFR of 0.65%
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
I'll let you do the math on how many are estimated to die without mitigation.
And for a lot of those who don't succumb to COVID-19, here are the extra-pulmonary effects:
https://www.nature.com/articles/s41591-020-0968-3/figures/2
Spreading the idea that shutting down was unwise is incredibly irresponsible.
> IFR takes into account both symptomatic and asymptomatic cases and may therefore be a more directly measurable parameter for disease severity for COVID-19.
The latest CDC estimates an IFR of 0.65%
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
I'll let you do the math on how many are estimated to die without mitigation.
And for a lot of those who don't succumb to COVID-19, here are the extra-pulmonary effects:
https://www.nature.com/articles/s41591-020-0968-3/figures/2
Spreading the idea that shutting down was unwise is incredibly irresponsible.
> Spreading the idea that shutting down was unwise is incredibly irresponsible.
Nonsense. I would argue that spreading the idea that shutting down was a good thing is and was incredibly irresponsible, but the difference is I don't believe in suppressing other peoples' ideas. But pro-lockdowners seem to love it. For the same reason they like the lockdown: it's a mentality that stems from a love of compulsion and control, and a sharp anxiety about living a full life.
> I'll let you do the math on how many are estimated to die without mitigation.
I don't advocate against mitigation (nursing homes, etc), but I advocate against containment full-stop.
Anyway, I have done the math. In fact, I've done the math with an IFR of .9% and assuming 82% of the population got infected (see Ferguson's paper).
2.2 million deaths. That's what the worst case scenario was.
And on balance, it was worth it.
What do I think the actual number is? Well, I'd use a new upper bound of maybe 600,000 - which BTW is around the number of cardiac deaths per year in the US. Amortized across 5 years, it becomes even less shocking.
These are upper bounds, btw. I think the actual number could be lower, but I don't bank on it. Unfortunately, given the way we classify deaths, it will be very difficult to find out what the "real" death toll was looking back.
Nonsense. I would argue that spreading the idea that shutting down was a good thing is and was incredibly irresponsible, but the difference is I don't believe in suppressing other peoples' ideas. But pro-lockdowners seem to love it. For the same reason they like the lockdown: it's a mentality that stems from a love of compulsion and control, and a sharp anxiety about living a full life.
> I'll let you do the math on how many are estimated to die without mitigation.
I don't advocate against mitigation (nursing homes, etc), but I advocate against containment full-stop.
Anyway, I have done the math. In fact, I've done the math with an IFR of .9% and assuming 82% of the population got infected (see Ferguson's paper).
2.2 million deaths. That's what the worst case scenario was.
And on balance, it was worth it.
What do I think the actual number is? Well, I'd use a new upper bound of maybe 600,000 - which BTW is around the number of cardiac deaths per year in the US. Amortized across 5 years, it becomes even less shocking.
These are upper bounds, btw. I think the actual number could be lower, but I don't bank on it. Unfortunately, given the way we classify deaths, it will be very difficult to find out what the "real" death toll was looking back.
Without shutting down it wouldn't be amortized.
You'd effectively have millions of additional deaths from lack of hospital capacity, more than doubling the yearly death rate. And additionally you'd have millions of more people with debilitating complications from all causes.
That's absolute insanity. You're devaluing life. Stop it. It's frankly scary to think you're out there.
You'd effectively have millions of additional deaths from lack of hospital capacity, more than doubling the yearly death rate. And additionally you'd have millions of more people with debilitating complications from all causes.
That's absolute insanity. You're devaluing life. Stop it. It's frankly scary to think you're out there.
> Without shutting down it wouldn't be amortized.
Huh? No it wouldn't. Read my other comments in the thread, the point is that after it works its way through the population, the set of SARS-CoV-2-naive individuals becomes dominated by new entrants to the world (babies/toddlers), who don't die from COVID-19.
So over a period of 5 years, the average yearly death will be this year's deaths / 5. That doesn't hold in the same way for the Flu since it does kill babies.
> You'd effectively have millions of additional deaths from lack of hospital capacity
This is just false. I can't really debunk it because you didn't make an actual argument, so let's leave it at that.
> And additionally you'd have millions of more people with debilitating complications from all causes.
Huh? Are you saying complications from COVID-19 itself, or are you saying non-covid reasons which would get neglected due to lack of medical care?
> That's absolute insanity. You're devaluing life. Stop it. It's frankly scary to think you're out there.
No, I actually value life, which is why I understand how precious it is, and what a cruel thing it is to do to subject an entire planet to a regime of isolation and fear. As I've said elsewhere in this thread, I also believe that lockdown leads to more mortality than doing nothing, so even if you don't care about wellbeing and just want to myopically look at lives saved, I'm arguing that lockdown is worse on both counts.
Huh? No it wouldn't. Read my other comments in the thread, the point is that after it works its way through the population, the set of SARS-CoV-2-naive individuals becomes dominated by new entrants to the world (babies/toddlers), who don't die from COVID-19.
So over a period of 5 years, the average yearly death will be this year's deaths / 5. That doesn't hold in the same way for the Flu since it does kill babies.
> You'd effectively have millions of additional deaths from lack of hospital capacity
This is just false. I can't really debunk it because you didn't make an actual argument, so let's leave it at that.
> And additionally you'd have millions of more people with debilitating complications from all causes.
Huh? Are you saying complications from COVID-19 itself, or are you saying non-covid reasons which would get neglected due to lack of medical care?
> That's absolute insanity. You're devaluing life. Stop it. It's frankly scary to think you're out there.
No, I actually value life, which is why I understand how precious it is, and what a cruel thing it is to do to subject an entire planet to a regime of isolation and fear. As I've said elsewhere in this thread, I also believe that lockdown leads to more mortality than doing nothing, so even if you don't care about wellbeing and just want to myopically look at lives saved, I'm arguing that lockdown is worse on both counts.
You cannot argue that there wouldn't be more infections if we hadn't shut down.
That is, if we hadn't shut down, we'd have exponentially more infections right now.
There are deleterious effects to shutting down. But your theory that shutting down has lead to more deaths is absurd.
That is, if we hadn't shut down, we'd have exponentially more infections right now.
There are deleterious effects to shutting down. But your theory that shutting down has lead to more deaths is absurd.
Thanks for your breakdown. May I ask what your background in medicine is?
> May I ask what your background in medicine is?
I have none.
I have none.
Word. Thank you.
Derek Lowe's latest commentary on SARS-COV-2 immunity and this paper specifically:
https://blogs.sciencemag.org/pipeline/archives/2020/07/15/ne...
https://blogs.sciencemag.org/pipeline/archives/2020/07/15/ne...
would anybody mind providing a summary of conclusions for the general audience here?