All of Rembert_Drijfmest's Comments + Replies

I don't follow your "so ..." People who have avoided contact since Feb are incredibly more likely to be delaying (perhaps forever) their date of infection. Basically none of them have yet had a mild case. It's an open question whether the strain we who've avoided it so far eventually are exposed to is more or less severe in symptoms (obviously it will tend to be more contagious) than the one people got in earlier waves. I always expected it would be (because fast onset fatal strains are quarantined more effectively and cannot spread) slower-onset, more lingering, but less severe. I don't have much reason to change my mind, even though you've brought an interesting historical claim into view. Besides hospital workers, hardly anyone is going to hospitals unless they have covid already, and although it's not perfect, hygiene is practiced. I agree that hospital workers are more likely to contract a severe strain; that's why they should arguably should have been variolated by intentional light exposure already.

Where is the evidence for the increased spreading through military hospitals? It's a nice story, and plausible.

Why wouldn't it have spread at as well in the trenches where you have repeated exposure to the same group of people? Open air/sunlight, perhaps? Or are you emphasizing the travel aspect (coming into contact with more people total than the mild cases)?

Oops! Thank you. I was aware of that, but got mixed up while writing and didn't separate my ideas. I meant "like 1918" as in a flu mutation that made it behave much more dangerously. I was thinking the next mutation might be more likely to target the old and sick instead of repeating the cytokine storm thing with the young, but either could easily happen (this one might cause a cytokine storm that attacks the old, in many cases, or at least I've read that is a possibility?). I also figured that in modern times it would be easy to intervene with the young because they weren't in trenches in a world war with a less developed medical system. But COVID-19 is so contagious that it doesn't seem way easier to control. Those are good and worrying points about natural selection. I'm not at all confident we're handling this intelligently. Maybe there's not much that can be done to help, but making it worse is not good.

I think different people have used it to mean different things, which is an easy way for concepts to shapeshift. The percentage of the population infected at the 'herd immunity' stage is dependent on R0, the transmission rate; each newly infected person has to, on average, hit less than one not-yet-immune person. And so if 80% of the population has already had it, you can afford to roll against up to 5 individuals; if 50% of the population has already had it, you can afford to roll against up to 2 individuals. Then the number of new infections is a shrinking number, and eventually you get no new infections (while some fraction of the population never got the disease). I think early on people were mostly worried about access to ventilators; it's 'fine' if people get the disease, so long as sufficiently few of them get it at any particular time. Drop the R0 to 1, and a manageable infection stays manageable (and an unmanageable one stays unmanageable). I think most internet commentators were overly optimistic about how effective minor adjustments would be, and empirically it's taken the 'social distancing' / 'shelter in place' / 'lockdown' state that most of the world is currently in to get the R0 below 1, rather than just people being more diligent about washing their hands. There are only a few ways out of this mess, and they all involve the number of active cases going (functionally) to 0. Suppression (whatever measures it takes to get R0 sufficiently close to 0, instead of 1), herd immunity (enough people getting it and recovering that future social interactions don't cause explosions), or a vaccine (which gets you herd immunity, hopefully with lower costs).