How much further can covid mutate?

[Thelm]

I’m just wondering. Is there a limit as to how far a virus can mutate? Are we going to still be in a race to contain it in five years time?

I just don’t know how this will end.

The world couldn't have suppressed the virus.. but individual nations within it could have, and indeed have done!.

Not disputing that. Then we’d still have to weigh up opening up to potential variants at some point. Anyway I can’t do why can’t we be NZ again, it’s been hashed so many times. And the people who think it’s possible will always think so.

It will mutate until everyone in the world is vaccinated. Think of it like the flu, OP you need a vaccination every year, not just because your immunity wears off, but because it has mutated. The vaccine will be slightly different every year.

@Dissimilitude

Yes it can mutate forever.

But that doesn’t mean it necessarily has infinite room to continue getting more transmissible. Think of evolution like a genetic search for the fittest virus. At some point, the virus will approach the optimum structure to spread. It won’t just continue getting more effective forever.

It will continue to evolve to escape current immunity, but mRNA vaccines can be manufactured quickly, at scale, and with updated genetic payloads to compensate for the latest variants.

We’ll be back to normal soon enough, with a booster shot every year or so for a while.

Oh, and zero covid was never a workable strategy long term. Never. This thing was always getting out. Even with China style suppression. It’s too infectious.

But that doesn’t mean it necessarily has infinite room to continue getting more transmissible.

Nobody has suggested that. What's becoming increasingly important is not the R0 for the virus, which is already closing in on measles, but the extent to which it is transmittable within vaccinated populations!

but mRNA vaccines can be manufactured quickly, at scale, and with updated genetic payloads to compensate for the latest variants.

They can be manufactured quickly with payloads corresponding to the newest variants, BUT.....

1. It takes time to vaccinate a population - by the time you've manufactured the vaccine in sufficient quantities AND distributed and administered the booster, THAT particularly variant is ancient history.
2. There's absolutely no guarantee that your immune system will take any notice of the booster. It's easy to train your immune system, it's harder to retrain it. It's quite possible that after each successive booster, we achieve a lower protection than before.

The main hope of scientists here is to come up with a vaccine that's ahead of the virus. A SARS-1 patient appears to have developed an antibody that confers immunity to ALL Coronaviruses. If we can somehow engineer a vaccine that delivers this ability to everyone, then we will defeat covid.

Never. This thing was always getting out. Even with China style suppression

Seems to have worked very well there though, despite the enormous population and no vaccines.... Once they're all vaccinated it'll be a breeze for China to maintain their status quo.
NB I believed as you through most of Jan last year - I didn't consider a country undertaking lockdown measures.

Good coverage here:
www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30800-8/fulltext

@MarshaBradyo

The world couldn't have suppressed the virus.. but individual nations within it could have, and indeed have done!.

Not disputing that. Then we’d still have to weigh up opening up to potential variants at some point. Anyway I can’t do why can’t we be NZ again, it’s been hashed so many times. And the people who think it’s possible will always think so.

What can I say? I'm a positive, "can do" optimistic sort of person.

I don't do defeatism.

But I completely understand why people don't want to hear about gigs of 50,000 people, and unrestricted wedding guest lists in N Z. when our government is weighing up the sweet spot of illness and death that the British people and the country's infrastructure will tolerate.

I don’t think anyone could call you that Princess

But no you don’t have to tell me about gigs, I’m Aus / U.K. citizen and have family who I obviously speak to every week. I know what zero Covid is and I also know the differences between countries very well, and people overestimate being ‘defeatist’ vs obvious geographical differences.

@MarshaBradyo

The world couldn't have suppressed the virus.. but individual nations within it could have, and indeed have done!.

Not disputing that. Then we’d still have to weigh up opening up to potential variants at some point. Anyway I can’t do why can’t we be NZ again, it’s been hashed so many times. And the people who think it’s possible will always think so.

China is a FAR better example than NZ. Granted we may not have achieved the same compliance in our first lockdown, so it would have taken longer to achieve the same results but we were nearly there.

After that How do new variants get in?

And before you say anything like "we can't do ..." No - we can do ANYTHING - what matters is cost... so the question is which has cost us more - the route we've taken, or closing international borders as Oz /China have done? Given that we are looking at a spend of several thousand £ per person tackling covid - heck Test/Track/Trace alone has cost us £500 each, it's a really easy question to answer lol.

Yes, we're reliant on imports, but we could have set up a system where containers were delivered to ports, and then collected by different lorries - expensive, but a drop in the ocean compared to what we have spent.

@strangeshapedpotato please can you provide the source for your claim that boosters are likely to have less and less effect.

If it makes you feel better, they're working on a vaccine for the entire coronavirus family. Could be the end of all COVID-19 variants, SARS, MERS and several common colds:
theconversation.com/a-single-vaccine-to-beat-all-coronaviruses-sounds-impossible-but-scientists-are-already-working-on-one-156373

After that How do new variants get in?

New variants get in when, say NZ have finished vaccinating and open borders. Then we’re all in the same boat.

The question is how long do you think we’ll get variants?

And how long will NZ remain closed?

Are you predicting they’ll remain closed until there are no new variants, in which case why vaccinate now if you have to do boosters yearly

@ineedaholidaynow

What happened to Spanish flu?

It's likely herd immunity happened - there weren't enough people susceptible to the virus for it to continue to spread widely. Natural immunity from infection to the H1N1 virus that caused Spanish flu lasts about 50 years so it takes a long time for the number of susceptible people to increase (by new babies without immunity being born and immune people coming to the end of their life) to a level that there will be another pandemic.

You can predict by modelling when it is likely to happen. The next H1N1 pandemic was considered overdue when I was an undergraduate studying epidemiology, a decade before swine flu arrived.

Incidentally - I just looked up how much covid has cost us.

Borrowing in 2019/2020 seems to have been about £20 billion
The figure for 2020/21 is estimated to be £355 billion falling to £234 for the following year.

If we assume that the £20 bn would have been maintained, then that amounts to ~£550 bn.

If we assume that after 2022 we'll be back to normal (highly unlikely) then you're looking at just over £8200 cost per person (taking pop as 67 million).

@strangeshapedpotato

Effectively forever, and because covid spreads easily during its incubation period, there is NO evolutionary pressure on it to evolve into a milder form. The ONLY selective factor is that variants that evade the immune system more successfully will win. Becoming a milder virus is not really on the cards.

Covid is a much more serious disease than influenza, and even flu can kill a LOT of people - the Spanish Flu variant of flu wiped out a good chunk of the world's population.

"Living with it" is quite simply not an option we should be considering. As long as the virus is spreading through a population, it will evolve to defeat any existing immunity, whether "natural" or "vaccine" acquired. Boosters are likely to have gradually less and less effect - training the human immune system is easy, but retraining it - somewhat harder.

"Living with it" means a world with a substantially reduced life expectancy. Significantly more spending on health care (i.e. higher taxes). And years in which lockdowns are required due to a more severe than usual strain circulating. Personally I want to avoid this future, but the sad lack of foresight and discipline across Western countries is making it inevitable.

Absolutely this. This virus doesn’t care if it kills its host. It transmits and replicates most 2-3 days before symptoms appear. Therefore there is no evolutionary pressure for it to become a milder disease like the average cold. When people say glib things like ‘enough is enough’ they really don’t know what they’re talking about.

Btw new variants can still get in Melbourne is in lockdown due to cases

So it doesn’t require italics on how impossible it is

£550 bln doesn't include (some very long term)

environmental costs from pollution linked to PPE manufacture, waste & transport
learning loss to kids, training delay & loss to young people
employment & industry-sector specific devastation
MH illness increased burden
delayed treatment received & seeking -> greater mortality & morbidity
moral injury to HCPs
increased grip by conspiracy theorists undermining social cohesion
QALYs lost linked to deaths, Long covid & acute illness

@cathyandclare

I read an article where a virologist said that there are a limited number of mutations on the spike protein before the virus loses its ability to bind to the receptors in the lungs. Frustratingly I can't find it now. I found it reassuring.

Yes there are a limited number of mutations of the spike protein. I can’t remember where I read that either. At least that’s something positive to hang onto!

[quote BlueBlancmange]@strangeshapedpotato please can you provide the source for your claim that boosters are likely to have less and less effect.[/quote]
Sorry but it's a knowledge of how the immune system work and I didn't say it was likely - I said quite possible. I make no claim as to how likely it is - but it IS a significant risk.

I'll explain the why of it.

Your immune system sees an intruder - in this case the spike protein of the vaccine. Now your immune system doesn't have eyes - it "sees" things in the same way a blindfolded person sees an object. It feels for shapes that it recognises.

When it encounters something new, it builds antibodies to "attack" a few of these "shapes". It doesn't know whether or not an individual attack will be successful - it only "knows" whether the overall attack has worked, i.e. whether the intruder has been defeated.

So let's think of an antigen like a car. Your immune system picks out the wing mirrors, the bonnet ornament and the wheels as items to attack. But ONLY the attack on the wheels succeeds - that's ok - it stops the virus....

Virus mutates - car changes the wheels. Your immune system still recognises the wing mirrors and the bonnet ornament so it attacks these.... and fails! So now it's back to square one, examining the new item and finding sites to attack.

But if you tried to vaccinate against the mutated virus (car) then because the vaccine doesn't reproduce, your immune system may falsely believe that its attack on the wing mirrors/bonnet ornament succeeded! It doesn't create new antibodies because it doesn't think it needs to!

Whether or not this happens is influenced by many factors, but essentially you're into diminishing returns with each successive booster. The decrease may be so small it's inconsequential, or it may be significant. We won't know until it happens.

I'm not trying to spread fear here - just point out that vaccines alone cannot be relied on to solve everything.

@MarshaBradyo

Btw new variants can still get in Melbourne is in lockdown due to cases

So it doesn’t require italics on how impossible it is

How many days has the average Australian spent in lockdown in the last year? How much has Oz spent per capita on dealing with the virus?

Strange I was still responding to your incredulous how do they get in line

Also timeframes for NZ?

How long variants - how long borders shut

@BlueBlancmange

Apologies - I did say "likely"

I withdraw that comment. I should have said it's a risk.

Btw can’t go back to last Feb when SAGE issued the advice they did.

Unless you with all your better knowledge could have steered them another way the experts advised what they did.

No amount of mooning over NZ and Aus will change it

I think when you grew up there it stops this kind of lamenting. It’s been going on over a year

@MarshaBradyo

You're throwing up strawmen is what you're doing.

Trying to equate a Melbourne lockdown with a failure of "keeping the virus out" plan.

Nope - the Melbourne lockdown is the fallback part of that plan. Unlike the UK where the moment we detected that cases had escaped Track and Trace, we gave up Trace and Trace (Feb 2020) - the rest is history.

In any containment policy, there will always be failures. What matters is whether you deal with the failures, or give up?

I asked you to compare the economic, social and health costs of the two approaches.

[quote strangeshapedpotato]@MarshaBradyo

You're throwing up strawmen is what you're doing.

Trying to equate a Melbourne lockdown with a failure of "keeping the virus out" plan.

Nope - the Melbourne lockdown is the fallback part of that plan. Unlike the UK where the moment we detected that cases had escaped Track and Trace, we gave up Trace and Trace (Feb 2020) - the rest is history.

In any containment policy, there will always be failures. What matters is whether you deal with the failures, or give up?

I asked you to compare the economic, social and health costs of the two approaches.[/quote]
I really want you to answer the NZ question

How long closed borders

How long variants

What's becoming increasingly important is not the R0 for the virus, which is already closing in on measles

Do you have a source for that @strangeshapedpotato? I thought estimates for R0 for the delta variant were around 5. That's nowhere in the realm of the R0 for measles of 12-18.

One of the reasons measles is so infectious is its small size allows it to remain airborne for a long time. SARS-CoV-2 is significantly larger.

@MarshaBradyo

Btw can’t go back to last Feb when SAGE issued the advice they did.

Unless you with all your better knowledge could have steered them another way the experts advised what they did.

No amount of mooning over NZ and Aus will change it

I think when you grew up there it stops this kind of lamenting. It’s been going on over a year

Unless you with all your better knowledge could have steered them another way the experts advised what they did.

Not just me - SAGE in Feb were crippled by group think. Had they published their minutes back then, literally thousands of qualified scientists in the UK would have been up in arms. As it was, (and I know this from multiple discussions with them), most assumed everything was in -hand and only realised it wasn't at the end of Feb when Track and Trace was abandoned.

Not just me

We missed out