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.

@chesirecat99

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.

I've seen estimates for the delta variant over 7, and the R0 estimates for measles actually vary a lot more than that - but yes it's unlikely sars-cov-2 would ever reach as high.

But that wasn't my point. In fact I was trying to say that the raw R0 values are almost totally irrelevant within a mostly vaccinated population.

@strangeshapedpotato but if this is a potential risk, then how come this is the first I've read about it in a year and a half? I've read quite a lot of scientific articles on vaccines and I don't recall ever having seen this mentioned. Surely it would be important to mention it.

@strangeshapedpotato there must surely be some scientific literature you can point us towards to back this up.

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

Clearly (even one you factor in the grotesque public health effects of lockdown which is often overlooked) Australia and New Zealand have done better than us. Immeasurably so. I’d love to be living there right now. The issue is, as marshabradyo points out, the fact we are so different to New Zealand and Aus geographically.

I used to live there and have family living there. Melbourne recently is not the only example of covid escaping into the community. My family are in Brisbane and they have had short sharp lockdowns. That’s despite the extremely tight restrictions on entry of two massively isolated countries.

I really would like to know how you propose to get to zero covid unilaterally here - how long you think it would take, and what measures would be necessary to maintain it given the significantly greater reliance on importing that we have.

Not to mention a land border with 27 other countries that we cannot close.

I know you say you aren’t trying to scare people but you must know that’s the effect you’re going to have when you basically say life will be like this forever because we cannot live with it.

@strangeshapedpotato

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

Also can you explain why this means it fails. Does it not mean that it has still recognised the virus despite the change and has therefore been able to attack and neutralise it?

Well there is the fact that vaccines would not have been granted emergency licence if a treatment were available.

And then there is evidence presented that a treatment is available that is effective prophylactically (vaccines aren't) and in all disease stages and that is effective against all known variants (vaccines that specifically target one variant can't keep up with even a slow mutating virus in a mass vaccination scenario with relatively high infection rates).

But unfortunately it's off licence, cheap and easily produced and has a huge safety record.

So, what to do? If health is your concern you have the same criteria for repurposed cheap treatments as for new, untested treatments and if none work you grant emergency licence for untested vaccination.

Has this happened? No. We are going all out for emergency use of untested vaccines, low criteria of success for new and expensive treatment that is restricted plus stringent criteria for off licence and cheap treatment.

@strangeshapedpotato I have read a lot of your posts.

It sounds like you are saying vaccines are useless pretty much.

If that is the case then seriously what is the point in all of this?

This ‘life’ we are living is not sustainable. This cannot be out life forever.

[quote BlueBlancmange]@strangeshapedpotato

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

Also can you explain why this means it fails. Does it not mean that it has still recognised the virus despite the change and has therefore been able to attack and neutralise it?[/quote]
Your immune system hasn't failed here! But the prior immunity doesn't work - it basically has to start from scratch. It recognises this because the attack fails as the virus continue to reproduce.

The point of writing this was to demonstrate how this can cause boosters to fail. A vaccine doesn't continue to reproduce! It's gone from the body quite quickly.

I can't find an article to give you that repeats what I've said, although I do recall reading one with the car analogy in before which I thought was an excellent way of putting it.
This article covers the reduced response frequently observed with vaccines against new variants though:
www.nature.com/articles/d41586-021-00241-6

The good news here is that there is some suggestion that mRNA vaccines may not be affected - one of the reasons for this may be that mRNA techniques enable very simple structures to be created in cells, i.e. your giving very specific targets to the immune system.

[quote MonsterMash2210]@strangeshapedpotato I have read a lot of your posts.

It sounds like you are saying vaccines are useless pretty much.

If that is the case then seriously what is the point in all of this?

This ‘life’ we are living is not sustainable. This cannot be out life forever.[/quote]
Not at all.

I'm saying that you cannot solely rely on vaccines, which is what the UK is currently heading towards doing.

Vaccines make containment and control A LOT easier, because they reduce all the numbers that matter. With vaccines you have lower transmission, so reduced R and you have reduced hospitalisations/deaths etc.

But we should (and still should) use vaccines to drive infection levels down to effectively zero. Yes, absolute zero is unlikely - cases will always pop up here and there, but you deal with them.

Once you get cases down to zero locally, you use travel restrictions to keep that area clear, with vaccines providing support for that strategy.

e.g. Even though the delta variant is less affected by vaccines, the bulk of its spread is through unvaccinated people! If it had arrived here 2-3 months later, it would have been so much easier to contain.

"Living with it" is quite simply not an option we should be considering

So what’s the alternative?

Masks and lockdowns forever?

@strangeshapedpotato

Ok, so vaccines do have a purpose if used with other measures.

However, my next question is do you ever see a scenario where all these measures will no longer be needed?

Will there ever be a time in the future where we can ‘live with the virus’.

Or will we be vaccinating, testing, social distancing, wearing masks, and locking down forever?

If the virus will forever mutate, and boosters will ‘possibly/ likely’ eventually fail. Then what happens in the future?

What happens if a variant appears that can completely evade the vaccines? Then what?

This is what I cannot get my head around. Plus, up until the thread I thought it was just a possibility but now it almost seems like it’s inevitable.

If the vaccines ever fail what on earth would then happen? Especially if you (or it might have been someone else - I have lost the plot a little and should probably stay away from Covid discussion) are saying there will never be herd immunity.

KOKOagainandagain

“there is evidence presented that a treatment is available that is effective prophylactically (vaccines aren't) and in all disease stages and that is effective against all known variants”

Care to share the name of this therapy?

“ We are going all out for emergency use of untested vaccines, low criteria of success for new and expensive treatment that is restricted plus stringent criteria for off licence and cheap treatment.”

You seem to be implying that the (UK?) government is not using any efforts to repurpose existing therapies. But this is wrong.

The U.K. runs one of the most comprehensive randomised, contolled clinical trials going (could only have been done through our nationalised health system) to investigate existing treatments for covid.

It is an astounding piece of medicine/science , one of the examples of what the U.K. has done incredibly well.

It’s run by Peter Horby at Oxford, was established in March 2020 and I’d called the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial.

This trial established the therapeutic benefit of dexamethosone which has been adopted worldwide. They are currently testing colchicine - another cheap, generic drug.

I don’t want to derail the thread from talk about what is going to happen in the long term, except to say that absolutely therapies are essential in reducing covid to no more than (endemic) “flu”.

I expect more will come online with time.

MonsterMash

“ Will there ever be a time in the future where we can ‘live with the virus’.

Or will we be vaccinating, testing, social distancing, wearing masks, and locking down forever?”

I think, a future where we live with the virus won’t be as dystopian as you think. It will be what we do now for flu (and many other infectious diseases) but you don’t really notice.

I think, just as with flu, we will be vaccinating, testing, conducting surveillance, controlling locally through public health teams (who already control outbreaks of infectious diseases by isolating cases), restricting international travel where necessary (as pre-pandemic the foreign office did from time to time for certain countries).

I would only add to that I hope there is a cultural change and society learns to be a bit more careful when they are ill and work from home if they can and wear masks in crowded indoor places e.g. the tube if it is the seasonal peak for covid or local levels are high.

Hopefully with most people vaccinated, it won’t be on the scale we’re seeing now, but on the much smaller scale you don’t notice for other diseases.

I thought not so long ago ie a few months back Dr John Campbell was anticipating that the virus and all its associated mutations would ultimately fizzle out in a few more years....?

@everythingthelighttouches

“New Zealand style max suppression.”

If we’d all acted like China (or New Zealand) in February 2020, we could potentially have avoided all this.

But the genie is out of the bottle now.

Yes agree, think we were very unlucky to have such a vacuum of leadership from the White House, we could have had a chance if any normal President had been there. Also the US being so wacky gave cover to UK and Brazil to also be so cavalier.

[quote MonsterMash2210]@strangeshapedpotato

Ok, so vaccines do have a purpose if used with other measures.

However, my next question is do you ever see a scenario where all these measures will no longer be needed?

Will there ever be a time in the future where we can ‘live with the virus’.

Or will we be vaccinating, testing, social distancing, wearing masks, and locking down forever?

If the virus will forever mutate, and boosters will ‘possibly/ likely’ eventually fail. Then what happens in the future?

What happens if a variant appears that can completely evade the vaccines? Then what?

This is what I cannot get my head around. Plus, up until the thread I thought it was just a possibility but now it almost seems like it’s inevitable.

If the vaccines ever fail what on earth would then happen? Especially if you (or it might have been someone else - I have lost the plot a little and should probably stay away from Covid discussion) are saying there will never be herd immunity.[/quote]
So taking a step back, let's first define what herd immunity is.

Herd immunity is when sufficient individuals have sufficient immunity that a virus cannot propagate through a population to infect anyone with reduced immunity.

If you cannot attain sufficient immunity, then herd immunity is not possible.

I'm not claiming herd immunity is NOT possible. I'm pointing out that it might not be. Like many other things people seem to take it for granted.

As far as the future goes, it's hard to say because the virus is unpredictable and I'm not in charge lol. Much depends on the actions taken, both in the UK and abroad - both the choices made and how well they're implemented!

Until about 3 weeks ago I was confident that the UK would achieve herd immunity against the Kent variant, get cases down to negligible levels at which point I hoped they'd finish the job and get it to zero and keep it there by good border management - something much easier to do when your population is wholly vaccinated, even if the virus has some vaccine resistance. Sadly this Delta variant has arrived too soon.

Addressing the doom-fearing:
For starters a vaccine is unlikely to completely fail. The virus only needs to be able to infect people and spread through them to be successful. It doesn't need to kill them! So while it's quite easy to see it becoming increasingly better at spreading through vaccinated people, it's far less likely it will significantly reduce the protection against serious illness.

The trouble is, while to a healthy individual, vaccines make covid relatively low risk - taken nationally, that risk adds up to an overwhelmed healthcare system, and every 1% reduction in protection is reflected by thousands of extra deaths.

In short, we have the same problem we always did. We just need to get case numbers down to the sort of level China is dealing with, where nearly all are either imported (and detected in quarantine) or occasionally escape into a community, promptly locked down, thoroughly tested and cases weeded out. Life is a little changed, but mostly it's back to normal.

Eventually, given the money being thrown at it, I'm confident they'll come up with a vaccine that is effective against ALL possible variants.

@colouringcrayons

While Trump clearly didn't help, it's hard to see a US president being able to take the necessary action when most of the power lies with individual states.
They couldn't have ordered a lockdown for example.

I can't see any way the US can ever be covid free - I don't think it was ever on the cards sadly.

It's good to see the high uptake of vaccines there though.

Flu is directly related to spanish flu, the latter much more deadly before it reduced in mortality rates

Rather tired of seeing this nonsense trotted out as an attempted argument for covid becoming milder eventually.

Anyone asking this must be asked, "What was flu like BEFORE the Spanish variant arose?"

"Oh, so it wasn't incredibly serious before Spanish Flu?"

"So it actually mutated into a MUCH more deadly form of Flu? Hmm - that doesn't seem to fit with your, 'Mutations are always to milder forms' argument does it?"

[quote strangeshapedpotato]@colouringcrayons

While Trump clearly didn't help, it's hard to see a US president being able to take the necessary action when most of the power lies with individual states.
They couldn't have ordered a lockdown for example.

I can't see any way the US can ever be covid free - I don't think it was ever on the cards sadly.

It's good to see the high uptake of vaccines there though.[/quote]
No, but leadership is everything and if a president said 'this is what we need to do' a lot of states would have followed. Trump gave cover to those who wanted to do nothing. Trump undermined Fauci etc at every turn.

In terms of the bigger picture I think global leadership was completely lacking and it really showed. The whole 'defund the WHO' etc - all a massive distraction when we should have been fighting the virus.

Until the richer countries do a global coordinated effort to help vaccinate the less able countries, CV19 is going to keep spreading and mutating, and threatening the current effective vaccines.

[quote SallyBasingstoke]@strangeshapedpotato you write " Until about 3 weeks ago I was confident that the UK would achieve herd immunity against the Kent variant, get cases down to negligible levels at which point I hoped they'd finish the job and get it to zero and keep it there by good border management"

There will never be zero cases of any variant, it's naive to think this at any level- the key is the severity of the disease and how it impacts the population not number of cases. Zero covid isnt possible unless you disagree with practically every scientist worldwide. The " kent variant" is all over Europe , keeping it to zero with " good border management " is farcical. As for China, are you honestly saying their reported death numbers/cases can be trusted - a country which has covered its tracks since the start of this saga ?

You then state you are confident of a vaccine that will protect against all variants. This is more nonsense, flu has been around over100 years killing hundreds of thousands of people which has huge numbers of variants with a flu vaccine that changes/ tweaked every year. We don't have a 1 size fits all vaccine for that and won't with covid- there isnt a leading scientist anywhere on the planet that believes that we will have a vaccine for all covid strains... if anyone suggested such an outlandish thing they would be laughed at and never allowed near a lab again. Throwing in a few words in caps lock just makes your points seem even more bizarre[/quote]
If you spent less time on YT watching conspiracy theoriest wax on about 5G, you might have heard they've isolated antibodies from a SARS-1 survivor seemingly effective at neutralising all coronaviruses.

Granted making a vaccine capable of creating such an antibody will be a challenge, but yes, I'm confident that given time they will.

Silly to compare flu and coronavirus again though. If you knew anything about the structures of the two viruses... oh what's the point. You're wedded to your conspiracies.