20 May

“That was before the Virus.”

Alan Moore.

Help me to science.

1: Is THE VIRUS a specially nasty mutation of the ‘flu virus we get every year; or is it a completely new thing? Is it inevitable that every century or so‘flu turns into something which we can’t cure; or has a brand new thing come along?

2: If the boffins come up for a vaccine against THE VIRUS does that potentially mean that it is beaten, like small pox and measles; or will it potentially reboot every year, like normal flu and the common cold?

3: In principle, in the absence of a vaccine, will THE VIRUS wither away of itself? If we did nothing would we eventually reach a point where everyone has either had it (and is immune) or else has died?In that extreme scenario, where does THE VIRUS go?

4: If there is a vaccine, how many people have to take it before life gets back to normal? Or does life never get back to normal? There will presumably be a fair number of lunatics saying that the vaccines give you 5G and THE VIRUS is a hoax caused by Kier Starmer’s donkeys. How many refuseniks would it take to keep the pandemic running?

5: Why two meters? Is it a precaution in case someone sneezes, or is there some chance that THE VIRUS can jump 78 inches when someone walks past me in the park?

6: Masks?

7: If there is no vaccine, how bad are things realistically going to get? Earth Abides bad? Survivors bad? Black Death bad? Or "like great Granny's time when there were things like small pox and TB that the doctor's couldn't do anything about? Are we talking human extinction? End of civilisation as we now know it? Twenty percent reduction of population? Or “just”a really, really, horrible annual death toll for older people

8: Is there any plausible metric by which you can assess “risk to population from catching THE VIRUS” vs “risk to population from stating at home.” Some people must die from lack of exercise, suicide/depression, not going to the doctor to check out unrelated conditions, getting murdered by abusive partners etc? Or are pandemics something you can Science and social consequences something you can only Politics?

9: What would happen if social distancing measures were made much more extreme? Suppose no-one could leave home without a pass, there were armed police patrolling the streets, and a weekly food parcel was delivered by people in full protective gear. Where would we be after three, six or nine months?

10: Is the idea of easing the lockdown as the infection rate goes down basically sound, never mind the ambiguity of the governments’ actual instructions?

11: Why are pirates more likely to be infected with THE VIRUS than anyone else?


Sophie Jane said...

1) It’s a different virus from flu, but not new. SARS was the same type of virus, and there have been moderate outbreaks of similar viruses in the past. So, different virus but a similar principle.

2) No one knows for sure yet, but there’s reason to hope for the first possibility. (Fly changes rapidly in small ways that get past the immune system’s learning ability. I don’t think covid viruses do that.)

3) Again, we don’t yet know, but there’s reason to hope for the first possibility. (Apparent cases of re-infection seem to be turning out to be failures of testing, but we don’t know how fast the virus changes.)

4) I don’t know, but this is the kind of information someone will know.

5) Something about how far droplets of moisture travel when you breathe them out. It’s a statistical thing, though, so 2m is a cut off for (what someone regards as) acceptable risk.

6) Don’t stop you getting it, unless they’re the very fancy kind doctors use, but may help a little to catch droplets and stop you spreading the virus to others. (Maybe a 10-15% reduction by best accounts.) And they’re a useful reminder to others to keep their distance. Also, some people fixate on them because they’re an easy visible symbol of taking precautions and make intuitive sense.

7) If there’s no vaccine and no acquired immunity then I guess we keep distancing until it dies out naturally (from not being transmitted) and/or it evolves a less lethal form. (There’s considerable selective pressure on diseases not to kill or immobilise their hosts - which is why the common cold does so much better than Ebola.) And if we can keep the transmission rate to less than one new case per person infected then in principle it goes away on its own.

8) You can nearly always do Science on these things, but it takes time to gather the data. How much less exercise are we getting on average? How much preventative medicine are we missing out on? And so on. The easiest thing we can do is measure excess deaths - how many more people died last month than we’d expect from last year’s figures - but that’s a crude measure (do reduced deaths from road accidents compensate, say?) and still takes time to compile.

9) That’s political question, both in the sense that we have a system that wants you to be hungry and homeless if you don’t do something profitable for the owners, and in the sense that people are bad at risk assessment and want to be out and about.

10) Cramped quarters at sea. Though it is at least easy to isolate a ship, and they systems of mutual aid to help cope.

Anonymous said...

What I want clarification on, as well, is this -

If someone has had the virus, they're okay to go and work out in the world etc because they won't catch it a second time (theoretically) - but it still means they can transmit the virus to other people, yes? on their hands and such. So even if we had a large percentage of people who had had the virus, we'd be at work but would we still still all have to socially distance and hand-wash/spray-clean everything and not hug each other? (in case someone with the virus happens to have shook our hands/coughed near us etc)

SK said...

In the absence of a vaccine (and it is entirely probably there will never be a vaccine), what will happen is the same as what happens with every virus: we learn to live with it. If this virus had appeared a hundred years ago instead of Spanish 'flu there would be none of this discussion; it would have gone around the world before anyone realised what had happened (probably killing fewer people; the total fatality rate seems to be lower than estimates for Spanish 'flu, and of course there were fewer very old people around a century ago; in a population with not many people over 60 this disease might not even have been noticed as a new thing, the death rate for those under that age group is so low and the symptoms so generally mild for younger people) and then faded into the background, with some people continuing to get it every so often, some people dying from it.

So, indeed, no, we're not talking 'end of civilisation' bad. We're exactly talking a new disease to add to all those others which are already out there. But we have better treatment options now than a hundred years ago, and more ways to keep people alive while their bodies fight it off (the latest seems to be using blood-thinning drugs to stop clots forming in the lungs, something only discovered because of the advanced CT scans we now have access to), so the survival rate even among those most vulnerable will be higher than it would have been then.

Regarding those immune going back out: yes, for a while hand-washing etc will still be important for exactly that reason. But eventually, as with all these things, the key is that enough people are immune that few people who are infected even meet a non-immune person during the period they are infectious, so the virus naturally doesn't spread. That doesn't mean no one ever gets it again (but we will never get to a situation where no one ever gets it again; in the entire history of medicine only one infectious disease, smallpox, has ever actually been eradicated) but it means that outbreaks are localised and spread slowly. The whole reason this is a problem is because the virus is so new that no one has immunity. If, say, 20% of the population were immune the spread would be slow; if 60% of the population were immune then a lot of outbreaks would die away naturally as the virus simply couldn't find enough vulnerable hosts to jump to in time.

Eventually, even without a vaccine, things will go back to normal. There will be pubs and hugging (if you're into that sort of thing) again. This too shall pass.

SK said...

If there’s no vaccine and no acquired immunity then I guess we keep distancing until it dies out naturally (from not being transmitted) and/or it evolves a less lethal form

We'll have to stop distancing at some point, because distancing stops the acquisition of population-level immunity and also slows down the evolution into a less lethal form (because if the milder forms don't spread in the community then the more lethal forms will spread in the hospitals, creating the reverse of the usual evolutionary pressure on a virus to become less dangerous to its hosts).

Ideally what we want is to spread it through the younger, healthy population while shielding the elderly until as many as possible of the young and healthy have had the mild form and are therefore immune, plus the mild form has become the dominant strain.

Eradication is impossible. People are going to continue to get this virus for ever; just like every other disease apart from smallpox.

Andrew Hickey said...

1) It's not a flu virus at all. It's actually closer to the common cold. It's not a brand new thing, but it's newly made the jump from animals to humans. There are untold numbers of such viruses, and every few years they make similar jumps (things like SARS, which is also *very* close to this virus, to the point that scientists refer to SARS as SARS-COV1, and this as SARS-COV2). Scientists have been expecting something like this for a long time, and have even said specifically that it was likely that a coronavirus would jump from bats in China, which this seems to have done.

2) No-one knows yet -- we don't have enough information about how long immunity from covid19 lasts.

3) We don't know yet. It's possible, but without knowing how long immunity lasts, we can't know for sure. It's also possible that if it sticks around for long enough, it'll become less dangerous, as mutations that don't kill the host become more prevalent.

4) It's all about that number R, which you may have seen mentioned in the news. To get it down to below-pandemic levels you have to make the rate of infection less than one. It *should* be the case that sixty to eighty percent of the population needs to be vaccinated to do that.

5) The virus is carried on people's breath. The closer to someone you are, and the more time you spend around them, the more virus particles from their breath you can pick up. If you spend three hours talking to someone who's two metres and one centimetre away, you're in far more danger than if you happen to walk past that same person at only one and a half metres away. Two metres is a reasonable compromise that means that you can be pretty sure that you're mostly safe.

6) A good idea. They don't do much to protect you, but they do a lot to protect others. Most memorable (though rather disgusting) explanation I saw of this was to imagine someone urinating in public, spraying it around everywhere. If you're both naked, you're going to get horribly wet. If *you're* wearing trousers, it won't be as bad as if you're not, but it still won't be pleasant. If the urinator is also wearing trousers, then he's the only one who'll get wet.

7) Assuming the virus stays the same, the best guess is that basically the total death rate in the UK doubles. It'd be nowhere near end of civilisation bad, somewhere between your "like great-Granny's time" and "just a really horrible annual death toll" options.

8) There are metrics for this that epidemiologists use. I don't know what they are, but I know they exist and are being used by people giving scientific advice about this stuff.

9) If you did that for a month or so, the virus would completely disappear from Britain. But as soon as you opened up at all, unless you completely closed all borders, it would come back again.

10) It's basically sound, yes. The crucial thing is to keep the infection rate a) below the rate that hospitals can cope with and b) low enough to eventually get rid of the virus altogether. If there were a proper infrastructure for testing and tracking in this country, it would be possible to get life back almost to normal relatively quickly. But sadly there isn't.

SK said...

Oh, and on masks: there's no clear evidence that they work and quite a lot of intuitive reasons to think they don't, even to stop infectious people passing it on: as anyone who's tried to tuck a ski snood into the bottom of their goggles and then found themselves blinded by condensation two minutes into a run can tell you, the water droplets in your breath don't just go straight out of your mouth and then stop as soon as they hit something, they find a way through every tiny opening, and jury-rigged masks have a lot of openings. All you're doing is spraying the virus particles out to the sides instead of straight ahead.

Masks can help in carefully controlled setting where the range of movements you make is limited, they're changed frequently, and they are taken off and on properly, (so basically in a hospital or a care home) but just wearing them on public transport or in shops has zero actual benefit apart from maybe making people feel a bit less scared about going out.

Think of them as comforting teddy bears for the frightened.

Avizandum said...

1 - It's a coronavirus. Influenza is an influenza virus (I think that there are four types that affect humans). Lots of viruses mutate over time, and some sit there for a long time in a zoonotic reservoir.

2 - We don't know, not least because we've never implemented a coronavirus vaccine. We did get quite close with the last SARS coronavirus, but it died away naturally so work stopped.

3 - We don't know but see 2!

4 - I have no idea, not least since estimates of R vary and we don't know seasonal variations that might be in play etc. It's less virulent than measles, though, so probably could handle a few more 5G-blaming mentalists.

5 - 2 metres is an arbitrarily neat distance but the likelihood of infection falls over distance. 100 metres would be damned safe and one metre a good bit less so. They chose an easily-remembered point on a probability curve.

6 - Used by enough people they will help a bit. Studies on how much vary immensely.

7 - Anyone who claims to know is probably Piers Morgan or Toby Young, depending which position they are taking up for social media applause. My wholy unqualified bet would be: very bad flu year every year until treatments improve.

8 - Excess deaths over time, assessed in retrospect. All social scientists claiming their models can predict accurately are frauds, which is their role as social scientists.

9 - See 8 but I bet we'd be fucked, not least because we'd cease to be able to pay for the food parcels or the salaries bribing the armed guards not to set up private fiefdoms.

10 - Once more, not so much a science decision as a political, utilitarian one balancing harm from each cause.

11 - Probably something involving Theodicy.

Louise H said...

The point about people who have recovered and are presumed immune is I think a matter of scale. By the time you've had sometime infectious leaving virus on a surface, that virus bring picked up on the hands of an immune person, deposited back on another surface and picked up by a potential victim who them conveys it to their face, you're talking about very small amounts of virus transmission and a consequential low risk# particularly with regular handwashing. An infected person on the other hand breathes out far larger amounts directly.

Gavin Burrows said...

I too have questions. Is it okay to ask them here? Even the ones phrased as statements are really questions.

1. A virus is a living thing. And like any living thing it needs a habitat. In this case the habitat is us. We're not there yet by any margin, but we could push things to a point where it becomes endangered. Then it becomes like a highly poisonous but relatively rare snake or spider. (I tried to Google 'Zoonotic reservoir". it means something like natural carrier?)

2. Vaccines are less about consolidated research than typing Shakespeare. You combine chemicals and test them on an industrial scale, hoping something works. Which makes their creation essentially unpredictable.

3. Given (as folk have said) masks are social and altruistic in function rather than individual, wouldn't they have to be adopted en masse to have any significant effect?

4. Perhaps the big one... Are events such as this simply the cost of globalisation?

5. That David Icke, is in he in fact a bit of a berk?

SK said...

A virus is a living thing.

A virus is not a living thing. You'll find some people who will disagree, but I don't think that a few strands of RNA wrapped up in a protein shell that can't reproduce on its own counts as 'living'.

Vaccines are less about consolidated research than typing Shakespeare. You combine chemicals and test them on an industrial scale, hoping something works. Which makes their creation essentially unpredictable.

That's never really been the case with vaccines. There's several ways of making them: you can take live viruses and do something to them so they can't reproduce; you can take harmless viruses and replace bits of them with bits of the one you're trying to create a vaccine to. And there are more esoteric modern methods like the one they're trying in Oxford, where (as I understand it) they are effectively trying to put together, from scratch, out of fragments of RNA and proteins, a thing which shares certain characteristics with the virus.

So it's not 'combining chemicals', it's a lot more focused than that.

But on the other hand the one thing they can't predict is how the immune system will respond to what they've done. So in that sense, yes, they just have to try it out and it may not work.

(And even if it does work, vaccines can have side-effects — sometimes quite serious ones — that don't become apparent for years after they are taken. That's why it usually takes many years and multiple trials to approve them for general use. Any vaccine produced and distributed to millions of people without going through proper long-term trials with follow-up is a massive risk and the ethical questions surrounding doing such a risky thing are huge. What if it's rushed through testing and given to millions of children — who have basically zero chance of dying from the virus — and it turns out that five years later it gives 0.5% of them brain damage? Or leaves them blind?)

Given (as folk have said) masks are social and altruistic in function rather than individual, wouldn't they have to be adopted en masse to have any significant effect?

They won't have any effect (except perhaps psychological) even if they are adopted en masse. So a moot point.

Perhaps the big one... Are events such as this simply the cost of globalisation?

No. Pandemics occurred before globalisation, and it's globalisation which has produced the advanced health technology which is giving us the means to find treatments such as the clot-busters referred to above.

(I suppose in a sense it's those advanced health systems which mean we have more elderly people who are vulnerable to dying from coronavirus, but I suspect that's not what you meant).

That David Icke, is in he in fact a bit of a berk?

Of all the aspectsof this that have surprised me, I think David Icke becoming a thing again is possibly the top one.

Richard Worth said...

Reducing the 'R' rate: is this something to do with 'Virus of the Caribbean'?