Eliminate it? Or ‘Live With’ Covid-19 and what follows?

Is China Responsible for Covid-19, or Scapegoat?

So far around 75% of countries who have lived with Covid19, most often not by choice, and around 25% of countries have lived in the shadow of Covid-19, but through elimination, mostly without Covid-19.

Vaccinations may allow living with Covid-19 to be more palatable, but they also provide an opportunity for more countries to eliminate Covid-19.

This raises a huge question of global significance: does humanity prefer to live with Covid-19, or use immunity through vaccinations as an opportunity to eliminate the virus.

What is ‘Living with Covid-19’?

Opening up when there will still be spread: Giving up on reaching herd immunity.

More and more the phase “we have to learn to live with Covid-19” seems to appear. The suggestion is, even if cases are rising, remove Covid-19 restrictions, and allow the virus to spread as a result. Since ‘herd immunity‘ is when there are sufficient people immune that a virus will not spread, this means removing restrictions without achieving herd immunity. This means giving up, or simply not waiting to achieve herd immunity through vaccinations.

Vaccines have promised the possibility of herd immunity through vaccinations, but given herd immunity is when cases do not rise even when restrictions are removed, this is a call to not for herd immunity. Why? There are 3 possible reasons:

  1. Everyone wanting a vaccine has been vaccinated, so it is considered fair to expose the unvaccinated.
  2. It has been decided herd immunity is impossible, but as with the common cold, the disease is not sufficiently severe to justify eradication.
  3. Even if herd immunity is possible, it has been determined that with the most at risk now vaccinated, it is an acceptable risk and lower cost to achieve herd immunity through exposing the rest of the population to the disease.

The UK seems to be choosing option 3, while Israel, even with a high level of vaccinations is reimposing restrictions as with their high level of vaccinations, cases are again rising.

Which path should a country choose? Or is Option 4: “Only remove all restrictions when the virus will no longer spread”, still an option? With herd immunity, even if a person from outside starts a cluster, that cluster would die out by itself because the spread factor has dropped below one. It seems no country is there yet.

Asymptomatic Spread: Will the waves just keep coming?

Theoretical practical flattened curve (blue bar is duration of flattening).

Early in the pandemic I wrote about the much misunderstood and misrepresented ‘best practice for pandemics’ referred to as ‘flattening the curve‘. In theory there would be only two waves: One with restrictions in place, and another after restrictions are relaxed.

Yet with Covid-19 many countries have seen more waves. Is this a sign that herd immunity is impossible with Covid-19, or just that we have not reached required vaccination levels?

It is possible that with Covid-19, as being vaccinated reduces rather than eliminates the risk of spread, that herd immunity becomes impossible. The graph of worldwide cases has at least three peaks, but these were largely driven by peaks in the the US (Jan 2021), India (April 2021) and a current rise that must turn into a peak driven by many countries together, rather than the whole world having three peaks together.

More disturbingly the US, Israel, and Japan are all heading for their 5th peak, the UK its 4th. Many other countries have also had a sequence of peaks that would be expected from an outbreak managed using a ‘stop-go’ containment plan of continually deliberately letting cases rise in order to achieve herd immunity by infection. Instead of this being by design, all these countries again rising cases again now as a result of more infectious strains of the virus. Herd immunity is proving elusive, likely because with Covid-19, vaccination is may not create sufficient immunity for herd immunity.

The Case for elimination, and against living with Covid-19:

Blaming China won’t stop outbreaks like Covid-19, and we can expect more pandemics.

It is popular to blame China for Covid-19. Trump even pointedly called it the ‘China virus’. However, perhaps blaming China is a way to avoid admitting that 21st century society is a hot bed for pandemics.

Really it, the evidence shows pandemics are becoming more frequent, and the most likely source of Covid-19, our 21st century society of almost 8 billion extremely mobile humans crowded onto one finite planet, it not going away and statistically will soon add another pandemic. It we don’t get ride of this one, we could soon have two to deal with at once. Should we just live with an ever increasing number of pandemic level viruses circulating?

UNESCO welcomes the release of the latest expert report from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) which establishes the links between biodiversity loss and the increase in pandemic risk factors. This scientific report highlights that the current COVID-19 crisis, which it has its origins in microbes carried by animals, and the previous global health pandemics all have one thing in common:  their emergence is entirely driven by human activities.

Unesco: 29/10/2020

Analysis of the origin of the virus does suggest China was the origin, but that given that no one blamed the 1918 flu on the USA, nor did they blame 2009 ‘swine flu’ pandemic on the USA, even though both appear to have began in the USA, blaming China just because that is where the first case occurred would seem a double standard.

Plus, the worst outbreak in Australia during 2020 clearly was imported from the US, and variants though to have originated in the UK, South Africa, Brazil and particularly India have taken over now as the source of concern. So why should we blame China?

We don’t blame the county where a virus starts because it could have happened anywhere.

Or could it have happened anywhere? Isn’t there a suggesting China is the ‘bad guy’ with this outbreak?

In reality. No. There is a slight chance bad management by China made the outbreak worse, and even a minute and highly unlikely chance accidentally released a virus that was already in nature and able to cause a pandemic, but even these unlikely scenarios do not change the underlying source: nature.

And it is not just my analysis, here is a review by the Sydney University scientist who was first in the world to isolate the virus: Leading biologists publish review of SARS-CoV-2 origin evidence – The University of Sydney

China gets blamed because it is good for social media, and good for politics, even in China!

Social media is gets engagement and thus revenue through outrage, and blaming China creates outrage against China, and outrage against those who blame China. Politically, leaders get better approval when there is an ‘enemy’, and blaming China allows American leaders to appear strong against China, and having the world blame China allows Chinese leaders to position China as being oppressed by the west and generate increased nationalism. Perhaps politically it is Chinese leaders who benefit most from China being blamed.

But none of this changes the reality, that there is a reason people where waring of just such a pandemic, and they were even movies about the scenario just before it happened: human society has created the breeding ground for pandemics.

And if we ‘live’ with this pandemic causing virus, we cannot be at all sure it will remain the only one we are living with at once.

Living with Covid-19 is not like living with another influenza: Its far, far worse.

Earlier this month, the Australian government announced a four-phase plan to return us to something resembling normality. Under this plan, Prime Minister Scott Morrison said, we will eventually treat COVID-19 “like the flu”.

The hope is vaccines will allow us to live with some transmission without many people getting seriously ill or dying.

But death and hospitalisation aren’t the only outcomes of COVID-19 we need to prevent. New research shows even young people can be left with chronic health problems after infection.

COVID-19 will always be a very different disease to the flu. We should aim to stamp it out like measles, not let it spread.

Dr Zoë Hyde: Epidemiologist, University of Western Australia.

I suggest reading the full article by Dr Zoë Hyde entitled: No, we can’t treat COVID-19 like the flu. We have to consider the lasting health problems it causes. In fact, since it is under creative commons, republish the article.

While there are politicians who suggest that, once the population is sufficiently vaccinated, Covid-19 could become “like the flu”, this is unrealistic claim is typically by those politicians have found the pandemic has improved their chances or re-election, and not something an actual expert would say.

The UK has not reached target levels of vaccination, but when considering most of the unvaccinated in the UK are in age groups of greatest socialisation and least likely to have shown symptoms if infected, the percentage of the population who are likely to have immunity is likely to be close to the maximum percentage that would be achieved by population alone. Despite this, many warn of the consequences of deciding to ‘live with’ Covid-19.

Without elimination, we are ramping up the virus incubator: a completely batty idea.

The most common source of pandemics are viruses that evolve in bats. So many viruses evolve in bats because bats have live with a lot of viruses. Humans living with Covid-19, means another population living with a dangerous virus, and therefore another factory to produce new viruses. The total number of bats in the world is unknown, but even if it does exceed the number of humans, human contact between humans is far higher than human contact with bats. Plus, a vaccinated population living with a virus is like a challenge to evolution “solve the problem of how to thrive in vaccinated hosts”.

Even living with Covid-19 in just 2021 poses a threat of creating ‘variant factories‘.

The chance of future pandemics will be far higher if we are living with dangerous viruses in the not just the bat population, but also the human population.

Living with Covid-19 the virus may mean a partially brain damaged population.

Being vaccinated means statistically means exposure to the virus in the vast majority of cases will not result in symptoms, however this does not mean zero copies of the virus, and does not ensure a person will not test positive or suffer ‘long covid’.

Coronavirus (Covid-19) cases in the UK are soaring, with the latest daily figure for 9 July showing at 35,707 cases. Leading scientists and clinicians are saying the government’s plan to ease lockdown on 19 July is both “dangerous” and “unethical”. But Johnson is sticking to his plan, which is herd immunity in all but name. Meanwhile, recent studies reveal that damage to brain tissue could be yet another consequence of long Covid.

Boris Johnson toys with herd immunity despite evidence linking long Covid to brain damage.

I do not believe the above article is suggesting Boris Johnson has brain damage as a result of his well know case of Covid-19, but there is the suggestion that opening up the UK is somewhat irrational. Then again, while only a small percentage of the electorate would have brain damage after 1 year of Covid-19, it is unknown how high that percentage would be after 10 or 20 years of a population living with Coivd-19. Apart from jokes about how a brain damaged population may help some political candidates, there is a serious side to the dangers of a long term experiment exposing the population to a dangerous virus, year after year, even if respiratory symptoms are known to be in almost all cases at the worst very mild in vaccinated people, when other affects are not yet known.

Children, currently not even vaccinated, could be subjected year after year for their entire lifetime.

Economic Cost of Living with Covid-19.

Start with the economic cost of influenza, which in the US alone in 2014 was estimated at more than $87 billion dollars annually. Then add the cost of ‘long covid’, vaccinating the entire population repeatedly, and trying to prevent outbreaks from vaccine resistant strains. Even in the best possible scenario, living with Covid-19 would be extremely costly, and the costs would continue year after year, while if Covid-19 is eliminated, annual costs would also be eliminated.

The ‘Flu’ is not that great to live with either, why would be want another worse version?

The Influenza virus mutates so frequently that it is more difficult to vaccinate against than Covid-19. With vaccines, we can lower the illness and mortality levels from Covid-19 to be comparable to those with influenza. But this is not like for like, this is that after vaccinating the entire population, we still have what is quite a big problem. Influenza and not something we want to live with either, and researchers are working to try find way to eradicate influenza, not add another problem just as bad.

It would be far better to ask “can we also eradicate influenza”, than “it is ok to have another one”.

The case for living with Covid-19, and against elimination.

Economic Cost of Elimination.

The main argument against elimination is that it requires the use of lockdowns, and these reduce economic activity. While living with the disease comes at cost to society and has an economic cost, a disease can even generate economic activity, while lockdowns used for elimination also eliminate economic activity and increase the enemy of economic activity: unpaid work.

Similarly, during lockdown during a pandemic, even if the same number of meals are eaten during the lockdown, if none of the meals are purchased at a restaurant, the result is a disaster for the economy.

On the other hand, if a pandemic makes retired people ill, there is increased economic activity through the medical services. If some die, then there is economic activity for the funeral system, although this is better there are no limits on people attending.

Economic Activity vs Wealth Production.

Note also that while a long pandemic may cause economic hardship for many, the wealthiest 5% of society tend to get wealthy during a pandemic. There are some very wealthy people with big marketing budgets who will lose wealth if Covid-19 is eliminated.

The combined worth of Australian billionaires was assessed to be 52.4% higher this week than at the same time last December.

By comparison, billionaires in the US and UK recorded an increase of about 25% over the same period, the Bloomberg index shows.

The Labor frontbencher Andrew Leigh said the figures “remind us of the importance of tackling inequality, which is significantly higher in Australia than it was a generation ago”.

“Those increases are remarkable,” the shadow assistant minister for Treasury and charities told Guardian Australia.

“Any of your readers would be punching the air if they had enjoyed a 20% increase in their wealth, and they would be double fist-pumping the air if they had a 50% increase, and yet that’s the story for the typical Australian billionaire.”

Australia’s billionaires became 50% richer during pandemic: Guardian (msn alt link)

Elimination is too hard.

Approximately 25% of the countries in the world have managed to eliminate the spread of Covid-19. Given that means it has been circulating in 75% of countries, then Covid-19 outbreaks keep happening in starting in the countries that have elimination, and each time these countries need to eliminate Covid-19 all over again.

It has been proven to be possible over and over again to eliminate Covid-19. The problem in keeping it eliminated is that the majority of countries are not yet even trying, so international travellers continue to re-introduce the virus.

Australia mid 2021: A Case study in elimination.

I will update this as the story unfold, but as previous described in July 2021: Vaccines or not, its not over yet, Australia has recently had an a new outbreak of the delta variant of Covid-19. Eliminating the delta virus, in a population with only less than 9% level of vaccination, in a country where a greater percentage of the population living in cities than in the USA or UK, will be a challenge. However if this can be managed, than most other countries should be able to also managed elimination, at least once vaccination rates are higher.

This outbreak started in a country previously free of local transmission of the virus, from a single case of infection of a driver transporting international flight crews to their hotels in Sydney. One of more flight crew passengers must have passed the infection of the delta strain through to the driver.

In the fully open city of Sydney, the driver visiting shopping centres and other venues before having symptoms and getting tested. This triggered an outbreak predominantly in the eastern suburbs of Sydney which after two weeks of ‘whack a mole’ resulted in a lockdown for Sydney. ‘Whack a mole’ because by the time the outbreak in the Eastern Suburbs appeared was under control, there was a new outbreak in the South Western suburbs of Sydney. Following the first case being detected on June 17th, there was a delay of 9 days until the first lockdown began, possibly to first allow the school term to complete. Initially the lockdown was to last 2 weeks and end before school returned, but this was extended due to that ‘whack a mole’ effect seeing cases rise in the second location even during the light lockdown.

Then 3 infected removalists travelled to Melbourne and were part of spreading the virus to Australia’s second largest city, before travelling to a third state capital, Adelaide. Before the spread to Melbourne was detected, the worst had already happened, and infected person had infected others at a crowded football match.

Now on July 16th, over 8 million Australians, in the cities of Sydney and Melbourne are in lockdown.

Conclusion.

To be added.

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