In good news, the CDC reports a 91% drop in flu infections this year[1]. Since people are sheltering in place and not going to school, there will probably be a lot less measles transmission too. One way to not get measles besides getting the vaccine is for kids to not leave the house and not have friends over, which is the norm in 2020. The 200,000 number of measles deaths referenced in the article was from 2019, before the pandemic.
Measles is a special case in terms of infection. There is a line of thought that exposure simply cannot be stopped, that immunization or inevitable infection are the only options. It is a truly airborne disease. If someone with measles coughs in a room and walks away, people walking through that room an hour later will be infected. The standard for social-distancing for measles wouldn't be 6 feet. It would be something like 600 feet, preferably upwind. I read once about the cleaning standard for clothes or objects exposed to measles. Not bleach. Fire. Lots of fire.
Measles in the past was endemic. Everyone got it at some point. Most survived and so the population was somewhat resistant. But today? Without that resistance it would spread through any unvaccinated population like something from a hollywood movie.
Measles is the most virulent common infectious disease, clocking in at R0 ~ 12 to 18. For comparison, Covid's is 2 to 6 and chickenpox 10 to 12.
Only about 1 or 2 out of a 1,000 measles infections results in death [2]. But something like 1 in 4 results in hospitalization. We don't have that hospital capacity.
Not sure why you're getting downvoted. It is absolutely the case that COVID should make us think very hard about how lucky we got this time. There's no reason to think this couldn't have happened with a virus 10 or 100x as deadly. Given many countries' poor performance containing it, I shudder to think what the next pandemic might look like.
I believe it's measles that is nearly fatal in the unborn and infants, causing organ damage and blindness.
There's a story of a US Marine escaping from measles quarantine in the US to visit Gene Tierney, a Hollywood starlet, in town who was pregnant, and the infant being born with severe life-long complications.
That is the argument for people to get vaccinated - to protect via herd-immunity those that cannot get vaccinated.
To some extent, the circulation of natural flu cases, of routine non-severe varieties, serves as a natural 'booster' refreshing immunity against related strains.
For example, every once in a while, a new flu strain hits a certain younger or middle-aged cohort much harder than usual, because some other strain decades ago left lingering immunity in yet-older people. Examples:
As a result, this season of abnormally-low flu infections may not be unvarnished good news. When normal interaction levels recur, we may see a rebound of flu cases – in numbers & severity – from all the people who didn't get a typical mild seasonal re-exposure. Decades from now, people may suffer for having missed a survivable-exposure-while-young. Time will tell.
one can wonder what other antigens we decreased the exposure to with the resulting immune system changes like decreased diversity and levels of antibodies present - i mean it may be kind of similar to the effect of living in highly antimicrobal environment which results in weaker immune system with all the allergies and autoimmunes as a result down the road. Even super-healthy people like astronauts have immune system weakening and hypersensitivites developed as result of decreased exposure to diverse antigens:
"Scientists compared blood samples of eight crewmembers who completed missions to the International Space Station with healthy individuals who remained on Earth. Blood samples were taken before launch, at several points during the mission and after the astronauts' return to Earth.
The results showed that NK-cell function is impaired in astronauts as compared with pre-flight levels and ground-based controls. At flight day 90, NK-cell cytotoxic activity against leukemia cells in vitro was reduced by approximately 50 percent in International Space Station crew members."
I wonder how that would compare to other extremely isolated groups, such as Antarctic researchers during the winter months. With the ISS, there is a large confounding factor in the lack of gravity, making it hard to tell which effects are from isolation.
> as result of decreased exposure to diverse antigens:
The link you posted doesn't make that claim. The word antigen doesn't even appear in the article you linked.
Rather, it claims:
"In order to do that, you have to first figure out what's causing the decline: Is it stress? Is it microgravity? Is it radiation? Is it a plethora of things? When we figure that out, we can try to find ways to directly target those factors and mitigate them."
Having said that, we know for a fact humans can't survive long term in a completely sterile environment as babies wouldn't have their integumentary system and digestive systems populated with commensal organisms shortly after birth in a completely sterile environment.
So it's seems at least plausible to me that living in a increasingly sterile environments is likely to be a net negative on overall health etc etc.
"Immune issues sound familiar to Dr. Jerry Linenger, an American astronaut who spent more than four months on the Russian space station Mir. He said he was never sick in orbit, but once he came back to Earth “I was probably more sick than I was in my life.”
Astronauts launch into orbit with their own germs and get exposed to their crewmates’ germs and then after a week with nothing else new in the “very sterile environment” of a space station “your immune system is really not challenged,” Linenger said."
Thus we can see that not being sick while in orbit, despite all the stress and other space factors - microgravity/radiation/etc. - which are supposed to weaken immune system, while getting sick on return when those space factors disappear clearly favors the immune system antigen exposure dependence explanation.
Yeah, I can see why having astronauts not get ill in space makes sense at the moment, and that for more long-term viability of living in space humans are going to probably have to take their mess and germs with them.
And also that lack of exposure to immune-challenges probably represents a net-negative effect on our well-being in this life and also reduced selection-pressure in the evolutionary sense.
The immune system is still not well understood. Vaccinations have certainly changed the course in a few ways. I've always found the story of the pertussis vaccine interesting: https://i.imgur.com/v8e8trm.png For one, it's a "vaccine" not against a virus, but a bacteria. More specifically, a toxin produced by the bacteria. Those that have been vaccinated are immune to the toxin, not necessarily the bacteria. So prior to 1950, most people that got whooping cough were around the age of 5. Now the only ones that get whooping cough are infants or the elderly.
Another example is the 1920 pandemic, where the weirdly high mortality in young adults prompted theories that the dominant strains of influenza changed around 1890, and people born after that would be naive for H1N1. There've been some interesting calls for tailoring seasonal flu vaccines not just for currently or expected circulating strains, but for the age of the recipient.
Maybe I'm misreading the article (or your post), but isn't that first article saying exactly the opposite?
> When someone is infected with a virus they’ve seen before, the immune system tends to pump out antibodies created during the first infection. That immune memory normally helps fight off secondary infections faster, but that memory can occasionally backfire if the virus has mutated in the right way to evade those original antibodies – as happened with last year’s flu.
i.e. youth exposure to a particular 70s/80s strain of the flu virus actually worsened the immune response in 2014?
One thing to note is that measles is a lot more contagious [1] than sars-cov-2 or any of the flu strains [2]. Measels is also an airborne disease [3], which is distinct from respiratory droplet transmitted diseases [4], like the sars-cov-2 virus [5]. As a result, many of the precautions that people are taking for the sars-cov-2 virus, while also effective against the flu, are not effective against measles. The measles boom in 2019 was driven by an anti-vaccine movement. The current reduction in vaccination is much larger and more widespread. I therefore don't think that we can conclude that measles cases will decrease in 2020 without data. I also wouldn't be surprised if we see an even larger measles boom when current precautions are phased out.
We realised it during the height of the lock down in spring. Our son did not interact with any other child for a few weeks, and only went out occasionally with a mask on. Then he suddenly got chicken pox...
poor kid. the body NEEDS exposure to shit. it needs to learn hoe to fight and how to survive. especially at a young age, when the immune system is still in formation.
come on, you should know this..
So... vaccines?
Because that's what they do, more or less. Introduce little bits of virus so the body can fight it off if we actually come in contact with it, and by this, it means that other are less likely to catch it too.
(Technical stuff means that sometimes, we don't even get the actual virus, but that point doesn't really take away from the argument).
The vaccines don’t train the immune system correctly. Usually when you are infected you get a fever and the immune system has to go trough a certain process. With vaccines you get the antibodies for the virus, but this makes the immune system react in a unnatural way.
You wind up with the same thing: Antibodies. And way safer than getting the actual disease. It isn't "unnatural", it just isn't from getting the disease.
Dying of measles we would be an effective darwin test. Only the most stupid refuse to get tested, usually in uneducated remote areas, not trusting the press (good), the government (good), but also not their teachers and doctors.
In the famous Coburg outbreak 2001 it was an anthroposophic school (Waldorf), infection rate 1000 of 200.000, no one died. In all subsequent outbreaks it was always such a school. The virus is transported from Waldorf School to Waldorf School with an average vaccination rate of only 60% compared to 90% elsewhere. Hence it could not jump over to the neighboring districts. Why these schools are not yet forbidden is interesting. But you can safely call it a Waldorf illness.
Only if you willfully didn't vaccinate: Otherwise, it is just that:
1) You are poor and can't afford medical treatment in time.
2) Very young and haven't been vaccinated
3) Not young, but don't have immunity for a variety of reasons, including unable to be vaccinated and immune system issues.
4) You are simply unlucky
This was common in Japan (and other Asian countries) long before COVID. Wearing a mask when sick has always been expected etiquette, and they’re also worn by healthy people who just want to be left alone in public.
You can still be exposed to mild stuff everywhere. YMMV. I choose shopping and school pickup because they're the places of biggest concentration of random sick people in my experience. I have regular contact with medical clinics and GPs so will get mild exposure either way.
The thinking before the pandemic was that there was almost no protection in wearing the mask for yourself which has been shown to be incorrect. The best thing to stop infection is still for everyone to wear a mask.
I get that some might want to use masks forever, but to me it's alienating. We are already quite isolated from our community in our homes and in our cars, if everyone starts wearing masks at normal places to meet other people in the community I think that would be a bit sad.
Exactly. In all of the mask discussions, there should be more focus on the kind of life we want and less on the science of masks. I think it's pretty obvious that masks have immediate infection control benefits, and always will.
But it's a perfectly valid opinion that the benefits do not outweigh the societal impact of treating each other like infection vectors instead of having normal social behavior (as well as the option to wear a mask or stay away from people if your priorities are different).
I would rather risk death than live the rest of my life in a bubble, and there needs to be more of a discussion of what people value and the tradeoffs we're making.
Normally I'd ignore that, but yes, that's the classic argument to try and short circuit real debate by making us think that one death anywhere is worse than small actions we can take. I disagree, just like I think we should be able to create other social policies that don't save everyone but that try to compromise between the kind of world we want and the safety of its inhabitants. It's hard to think about and takes strong leadership to navigate, but instead of talking about that we focus of hyperbole and hashtags
Yeah and the article says it has been rising since 2017. This isn't really about covid, we have a global outbreak of measles and it is mega contagious.
You can have numbers rising since 2017 while still seeing that Covid has further increased numbers by disrupting normal vaccinations. I'm pretty sure we do have a fair way to know how about how many measles vaccines were manufactured and likely used from year to year.
I didn't get the big push for flu shots this year. Between social distancing and masks, it's obviously going to spread a lot less, there some risk to going to a clinic to get the shot, and we normally use data from the southern hemisphere to predict which strains will be dominant this season, but with significantly reduced travel and social restrictions in the southern hemisphere, the data's going to be bad, so this year's flu shot won't be as effective.
Earlier in the year I decided I was going to get a flu shot this year, for the first time ever. I was in the hospital for a non-Covid-related thing, and a nurse convinced me to do it for everyone else. Okay, sold.
And then around April it became evident to me that maybe it is fine to wait until next year.
Heh, I was sneezing a lot late last year, and put an entry into my calendar to get a flu jab in October 2020. (I've never gotten one before, but figured that maybe I've hit the age where my body doesn't bounce back as quickly anymore.)
The argument pushed here was that covid and flu combine badly. If you have both at the same time, it results in harder case of covid.
So you are supposed to get flu shot, so that if you get covid, you have better chance of it going easily.
The company I work for organized flu shots and you did not had to go to clinic. It was in work, people were spread out so you was in room alone when they shot you.
1. I do NOT want to get sick and wonder if I have COVID-19.
2. The medical establishment does NOT want a bunch of flu cases flooding into already-overwhelmed hospitals.
3. Is there a possibility of interaction between COVID-19 and the flu? I have no idea, I just made this up.
so yeah, I think the risk of the flu is a lot lower, and the vaccine might be less effective, and there are risks to getting vaccinated, but presumably the various risks of the flu during a pandemic are worse than the risks of the flu during normal times.
> with significantly reduced travel and social restrictions in the southern hemisphere, the data's going to be bad, so this year's flu shot won't be as effective
This does not seem correct. The data on this does not require travel or social interaction. The CDC (and other gov't agencies throughout the world) literally has cooperation with sites around the world to monitor the rise of new flu strains. These sites use technology like: the telephone, the internet, and the fax machine, to transmit the information the world uses to develop the current generation flu vaccine.
What I meant is that if people aren't traveling, strains will be more localized, so what happened in Australia last summer tells us little about our winter.
It is an hypothesis, but the data suggests that the effect will be weak to non-existence. Data shows that the seasonal influenza pattern existed before modern era levels of international travel.
The issue is - COVID, too, shall pass, people will come out in the open again, and meanwhile the measles vaccination rates have dropped a lot, thanks to irrational beliefs made popular by "influencers".
Maybe its the norm in US, but in Europe kids are very much going to school even if overall the society in given state is close to standstill. Not claiming every single state is like that here over the pond (situation evolves), but most are. Even in most infectious region per 100k citizen in last 14 days - canton Geneva in Switzerland, schools are running open, so are kindergartens.
Doesn't make much sense, I know. But on the other side at least for us we are not skipping nay vaccinations, nor for us (mainly flu) nor for out 11 month old kiddo.
Some amount of in-person-schooling-as-necessary-function makes a lot of sense. We know that kids under 10 are very unlikely to transmit Covid, and younger kids are also the least able to thrive in a remote learning environment. My SO is currently teaching second grade (7-8 year olds) remote, and I get nightmares just imagining trying to keep 7-year-old me staring at a teacher on a computer screen (that was a difficult enough task in person). If you can orchestrate your staff in such a way that they're in limited contact with one another (maybe specials suffer) you can probably teach younger kids safely.
> We know that kids under 10 are very unlikely to transmit Covid
Source? My impression was that very few cases of transmission from young kids were observed, precisely because they were isolated. The adults might bring Covid into the house and spread it to the entire household, but the kids staying home means they can only get it from the adults. Nothing about being intrinsically less contagious, and everything about having an environment that minimizes contact.
Flu immunity doesn't mean all that much because flu viruses mutate so quickly. That's why the flu shot has to be given every year: it protects against different strains, whatever is predicted to be predominant that year.
Natural immunity is much more effective for viruses that don't change much: measles, polio, chickenpox, coxsackievirus (hand-foot-mouth), even common-cold coronaviruses.
Infant immune systems are significantly dependant on exposure to infections to workand transition from their in vitro system. Lack of natural exposure is already thought to be responsible for a whole host of medical issues.
probably the most underrated danger of the pandemic, the degree to which it crowds out and diminishes successes in fighting countless of other diseases and systemic issues. Food security, health and safety of probably hundreds of millions in the developing world is threatened and year long progress seems to be undone because everyone has to deal with covid 24/7. Damage is probably immeasurable.
The net effect of covid is going to hard to calculate. We may save a flu season, car crashes are way down, I don’t think crime is down in the US. Given the demographics of covid deaths, it’s not clear that covid deaths will be much of a net positive beyond a year, but vaccination campaigns stalled, cancer screening stopped, no dental care, elective procedures postponed, obesity booming up, mental health issues, and the secondary effect of a serious economic crisis on health too.
Car crashes aren't way down. In the first half of the year driving was down 17% but deaths per mile driven went up by 15%, so total deaths per capita was only slightly down. The pandemic has left us with only the more desperate people doing a lot of driving, and those are low-earning, highly stressed, chronically fatigued people in older cars.
I think this is the wrong hypothesis about why cars are more dangerous right now. I am a much worse driver right now than I was a year ago because it has been a year since I have driven consistently. It's like riding a bike, in that you get worse at it if it's been a while since you've done it.
I agree that it is part of it. I know that the first time I got back in my car after the first month of staying at home I felt like I didn't know how to drive.
Well - it's damage the world "chose" - via lockdowns, fear and hysteria, etc. When I talk about covid with people, I often notice difficulty to distinguish between covid the virus and covid the event (and associated things the world is doing to deal with it). Some seem to insist on attributing fallout like this to being caused by the _virus_ and as something that was never in our control. That is false. Covid doesn't make measles spread. Covid doesn't force people to not get vaccinated for measles. The culture and mitigation society chose to develop around covid caused these things.
The "world" didn't "choose", because different parts of the world responded to the pandemic radically differently.
Places that locked down immediately, like Hong Kong, Taiwan, and New Zealand, have mostly prevented spread within their borders, and are not experiencing the same fallout as other nations.
Other parts of the world did partial lockdowns, or mask recommendations, or nothing at all. With both my state and nation leading the charge in new cases per day, I am personally experiencing how that is going...
Taiwan "locked down immediately" but the Taipei metro was never below 2/3rds usual ridership. Right. It's not your garden variety lock down.
While the US government authorities were telling people "Masks don't work" and armies of conformists were busy shaming mask wearers for not thinking about 'our frontline workers' and nonsense like that, Taiwan just built sufficient capacity to make a mask for each person every 3 days. "Don't hoard your masks. Give them away to our precious medical personnel". Total fucking bullshit.
There are lots of people who went around telling people that masks don't work unless they're N95, that N95 don't work unless you're trained, that N95 don't work if you reuse. All total bullshit.
I share your frustration, but no one in this chain above rewrote history.
Everyone agrees that the US response to covid was abjectly terrible. The response should have been to suddenly and dramatically develop a capacity for producing masks. It’s true that in the early days we weren’t sure if it was transmission through air or contaminated surfaces that was more problematic, but we can already wash our hands. We can’t stop breathing.
Instead, the US president spent months attacking anyone who said covid is a problem, the CDC screwed up testing, and health authorities backpedaled on masks while giving conspiracy theory-level justifications.
I was there too. The really sad part is that now we know how to get this under control (and a few countries that really tried everything, like those listed by GP, got it right at the outset), but the politics have become so fraught that I doubt we’ll this under control in the US before it’s spread to everyone.
The part I object to is this idea that the right response is a total lock-down where we stay Wuhan-style in our houses like Li Bai waiting until only the house remains.
If that was not intended by anyone in the comment chain, then consider my comment rescinded.
> The "world" didn't "choose", because different parts of the world responded to the pandemic radically differently.
To play devil's advocate though, there is a certain degree of "peer pressure" that countries can put against other countries to "encourage" a different response. Travel bans and negative press alone are enough to pressure countries reliant on tourism to respond differently than they normally would have.
Also the examples you listed are mostly island nations, USA and EU have basically open uncontrolled borders between members of the union so it's very hard to control migratory spreading.
> Places that locked down immediately, like Hong Kong, Taiwan, and New Zealand, have mostly prevented spread within their borders, and are not experiencing the same fallout as other nations.
This isn't fully true. Look at Australia, which all but declared victory against Covid many months ago, but has continued to need rolling lockdowns as the virus spreads as soon as the lockdowns end.
Lock downs just aren't a long-term solution, all they can do is "flatten the curve."
Australia doesn’t have rolling lockdowns “as the virus spreads”. It does have a law-abiding population, geographic isolation and luck.
In most states, life is almost normal, and has been for months. In New South Wales, for political reasons, they aren’t going all-out against Covid, but even there, they’ve managed to control the virus through effective contact tracing.
Victoria, which became the worst affected state because of the second wave (from foreign arrivals), seems to have recovered well after a stringent lockdown, and is on track for full reopening.
Ultimately, Eurasia is probably too interconnected, and the US is too individualistic to make a dent in Covid, but Australia is not a good example of failed lockdowns, since lockdowns actually worked extremely well there.
The case of Australia doesn't disprove the fact that there are countries that managed to have even better response, with even less negative effects to their people. It illustrates how every environment has its unique challenges, but doesn't disprove that better responses (observable mostly in Asian countries) are possible.
It wouldn't have mattered because they were Covid-free in June, only to implement a full lock-down (complete with military check-points) only two months later.
People are so freaked out about covid that they're getting tunnel vision. There are more risks out there than just covid, and focusing only on the one risk to the exclusion of all else is likely to lead to other problems.
If you or your child do not have the 2 doses of MMR vaccine, get on that pronto. Many pharmacies can also perform the vaccination. A single dose is 93% effective, while 2 doses are 97% effective.
There are only-partially-understood immune processes that go by the names 'trained immunity' or 'bystander immunity' - where encountering one infectious agent (including just an immunogenic vaccine) can "rev up" the immune system to be more ready for other infections – even those of very-different types.
For example, there are preliminary indications that flu vaccines, Tuberculosis vaccines ("BCG"), & Measles-Mumps-Reubella vaccine ("MMR") may each decrease Covid-19 infection rates or severity-of-cases.
Given that, letting usual immunization practices decay under Covid-19 disruptions is double-destructive. If anything, other vaccination schedules should accelerate, even towards a point of over-vaccination.
At the beginning it was said that we do not fully understand consequence of community lock down, i think this will just be one of many long tail effects. Will be interesting to see if it was really a good idea in the long run.
When the error margin on the fatality rate was so wide at the beginning it maybe had some value because the worst case was so bad. But now that we have a wealth of data on who the vulnerable are and what's the actual impact the pendulum has shifted, the mounting potential downsides are growing as they were always understood to be and in some places more lock downs are the equivalent to holding back the ocean with a bucket with a hole in it.
How the hell are people going to even catch measles right now? I would expect that the social distancing measures are going to do more than the vaccines ever would.
Initially, deaths had a doubling time of 3 days, and the infectious period for covid is weeks. I haven't seen a reasonable calculation of R_0 that was less than 3.5.
Yeah it's difficult to estimate, very dependent on what environment you study. Nevertheless, measles is clearly different from covid, IIRC because it survives so much better outside it's hosts.
About R0 values, here's some data from that cruise ship, early on in the pandemic:
The diamond princess is a truly terrible place to try to get an estimate for R_0. A cruise ship outbreak is likely to be A) many times more infectious, and B) the countermeasures applied are likely to be many times more intense.
Ultimately, a cruise ship is a bad place to look for estimates on R_0 in more broadly applicable contexts, and trying to calculate R_0 so early, when the number of people actually infected is not well known, is a task doomed to failure.
Furthermore, I trust big studies with large confidence intervals done by national laboratories
https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article, more than I trust studies done by people whose methods section is "we plugged it into R".
Measles is one of the most contagious diseases known. Despite extensive vaccination and humans being the only reservoir for the virus, it has proven to be difficult to eradicate. It is very effective at spreading through the air even when there are few susceptible hosts.
[1] https://www.cdc.gov/mmwr/volumes/69/wr/mm6937a6.htm