A few days ago Benjamin Wallace-Wells interviewed Michael Mina, an immunologist and epidemiologist who argues that COVID-19 is a "textbook virus": the more times you're exposed the more protection you'll have. He's frustrated that we didn't acknowledge this from the start:
This is a very different story about immunity than we were told through most of 2020 and into 2021, though. Back then, I think the conventional wisdom was that a single exposure — through infection or vaccination — would be the end of the pandemic for you. If this is basic virology and immunology, how did we get that so wrong?
The short answer is that epidemiologists are not immunologists and immunologists are not virologists and virologists are not epidemiologists.
....The worst thing we can do during a pandemic is set inappropriately high expectations. These vaccines are incredible, they’ve had an enormously positive impact on mortality, but they were never going to end the pandemic. And now, there’s a huge number of people questioning, do these vaccines even do anything?
Is this really right? My recollection is that quite early on the epidemiological community was fairly united in suggesting that COVID was probably going to become endemic, like flu, and would require routine annual vaccinations. That's certainly been my working assumption for the past couple of years.
Now, it's true that this message doesn't seem to have gotten across. The shockingly low rate of people getting boosters is evidence of that. And around the world, governments have become unwilling to push boosters for the entire population. That's unfortunate, but hardly the fault of the epidemiological community.
Of course, even takeup of the annual flu shot is only about 50%, and that's been around forever, complete with endless marketing campaigns. If half the country won't even get a flu shot every year, COVID never stood a chance.
In any case, the moral of this story is: get vaccinated! Again. Then, next year, do it again. And then again. Just do it.
I feel like very early on there was a sense that, if we locked down for a few weeks, if we masked and social distanced, and if enough people got vaccinated when that became available, we could nip COVID in the bud, stop it from spreading and effectively end it before it became endemic.
Maybe that was over-optimistic and obviously too many people rejected all those measures as soon as politics got involved, so there was never a chance. But yeah otherwise I remember it was pretty clear they anticipated this would become an annual vaccination like the flu shot.
It is my impression that we were well on our way to “nipping Covid in the bud” when Delta hit and changed everything.
I think major doubts about that were becoming common by the summer of 2021 (I've lost track of the timing of the various variants, and the labels we use). By that time there was increasing media coverage of people getting infected a second (or third time). And certainly by the autumn of that year, it was looking likely Covid wasn't going away after one or two violent waves, in the manner of Spanish flu.
If you look at the graph on US. deaths at the worldometers site you see Covid deaths in the low thousands per day during January of 2021 and deaths in the low hundreds during July. As I recall it, it was late July to early August when Delta hit and deaths returned to the thousands per day. I believe that part of the problem was that some of the states (Florida) let down their guard and opened things up too early.
I recognize that part of the reason for the spike in deaths during December 2020-January 2021 was the effect of the holidays but that was also the period when the vaccine came out and I think it was doing a really good job on the then current variant but then became way less effective with Delta.
That's close to what I recall-- delta changed everything in terms of expectations because it was just so contagious.
Earlier on I seem to remember talk about achieving "herd immunity" as a goal, by reaching a high enough percentage of vaccinated and recovered people in the whole population. 70 to 80% or some number like that. Delta, both wildly contagious and much less lethal, made it almost inescapable and shifted the talk to controlling it as an endemic and much less dangerous disease.
I think too many people have forgotten how lethal it was in that first year. Much of the "slow the spread" effort was to save hospitals from being completely overrun.
And when hospitals weren’t overrun the anti-vax people said “see, it wasn’t so bad after all” instead of “hey, the lockdowns and other precautions worked”.
Large studies have shown lockdowns and masks didn't help.
There was never a realistic hope that we could effectively end covid-19, but there was early hope that vaccines would provide enough protection against infection and transmission that mostly life would be able to go back to normal, as well as well-grounded fears that immunity would wane and the virus mutate too quickly to avoid repeated waves. It was Delta, and in particular the Provincetown outbreak of Delta in early July, 2021, that provided the convincing evidence that optimism was not warranted.
I think the hope was that the vaccine would be effective like the polio vaccines. Instead, it reduced hospitalization and deaths, but didn't prevent people from contracting COVID. I contracted COVID the first time two weeks after my fourth vaccination, and again a couple weeks ago. I was planning to get my sixth jab instead of contracting COVID, but I think I can put the jab off for a couple months.
I think most people really struggle with the fact that not only did we know nothing about the virus initially, the rules changed with each new variant. So people would get stuck on one particular moment in time, and then were exasperated at the CDC that none of those rules were true any more.
When the original strain was circulating we really did think the virus could be eradicated given that the vaccine seemed to prevent spread, surgical masks alone were moderately effective, etc. Hence mandates!
That quickly evolved with each new, more contagious variant such that now the vaccines don't come close to preventing spread, an N-95 level mask is needed for moderate protection, etc. Even how long to wait between vaccines has changed with each new variant.
People need to burn it into their minds: this thing and its rules are a moving target.
I went back to the CDC web site on COVID-19 to look at the current list of variants. There were a bit over 30. Fortunately "variants of concern" haven't gone up nearly as much. But this is a pretty changeable virus.
The initial fairly extreme anti-covid measures were clearly expressed as being intended to "flatten the curve", which is to say to slow the rate of spread enough that therapies, mainly respirators, could be made available in sufficient numbers. I don't know about others, but I NEVER had the idea that there was any prospect at all of nipping Covid in the bud.
I got Spikevaxed two weeks ago.
We just got back from the Rite Aid where we got the latest Moderna booster. We'll be ready for the holiday season.
It seems to me that pretty early on, we knew or heard about people who got it twice, which ruined any "single exposure" theory. Nobody really knew anything for sure, but I don't remember assuming that getting it once would mean I didn't have to ever worry about getting it again.
Yeah. There were hints of this even before vaccines were released, and fairly widespread reporting of this phenomenon by,I think, the summer of 2021.
The second case might have been the dreaded "Long COVID." But as you say, early on the world was grasping straws and still trying to define terms.
So far, I've gotten vaccinated every time it was available. I've gotten 4 so far, with the most recent being the Bivelant vaccine last october. So, almost a year later, I ended up contracting Covid in August. It was pretty bad, but assuming the vaccine did ameliorate the disease, not as bad as it otherwise could have been.
Being only a couple months later now, should I get vaccinated again or should I wait until later, relying on the immunity of contracting the disease recently?
The CDC website has good answers regarding your situation. If I remember correctly, a six month wait is recommended. I do remember that you should wait two months between vaccinations (for example bivalent not available, take old run, two months, then take bivalent). In any case - to the Internet you go!
If I were in your shoes I’d vaccinate just before Thanksgiving. That would give you the most protection for the holidays. But that’s just layman me.
I had my flu shot 3 weeks ago, scheduled my COVID shot for next week (the local pharmacies started getting the new version of the vaccine two weeks ago), and will then set up the RSV vaccination.
My wife and I both tested positive for COVID in early September despite the initial shots, and boosters as recommended. Probably the ERIS strain, since that was what was peaking back then. My case was pretty mild, about like a cold with a lot of mucus production. My wife had it a bit rougher - some joint pain in addition to cold symptoms. Pretty much done in under a week.
It takes a while for immunity to develop. I've heard about one week to start and about six weeks to peak. That suggests taking your Thanksgiving vaccine in mid-October.
I'm in the same boat. Vaccinated to the max, finally caught Covid this last August. I'll definitely be getting the booster when I can.
The current recommendation from the CDC seems to be wait 3 months (it was 6 months previously, but new variants always rewrite the rules), so yeah, just before Thanksgiving.
A study by the Cleveland Clinic showed two years ago that the more boosters one gets, the more likely they will get Covid.
The main danger is not that people will be susceptible to endemic viruses, like ordinary flu and colds, it is that the next pandemic-type virus will be worse than covid or have a different age distribution. The Spanish flu attacked mostly younger people - maybe the next one will hit children. It seems certain that in the next pandemic a large fraction will reject vaccinations altogether and that schools, if not the whole country will be kept open.
If children are also at risk, the whole dynamics will be completely different. You cannot really project between the two situations (children-at-risk vs children-not-at-risk).
I can project confidently that the MAGA fraction of the country will reject vaccinations in any kind of pandemic. Even if the danger is detected earlier the spread will probably be worse.
You can certainly "project confidenttly". That doesn't mean you get it right.
People think differently when children are affected, and that will apply to large part of the MAGA too. The exact effect is not really predictable.
Some doubt was recently cast on the idea that the Spanish flu attacked mostly younger people. Today's Seattle Times reprinted an NYT story that a a closer look by an anthropologist at the University of Colorado, Boulder (SharonDeWitte) found a number of young victims were in frail condition - not very healthy to begin with.
Given the wartime security clamp-downs in Europe and the US, it was very hard to get good data (and the reason it was called "the Spanish Flu" was because Spain was not suppressing information about it - so reporters got their information mostly from Spanish publications.
The UC study was done on skeletons held at the Cleveland Museum of Natural History from the period of the Spanish flu epidemics.
Interestingly enough, I read a number of years ago that one of the reasons that FDR set up the CCC and the WPA was that during WWI recruiting an appalling number of volunteers were turned away due to poor health - often tied to lack of adequate medical care AND poor nutrition. One of the biggest draws of those two organizations was good care, including "three hots and a cot" going along with structured exercise and work.
The relatively small size of the sample ((shin bones of 81 people out of a collection of 3000 skeletons) means the study may not be definitive, but it is an interesting bit of food for thought.
I haven't seen that particular study, but what I remember from other sources is that the most serious damage resulted from so-called "cytokine storms" that were basically immune system over-reactions, and that meant the worst-hit were prime-age people with healthy immune systems-- basically young adults in otherwise good health.
No reason it couldn't have been both those types and others who were frail. As I recall, its first appearance in the US was when it swept through Army barracks. These were people who'd passed the physicals and were, shall we say, in the Army's care for a while so not likely to be those frail slum-dwellers.
Malnutrition was common outside the slums, as well. That was one of the finds that got FDR fired up. Supposedly even good, strong farmer lads (proper cannon fodder, as it were) were getting turned down.
Too many farms had gone mono-crop (wheat and corn) long before the dust bowl. And I don't think there was crop insurance against disaters back then.
My grandparents on my mother's side of the family were lucky - well outside the dust bowl in Oklahoma. Her father was also very distrustful of mono-crop and their farm had something of everything.
Some heirloom wheat, corn, alfalfa, peanuts, fruit trees, and lots of vegetables. A few cows for milk (and meat when they stopped producing), chickens for both eggs and meat. pigs. sheep, and goats. Also hay.
Most of the extended family depended on her fathers farm. She described once a month gatherings where all the families gathered at the farm. Huge meals were cooked, with the purpose of generating lots of leftovers to be taken home. Massive laundry work was done to get the dust out of clothes. All the male relatives were working the fields, getting in harvest, fixing everything needing fixing, replacement, painting, welding, whatever. All the female relatives were doing major cooking, laundry, repairing battered clothing, herding chickens, goats, pigs, and cows.
You could overlay that map with median education rates and see much the same result. How long before the GOP starts to realize they're killing off their base?
They don't care about killing them, so why should realize anything?
My recollection is that we were planning for regular vaccinations, into perpetuity, but maybe we got lulled into complacency in that the initial protection from the vaccine was remarkably high. And that maybe if there were 95% uptake on that vaccine, we might have lucked out in stamping this out. But that was never going to happen.
My other recollection is that David Wallace Wells is kind of an idiot. Go read his interview with Fauci about masking. It's frustrating. This article is more of the same. He's kind of got this surface level knowledge that he mangles horribly in his articles.
But yeah, between initial shots and boosters, I've done this 7 times now? And unless we've had completely asymptomatic cases (always possible), neither me nor my wife has ever had COVID. And we haven't been hiding away.
David Wallace Wells is both an idiot and a liar.
https://www.mattball.org/search?q=David+Wallace+Wells
I presume y'all have heard RFK, Jr. is running third party, and the GOP is apoplectic. It would be the sweetest of ironies (not to mention cosmic justice) if the one thing that finally ends Donald J. Trump's political career is an anti-vax lunatic.
Reap what you sow, bitches.
My recollection of the early wave was that people were thinking it was like ebola - altho obviously not as deadly - and if we could stamp it down early we could 'win' and go on with our lives and never hear about it again. Altho pix of refrigerator trucks outside NYC morgues suggested 'not as deadly' was rather relative.
I recall 'endemic' and 'herd immunity' talk were a (bit) later, but certainly circulating. I'd been saying for years (yikes! has it been that long?) that it was likely going to be a wave/flu sort of thing and we'd be getting annual shots.
Final data point wrt uptake: I setup an appt at my local retail to get it yesterday, and was told my insurance wouldn't pay for it there. (!) I guess I was getting gov ("free") shots earlier. FWIW, they are the same with annual flu: I have to go to my PCP to get it. (Yes, I'm in an HMO.)
Does the HMO have a preferred pharmacy? If so that might be your work around in the future.
I went for my booster and was told it wasn't in my insurer's (Anthem Blue Cross) formulary. Called Anthem. They said there was a computer glitch. Went next day and got the shot.
Done and done. COVID nouveau vaxx and flu vaxx same sitting. Shoulders ached but that's it.
Besides all that, you are correct in the assessment that it was communicated that a regime of boosters would be needed because of the virus' immunity escape abilities that were noted very early on. In fact, that was one of the "shockers" that everybody had. What do mean I have COVID, I was vaccinated?!?
If it doesn't fit on a bumper sticker...
We had a trip planned from Sept 16 to Sept 27. The new booster came to our area on the 14th; I didn't want to fly and react to the vaccine at the same time. My wife and I had to come home early from our trip (on the 25th) and both tested positive on the 26th.
So my plan now is to get my flu shot later this month, and the bivalent COVID booster (shot #6) in late November.
My first case of COVID was two weeks after a booster (shot #4, March 2022).
Got mine!
Donald Trump should take up drink.
Imagine the difference that would make.
He might be even likable...
nahhhhh.
One Rudy is enough.
+1
Can’t - not eligible on the NHS, not available privately.
Earlier this year I got a fourth vaccination shot. Less than two months later I tested positive for Covid for the first time (while traveling). My Symptoms were like a fairly average cold, and there was one night I had trouble sleeping. I was in fact surprised to test positive since my experience was so much like a cold. I don’t think I ever had a fever with that infection (unless it was very slight). Still, the timing was odd: so soon right after a fourth vaccination shot. Was it an ineffectual shot? or would my Covid experience have been so much worse without it?
Can I get vaccinated against Steve Garvey? Now (joke) running for Senate.
Your recollection is wrong, Kevin. Early on it was very much that the vaccine would provide permanent immunity.
From my recollection: when the vaccine came out, articles were clear that the vaccines were only tested to reduce death, but we wouldn't know if they would prevent you from getting it at all or transmitting it. However, a) most people just think of childhood vaccines, where you get one (or a few) doses and never worry about it again, and b) early data was that it did a pretty good job preventing you from catching (or transmitting) it. So people kind of assumed that.
I think in early spring you heard more articles theorizing that we might need a "fall booster", but even that was very hypothetical. It wasn't until we got to the first big variant (was that delta?) and also we began to see that the preventative effects of the vaccine would wear off that the idea of boosters became more of a concrete notion.
My experience of the pandemic is that if you dug around enough at any stage, you could find some scientist saying the right thing or warning of the right thing. But it was hard to find, and there was always conflicting information, and regular people didn't have the time to dig into this stuff, and a good chunk of the people willing to "do their own research" were just looking for anything to validate their preconceived ideas.
I think the biggest contributor to distrust, which in turn led to more than the usual amount of misinformation, is the general lack of appreciation for how science works: When the data changes, the answers to the questions change, too. Most of the time, this isn't something that directly affects people day to day. But with something as new and as potentially devastating as COVID, the data changes very quickly. People want there to be a single definitive answer, even where there can't be one.
I think that the dependency of the current scientific understanding on the current state of data was not made clear enough. There wasn't enough of "based on the data we have at the moment,...." before public statements.
If you’re young and healthy, it doesn’t matter I think. I’m healthy, but getting old! Never had the virus even once. You’re welcome.
I'm an old retired health care professional. I do get all of my shots but trying to get a Covid shot right now, is like trying to pull hens teeth. I will get it but likely not immediately.
I feel for those who need them but the vaccine is just are not showing up at pharmacies. Rumour has it that the gov ran the last shots and is no longer distributing. Any ideas about the distribution? This was from the pharmacist.
Old retired surgeon here and I’m having the same problem. None of our local pharmacies (here in Maine) have it unless you schedule well out into November. What is that all about?
“The worst thing we can do during a pandemic is set inappropriately high expectations.”
I’m pretty sure the actual worse thing we could do is do nothing and let the virus run rampant through the population. Take absolutely no precautions and let millions more die than absolutely necessary because precautions are too inconvenient.
I've had the two vaccinations and a booster. Despite my belief in the science, I'm having a hard time working myself into going for another round of vaccinations.
An old friend of mine suffered from some kind of cardiac inflammation within a day or two of his last booster. He's over 70 and had no previous heart problems. Now he can barely walk to the mailbox and back. His prognosis is not good. We share a doctor and he's not planning to get another vaccination unless his job requires it.
I know this is all anecdotal, but it is close to home as well.
With regard to flu shots: As a child I was told I was allergic to chicken feathers and to never have a flu shot. I've had mixed messages from the medical establishment ever since, so I've never had one. I've maybe had a couple of mild flu infections in my 66 years. My mother has never had the flu or an inoculation, so genetics could be involved. I do know two people who had Guillain-Barré Syndrome immediately after flu shots.
I truly believe that vaccines in general, and in particular the covid vaccine, are a boon to the world and have saved millions of lives. I don't regret getting the vaccines; we even got ours at mass vaccination events at the Darlington Speedway. But I can't help asking myself if I'm one dose away from a bad thing happening and what's the risk/reward ratio.
Some intense scientific investigation of these issues and public explanation of the results of such investigations are called for. I would like to find reasons to be reassured.
Just look at that map. The ghost of the Confederacy strikes again.
Notice that Drum doesn't mention that many Europeans won't allow people under 50 (or 65 in some countries) to get a Covid booster. That is mostly due to a Danish group showing in spring 2022 that for those under 50 the risk of injury including death outweighs any benefits.