I’m an epi professor and longtime HN lurker. I wrote a short essay yesterday about how to think about these mysterious outbreaks [1]. Briefly, the most common outcome is they are determined to be an endemic disease. Less likely is an emerging infectious disease. The most concerning possibility is something novel or highly unexpected.
This is a great article, and for anyone that wants a cheat sheet for the thread (and to double check my read):
* The "endemic disease" bucket describes things like cholera and known influenza strains, and what we're seeing is hazy reporting of flare-ups that happen in low-resource areas around the world on the regular.
* The "emerging infectious disease" bucket describes stuff like Ebola, which is scary but we've got something like a reasonable history of responding and containing to it, if we take it seriously.
* "Novel" is C19, or the first outbreaks of Ebola at the time, the point presumably at which we'd start thinking about novel precautionary measures applied preemptively.
So basically, if it's any of numerous reasonably well-known but very local diseases a fluid's probably going to go colored in some field test kit and say which one, else it could be something known (and often of known substantial concern for large-scale contagion) but too rare or understudied to have cheap robust quick tests yet so that has to be shipped to a real lab (probably with very high biosecurity rating), and if the lab doesn't recognize what they're seeing in their electron microscope and has to do fundamental research first to get a good biochemical profiling it's something truly expanding the boundaries of known infectious pathology?
I don't exactly want to dispute that, but I would like to remark it's not entirely clear-cut.
SARS-CoV-2 response could be as rapid as it was in no small part because two decades of research on SARS-CoV more or less was applicable, and looking at genetic similarity alone contemporary variants of SARS-CoV-2 are now more different from the original strain isolated in Wuhan than that strain is different from SARS-CoV.
So was the threat from pathogenic Coronaviruses really novel? To a degree, and depending on what aspects one chooses to emphasize maybe.
Also, I'd say the pathogen itself doesn't necessarily need to do the changing in the context of emerging diseases. I'd take it to mean they have potential to become more prevalent or have a more significant impact, but that could easily also be due to changes in conditions, including human behavior.
> I would like to remark it's not entirely clear-cut
Are you saying this as an epidimeologist? (I'm not an epidimeologist. I've only studied the math.)
> looking at genetic similarity alone
Epidimeology is the study of disease in a population. You can't look at the virus alone.
The dividing line between emerging and novel is brighter than between emerging and existing. It has to do with whether the population has pre-existing immunity. SARS-CoV infection conferred no immunity to SARS-CoV-2. Getting infected with the Alpha variant, on the other hand, conferred immunity to Omega.
> I'd say the pathogen itself doesn't necessarily need to do the changing in the context of emerging diseases. I'd take it to mean they have potential to become more prevalent or have a more significant impact, but that could easily also be due to changes in conditions, including human behavior
Literally in the Wikipedia. "EIDs may also result from spread of an existing disease to a new population in a different geographic region, as occurs with West Nile fever outbreaks."
It is nice that things aren't so bad that nobody is even keeping an eye out for things like this. There's some comfort in knowing that somewhere smart people are looking into it.
We watched it live in 2020 and we failed so hard that this is probably the worst time for any new pandemic, especially one that can be described as being in any way "flu like". We've learned from experience that no matter how many people start dying, huge parts of the population will not take it seriously and that governments will only care about keeping the workers busy making money for their employers even while those employers refuse to provide them with PPE or sick time. Nobody trusts the CDC as it is, and that will only get worse with the coming administration.
I'm just hoping that this isn't anything new, and that it doesn't spread very far.
I disagree about trusting the CDC, I have no reason not to trust them.
They'll do their best job to understand threats, avoid making confusing statements. But if there is a threat and people are dying in hospitals in large numbers without much information, they'll do their best to make health safety precautions, but they will probably make some mistakes. This is pretty common in science too.
The CDC never had the trust of many people to start with, but their repeated failures at communication didn't do them any favors. They also repeatedly allowed themselves to be bullied and manipulated. For example, they changed the recommendation to stay home 5 days after testing positive, but that change wasn't based on any new evidence that would contradict their old recommendation.
Cause the "experts" did such a good job last time.
I learned from the last pandemic that the so called "experts" were in fact incompetent at best and power tripping political ideologues at worst. It was crazy watching the last 100 years of germ theory and infectious disease get thrown out and start over from scratch
1. The virus isnt real it's a conservative conspiracy
2. The virus is real but isnt spreading human to human (it obviously was at this point)
Bonus: Thinking the virus came from a lab doing research on that exact virus in proximity to the first cases was a conservative conspiracy instead of an obvious first guess
3. The virus is spreading human to human but not through the air (it obviously was highly probable given respiratory symptoms)
4. Masks dont work
5. Masks do work
6. Masks do work and you should always wear outside your house but not needed at BLM protests
7. The social distancing rules had zero scientific backing
this sounds exactly like the scientific discovery(ies) of something unknown. you are scrambling in this case to figure things out and you want to do it as fast as possible because you know - the government has decided to lock everyone up. so you go about trying to figure it out. but science is not dogma, if you first believed that masks do work and then get a proof that they don't after enough people start wearing them and you perhaps see that that shows otherwise, you pivot. this is exactly what you want, you don't want "experts" to sit and go "shit, we told everyone to wear masks, we now have this new data which shows limited utility but shit we can't say we were wrong, lets have everyone keep wearing masks... maybe even double-down and say you should wear masks alone in the shower cause virus might be in the water too..."
We did not have new data on masks when the messaging on masks changed. The science said masks do not protect you and that is why experts initially said so. Then, they figured that this is not what people wanted to hear. People wanted to be told what to do to be safe and would not take “we do not know” as an answer. Politicians latched on this, the media latched on to this, and somehow it became a partisan issue. The path of least resistance was to just shut up, wear a mask and wait for the hysteria to subside.
Yes, good points. Politicians and the public and all of us can have trouble when it's a rush situation with deadly consequences and the experts make their best prognosis based on previous times in some part - then they revise best practices as they gain knowledge.
This happens all the time but it's not usually so visibly combined with conspiracy theories about controlling people and all that kind of crazy stuff. America is so influenced by foolish postings on social media and popular, but not fact-based TV networks.
There was the realization that covid spread in a different way than the flu and the discovery of things spreading through the air was a bit surprising and unexpected, compare with traditional flu issues.
this wasn't a partisan issue in the beginning. it only became a partisan issue when 50% of the population started getting the "scientific information about efficacy of wearing masks" via Mary from Pennsylvania on "X"
same with the vaccines. the loudest pro-vaccine politicians (e.g. DeSantis) after seeing posts on "X" from our PA/MT/MO experts decided it would be super beneficial to their political career to make that a partisan issue as well :)
>it only became a partisan issue when 50% of the population started getting the "scientific information about efficacy of wearing masks" via Mary from Pennsylvania on "X"
Really? Only then? No partisan aspect to official narratives about masks and virus origin being practically imposed upon the public via all narrative-sympathetic media and social media channels?
No partisan aspect to the blatant hypocrisy of BLM protests being no problem in terms of mass gatherings, while any other type of mass grouping was considered wrong, and something only done by ignorant covid-deniers?
Not to even mention the whole "don't use masks you selfish pig, no wait! use masks, yes, use them you ignorant bumpkin!" debacle...
I guess none of these wonderfully varied and acrobatic narratives in the least bit created good reason to make large numbers of people start mistrusting the hell out of a whole range of politicians and media personalities.
> it is safe to say now that the events of 2020-2021 were a mass hysteria.
Were they?
> There have been reported 7,076,316[4] (updated 3 December 2024) confirmed COVID-induced deaths worldwide. As of January 2023, taking into account likely COVID induced deaths via excess deaths, the 95% confidence interval suggests the pandemic to have caused between 19.1 and 36 million deaths
1. how many of those deaths were among healthy people below the age of 50, who constitute 90% or whatever of the workforce? was there any point forcing children and teenagers into confinement for months?
2. did COVID get eradicated in mid-2022, when virtually all supposed countermeasures were abandoned?
You're right that we are in the zone of intense cognitive dissonance right now. COVID is everywhere but no one does anything. People that don't protect themselves by wearing respirators and cleaning the air will likely pay a price.
The virus is weaker. We understand it better, which means better diagnosis and treatment. And we have vaccines, which reduce the burden on the hospitals.
1. How many would you consider an acceptable number of deaths?
2. No, Covid is still very much around, and people are still very much dying from it. It was the 10th most common cause of deaths in 2023, and a lot of people have lingering symptoms.
2 - The current medical consensus is that not only has it not been eradicated -- it likely never will be.
Definitely mass hysteria.
To a partial extent it was. But it defintely wasn't simply a matter of mass hysteria.
Are you wiling to recognize that reality can sometimes have conflicting qualities -- e.g. there can be simultaneously "too much of a reaction" against a perceived threat; but also "some kind of serious response was needed; no one could possibly have known at the time what the optimal response would have been; sometimes it's better to err on the side of caution"?
Especially in regard to things like once-per-century pandemics, which are obviously still poorly understood?
In seriousness, that we're largely not the logical beings we pretend to be, but selfish irrational creatures.
Toilet paper isn't even a necessity. Hoarding canned and dry goods I'd kind of understand. Toilet paper was just such an odd choice. Even the producers said they aren't going to make more, there's plenty to go around. Yet people hoarded it like gold.
the crazy part was that this was a phenomen in many countries. What does this say? That it's human nature? Or that our culture is just too damn similar? I don't know but worth some studies for sure ;)
A couple of viral posts of empty shelves easily crossed langugage barriers? It's not like every country lives in complete isolation, we all share the same internet.
I think it's a joke? Probably referencing how everyone said that COVID-19 wasn't airborne and we were hyper focused on surface transmission when it is, in fact, airborne
I love how everyone is a retrospective expert on COVID-19, claiming things were "obvious" about it when it was in fact, a brand new disease - characterized by in fact, never having been seen before and as a result was completely unknown.
"It was airborne! They should've known that!" - like, how? You can't exactly grab a few hundred people, and run an experiment where you deliberately infect a bunch of them with a brand new, deadly disease to really pin down the transmission mechanism. And given that everyone lost their minds over face masks, "wash hands" was some pretty mild initial advice while so much wasn't certain.
It was obvious to lay people observing the situation that it was airborne- with things like the choir singing superspreader event in March 2020. This was so unlike past airborne diseases, that this was a rare case where being formally educated in virology seemed to make it harder observe the obvious.
2) Do you honestly think that 124 people have died to prop up science funding?
If so, can you think of an easier way for US researchers to advance their evil plans and secure funding than having these people in a completely different country die and that country's health authority raises concerns in the media?
I mean, even if that is the plan, don't you think that's a bit subtle and ineffective to convince a highly conservative; conspiracy theory friendly US administration to fund science?
Most political systems/tribal groups punish science minded people.
To gain power and influence you need to state your position and stick to it. New evidence to the contrary? Reiterate and double down on your position. Attempt to discredit the evidence. Having people die doesn’t matter as long as you stick it out.
The last thing you should do is incorporate new evidence and change your mind as a result.
While establishment politics in academica sucks the original comment was so poorly thought out as to be farce.
The (people who want science funding in the US) manipulated (another country's health authority) so that (Donald Trump and RFK would give them science funding), because both are known particularly to be influenced by the CDC equivalent of the Congo.
Regions with higher population growth are probably better suited to dealing with pandemics, in the sense that they have larger young healthy populations, so they should suffer less and bounce back more quickly.
With a twist : this time is only affects kids, only cheap repurposed medecines work, we have too much information about where it comes from, and none pays any attention.
Epidemiological experts are in the region to take samples and investigate the disease, the minister said...
“At the current stage, we cannot speak of a large-scale epidemic, we must wait for the results of the samples taken,” health minister Kamba said regarding the mystery flu-like disease.
Not really "on alert" then, just waiting to see if what we're seeing is novel or what.
I see people here in the US take The Beaverton seriously. I see people in Canada take The Onion seriously. It's hard to evaluate things like this from the outside.
[1] https://caitlinrivers.substack.com/p/understanding-mysteriou...