I’m not making any argument. I’m just accepting what I now see as reality. My optimism for any sort of real control for the world as a whole outside of lockdowns erodes each day.
I’m only asking what will happen if a vaccine is actually not around the corner? How long can this be sustained throughout the world? No one talks about a plan B.
Plan A is to contain the virus, get as much of the economy open as possible, keep as many people safe as possible and wait for a vaccine. We know some activities just aren’t possible and some businesses can’t be open or be open with any meaningful demand. That’s part of the process. If we get to the point where there’s no hope for a vaccine we then have to see what the state of the virus is to form a plan B.
Yeah. I appreciate all this but i don’t think you’re understanding me. I’m not questioning restrictions in the present. I’m questioning that there is no option even being discussed if the vaccine doesn’t work out. All the eggs are in the vaccine basket with no other viable option being considered for the long term. It should definitely be discussed now. Not planning for this is a horrible idea. Plan B should be ready to go if the vaccine doesn’t come.
Vaccine or no vaccine doesn't matter. The plan always has the same goal, "reduce the transmission enough that the sources of virus have no place to replicate and it's contained". A vaccine is just one way that's done, but it's not the only way. Likewise, the tools for doing this is different if there are only a few cases or if it's rampant with many active cases. It makes no sense to use the wrong tools for the wrong conditions.
Our issues are not about how to accomplish containing an infectious disease. They're around what we're willing to do vs the things that need to be done based on the active conditions.
When things were out of control with large community spread, we did the things to deal with that, at least some. But, we fell apart and continue to fall apart on the things needed to contain smaller community spread in most places. The problem becomes, if you don't contain smaller community spread, it gets bigger. We're doing pretty good at slowing the increase in community spread, so it'll get to widespread less quickly than it did the first time. But we're not really doing enough to reduce it.
In the US, we don't have rampant TB spread. There's a vaccine, but it's not really used in the US, and yet we still don't have rampant TB spread. What we do have is well understood and used isolation protocols, contact tracing, and surveillance testing for TB. It helps that we've been able to keep the community spread low enough that these things are practical. Although, in recent years funding has struggled for even this and cases have gone up as things are missed. The same with several STD diseases too. I'm sure one of the hospital workers posting can comment on what they do when there is a suspected TB case for isolation, testing, and then tracing if it's positive. Along with how long it takes from suspicion to test result, plus the extra pain maintaining the isolation is during that time.
That's the goal, get the community spread small enough that we don't need any restrictions designed to "slow the spread" because the spread can be contained instead.
- A vaccine can do that, as it eliminates people who can be infected.
- A lock down is temporarily good when spread is rampant, because it stops all interaction. Its' not good when spread is smaller, it's like using a sledgehammer to drive deck nails.
- Rapid testing, contact tracing, targeted isolation works when spread is small and testing is fast enough. This is how TB is handled. We're not reporting on testing that's fast enough for this vs just tests taken. Anecdotally, this is where we're clearly failing. If every contact is assumed positive, isolates until they get their result, and traced when positive, this can contain instead of slow. But it doesn't work with slow testing. Even if the contact isolates for two weeks while getting a result, they still may have infected people in the days before they isolated. Contacts that will never be traced based on a result that comes back a week late.
- Surveillance testing, with rapid results followed by contact tracing. This works to catch gaps in the primary testing, things that slip through for whatever reason. For opening schools, this would mean doing some amount of surveillance testing of the school population often enough to get ahead of spread instead of after someone shows symptoms. To know that there is an issue before it's effectively impacted everyone.
We've seen both the NWSL and NBA do this on much smaller scales. Those worked because they could reduce their community spread to 0 and then keep it there.
That's the plan, reduce community spread to a manageable level that it can be contained, and acted on fast enough to keep it contained. It's the only plan. Everything is just how we get there.
So then really it is a moot point talking about daily death numbers. No one will know the real numbers for weeks
Exactly. For the death numbers, just read the updated and corrected numbers from up to 3 weeks ago. Ignore everything newer than that, it'll all be adjusted and is just noise. Which also means the deaths number isn't a very good monitor for current conditions. Between deaths lagging infections to begin with, and then death statistics reporting lagging more, as a measure it's great at telling you what was going on a month or two ago but not so much what's going on now. Just like most economic data that is reported a month or quarter after the fact. It's still important to know, to understand the big picture, but it's not going to help with the detailed picture for today.
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