Probability that covid will become endemic

[LearningMachine]

Some folks in the medical and academic communities believe that there is a good chance Covid will end up becoming an endemic like the common cold or the flu, which needs a new vaccine every year.

 

Wondering if anyone in the group has looked into credible sources to help figure out the probability range for this happening.  Once we know the probability range, if the high end of the probability range is high enough, we can talk about potential implications to airlines, remote work, density in cities, etc.

 

Here are some articles I've run into:

* https://www.huffingtonpost.co.uk/entry/covid-19-endemic-pandemic-epidemic_uk_5f99a2abc5b6aab57a0eb788?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAFY2D4Q9zh3-O_LifL8Km8l7eait0vUsQ5u9Sxy6bWucWEPwkcijmsuJlk64j2OaBsW8pgUSJLPoqSvXmyaze-412bD9YFU55UvwlZJnlWgodlmVyuMuVErL-iV3MShTAg32rSybeVNwo5lX7mQs8x9perwMjJ9083wvT0KzdJGZ

* https://science.sciencemag.org/content/370/6516/527

* https://www.publichealth.columbia.edu/public-health-now/news/will-covid-19-virus-become-endemic

* https://www.sciencedaily.com/releases/2020/10/201015101820.htm#:~:text=Evidence%20suggests%20COVID%2D19%20could,temperate%20regions%20similar%20to%20influenza.

 

[clutch]

Even if it becomes endemic, things will return to normal. Both the transmission rate and fatality rate will continue to lower (with vaccine and better treatment), making this another type of the common flu. Not to mention, we will reach some form of herd immunity -- as it did with (and ended) the Spanish flu. We haven't changed much of our behaviors because of the flu.

 

The only implication/change I would like to see is on the long-term care front. Not only because of COVID, but is this really how our society should deal with older people -- basically putting them in a prison?

[Viking]

Great question. There is still so much we do not know. Like what happens if the virus mutates?

 

So while the news from Pfizer and Moderna is certainly encouraging there remain many forks in the road ahead.

[Peregrine]

Great question. There is still so much we do not know. Like what happens if the virus mutates?

 

So while the news from Pfizer and Moderna is certainly encouraging there remain many forks in the road ahead.

 

The flu mutates frequently. All viruses mutate.

[KCLarkin]

Preprint released today suggests long-term immunity for 90% of people. Perhaps for decades as seen with SARS.

 

Comparisons with flu are misplaced on all levels.

 

So, in summary:

1. Covid is certain to become endemic

2. Between vaccines and acquired immunity this virus will not be material beyond 2022

[LearningMachine]

Preprint released today suggests long-term immunity for 90% of people. Perhaps for decades as seen with SARS.

 

Comparisons with flu are misplaced on all levels.

 

So, in summary:

1. Covid is certain to become endemic

2. Between vaccines and acquired immunity this virus will not be material beyond 2022

 

Thanks KCLarkin, would it be possible to share the link to the source? 

 

Which one of the below are you saying?

• (a) 100% certainty that Covid-19 coronavirus will not mutate, unlike the flu coronaviruses, or
  
• (b) 100% certainty that the same vaccine we get once for Covid-19 coronavirus will be able to provide immunity against all mutations of Covid-19 coronavirus, unlike the vaccine for flu coronaviruses.
  

[LearningMachine]

Even if it becomes endemic, things will return to normal. Both the transmission rate and fatality rate will continue to lower (with vaccine and better treatment), making this another type of the common flu. Not to mention, we will reach some form of herd immunity -- as it did with (and ended) the Spanish flu. We haven't changed much of our behaviors because of the flu.

 

How is the transmission rate, that is, R0, going to go down for mutations of Covid-19 coronavirus with vaccine and better treatment?

 

Flu has an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average.

Spanish Flu had an R0 about 2.2 to 2.9, and effectively lowered further due to less travel sometime after World War I was over.

Covid-19 coronavirus strains have an R0 as high as 5 or higher, exacerbated further by dense populations and travel.

 

Do we know of other ways of lowering R0 for Covid-19 strains other than behavior change?  We cannot say with 100% certainty that herd immunity will continue to provide immunity for mutated strains of Covid-19.  We do know that herd immunity does not provide immunity for mutated strains of flu coronaviruses.

[clutch]

Even if it becomes endemic, things will return to normal. Both the transmission rate and fatality rate will continue to lower (with vaccine and better treatment), making this another type of the common flu. Not to mention, we will reach some form of herd immunity -- as it did with (and ended) the Spanish flu. We haven't changed much of our behaviors because of the flu.

 

How is the transmission rate, that is, R0, going to go down for mutations of Covid-19 coronavirus with vaccine and better treatment. 

 

Flu has an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average.

Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Do we know of other ways of lowering R0 for Covid-19 strains other than behavior change?  We cannot say with 100% certainty that herd immunity will continue to provide immunity for mutated strains of Covid-19.  We do know that herd immunity does not provide immunity for mutated strains of flu coronaviruses.

 

Vaccines. The transmission rate will go lower if more people are immune to it. Isn't that obvious?

 

If the virus mutates and presents a serious threat again, I'm sure that we will develop another vaccine that works.

[LearningMachine]

Even if it becomes endemic, things will return to normal. Both the transmission rate and fatality rate will continue to lower (with vaccine and better treatment), making this another type of the common flu. Not to mention, we will reach some form of herd immunity -- as it did with (and ended) the Spanish flu. We haven't changed much of our behaviors because of the flu.

 

How is the transmission rate, that is, R0, going to go down for mutations of Covid-19 coronavirus with vaccine and better treatment. 

 

Flu has an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average.

Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Do we know of other ways of lowering R0 for Covid-19 strains other than behavior change?  We cannot say with 100% certainty that herd immunity will continue to provide immunity for mutated strains of Covid-19.  We do know that herd immunity does not provide immunity for mutated strains of flu coronaviruses.

 

Vaccines. The transmission rate will go lower if more people are immune to it. Isn't that obvious?

 

If the virus mutates and presents a serious threat again, I'm sure that we will develop another vaccine that works.

 

Hence, my question at the start of the thread, i.e. what is the probability that we would need a vaccine every year?  So, you agree that the probability of that is non-zero?

[KCLarkin]

Which one of the below are you saying?

• (a) 100% certainty that Covid-19 coronavirus will not mutate, unlike the flu coronaviruses, or
  
• (b) 100% certainty that the same vaccine we get once for Covid-19 coronavirus will be able to provide immunity against all mutations of Covid-19 coronavirus, unlike the vaccine for flu coronaviruses.
  

 

https://www.biorxiv.org/content/10.1101/2020.11.15.383323v1

 

100% certainty that Covid-19 will mutate but at a much slower rate than influenza viruses (we should be grateful this isn't "just the flu").

 

To simplify, let's assume the rate of mutation is related to mutations during the following:

1. Replications within a host (human or animal)

2. Jumping between hosts

3. Jumping between species

 

This suggests that rate of mutation will be highest at the peak of the pandemic when the virus is replicating rapidly in people and jumping rapidly between hosts. We've had perhaps trillions of replications, yet vaccines are showing 90% efficiency. This shows that the virus is not mutating rapidly (which is also shown in genetic tracing).

 

You could foresee some random mutation that allows Covid-19 to evade the vaccine, but the probability is related to the number of mutations. So the likelihood of a dangerous mutation occurring after June 2021 is much lower than one occurring in 2020.

 

Edit to add: So that suggests you won't need a yearly vaccine solely due to mutations. You might still need one for waning immunity, but the preprint above suggests immunity could be reasonably long-lived.

 

 

[clutch]

Even if it becomes endemic, things will return to normal. Both the transmission rate and fatality rate will continue to lower (with vaccine and better treatment), making this another type of the common flu. Not to mention, we will reach some form of herd immunity -- as it did with (and ended) the Spanish flu. We haven't changed much of our behaviors because of the flu.

 

How is the transmission rate, that is, R0, going to go down for mutations of Covid-19 coronavirus with vaccine and better treatment. 

 

Flu has an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average.

Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Do we know of other ways of lowering R0 for Covid-19 strains other than behavior change?  We cannot say with 100% certainty that herd immunity will continue to provide immunity for mutated strains of Covid-19.  We do know that herd immunity does not provide immunity for mutated strains of flu coronaviruses.

 

Vaccines. The transmission rate will go lower if more people are immune to it. Isn't that obvious?

 

If the virus mutates and presents a serious threat again, I'm sure that we will develop another vaccine that works.

 

Hence, my question at the start of the thread, i.e. what is the probability that we would need a vaccine every year?  So, you agree that the probability of that is non-zero?

 

Yes, but it won't change our behaviors to the point that the industries you pointed out will significantly change.

 

We get flu vaccines every year.

[LearningMachine]

Even if it becomes endemic, things will return to normal. Both the transmission rate and fatality rate will continue to lower (with vaccine and better treatment), making this another type of the common flu. Not to mention, we will reach some form of herd immunity -- as it did with (and ended) the Spanish flu. We haven't changed much of our behaviors because of the flu.

 

How is the transmission rate, that is, R0, going to go down for mutations of Covid-19 coronavirus with vaccine and better treatment. 

 

Flu has an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average.

Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Do we know of other ways of lowering R0 for Covid-19 strains other than behavior change?  We cannot say with 100% certainty that herd immunity will continue to provide immunity for mutated strains of Covid-19.  We do know that herd immunity does not provide immunity for mutated strains of flu coronaviruses.

 

Vaccines. The transmission rate will go lower if more people are immune to it. Isn't that obvious?

 

If the virus mutates and presents a serious threat again, I'm sure that we will develop another vaccine that works.

 

Hence, my question at the start of the thread, i.e. what is the probability that we would need a vaccine every year?  So, you agree that the probability of that is non-zero?

 

Yes, but it won't change our behaviors to the point that the industries you pointed out will significantly change.

 

We get flu vaccines every year.

 

Thanks clutch, it is a very fair point that we get flu vaccines every year, and don't worry about flu that much while going on about our lives.

 

Let's also assume that we will eventually be able to treat covid-19 without requiring hospitalization for a big percentage of people.

 

One difference that will likely stay is that Flu coronaviruses have an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average, while Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Where that difference might play out is in some people's behavior while they are waiting to get the vaccine for new strains.  With flu coronavirus strains, because the transmitability is lower, we don't worry too much about the risk and go about our usual behaviors.  With Covid-19 coronavirus strains, because of higher risk of catching it, our behaviors might be somewhat more constrained than with flu while waiting for vaccine for new strains of the year.

 

Look at some of our behaviors currently while we are waiting for the Covid-19 vaccine.  I agree with you once treatment without hospitalization is possible for a big percentage of people, we probably won't restrict our behaviors as much as now while waiting for vaccine for new Covid-19 strains, but we might not relax our behaviors all the way to how we act while waiting for flu vaccines because of increased transmitability with Covid-19 coronavirus strains.

 

If the probability of Covid-19 coronaviruses becoming endemic like flu coronaviruses materializes, there will probably be some effect on our behaviors longer term, which will probably have some impact to whether 100% of people will go back to working from office 100% of the time.

[LearningMachine]

Which one of the below are you saying?

• (a) 100% certainty that Covid-19 coronavirus will not mutate, unlike the flu coronaviruses, or
  
• (b) 100% certainty that the same vaccine we get once for Covid-19 coronavirus will be able to provide immunity against all mutations of Covid-19 coronavirus, unlike the vaccine for flu coronaviruses.
  

 

https://www.biorxiv.org/content/10.1101/2020.11.15.383323v1

 

100% certainty that Covid-19 will mutate but at a much slower rate than influenza viruses (we should be grateful this isn't "just the flu").

 

To simplify, let's assume the rate of mutation is related to mutations during the following:

1. Replications within a host (human or animal)

2. Jumping between hosts

3. Jumping between species

 

This suggests that rate of mutation will be highest at the peak of the pandemic when the virus is replicating rapidly in people and jumping rapidly between hosts. We've had perhaps trillions of replications, yet vaccines are showing 90% efficiency. This shows that the virus is not mutating rapidly (which is also shown in genetic tracing).

 

You could foresee some random mutation that allows Covid-19 to evade the vaccine, but the probability is related to the number of mutations. So the likelihood of a dangerous mutation occurring after June 2021 is much lower than one occurring in 2020.

 

Edit to add: So that suggests you won't need a yearly vaccine solely due to mutations. You might still need one for waning immunity, but the preprint above suggests immunity could be reasonably long-lived.

 

Thanks KCLarkin, this is helpful. 

 

Based on this, looks like probability of Covid-19 coronaviruses becoming an endemic is much lower than flu coronaviruses.

[clutch]

Thanks clutch, it is a very fair point that we get flu vaccines every year, and don't worry about flu that much while going on about our lives.

 

Let's also assume that we will eventually be able to treat covid-19 without requiring hospitalization for a big percentage of people.

 

One difference that will likely stay is that Flu coronaviruses have an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average, while Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Where that difference might play out is in some people's behavior while they are waiting to get the vaccine for new strains.  With flu coronavirus strains, because the transmitability is lower, we don't worry too much about the risk and go about our usual behaviors.  With Covid-19 coronavirus strains, because of higher risk of catching it, our behaviors might be somewhat more constrained than with flu while waiting for vaccine for new strains of the year.

 

Look at some of our behaviors currently while we are waiting for the Covid-19 vaccine.  I agree with you once treatment without hospitalization is possible for a big percentage of people, we probably won't restrict our behaviors as much as now while waiting for vaccine for new Covid-19 strains, but we might not relax our behaviors all the way to how we act while waiting for flu vaccines because of increased transmitability with Covid-19 coronavirus strains.

 

If the probability of Covid-19 coronaviruses becoming endemic like flu coronaviruses materializes, there will probably be some effect on our behaviors longer term, which will probably have some impact to whether 100% of people will go back to working from office 100% of the time.

 

I can understand your point of view better now. I do think working from home more (not 100%, but >0%) will be permanent now. Besides preventing the spread of diseases, there are many benefits that people have now recognized and will convince the companies to allow people to work from home more. I'm invested in a number of enterprise software/digitization companies for this reason.

 

Regarding the transmission rate, I think that R0 for the typical flu is much lower because the larger portion of the population has already built immunity and some of them are vaccinated. If the same virus was novel like Covid-19, I'm pretty sure the R0 would be higher, although not high as Covid-19.

[LearningMachine]

Thanks clutch, it is a very fair point that we get flu vaccines every year, and don't worry about flu that much while going on about our lives.

 

Let's also assume that we will eventually be able to treat covid-19 without requiring hospitalization for a big percentage of people.

 

One difference that will likely stay is that Flu coronaviruses have an R0 of about 1.3, i.e. one person can spread it to 1.3 people on average, while Covid-19 coronavirus strains have an R0 as high as 5 or higher.

 

Where that difference might play out is in some people's behavior while they are waiting to get the vaccine for new strains.  With flu coronavirus strains, because the transmitability is lower, we don't worry too much about the risk and go about our usual behaviors.  With Covid-19 coronavirus strains, because of higher risk of catching it, our behaviors might be somewhat more constrained than with flu while waiting for vaccine for new strains of the year.

 

Look at some of our behaviors currently while we are waiting for the Covid-19 vaccine.  I agree with you once treatment without hospitalization is possible for a big percentage of people, we probably won't restrict our behaviors as much as now while waiting for vaccine for new Covid-19 strains, but we might not relax our behaviors all the way to how we act while waiting for flu vaccines because of increased transmitability with Covid-19 coronavirus strains.

 

If the probability of Covid-19 coronaviruses becoming endemic like flu coronaviruses materializes, there will probably be some effect on our behaviors longer term, which will probably have some impact to whether 100% of people will go back to working from office 100% of the time.

 

I can understand your point of view better now. I do think working from home more (not 100%, but >0%) will be permanent now. Besides preventing the spread of diseases, there are many benefits that people have now recognized and will convince the companies to allow people to work from home more. I'm invested in a number of enterprise software/digitization companies for this reason.

 

Regarding the transmission rate, I think that R0 for the typical flu is much lower because the larger portion of the population has already built immunity and some of them are vaccinated. If the same virus was novel like Covid-19, I'm pretty sure the R0 would be higher, although not high as Covid-19.

 

My understanding is that Covid-19 coronavirus strains are more contagious than flu coronavirus strains because former survive outside the host longer than latter. 

[samwise]

Passing on from a health expert.

 

“95% efficacy is the stuff of dreams, where you dream about eradication of the disease rather than just containment. E.g. MMR vaccines are 97% efficacy against measles, and the disease hardly exists anymore. And that’s when measles has R0 of over 15. “

 

So depending on how long immunity lasts and how fast the virus mutates, it might not become endemic.

[Cigarbutt]

Passing on from a health expert.

“95% efficacy is the stuff of dreams, where you dream about eradication of the disease rather than just containment. E.g. MMR vaccines are 97% efficacy against measles, and the disease hardly exists anymore. And that’s when measles has R0 of over 15. “

So depending on how long immunity lasts and how fast the virus mutates, it might not become endemic.

The following is submitted for analytical purposes and may have investment implications but political aspects have been sterilized, to the extent possible.

 

FWIW, I think Covid-19 is likely to become endemic, within a year or two, but it will likely be an immaterial kind of endemicity. Below are the key factors considered as well as references used.

 

-Availability of effective vaccines (% and strength of response, duration of protection)

This looks promising but longer term duration is still unknown. How many in the population (at-risk and as potential spreaders) will take them is a limiting factor if vaccination rates don’t reach certain levels. Also, it’s still unclear if older and at-risk cohorts will be able to build and maintain sufficient immunity levels (available, on demand for antibodies or from “memory” cells). The typical FDA agreement includes to complete follow-up studies for safety and efficacy for at least two years.

 

-Virus characteristics

Many respiratory viruses are endemic, including the four well known common cold (beta family) coronaviruses. Longer term studies point to a very real risk of endemicity. More virulent CVs (SARS and MERS) seem to be associated with longer and more robust immunity. Covid-19 is kind of hybrid so common sense would indicate that endemicity risk is real.

CVs tend to mutate less than influenza for instance (because of a very unusual and fascinating proof-reading mechanism during replication and specific to this class of RNA viruses) but this is both good and bad. The good part indicates that covid-19 will tend to be slow to genetically escape existing immunity but the bad part indicates that when a new genomic form with new characteristics is reached, this stable form may bear less favorable characteristics for the host (including for immunity) and may persist longer.

Whatever residual immunity (natural or vaccine-related), reinfections are likely to be less severe which opens the eventual possibility of eradication to the same degree that it opens the door to low grade endemicity.

 

-Population and environmental characteristics

With the virus impact becoming less significant and with less public awareness or media attention, non-pharmacological measures will tend to be abandoned, not enough to cause major and widespread outbreaks over time but enough to allow endemicity in many populations. The virus has become truly global and the world has grown smaller.

Seasonal and various environmental factors (for most areas of the world) may become a feature for Covid-19, following what other common cold coronaviruses have become over time.

-----

So, on a weighted basis, it’s likely that Covid-19 reservoirs will persist over time but are unlikely to trigger material events on a global basis.

 

For references, I was lucky to be able to listen to a very strong presentation 8 days ago by various ‘experts’. One of the presentations dealt specifically with immunity, reinfection risks and vaccinations. She covered, in a few minutes, most of the relevant research, some of which is mentioned in the CDC link found below (pages 12-22 for post infection immunity, pages 23-32 for reinfection risk). The study mentioned on page 28 is somewhat interesting (design, implications, despite limitations). Also found below is a link to a site monitoring progress on the vaccine front. The amount of human capital involved is mind boggling. The people involved have obvious financial incentives but there is an unusual amount of drive, especially in smaller operations.

https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-10/COVID-Wallace.pdf

https://covid19.trackvaccines.org/vaccines/

[LearningMachine]

Passing on from a health expert.

“95% efficacy is the stuff of dreams, where you dream about eradication of the disease rather than just containment. E.g. MMR vaccines are 97% efficacy against measles, and the disease hardly exists anymore. And that’s when measles has R0 of over 15. “

So depending on how long immunity lasts and how fast the virus mutates, it might not become endemic.

The following is submitted for analytical purposes and may have investment implications but political aspects have been sterilized, to the extent possible.

 

FWIW, I think Covid-19 is likely to become endemic, within a year or two, but it will likely be an immaterial kind of endemicity. Below are the key factors considered as well as references used.

 

-Availability of effective vaccines (% and strength of response, duration of protection)

This looks promising but longer term duration is still unknown. How many in the population (at-risk and as potential spreaders) will take them is a limiting factor if vaccination rates don’t reach certain levels. Also, it’s still unclear if older and at-risk cohorts will be able to build and maintain sufficient immunity levels (available, on demand for antibodies or from “memory” cells). The typical FDA agreement includes to complete follow-up studies for safety and efficacy for at least two years.

 

-Virus characteristics

Many respiratory viruses are endemic, including the four well known common cold (beta family) coronaviruses. Longer term studies point to a very real risk of endemicity. More virulent CVs (SARS and MERS) seem to be associated with longer and more robust immunity. Covid-19 is kind of hybrid so common sense would indicate that endemicity risk is real.

CVs tend to mutate less than influenza for instance (because of a very unusual and fascinating proof-reading mechanism during replication and specific to this class of RNA viruses) but this is both good and bad. The good part indicates that covid-19 will tend to be slow to genetically escape existing immunity but the bad part indicates that when a new genomic form with new characteristics is reached, this stable form may bear less favorable characteristics for the host (including for immunity) and may persist longer.

Whatever residual immunity (natural or vaccine-related), reinfections are likely to be less severe which opens the eventual possibility of eradication to the same degree that it opens the door to low grade endemicity.

 

-Population and environmental characteristics

With the virus impact becoming less significant and with less public awareness or media attention, non-pharmacological measures will tend to be abandoned, not enough to cause major and widespread outbreaks over time but enough to allow endemicity in many populations. The virus has become truly global and the world has grown smaller.

Seasonal and various environmental factors (for most areas of the world) may become a feature for Covid-19, following what other common cold coronaviruses have become over time.

-----

So, on a weighted basis, it’s likely that Covid-19 reservoirs will persist over time but are unlikely to trigger material events on a global basis.

 

For references, I was lucky to be able to listen to a very strong presentation 8 days ago by various ‘experts’. One of the presentations dealt specifically with immunity, reinfection risks and vaccinations. She covered, in a few minutes, most of the relevant research, some of which is mentioned in the CDC link found below (pages 12-22 for post infection immunity, pages 23-32 for reinfection risk). The study mentioned on page 28 is somewhat interesting (design, implications, despite limitations). Also found below is a link to a site monitoring progress on the vaccine front. The amount of human capital involved is mind boggling. The people involved have obvious financial incentives but there is an unusual amount of drive, especially in smaller operations.

https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-10/COVID-Wallace.pdf

https://covid19.trackvaccines.org/vaccines/

 

Thanks Cigarbutt, this is super-helpful.  If the covid-19 reservoirs persist over time, even if it doesn't cause a material event on a global basis, would it impact behavior of some percentage of the population, e.g. not travel as much as they did pre-covid, not go to places with lots of people as much, etc.?

 

Maybe the behavior change will depend on the perceived probability of risk, and how readily available are the alternatives to taking risk, i.e. working from home, ordering everything online, etc.?  If the perceived risk is as high as it was (1) getting on 737 Max right after two crashes, maybe some would pick an alternative if available but if it as low as (2) driving a car, maybe people will accept.  Wondering where on the spectrum between #1 and #2, we'll end up landing.  The point on spectrum will probably change over time as well depending on how many covid-19 infections we hear about over time.

[Cigarbutt]

...

If the covid-19 reservoirs persist over time, even if it doesn't cause a material event on a global basis, would it impact behavior of some percentage of the population, e.g. not travel as much as they did pre-covid, not go to places with lots of people as much, etc.?

Maybe the behavior change will depend on the perceived probability of risk, and how readily available are the alternatives to taking risk, i.e. working from home, ordering everything online, etc.?  If the perceived risk is as high as it was (1) getting on 737 Max right after two crashes, maybe some would pick an alternative if available but if it as low as (2) driving a car, maybe people will accept.  Wondering where on the spectrum between #1 and #2, we'll end up landing.  The point on spectrum will probably change over time as well depending on how many covid-19 infections we hear about over time.

Interesting but difficult to handicap. Who knows what will happen but it's likely that our future will mostly look like before with the exception of changes in relation to a relative acceleration of previous trends, with some areas more ripe than others. i would say business travel and higher education are good candidates.

An interesting concept for the thought process is hysteresis (there are www opinions circulating now linking hysteresis with Covid-19). Hysteresis is used in many fields and i think it originated in pure physics but is also applied in 'softer' sciences, including finance. It has to do with an effect that persists after a temporary force or shock happens. Lingering effects of the virus will persist depending on the variables you mention but what will determine the outcomes is basically strongly tied to the condition of the host before. The hysteresis concept is also applicable for people who got sick (and getting sick) with Covid in relation to imaging changes seen in lung tissue. For Covid-19, it has been described (like just many cases of pneumonias) that patients who started to respond (mostly through their own intrinsic forces, supported by extrinsic measures) were showing deteriorating lung tissue anomalies on imaging, with a delay of a few days or even 2 to3 weeks before images started to improve, when the person actually felt fine and was often discharged. i think that's what Mr. Buffett said when he fundamentally discussed the risks related to waiting for a cheery consensus.

[LearningMachine]

Now that the probability of a (1) new strain that is more contagious than the (0) original strain has materialized, what do those who know more think is the probability that we'll have (2) another strain for which the current vaccines won't help develop immunity?

 

I understand the current belief is that the current vaccines will help develop immunity for #1.  I'm curious what folks think about probability of #2.

[LearningMachine]

The Rockefeller researchers got blood samples from 20 people who had received either the Moderna or Pfizer vaccine and tested their antibodies against various virus mutations in the lab.

 

With some [mutations], the antibodies didn’t work as well against the virus — activity was one-to-threefold less, depending on the mutation, said the study leader, Rockefeller’s Dr. Michel Nussenzweig.

 

Source:https://www.marketwatch.com/story/some-covid-19-variants-may-reduce-effectiveness-of-vaccines-01611184451?mod=home-page#

 

[Cigarbutt]

The Rockefeller researchers got blood samples from 20 people who had received either the Moderna or Pfizer vaccine and tested their antibodies against various virus mutations in the lab.

With some [mutations], the antibodies didn’t work as well against the virus — activity was one-to-threefold less, depending on the mutation, said the study leader, Rockefeller’s Dr. Michel Nussenzweig.

Source:https://www.marketwatch.com/story/some-covid-19-variants-may-reduce-effectiveness-of-vaccines-01611184451?mod=home-page#

The Rockefeller 'scientists' produce solid work but the sample is small. In short, this is something that needs to be monitored for non-linear changes (unlikely) and, even with some delay, vaccine makers are equipped with relevant experience to modify vaccines accordingly.

Taking a wider perspective, this 'new' (entering an immunologically naive population) virus (and minor variants) is having an unprecedented opportunity to circulate (and to mutate). What is surprising (and comforting) is actually the relatively low amount of genetic drift (compared to other viruses). This Covid-19 thing suffers (at least so far) from a lack of genetic diversity and this is another factor that supports the hypothesis that it will become a relatively low-grade endemic problem (and likely less of an issue than the flu over time). The following discussed that aspect:

https://www.pnas.org/content/pnas/early/2020/09/18/2017726117.full.pdf

Figure 1 is worth a thousand words.

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This post is pretty useless for an investment board. So let's use an analogy. This virus will run into difficulty (spreading and causing harm) the same way a company that has introduced a popular product maintains an echo-chamber type Board of Directors with little capacity to adapt.

[maplevalue]

On the topic of mutations/endemicness, it seems one rarely hears about mutations leading the virus to become more deadly (i.e. right now it seems like the UK variant is just more contagious). Is there a natural tendency, or a medical term for, these viruses to become more contagious/less deadly as time goes on (from an evolutionary perspective this would seem to make sense)?

[Cigarbutt]

On the topic of mutations/endemicness, it seems one rarely hears about mutations leading the virus to become more deadly (i.e. right now it seems like the UK variant is just more contagious). Is there a natural tendency, or a medical term for, these viruses to become more contagious/less deadly as time goes on (from an evolutionary perspective this would seem to make sense)?

Interesting question. A controversial one though as the origin of viruses is, itself, a very controversial topic. Viruses like coronaviruses mutate less than the typical viruses but it still provides an accelerated version compared to DNA organisms. Because of frequent replications, it's probably best (evolutionary standpoint, to 'survive') to keep a dense set of genetic information and to have genes involved simultaneously in multiple characteristics. The result is that mutations are very likely to be deleterious (the new variant disappears rapidly). Typically in viruses, it's very rare that the contagiousness or virulence do change significantly during a spread. Covid-19 is unusual because of the law of large numbers. Still, the significance of the vast majority of mutations is only to be able to track origins (signature of the virus). Everything is possible but the vast majority of isolated mutations are unlikely to change virulence (many genes involved) and unlikely to rapidly introduce significant changes in contagiousness (it seems there are some variants of that nature out there for Covid-19 because of the global spread and incredible number of replications). i would say this is just good or bad luck on very low odds and not from an evolutionary plan that would take longer to accomplish. From a purely evolutionary perspective, the best scenario would be to increase contagiousness and to decrease virulence but, because of the factors mentioned above and because of the ongoing process to quasi-herd immunity, this is unlikely to play out significantly.

The large six-sigma squared event was when a mutation (or lab event?) opened the possibility to jump species. This is an area where humans can have an impact (positive or negative). i would offer the opinion that, at this point, the likelihood of a more virulent virus is higher from a new event at the source than as a result of an evolutionary process of Covid-19. In his book La Peste, Camus said it well (just like bear markets): "Everyone knows that pestilences have a way of recurring in the world; yet somehow we find it hard to believe in ones that crash down on our heads from a blue sky."

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This post is quite useless for an investment board. So, here's an investment-related analogy for the virus mutation question. In 1998, Larry Page and Sergey Brin started to work in a small garage and developed a product that spread and gained market share. Let's say you switch one of the two co-founders for any member of this board, or even most other citizens in the world, you may end end with a more contagious product or a more virulent competitor but it would be highly unlikely. The initial mutation was the key one. i hope that makes some sense.

[writser]

On the topic of mutations/endemicness, it seems one rarely hears about mutations leading the virus to become more deadly (i.e. right now it seems like the UK variant is just more contagious). Is there a natural tendency, or a medical term for, these viruses to become more contagious/less deadly as time goes on (from an evolutionary perspective this would seem to make sense)?

 

There was an interesting article in the Economist recently touching on that subject: https://www.economist.com/science-and-technology/2021/01/02/sars-cov-2-is-following-the-evolutionary-rule-book .

 

So far, the evidence suggests that despite their extra transmissibility, neither new variant is more dangerous on a case-by-case basis than existing versions of the virus. In this, both are travelling the path predicted by evolutionary biologists to lead to long-term success for a new pathogen—which is to become more contagious (which increases the chance of onward transmission) rather than more deadly (which reduces it).

 

I am unfortunately not an evolutionary biologist but that makes sense to me. There is no evolutionary advantage in a virus becoming more deadly. In fact it is probably a disadvantage, both because dead people cannot spread a virus effectively and because society would go in lockdown XXXXL if a new mutation is ten times as deadly.

 

I guess that doesn't make it impossible in the short term though.