“I worry that recently I’ve lacked sufficient skin in the game. Everyone I personally care about is vaccinated or young enough that they don’t need vaccination, so the real sense of danger is largely gone.”
[Quotes because editing after using “>” for quotes is totally broken here.]
The strategies being employed at the moment in countries partially but not sufficiently vaccinated are to a close approximation the optimum for evolving viruses that are more transmissible to vaccinated people. We have a huge number of infected and a huge number vaccinated in the same population thus the maximal evolutionary pressure and opportunity.
So it is somewhat likely—hard to tell how likely—that variants that are resistant to the vaccines will appear.
When a disease is only slowly transmissible there is an evolutionary incentive for it to become less ( and less quickly) fatal. However diseases that are easily transmitted have far less incentive to become less quickly fatal e.g. cholera in some parts of the world.
My conclusion is that given the risk that a more transmissible, more vaccine resistant and more deadly variant will appear, everyone has skin in the game.
Not to mention the “long covid” syndrome which is very nasty and fairly prevalent in young people. And that we really have little idea of the long term consequences of non-fatal infections in young people.
I remember when Chicken Pox was considered a mild and harmless illness. Tell that to people who have suffered years of excruciating pain from shingles as a result of Chicken Pox later in life.
I tried estimating the chance that a new variant would arise in the UK in the next couple of months:
I think the risk of a new superbad variant arising in the UK is 6%. We’ve seen two game-changing variants so far (Alpha and Delta) out of roughly a billion Covid cases (extremely crude estimate). The UK will have roughly 10 million cases in the coming three months (extremely crude estimate). That would be 1% of the total so far, so a 2% prior for a new game-changing variant (since this happened twice already). Conditions for evolving vaccine evasion have never been better, which adds at least a factor 2, I would think. It’s more in expectation, so maybe 3.5. (Also, the Alpha variant happened in the UK, so maybe conditions are particularly favorable for virus evolution here for reasons I don’t understand.) OTOH, I may be ignoring that the virus has run out of low-hanging mutations. Overall, I’m going with a 6% chance.
Note that I don’t necessarily predict a new variant to be more deadly by itself. (But it would be more deadly given better resistance to vaccines.)
It’s indeed scary that the same experiment will be run across many countries, so in absolute terms, the odds are much larger than what’s correct for the UK for the next couple of months.
But the risks per country are heavily correlated (are there low-hanging mutations that increase transmissibility?), and overall I’m not sure I’d go above 40% for a new superbad variant in 2021. I think this is partly also influenced by having read some experts express a lot of confidence that the antibodies to the spike protein, especially from the Pfizer and Moderna vaccines, are fairly hard to circumnavigate when you’re the virus, because probably all Covid viruses need some kind of similar-looking spike protein. Even so, you could get a variant where infection is reduced by 50-70% after two shots of Pfizer, instead of the 15-30% we see currently. That would basically guarantee that nearly everyone gets exposed to long Covid risks of having to go through one illness.
Honestly I think it’s quite the opposite. There is no particular reason that lineages that escape immune reactions would be more likely to be driven into existence in a population largely vaccinated or largely infected, and you don’t talk about this in the context of people who have been naturally infected.
We are pulling the inevitable, the time that everyone has immune memory, closer in time to the present and ensuring that we get there with fewer rounds of viral replication in the mean time.
“I worry that recently I’ve lacked sufficient skin in the game. Everyone I personally care about is vaccinated or young enough that they don’t need vaccination, so the real sense of danger is largely gone.”
[Quotes because editing after using “>” for quotes is totally broken here.]
The strategies being employed at the moment in countries partially but not sufficiently vaccinated are to a close approximation the optimum for evolving viruses that are more transmissible to vaccinated people. We have a huge number of infected and a huge number vaccinated in the same population thus the maximal evolutionary pressure and opportunity.
So it is somewhat likely—hard to tell how likely—that variants that are resistant to the vaccines will appear.
When a disease is only slowly transmissible there is an evolutionary incentive for it to become less ( and less quickly) fatal. However diseases that are easily transmitted have far less incentive to become less quickly fatal e.g. cholera in some parts of the world.
My conclusion is that given the risk that a more transmissible, more vaccine resistant and more deadly variant will appear, everyone has skin in the game.
Not to mention the “long covid” syndrome which is very nasty and fairly prevalent in young people. And that we really have little idea of the long term consequences of non-fatal infections in young people.
I remember when Chicken Pox was considered a mild and harmless illness. Tell that to people who have suffered years of excruciating pain from shingles as a result of Chicken Pox later in life.
I tried estimating the chance that a new variant would arise in the UK in the next couple of months:
Note that I don’t necessarily predict a new variant to be more deadly by itself. (But it would be more deadly given better resistance to vaccines.)
It’s indeed scary that the same experiment will be run across many countries, so in absolute terms, the odds are much larger than what’s correct for the UK for the next couple of months.
But the risks per country are heavily correlated (are there low-hanging mutations that increase transmissibility?), and overall I’m not sure I’d go above 40% for a new superbad variant in 2021. I think this is partly also influenced by having read some experts express a lot of confidence that the antibodies to the spike protein, especially from the Pfizer and Moderna vaccines, are fairly hard to circumnavigate when you’re the virus, because probably all Covid viruses need some kind of similar-looking spike protein. Even so, you could get a variant where infection is reduced by 50-70% after two shots of Pfizer, instead of the 15-30% we see currently. That would basically guarantee that nearly everyone gets exposed to long Covid risks of having to go through one illness.
Honestly I think it’s quite the opposite. There is no particular reason that lineages that escape immune reactions would be more likely to be driven into existence in a population largely vaccinated or largely infected, and you don’t talk about this in the context of people who have been naturally infected.
We are pulling the inevitable, the time that everyone has immune memory, closer in time to the present and ensuring that we get there with fewer rounds of viral replication in the mean time.