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Society Will Never Be Free of Covid-19–It’s Time to Embrace Harm Reduction (cato.org)
39 points by hncurious on Aug 31, 2021 | hide | past | favorite | 35 comments


I sincerely think Covid is now just being used to decrease carbon emissions by having everyone work from home or at least not exit houses as much due to mass hysteria of "yet another variant". Viruses of all kinds will keep trying to kill us regardless if we call it the flu or covid, if we keep everyone scared to exit their houses they will invariably use less resources from the world.

So yeah, a world free of covid isn't on anyone's best interest.


A limited set of knowledge workers are working at home, not 'everyone'.


Arguably it's in the interests of the people dying, and getting crippled by long covid.


> a world free of covid isn't on anyone's best interest

LOL!


I'm sick of these "Covid will not be eradicated" doom and gloom articles; it seems they are always peddling politics or a poorly disguised anti-vaxx messaging.

> The only human virus ever to be eradicated was smallpox, and that took 200 years

Bullshit; it would not take 200 years with our current level of technology and understanding.

Smallpox was declared by the WHO to be eradicated in 1980. The last naturally occurring case was in 1977.

https://en.wikipedia.org/wiki/Smallpox_vaccine

"The smallpox vaccine was the first vaccine to be developed against a contagious disease. In 1796, the British doctor Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox virus. Cowpox served as a natural vaccine until the modern smallpox vaccine emerged in the 20th century. From 1958 to 1977, the World Health Organization conducted a global vaccination campaign that eradicated smallpox, making it the only human disease to be eradicated."

Really, if we honestly look at it, the actual eradication of smallpox took only 20 years. The 1796-195x years were just hobbling along with poor vaccines and half-assed effort.

Also, most of the focused effort was only the last 10 years of that.

"Smallpox was eradicated by a massive international search for outbreaks, backed up with a vaccination program, starting in 1967. It was organised and co-ordinated by a World Health Organization (WHO) unit, set up and headed by Donald Henderson. The last case in the Americas occurred in 1971 (Brazil), south-east Asia (Indonesia) in 1972, and on the Indian subcontinent in 1975 (Bangladesh). After two years of intensive searches, what proved to be the last endemic case anywhere in the world occurred in Somalia, in October 1977."

So, there is support in taking the viewpoint that when the effort was properly stepped up, it was licked in ten years.


I agree "never" is too gloom and doom, but otherwise it's a realistic point of view. Covid is endemic and we should start treating it as such.

Acting as though we're going to eradicate it any day now is nonsensical. We'd need a global solution, a solution to animal reservoirs and a vaccine that isn't leaky. If and when we have a solution, then we should implement it. In the meantime, let's face it: It's endemic and it's time to go back to normal. Everyone, in the US at least, can get the vaccine if they want to reduce their risk.


Were there animal and insect reservoirs for smallpox? How quickly did it mutate relative to SARS-CoV-2? Were the vaccines developed for it sterilizing vaccines, or did they allow vaccinated people to continue getting infected in large numbers?


No, there were not animal reserves for smallpox. And that makes a huge difference. There are a lot of mammals that can host coronaviruses. We'd have to eliminate it from those animals, also. Things like bats, civits, minks, etc. This is not likely to happen, given the difficulty of inoculating animals.


Smallpox ONLY infected humans. COVID and other coronaviruses infecting dozens of animals.

And genetically they are as different as a worm is to a human.


What you say isn't factual. the article compares smallpox with covid, which is a mistake. But the virus is endemic and will be. There is no chance of herd immunity. Not with the flu, not with the cold and not with this. That is the current reality. Perhaps we will some day have the means, but until then, we have to let people live again.


If you know ANYTHING about coronaviruses, you know COVID will never be eradicated. There has NEVER been an effective vaccine against any coronavirus.

And the current vaccines have NOT CHANGED THAT FACT.

The nature of coronavirus pretty much assures no vaccine can ever be possibel due to how they mutate.

Being Pollyanna about technology and vaccines will NEVER change biology and reality as we understand it in STEM!


The way to address it is to treat public health as a national security issue. This is actually what happened here in the UK after WW1 and pushed forward hard after WW2 with the establishment of the NHS.

In WW1 the UK armed forces were shocked at the low levels of health and nutrition in recruits, such that large numbers were unfit to serve. This also affected labour available for strategic industries like arms and munitions. This is why the establishment of robust public health systems and a public primary care system were not controversial here and mostly still aren't. I say this as a lifelong conservative voter. This isn't about socialism. We're not a huge nation and we needed a healthy capable population.

We're waging a global war on this virus, whether we like it or not. What we need is co-ordinated and effective action on a global scale to combat it. The virus itself, and the delta variant has showed that what happens in one country is of vital interest to the rest of the world, we're all in this together. However the first step to effective international action is for the nations with the resources to act globally to put their own houses in order first. Here in Britain this is what we've done, with a few missteps and misjudgements along the way, but we're finally on top of this thing.

Vaccination, vaccination, vaccination. All the other tools we have - lockdowns, mitigating treatments, masks, they're all useful tools in their place, but the Vaccine research efforts were our Manhattan project. The vaccines are the wonder weapons. They're the path to getting on top of this thing.

We're in this for the long haul. New variants will arise that are more infection, more deadly, vaccine resistant, or all three. We need to be ready for them. This is the real deal, it's a proper global war with a massive global body count, and we need to stop bickering about it and get organised.


We really don't know if/how the virus will mutate.

Especially in the sense of how a given set of mutations will impact transmissibility, virulence and vaccine effectiveness.


Technically true, we can't predict when or if specific mutations will or won't occur. We do know this virus has in fact already mutated significantly on two of these axes though (virulence and vaccine resistance), as variants have emerged that vary in some degree in those ways, and it seems somewhat optimistic to think it won't continue to do so.

Fortunately it's not mutated too much in terms of vaccine resistance. Delta seems significantly more resistant to single doses than Alpha but a second dose so far does the job. We've only recently exposed the virus to large numbers of vaccinated people though, so there's not been much time for resistant variants to gain an advantage.


"Wars on X" have NEVER worked except in elementary symmetric warfare (where both sides where well visible uniforms and do not practice any stealth techniques).

The "War on Drugs", "War on Poverty", "War on Terrorism", "War on Alcohol" (Prohibition) all are 100% failures.


> public health officials should be telling individuals some basic things that they can do to really reduce harm: people with symptoms of a respiratory infection, vaccinated or unvaccinated, should stay the hell away. They shouldn’t visit vulnerable friends or relatives. They should cancel social plans. They should call in sick for work. They should get tested and stay home until recovered. Employers should insist that sick employees stay home.

Not only telling people. We should work to enable this. Missing a week of work can be expensive and many are broke. There is a perverse incentive here. I'm not sure the best way to address it.


The data also indicate that it's likely that: 1. Reducing weight to a healthy level 2. Getting enough vitamin D are very likely to contribute to better outcomes for the disease, and we've known this for quite some time. Not only have I not seen any public health messaging around this, but the policies that have been in place have trended towards reducing the sorts of activities that would result in better outcomes based on these factors.


Problem is that, with COVID, you can be completely asymptomatic and yet still highly infectious. If the problem was as simple as telling all the sick people they had to stay home, that would be easy.


In the US, employers are legally permitted to mandate vaccinations. Countries can mandate them for border crossings (air, sea, and land). Mandate them. Those who opt out (without legitimate medical reason) are the ones who can face the costs of their choice, instead of society collectively carrying the burden.

Like Cato says, "embrace harm reduction."


Sure, as long as we also ban fast food, tobacco, alcohol, and raise the minimum standard for food at the grocery store to USDA Organic. I'm tired of carrying these unhealthy peoples' burdens. Might as well target the actual big causes of death, like heart, lung, and liver disease.


No, we don’t have to do those at the same time as a public health crisis, and ICU beds are not overflowing due to the maladies you enumerated. They are overflowing because of the unvaccinated.


>They are overflowing because of the unvaccinated.

Source for this claim? Asking because I see stats being thrown around constantly: unvaccinated are 97% of ICU patients, etc. The only problem is, there's no data to back it up.

I've followed sources to the very end to try and locate this data but it doesn't exist. Most lazily point at the CDC but even they openly admit the data isn't reliable because they aren't tracking breakthrough cases correctly.

Maybe your source is legit.


Associated Press did an analysis of the data. The CDC won't give numbers because the figures we have are patchy, good for some states and poor or non existent from others, so they can't calculate population wide figures. The AP just looked at the most comprehensive figures we have for those areas that do have strong reporting.

https://apnews.com/article/coronavirus-pandemic-health-941fc...

This is also consistent with figures from the UK that keeps much more comprehensive and consistent records, because it has a unified national health infrastructure, as well as much higher vaccination rates.


The data for vaccination status of people that are hospitalized should not be impacted by the way people that are not hospitalized are tracked...the proportion of vaccinated people in the ICU is independent from the overall number of breakthrough infections (because their vaccination status can be recorded by the hospital directly).


Most of the unvaccinated in the ICU are either overweight, have preexisting conditions, or are old. I don't see any reason not to attack other root causes to clear out the ICUs while we are at it, right?


Long term health should absolutely be prioritized. However, given resources are limited (especially people's attention span), we should prioritize the highest impact, lowest cost opportunities to return back to our previous normal.

It's easier to move the needle with vaccinations and masks, compared to obesity and smoking - both of which have been in the crosshairs of public health officials for decades. They're just harder to move in the short term.


Well, actually, you can safely lose 2 lbs per week of body weight. The pandemic has been going on long enough that that works out to 150 lbs for someone who started slowly losing weight as soon as the pandemic began (the obesity connection was obvious and well publicized early on)

Almost all obese people are less than 150 lbs overweight. So yeah, at both an individual and societal level, we should have responded (and should respond today) by treating obesity as a public health emergency (or at an individual level a personal medical emergency) similar to early stage cancer, severe hypertension, or serious nutrient deficiency, etc.

The medical evidence even before covid was clear: obesity kills.

I'm going to cross over into controversial territory when I say that in the total absence of modern processed foods and modern sedentism, becoming or staying obese is difficult for most people. (If this were not true, how to explain that obesity was and is rare in places with neither of the above? Why do my size L clothes get labelled as size XL in France and Asia? Why do obesity levels keep rising in America as sedentism and processed food keep marching on? WHY was obesity unknown in my family until immigrated from a traditional agricultural society where every family had deep culinary knowledge and walked or rode horses everywhere to a modern industrialized car dependent one where food comes from freezers and microwaves, and then immediately became very common? Why is Asia thinner than Europe, Europe thinner than NYC and other walkable northeastern cities with a lot of food choice, and those places thinner than flyover country america?)

This is an easy problem to solve. It hasn't been solved for decades because bathing the population in processed food and sedentism can't be offset by a few public service ads imploring people to spend all their energies fighting their artificially unhealthy environment. Instead, just give people a healthy environment and watch the problem melt away.

Sell healthy food as ubiquitously as fast food and make it easy to get around without a car. Problem solved or at least severely improved. Lots of data obviously showing this.

This is a problem we can solve, or at least make enough headway on to save millions of lives. We should have been on it before, but covid should have been a watershed moment on this.

Instead we got pandemic stress baking and in some places, even outdoor exercise bans.


In the spirit of embracing harm reduction, perhaps it's time to consider whom pronouncements by the Koch-funded Cato Institute are intended to benefit.

Bring on the downvotes.


There are a lot of things we could do that are effective that would boil down to cultural changes. I just know how to effectively promote such approaches.

I have a compromised immune system. Germ control is a big part of my life.

I do simple things that are readily available, like get takeout instead of eating at the restaurant and use self checkout as much as possible. I know these strategies are effective. I just don't know how to get past a bunch of people wanting to dismiss it as anecdotal and "That's just your opinion, man!"

Which makes no sense to me given the current state of things. But that's how it tends to go, if people are bothering to be polite. It sometimes is a lot uglier, which makes it hard to bring up such ideas at all.


Harm reduction would mean keeping masking and mandating vaccines for a couple years until the situation stabilizes whereupon more traditional flu measure would be enough. While areas are still seeing icu and LO2 shortages when restrictions are relaxed, any valid harm reduction requires at a minimum continued masking and vaccinations.


Simply don't understand the rush to open; historically pandemics have disrupted societies for decades. This is a chance to do something new and move away from a financial system that is destroying Earth.


People have roamed and moved their bodies about since the first human walked. The unnatural state is one of prohibited movement where the doldrums of the everyday with its same walls, same chipped paint corner of a bedroom, same routine, same one yellowed box of a shelter are The Encounter.

Novelty, curiosity and exploration made the Human. You can no more take it out of us than the cat's meow. These cycles of lockdown can't last much longer without mass revolts. I say that not as one who is some great conspiracy thinker or who has a particular anger toward the G-Man for penning me in.

We've done that now, tried our best. It's time for a new approach.


There's nothing about things not being "open" that relates to someone's ability to "move around" in spite of the poorly chosen terms like "lockdown", which means in this context "I can't go hang out in my favorite bar" or "I have to wear a mask" when it used to mean "All the inmates must return to their cells"


> historically pandemics have disrupted societies for decades

Per-capita, the 1918 flu pandemic killed far more people (and far younger people) than Covid. Why is there nothing in history books about major disruptions to society and normal throughout the 20s and 30s as a result?


I thought that most info was suppressed throughout Europe due to WW1, and that's why it was also why it's called the Spanish Flu.

They weren't at war so were happy actually putting information on the radio/newspapers while everyone else suppressed it because they didn't want troops at the front line worrying about their families dying of plague behind them...




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