Connect and get the inside scoop on Airline Companies

Welcome to Airline Pilot Forums - Connect and get the inside scoop on Airline Companies

If this is your first visit, be sure to check out the FAQ. Join our community today and start interacting with existing members. Registration is fast, simple and absolutely free.


User Tag List

Post Reply
 
Thread Tools Search this Thread
Old 06-26-2020, 04:29 PM   #1  
Gets Weekends Off
Thread Starter
 
Excargodog's Avatar
 
Joined APC: Jan 2018
Posts: 4,016
Default We need a plan B for no vaccine.

OK, this is not going to be short. If that bothers you, just type TLDR right now and move on. You’ll save yourself aggravation.



I’m writing this because of the number of people posting who apparently believe that all we have to do is wait for a coronavirus vaccine and the problem will be solved. All we need is for the American Public to have a little patience, a little discipline, wear their masks and keep up the social distancing and in six months or a year or so, the vaccine will take care of everything. Those people need to be aware of at least three issues:



First, there is no guarantee an effective vaccine will EVER be produced. No one is claiming one CAN’T be produced, simply that it isn’t going to be easy, probably won’t be quick, and it is far from certain it will ever be produced. And even if it can, it may take a long time.



Let’s look at history. The Spanish Flu pandemic 100 years ago was far more deadly than COVID 19 has been (at least as of yet) and it stimulated a search for a vaccine. It was 12 years before the first primitive vaccine came out. But OK, COVID 19 is not influenza, it’s a coronavirus. It’s a little different.



There are at least four coronaviruses that have been with us for a long time, and we’ve never developed vaccines against them. OK, maybe that’s for lack of trying, because all they do in most people is cause the common cold. Nobody dies of them unless they are so riddled with preexisting medical problems that a cold is all it takes. Even so, we’ve known about them for a long time, they are somewhat of economic importance, and a few researchers have looked at what it would take and decided it would be too much effort, technically difficult, for too little possible gain. Not impossible perhaps, but not easy.



The two other more recent additions SARS and MERS, don’t have vaccines either. Both are far more lethal than COVID-19, which makes them less of an epidemic threat since they tend to make those infected deathly ill and well, dead, before they can spread much. The problem with COVID-19 from an epidemiological perspective isn’t that it’s all that deadly really, there are a lot more deadly viruses (like Ebola or rabies) but rather it ISN’T all that deadly allowing rather wide spread.



It’s sort of like Goldilocks and the three Bears. Really benign viruses, like the coronaviruses that cause colds, spread pretty readily but do little damage so nobody has invested a lot of money in producing vaccines for them. MERS and SARS kill people so quickly it’s hard for them to spread and generally die out quickly so nobody has invested a lot in producing vaccines for them either. But it appears, from what little phase 1 research has been done, that if a good coronavirus vaccine is possible it will take at least two shots 2-3 weeks apart.



Secondly, what would likely be the characteristics of a vaccine if it could be developed. It was mentioned above that it was twelve years before a flu vaccine was developed and that vaccine has been continuously improved for the last 100 years. Yet we still have flu. That’s because the influenza vaccine is not terribly effective generally speaking.

On a good year (like this most recent one) the vaccine is about 50% effective against the flu strain going around, and on a bad year (like the one before that) it is about 10% effective.

After 100 years of work that’s still state of the art. And perhaps for that reason we don’t really get maximum benefit out of it even though it is available. Typically, only a little over half of adults and not quite two-thirds of kids get their flu shot which needs to be given annually to be most effective. It certainly isn’t impossible that a coronavirus vaccine could do better, or be developed far quicker but there certainly is nothing in the history of vaccine production to date that suggests that is likely.

Thirdly, it’s the logistics. Edward Jenner, a Scottish family doctor discovered vaccination with cowpox as a preventive for Smallpox in 1796. His work was widely publicized in 1801. Smallpox was not a trivial disease, it was occurring worldwide and had a case-fatality rate of over 30%, comparable to that of MERS. And from an efficacy standpoint, vaccination was highly effective, a single inoculation providing immunity for at least 10 years and more likely twenty. And EVERYONE wanted to get rid of smallpox, there was massive international cooperation, even during the Cold War, so it only took until 1980 - 184 years after development Of the vaccine - for smallpox to be made extinct.



The Salk vaccine was a four shot series to protect against polio that was introduced in 1955. It was largely replaced by the Sabin vaccine a year later - despite the unfortunate habit of the Sabin attenuated virus to occasionally revert to its original (paralyzing) form. But now, 65 years later and despite the Sabin vaccine being capable of being given orally, we STILL haven’t eliminated polio in the world. When you are dealing with a third of a billion people in the US or seven point eight billion worldwide, the logistics to getting the necessary dose(s) to people really matter, even before the days of the antivaxxers making things more difficult. That’s just fact.



Now I’m not saying a good, cheap, effective, and easily administered vaccine against coronavirus is impossible, because few things are really impossible, and I’m not saying it can’t be done in less than a decade because that isn’t impossible either, I’m just saying that there is not one damn time in the historical record that something of this magnitude has been done that quickly and that if it IS done this time it will be a first.

And what that suggests to me is that we can’t just shut down the economy until there is a vaccine, because that could well take a decade and a decade of a collapsing economy is going to cause wars, revolutions, mass famine, etc., and whether you are red, blue, green, or some other color, if you check the historical record that’s what you are going to find. Pandemics are often followed by massive political unrest, economic breakdown, and conflict.



People might just have to get used to the idea of running the economy at levels that keep the ICUs full, letting people catch it and having some of them even die, because the promised arrival of salvation by immunization is not really that likely and the alternative if we don’t keep the economy going will be even worse.
Excargodog is offline  
Old 06-26-2020, 04:39 PM   #2  
Gets Weekends Off
 
Downtime's Avatar
 
Joined APC: May 2020
Posts: 196
Default

Quote:
Originally Posted by Excargodog View Post
OK, this is not going to be short. If that bothers you, just type TLDR right now and move on. Youíll save yourself aggravation.



Iím writing this because of the number of people posting who apparently believe that all we have to do is wait for a coronavirus vaccine and the problem will be solved. All we need is for the American Public to have a little patience, a little discipline, wear their masks and keep up the social distancing and in six months or a year or so, the vaccine will take care of everything. Those people need to be aware of at least three issues:



First, there is no guarantee an effective vaccine will EVER be produced. No one is claiming one CANíT be produced, simply that it isnít going to be easy, probably wonít be quick, and it is far from certain it will ever be produced. And even if it can, it may take a long time.



Letís look at history. The Spanish Flu pandemic 100 years ago was far more deadly than COVID 19 has been (at least as of yet) and it stimulated a search for a vaccine. It was 12 years before the first primitive vaccine came out. But OK, COVID 19 is not influenza, itís a coronavirus. Itís a little different.



There are at least four coronaviruses that have been with us for a long time, and weíve never developed vaccines against them. OK, maybe thatís for lack of trying, because all they do in most people is cause the common cold. Nobody dies of them unless they are so riddled with preexisting medical problems that a cold is all it takes. Even so, weíve known about them for a long time, they are somewhat of economic importance, and a few researchers have looked at what it would take and decided it would be too much effort, technically difficult, for too little possible gain. Not impossible perhaps, but not easy.



The two other more recent additions SARS and MERS, donít have vaccines either. Both are far more lethal than COVID-19, which makes them less of an epidemic threat since they tend to make those infected deathly ill and well, dead, before they can spread much. The problem with COVID-19 from an epidemiological perspective isnít that itís all that deadly really, there are a lot more deadly viruses (like Ebola or rabies) but rather it ISNíT all that deadly allowing rather wide spread.



Itís sort of like Goldilocks and the three Bears. Really benign viruses, like the coronaviruses that cause colds, spread pretty readily but do little damage so nobody has invested a lot of money in producing vaccines for them. MERS and SARS kill people so quickly itís hard for them to spread and generally die out quickly so nobody has invested a lot in producing vaccines for them either. But it appears, from what little phase 1 research has been done, that if a good coronavirus vaccine is possible it will take at least two shots 2-3 weeks apart.



Secondly, what would likely be the characteristics of a vaccine if it could be developed. It was mentioned above that it was twelve years before a flu vaccine was developed and that vaccine has been continuously improved for the last 100 years. Yet we still have flu. Thatís because the influenza vaccine is not terribly effective generally speaking.

On a good year (like this most recent one) the vaccine is about 50% effective against the flu strain going around, and on a bad year (like the one before that) it is about 10% effective.

After 100 years of work thatís still state of the art. And perhaps for that reason we donít really get maximum benefit out of it even though it is available. Typically, only a little over half of adults and not quite two-thirds of kids get their flu shot which needs to be given annually to be most effective. It certainly isnít impossible that a coronavirus vaccine could do better, or be developed far quicker but there certainly is nothing in the history of vaccine production to date that suggests that is likely.

Thirdly, itís the logistics. Edward Jenner, a Scottish family doctor discovered vaccination with cowpox as a preventive for Smallpox in 1796. His work was widely publicized in 1801. Smallpox was not a trivial disease, it was occurring worldwide and had a case-fatality rate of over 30%, comparable to that of MERS. And from an efficacy standpoint, vaccination was highly effective, a single inoculation providing immunity for at least 10 years and more likely twenty. And EVERYONE wanted to get rid of smallpox, there was massive international cooperation, even during the Cold War, so it only took until 1980 - 184 years after development Of the vaccine - for smallpox to be made extinct.



The Salk vaccine was a four shot series to protect against polio that was introduced in 1955. It was largely replaced by the Sabin vaccine a year later - despite the unfortunate habit of the Sabin attenuated virus to occasionally revert to its original (paralyzing) form. But now, 65 years later and despite the Sabin vaccine being capable of being given orally, we STILL havenít eliminated polio in the world. When you are dealing with a third of a billion people in the US or seven point eight billion worldwide, the logistics to getting the necessary dose(s) to people really matter, even before the days of the antivaxxers making things more difficult. Thatís just fact.



Now Iím not saying a good, cheap, effective, and easily administered vaccine against coronavirus is impossible, because few things are really impossible, and Iím not saying it canít be done in less than a decade because that isnít impossible either, Iím just saying that there is not one damn time in the historical record that something of this magnitude has been done quickly. And what that suggests to me is that we canít just shut down the economy until there is a vaccine, because that could well take a decade and a decade of a collapsing economy is going to cause wars, revolutions, mass famine, etc., and whether you are red, blue, green, or some other color, if you check the historical record thatís what you are going to find. Pandemics are often followed by massive political unrest, economic breakdown, and conflict.



People might just have to get used to the idea of running the economy at levels that keep the ICUs full, letting people catch it and having some of them even die, because the promised arrival of salvation by immunization is not really that likely and the alternative if we donít keep the economy going will be even worse.

Some good points actually. That said MERS has a vaccine candidate but since as you noted SARS had a candidate but the funding dried up when it was eradicated. It seems they have worked out the kinks but you are right. The only problem with the herd immunity approach is we donít know how long the immunity last. That said if we get a vaccine similar to flu that would be a huge win as it may stop infection but it does prime your immune system often preventing serious disease.
Downtime is online now  
Old 06-26-2020, 04:51 PM   #3  
Gets Weekends Off
Thread Starter
 
Excargodog's Avatar
 
Joined APC: Jan 2018
Posts: 4,016
Default

Quote:
Originally Posted by Downtime View Post
The only problem with the herd immunity approach is we don’t know how long the immunity last.
True, but neither do we know the duration of immunity that might be provided by a vaccine not yet developed.

Quote:
Originally Posted by Downtime View Post
That said if we get a vaccine similar to flu that would be a huge win as it may stop infection but it does prime your immune system often preventing serious disease.
I’d assume you meant ‘not’ stop disease. And while that also is true, there is some overlap between strains, if what the CDC is now claiming is true - that 90% of coronavirus infections are undiagnosed - then the incidence of serious disease with coronavirus is already almost as low as that of influenza, at least influenza with half of us adults getting our annual flu shot.
Excargodog is offline  
Old 06-26-2020, 04:51 PM   #4  
Gets Weekends Off
 
AntiPeter's Avatar
 
Joined APC: Jan 2017
Position: Pilot
Posts: 170
Default

Quote:
Originally Posted by Downtime View Post
Some good points actually. That said MERS has a vaccine candidate but since as you noted SARS had a candidate but the funding dried up when it was eradicated. It seems they have worked out the kinks but you are right. The only problem with the herd immunity approach is we donít know how long the immunity last. That said if we get a vaccine similar to flu that would be a huge win as it may stop infection but it does prime your immune system often preventing serious disease.
If herd immunity doesn't last then the immunity from a theoretical vaccine won't last either.

I don't think it's accurate to define immunity through antibodies only. Antibodies commonly fade with previous coronavirus strains, however T-cells are very important to immune system response and prevent re-infection of previous viral strains even when antibodies are no longer detectable.

Herd immunity will likely occur before a vaccine is successfully developed and distributed, whether or not we fight it. The question in my mind is, how much do we want to destroy and fight before we realize that nature is in control? How much denial is left?

If we assume the CDC iFR of 0.26% was correct in May (the most recent estimate) and 125,000 people have died from COVID-19, that means approximately 14% of Americans have already been infected and that is with a multi-month fairly broad lockdown and other mitigation measures. Personally, I don't believe those measures were particularly effective, in fact...I think they will be a failure. However, assuming they were effective and now stopped, if herd immunity requires 60-80% of the population to be infected it's possible herd immunity will be achieved by 2021.

We are at the end of June now, so it's possible 20% of the population has already been infected (current iFR of 0.2% with 130,000 deaths by the end of June). We could already be 1/3rd of the way there!

The iFR usually decreases with time, so assuming less and less people will die from the virus that are infected, and assuming the infections in the South continue...the cat is out of the bag.

The government is not in control and people will not tolerate another lockdown. The riots caused rebellion and apathy by the populace, all the government can do now is to appear it is in control and save face from it's failed policy.

The bigger question is the pervasive irrational hypochondria that now exists among Americans. As one who has had hypochondria in the past, I know it is extremely difficult to become more rational and objective when dealing with fears of mortality and disease. To me this is a bigger problem to get things back to normal than the virus itself. The media and politicians are making the problem much, much worse. The manipulation that is causing depression, anxiety and hysteria is a black mark on humanity, it frustrates me how gullible people are and how they are blind to their own irrationality and misery, much of it unneeded. I've been there, and being anxious about health issues is a destructive mental hell I wouldn't wish on anyone.

The elderly, the morbidly obese and those with cardiac issues should be very careful. This virus is obviously extremely contagious, which makes me doubt mitigation measures like masks and hand washing are particularly effective.

Last edited by AntiPeter; 06-26-2020 at 05:04 PM.
AntiPeter is offline  
Old 06-26-2020, 04:58 PM   #5  
Gets Weekends Off
 
Downtime's Avatar
 
Joined APC: May 2020
Posts: 196
Default

Quote:
Originally Posted by AntiPeter View Post
If herd immunity doesn't last then the immunity from a theoretical vaccine won't last either.

I don't think it's accurate to define immunity through antibodies only. Antibodies commonly fade with previous coronavirus strains, however T-cells are very important to immune system response and prevent re-infection of previous viral strains even when antibodies are no longer detectable.

Herd immunity will likely occur before a vaccine is successfully developed and distributed, whether or not we fight it. The question in my mind is, how much do we want to destroy and fight before we realize that nature is in control?

If we assume the CDC iFR of 0.26% was correct in May (the most recent estimate) and 125,000 people have died from COVID-19, that means approximately 14% of Americans have already been infected and that is with a multi-month fairly broad lockdown and other mitigation measures. Personally, I don't believe those measures were particularly effective, in fact...I think they will be a failure. However, assuming they were effective and now stopped, if herd immunity requires 60-80% of the population to be infected it's possible herd immunity will be achieved by 2021.

The iFR usually decreases with time, so assuming less and less people will die from the virus that are infected, and assuming the infections in the South continue...the cat is out of the bag.

The government is not in control and people will not tolerate another lockdown. The riots caused rebellion and apathy by the populace, all the government can do now is to appear it is in control and save face from it's failed policy.

The bigger question is the pervasive irrational hypochondria that now exists among Americans. As one who has had hypochondria in the past, I know it is extremely difficult to become more rational and objective when dealing with fears of mortality and disease. To me this is a bigger problem to get things back to normal than the virus itself. The media and politicians are making the problem much, much worse. The manipulation that is causing depression, anxiety and hysteria is a black mark on humanity.

So yes but that is the current vaccine plan assuming one can be developed is for yearly boosters like the flu. Also I would put money on an effective treatment before a vaccine but who knows.
Downtime is online now  
Old 06-26-2020, 05:02 PM   #6  
Gets Weekends Off
 
AntiPeter's Avatar
 
Joined APC: Jan 2017
Position: Pilot
Posts: 170
Default

Quote:
Originally Posted by Downtime View Post
So yes but that is the current vaccine plan assuming one can be developed is for yearly boosters like the flu. Also I would put money on an effective treatment before a vaccine but who knows.
I think you are correct. There have already been effective treatments for those severely ill in ICUs, like steroids. Ironically, steroids were rejected as a treatment the first few months of the pandemic. Fatally rates have gone way down, I assume at least partially because treatments have gotten significantly better.
AntiPeter is offline  
Old 06-26-2020, 05:31 PM   #7  
Gets Weekends Off
 
Knobcrk1's Avatar
 
Joined APC: Jul 2017
Posts: 335
Default

So what are you guys actually advocating? We get the herd immunity pipe dream but how do you actually would like that to happen? Just 100% no restrictions? Thatís what happened basically in the states that are exploding with cases with near capacity, and thatís from hospital officials not the media. What about other countries that have reversed and basically brought the cases to near zero? Whereís the herd immunity there? Wear a mask, social distance. Itís pretty simple. This could have been reversed by fall if we had kept the same trends as end of May.
Knobcrk1 is offline  
Old 06-26-2020, 06:01 PM   #8  
Line Holder
 
Skylarking's Avatar
 
Joined APC: Feb 2019
Position: Treading water in the pool
Posts: 79
Default

Quote:
Originally Posted by Knobcrk1 View Post
So what are you guys actually advocating? We get the herd immunity pipe dream but how do you actually would like that to happen? Just 100% no restrictions? Thatís what happened basically in the states that are exploding with cases with near capacity, and thatís from hospital officials not the media. What about other countries that have reversed and basically brought the cases to near zero? Whereís the herd immunity there? Wear a mask, social distance. Itís pretty simple. This could have been reversed by fall if we had kept the same trends as end of May.
1. Do a much better job of protecting the vulnerable. This is not a scientific challenge. It's a logistics challenge that we could solve for a much cheaper price than the damage we've done to the economy.
2. Let the less vulnerable live their lives and create the herd immunity. This will protect the vulnerable in the long run.

Neither of these things will probably ever happen, but that's the answer..........
Skylarking is online now  
Old 06-26-2020, 06:39 PM   #9  
Gets Weekends Off
 
Knobcrk1's Avatar
 
Joined APC: Jul 2017
Posts: 335
Default

Quote:
Originally Posted by Skylarking View Post
Let the less vulnerable live their lives and create the herd immunity. This will protect the vulnerable in the long run.

.

In order for there to be herd immunity something like 200 million need to be infected. Also we donít know if we can actually develop immunity in the long run, not to mention long term complications of contracting it. Also some hospitals in the states that are most populated with highest rates are sending patients to kids hospitals as theyíve ran out of space. The rates in these states are skyrocketing. And this is after like two weeks of openings. So again, how do you advocate doing it? What is the problem with wearing a mask and social distancing which the doctors are saying works, saves lives and curbs the rates.
Knobcrk1 is offline  
Old 06-26-2020, 06:40 PM   #10  
Gets Weekends Off
 
Tom Bradys Cat's Avatar
 
Joined APC: Dec 2019
Posts: 328
Default

Quote:
Originally Posted by Knobcrk1 View Post
What about other countries that have reversed and basically brought the cases to near zero?.
They have used up their economic fire power to simply delay the start date of their outbreak.
Tom Bradys Cat is offline  
 
 
 

 
Post Reply
 



Thread Tools Search this Thread
Search this Thread:

Advanced Search


Related Topics
Thread Thread Starter Forum Replies Last Post
MEC only retirement Vote?? from Block Rep Flaps50 FedEx 129 12-17-2017 05:09 PM
Base Plan vs Buy Up Plan w/Tricare Standard (or other secondary insurance) DLax85 Cargo 11 01-18-2017 07:53 PM
Southwest Pilots 401K Ranked Number 1 shoelu Major 24 12-21-2011 12:20 PM
Chapter 11 threat to Pensions Sir James Money Talk 2 09-30-2005 06:42 AM
Delta pilot exodus RockBottom Major 3 09-23-2005 02:01 PM


All times are GMT -8. The time now is 03:44 PM.