How do pandemics end?


In an effort to curb the rise in infections and deaths due to the spread of the Delta variant of covid-19, Joe Biden has announced sweeping measures to try and turn the tide. He has mandated that all federal workers and contractors be vaccinated and that all businesses with over 100 employees do the same. He has greatly reduced the options available for not getting vaccinated, especially for federal workers.

In his most forceful pandemic actions and words, President Joe Biden on Thursday ordered sweeping new federal vaccine requirements for as many as 100 million Americans — private-sector employees as well as health care workers and federal contractors — in an all-out effort to curb the surging COVID-19 delta variant.

Speaking at the White House, Biden sharply criticized the tens of millions of Americans who are not yet vaccinated, despite months of availability and incentives.facilities receiving federal benefits will also face the same requirements, he said.

The expansive rules mandate that all employers with more than 100 workers require them to be vaccinated or test for the virus weekly, affecting about 80 million Americans. And the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid also will have to be fully vaccinated.

Biden is also requiring vaccination for employees of the executive branch and contractors who do business with the federal government — with no option to test out. That covers several million more workers.

It may seem sometimes, given the rise and fall of infections as new variants emerge, that this pandemic is never going to end. But history shows that pandemics do come to an end eventually. That does not mean, however, that the cause of the pandemic disappears even with vaccinations, as Nükhet Varlik, a professor of history at the University of South Carolina, explains.

Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us, because it is nearly impossible to fully eradicate them.

The only disease that has been eradicated through vaccination is smallpox. Mass vaccination campaigns led by the World Health Organization in the 1960s and 1970s were successful, and in 1980, smallpox was declared the first – and still, the only – human disease to be fully eradicated.

So success stories like smallpox are exceptional. It is rather the rule that diseases come to stay.
Take, for example, pathogens like malaria. Transmitted via parasite, it’s almost as old as humanity and still exacts a heavy disease burden today: There were about 228 million malaria cases and 405,000 deaths worldwide in 2018. Since 1955, global programs to eradicate malaria, assisted by the use of DDT and chloroquine, brought some success, but the disease is still endemic in many countries of the Global South.

Similarly, diseases such as tuberculosis, leprosy and measles have been with us for several millennia. And despite all efforts, immediate eradication is still not in sight.

Add to this mix relatively younger pathogens, such as HIV and Ebola virus, along with influenza and coronaviruses including SARS, MERS and SARS-CoV-2 that causes COVID-19, and the overall epidemiological picture becomes clear. Research on the global burden of disease finds that annual mortality caused by infectious diseases – most of which occurs in the developing world – is nearly one-third of all deaths globally.

So it seems like the best we can hope for is that over time, we reach some kind of steady state with levels of infection low enough that we can deal with it without causing panic or overwhelming the health services. This does not mean that we should not take preventative measures. What things like vaccines and mask wearing and physical distancing can do is hasten the arrival of that steady state and reduce the levels of death and suffering on our way there.

It will also mean that those who defy those safety precautions can never be proven wrong. We should note that just 1% of the people who are infected with covid-19 die and another 20% are still active. That means about 80% recover, even though they may have gone through a harrowing experience and suffer from long term ailments.

This means that there will be some people who recklessly ignore all safety precautions and still not get infected or get infected and choose to treat themselves with ivermectin, hydroxychloroqine, bleach or other dubious and even dangerous treatments who will also recover and believe even more firmly that it was these treatments that saved them.

There is little we can do to convince them otherwise because statistics is hard and confirmation bias is strong.

Comments

  1. Pierce R. Butler says

    … availability and incentives.facilities receiving federal benefits …

    Even if that period were fleshed out into an ellipsis (bridging several ‘grafs in the original), this still comes out as hash.

    Rather appropriately, considering the situation at hand.

  2. mnb0 says

    “It will also mean that those who defy those safety precautions can never be proven wrong.”
    Duh, science is not about proofs anyway -- those people demand absolute, 100%, everlasting certainty.
    In countries where high percentage of the population is vaccinated about 90% of the IC patients are not vaccinated. That evidence is good enough for me; defiers of course will explain this way some way or another. If they can’t they just will neglect such inconvenient facts.

    “There is little we can do to convince them.”
    That’s why we should focus on the group of doubters. Too bad you neglect them in your analysis, because this group is at least as big as the group of stubborn defiers.

  3. garnetstar says

    Would like to point out that one reason that smallpox is exceptional in having been eradicated is the stupidity of people, as Mano has said, who resist vaccination for diseases that *could* be eradicated, like measles and polio.

    Glad that Biden has been decisive. He does seem like a parent: he gave us a chance, he encouraged us, he made it easier to get, then when some said “Waaa, I don wanna!” like two-year-olds, he said “I’m the dad and you’re the child, and you’re going to do what I say because I said it.”

  4. blf says

    The only disease that has been eradicated through vaccination is smallpox.

    Whilst in-context Professor Nükhet Varlik does clarify they are talking about human diseases, there is a second disease which was “eradicated through vaccination” — rinderpest, a cattle disease.

  5. jrkrideau says

    IIRC the last serious outbreak in Western Europe of the plague (aka Black Death) faded out once most of London UK burned down in 1666.

    So if we torch London, Sao Paulo, New York, Mexico City, Mumbai and a few other small towns we should be okay.

  6. KG says

    Duh, science is not about proofs anyway- mnbo@2

    Of course it is. For example, science proved that there was a trans-Uranic planet (predicted on the basis of features of Uranus’ orbit) when Neptune was discovered. DNA has been proved to be the hereditary material of all cellular organisms so far investigated. The platypus was proved to be a real animal, and oviparous, contrary to the belief of many scientists. I really could go on indefinitely. The notion that science is not about proof seems to derive parly from Popper, who was mostly interested in universal generalizations (which are not provable, but are only a small part of science), and partly from restricting the term “proof” to the meaning used in mathematics, where something is only proved if its negation is shown to be logically impossible, ignoring the use of the term in law, and in everyday discourse, where such a standard is not and could not be used.

  7. KG says

    Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us

    If you think about it, it should be obvious we can’t possibly know that. There could have been millions of pathogens that died out without ever having been identified. One plausible example for which there is some historical evidence: whatever pathogen caused English sweating sickness.

  8. friedfish2718 says

    Mr Singham asks: How do pandemics end?
    .
    Answer: When the deaths stop.
    .
    Civilizations, cultures, ethnic groups are not at existential risk if they suffer an epidemic of an illness from which nobody dies.
    Yes, some pandemics did wipe out some civilizations.
    .
    Yes, some civilizations survive pandemics without vaccinations
    .
    Apart from a few states (such as Florida) and nations (such as Sweden), the powers that are have fallen in the uniquely American trap of endless war. I say ‘uniquely’ since only America has the material means to prosecute eternal war. Having the material means made it easy for the american governing class to believe that the endless war can be won. Unfortunately, if it is endless, the war cannot be won. The same with the endless war on the Wuhan.
    .
    The Global Governing Class (GGC) lost proper focus on the Wuhan war. Instead of keeping track of ever declining death rates, the GGC suffers neck whiplash from tracking the ever fluctuating infection rates. It took the W.H.O. 30 years to eradicate smallpox. And smallpox does not mutate. The arrogance of the GGC is that they believe they can eradicate the Wuhan in 2 years, thus setting themselves up for eternal war (the Wuhan mutates frequently). Although vaccination played a large role in the eradication of smallpox the main method was isolation and quarantine of the sick. The main tool the GGC is using is lockdowns: quarantine of the healthy along with the sick. Lately Australia and New Zealand set up isolation camps for those tested positive, following the example of China.
    .
    A prominent california paper started plotting on its webpage 7-day rolling average of death rates and it was showing steady declining rates. Then there is a recent delta-variant surge and the newspaper stopped posting the declining death rates and started posting only the infection rates. Got to focus on the fear-mongering. Declining death rates do not promote fear-mongering.
    .
    Mr Singham contributes to the fear-mongering by stating: “That means about 80% recover, even though they may have gone through a harrowing experience and suffer from long term ailments.” Notice that Mr Singham wrote “MAY”. Wishful thinking? If Wuhan survivors did not DIE, they MUST ALL (100%!!!) have SERIOUS and TERRIBLE ailments of, say, heart, liver, kidneys, lungs (PULMONARY SCARRING!!!), intestinal tract. I read of NO hospital being overrun by patients with post-Wuhan heart, liver, kidney ailments. Reading old newspapers about the 1918 pandemic, there was no mention of waves of patients suffering from heart, liver, kidney ailments. And the 1918 spanish flu virus was -- per capita basis -- 20 times deadlier than the Wuhan.
    .
    Mr Singham contributes to the fear-mongering by stating: “…choose to treat themselves with ivermectin, hydroxychloroqine, bleach or other dubious and even dangerous treatments who will also recover and believe even more firmly that it was these treatments that saved them.” Ah!!! Mr Singham is a fan of Rachel Maddow who parrotted the canard by the Rolling Stones magazine about gun shot victims not having access to ER’s because there was a flood of ivermectim overdose patients. Such fairy tales promoted by the Left. Japan encourages the use of ivermectin while Australia prohibits its use. Given that Australia is trying to out-totalitarian China, I will mistust Australia on all things Wuhan. What is China’s position on Ivermectin and Hydroxychloroquine?
    .
    Joe Rogan took ivermectin under a doctor supervision. President Trump took hydroxychloroquine under a doctor supervision. Mr Singham acts/talks like a dead-ender. The TDS virus is a powerful virus which affects the brain. Patents on ivermectin and hydroxychloroquine have expired thus Big Pharma is adverse to low-cost medication. Where is the profit in ivermectin and hydroxychloroquine?

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