Thread by @yaneerbaryam

COVID-19 must be eliminated, not become endemic, if America is to survive

"More and more people seem to be accepting the idea the future will include COVID-19.

"Those people don’t understand what that means.

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dailykos.com/story/2021/10/…

Take The Wall Street Journal, which on Friday published an article stating “COVID-19 will soon become endemic—and the sooner the better.”
"This... is not just a formula for millions of deaths, but an absolute ticket to the end of the line for America, and likely for what..

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"we currently think of as modern society. We simply cannot live with endemic COVID-19.

"Hang on, let me say that again: We. Cannot. Live. With. Endemic. COVID-19. I can be louder. And I will be.

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"Expectations of the “epidemic COVID-19” crowd seem to be that each year people will line up for their COVID-19 shot when they get their flu shot, that things will go back to a pre-pandemic “normal,” and that “Oh, George is home with the COVID-19” will just join everyday...

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"..watercooler chatter alongside “Poor Cecelia is out with the flu.” A flurry of “get well soon!” emails, a week or two of moaning in bed, and George and Cecelia will both drag their achy asses back to the office and clear their crowded inboxes.

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"But that is not at all how allowing epidemic COVID-19 to become endemic COVID would work.

"Here’s how it would actually play out:
"Forget having any kind of regular schedule

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"We’ve had COVID-19 spikes in every season, because the transmission rate of COVID-19 is so high that it takes extraordinary precautions—masks, social distancing, improved ventilation, and vaccination—to put the genie back in the bottle and drive the effective R0 below 1.

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"And because COVID-19 is so highly contagious, it’s not going to be just one person home with the disease. The first thing we’d have to live with if we accept endemic COVID-19 is the idea that not just individual cases, but dense local outbreaks, could happen at any time.

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"It would look like a world where businesses and schools frequently have to close for days or weeks because too many people were simply too ill to carry on.On a purely economic basis, the CDC estimates that outages due to the flu cost American business over $10 billion a year

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"COVID-19’s impact would be many times that amount, and far more disruptive.

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"PREPARE FOR HEALTHCARE THAT'S MUCH MORE COSTLY

"Endemic COVID-19 doesn’t mean it boils at a low level everywhere...Every single locality in the nation would be subject to a possible overrun of the local healthcare system at any time.

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"The scenes that have appeared so many times over the last year—tents being erected in parking lots, exhausted nurses wandering hallways choked with patients—would recur again and again"

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"AN EMPTY SEAT AT EVERY TABLE

"What happens when the healthcare system fails to accommodate the latest surge/spike/wave is clear enough:.. leading to death rates of 13% or higher in some communities over the short term.

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"That is, of course, the most extreme outcome. But on a more regular basis, COVID-19 is still very much not the flu. Where seasonal flu has a fatality rate of around 0.1%, the overall value for COVID-19 in the US to date is 1.6%. Worldwide ...around 1.3%.

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"On both a personal and economic level, that increase in the rate of deaths would be a gut-punch to the nation. It’s the kind of situation that requires an emotional sea change; one that increases the chances that anyone you know—any associate, any friend,...

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"..any member of the family—could vanish at any time. That’s already true, of course. But this would be an almost 6% increase in the total number of deaths each year. Every single year.

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"Flu, with basic reproductive number of 1.4 and an average rate of 51% vaccination each year, generates an average of around 35 million cases each year. In the 2017-2018 season.. there were an estimated 50 million cases of flu, one million hospitalizations, 90,000 deaths.

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"Now scale all that up for a disease with a minimum R0 of 5, and hospitalization and fatality rates 10 times that of flu. If the U.S. treats endemic COVID-19 like it does the flu, a “bad COVID-19 year” could easily see another 200,000 or 300,000 deaths. Maybe more.

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"DEATH IS ONLY THE TIP OF THE ICEBERG

"From the start of the pandemic, there have been those who shrugged off the threat with some variation of the phrase “why be worried when XX.X%” of people don’t die?”

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"For XX.X%, substitute any number between 99% and 99.9999%, depending on how unrealistic and dismissive the person making the statement was being at the time.

It’s a foolish formulation, that blithely dismisses the deaths of Americans of every race, age, in every locality.

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"However, that’s not the most foolish part of the statement.

"While diseases like the flu can definitely generate “complications,” lasting damage for survivors is very rare, while lasting damage from COVID-19 is anything but.

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This study shows over a third of those who tested positive for COVID-19 have symptoms months later. Some of these patients were asymptomatic at the time they tested positive for COVID-19, and still developed serious, long-lasting issues weeks later.
journals.plos.org/plosmedicine/a…

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"Going back to our watercooler, when Cecelia comes back to the office after two weeks of flu, she may be wiped out from body aches and dehydration. But she doesn’t come back with hearing loss, brain fog, and a fresh case of diabetes.

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"Thus the cost of COVID-19 can’t be compared to that of the flu, because in addition to the greater number of deaths, COVID-19 causes enormously more long-term illness than any current endemic disease.

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DIFFICULT IS NOT IMPOSSIBLE

Living with endemic COVID-19 means living in a nation where businesses and schools are subject to extended and erratic closings, where healthcare systems can be overrun at a moment’s notice, where hundreds of thousands more die, and where

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"..millions of Americans are hit with long-term damage that can render them unable to work or dependent on long-term care. And again, that’s not a short-term situation, that’s what endemic COVID-19 would look like every year.

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"Those willing to buy into this endemic vision call the idea of eradicating COVID-19, or pushing it down to the level of a rarely appearing disease, “unreasonable.” The Wall Street Journal in particular goes out of its way to pretend that this is impossible, citing smallpox

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"..as the only disease ever eradicated and listing the reasons why it was so much easier to defeat than COVID. But there is an enormous gulf between dealing with COVID-19 as an endemic disease that is just accepted into the cycle of everyday life,

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".and causing SARS-CoV-2 to become extinct in the wild.

That gulf holds everything from polio to COVID’s close relatives, SARS&MERS. None of those viruses has been completely eliminated, but they’ve been rendered so rare that they are no longer a threat to anyone, anywhere.

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"Reaching that goal for COVID-19 means hitting a vaccination rate in excess of 90%. It involves using new antiviral treatments to not just combat hospitalizations, but to reduce transmission in the homes of those exposed.

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"It involves continuing to use masks and social distancing to break the chain of transmission in areas where COVID-19 is still present in the community.

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"Those advocating for endemic COVID can say that eliminating it is “unreasonable” all they want, but living with it is impossible. Eradicating COVID may be difficult, but it doesn’t come with a massive body count or millions with diabetes, blindness, or other afflictions.

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"Whatever the price of defeating COVID-19 may be—economically, socially, politically—it must be paid. Because the alternative is a stark threat to our nation.

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Also relevant. Discussion for the UK but similar points relevant to other countries in Europe and the US.

History of elimination in the UK

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