Covid is not gone, not mild, and we’re helping it get worse

The myth of increasing mildness allowed economies to go back to “normal” without spending more money. No need to improve ventilation. No need to provide vaccines against transmission and infection, only against “serious disease.”

But … we had been warned. The early data pointed toward this:

[A friend’s] third bout of Covid was significantly worse than the previous time they caught it.

“I thought every time you catch an illness it’s supposed to be a bit better each time?”

The misleading codswallop around covid drives me straight into podium pounding. A BBC article ^[1] has several examples.

This year even fewer people are being offered the vaccine [in the UK, but also everywhere else]. … Prof Openshaw says he is not a “doomster”, but thinks the result will be “a lot of people having a pretty nasty illness that is going to knock them out for several days or weeks.”

“I’m also hearing of people having nasty bouts of Covid, who are otherwise young and fit. It’s a surprisingly devious virus, sometimes making people quite ill and occasionally leading to having ‘long Covid’,” he says. …

The official government decision in the UK is to vaccinate those at risk of dying from Covid or needing hospital treatment. This relieves pressure on the National Health Service.

Prof Riley argues: “But that’s not to say people who are under 65 are not going to get Covid, and are not going to feel pretty rough. ..

“A lot of people have very little immunity to the Omicron viruses and their variants.”

If you are feeling rough with Covid – or rougher than you have done before – it could be this combination of waning antibodies and evolving viruses.
…

So where does this leave the thought that Covid is on a trajectory towards becoming a mild, innocuous infection?

There are four other human coronaviruses, related to Covid, that cause common cold symptoms. One of the reasons they are thought to be mild is we catch them in childhood and then throughout our lives.

Prof Openshaw is clear “we are not there yet” with Covid, but “with repeated infection we should build up natural immunity”.

In the meantime will some of us have to suck up a grotty winter?

“I fear so,” says Prof Riley.

Let’s take these in turn.

Regarding government decisions to vaccinate only those likely to end up in hospitals. This means nobody else needs the vaccine, right? Because nobody else gets sick, right? No. Wrong. We would have heard about the end of covid among all younger people. We haven’t. Quite the contrary. So governments have some other reason for limiting vaccinations. Money is one that comes to mind.

• Governments want to save money, but they also want to avoid horrible headlines about refrigerated morgue trucks lining up outside hospitals. They are NOT concerned about your pain or suffering. The lack of funding for universal vaccination does NOT mean the only people in danger are the old and the sick.
• Anyone can get long covid, even after an infection with no symptoms. (Chances go up the worse the symptoms.) About one in twenty five people get life-altering long covid ^[2].
• You have the same, or a slightly increased, chance of getting long covid with EACH covid infection ^[3]. So dodging the bullet once or twice or three times means very little. If you get covid twenty five times, the odds of a permanent disability approach 100%. Have you had twenty five colds in your life? Covid is transmitted the same way. But the long term effects are not the same. Give it a generation or so, and some huge proportion of people will be walking (if they’re lucky) wounded. (See also below about evolution.)
• Further, just a couple of years downstream from covid — which is all the data we have since it’s a new disease — lethal heart attacks, strokes, any cardiovascular diseases, happen statistically significantly more often in survivors of covid ^[4]. So does dementia ^[5]. And diabetes ^[6]. And the list ^[7]goes on ^[8]. Fun, huh?
• So governments funding vaccines only for the old and the sick does not mean safety for anyone. It means they Do Not Care. Except for those headlines.

About those evolving viruses:

• First, let’s consider the soothing assurance they’ll get more mild. Yes, that can happen, as with common colds. The reason it happens is because some people died, the ones in whom it was not mild. The reason it happens is because some people stayed too sick to produce children.
• Evolution rewards producing more progeny. Nothing else. (If you’d like more information, this is all basic biology. A first year college biology textbook can get you started.)
• The process of weeding out susceptible people takes centuries. If you’re one of them, the process is not going to feel “mild.” If one of them is your child or your partner, or your parents, the process is not going to feel mild.
• So, sure, with repeated infection we’ll build up natural immunity. There’s a lot of death and disability and grief and poverty along the way, though. And we’re just at the earliest days of the process with covid.
• There is one driver toward “mildness” on the viral side. The virus produces the most progeny if the host stays well enough to keep mingling with others, at least initially. Once it’s spread, it does not care what happens to you. You can be incapacitated or die. It doesn’t change the success of the virus. So, yes, there’s evolutionary pressure for initial mildness. There is none, on the viral side, for making sure you’ll be okay.

While I’m on the subject of evolution, let’s talk about what makes a virus become unimportant. One route is it kills the people who have problems so none of the remaining people notice any suffering. The second route is the virus evolves away from being able to infect people. (That does happen, but rarely ^[9].) A third option, only available recently due to science, is to vaccinate everyone so universally that transmission is impossible and the virus dies out in humans. (That was achieved with smallpox, and almost with polio until some antivaxxers felt that getting sick was better.)

The key point is how the virus evolves. In smallpox, for instance, production of new variants is very slow (for a virus). So it can’t quickly jump across species. That means the human variant is found only in humans and there is no animal reservoir that can reinfect people even if it’s stamped out.

In covid the rate of new variant production is very high. That means only very strict anti-transmission measures (lockdowns) would have helped, and (once it was available) vaccination of everybody very fast to stamp it out before variants appeared that could escape. We didn’t do that because it was too much trouble and who wants their tax dollars going to vaccinate some foreigners. Now we have omicron variants that are highly infectious ^[10]. The kind where walking through a room two hours after an infected person is enough to catch it.

[2023-12-21 Edited to add: the newest ‘variant of concern’ JN.1, offshoot of BA 2.86 on the omicron branch, is the most infectious yet. This is not by accident. Viral variants that are better at spreading will spread more (um, duh), meaning they produce the most progeny, which equals evolutionary success. So the more viruses we allow to be out there, the more we’ll see increasingly infectious variants.]

Variants are random. The virus is throwing things at the wall, so to speak. Sometimes those changes are not good for the virus and it dies out, as I mentioned above. Sometimes the changes do little. And sometimes they make the virus worse for humans. The worst would be a variant that spreads while people don’t even feel sick (covid? check), have high infectivity (covid? check), and then a disabling or lethal progression in most people (covid? not yet).

The more viruses there are “throwing things at the wall,” the more likelihood one of those millions of throws will be a lethal variant.

That’s what we’re enabling by telling everyone to get sick and not worry about it.

Are there solutions? Of course. They cost money or tiny changes in behavior. Governments and too many people would rather pretend they’re immortal than make the effort.

• Inhaled mucosal vaccines, aka nasal vaccines, that prevent transmission, not just death. There are some very promising candidates ^[11] in animal trials and early stage clinical trials (e.g. more here ^[12]). If governments cared about more than headlines, and supported mucosal vaccines the way they did the (brilliant!) injected mRNA vaccines, we’d have them already.
• UVC lighting ^[13]. Ultraviolet-C light is lethal to bacteria and viruses, but too weak to harm people. Those who know say you can even look straight at it without damage to your eyes, although I wouldn’t test that on myself. But there’s no need to stare at it. So long as the lights are directed toward walls or ceilings, or into a disinfecting unit, they can clean room air down to undetectable quantities of virus.
• Ventilation improvements ^[14]. Room air needs at least five changes per hour with fresh air, not recirculated, and to pass through HEPA or equivalent filters to remove viral particles. Corsi boxes ^[15] are a do-it-yourself way to do this until building regulations catch up. UVC lighting can be incorporated into the system to disinfect the circulating air. These ventilation changes would drive down the incidence of all respiratory diseases to mere hundredths of what they are now, just like closed sewers drove down all the diseases dependent on the fecal-oral pathway.
• Accurate, free testing ^[16] (at point of use), universally applied, to avoid asymptomatic spread. Number of repeat tests needed for certainty depends on the frequency of false negatives in a given test.
• Financial support to all who have positive tests so they can stay home and not spread disease.
• Masking ^[17] on buses and any other enclosed spaces where people gather on a transient basis. (Yes, masking, I know, how unbearably awful. You know what? You get used to it if you don’t drive yourself up a tree about it, and if the disease is at low enough levels that you only have to do it for short periods of time, like on a bus.)

So, the short version is: almost all the covid suffering is preventable. Stupid money-serving myths about mildness only create the suffering we’re desperate to pretend away.