Covid-19 will become endemic (Updated 2021-08-21)

Update 2021-08-21: The Delta variant has now become the dominant strain, but apparently does no more damage than earlier variants. It is at least a hundred times more infectious than earlier variants. Since even in vaccinated people it takes time for the immune system to react, so-called "break-through" infection in vaccinated people are fairly common. But unvaccinated people are about seven times more likely to be hospitalised, and to die.

Evolutionary theory predicts this: Any mutation that improves the odds of infecting a host will eventually dominate. The same theory predicts that more variants will arise, but if they are less infectious than Delta, they will not spread. The most worrisome possibility is that Delta could morph to be more  damaging.

Since none of the vaccines prevent infection 100% of the time,  the virus (SARS-COV-19) will continue to infect people, and mutated strains will continue to arise. Sooner or later, there will be a strain that the immune response to vaccines will not be able to fight efficiently, which means that the infected people will be shedding virus longer, which will hasten the spread of that strain. There is of course the likelihood that the immune response will also change, but that change will be slow, and so such new strains will at first infect a lot of people.

So we will have a virus that  mutates regularly, and epidemics will come and go. Covid-19 will become an endemic disease like the flu. Both will cause epidemics at fairly regular intervals. The evidence so far indicates that the covid epidemics will be worse.

NB: I have corrected an omission in the discussion of false test results below. The actual effect of a test error rate depends on whether it's the same or different for positive and negative results.

Update 2021-01-25: There are two worrisome new variants of the virus. One identified in the UK, the other in South Africa. Both are more infectious, and both may be more lethal, but the vaccines apparently work as well as with the original variants. The vaccination programs have hit predictable snags in production and logistics, causing a great deal of pointless finger-pointing.

 Today WHO announced that covid-19 "may" become endemic.

Huh?????

No "may" about it. It will become endemic. The reason? Several, actually.

a) The wide range of responses to exposure to the virus, which vary from zero symptoms to serious and lethal illness to serious and lethal complications, to long-lasting after-effects. People with zero to mild symptoms are infectious.

b) Mutation. Current research on the mutated strains suggests that the virus will mutate continually, which means that by the time a vaccine or drug is developed, it may not work. Mutation also implies that vaccines and drugs would have to be updated at intervals, and that some future strains may be even more lethal than the current ones.

c) Variable immunity to the virus, which means re-infection and recurrence of the illness is certain. In fact, it's already happening. Also, the presence of antibodies does not guarantee immunity.

d) Variable incubation stage. It ranges from about 5 days to about 14 days after exposure. Also, repeated exposure seems to be a factor.

e) Variable asymptomatic but infectious stage, which follows incubation. Current data suggest two to four days.

f) Error rate of antibody test. It's about 90% accurate. Suppose an actual infection rate of 5%, then the false positive rate will close to 70%. (See the Wiki article on the base rate fallacy and the Footnote below.) This means that the anti-body test will generate a false sense of security.

These factors add up to guaranteed infections in future. The only unknowns are the future rates of infection, what factors affect those rates, and how lethal future infections will be. Experience with the flu shows that every now and then a more lethal strain will emerge. Current data suggest that covid-19 will be somewhere between twice and five times as lethal as the flu.

We will have to learn to live with it. It's likely that covid-19 will always be worse than the flu.

Footnote: Why a 90% positive accuracy isn't very good.
Suppose a 5% infection rate. Suppose a test with 90% accuracy for both positives and negatives. Then, in a population of 100,00, we will have:

Actual positives: 5,000
Detected actual positives: 4,500
Actual negatives: 95,000
Negatives detected as false positives: 9,500
Total positives detected: 9,500 + 4,500 = 14,000
Percentage of false positives: (9,500/14,000) x 100 = 67.8%

So if you get a positive test, it's more than twice as likely that you're negative than you're positive.

Two more by Dickson

Gordon R. Dickson. Beginnings (1988) Another Dickson selection. Reprints several much-anthologised stories, eg, “Danger – Human!” and  “Idiot Solvant”. Includes “Soldier, Ask Not”, one of the early Dorsai tales, and still one of the best meditations on the role of the soldier. Worth picking up if you find a copy. I found this one on a remainder rack, paid $4.95, worth the price. *** to ****

Gordon R. Dickson. Wolfling. (1969) Jim Keil is inserted into the decadent Empire’s heart by means of a bullfight staged to entertain the High-born visiting Alpha Centauri 4. He advances step by step into the Emperor’s favour, and prevents an assassination attempt by the Emperor’s cousin. He must defend himself against the would-be assassin, and wins (of course). Returned to Earth, he stands trial for treason, because the authorities fear his actions will draw the wrath of the Empire. He survives that final ordeal, too (of course). And he gets the girl (of course).

    One of Dickson’s early attempts at painting Earth and Earthlings as exceptional. He succeeds, not only because he develops plausible implications of his premises, but because of his above average ability to create characters that drive the story. True, the characters here are stereotypes, but in their context they seem to be more. Creating that illusion well enough that we accept it while the story unfolds is all that’s required, and Dickson delivers.
    Oh yeah, “wolfling” is the High-borns’ name for him, since he comes from an uncivilised world. ***

Strange talents, useful quirks: Dickson's Mutants

Gordon Dickson. Mutants (1970) A collection chosen by Dickson himself. It includes the classic “Warrior”, reprinted by Dickson in at least one other collection, and  anthologised several times elsewhere. Dorsai Commandant Ian Graeme comes to New York to seek justice for 32 men under his command who were led into unacceptable danger by their officer. The story draws a distinction between the merely military man and the man of war, or warrior.
     Another classic, “Danger – Human!”, explains both why humans have managed at least three times to build Galaxy-dominating empires, yet have failed to make them last.  Some aliens kidnap Timothy Parker,  a man from Vermont, alter his physiology and psychology to prevent death and madness, and keep him in a triply-secured cage to find out what makes humans tick. He gets out, steals a spaceship, and heads for home, where its technology will no doubt be used for a fourth excursion into interstellar space and the building of a rapacious empire.
     Dickson writes thematic stories, fables or parables really. But he has a knack for meshing character and plot so well that the didactic purposes rarely interfere with the believability of his tales. He sets his stories in several different futures, carefully imagined and plausible. He writes well, exemplifying Strunk and White’s advice to avoid adjectives and the passive voice. I’ve never been disappointed in one of his stories. Recommended. *** to ****

Seven Fables about War: 7 Conquests (Poul Anderson)

Poul Anderson. 7 Conquests (1970) Anderson had a rather bleak view of human nature: War, chicanery, criminal intent and a propensity to violence are inbred in our species. This collection’s seven parables about the nature of war explore his thesis that war is species-specific behaviour. Or at any rate inevitable once our species achieved a city-based social system.
     The first tale, “Kings Who Die” meditates on Campbell’s Hero of a Thousand Faces. In “Cold Victory”, the contested thesis is that individuals cannot guide the course of history, that the great currents of social change merely carry them along. The story shows that the two propositions are compatible. It also mourns the tragedy of a family caught on opposite sides. “Inside Straight” posits an extreme version of the Libertarian fantasy of absolute individual freedom and responsibility, presented as a society in which almost every transaction is a wager. It’s contrasted with a rigidly authoritarian society, whose representative misreads the absence of centralised control as military weakness.
     A good collection. ** to ***

An Andre Norton anthology

     The Book of Andre Norton (1975) In hardback, The Worlds of Andre Norton. A good collection: five short stories; an essay by Norton about reading and writing fantasy; a critical analysis of her writing by Brooks; a bibliography, compiled by Jakusz-Hewitt; and two “novelettes”, better described as longish short stories. A good introduction to Norton’s work and reputation, and recommended for that reason alone.
     So how does Norton’s work look now? She wrote most of it the 1950s to 1970s, a time when SF expanded beyond its existing boundaries of fantasy, wowser technology, and swashbuckling adventure. The mostly male writers dabbled in everything from careful extrapolations of current technology, to adaptations of older genres, to sociological speculation, to future and alternative histories. It was the Golden Age because the writers showed SF, redubbed “speculative fiction”, was a mode rather than a genre, and like any mode could be used for any genre and any literary purpose.
     Norton preferred fantasy, and (as Brooks remarks) doesn’t like hard science and machine technology. But she has no qualms imagining energy-beam weapons. She likes magic and mind-talk, and alliances between humans and other animals. She uses the old mythologies to tell stories of ethical quandaries.
     There’s a strong romantic streak in her writing, with handsome and chivalrous warrior heroes and beautiful strong and wise women to match with them after the usual interference from fate, or evil or merely stupid humans. The short stories are better focussed than the longer pieces, which often have the feel of role-playing games, with one damn thing after another preventing the hero and heroine from reaching their goal. They are entertainment very much of their time. SF then catered to the taste for adventure stories in which the reader could identify with the hero. Nowadays, SF is more likely to engage one’s political indignation and confirm one’s curmudgeonly despair over the human race’s follies.
     Recommended for any Norton fan, and for anyone who wants a taste of what at 50 or 60 years old is already ancient literature. ** to ***

The state of corona virus knowledge as of today (May 3, 2020)

SARS-CoV-2 (the virus) and covid -19 (the illness)

Here’s what “we” know and don’t know as of 2020-05-01. “We” are the people who’ve collected and interpreted the data. “We know” means the data strongly support the conclusion. “We don’t know” means there are insufficient data to draw a conclusion. Compiled from reports in science news magazines, media reports, and Q & A sessions with experts.-WEK

A)    We know: Some people are infected with the virus but don’t get sick.
    We don’t know: how many.

B)    We know that the effects of the virus range from zero to death; and mild to lethal complications.
    We don’t know: Why the virus has such a wide range of effects.

C)    We know: there is a time between infection and symptoms during which a person will be infectious.
    We don’t know: the actual range of both time and severity of this infectious state.

D)    We know: that people who’ve been infected will have anti-bodies in their blood;
    We don’t know: whether the presence of antibodies gives immunity, nor what degree  of immunity, nor how long such immunity might last.

E)    We know: there will be second wave of infection, and probably a third and fourth one,
    We don’t know: how bad these subsequent waves will be.

F)    We know: that some of the economic and social effects will be permanent.
    We don’t know: which effects, nor how these effects might change over time, nor what  the knock-on effects will be.

G)    We know: covid-19 will become another infectious disease that will take its yearly toll.
    We don’t know: when that will happen, nor how common or lethal covid-19 will be.

H)    We know: that some anti-viral treatments show some activity against SARS-CoV-2.
    We don’t know: whether that activity will be good enough for effective tretament.

I)    We know: effective treatments and a vaccine will reduce the danger of covid-19 to that of the flu.
    We don’t know: which treatments will be effective.
    We don’t know: whether a vaccine is possible, and if possible, how well it is likely to work.

J)    We know: the counter-measures have reduced infection rates.
    We don’t know: how effective those counter measures actually were.

K)    We know: that a combination of dry cough and high fever, with some other signs such as difficulty breathing, indicate covid-19. But only a test can confirm the diagnosis.
    We don’t know: what other signs and symptoms may be indicators of covid-19.

Update 2020 05 04: UK doctors have observed covid-19 patients with low and extremely low blood oxygen levels, but without the usual distress. Another puzzle.

Humans rule, except when they don't: A Fred Pohl collection

Frederik Pohl. The Abominable Earthman (1963) Collection of some of Pohl’s early pieces. The title story tells about a sociopathic but genial ne’er-do-well who inadvertently becomes humankind’s saviour when he discovers how to control the insectoid invaders (from a planet trailing Sirius) by offering them regular hits of CO2, which for them is an addictive and mind-addling drug.
     Several of the other stories have an equally shaggy-dog denouement, e.g. Punch, which warns us to beware of aliens bearing gifts. This genre was very popular at the time, and Pohl’s work is better than most, I think because he takes his serious themes seriously, even in his comic writing. He uses SF to explore what it means to be human. Like Ambrose Bierce, he “sees things as they are, not as they are supposed to be.” Which makes him a cynic, but an entertaining one. In his longer, more ambitious works (like the novella, Whatever Counts, included here) he tends to portentousness.
    Still, he’s one the best writers of the era, and any of his books is worth reading. ** to ****.