Coronavirus

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Wayland
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In reply to PackPA2015 • 4:22p, 3/25/21
PackPA2015 said:
Wayland said:
CLI surveillance out today.

25-49, 50-64, and 65+ all with about the same number of admits for C19. Slight increase overall due to the small uptick in 25-49s.

50-64 showing slightly higher than the other 2.

A little concerning to me with cases and hospitalizations slightly increasing. We have seen that locally as well. Could be just a small bump and not matter in the long run, but really shows that we need to continue to increase vaccination rates in new age groups. I would also recommend continuing our masking (I know, some will disagree).
I'll reserve judgement on calling the anything an 'increase' yet. The changes are low enough that they could be an artifact of increased or focused testing. As case numbers get lower, and kind of localized outbreak gets exaggerated in the data.

We are definitely in a plateau, but this is what I expected in March anyways. Peak around New Years, declining to March plateau, seeing further decrease (hopefully) in April.

And while hospitalizations have been relative flat, ICU numbers have been decreasing (knock on wood). We have no idea what the actual 'floor' currently is. Single day fluctuations aren't significant.

Hopefully the trends continue to be positive, but even if we have a final death knell wave, between infection and vaccination the vast majority of seniors (and hopefully soon) at risk will have conferred protection.
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PackPA2015
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In reply to Wayland • 4:27p, 3/25/21
All fair points. I, along with everyone else, just want to get back to normal as quickly as possible. I really do not want to see a fourth wave of any type.

Locally, it has just seemed to be a consistent week long small increase in case numbers and a 1% increase in positivity. This is with amount of tests being performed steadily declining. In fact, our local health department has quit testing all together to put all staff towards vaccinations. Then, we got the email from our hospital system showing a doubling of hospitalizations within the last 3 days. Again, hopefully not a trend, but something to monitor very closely going forward. I agree with you (I think you said this) and Davie that this bump will likely be from that 40-64 age range which has not been heavily vaccinated as of yet.
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Wayland
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7:11p, 3/25/21
FYI here is the backlog deaths from today. No trend change.





Level cases

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PackPA2015
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9:26a, 3/26/21
A little evidence, although only his opinion, for the lab escape theory.

Former CDC Director on Virus Origination


Vaccines proving they work in real life situations outside of a randomized control trial. They work really, really well if you can make it to two weeks past the second dose. Study was in healthcare workers at UC San Diego and UCLA in 1st link and in Israel in the 2nd link.

Vaccine Efficacy in Real World Situations

Vaccines Working in Israel even with Variant Spread
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Wayland
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In reply to Wayland • 10:23a, 3/26/21
Wayland said:
FYI here is the backlog deaths from today. No trend change.





Level cases

Looks like Wake found another 30 or so backlog deaths to report today.
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Daviewolf83
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In reply to PackPA2015 • 10:33a, 3/26/21
Staff
PackPA2015 said:
A little evidence, although only his opinion, for the lab escape theory.

Former CDC Director on Virus Origination


Vaccines proving they work in real life situations outside of a randomized control trial. They work really, really well if you can make it to two weeks past the second dose. Study was in healthcare workers at UC San Diego and UCLA in 1st link and in Israel in the 2nd link.

Vaccine Efficacy in Real World Situations

Vaccines Working in Israel even with Variant Spread
Thanks for the info. I did see the quotes for the former CDC Director this morning and found them to be "interesting." Given past events, I have always considered lab escape as a viable option, but I think there are some other plausible causes in addition to this one. I think it is possible we will never know how the infection began to spread.

As far as efficacy, I did see a report from a biostatistician that provided the following info on efficacy:
-Without vaccinations, you would expect to see 26 infections out of 1,000 people
-With full vaccination of a population, you could expect to see 0.5 infections out of 1000 people

Very compelling information to consider.
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wilmwolf
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10:37a, 3/26/21
I'm glad we are at least able to say publicly now that there is a possibility that the virus may have escaped from the lab. The resistance to acknowledging that it was possible was dumb. We'll likely never know, and it doesn't mean that it was something nefarious, but if you are researching a virus, and that virus or something very similar turns into a global pandemic that happens to originate in the city where the lab is located, it shouldn't be controversial to say it is possible.
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statefan91
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10:46a, 3/26/21


Davie - can you weigh in on this? I know you were disappointed with J&J rollout but it sounds like they've been able to fix some of the production issues.
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ncsualum05
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In reply to Daviewolf83 • 11:11a, 3/26/21
Daviewolf83 said:
PackPA2015 said:
A little evidence, although only his opinion, for the lab escape theory.

Former CDC Director on Virus Origination


Vaccines proving they work in real life situations outside of a randomized control trial. They work really, really well if you can make it to two weeks past the second dose. Study was in healthcare workers at UC San Diego and UCLA in 1st link and in Israel in the 2nd link.

Vaccine Efficacy in Real World Situations

Vaccines Working in Israel even with Variant Spread
Thanks for the info. I did see the quotes for the former CDC Director this morning and found them to be "interesting." Given past events, I have always considered lab escape as a viable option, but I think there are some other plausible causes in addition to this one. I think it is possible we will never know how the infection began to spread.

As far as efficacy, I did see a report from a biostatistician that provided the following info on efficacy:
-Without vaccinations, you would expect to see 26 infections out of 1,000 people
-With full vaccination of a population, you could expect to see 0.5 infections out of 1000 people

Very compelling information to consider.
Regarding Redfield's opinion... that has been my belief all along. Last year if you said that on TV you got excoriated by the corrupt fake media. If you follow the SCIENCE though the accepted theory makes no sense. Much more plausible of a lab accidental infection and quick spread. Also... this is China... what did they do way back in the beginning? They silenced people at the lab, silenced doctors treating people, and burned a lot of evidence at the lab. No reason to trust any WHO investigation at this point either particularly since China has had ample time to cover things up and the WHO has been in cahoots with China.
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TheStorm
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In reply to RunsWithWolves26 • 11:26a, 3/26/21
RunsWithWolves26 said:
What do you mean by no sensation?
Meaning right after I took the shot, I could only still tell I had just had a shot up to MAYBE the next three (3) minutes, then after that - nothing... never had any soreness, no side effects whatsoever, etc. and now I'm 48 hours past my shot. Again, mine was Pfizer.
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RunsWithWolves26
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In reply to TheStorm • 11:32a, 3/26/21
Thanks. I'm getting my first Pfizer shot next week so hoping for an easy process and an easy process on the second one.
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TheStorm
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In reply to RunsWithWolves26 • 11:51a, 3/26/21
RunsWithWolves26 said:
Thanks. I'm getting my first Pfizer shot next week so hoping for an easy process and an easy process on the second one.
The process (at Walgreen's) was slower than it should be in talking about an efficient way of getting vaccines out during a pandemic, but it was certainly manageable for us (my wife and I) as individuals... they were on a pace of six (6) vaccines an hour and I was in and out in 45 minutes...

We were at the Richlands Highway (NC-24 West) location in Jacksonville near the newer Walmart just off Business 17...
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wilmwolf
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In reply to TheStorm • 11:55a, 3/26/21
Yup, Walgreens in a bit of a tough spot, at least the one I went to, because the person giving the shots is still working in the pharmacy. I was frustrated because I took the time to print and fill out the paperwork as instructed, only to get there and be told the form had changed and I had to fill out the new form, which of course was identical in basically every way to the one I had filled out. It is what it is I guess. Ultimately I was in and out in a little over 30 minutes.
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Wayland
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12:42p, 3/26/21
Wake dropped 20 more deaths stretching all the way back to July. Other than that trends don't change. Cases plateau.


But interesting and promising data. Other coronaviruses are making a comeback! I know most people don't want to see viruses. But if we are seeing a resurgence then they aren't being dominated by C19 anymore, (if you believe in that viral dominance theory).



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Daviewolf83
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In reply to Wayland • 1:40p, 3/26/21
Staff
Wayland said:
Wake dropped 20 more deaths stretching all the way back to July. Other than that trends don't change. Cases plateau.


But interesting and promising data. Other coronaviruses are making a comeback! I know most people don't want to see viruses. But if we are seeing a resurgence then they aren't being dominated by C19 anymore, (if you believe in that viral dominance theory).



I saw an interesting paper/study a couple of days on the viral dominance theory, as it relates to Covid. I keep trying to reconcile the fact that masks stopped the outbreak of flu this past year, but they did not stop the large, seasonal spike in cases for Covid-19 between late September and early-February. If masks were not responsible for significantly lowering the incidence of Covid-19, how did they drastically impact incidence of the flu, when both are airborne viruses. I will see if I can find the paper and post the link to it in this thread.

I know many of you believe masks were the answer and you think it might be a good idea to wear masks next flu season, but I am not as certain they were as much of a help in preventing flu infection as it may appear. I have also read that a big driver of flu season are kids and the fact many public schools were not in-person during flu season, may have helped to positively impact the incidence of flu this past year. As I have stated before, unless I am sick, I have no intention of wearing a mask during flu season in upcoming years. I'll get a flu shot and take my chances.

Just so everyone is aware, the viral dominance theory postulates if someone is infected with Covid-19, they are highly unlikely to also be infected with the flu virus. With fewer people becoming infected with the flu, it makes it difficult for it to spread through the population. With the fact that so many people were infected with Covid-19 this past year, it is possible Covid-19 infections tamped down flu infections, even for those who were asymptomatic with Covid-19. It is definitely a theory that demands additional study.
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wilmwolf
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In reply to Daviewolf83 • 1:48p, 3/26/21
"If masks were not responsible for significantly lowering the incidence of Covid-19, how did they drastically impact incidence of the flu, when both are airborne viruses. I will see if I can find the paper and post the link to it in this thread. "

Please do. I posed this conundrum a few hundred pages ago and was roundly criticized for trying to reconcile this seeming discrepancy. I think that the school kid aspect of it is probably a major contributor, but it will be interesting to see other theories.
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Daviewolf83
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1:57p, 3/26/21
Staff
Below are the links to two articles on viral interference. One is the study I referred to in my previous post. It is an article in The Lancet that shows how incidence of rhinovirus impacted the spread of Influenza. Viral interference si thought to have been one of the key reasons the Swine flu ended in 2009.

Interference between rhinovirus and Influenza A: a clinical data analysis and experimental infection study

The second link is to an article in Medium, discussing viral interference and making a case for Covid-19 impacting the incidence of flu this year.

The Unexpected Case of the Disappearing Flu

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Daviewolf83
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In reply to wilmwolf • 2:06p, 3/26/21
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wilmwolf80 said:
"If masks were not responsible for significantly lowering the incidence of Covid-19, how did they drastically impact incidence of the flu, when both are airborne viruses. I will see if I can find the paper and post the link to it in this thread. "

Please do. I posed this conundrum a few hundred pages ago and was roundly criticized for trying to reconcile this seeming discrepancy. I think that the school kid aspect of it is probably a major contributor, but it will be interesting to see other theories.
I think you will like the second link I just posted. I had an interesting Twitter interaction last week (before I muted the person) with some fool on Twitter. She was convinced that we needed to continue to track cases, since it helped her to know who was not wearing a mask and causing the pandemic to continue. Of course, she could not resist the impulse to take a swipe at people who supported Trump. The sad thing is there were several people who liked her Tweets.
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statefan91
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3:33p, 3/26/21
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Wayland
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In reply to wilmwolf • 4:35p, 3/26/21
wilmwolf80 said:
"If masks were not responsible for significantly lowering the incidence of Covid-19, how did they drastically impact incidence of the flu, when both are airborne viruses. I will see if I can find the paper and post the link to it in this thread. "

Please do. I posed this conundrum a few hundred pages ago and was roundly criticized for trying to reconcile this seeming discrepancy. I think that the school kid aspect of it is probably a major contributor, but it will be interesting to see other theories.
Which is why I have said OVER AND OVER. We have had 42.... FORTY TWO... total identified cases of the flu (all types which is over 5 different flu not including the not subtyped!! ) in NC this year.

Why are we not contact tracing them? That is the real benefit to the greater science and virus transmission understanding.

We have like 1000 contact tracers. We should have a handful of them trying to figure out where the hell the 1 case of Flu-B (Victoria) in NC came from. Or for that matter ANY of them, it should be fascinating.

They are still doing thousands of flu tests a week. This week they found .... one.

I would hope there are scientists out there that care and are tracking this stuff down.
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bigeric
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5:19p, 3/26/21
Sound like a virus has no immunity against another type virus. The more virulent/stronger one wins.
Like I said, if you can't get hyped for the Carolina game, why are you here?
-Earl Wolff-
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ncsualum05
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8:23p, 3/26/21
What they need to be doing is tracking where all this puke and crap norovirus is coming from. Bet there's more cases of that than anything else right now. And I can tell you from experience it's the worst one I've ever had. Went from 10:30-6:30 the next morning non stop with no reprieve.
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PackPA2015
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In reply to Daviewolf83 • 9:33a, 3/27/21
Daviewolf83 said:
Below are the links to two articles on viral interference. One is the study I referred to in my previous post. It is an article in The Lancet that shows how incidence of rhinovirus impacted the spread of Influenza. Viral interference si thought to have been one of the key reasons the Swine flu ended in 2009.

Interference between rhinovirus and Influenza A: a clinical data analysis and experimental infection study

The second link is to an article in Medium, discussing viral interference and making a case for Covid-19 impacting the incidence of flu this year.

The Unexpected Case of the Disappearing Flu



The author of the second article does not appear to address the varying amounts of viral load needed to infect. These differ vastly between different viruses of all types. The amount is not fully known for COVID-19, but based on ease of transmission it appears to be lower. So if a mask lowered the amount of particles an individual received during an interaction, then the individual could be infected with COVID, but not influenza. That has nothing to do with size of the viral particles.

Obviously, this needs a lot more study, but could explain part of the differences. As I have said many times before, schools being remote or hybrid has to be a huge reason for lower flu transmission. To sum it all up, I'm sure there are a million pieces to why flu has all but disappeared this season, but I don't think you can just say masks, social distancing, and hand washing have nothing to do with it.
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Wayland
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In reply to PackPA2015 • 9:54a, 3/27/21
PackPA2015 said:
Daviewolf83 said:
Below are the links to two articles on viral interference. One is the study I referred to in my previous post. It is an article in The Lancet that shows how incidence of rhinovirus impacted the spread of Influenza. Viral interference si thought to have been one of the key reasons the Swine flu ended in 2009.

Interference between rhinovirus and Influenza A: a clinical data analysis and experimental infection study

The second link is to an article in Medium, discussing viral interference and making a case for Covid-19 impacting the incidence of flu this year.

The Unexpected Case of the Disappearing Flu



The author of the second article does not appear to address the varying amounts of viral load needed to infect. These differ vastly between different viruses of all types. The amount is not fully known for COVID-19, but based on ease of transmission it appears to be lower. So if a mask lowered the amount of particles an individual received during an interaction, then the individual could be infected with COVID, but not influenza. That has nothing to do with size of the viral particles.

Obviously, this needs a lot more study, but could explain part of the differences. As I have said many times before, schools being remote or hybrid has to be a huge reason for lower flu transmission. To sum it all up, I'm sure there are a million pieces to why flu has all but disappeared this season, but I don't think you can just say masks, social distancing, and hand washing have nothing to do with it.


Then how do you explain it disappearing worldwide in March 2020 also in places that did none of those things, Sweden, Japan (to a lesser degree), all of South America? The entire U.S.?

Flu disappearance wasn't a local or regional phenomenon. It was worldwide. And all we heard in the U.S. was how bad some states were at following COVID protocols.... Yet no flu.

It is certainly complicated, but crediting NPI s for flu when they had largely no effect on COVID doesnt sell to me.
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packofwolves
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10:01a, 3/27/21
We were able to get into Wakemed Raleigh for first Pfizer dose this morning.

If your still looking for a vaccine in wake county, open a Wakemed my chart account. It is a two step process, where they send you an authorization code. After you have an account, check it regularly for appointments to open up. Definitely check through out the day on Thursdays and very early Friday morning.
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PackPA2015
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In reply to Wayland • 10:34a, 3/27/21
Wayland said:
PackPA2015 said:
Daviewolf83 said:
Below are the links to two articles on viral interference. One is the study I referred to in my previous post. It is an article in The Lancet that shows how incidence of rhinovirus impacted the spread of Influenza. Viral interference si thought to have been one of the key reasons the Swine flu ended in 2009.

Interference between rhinovirus and Influenza A: a clinical data analysis and experimental infection study

The second link is to an article in Medium, discussing viral interference and making a case for Covid-19 impacting the incidence of flu this year.

The Unexpected Case of the Disappearing Flu



The author of the second article does not appear to address the varying amounts of viral load needed to infect. These differ vastly between different viruses of all types. The amount is not fully known for COVID-19, but based on ease of transmission it appears to be lower. So if a mask lowered the amount of particles an individual received during an interaction, then the individual could be infected with COVID, but not influenza. That has nothing to do with size of the viral particles.

Obviously, this needs a lot more study, but could explain part of the differences. As I have said many times before, schools being remote or hybrid has to be a huge reason for lower flu transmission. To sum it all up, I'm sure there are a million pieces to why flu has all but disappeared this season, but I don't think you can just say masks, social distancing, and hand washing have nothing to do with it.


Then how do you explain it disappearing worldwide in March 2020 also in places that did none of those things, Sweden, Japan (to a lesser degree), all of South America? The entire U.S.?

Flu disappearance wasn't a local or regional phenomenon. It was worldwide. And all we heard in the U.S. was how bad some states were at following COVID protocols.... Yet no flu.

It is certainly complicated, but crediting NPI s for flu when they had largely no effect on COVID doesnt sell to me.


I think I didn't make my point very well. I think it is not an all or nothing phenomenon. I don't think NPIs are the whole story, but I think it contributes. That is why I disagreed with the second article. I don't think it can all be explained with viral dominance or the other theories as well. They all contribute to the final picture.
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Daviewolf83
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In reply to PackPA2015 • 3:03p, 3/27/21
Staff
PackPA2015 said:
Daviewolf83 said:
Below are the links to two articles on viral interference. One is the study I referred to in my previous post. It is an article in The Lancet that shows how incidence of rhinovirus impacted the spread of Influenza. Viral interference si thought to have been one of the key reasons the Swine flu ended in 2009.

Interference between rhinovirus and Influenza A: a clinical data analysis and experimental infection study

The second link is to an article in Medium, discussing viral interference and making a case for Covid-19 impacting the incidence of flu this year.

The Unexpected Case of the Disappearing Flu



The author of the second article does not appear to address the varying amounts of viral load needed to infect. These differ vastly between different viruses of all types. The amount is not fully known for COVID-19, but based on ease of transmission it appears to be lower. So if a mask lowered the amount of particles an individual received during an interaction, then the individual could be infected with COVID, but not influenza. That has nothing to do with size of the viral particles.

Obviously, this needs a lot more study, but could explain part of the differences. As I have said many times before, schools being remote or hybrid has to be a huge reason for lower flu transmission. To sum it all up, I'm sure there are a million pieces to why flu has all but disappeared this season, but I don't think you can just say masks, social distancing, and hand washing have nothing to do with it.

I posted these articles in reaction to some of the ridiculous things being stated on social media and even in this thread with regards to the flu and masks. Many on social media and this platform stated that they believe masks were the reason why the flu disappeared this year and as a result, we should implement a masking policy in the future during flu season. Quite frankly, this is an absurd conclusion to make and is one that is not based on the available evidence. As you said, there are likely many reasons why the flu disappeared, so for many to say masks are the reason is just silly. This ranks up there with the Twitter fool that wanted to argue with me that people not wearing masks are the reason why the virus is spreading.

Add to this, the on-going absurdity of requiring people who have been fully vaccinated to wear a mask. Case in point is Rutgers University. For this coming Fall semester, they are requiring all on-campus students to be vaccinated. This is good policy. At the same time, they are also going to require all fully vaccinated people to continue to wear a mask and social distance in the Fall. This is an absurd policy. This follows right along with Dr. Fauci and others who say that even after being vaccinated, we must continue to wear a mask and social distance. It implies that vaccines will not allow us to return to normal.

Over the past few months, I have become a fan of Dr. Monica Gandhi on Twitter. Dr. Gandhi is an infectious disease doctor at UCSF. She has provided clear information on the benefits of the amazing vaccines we have now and how they can return us to normal. She provides regular updates on how the vaccines will work to protect, by stimulating our bodies to produce antibodies and T-Cells that should provide robust protection. Just today, she posted a chart showing some summary results from early studies that demonstrate that the vaccines do reduce transmission of the virus. I am posting it below for others to see.



Additionally, she had this to say today on Twitter with regards to our return to normal (note her last sentence):


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Daviewolf83
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3:14p, 3/27/21
Staff
Some good news, in NC the number of Covid-19 patients in ICU is now the lowest it has been, since NCDHHS started reporting this information the first week of June.

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PackPA2015
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In reply to Daviewolf83 • 3:22p, 3/27/21
I agree with your above points. I think theories can go too far in both directions - that masks are end all be all or that masks are worthless. The truth is somewhere in between, imo. I don't think you can say that masks and other precautions together had zero effect on influenza and other viruses. I do not believe it is the sole reason either. I do think it helped.
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RunsWithWolves26
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7:07p, 3/27/21
Got my first dose of Pfizer today in onslow county. They have opened up to 18 and older as well. Went to the american legion and it took maybe 15 mins to get it even with one piece of paper work to fill out.
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Civilized
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In reply to RunsWithWolves26 • 10:35p, 3/27/21
RunsWithWolves26 said:
Got my first dose of Pfizer today in onslow county. They have opened up to 18 and older as well. Went to the american legion and it took maybe 15 mins to get it even with one piece of paper work to fill out.

Great news man. Glad a bunch of folks on here have been able to find doses.
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vanuel
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12:15a, 3/28/21
I got the second shot of Pfizer on Thursday. No side effects. We now have everyone at the shop vaccinated with both doses. Were able to stay open the whole year without Covid getting in the building, no shutdowns or quarantines. 2020 was rough as a cob though. All kinds of supply chain issues, schedule challenges, and having all of our office people at home trying to work together with the shop guys to get equipment built and out the door. Feels like we are turning the corner now. Lots of people getting vaccinated.
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RunsWithWolves26
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5:51a, 3/28/21
Arm started getting sore last night and I felt tired(could be that I just don't sleep much anyway). Had a touch of a headache but nothing major.
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Mormad
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In reply to PackPA2015 • 8:06a, 3/28/21
PackPA2015 said:
I agree with your above points. I think theories can go too far in both directions - that masks are end all be all or that masks are worthless. The truth is somewhere in between, imo. I don't think you can say that masks and other precautions together had zero effect on influenza and other viruses. I do not believe it is the sole reason either. I do think it helped.


You are correct. It did help. No way to deny it. Just like condoms block exposure to HIV in bodily fluids to help reduce transmission but aren't the reason HIV isn't the national story anymore, masking and social distancing reduce exposure to all respiratory viruses and therefore reduce our numbers. Again, saying NPIs "don't work" for covid or any other communicable resp virus is like saying eating right, exercise, and avoidance of smoking doesn't work for heart disease because people still have MIs. It's not hard to predict that our numbers would have been exponentially higher without NPIs. Would have reached herd immunity a lot faster though.

That said, factors such as incubation times, population immunity, viral load, viral replication, viral dominance, climate, and snotty kids play a huge roll, especially when trying to compare and contrast different virions. Flu has a very short incubation time but it's probably less infectious than covid as humans have been exposed to flu viruses their whole lives and therefore there is some underlying level of population immunity. Kids are known spreaders of flu, and the incubation time in them is longer than in adults. Separating them, while proving to be less necessary with covid, was YUGE for reducing flu because of these simple facts about influenza in kids.

I get what the second writer is saying, and to a degree he's quite correct and asks valid questions that honestly there are simply only theoretical answers based in scientific theory and observation at this stage of covid history, but I'll tell you right now every ID doc i know feels if you don't want the flu next year then wear the silly mask and keep your distance (and if the kids don't give it to you) and you will GREATLY reduce your risk of getting it. Most won't do it, and that's cool, but i won't scoff at the ones who will. Just like with covid, doesn't mean you won't get the flu, but it'll greatly reduce your risk. Staying away from people is obviously more effective than masking, but none of us wanna be a hermit.
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In reply to Mormad • 9:14a, 3/28/21
Implying that masks must not work because flu numbers fell off a cliff and there is still a lot of COVID out there is an analysis that's full of obvious holes.

Masks aren't the answer. They help, in concert with multiple other mitigating behaviors.

The biggest hole in the analysis, to me, is the difference in transmissibility piece. If masks and distancing drop the R0 of flu from 1.x to 0.x for instance, that virus never gets off the ground during its normal seasonal ramp up since the R0 is below 1 out of the gate. ItS chances of spreading during that season are DOA.

In contrast, if COVID has an R0 of 2.x AND very broad worldwide community spread before broad implementation of NPI's, even if masks drop the R0 of COVID they don't drop it from 2.x to 0.-anything. It's 2.9 to 2.2, or 2.5 to 1.8, or something. Even though masks "work" they don't work so well that they stop COVID spread on their own.

You need masks + distancing + some natural immunity + some vaccine immunity + hand washing + ... to get R0 of COVID well under 1. Go look at exponential R-curves for illustration. Massive differences in transmission for R0 of 3 vs 2 vs 1.1 vs 0.9 vs 0.5.

One of the most mind-bending things to me when reading about this is that measles has a natural R0 of 15. 15!!!

Also read a great, balanced piece last night on the possibility that COVID originated in the Wuhan lab. The research on this disease in coming years will be fascinating.

https://undark.org/2021/03/17/lab-leak-science-lost-in-politics/
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