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Are Opioids the answer?

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as long as there are per death rebates

I did a similar analysis. Although I disagree with their r0 and I think vaccines may prioritize to people who haven’t had the virus, I used similar logic.

Herd immunity threshold is probably a bad way of thinking about it. Idk if any of the vaccines will be good enough at blocking transmission to reach sustained herd immunity with achievable vaccination levels, especially on a sustained basis.

Much more likely is an endemicity scenario where SARS-CoV-2 sticks around forever as a seasonal respiratory virus, coming and going in waves.

My hope is that this isn’t a big deal and severe symptoms are heavily blunted by vaccines and past infections, even as the virus keeps mutating (especially given the durability of protection from CD8 T cells and the like). So far the data is quite good on this, including with the E484K mutation (the one that shows “vaccine escape” tendencies).

They’re certainly possible, and they’ve happened. Not very common though. I do think the media has mostly overhyped how likely one is to be a carrier of the virus if they’ve already had Covid once in a bid to not incentivize getting Covid to get out of The Rules.

My expectation is that they’ll become significantly more common as the virus continues to mutate a bit (E484K is already showing itself to get past protection from prior infection) and antibodies wane. That’s how it works with the other human coronaviruses.

But my current expectation - and this is a take that I think is both optimistic and realistic! - is that protection from severe disease should be pretty durable after you’ve been exposed to the spike protein once (via a vaccine or an infection). In the vast majority of cases, that is.

If we start seeing large numbers of hospitalizations from people who were vaccinated or already had Covid once, then count me terrified.

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