As someone who doctors once put "12 hours from coma" due to malaria (and I was in rural Tanzania, so coma == death out there), this is straight up the best news I've heard in a very long time.
Seriously, don't get malaria if you can help it. Your bones hurt from the inside out while you lay in a pool of your own sweat, crawling to the toilet every hour or two because of oscillating vomiting and diarrhea. Since you're most likely in a developing country, air conditioning is usually out of the question (you're shivering in the 100F+/35C+ temps anyways from the fever). The drugs, if you're lucky, only give you the most vivid and disconcerting dreams you've ever had (if you're unlucky, which 50% of people are, they're the most horrifying night terrors you can imagine).
The good news is it's highly treatable. The bad news is that at ~$3 for a round of treatment it's prohibitively expensive if you're only making $2/day and have a family to support.
We only got rid of it here in the US because of DDT. Malaria was endemic in the South (and parts of the North in the summer) until the mid-20th century.
I grew up in Tanzania! Can I ask where you were, and what you were doing?
BTW - I had malaria about 5-6 times while growing up. What you describe sounds like a particularly bad case (1-2 of mine were like that). My experience, and that of my peer group (lower-middle class by western standards, top 0.1% by Tanzanian standards) was that if you got an early diagnosis and had access to drugs it was usually akin to a severe flu unless you got unlucky with the strain/severity.
It was culturally very normalised to get two malaria tests any time anyone felt sick, because the commonly accepted belief was that anything could be malaria, and false negatives were too common.
I always thought the main problem with malaria in Tanzania was that 99.9% of the country (especially rural areas) does not have access to quick testing and easy drugs, and for them it's a death sentence. That's not to downplay it, but more to emphasise the socioeconomic dimension.
I caught it in Arusha (back in 2008, when Arusha was much less built up than it is now). Got sick about two weeks later outside of Dar. At the time I was a journalist working on some freelance stories.
I've actually gone back and worked with local duka la dawas (sorry about the spelling, my Kiswahili is really out of practice) in figuring out ways we can help rural populations get easier access to the medication. It's often not that it's not there, it's that the medicine is too expensive.
It's still such a horror show of a disease (among the many many other horror show diseases). My heart broke for every mother I saw with their feverish infants in the same waiting room I was in.
In Cambodia, I got what I assume must have been a less serious case, because I didn't have any vomiting or diarrhea, only the worst headache I've ever had in my life. Luckily the lack of air conditioning wasn't a big problem, because it was close to the coldest part of the year.
It permanently reset my pain scale. When I later had a pulmonary embolism and appendicitis, the doctors were confused that I said my pain was only 7 on a scale of 1 to 10.
The drug I took for it (mefloquine) didn't give me any unusual dreams, but it permanently altered something in my brain.
I don't agree that DDT is necessary to eradicate malaria. See for example that malaria has been eradicated in Thailand (except for border areas), but not (yet) in Cambodia, Laos, or Myanmar, despite having the same climate. A combination of regular pesticides and flood control are sufficient - if the government is competent and dedicated. It's a political problem, not a technical problem.
RE: DDT, I didn't mean to imply it's the only way these days, just that there was a very good reason it was so popular in the former part of the 20th century. I love the tune to "Big Yellow Taxi" but it was never about "spots on my apples." It still is used in very rare and specific circumstances, but we have a lot better understanding of how to stop mosquito. Which is why they're really only a problem in poor countries, mitigation is unfortunately not cheap and convenient.
Yup those dreams are real on the medicine ! Damnn ! I SAW aliens like the little grays, they were in my bedroom when I woke up. Till this day I'm not sure if it was the pills and a dream or if there were real grays visiting me... Maybe they needed a specimen that took malaria-pills ? Never taking malaria pills again. And I live in South Africa.
And malaria reemerged elsewhere after DDT was banned around 1973 thanks to Rachel Carson's book. A professor of pediatrics summarizes how millions died as a result and how WHO reinstated DDT in 2006.
https://www.thedailybeast.com/how-rachel-carson-cost-million...
That's not quite right to cast the blame on her. She was right, DDT indeed accumulated in soil and caused bad effects. Blame the people that actually made the call to ban DDT without a plan to prevent the bad consequences. That move could have been handled better.
Is there a reputable non-profit I can donate to that provides this treatment? The idea that $3 is unaffordable for so many is so sad. I would gladly provide for a number of people to be treated if I could trust the money goes to them.
This fund goes to GiveWell's top charities, unless there's something that the fund managers think could do better in expectation. (For context, the EA Meta fund went towards founding GiveWell and https://80000hours.org/; they know what they're doing.) If you're too lazy to keep track of GiveWell's top charities at any given time, or want to contribute to medium-risk high-reward causes too, that's a good place to put your money.
I realize now I could have googled that myself, but it is nice sometimes for the things you thought of to be validated by others. Thank you! Adding this to my yearly donations list.
What drug did you take? I got malaria and a friend mixed up a white powder with bottled water and I injected it in my leg. I was better in 24 hours and don’t recall any side effects.
My guess is the drug was chloroquine, but not sure. Based on other’s experiences, I am glad I was young and dumb enough to opt for a questionably sterile injection.
I was fortunate to have made a friend that worked in oil services in Nigeria, and he had “malaria training” from Schlumberger, and the bottled water injection sounds crazy, but was the recommended treatment.
I was on cholorquine. It was four pills, twice a day, for three days. They do have one-and-done pills that are MASSIVE, but they, from my friends' advice really screw with you even more than the normal stuff. Note: DON'T drink while being treated for malaria. The parasites hide out in your liver, and the drugs shut it down further. 1/3 of a pint and you're spinning like a freshman during welcome week.
The anti-malarial drugs are not all the same. I've taken hydrochloroqine a few times without much side effect. Mefloquine is on a completely other level, at least for some people.
One of my closest friends from university was also a work colleague at the time he went on a recruiting trip to India and his travel doctor prescribed mefloquine for him. It's standard practice to keep taking the drugs for some time (2 weeks, IIRC) after leaving a malarial area, and he was noticeably mentally altered when he returned. He seemed uneasy with his eyes darting around, and he wasn't his normal outgoing self. He seemed a bit paranoid. The incident that brought it all into sharp focus involved a couple of colleagues that were your garden variety gossipy braggarts and I had a minor disagreement with one of them that we resolved quickly, but which prompted my friend to whisper to me "You don't get it. They're not good people." He gave me a look like I was the crazy one for believing the minor argument was resolved. (On the one hand, he was right. I would never trust the one any further than I could throw a fully loaded server rack. However, I still smiled, remained social, and watched my back.) I googled [mefloquine paranoia] and went down a deep rabbit hole. I found out that mefloquine has been suspected in several incidents of peace-keeping troops getting paranoid and attacking unarmed civilians. [mefloquine "freaky Friday"] or [mefloquine "wacky Wednesday"] may be a better search. Also, at least at that time, several sites said that if you had ever taken mefloquine in your life, you were ineligible for one of the front-line malarial treatments should you ever contract the disease.
Due to his mood changes / paranoia, I strongly suggested he talk to his doctor about coming off of his medication after just one week back in the U.S.
> 100F+/35C+ temps
Note that 35 C is below normal body temperature. 100F ~= 37.8 C. I used to donate plasma once a month back when I lived in the U.S. (I'm fortunate enough to not have cytomegalo virus, so newborns, chemo patients, HIV patients, etc. can receive my blood.) My body temperature for my pre-donation check-up was typically 35.8C/96.4F.
Here's a lengthier but fascinating description and personal history of someone who caught malaria and treated it with quinine derivatives (and then caught it again...):
> The drugs, if you're lucky, only give you the most vivid and disconcerting dreams you've ever had
Now I'm intrigued. What do anti-malarials do to healthy people? Does anyone take them recreationally to experience this effect, the way they do other "weird downers" like mescaline/DMT/salvinorin/etc? Or is the psychotropic effect of the drug predicated on actually having malaria?
I took Chloroquine as a prophylactic anti-malarial before and during a trip to Central America. You can get the crazy dreams whether or not you’re infected. Mine were, fortunately, quite vivid (and sometimes lucid) but not disturbing. The scenarios were pretty wild though. Other friends of mine had less pleasant experiences. For example, one had a recurring dream that his abdomen got ripped open, a load of pebbles fell out (instead of viscera), and a flock of ravens came and eat the pebbles while he watched in agony. Every night, over and over, for about two months.
During your waking hours, nothing feels amiss at all. Keep in mind too that the dosing is once a week. It took a week or two for the effects to start for me, and they persisted for almost a month after I was home. Unlike reports from the various psychedelics you listed, I felt absolutely no euphoria or “spiritual awakening” from any of it; I just woke up every morning and thought “wow, that was fucked up!”
I wonder how much of the "crazy dreams" comes down to people usually taking such a drug when travelling and having new experiences/seeing new places/expanding their mental schemas (which is known to increase BDNF / promote neuronal plasticity, and therefore likely to cause intense dreaming under the "memory reconsolidation" hypothesis of dreaming.)
It'd be interesting to compare to the dreams of people who take the drug without travelling, e.g. medical staff native to malarial regions, who take it as a prophylactic when interacting with malaria-infected patients.
Yeah that would be curious to investigate for sure!
I can only speak to my own experiences, but while I have observed the phenomenon you describe in preparation for travel/while travelling, Chloroquine dreams were waaaaay more dramatic than anything I've experienced with other travel. I forget what the exact timeline was, but I think I started taking them about a month before departing, and the dreams started about two weeks before departing, and stayed pretty much constant until a few weeks after I'd been home and stopped taking the pills.
I have been prescribed it a number of times. You are supposed to take it for a while after being in a maleria area, or at least I was told to do so. The dreams persisted back home.
The area I was visiting was not so different from other places I had visited or worked, just with a greater chance of maleria and lower chance of getting quick treatment.
In my experience (since I was living there, not really "traveling" at the time) it's not really tied to the travel. For instance, I mostly was stuck in laser rock shows, but like flying through them at high speed. Not particularly an East-African experience.
I get incredibly weird and vivid dreams from Prednisone and I know a friend who was prescribed Benzo (not sure what kind) and also got very vivid dreams. I don't know if is the same type he describes but it is like a normal dream; just stronger and odder for me (with a completely different medication).
It is nothing like a psychedelic trip for me.
If you want to try and see if you get weird/strong dreams there are a lot of anecdotes around the supplement ZMA. It is just anecdotes but I've seen threads started on many different training forums from newbies asking about it.
As you see, not too much data but it is still something. From the reports, it doesn't look like there is recreative potential. It doesn't hurt to look but the general idea is that if a strong psychoactive is not heavily controlled/illegal, the effects are usually nothing but unpleasant.
The prophylaxis medication is typically a broad spectrum antibiotic like doxycycline. There are other more expensive options which you take for a shorter period afterwards vs doxy which you have to take every day plus a month after.
However.. Some of the alternative drugs have very serious warnings that if you have any history of mental illness you probably shouldn't take them. Mefloquine is particularly prone to this I think and the symptoms sound like what the OP described (insomnia, vivid dreams, etc). You shouldn't have that with doxycycline, but it can make you photosensitive which isn't ideal in Africa.
See my other post here about my friend getting paranoid on mefloquine, leading to my discovering that mefloqine is suspected in playing a role in several instances of peacekeepers attacking unarmed civilians. Search [mefloqine "freaky Friday"].
I haven't taken them myself, but my coworkers quit taking even though the company was buying them. So I assume it isn't the type of high people do willingly. Other coworkers took them with no problems though, so it seems somewhat person specific what the reaction is.
See my long post elsewhere in this thread about my friend getting paranoid on mefloqine, leading to my discovering that some suspect mefloqine has played a role in multiple instances of peacekeepers attacking unarmed civilians.
> More than 400,000 people are killed by malaria each year, most of them children under the age of five.
This is one of those sentences that is just too easy to read over. But losing a young child to a disease must be unbearably painful. Multiply that grief by 400,000.
My greatest comfort in these times is that COVID19 appears to have little effect on young children. I wish these researchers the best, and I hope they get all the support they need.
I would really like to know if covid19 is worse than malaria, globally. Up until now it seems that it is worse only because it affects us. I was shocked to find out there is no treatment for malaria when I traveled in affected areas. I felt the same way as I am today, except I was the only one feeling like that.
Around 500,000 people died of malaria in 2018. COVID-19 deaths are currently at 250,000 (according to worldometers.info), but deaths are only just starting to slow down, and it's unclear how many deaths are going unreported. (There has been suggestion that in some places, actual deaths may be twice as high; apparently even after one adds reported COVID-19 deaths to an area's expected "regular" deaths, there is a shortfall vs actual deaths.)
It's worth noting that in terms of person-years lost, an average malaria death is significantly worse as it predominantly kills children under the age of 5.
Alternately, the person years of those children haven’t started, and can easily be replaced... Maybe we shouldn’t just be ranking people by age, if we want to come to moral outcomes?
> we shouldn’t just be ranking people by age, if we want to come to moral outcomes?
Agreed. But I think quantifications can still be useful.
Person-years probably aren't the right sort of quantification though, in that they blend together too many kinds of human experience. But I imagine most people would agree that statements like "X% of grandparents, lost 10 years earlier than expected" or "Y% of children under 10" allow for comparing the relative impact on families.
Quantifying losses doesn't mean that we consider the quantified as fungible.
I don’t understand what you mean when you write person years of those children haven’t started yet? They were born, so how have their person years not started?
And in context of opportunity cost, in a situation where limited medical resources need to be allocated, it’s not a controversial opinion that a 90 year old can be let go in favor of saving a 10 year old.
The notion of valuing a life at age 15 higher than at age 5 is pretty reasonable. If the value starts at zero at conception, ends at zero at death, then -- if it's a continuous function -- there has to be a rising curve followed by a falling curve. And this seems to fit with some choices I'd make in contrived trolley problem scenarios. Though it's not the only variable, when you get to particularities.
"Potential" person years lost, I guess. If you used "person years" the same way you use "Our firm has a combined 125 years of experience" then it's the other way round.
(Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.)
Yes, "potential person years" or a similar phrasing would have been clearer.
>(Grim discussion, I guess, but I'm just not certain I agree with the unspoken assumption that seems to be in that statement, that the younger the death, the more tragic/more effect on society.)
It is a matter of morality and personal ethics. I chose to mention it only because the discrepancy in this case is so large, and it felt almost misleading to not relate the information. That said, I regret framing it in such a coldly utilitarian way.
These cold terms are how these discussions are had in industry. It's the core behind value based pricing - quality adjusted life years or QALYs are what many health systems use to determine what they will or wont pay for. As long as money is scarce, these are how conversations are had. A drug that saves a child's life is worth more, and people are willing to pay more, than a drug that saves an older person's life. There are cutoffs and thresholds. In the UK, with a few exceptions, a drug cant cost much more than 30 thousand pounds for each extra quality adjusted year of life (e.g. an extra year bedridden might only count as 30% of a year, while an extra year closer to functional might count as 95%) for NICE to approve paying for it. In the developing world, the value of a human life is set at about 2x GDP per capita per QALY. In the US, for a drug to be cost effective, it should be less than 150,000 dollars per QALY (but many drugs aren't).
The usual metric is QALY, "quality-adjusted life years". (The idea of quality adjustment being that three years of being 82-84 isn't as good as three years of being 22-24.)
It's a horrible assumption. I know that my parents probably have only 5-15 years of their life left, so I make sure to have contact with them as much as possible, and keep up longevity research, though I know that they don't like to experiment as much as I would in their place.
> I know that they don't like to experiment as much as I would in their place.
Hard to know. Do you think there's zero chance that, when you're their age, you might be the one telling your adult kid that you've had a happy, long life, and don't feel the need to experiment with longevity?
average malaria death is significantly worse as it predominantly kills children under the age of 5
It's not only deaths, it's also lost opportunity, as malaria is a chronic disease. Children miss out on schooling, adults miss out on work, and malarious areas miss out on investment.
I'd been hearing the numbers might be inflated from diagnoses on dead people without tests. Hard to know what's really going on with anything with all the conflicting information.
Almost certainly the other way around. The most useful measure is "excess deaths" -- those are simply the statistical "excess" of deaths we are currently experiencing compared with the average at this time in years past, and are uninfluenced by diagnoses, coroners, politicians, etc.
Here are some good state-by state graphs [1], and here's a country-wide graph [2]
By any measure, our "excess deaths" since February have spiked enormously, and significantly more than the current official Covid death count.
Some may be due to hospitals overflowing preventing other care. But it's pretty clearly all Corona-related.
I agree, but the real number would be comparing to lockdown death rates w/o covid.
Over the past few years, the evidence linking human health and overall mortality to isolation and human contact has been increasing.
Don't get me wrong I'm staying locked down for the foreseeable future, but I have family and close friends whose mental health I'm seriously worried about. Not to mention physical health from stress, isolation, reduced activity, and can't afford to eat as healthy / stress-eating.
No idea if those are trends that will even come close to direct covid deaths, but we can't make informed decisions considering them.
> But it's pretty clearly all Corona-related.
If you count the above as "Corona-related", then I don't think the number has much meaning in terms of informing public policy.
It actually has been studied and it looks like, in terms of absolute bulk numbers, that at least in developed countries like the US lockdown decreases deaths overall. Here's an Ars article from last week with a summary and some links for some further reading if you're interested [1]. Basically though while suicides go up, a lot of other causes of death plummet. Auto accidents for example a big source of yearly mortality that drop a ton if, well, people aren't getting in their vehicles so much. Air pollution has plummeted [2] as well, another significant source of deaths. People are bored at home and thus work out more, tend to eat better, etc.
Of course as that article and any other responsible ones should point out, the benefits and harms fall quite unevenly, and there is a lot of real misery too. And at some point the economic harm from ongoing lock down would certainly affect more and more people regardless of previous income. But even so as far as society overall goes it at worst looks like a wash right now, and seems more likely to lean towards fewer deaths. So excess vs previous years does look like a valid number to use as some level of gut check given the ongoing poor state of testing.
> Hard to know what's really going on with anything with all the conflicting information.
Yes, but you don't have to give up. If you use critical thinking and assess the competing claims and the strength of the evidence for them, it becomes clear that the evidence for inflated counts is extremely weak, bordering on hearsay, and inconsistent with the overall data, while the evidence for extra uncounted deaths is much broader and stronger and consistent with the overall data, so while there is uncertainty about the true numbers, on net it's reasonable to assume more deaths are being missed than overcounted.
Should we assume that social isolation, lack of physical activity, change of habits, being laid off a job and worse health care (preventive for example) have no impact on the number of deaths? That's quite a big assumption.
There are certainly some deaths being incorrectly attributed to COVID-19, but I think the data conclusively rejects the hypothesis that there is rampant COVID-19 over-reporting.
The main difference is that malaria, as bad as it is, is not contagious between people. So while the numbers are bad, there’s effectively a lid on them—they aren’t suddenly going to start growing exponentially.
With covid, the worst case scenario with no mitigation is quite literally that everyone in the world gets it in fairly short order, which could cause tens of millions of deaths even with low IFR estimates, plus all the social and economic destabilization that implies.
I thought hydroxychloroquine was a much vaunted treatment for malaria?
COVID certainly has a lower mortality right now, but it's only because of the extreme precautions we've all taken. In a world where we didn't bother, I presume that would completely change.
Malaria has kept getting resistant against more and more medication. This map [1] is pretty terrifying - very few areas that have malaria does not have some extent of (hydro-)chloroquine resistant malaria.
What precautions would reduce the mortality? Social distancing, masks, etc. can decrease the chances of spreading the disease but I don't see how they reduce mortality once you catch it.
I think it depends on the strain (species?) of malaria and even the geography of where a person has been infected. Some infections are more resistant to treatment than others.
One way to find out is to look at the overall death rates (of all causes) in an area and see how it evolved. NY started doing that and found there's a discrepancy. One explanation among others is that some people who've caught it and died from it never got a positive test (either no test, or false negative).
That seems to point to the opposite happening: a higher mortality that is still not fully understood for lack of accurate data.
I do overall agree with you, but Norway has lower than usual number of deaths this year, so not sure what to do with that. I guess if you just compare the deaths to average you are still under reporting because of the stay at home orders it is sort of expected that less people die.
Don't forget the secondary effects of shutting down entire countries: depression, supply chain failures, sudden poverty, degradation of infrastructure, and increasingly lack of exercise and unhealthy eating as this drags on.
I suspect that will account for most of the differential, and possibly even be the more important number. (because many countries diagnose deaths with covid as deaths by covid)
Later on it may be a major factor, but right now it is probably outweighed in the counts by less car accident deaths, lower transmission of other communicable respiratory diseases, and less work and leisure accidents.
The secondary effects are much worse. The virus is being used as an excuse to get more control of the people and planet by the psychopaths. They don't really care about us.
I don't know why something so easily disproved is being repeated so often. The worst-case of an economic shutdown is not worse than 2 million dead people.
Added bonus: the economic outcome of 2 million dead people is bad too, perhaps worse than a shutdown of (largely) healthy people. It's not an either/or, economic hardship right now is unavoidable. The choice is between getting a handle on the virus or not, and thousands dead instead of millions.
Confirmed and probable deaths are 16700 for a population of 8.4 million we come to about 1% IFR. However the excess deaths (for example how we count deaths during flu seasons) are 21000, so we are likely undercounting covid 19 deaths. Based on that number the IFR is 1.2% both these numbers are significantly higher than the flu. The other thing is that the numbers there are taken at similar times. However there is an incubation time of about 4 days (IIRC) and a time to death from first symptoms of about 10 days. So we really should compare the infection rate now with the death toll in 2 weeks. Which likely will increase IFR
Age affects everything. The diamond princess cohort is much older than the population average. Older people are more likely to die from the disease, suffer symptoms from the disease, and catch the disease, all things being held equal.
The concept of death rates, symptomatic rates, and even transmission rates as a generic term is meaningless because it depends entirely on the age demographics of the population (and behavior, and other things, etc.).
The idea the most people who catch it are asymptomatic is true if our antibody tests aren't throwing out massive false positive rates. For something closer to the general population, the USS Theodore Roosevelt is probably a better guess.
Looks like 90% of them had the disease on April 11. By April 20, 60% were asymptomatic. The last update seems to have been on April 22, with about 50% asymptomatic. That's probably a good bet for an actual figure in my opinion.
That's correct, my mistake on the infection rate of 90%. The 60% on the wiki figure is coming from an article written April 16. I did a bit of digging and found a navy statement from the 22nd which said 50%.
However given my error on the 90%, it seems much more likely that a large proportion of the people asymptomatic on the 22nd had caught it more recently than I was assuming, so the asymptomatic rate is probably a bit worse.
I would assume the crew of a military ship are substantially younger and healthier than the general population. Since both health and age seem to play a key role, 50% is almost certainly an upper bound, with the true number lying between 17% and 50%
Most will be in the range of 20-40. Some will be older, but none will be kids. So take it as you will. The true number doesn't have any intuitive meaning anyway, since the likelihood of being infected is correlated with the likelihood of being symptomatic.
E.g. if hypothetically people under 20 never exhibit symptoms but also never get the disease, they won't bring the asymptomatic rate down because they won't be infected in the first place.
There are indications that severity of infection is proportional to the initial viral load. I'd imagine that being locked in close quarters on a warship would subject the sailors to a higher viral load than you'd expect in the general population, and subsequently they'd have on average more severe infections, so it could be lower than 50%.
More likely much higher when you start parsing how China determines COVID cases/deaths. Or those people not allowed in hospitals. There deaths do not count.. so there is a big difference but going the other way.
Total confirmed Covid deaths currently stand at 230,000. But total mortality data, where available, points at excess mortality of around 50% to 100% more than that. That puts current mortality somewhere between 300,000 and 500,000. Malaria deaths are also around 400,000 says Wikipedia. But, crucially, that's annual death. Even in the optimistic case of Covid deaths currently being at their peak and going down as fast as they grew on the way up, total deaths are double Malaria's. And looking at the graphs, it doesn't seem like it's receding symmetrical to its growth.
As to regional differences, see here for some recent excess-mortality data that includes Ecuador and Brazil, two countries that don't have Malaria but share some characteristics with countries that do, such as climate and relative poverty: https://www.ft.com/__origami/service/image/v2/images/raw/htt...
This isn't going to spare the countries affected by Malaria, except that some of them have a demographic advantage.
The only redeeming factor in Covid's favour is that mortality isn't the only, and possibly not even the most important, harm of Malaria: Just like Covid, it kills only a minority of those infected. But survivors sometimes suffer chronic relapses, enduring symptoms such as fatigue, and, in children, cognitive deficits.
That will be over many years however. Maybe 2-3 years.
Some estimates put Covid-19 at 10 years lost per person average.
If you can get it multiple times, which is likely after a few years, it'll keep killing forever but it'll slow down, and we might even slow it even more in the richer countries, like we sort of bother with the Flu for, if a vaccine is ever possible.
Currently China has an unsustainable model going (School is not back properly) for 1.4 billion. If however they can move to a sustainable model, maybe they might not get it..... Good luck everyone else.
I think 80% for heard immunity is a pretty high count.
IFR is a guess and yours could be right. It is lower than NYC but the developing world is much younger than the west so they might have a much lower IFR unless their lack of available health care hurts them too much.
Hopefully IFR will drop as well as we learn to protect the elderly better.
The aversion to testing by the American government is how we know that we live in dark times. I look forward to see what Silicon Valley finds in their testing of people that died in november.
What makes you think it's an aversion to testing? It seems to me more just general incompetence and slow response that caused the testing crisis in the US.
My own comfort is in knowing that this virus can be kept at bay if my immune system is strong enough, and as a mindful engineer and a living being I understand which behaviors are optimal for health and which are harmful... and in these times I am conditioned to maximize helpful behaviors and minimize harmful ones.
We have to stay on top of it regardless of age. My kid now takes her C, D, Zinc and we've gone on a sugar cleanse (sugar has been found to impair the immune system, depending on your tolerance for it)
You insult the people who work hard every day to find cures and preventative measures for malaria that not only work better than DDT, but also don't drive a major part of worldwide ecosystems to extinction.
I've had the privilege of working with some of those people. They deserve far better than this contemptible nonsense of yours.
I've heard that mosquitoes are believed to be completely replaceable in the food chain of the various species which prey upon them. Considering how mosquitoes are a vector for _numerous_ diseases, malaria being the most deadly but still one of many, what's stopping research into eradicating mosquitoes entirely? A lack of research and surety on the overall effect on the ecosystem?
Honestly, fuck mosquitoes. If the mosquito laser system were ever actually viable/purchasable, I'd happily drop thousands of dollars to keep those bastards out of my bedroom at night.
Seriously -- I didn't realize how bad it could get until I got to Vienna and a local told me that residents of the city are required to be inoculated against ticks because they can make you brain dead, epilepsy, etc, and I didn't believe it... but it's real
https://www.iamat.org/country/austria/risk/tick-borne-enceph...
I read somewhere that they are not important and that is good enough source for me. It could have been written on a post-it for me to support an eradication campaign.
There is a hope that gene-drive targeting doublesex gene can be effective in eliminating mosquitos (and likely other insect species if we want) https://www.nature.com/articles/nbt.4245.
There have been many articles about this on HN last year, but there was also a depressingly large number of people commenting how precious mosquitos are, and that the maximum measure we are allowed to consider is modifying mosquitoes to not transmit malaria, and that even thinking of eliminating "the whole species" is a sin.
Aren't there lots of mosquitoes that don't transmit deadly diseases, or don't bite humans at all? They're not going to go away as a category even if we did eradicate anopheles et al. I mean, do the research to find out if they're some plant's sole pollinators, but otherwise I can't see anything to lose.
This article is hot garbage. The specific mosquito (Anopheles) that transmits malaria plays no special role in any ecosystem that can’t be filled by another species. They have been doing this research for years now, and yet this author didn’t cite any of it.
I fully expected this to be another article on wolbachia. It's a pleasant surprise to see another microbe that can help block malaria in mosquitoes. Between the two a good dent might be put into that and other diseases. Wolbachia was shown to help with dengue too, and at least somewhat with Chikungunya and Zika - which are viral. This sort of trend looks hopeful for the future.
If we're really fortunate and have the people and funds made available to do this sort of research, perhaps we could see West Nile, yellow fever, Lyme disease, bubonic plague, Rocky Mountain spotted fever, and other bite-passed pathogens severely curtailed.
If it has a survival benefit for mosquitos, it will reach 100% by itself. Since that hasn't happened, I'm a little worried that there are some caveats here.
Maybe it happened already. Growing in Kenya in the 80s, many regions were considered malaria endemic. A number of this regions from these 2000s are now considered malaria-free. Could this be the reason? I don't know.
Most tropical/subtropical areas that are malaria-free did it by virtually eliminating mosquitoes with pesticides long enough that malaria was virtually eliminated in the human population, which eliminated malaria in the mosquito population when the mosquitoes rebounded.
I don't think the malaria virus affects the mosquito itself from what I can tell, so it's inconsequential to the mosquito and its reproduction whether it has the fungus or not.
For the mosquito, it's just one potential disease from one potential food source.
Malaria isn't really that bad of a time for mosquitoes anyway. It might even increase their chances of reproducing by driving them to feed more on humans.
Given how helpless much of the world is against Malaria and how many people it continues to kill each year, this strikes me as one of the most significant scientific discoveries of our lifetime. Am I missing something?
Even if it works well in the lab, it might not work at scale for any number of reasons. Definitely a potentially huge breakthrough, but let's not count our chickens before they hatch.
If anything, that would seem to make it even more significant. Treatments for people often have side-effects for the patient, and as we see with increasing resistance, side-effects for the population as a whole.
This is potentially a way to stop malaria permanently with few side effects.
He asked what he was missing and I pointed out that the headline was referring to malaria in mosquitoes, and not malaria in humans (as a human reading it might assume).
I wasn't making any point about overall impact. One is simply a much, much bigger news item than the other (It's "We can cure 400k people with malaria right now!" vs. "We've made a promising step in the overall fight against malaria" -- one has never happened and one happens monthly).
The BBC retained this ambiguity for clickbait reasons. I was just dispelling the ambiguity. If they added "in mosquitoes" to the headline this wouldn't have happened. But then we also wouldn't be commenting on it.
> He asked what he was missing and I pointed out that the headline was referring to malaria in mosquitoes, and not malaria in humans
Yes, but mosquitos are a vector for malaria in humans. If mosquitos are infected (at scale) with the microbe and can be cured or made "immune" to malaria, it effectively stops the transmission of malaria to people. If the science checks out and infected male mosquitos are released into the environment in areas with high (human) malaria infection rates, it becomes extremely easy (fast, cost effective, simple) to prevent new malaria infections in people.
This general approach is already being used today, albeit with less success. See Google's "Debug" project:
Dismissing the importance of the findings here as "only treating malaria in mosquitos" ignores the much broader implications of the research here. The headline is not sensational, and the perceived ambiguity in the headline does not decrease the significance or potential importance of the discovery.
It's extremely trashy to quote someone when they didn't actually say the thing you put in quotation marks. Bother someone else with your straw-man bullshit.
I see no indication that they missed that. Are you implying that it is less significant than if it directly treated people? Stopping the vector that infects people seems just as good, if not better.
Coming from a malaria-prone region and remembering the times I had to take Chloroquine injections and trying different malaria tablet treatments just makes this the best news I’ve heard this year. I hope they can conclude on these findings fast enough.
So this microbe is already circulating in the mosquito population at a 5% infection rate. The scientists propose either:
a) release spores en masse to infect mosquitoes
b) infect male mosquitoes in the lab and release them into the wild to infect the females when they have sex
There is an obvious third way. We could attempt to genetically engineer a more virulent strain of the pathogen and release it into nature. In the current climate I think this is less than likely to happen.
Once you genetically engineer the virulent strain, the way you are going to release it is through either of the first two ways. So it's not as much a third way as it is an augmentation of either of the first two.
Many people (~thousands) in the US use a few species of Cryptoleptis (sanguinolenta) to good effect for Babesia, a less virulent and dangerous "cousin" of Malaria. It is generally safe for all ages. It is also used pretty effectively in Africa for Malaria (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956313/ ... more studies should be done!). It is often hard to get young children to describe their symptoms, but night sweats and temperature disregulation (via nervous system) are common in both parasitic pathogens. At any rate, the more low cost solutions with minimal to zero side effects we have, the better.
Still working through this and the original paper, but while it can cause encephalitis in humans, it seems to be ubiquitous already anyway, and we don't seem to typically get it from insects. Setting aside the fact that you could swap malaria for almost any other infectious disease and humanity would be massively better off.
(Caveat: IANA Microbiologist and welcome corrections.)
I should have said "not uncommon" rather than "ubiquitous," but it appears it already is blocking malaria development in a small portion of mosquitoes.
It's one of those bugs that can opportunistically infect humans when their immune system is severely limited (i. e. end-stage untreated AIDS, unfortunate incident at a nuclear reactor). But that's a situation where almost anything will kill you.
(I once had a professor who likened it to a run-down house with young trees sprouting from the roof, adding that he'd be somewhat, but not extremely, surprised to find a immunocompromised patient with moss growing somewhere)
Malaria has been a big deal for the Gates Foundation for a long time. I recall reading discussions of his hope to breed, or maybe genetically modify, the relevant mosquitoes to make them incapable of carrying malaria, then manipulating the wild population to uptake the genetic change.
This is an incredibly dangerous idea -- I do not think we should be genetically messing with mosquitoes, whatever the perceived or desired benefits, when the downside (a bad strain multiplying exponentially) could be horrible for all of us.
AFAIK there isn't much genetic engineering involved in that project at the moment. They just rear male mosquitos that are infected with a Wolbachia bacterium (making them sterile).
Conversely, if we find a way to do this safely, this could be important for far more than just malaria... and “just” solving malaria would be hugely beneficial.
Seriously, don't get malaria if you can help it. Your bones hurt from the inside out while you lay in a pool of your own sweat, crawling to the toilet every hour or two because of oscillating vomiting and diarrhea. Since you're most likely in a developing country, air conditioning is usually out of the question (you're shivering in the 100F+/35C+ temps anyways from the fever). The drugs, if you're lucky, only give you the most vivid and disconcerting dreams you've ever had (if you're unlucky, which 50% of people are, they're the most horrifying night terrors you can imagine).
The good news is it's highly treatable. The bad news is that at ~$3 for a round of treatment it's prohibitively expensive if you're only making $2/day and have a family to support.
We only got rid of it here in the US because of DDT. Malaria was endemic in the South (and parts of the North in the summer) until the mid-20th century.