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Thomas House
@tah-sci.com

A useful concept in outbreaks is the "reasonable worst case", which is not the worst that can happen but is significantly worse than the current trajectory. The current trajectory is that this is a very distressing situation for those involved that we can take meaningful steps to avoid in future. >

The Guardian@theguardian.com

Third Briton has suspected hantavirus linked to cruise ship outbreak

theguardian.comThird Briton has suspected hantavirus linked to cruise ship outbreakPatient remains in south Atlantic island of Tristan da Cunha, say health officials, as vessel heads to Tenerife * Explainer: What is hantavirus? A third British national has been diagnosed with suspected hantavirus linked to a cruise ship outbreak, health officials have said. The UK Health Security Agency (UKHSA) had already confirmed two cases among British nationals, who are in hospitals in the Netherlands and South Africa. It said a third has been reported on the south Atlantic island of Tristan da Cunha, where the patient remains. Continue reading...
Thomas House
@tah-sci.com

> Given this, a reasonable best case is no further infections and deaths. For a reasonable worst case, we could look to the larger Ebola outbreaks - not a major pandemic like COVID, but we do sometimes see extended epidemics of pathogens that are ultimately controlled. >

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Thomas House
@tah-sci.com

> A situation where a significant percentage of the World's population catches hantavirus as happens for flu and coronavirus isn't physically impossible - there's a chain of possible events where it happens - but these would be very rare, certainly in combination. >

Thomas House
@tah-sci.com

> This kind of risk communication is really difficult - pandemics happen, and often where we aren't expecting. Public health agencies and specialists aren't hiding this when they say that's not within the reasonable worst case planning for a given outbreak, as it usually isn't.

seancj.bsky.social
@seancj.bsky.social

This both seems intuitively correct, to me, but also I'm not sure just exactly *why* it should be that way? Like, what are (to semi-quote your later point) the factors that make this physically very unlikely (if not, as you state, impossible) ? To be clear, I don't doubt your sincerity!

Thomas House
@tah-sci.com

It's mutation to become a significantly better adapted human pathogen that is the main bottleneck. This can and does happen of course, it's just very unlikely. In contrast a situation where there is a much longer period than we would like of finding cases seems sadly quite probable now.

Thomas House
@tah-sci.com

Technically you can also have the evolution to adaptation without a new mutation if things like recombination and reassortment happen but exactly the one of these that yields a step change in viral fitness is still very rare.