US Herd Immunity Unlikely
Covid appears here to stay, so the goal is management.
The NYT reports on what has been the likely outcome for some time now: Reaching ‘Herd Immunity’ Is Unlikely in the U.S., Experts Now Believe.
more than half of adults in the United States have been inoculated with at least one dose of a vaccine. But daily vaccination rates are slipping, and there is widespread consensus among scientists and public health experts that the herd immunity threshold is not attainable — at least not in the foreseeable future, and perhaps not ever.
Instead, they are coming to the conclusion that rather than making a long-promised exit, the virus will most likely become a manageable threat that will continue to circulate in the United States for years to come, still causing hospitalizations and deaths but in much smaller numbers.
How much smaller is uncertain and depends in part on how much of the nation, and the world, becomes vaccinated and how the coronavirus evolves. It is already clear, however, that the virus is changing too quickly, new variants are spreading too easily and vaccination is proceeding too slowly for herd immunity to be within reach anytime soon.
The piece goes on to note that the current estimated threshold of vaccinations to achieve something like herd immunity is ~80% of Americans. This is in an unlikely result.
Indeed, getting 80% of the country to do anything is a massive task, but this particular goal was clearly made nearly impossible by the politicization of public health over the life of the pandemic. (Which continues via media figures like Joe Rogan and Tucker Carlson).
Polls show that about 30 percent of the U.S. population is still reluctant to be vaccinated. That number is expected to improve but probably not enough.
The geographic distribution of the unvaccinated also matters (which can be linked to politics as well):
“Disease transmission is local,” Dr. Lipsitch noted.
“If the coverage is 95 percent in the United States as a whole, but 70 percent in some small town, the virus doesn’t care,” he explained. “It will make its way around the small town.”
The goal remains to vaccinate as many persons as possible and to manage the disease going forward.
I recommend the whole piece.
We were never going to reach a theoretical herd immunity. Even if 80% is the magic number (and we really don’t know what the real number is but only a possible range), about 22-23%of Americans are under 16 and are not eligible to get a vaccine anyway. Add in numbers of people who cannot for medical reasons get a vaccine and those who are just stupid (a large % of Americans), the goal was clear to me a long time ago that herd immunity was not within reach.
COVID is never going away – Trump and his ilk saw to that. This is the new normal now and we’ve got a new perennial disease to make life more complicated and miserable worldwide. At best we can do whatever we can to make sure to protect everyone who’s willing and let it burn through the ignorant, praying it won’t mutate enough to kill the rest of us. At worst we watch a chunk of humanity die off that didn’t have to so stupid people can be free to be stupid. There’s only so many mutations something like COVID can go through and remain genetically viable so eventually we’ll get to a stable point….. but not any time soon and possibly not even in our lifetimes.
@Scott:
Not quite.
They’re not elegible now, because some age groups weren’t included in the clinical trials. there was a rush to get the vaccines out, and it made sense to focus on age groups at greater risk. Over the course of the year, trials for younger age groups will be concluded.
@KM:
My biggest fear is that the GOP will wrest back the White House in 2024, then abolish pretty much all public health safeguards — maybe even the CDC — leaving the country defenseless not only against more virulent COVID mutations but also the next pandemic. And there will be another one.
Sometimes I sit here and think, “Maybe I’ll get lucky, and my cancer will come back and just kill me before 2024.” It’s a terrible way to live. I’m not suicidal. I don’t want to die. That’s why I’m so angry and resentful.
@Scott: To add onto Kathy’s comment, the Pfizer’s application for an EUA for 12-15 year old children has already been filed and is being considered by FDA. I expect it to be approved this month.
It is a misnomer to discuss any nation reaching herd immunity as some nirvana, as long as there are populations in the world that go unvaccinated or do not become ill with C-19, the potential for mutations exists and as we learned with the initial outbreak, it won’t be contained by national borders.
What will happen is there will be regions where outbreaks of C-19 and variants will be small and be a nuisance factor, while other regions will continue to suffer high infection rates, death and long term complications. At some point the vaccines will receive final FDA approval rather than emergency authorization and then we will see employers make vaccinations a condition of employment and insurance companies make it a condition of issuance.
Honestly, given the realities of American Culture, I wish the Federal Government just financially incentivized vaccination. Either as a direct stimulus* or possibly a tax credit. Still might not get us all the way there, but would get us closer.
* – this would have to include “undocumented** immigrants.”
** – note that for the purposed of this discussion there is more than enough documentation to deliver direct stimulus to them.
@Sleeping Dog:
That’s why I’m not so much concerned with COVID-19 per se, but the bigger picture of the GOP tearing down public health safeguards and sowing distrust in vaccines. If these awful people had been in charge during the polio epidemic, we’d still be holding telethons for paralyzed children. “Only” ~1% of polio victims had permanent paralysis, and “only” 5%-10% of those patients died. The overwhelming majority of patients had only minor symptoms, or none at all; 95%-99% of those infected were asymptomatic.
Sound familiar?
@KM: As much as I’d like to blame Trump for this problem, and acknowledging that what he did added virtually nothing of benefit to solving the problem, we were always more likely than not to arrive at this point on this particular trip.
Covid was never going away, it’s a clever little bug, highly adaptable, mutates like a pro. It’s going to be our new annual vaccination, flu plus Covid. Which is really a hell of a great outcome, all things considered, thanks to science.
Sadly, science has not yet found a cure for stupidity. So, while rational people will be safe, stupid people will continue to be vulnerable, to get sick and to die. The next generation will have slightly less DNA contributed by stupid people. Darwin smiles and nods his shaggy head.
@Michael Reynolds: Covid/Flu combo would be great for me. I was allergic to flu vaccine when young, so I’ve never gotten the habit of taking a flu shot. Having a time of year to get both at once would be really good in my situation.
@Michael Reynolds: Sadly, no. COVID has a greater impact on older populations after they had a chance to reproduce.
@Scott: The inability to give people under 16 vaccinations is almost certainly temporary with testing going on now to determine safety and effectiveness.
@Michael Reynolds:
Especially since the new mRNA vaccine technology certainly looks like it will be possible to cover a much wider range of variants than has been possible before. For flu, too, not just Covid. And about a third of common colds are coronaviruses, not rhinoviruses.
@Scott:
That’s what we know so far. We don’t know the long term effects of COVID simply because it’s so new. Just because it kills off the old faster (most diseases do that) doesn’t mean it won’t have significant impacts on asymptotic infected youth later on in their lives. If you catch it at 16 and end up with ED at 25, passing on those genes gets a whole lot harder.
@just nutha:
I’ve read Moderna is planning just such a thing.
Strictly speaking, they’d make one vaccine for each, which means a set of mRNA particles in protective lipid coating for CODI and one for Flu, and combine them in one vial. In practice, that’s one shot for both.
There’s more than one way to get here immunity — the asshats will just need to get covid if they don’t want the vaccine.
@Nightcrawler:
And “no one dies of AIDS* and only gays and heroin addicts will ever get it.”
It’s an old story.
The problem lies with the numbers. 1% of the US population is about 3.3 million people. For the whole world it’s about 70 million. That’s more people than are estimated to have perished in WWII (around 50 million, including civilians).
* Technically, people died of opportunistic diseases, but these were made possible by the weakened immune system that is produced by HIV. It’s a bit like saying a person you shot didn’t die of a gunshot wound, but of exsanguination. And that’s a lot like what the covidiots are saying about COVID these days.
If Trump were any kind of decent human being, he’d be hitting the road right now trying to get people vaccinated. A huge fraction of the vaccine hesitant are his supporters and some of the people pushing anti-vax nonsense are the voices that support him. A concerted effort may not get us to herd immunity, but it could get maybe a few million more to roll up their sleeves.
But he won’t do it. Because he’s not a decent human being.
@Hal_10000:
The only question the Orange Ass asks himself is “What’s in it for me?” He doesn’t give a damn past that.
@Scott:
For now, but what is currently happening is that because older populations have been vaccinated and younger ones aren’t, covid will continue to circulate–and mutate–based on its available hosts. This means that it’s entirely possible that it will either peter out after infecting X% of young people, OR, it could develop into a more virulent strain that has a more severe effect on young people–we just don’t know. Not to mention we don’t know what the long-term health impacts are, as KM noted.
The next public health disaster is “long COVID,” which could be impacting up to 1/3 of survivors (nobody is sure about the exact number).
The U.S. healthcare system is nowhere near “prepared” for this, especially in states that didn’t expand Medicaid.
We’re going to see a lot more people like Kent Taylor. Mind you, this was someone with all the money in the world. Access to care wasn’t the problem. The problem was that there are no treatments for long COVID.
@Kathy: Not as concerned about how they do it as I am about being more likely to get both than I am now.
@Hal_10000:
But we know he isn’t, so we’re having a If Wishes Were Horses moment.
@Hal_10000:
Trump isn’t a decent person by any stretch of the imagination, but even if he were, I doubt the rabid anti-vaxxers would take the shot even if he showed up on their doorsteps to deliver it to them personally. They’re convinced that the pandemic is a hoax. Or that the vaccine will alter their DNA or sterilize them.
@Nightcrawler:
Take Texas as an example:
Feds rescind health care funding agreement that would have paid for care for uninsured, poor Texans after 2022
Medcaid expansion would benefit all poor Texans, so the GOP’s preferred method is to use executive fiat to steer the money to the state, which in turn will make sure it only goes to the “right” poor people. I’m willing to bet 1 fun token that the billions Texas received through the 1115 waiver was heavily weighted toward hospitals in mostly white rural areas.
Same as how Kentucky passed work requirements for medicaid expansion and then immediately exempted all the majority white counties from those work requirements.
It’s back door genocide and it’s the same thing they’ll do with Long Covid: rural white areas will get funding, urban or minority areas will just be left to let people die.
I wonder about countries that contained the outbreak well or relatively well, like Vietnam, New Zealand, or Taiwan. Their vaccination efforts, per Bloomberg*, can be charitably called slower than an arthritic snail, but there isn’t much danger of contagion locally.
I suppose there’s no urgency, but this will delay the time when the people in these countries can travel abroad. It may affect trade and business in other ways, too.
I wonder, too, how a booster shot will work, given the variety of vaccines available. If you had J&J, can you booster with Pfizer? I guess we’ll have to find out by experience.
*It requires registration, but there’s no paywall.
@Kathy:
The front page of yesterday’s NYT print edition, featured a world map denoting the current rate of covid infection, what was most interesting was, not where the virus is virulent but which countries appear to be minimally effected. Most of Africa was shown to be only minorly effected, which raises an interesting question as to why?
@KM:
But I knew what you meant.
@Sleeping Dog:
You also have to question the quality of the data.
But, the areas hit by Ebola in the past likely have procedures in place for tracking and containment, and recent memory of horrors from disease.
There have been early studies suggesting that Neanderthal DNA has particular vulnerabilities for covid, and there aren’t a lot of Neanderthals in Africa. (The US experience would show that the harms of being black in this country are greater than any hypothetical genetic difference, if those studies bear out).
I don’t think we will have good answers to a lot of this for a while.
@Sleeping Dog:
I’ve had thoughts on that.
First, what @Gustopher said, especially in prior experience with contagious diseases. Next, Africa ins’t as well-connected by travel and trade to the rest of the world as, well, the rest of the world is to itself. One of the better connected African nations is South Africa, where the pandemic made itself at home. Lastly, SARS-CoV-2 doesn’t do as well in warmer climates.
These are mere thoughts, mostly correlations. In all honesty, I do not know.
Vaccine doubting science deniers claiming the Covid vaccine is less effective because there are “idiots” who will not get it. Vaccines do not work if everyone is not forced to get it.
You need to get multiple doses of each Covid vaccine. Pfizer-BioNTech, Moderna and Johnson & Johnson’s Janssen.
@Kathy:
One possibly useful reference point for boosters is that they want me to get an annual flu shot, each year with a somewhat different mix of virus proteins. I don’t remember reading anything about the synthetic lipids in the Pfizer and Moderna vaccines not being broken down pretty quickly and easily by our livers.
@SKI: and right on cue, the NYT reports that: The F.D.A. is set to authorize the Pfizer-BioNTech vaccine for those 12-15 years old by early next week.
Hopefully minors will qualify for vaccines soon, as there’s a good case to be made for their need. Some are getting Long COVID.
@Hal_10000:
And the same can be said of the rest of the Republican pols and Rupert Murdoch and the rest of RW media. Especially Murdoch.
@Michael Reynolds:
As if predicted: Florida governor cancels all local COVID-19 emergency orders
These people here… So proud of their ignorance.
Glad I will be going back to Denver soon.
That map intrigues me. State boundaries are very pronounced. State boundaries seem to make much more difference than urban/rural distinctions between counties. Perhaps some states have been more effective at getting the vaccine to their residents? Or is this a jawboning effect?
I suspect the former, since Alabama seems to be doing noticeably better than Mississippi.
@Kathy:
Seems to be doing pretty well in Brazil. Did ok in the US last summer too.
The warmer climate thing is not as pronounced as we would hope, at the very least. A marginal impact compared to everything else.