Herd immunity is achieved when enough of a population becomes immune to a disease. There are only two ways of achieving that: vaccines and natural immunity (people getting sick naturally). But, there’s only one ethical way to achieve this with COVID-19 (we need to achieve 70-80% immunity with COVID-19)- and that’s not doing what we are doing. You have probably seen or heard about the emails from Paul Alexander, a Trump-appointed HHS advisor, with statements like “We want them infected”. These were sent in the summer and many of us talked about this in the summer – this was the same time the Great Barrington Declaration came out and was touted as the way to achieve herd immunity (I wrote a LOT debunking that and will post those at the end).
๐๐ก๐ ๐ซ๐๐๐ฌ๐จ๐ง ๐ฐ๐ก๐ฒ ๐ ๐๐ฆ ๐ฐ๐ซ๐ข๐ญ๐ข๐ง๐ ๐๐๐จ๐ฎ๐ญ ๐ญ๐ก๐ข๐ฌ ๐๐ ๐๐ข๐ง ๐ข๐ฌ ๐๐๐๐๐ฎ๐ฌ๐ ๐ญ๐ก๐ ๐ญ๐ก๐จ๐ฎ๐ ๐ก๐ญ๐ฌ ๐๐ฑ๐ฉ๐ซ๐๐ฌ๐ฌ๐๐ ๐ข๐ง ๐ญ๐ก๐ ๐๐ฆ๐๐ข๐ฅ๐ฌ ๐๐ซ๐ ๐ฐ๐ก๐๐ญ ๐ฆ๐๐ง๐ฒ ๐๐ซ๐ ๐๐๐ฅ๐ข๐๐ฏ๐ข๐ง๐ – ๐๐ง๐, ๐ญ๐ก๐จ๐ฌ๐ ๐๐๐ฅ๐ข๐๐๐ฌ ๐๐ซ๐ ๐๐ข๐๐ญ๐๐ญ๐ข๐ง๐ ๐๐๐ญ๐ข๐จ๐ง๐ฌ ๐ญ๐ก๐๐ญ ๐๐ซ๐ ๐ก๐๐ซ๐ฆ๐๐ฎ๐ฅ ๐ญ๐จ ๐จ๐ฎ๐ซ ๐๐จ๐ฆ๐ฆ๐ฎ๐ง๐ข๐ญ๐ข๐๐ฌ – ๐ฐ๐ ๐๐ซ๐ ๐ฌ๐๐๐ข๐ง๐ ๐ญ๐ก๐๐ญ ๐ฐ๐ข๐ญ๐ก ๐ซ๐๐๐จ๐ซ๐ ๐ก๐จ๐ฌ๐ฉ๐ข๐ญ๐๐ฅ๐ข๐ณ๐๐ญ๐ข๐จ๐ง๐ฌ (๐๐๐,๐๐๐ ๐ฒ๐๐ฌ๐ญ๐๐ซ๐๐๐ฒ) ๐๐ง๐ ๐๐๐๐ญ๐ก๐ฌ (๐,๐๐๐). ๐๐ก๐ “๐ฅ๐๐ญ ๐ข๐ญ ๐ซ๐ข๐ฉ” ๐ฆ๐๐ง๐ญ๐๐ฅ๐ข๐ญ๐ฒ ๐ข๐ฌ ๐ฌ๐ง๐๐๐ค๐ข๐ง๐ ๐ข๐ง๐ญ๐จ ๐ฉ๐๐จ๐ฉ๐ฅ๐’๐ฌ ๐ญ๐ก๐จ๐ฎ๐ ๐ก๐ญ๐ฌ, ๐๐๐๐๐๐ญ๐ข๐ง๐ ๐ญ๐ก๐๐ข๐ซ ๐๐๐ญ๐ข๐จ๐ง๐ฌ ๐๐ฒ ๐ฆ๐๐ค๐ข๐ง๐ ๐ฎ๐ฌ ๐ญ๐จ๐จ ๐๐จ๐ฆ๐๐จ๐ซ๐ญ๐๐๐ฅ๐, ๐ฐ๐ข๐ญ๐ก ๐๐๐ฏ๐๐ฌ๐ญ๐๐ญ๐ข๐ง๐ ๐ข๐ฆ๐ฉ๐๐๐ญ๐ฌ ๐จ๐ง ๐จ๐ฎ๐ซ ๐๐จ๐ฆ๐ฆ๐ฎ๐ง๐ข๐ญ๐ข๐๐ฌ. ๐๐ง ๐จ๐ญ๐ก๐๐ซ ๐ฐ๐จ๐ซ๐๐ฌ, ๐ข๐ญ ๐ฆ๐๐ญ๐ญ๐๐ซ๐ฌ ๐ฐ๐ก๐๐ญ ๐ฐ๐ ๐๐๐ฅ๐ข๐๐ฏ๐ ๐๐๐จ๐ฎ๐ญ ๐ญ๐ก๐ข๐ฌ ๐๐ข๐ฌ๐๐๐ฌ๐ ๐๐๐๐๐ฎ๐ฌ๐ ๐ข๐ญ ๐ข๐ฌ ๐๐๐๐๐๐ญ๐ข๐ง๐ ๐ก๐จ๐ฐ ๐ฐ๐ ๐๐๐ญ. ๐๐ก๐ข๐ฌ ๐๐๐๐๐๐ญ๐ฌ ๐๐ฅ๐ฅ ๐จ๐ ๐ฎ๐ฌ.
We can’t become complacent. But, what I am seeing more and more are people going to holiday parties or church events or gyms or restaurants like business is usual. That’s what I mean by this mentality sneaking into our actions. So, what we are doing (and believing) is not working. Let me show you through quotes from the emails. You have probably heard similar thoughts from friends or family members:
โ 1. โInfants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk….so we use them to develop herd…we want them infected….and recovered…with antibodies.” -The thought was to shield the at-risk and elderly from the group noted in the quote above. Two things are wrong with this statement: 1) It’s really hard to shield the above group from at-risk individuals. The quoted group is still visiting grandparents, going to restaurants (with at-risk people at nearby tables), going to school/riding buses with at-risk individuals, or going home to at-risk individuals. At-risk individuals are those with hypertension, obesity, moderate/severe asthma, persons over 50,..so, shielding is really hard to do. 2) We don’t recognize long-haulers. This is not the flu or a simple cold – so, many healthy people are still trying to recover from COVID-19. We’ll talk about that more below.
โ 2. โWe always knew as you relax and open up, cases will rise.โ…โbut are the new cases problematic???โ You’ve probably heard people say this too. We can’t act like the new cases rising are “fine” because they are among younger, healthy individuals. The spillover to at-risk individuals from these individuals is well-documented, and is contributing to the surge we are seeing in hospitals and deaths. And, we are still not catching all new cases – our positivity rates are way too high (indicating the new cases are not simply due to more testing-they are due to more spread). That disturbing trend of increasing positivity rates (indicating increasing spread) is seen in EVERY state except 3 – ๐๐ข๐๐ญ๐ฎ๐ซ๐ ๐. So, yes, new cases are problematic.
โ 3. โWe need also to tout the good stories as we know of elderly with serious conditions who get it and surviveโฆthis is key to tell,โ he added. Yesterday, 3,600 people died of COVID-19. That’s an average of 1 death every 40 second. COVID-19 is now the leading cause of death in the US (and, doctors are not lying about that on a death certificate). ๐๐ข๐๐ญ๐ฎ๐ซ๐ ๐. The US has the 4th highest mortality rate per capita in the world among countries with the most cases. It’s also not just the elderly dying of this (not that they are expendable). The mortality rates jumps up at 50 years of age. And, the racial minorities groups are dying much younger and at higher rates than their white counterparts.
โ 4. What is key to tell is about our hospitals being slammed (๐๐ข๐๐ญ๐ฎ๐ซ๐ ๐). If the rate is above 10%, that’s concerning. If the rate is above 20%, that’s extreme stress. If the rate is above 50%, that means the hospital is overloaded. 53 counties is the US are at the 50% or above mark, and expected to increase for at least another month. What that means is not having a bed if you need one – for any condition.
โ 5. We have to tell the story of the long-haulers. With COVID-19, it’s not only about surviving. This virus can have devastating impacts on nearly every organ of the body, with symptoms like brain fog, heart conditions, severe fatigue, dizziness, and others more than 90 days out. The average age is 44 with women outnumbering men 4 to 1. Women with no underlying health conditions. Up to 10% of persons with COVID-19 will be long-haulers: So far, that’s at least 1.6 million people.
โ So, where are we in the US in achieving herd immunity? 15% (๐๐ข๐๐ญ๐ฎ๐ซ๐ ๐). And, 306,000 deaths and record number of hospitalizations. If you do the quick math of trying to achieve 70% herd immunity, that equates to over a million deaths and over 20 million long-haulers. Focused protection is not working. We need to be careful letting that mentality sneak into our actions. It’s making quite a few people feel comfortable to go along like the surges we are seeing (in cases, hospitalizations, and deaths) are normal or expected or unavoidable. It’s not. For the love of your communities, wear a mask, distance, wash your hands, stay home when you can. Be part of the solution, not the problem.
โ The only ethical way out of this pandemic is through a vaccine. ๐ ๐ซ๐๐๐จ๐ ๐ง๐ข๐ณ๐ ๐ฆ๐๐ง๐ฒ ๐จ๐ ๐ฒ๐จ๐ฎ ๐๐๐ฅ๐ข๐๐ฏ๐ ๐ญ๐ก๐ข๐ฌ ๐๐ง๐ญ๐ข๐ซ๐ ๐ฉ๐จ๐ฌ๐ญ ๐๐ฅ๐ซ๐๐๐๐ฒ. ๐๐๐ฒ๐๐ ๐ญ๐ก๐ข๐ฌ ๐ฉ๐จ๐ฌ๐ญ ๐๐๐ง ๐๐ ๐๐ง ๐๐ฑ๐ญ๐ซ๐-๐๐จ๐ฌ๐ ๐จ๐ ๐๐ง๐๐จ๐ฎ๐ซ๐๐ ๐๐ฆ๐๐ง๐ญ ๐ญ๐จ ๐ญ๐๐ค๐ ๐๐ฏ๐๐ง ๐ฆ๐จ๐ซ๐ ๐ฉ๐ซ๐๐๐๐ฎ๐ญ๐ข๐จ๐ง๐ฌ ๐ญ๐ก๐๐ง ๐ฒ๐จ๐ฎ ๐๐ฅ๐ซ๐๐๐๐ฒ ๐๐ซ๐, ๐๐ฌ๐ฉ๐๐๐ข๐๐ฅ๐ฅ๐ฒ ๐๐ฌ ๐ฒ๐จ๐ฎ ๐ฆ๐๐ค๐ ๐ก๐จ๐ฅ๐ข๐๐๐ฒ ๐ฉ๐ฅ๐๐ง๐ฌ. Be careful if you go out and tighten your bubble even more.
BTW, if you want to follow the FDA panel meeting today about the Moderna vaccine, go here: https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-december-17-2020-meeting-announcement.
-Friendly neighbor epidemiologist
***I LOVED reading through the comments on yesterday’s post. I would encourage you to go read them if you need some joy in your life. Thank you for sharing those incredible stories!***
โ SOURCES:
Positivity rates (Picture 1): https://coronavirus.jhu.edu/testing/tracker/map/weekly-change-percent-positive
Leading case of death (Picture 2): http://www.healthdata.org/sites/default/files/files/Projects/COVID/briefing_US_20201204.pdf
Hospitals (Picture 3): https://www.npr.org/sections/health-shots/2020/12/09/944379919/new-data-reveal-which-hospitals-are-dangerously-full-is-yours#res944380257
Herd immunity (Picture 4): https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30555-5/fulltext Global deaths per capita: https://coronavirus.jhu.edu/
Long-haulers:
It’s not just about dying from COVID-19. Let’s talk about long-haulers. – https://tinyurl.com/y2nomqkj
Long-hauler 10% – https://jamanetwork.com/journals/jama/fullarticle/2771111
๐๐๐ ๐๐๐๐๐ ๐๐๐๐๐๐๐๐๐๐ ๐๐๐๐๐๐ ๐๐๐ ๐๐๐ ๐๐๐๐ ๐๐๐๐ ๐๐๐๐๐๐๐๐๐๐:
1. GBD Part 1 – https://tinyurl.com/y3spdcpu
2. GBD Part 2 – https://tinyurl.com/y4qywa9m
3. John Snow Memorandum
Part 1 – https://tinyurl.com/y5r9wxzd
4. John Snow Memorandum
Part 2 – https://tinyurl.com/y4ckxr9w
Will herd immunity work? 1. https://tinyurl.com/y6qy4xay
2. https://tinyurl.com/yyu3u6gq
3. https://tinyurl.com/y2xbbh52