๐‡๐„๐‘๐ƒ ๐ˆ๐Œ๐Œ๐”๐๐ˆ๐“๐˜: “๐‹๐ž๐ญ ๐ข๐ญ ๐ซ๐ข๐ฉ” ๐ข๐ฌ ๐ง๐จ๐ญ ๐ฐ๐จ๐ซ๐ค๐ข๐ง๐ , ๐ข๐ฌ ๐ฌ๐ง๐ž๐š๐ค๐ข๐ง๐  ๐ข๐ง๐ญ๐จ ๐จ๐ฎ๐ซ ๐š๐œ๐ญ๐ข๐จ๐ง๐ฌ, ๐š๐ง๐ ๐ฌ๐ฅ๐š๐ฆ๐ฆ๐ข๐ง๐  ๐ข๐ง๐ญ๐จ ๐จ๐ฎ๐ซ ๐ก๐จ๐ฌ๐ฉ๐ข๐ญ๐š๐ฅ๐ฌ

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).

๐“๐ก๐ž ๐ซ๐ž๐š๐ฌ๐จ๐ง ๐ฐ๐ก๐ฒ ๐ˆ ๐š๐ฆ ๐ฐ๐ซ๐ข๐ญ๐ข๐ง๐  ๐š๐›๐จ๐ฎ๐ญ ๐ญ๐ก๐ข๐ฌ ๐š๐ ๐š๐ข๐ง ๐ข๐ฌ ๐›๐ž๐œ๐š๐ฎ๐ฌ๐ž ๐ญ๐ก๐ž ๐ญ๐ก๐จ๐ฎ๐ ๐ก๐ญ๐ฌ ๐ž๐ฑ๐ฉ๐ซ๐ž๐ฌ๐ฌ๐ž๐ ๐ข๐ง ๐ญ๐ก๐ž ๐ž๐ฆ๐š๐ข๐ฅ๐ฌ ๐š๐ซ๐ž ๐ฐ๐ก๐š๐ญ ๐ฆ๐š๐ง๐ฒ ๐š๐ซ๐ž ๐›๐ž๐ฅ๐ข๐ž๐ฏ๐ข๐ง๐  – ๐š๐ง๐, ๐ญ๐ก๐จ๐ฌ๐ž ๐›๐ž๐ฅ๐ข๐ž๐Ÿ๐ฌ ๐š๐ซ๐ž ๐๐ข๐œ๐ญ๐š๐ญ๐ข๐ง๐  ๐š๐œ๐ญ๐ข๐จ๐ง๐ฌ ๐ญ๐ก๐š๐ญ ๐š๐ซ๐ž ๐ก๐š๐ซ๐ฆ๐Ÿ๐ฎ๐ฅ ๐ญ๐จ ๐จ๐ฎ๐ซ ๐œ๐จ๐ฆ๐ฆ๐ฎ๐ง๐ข๐ญ๐ข๐ž๐ฌ – ๐ฐ๐ž ๐š๐ซ๐ž ๐ฌ๐ž๐ž๐ข๐ง๐  ๐ญ๐ก๐š๐ญ ๐ฐ๐ข๐ญ๐ก ๐ซ๐ž๐œ๐จ๐ซ๐ ๐ก๐จ๐ฌ๐ฉ๐ข๐ญ๐š๐ฅ๐ข๐ณ๐š๐ญ๐ข๐จ๐ง๐ฌ (๐Ÿ๐Ÿ๐Ÿ‘,๐ŸŽ๐ŸŽ๐ŸŽ ๐ฒ๐ž๐ฌ๐ญ๐ž๐ซ๐๐š๐ฒ) ๐š๐ง๐ ๐๐ž๐š๐ญ๐ก๐ฌ (๐Ÿ‘,๐Ÿ”๐ŸŽ๐ŸŽ). ๐“๐ก๐ž “๐ฅ๐ž๐ญ ๐ข๐ญ ๐ซ๐ข๐ฉ” ๐ฆ๐ž๐ง๐ญ๐š๐ฅ๐ข๐ญ๐ฒ ๐ข๐ฌ ๐ฌ๐ง๐ž๐š๐ค๐ข๐ง๐  ๐ข๐ง๐ญ๐จ ๐ฉ๐ž๐จ๐ฉ๐ฅ๐ž’๐ฌ ๐ญ๐ก๐จ๐ฎ๐ ๐ก๐ญ๐ฌ, ๐š๐Ÿ๐Ÿ๐ž๐œ๐ญ๐ข๐ง๐  ๐ญ๐ก๐ž๐ข๐ซ ๐š๐œ๐ญ๐ข๐จ๐ง๐ฌ ๐›๐ฒ ๐ฆ๐š๐ค๐ข๐ง๐  ๐ฎ๐ฌ ๐ญ๐จ๐จ ๐œ๐จ๐ฆ๐Ÿ๐จ๐ซ๐ญ๐š๐›๐ฅ๐ž, ๐ฐ๐ข๐ญ๐ก ๐๐ž๐ฏ๐š๐ฌ๐ญ๐š๐ญ๐ข๐ง๐  ๐ข๐ฆ๐ฉ๐š๐œ๐ญ๐ฌ ๐จ๐ง ๐จ๐ฎ๐ซ ๐œ๐จ๐ฆ๐ฆ๐ฎ๐ง๐ข๐ญ๐ข๐ž๐ฌ. ๐ˆ๐ง ๐จ๐ญ๐ก๐ž๐ซ ๐ฐ๐จ๐ซ๐๐ฌ, ๐ข๐ญ ๐ฆ๐š๐ญ๐ญ๐ž๐ซ๐ฌ ๐ฐ๐ก๐š๐ญ ๐ฐ๐ž ๐›๐ž๐ฅ๐ข๐ž๐ฏ๐ž ๐š๐›๐จ๐ฎ๐ญ ๐ญ๐ก๐ข๐ฌ ๐๐ข๐ฌ๐ž๐š๐ฌ๐ž ๐›๐ž๐œ๐š๐ฎ๐ฌ๐ž ๐ข๐ญ ๐ข๐ฌ ๐š๐Ÿ๐Ÿ๐ž๐œ๐ญ๐ข๐ง๐  ๐ก๐จ๐ฐ ๐ฐ๐ž ๐š๐œ๐ญ. ๐“๐ก๐ข๐ฌ ๐š๐Ÿ๐Ÿ๐ž๐œ๐ญ๐ฌ ๐š๐ฅ๐ฅ ๐จ๐Ÿ ๐ฎ๐ฌ.

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:

โœ… 1. โ€œInfants, 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.

โœ… 2. โ€œWe always knew as you relax and open up, cases will rise.โ€…โ€œbut 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 – ๐๐ข๐œ๐ญ๐ฎ๐ซ๐ž ๐Ÿ. So, yes, new cases are problematic.

โœ… 3. โ€œWe need also to tout the good stories as we know of elderly with serious conditions who get it and surviveโ€ฆthis 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). ๐๐ข๐œ๐ญ๐ฎ๐ซ๐ž ๐Ÿ. 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.

โœ… 4. What is key to tell is about our hospitals being slammed (๐๐ข๐œ๐ญ๐ฎ๐ซ๐ž ๐Ÿ‘). 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.

โœ… 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.

โœ… So, where are we in the US in achieving herd immunity? 15% (๐๐ข๐œ๐ญ๐ฎ๐ซ๐ž ๐Ÿ’). 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.

โœ… The only ethical way out of this pandemic is through a vaccine. ๐ˆ ๐ซ๐ž๐œ๐จ๐ ๐ง๐ข๐ณ๐ž ๐ฆ๐š๐ง๐ฒ ๐จ๐Ÿ ๐ฒ๐จ๐ฎ ๐›๐ž๐ฅ๐ข๐ž๐ฏ๐ž ๐ญ๐ก๐ข๐ฌ ๐ž๐ง๐ญ๐ข๐ซ๐ž ๐ฉ๐จ๐ฌ๐ญ ๐š๐ฅ๐ซ๐ž๐š๐๐ฒ. ๐Œ๐š๐ฒ๐›๐ž ๐ญ๐ก๐ข๐ฌ ๐ฉ๐จ๐ฌ๐ญ ๐œ๐š๐ง ๐›๐ž ๐š๐ง ๐ž๐ฑ๐ญ๐ซ๐š-๐๐จ๐ฌ๐ž ๐จ๐Ÿ ๐ž๐ง๐œ๐จ๐ฎ๐ซ๐š๐ ๐ž๐ฆ๐ž๐ง๐ญ ๐ญ๐จ ๐ญ๐š๐ค๐ž ๐ž๐ฏ๐ž๐ง ๐ฆ๐จ๐ซ๐ž ๐ฉ๐ซ๐ž๐œ๐š๐ฎ๐ญ๐ข๐จ๐ง๐ฌ ๐ญ๐ก๐š๐ง ๐ฒ๐จ๐ฎ ๐š๐ฅ๐ซ๐ž๐š๐๐ฒ ๐š๐ซ๐ž, ๐ž๐ฌ๐ฉ๐ž๐œ๐ข๐š๐ฅ๐ฅ๐ฒ ๐š๐ฌ ๐ฒ๐จ๐ฎ ๐ฆ๐š๐ค๐ž ๐ก๐จ๐ฅ๐ข๐๐š๐ฒ ๐ฉ๐ฅ๐š๐ง๐ฌ. 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!***

โœ… 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

๐“๐‡๐„ ๐†๐‘๐„๐€๐“ ๐๐€๐‘๐‘๐ˆ๐๐†๐“๐Ž๐ ๐ƒ๐„๐๐€๐“๐„ ๐€๐๐ƒ ๐“๐‡๐„ ๐‰๐Ž๐‡๐ ๐’๐๐Ž๐– ๐Œ๐„๐Œ๐Ž๐‘๐€๐๐ƒ๐”๐Œ:

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

4. https://tinyurl.com/yypydyt2

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