𝐇𝐄𝐑𝐃 𝐈𝐌𝐌𝐔𝐍𝐈𝐓𝐘: “𝐋𝐞𝐭 𝐢𝐭 𝐫𝐢𝐩” 𝐢𝐬 𝐧𝐨𝐭 𝐰𝐨𝐫𝐤𝐢𝐧𝐠, 𝐢𝐬 𝐬𝐧𝐞𝐚𝐤𝐢𝐧𝐠 𝐢𝐧𝐭𝐨 𝐨𝐮𝐫 𝐚𝐜𝐭𝐢𝐨𝐧𝐬, 𝐚𝐧𝐝 𝐬𝐥𝐚𝐦𝐦𝐢𝐧𝐠 𝐢𝐧𝐭𝐨 𝐨𝐮𝐫 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐬

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).

𝐓𝐡𝐞 𝐫𝐞𝐚𝐬𝐨𝐧 𝐰𝐡𝐲 𝐈 𝐚𝐦 𝐰𝐫𝐢𝐭𝐢𝐧𝐠 𝐚𝐛𝐨𝐮𝐭 𝐭𝐡𝐢𝐬 𝐚𝐠𝐚𝐢𝐧 𝐢𝐬 𝐛𝐞𝐜𝐚𝐮𝐬𝐞 𝐭𝐡𝐞 𝐭𝐡𝐨𝐮𝐠𝐡𝐭𝐬 𝐞𝐱𝐩𝐫𝐞𝐬𝐬𝐞𝐝 𝐢𝐧 𝐭𝐡𝐞 𝐞𝐦𝐚𝐢𝐥𝐬 𝐚𝐫𝐞 𝐰𝐡𝐚𝐭 𝐦𝐚𝐧𝐲 𝐚𝐫𝐞 𝐛𝐞𝐥𝐢𝐞𝐯𝐢𝐧𝐠 – 𝐚𝐧𝐝, 𝐭𝐡𝐨𝐬𝐞 𝐛𝐞𝐥𝐢𝐞𝐟𝐬 𝐚𝐫𝐞 𝐝𝐢𝐜𝐭𝐚𝐭𝐢𝐧𝐠 𝐚𝐜𝐭𝐢𝐨𝐧𝐬 𝐭𝐡𝐚𝐭 𝐚𝐫𝐞 𝐡𝐚𝐫𝐦𝐟𝐮𝐥 𝐭𝐨 𝐨𝐮𝐫 𝐜𝐨𝐦𝐦𝐮𝐧𝐢𝐭𝐢𝐞𝐬 – 𝐰𝐞 𝐚𝐫𝐞 𝐬𝐞𝐞𝐢𝐧𝐠 𝐭𝐡𝐚𝐭 𝐰𝐢𝐭𝐡 𝐫𝐞𝐜𝐨𝐫𝐝 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧𝐬 (𝟏𝟏𝟑,𝟎𝟎𝟎 𝐲𝐞𝐬𝐭𝐞𝐫𝐝𝐚𝐲) 𝐚𝐧𝐝 𝐝𝐞𝐚𝐭𝐡𝐬 (𝟑,𝟔𝟎𝟎). 𝐓𝐡𝐞 “𝐥𝐞𝐭 𝐢𝐭 𝐫𝐢𝐩” 𝐦𝐞𝐧𝐭𝐚𝐥𝐢𝐭𝐲 𝐢𝐬 𝐬𝐧𝐞𝐚𝐤𝐢𝐧𝐠 𝐢𝐧𝐭𝐨 𝐩𝐞𝐨𝐩𝐥𝐞’𝐬 𝐭𝐡𝐨𝐮𝐠𝐡𝐭𝐬, 𝐚𝐟𝐟𝐞𝐜𝐭𝐢𝐧𝐠 𝐭𝐡𝐞𝐢𝐫 𝐚𝐜𝐭𝐢𝐨𝐧𝐬 𝐛𝐲 𝐦𝐚𝐤𝐢𝐧𝐠 𝐮𝐬 𝐭𝐨𝐨 𝐜𝐨𝐦𝐟𝐨𝐫𝐭𝐚𝐛𝐥𝐞, 𝐰𝐢𝐭𝐡 𝐝𝐞𝐯𝐚𝐬𝐭𝐚𝐭𝐢𝐧𝐠 𝐢𝐦𝐩𝐚𝐜𝐭𝐬 𝐨𝐧 𝐨𝐮𝐫 𝐜𝐨𝐦𝐦𝐮𝐧𝐢𝐭𝐢𝐞𝐬. 𝐈𝐧 𝐨𝐭𝐡𝐞𝐫 𝐰𝐨𝐫𝐝𝐬, 𝐢𝐭 𝐦𝐚𝐭𝐭𝐞𝐫𝐬 𝐰𝐡𝐚𝐭 𝐰𝐞 𝐛𝐞𝐥𝐢𝐞𝐯𝐞 𝐚𝐛𝐨𝐮𝐭 𝐭𝐡𝐢𝐬 𝐝𝐢𝐬𝐞𝐚𝐬𝐞 𝐛𝐞𝐜𝐚𝐮𝐬𝐞 𝐢𝐭 𝐢𝐬 𝐚𝐟𝐟𝐞𝐜𝐭𝐢𝐧𝐠 𝐡𝐨𝐰 𝐰𝐞 𝐚𝐜𝐭. 𝐓𝐡𝐢𝐬 𝐚𝐟𝐟𝐞𝐜𝐭𝐬 𝐚𝐥𝐥 𝐨𝐟 𝐮𝐬.

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:

✅ 1. “Infants, 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.

✅ 2. “We always knew as you relax and open up, cases will rise.”…“but are the new cases problematic???” 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 – 𝐏𝐢𝐜𝐭𝐮𝐫𝐞 𝟏. So, yes, new cases are problematic.

✅ 3. “We need also to tout the good stories as we know of elderly with serious conditions who get it and survive…this is key to tell,” 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). 𝐏𝐢𝐜𝐭𝐮𝐫𝐞 𝟐. 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.

✅ 4. What is key to tell is about our hospitals being slammed (𝐏𝐢𝐜𝐭𝐮𝐫𝐞 𝟑). 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.

✅ 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.

✅ So, where are we in the US in achieving herd immunity? 15% (𝐏𝐢𝐜𝐭𝐮𝐫𝐞 𝟒). 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.

✅ The only ethical way out of this pandemic is through a vaccine. 𝐈 𝐫𝐞𝐜𝐨𝐠𝐧𝐢𝐳𝐞 𝐦𝐚𝐧𝐲 𝐨𝐟 𝐲𝐨𝐮 𝐛𝐞𝐥𝐢𝐞𝐯𝐞 𝐭𝐡𝐢𝐬 𝐞𝐧𝐭𝐢𝐫𝐞 𝐩𝐨𝐬𝐭 𝐚𝐥𝐫𝐞𝐚𝐝𝐲. 𝐌𝐚𝐲𝐛𝐞 𝐭𝐡𝐢𝐬 𝐩𝐨𝐬𝐭 𝐜𝐚𝐧 𝐛𝐞 𝐚𝐧 𝐞𝐱𝐭𝐫𝐚-𝐝𝐨𝐬𝐞 𝐨𝐟 𝐞𝐧𝐜𝐨𝐮𝐫𝐚𝐠𝐞𝐦𝐞𝐧𝐭 𝐭𝐨 𝐭𝐚𝐤𝐞 𝐞𝐯𝐞𝐧 𝐦𝐨𝐫𝐞 𝐩𝐫𝐞𝐜𝐚𝐮𝐭𝐢𝐨𝐧𝐬 𝐭𝐡𝐚𝐧 𝐲𝐨𝐮 𝐚𝐥𝐫𝐞𝐚𝐝𝐲 𝐚𝐫𝐞, 𝐞𝐬𝐩𝐞𝐜𝐢𝐚𝐥𝐥𝐲 𝐚𝐬 𝐲𝐨𝐮 𝐦𝐚𝐤𝐞 𝐡𝐨𝐥𝐢𝐝𝐚𝐲 𝐩𝐥𝐚𝐧𝐬. 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!***

✅ 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

𝐓𝐇𝐄 𝐆𝐑𝐄𝐀𝐓 𝐁𝐀𝐑𝐑𝐈𝐍𝐆𝐓𝐎𝐍 𝐃𝐄𝐁𝐀𝐓𝐄 𝐀𝐍𝐃 𝐓𝐇𝐄 𝐉𝐎𝐇𝐍 𝐒𝐍𝐎𝐖 𝐌𝐄𝐌𝐎𝐑𝐀𝐍𝐃𝐔𝐌:

1. GBD Part 1 – https://tinyurl.com/y3spdcpu

2. GBD Part 2 – https://tinyurl.com/y4qywa9m

3. John Snow Memorandum