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COVID crisis won’t end any time soon



This column is about my layman’s understanding of the COVID-19 crisis in the United States: It is grim now and isn’t going to end in the near future.

In recent developments, infections are swamping the United States, which recorded 42% of all its coronavirus cases in July, according to the New York Times. A University of Washington study projected that the death toll from COVID will reach 300,000 by Dec. 1 if Americans do not consistently wear a mask outside.

As of Aug. 3, the country continues to log 50,000 to 60,000 new coronavirus cases a day, a figure that Dr. Anthony Fauci, the government’s top infectious disease expert, said needs to drop to 10,000 by September to gain some level of control over the pandemic before fall.

Another aspect of this crisis is the hope for achieving “herd immunity,” defined by the Centers for Disease Control as “a situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely.”

There is a range of opinions as to how many people would need to develop immunity to reach the herd immunity threshold. The Washington Post reported on a simulation based on a scenario where there is no vaccine and that the threshold is 60%, a midrange number. The projection concluded that 2.95 million Americans would die before herd immunity is achieved.

Will a vaccine save us? Not so fast.

Jesse Goodman, the former chief scientist at the Food and Drug Administration said in July that the country is five months into the pandemic and probably another five from a safe and effective vaccine, assuming the clinical trials work out perfectly. Even when a vaccine is introduced, Goodman believes there will be several months of significant infection, or at least risk of infection.

A vaccine can be approved by the federal government if it is proven to be 50% effective. Once approval is granted there will be logistic hurdles to producing, delivering, storing and administering the vaccine. If several vaccines are approved the logistics are more complicated because each may have different requirements for use and storage. Some may require two shots. Health care providers and officials will need to make sure that someone getting the first dose of vaccine “A” gets the appropriate second dose of the same vaccine.

Vivek Murthy served as surgeon general under former President Barack Obama and led U.S. responses to the Ebola and Zika outbreaks. This is his opinion as reported by Fortune magazine: “If the goal is to return life to some semblance of what it was like pre-pandemic, I don’t see that happening in 2021 … even in an optimistic scenario, it would likely be closer to mid-2021 that we would see vaccines starting to be distributed at scale.”

Here’s an important point: “If you get a vaccine that just meets the guidelines, the chances are you’re not going to be able to achieve herd immunity,” said Walter Orenstein, associate director of the Emory Vaccine Center. “You tamp down transmission, substantially. It decreases your risk of getting exposed, but it doesn’t eliminate it. But a 50 percent effective vaccine is a lot better than zero percent effective vaccine. I would take it.”

Unfortunately, a significant minority of Americans may not take Dr. Orenstein’s advice. According to a Washington Post-ABC poll , when asked if they would get vaccinated, 27% said “maybe not’ or “definitely not.”

What about the simple steps individuals can take to slow the spread of the disease? According to a Gallup survey conducted June 29-July 5, 44% of U.S. adults say they “always” wear a mask when outside their homes, and 28% say they do so “very often.” At the same time, three in 10 report doing so less often, including 11% “sometimes,” 4% “rarely” and 14% “never.

How much do face masks matter? In an email to me, Dean Owen of The Institute for Health Metrics and Evaluation said projected deaths between now and Dec. 1 could drop by 50% if 95% of the people in the U.S. wear masks every time they leave their homes.

An added problem is that there continues to be super-spreader events. A biker rally in Sturgis, South Dakota, earlier this month drew a crowd of 250,000. Stay tuned for the Covid casualty count.

Those living in college towns have good reason for concern. The Chronicle of Higher Education reported that “In recent weeks, Covid-19 cases have exploded among people in their 20s and 30s. Public-health officials say that’s partly because of so-called super-spreader events, including gatherings of college students in off-campus houses, fraternities, and bars.”

Vacations and large family gatherings for Labor Day, Thanksgiving and Christmas offer ample opportunity for more super-spreader events.

So when will this Covid crisis end? “It’s very unlikely we’re going to be able to declare the kind of victory we did over SARS,” says Stephen Morse, an epidemiologist at Columbia University.

Yonatan Grad, an infectious-disease researcher at Harvard, and his colleagues have modeled a few possible trajectories. Grad pointed out, in an interview with the Atlantic magazine, that a great deal depends on the strength and duration of immunity against the virus. If immunity lasts only a few months, there could be a big pandemic followed by smaller outbreaks every year. If immunity lasts closer to two years, COVID-19 could peak every other year.

Our current president said “It is what it is” in a recent interview. What it is, unfortunately, is the worst health catastrophe in at least 100 years. It is a health and economic disaster that could have been, and still might be, mitigated if more Americans observed public health guidelines on mask wearing, social distancing and large gatherings. It is a pandemic that is not going to end anytime soon.

Richard Fein’s purpose in writing his columns is to promote civil discourse on topics of public interest. Richard holds a Master of Arts degree in Political Science and an MBA in Economics. He can be reached at columnist@gazettenet.com.



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