Mon 2021-Oct-25

Are We Close to the End of the Pandemic?

Well… are we?

What does it take?

Look, I know we’re all tired of COVID-19. (If you’re not tired of it, then you’re not paying attention. Good luck with that.) Are we close to the end, or not? And what does “the end” even mean?

It seems pretty clear now that we won’t be rid of COVID-19 any time soon: the SARS-CoV2 virus is too well-established in animal reservoirs all over the world. [1] Since we have contact with those animals, there will be zoönotic transfer for approximately forever, until either humans or the virus change. It’ll likely be the virus, but I have no idea of the time scale.

As we saw in the previous post on this crummy little blog that nobody reads, just hoping for ‘natural’ immunity means getting COVID-19 about every 18 months until dead. So the only feasible pathway forward is vaccination with periodic boosters.

How’s that going?

Vaccination progress

Not so great, actually.

Yesterday in the New York Times was a report that nations who were early leaders in vaccination are now laggards. [2]

Of immediate and striking interest to your humble Weekend Editor was the accompanying picture, shown here: an anti-vax rally in New York City in 2021-Sep, with closely packed people none of whom are masked! Sit with those facts for a minute: they won’t get vaccinated, they won’t social distance, and they won’t mask. Consequence: they will get COVID-19.

This is why the pandemic drags on. People refuse to take the safe, free, easily available routes to safety. Today 57% of the US population is fully vaccinated. For comparison purposes Portual has 87%.

Keep in mind that the Delta variant of SARS-CoV2 has an $R_0 \sim 6.0 - 7.0$ [3]. That’s… disturbingly large, though not as large as measles, which is terrifyingly large. But with the COVID $R_0$, the usual simple models then tell us that herd immunity happens when the immune fraction $h$ is:

$h = 1 - \frac{1}{R_0} = 1 - \frac{1}{6.0 \mbox{ to } 7.0} = 83.3\% \mbox{ to } 85.7\%$

So Portugal has likely achieved herd immunity, barring even more virulent strains. The US at 57% is nowhere near that, despite starting earlier with vaccination. It appears we can’t count on ‘natural’ immunity from people who have recovered from COVID-19, since that fades enough by 18 months to be a problem.

Now, it’s not uniform in the US. The miserable American South has remained mired in a political swamp of ivermectin and Republican propaganda. The northeast has been pretty ok. But the best standout for vaccine performance has been Puerto Rico with 73%, better even than New England. CNN reports that they are the most heavily vaccinated US region. [4] So congratulations to sensible Puerto Ricans, along with Native Americans, who are the most vaccinated US ethnic group!

Why aren’t the rest of us as good as them? Basically: superstitious vaccine resistance.

From the NYT article:

“Every country has an anti-vax movement, but in most countries it’s exceedingly small,” said Dr. John Swartzberg, a professor at the School of Public Health at the University of California at Berkeley who has taught a seminar on vaccine hesitancy for several years. “It’s not a new movement, but it’s never had the traction it has today.”

Social media has been “irresponsible” in dealing with unfounded rumors, he said, and the United States has been “the poster child of a country that has not handled the messaging about vaccines.”

In countries like France, Italy and Canada, officials began requiring people to use health passports to show proof of vaccination to enter many establishments, a move that is credited with improving their vaccination efforts.

“We do not have the barriers of supply or distribution or access to the vaccine,” said Dr. Leana Wen, a public health professor at George Washington University. “The only barrier at this point is people’s willingness to be vaccinated. That’s what’s going wrong compared to other countries that have solved their supply, distribution and access issues.”

Think about that: “people’s willingness to be vaccinated” is the only barrier. As Dr. Tedros Adhanom Ghebreyesus of the WHO put it:

The Weekend Conclusion

It ends when we choose to end it. You have the capability; will you use it?

Notes & References

1: T Prince, et al., “SARS-CoV-2 Infections in Animals: Reservoirs for Reverse Zoonosis and Models for Study”, Viruses 13:3, p 494, 2021-Mar-07. PMID: 33802857, DOI: 10.3390/v13030494

2: A Paybarah, V Patel, & A Kannapell, “The U.S. and Israel were early world leaders on vaccinations. Now they are trailing.”, New York Times Daily Covid Briefing, 2021-Oct-24.

3: Authors redacted, “Improving comunications around vaccine breakthrough and vaccine effectiveness”, 2021-Jul-29. Originally obtained by the Washington Post. See slide 15 for the plot of fatality vs estimated $R_0$ for various viruses, including Delta SARS-CoV2.

4: R Sanchez, “How Puerto Rico became the most vaccinated place in America”, CNN, 2021-Oct-24.

Published Mon 2021-Oct-25

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