Will Vaccines End The Pandemic?

We are tired. Tired of the isolation, the anxiety, and the job uncertainty of the pandemic.  When vaccines were released a few months ago, many of us breathed a sigh of relief.  Finally, we could get back to our lives. But, unfortunately, that hope may be premature…

What vaccines are currently available?

In the United States, currently, two vaccines are authorized and recommended to prevent COVID-19: Pfizer and Moderna, both of which require two doses of the vaccine for full protection. However, many more are being tested and show a lot of promise. In fact, there are nearly 240 novel vaccine candidates in development.

Both the vaccines available and the ones being tested show up to 95% effectiveness in preventing transmission… which is great cause for hope!

Why aren’t the vaccines enough?

The problem is that the virus is already so widespread that it is unlikely that vaccines will be able to be produced and distributed quickly enough to make a significant impact in many areas.

Dr. Shaman, an epidemiologist at Columbia, estimates that more than 105 million people have already been infected across the U.S., which is a number well above the number of cases that have been reported.

To complicate things further, the numbers are different in different areas of the country. For instance, Shaman’s group estimates that 60 percent of the population in North Dakota has already been infected. This high rate of infection means that vaccines will not matter nearly as much as in some other areas like Vermont, where the infection rate is only 10%. Whereas COVID will mostly burn out on its own in North Dakota, a swiftly distributed vaccine can make a major difference in keeping the death rate low in Vermont.

But, can Americans manage to avoid getting the virus before the vaccine is distributed? What if that vaccine takes months to arrive?

How many more Americans will be infected before vaccines are distributed?

Shaman and his team have created models showing that millions more Americans will contract COVID before the vaccines are fully distributed. Their model factors in things like the speed and order of vaccine distribution, the effectiveness after one and two doses, current social distancing measures, and the transmissibility of the virus. It also assumes that the CDC guidelines of prioritizing groups like health care workers and older adults will be followed and that vaccinations will be ramped up to five million doses per week.

Can continuing restrictions lower the number of people infected?

Shaman’s model looked at how the rate of infection would vary according to how long restrictions remained in place.  What they discovered was that the scenarios in which restrictions were strengthened and then kept in place until much of the population could receive the vaccine resulted in some of the fewest total infections.  For instance, strengthening restrictions until February would likely result in 9 million fewer infections, while maintaining restrictions until late July would result in 19 million fewer infections.

This is difficult news for all of us who have been social distancing for almost a year now.

How have Dr. Shaman’s findings been received? 

While the model has not yet been published or peer-reviewed, many scientists are in agreement with Shaman’s findings. Lauren Ancel Meyers, a professor of biology and statistics at the University of Texas at Austin, confirms that “The more the virus spreads before the vaccine reaches people, the fewer deaths we can prevent with the vaccine.”

But, she and other scientists agree that there are other variables that may change the course of the next few months. Dr. Meyers noted that mortality figures could come down sooner than infections with the right vaccination strategy, which could allow some parts of the country to lift restrictions earlier.

Trevor Bedford, a geneticist at the Fred Hutchinson Cancer Research Center and the University of Washington added that the Biden Administration has promised to accelerate the pace of the vaccination rate, and, if that holds true, opening the country may happen sooner.

Dr. Bruce Y. Lee, a professor of health policy and management at the City University of New York, is also a bit more optimistic than Shaman. He predicts that due to “herd immunity” from vaccines and previous illness, the virus could drop to much lower levels by July. But, David Engelthaler, who leads the infectious disease branch of the Translational Genomics Research Institute in Arizona, notes that even with herd immunity, clusters and spikes will continue to happen. Even so, he believes the pandemic will start to wind down by late spring or early summer.

But many politicians remain cautious of premature hope. Mayor Jenny A. Durkan of Seattle is preparing her constituents for the long haul, telling them to expect to continue to social distance “at least through the summer and probably into the fall.”

How do the new variants factor in?

The new variants of COVID can also change the trajectory of the disease.  B.1.1.7 is the variant that was first discovered in the UK but is now traveling quickly around the world. While B.1.1.7 does not appear to be more lethal than the original strain, it’s 50% more easily transmitted than common variants which can be even more problematic.

This new variant will likely result in a lot more deaths before the pandemic is under control because higher transmissibility is generally more concerning than a higher mortality rate.  In fact, a virus which is 50 percent more transmissible will kill far more people than one which is 50 percent more deadly.

The other concerning variant is E484K, which was discovered in South Africa.  E484K not only is more contagious than the original strain, but may also be capable of evading existing antibodies (produced by vaccines or natural infection) some of the time.

Both of these variants and others that are likely to emerge will present additional challenges in ending the pandemic. Fortunately, the vaccines still seem to be mostly effective against all of the strains.

Until a sizable population of the country is vaccinated, we will have to continue to rely on measures to stay safe.

How can we protect ourselves?

It can be very tempting to loosen restrictions after so many months of isolation.  But, while there is hope ahead, it’s important to remain extra cautious for the next few months until vaccinations are widely distributed. In fact, the new variants and winter spikes mean that even more caution is needed.  Here are some ways you can protect yourself:

Wear the right mask

While a cloth mask may have been enough previously, the new variants require better protection. N95 and surgical masks are your best options, but if that’s not available look for masks that use tight weaves and multiple levels of material. It’s also important to make sure that the mask fits well. Masks that hang loose or have gaps can decrease the effectiveness by 50%.

Social Distance… Even more than you have been

While a masked trip to the grocery store was relatively safe a few months ago, it’s important to take even more precautions now.  Limit outings to only what’s absolutely necessary and make sure to shop in spaced out, well-ventilated stores.  Consider going shopping early in the morning when there are fewer shoppers.

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