We do not have a cure, just a treatment that seems to reduce recovery time for COVID-19 infections by about 4 days. Remdesivir. And while there are vaccines in an R&D/testing process – 123 that I have found – and a promising use of antibodies from those who have recovered, we are unlikely to see a viable vaccine widely available until well into 2021. The virus itself has mutated dozens of times already, with a stronger strain from Europe (versus the original Wuhan variety) being the primary source of infection in New York City. Mutations can weaken or strength a virus, but unless these is a severe genetic variation in the RNA, mutations probably won’t impact the effectiveness of a vaccine… assuming (still just an assumption) we develop an effective vaccine. It is equally possible that several vaccines could fit the bill, some more effective or few lower risks than others.
However, whether the federal government, which has failed abysmally in the timely distribution of “all things COVID-19” – from test kits to cotton swabs to masks to PPE at every level and has even proselytized the effectiveness of unproven hydroxychloroquine which carries severe (potentially fatal) side effects – is even capable of being able to implement wide distribution of a vaccine if and when it becomes available is very much in doubt. Already, there are projections that we are not even attempting to manufacture sufficient and appropriate glass vials to hold the number of injectable vaccines we would need.
The Washington Post (June 11th) reported that “there is a surge in coronavirus cases in states that precipitously reopened. The New York Times reported Wednesday [6/10, updated 6/11] that 21 states are experiencing an uptick in cases (‘[Persistent] growth continues in Arkansas, North Carolina and Florida. And in South Carolina, there have been nearly 1,000 new cases in the last two days’). Counties with the highest number of new cases are primarily in red states (Iowa, Mississippi, Alabama, Texas).” So much for the perception of relative rural immunity from the ravages of COVID-19.
Additionally, worries over these infection upticks combined with projections that there the economic malaise will remain a long-term problem finally tanked the stock market on June 11th: “Stocks dropped by the most since mid-March on Thursday [6/11] following the Federal Reserve’s monetary policy decision, in which policymakers highlighted the ongoing economic concerns spurred by the coronavirus pandemic and measures taken to contain it.
“The Dow dropped 6.9%, or 1,861 points, for its worst day since March 16. The decline marked the fourth biggest point-drop for the Dow on record. The VIX Volatility Index (^VIX), or so-called fear gauge, spiked more than 50%.” Yahoo News, June 11th.
America is opening for business, and it does not seem likely that this policy is likely to reverse even if infection rates explode. There isn’t the slightest doubt that Donald Trump is totally committed to an immediate and accelerated reopening of… er… everything. Some may have to die so that others are able to earn… and so the economy can rise sufficiently to hand Trump the November election. When you factor in the person-to-person contact generated by crowds of protesters, it gets downright scary. Trump needs an economic miracle to resuscitate his declining poll numbers. He is setting up for a series of upcoming crowd-format Trump-rallies, expecting few attendees to wear masks. These Trumpers do have to waive their right to sue the venue or the Party if they contract COVID-19 at these political gatherings.
Warnings from medical experts, including the World Health Organization and the Centers for Disease Control, that opening up too quickly, while the virus is still raging in the relevant communities, increases the likelihood of in person-to-person contact – virtually the only way the virus replicates and spreads. And that, in turn, always explodes the volume of infection and mortality rates. Experts suggest that even where reopening is permitted, activities where people are exposed to other people require wearing masks, safe-distancing and general precautions to be mandatory. But there is a red state political statement – if you support Donald Trump, show that support by not wearing a mask – that explains why there is a surge in new infections in areas that adhere to that belief. Small towns and rural communities are witnessing COVID-19 numbers they once believed were exclusively a big city risk. You can see the list of rural states where the virus is on the rise in my March 31st Wanting Answers, Finding Pain blog.
So, underlying the premature opening of the economy, evidencing a willingness to keep the economy open even if we return the horrific numbers we experienced in March, is effectively a commitment to a “herd immunity” solution. For most societies, that requires that 60-80%+ of the population be exposed to the virus, which normally occurs over two to three waves of infections. We do seem to have passed the point of no return; there is now a groundswell for reopening, even as so many Americans are still deeply concerned for the ongoing and perhaps even escalating risks. The seeming reduction in some states, and the reduced steepening of the rising curve where that is present in states where infections are still rising, seems to suggest to some that the worst is over. Not exactly unless we are very, very lucky.
There are always lulls between viral infection waves, “lulls” properly named because they lull the population into a false feeling that the worst has past… when it has not. Sure, if a cure or a widely deployed vaccine makes the scene, that is an effective alternative to getting so many people sick. We can also kill off that disease by eliminating its ability to spread. Clear and uniform social distancing, holding public gatherings to a bare minimum and always requiring masks. Too bad we are not doing that. Just looking at the crowds of protesters, pressed together, many without masks. In 75 US cities. We won’t know until late June whether or not that concerted gathering activity will explode the infection rates anew.
Take a good look at the above graphic, prepared by the New York Times. Think about how bad COVID-19 hit New York. You can see the concentration of the virus very clearly, and New York was seriously slammed, particularly in March and April. Mass graves. Temporary morgues. Shortages of ventilators. Medical personnel getting sick in droves. Then look at the concentration of infected individuals within the general population required to implement herd immunity. Look at how many more people than the New York dispersement would be required to replicate that immunity. If the Spanish Flu is an indicator, it hit that 70%+ penetration level, saw three waves over three years (1918-20), a pandemic that even debilitated President Woodrow Wilson for the rest of his presidency (he died in 1921), before that herd immunity killed off the virus.
“Some countries – notably Sweden, and briefly Britain – have experimented with limited lockdowns in an effort to build up immunity in their populations. But even in these places, recent studies indicate that no more than 7 to 17 percent of people have been infected so far. In New York City, which has had the largest coronavirus outbreak in the United States, around 20 percent of the city’s residents have been infected by the virus as of early May, according to a survey of people in grocery stores and community centers released by the governor’s office…
“Viewed together, the studies show herd immunity protection is unlikely to be reached ‘any time soon,’ said Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health… The herd immunity threshold for this new disease is still uncertain, but many epidemiologists believe it will be reached when between 60 percent and 80 percent of the population has been infected and develops resistance. A lower level of immunity in the population can slow the spread of a disease somewhat, but the herd immunity number represents the point where infections are substantially less likely to turn into large outbreaks.
“‘We don’t have a good way to safely build it up, to be honest, not in the short term,’ Dr. Mina said. ‘Unless we’re going to let the virus run rampant again – but I think society has decided that is not an approach available to us.’” New York Times, May 28th. If there is no second wave, if we get this pandemic completely under control, and the economy only goes up, that would be perfect. Exactly what are we doing to make that remotely possible? How about that vaccine?
Do we actually understand that even targeting 2021 for a vaccine requires an unprecedented historical feat that has never happened before? There are 102 CV-19 vaccine development efforts that I know of. We’ve already seen an overoptimistic release of preliminary test results (from Moderna), a really small sample, but those reports didn’t account for those “other” test subjects where the vaccine was not effective. More work to be done.
“Given the challenges of biomedicine, there are no guarantees that a vaccine candidate will succeed. One study found that over a 20-year span, an average vaccine had a 6% chance of making it to market. Notably, HIV still does not have a vaccine 30 years after it rose to prominence in the U.S., though it does have lots of treatments, including ones capable of suppressing the worst effects of the disease and mitigating its spread.
“Development is not the only cumbersome aspect of making a vaccine that’s accessible to everyone. Building up vaccine production facilities traditionally takes years. Companies that are working on COVID-19 vaccines are already discussing how to scale manufacturing infrastructure for candidates that are still in an early stage of development. Even with significantly crunched timelines, it could take a long time before a vaccine is widely available. However, biomedical companies, the government, and philanthropists are working to scale up vaccines quickly. Moderna, a company with an mRNA vaccine in clinical trials, says that it will have tens of millions of doses of its yet-to-be-approved vaccine by 2021, thanks to funding from the Biomedical Advanced Research and Development Authority. Johnson & Johnson, meanwhile, has announced a partnership with a manufacturer to supply 1 billion doses of its proposed vaccine. There is no guarantee that either Moderna or Johnson & Johnson’s vaccine will ultimately work.” FastCompany.com, June 1st. It is equally possible that several vaccines (if developed) could fit the bill, some more effective or with lower risks than others. Who knows what the defects are likely in that “first available” application?
But risky social interaction, exacerbated by a combination of “opening too soon” and massive crowded protests where social distancing is all but ignored, is not going to make our collective reality any more pleasant for a while. Even here in Los Angeles, as I watch people walking (protesting?) down the street, sometimes in groups, without masks, I wonder how much worse it must be in states where there isn’t even a suggestion that masks and social distancing is required.
Think all this “social distancing” was and continues to be a colossal waste of time and effort, as do so many who simply want to go to work and open up completely? A new, peer-reviewed study at the University of California (Berkeley) tells us: “In the absence of [such social-distancing] policy actions, we estimate that early infections of COVID-19 exhibit exponential growth rates of roughly 38% per day. We find that anti-contagion policies have significantly and substantially slowed this growth. Some policies have different impacts on different populations, but we obtain consistent evidence that the policy packages now deployed are achieving large, beneficial, and measurable health outcomes. We estimate that across these six countries, interventions prevented or delayed on the order of 62 million confirmed cases, corresponding to averting roughly 530 million total infections. These findings may help inform whether or when these policies should be deployed, intensified, or lifted, and they can support decision-making in the other 180+ countries where COVID-19 has been reported.” The effect of large-scale anti-contagion policies on the COVID-19 pandemic, published in the June 8th edition of Nature.com.
Since 71% of the US economy is consumer driven, exactly what happens when consumers start dying off again, stop going out to spend money out of fear, some businesses shut down again and hospitals are brimming with very, very sick people? With half of all adults in this country having one or more relevant health conditions making them more vulnerable to CV-19 infection… exactly when do our losses stop being “acceptable”? Particularly when the federal government is fully capable of writing enough checks to get us through this without putting so many workers at risk.
I’m Peter Dekom, and Americans hate being told what to do, are willing to believe all sorts of conspiracy theories to support that stubborn streak, even if it kills them.
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