Our New Normal…
COVID-19 national immunity is beginning to emerge, which will lead the US to a new post-COVID normal. The “lessons learned” in the previous blog provide the necessary ingredients. The path we take will not totally satisfy anyone. However, the end result will help restore our lives, our health and our economy.
Here’s how today’s discussion will proceed:
– Vaccine Pushmi-Pullyu
– Achieving National Immunity
– There Will Be A Post-COVID Normal
Let’s start by looking at the contradictory, love-hate, push-pull aspects of COVID-19 vaccines, with due apologies to Hugh Lofting.
The coronavirus vaccine was hailed as the pathway to a quick normal. However, the vaccine has been not only a facilitator but also an impediment. This may be the first time that a public health issue has generated such passionate advocacy.
Vaccines have saved many lives, and are routinely required in schools, the military, and for some travel. So it surprised a lot of us that so many refused to accept the jab.
Anti-vaxxers have unfairly demonized the vaccine and its pharma developers. However, advocates of universal vaccination have also been unfair, by oversimplifying the reasons that people say “no.” The true reasons for opposing, or at least hesitating about, vaccination are in fact very complex:
Social Media: People see social media every day, often every hour. But they see a physician, if at all, only a few times a year. As a result, opinions expressed on social media dominate and drown out anything that a medical professional may say.
Cognitive Bias: Modern life is complicated, and it’s understandable that people want to simplify it where they can. That’s one reason that folks seek out information that confirms their beliefs.
Mandate Revolts: It’s a short step from uncertainty or reluctance to resenting compulsion; hence the passionate protests against “mandate-heavy approaches” to virus control.
Personal Values: A thoughtful analysis identifies self-esteem, values and pride as strong motivators against vaccination for many people.
However, a vaccine is not the only way to acquire immunity to coronavirus. You can also become immune by getting sick with the virus and recovering from it. Some anti-vaxxers argue that if a person recovers from a COVID-19 infection, he’s just as immune as if he had a vaccination. Therefore, instead of requiring vaccination, it would make more sense to require that people be immune to the disease.
How many people would qualify? An ongoing study at Centers for Disease Control tries to find this out. By looking at a random selection of blood samples, researchers found that the percentage of Americans over age 16 with COVID antibodies has risen tremendously. From July to December 2020, when vaccines were not yet available, the number of people with antibodies from infections rose from 3.5% to 11.5%. It continued to rise, so that by May 2021, 20% of Americans had antibodies derived from COVID infections.
The total fraction of Americans with antibodies either from an infection or from a vaccine turned out to be 83% in May, and is continuing to rise today.
Is Infection Better Than A Jab?
Does this mean that a combination of vaccination plus infections will soon propel us into a utopian state of herd immunity? Well, maybe. But there are complications:
- Some folks claim that immunity gained from an infection is superior to that gained from a vaccination.
- But there is strong disagreement among scientists as to whether infection or vaccination is a stronger protection.
- Which immunity is best seems to depend on an individual’s response to infection. Moreover, the answer may change as new COVID variants emerge.
- Nevertheless, most scientists would agree that “both” is better than “either” for almost every person. Recovered immunity is strengthened by the addition of vaccination; and a vaccinated person who catches and recovers from a “breakthrough” infection will gain additional protection beyond that conferred by the vaccine.
Achieving National Immunity
You can see where we’re headed: we will achieve effective immunity in the US population as a whole. Effective meaning that health care facilities can operate at less than full capacity. And effective meaning that we can allow activities that individuals value: most of the time, for most people, in most locations.
This national immunity will not follow the path espoused by any of the extreme voices giving their opinions. Instead, it will be a patchwork of different types of immunity, with almost every person protected by one or more of these:
Innate, or Natural, Immunity
Some people are simply more resistant to the coronavirus, which we might call innate immunity, or natural immunity. This is shown most dramatically by the “youth immunity” that protects younger persons, per a previous blog. However, there’s also variation in immune system response among adults: some escape serious disease even when family members are very sick.
As noted above, a substantial fraction of our population shows coronavirus antibodies, implying that they were infected but recovered from it. This occurs in several ways:
- Some people catch coronavirus, then recover, without experiencing any symptoms of disease.
- Monoclonal antibodies and antiviral treatments are softening the symptoms of people who would otherwise suffer greatly from an infection.
- Improved treatment protocols are improving the survival rate of those who are hospitalized with COVID-19.
Some would argue, OK, let’s let people mingle without masks so we can all get infected and (most of us) recover. However, experts warn that intentionally welcoming infection would be a costly strategy, because it would kill vulnerable people who might otherwise not die.
The strongest contributor to national immunity is vaccination. Recent numbers show that at least 66% of the US population has received at least one vaccine dose. And of course, that represents an even larger percentage of those old enough to be eligible for the jab. Their motives are as diverse as anyone might imagine:
- Respect for authority and for CDC or FDA recommendations.
- To protect oneself.
- To protect other people.
- Following the lead of friends and peers.
- Rewards (“carrots”) such as a monetary bonus, a free doughnut, a free beer, a lottery entry, …
- Penalties (“sticks”) such as requirements for a desired activity (restaurants, concerts, public transport, travel to some destinations, …)
- Employer encouragement or request
- Employer requirement. Some attorneys are advising employers to require vaccination to reduce their liability and many are doing just that. Requiring vaccination to keep one’s job turns out to be a strong motivator for reluctant vax recipients.
There Will Be A Post-COVID Normal
National immunity has not yet arrived. We know this because COVID is still badly straining hospital resources in a number of states.
However, once the immediate crisis abates, national immunity should arrive soon. The sum of the immunities described above (innate, post-COVID and vaccination) will lead to almost everyone in the US having some level of protection from coronavirus. And once hospitals are no longer strained to their limits, those who still catch the disease will have access to care and to the latest treatments.
Guessing the Future
My reading makes me believe that in future years, coronavirus will probably become like influenza. That is, it will be a chronic disease, sometimes fatal, with vaccines available for those who want them. Those who profit from COVID misinformation and politicization will eventually move on to promote other fears and cure-alls.
Of course, the new normal will first appear in some wealthier countries. There are many countries that have barely begun to control this terrible scourge. They too need to find paths to a new normal, hopefully with the help of countries who have resources to share. When this change has finally migrated across the globe, someday it may be difficult to remember how deadly and how passionately contested coronavirus once was.
We each have our own views and feelings about the pandemic. I hope this discussion helps persuade you that a viable answer is evolving around us, in the form of a COVID-19 national immunity. That day has been too long in coming!
– pexels.com: flower facemasks by Michelle Leman; DIY facemasks by cottonbro
– wikimedia pushmi-pullyu and other Dr Dolittle characters
– pixabay.com: happy people by vilandrra, concert by ktphotography
As usual a very good assessment of the status. Thank you. One thing I want to point out is that there reports of significant (~10-20% ?) of the people who catch and recover from Covid (before getting vaccinated)have long term effects. These may cause additional burden on the health system as well as lowering the life quality.
Hi Metin, and thanks for your comment! It’s true, that if people choose to catch Covid instead of getting a vaccination, their risk is more than hospitalization and death: it entails “long Covid” as well, to a degree that is not yet understood (per one Time article, affecting 25% of those infected! https://time.com/6073522/long-covid-prevalence/). I don’t know how much long Covid burdens the health system, but it certainly hurts the life quality of those who choose that path instead of the vax. How sad that so many irreversible life decisions are being made based on hearsay rather than legitimate data. – Art