Some good news, and some realism about the pandemic
Dr. Steven Markowitz, MD, DrPH — Wed, Mar 30, 2022 @ 15:03 PM
At this moment (March 2022), it is a hopeful time during the viral pandemic with infection rates plummeting and no surprises have appeared on the horizon.
We are approaching the low infection rates of last June and July, when we thought the pandemic was over. That was before any of us heard of Delta or Omicron.
Will we have to learn the rest of the Greek alphabet?
Could we be wrong again?
Let’s examine the good news:
Nearly 90 percent of people 65 years old and over in the U.S. are fully vaccinated. That is great news because three of every four COVID-19 deaths in the U.S. have occurred in this age group.
In total, about three-fourths of the remaining adults (age 18-64 years) are also fully vaccinated. We still have progress to make with children, who fortunately tend to experience milder COVID-19 disease.
High population immunity
New CDC data show as many as 140 million Americans (over 40 percent of the population) were infected with the COVID-19 virus. Many of them were not vaccinated, but now have some level of immunity as a result of being infected with the virus.
Despite being vaccinated, we also know people were re-infected with the COVID-19 virus, though a much smaller percentage compared to the unvaccinated.
When you add together the large number of vaccinated people and the large number of people who were naturally infected, you reach a key figure because it means a very large proportion of the U.S. population has some level of immunity to the COVID-19 virus.
How much immunity and how long it lasts are important questions, but we can hope we face the next viral variant with considerable defense in place.
Whether or not you have received a booster shot, you can appreciate how the scientists, pharmaceutical companies and the government quickly found the means to counter the predictable decrease in immunity that occurs months after vaccination or natural infection.
It means that, if there is a new dangerous variant, we will very likely have a booster available to counter that variant.
You may or may not be excited about getting the booster, but you can take comfort from the fact that we will not face a new pandemic wave empty-handed. This is not March 2020. (By the way, for the skeptics, a booster shot is far better than a long COVID-19 stay in the ICU.)
Doctors and nurses have been caring for people with COVID-19 for two years now, and with 140 million infected people and 950,000 deaths in the U.S., they have seen it all, including all the nasty variations of the COVID-19 illness.
We now have new oral medications that can vastly lower the chances of serious illness and death, if taken early in the course of the illness. While there is still no effective “antibiotic” for those with serious COVID-19 illness, the other means to support the very sick through illness – oxygen, ventilators, steroids, etc. – have been greatly improved since the beginning of the pandemic.
A new pill called Paxlovid can prevent serious illness and death among people infected by the COVID-19 virus who are at high risk due to immunocompromise or major illness with heart, lung or kidney disease or cancer.
It must be started during the first five days of COVID-19 symptoms. This means you must be tested promptly if you develop COVID-19 symptoms and then promptly seek treatment if you test positive. So, if you
get symptoms, do not delay!
The world is getting vaccinated
Who cares, you might ask, whether the people in Bolivia, the Congo or Bangladesh get vaccinated? We do.
If for no other reason than because the new versions of the virus – the variants – can originate anywhere in the world and show up at our doorstep a few weeks later.
This is what happened when the virus first appeared in China in late 2019, and again with the omicron variant in South Africa in November 2021.
Over 4 billion people in the world have now been fully vaccinated (with about 11 billion doses given). This is 56 percent of the world’s population. The U.S. has donated half a billion vaccine doses to other countries and has pledged to distribute another 500 million doses by January 2023.
Clearly, there is room for more progress, but we should recognize this global achievement.
Now, the realism
For all the good news, a dose of realism about the pandemic is still required. Consider this:
Many people are still vulnerable
You may be setting aside your mask, but many of your neighbors, family members and co-workers are immunocompromised – over 7 million in the U.S. – and still need to take care to avoid infection.
They have cancer, lupus, a kidney transplant, any number of other health conditions or are on medications that do not allow them to mount a full immune response to the COVID-19 virus.
Add to this group the many older people in the U.S. whose immunity wanes more quickly or is less potent due to age. They too are vulnerable to serious viral illness.
We have to help them by taking measures to avoid spreading virus and by making needed accommodations in meetings, at the office or at public gatherings.
The virus is unpredictable
That viral genes mutate quickly is a biological fact.
We will see new variants of the COVID-19 virus.
The two critical questions are: Whether the new variants will be more infectious or lethal than what we have seen to date, and will our immunity – vaccination-based and/or natural infection-based – be effective against the new variants? We will not know until they arrive.
Lastly, let me make a plea for patience.
None of us have ever seen a pandemic before, so if the science evolves or CDC changes their advice, remember all of us are learning as the pandemic unfolds.
So, keep your masks handy, temper your optimism with caution and keep an eye out for your Brothers and Sisters. We will do what we need to do to get through this pandemic.