The COVID End Game
In February, Dr. Marty Makary of the Johns Hopkins School of Medicine made news with a Wall Street Journal op-ed. It was confidently entitled, “We’ll Have Herd Immunity by April.”
You’ve probably heard that term tossed around: herd immunity. It’s when we have enough immunity to prevent COVID from spreading freely. There are not enough human hosts for the virus to meaningfully move around.
Makary reasoned that many more people had developed immunity than are captured by positive tests. You can have COVID but not get counted as having it. Say Jack and Jill are happily married. Jack gets COVID. He’s in bad shape. But Jill’s fine. No symptoms. So, she never gets tested. She’s probably telling her friends, “Jack was so sick, but I never got it.”
Confirmed Cases Provide a Low Estimate
Except she probably did have it, given how easily COVID spreads. Good chance Jill had a mild or asymptomatic case. The U.S. has some 31 million confirmed COVID cases, but many more actual cases. That sound bad, but it’s actually good: Exposure to COVID is how you develop immunity. Makary’s February estimate was that just over half the population had some COVID immunity due to exposure.
How many of your friends and relatives have had COVID? For me, it’s about a quarter. Now figure more of them had it, but never got symptoms. Makary’s estimate doesn’t seem crazy.
Vaccinations are Way Up
Okay, but depending on when you got COVID, your immunity probably doesn’t last forever. The Moderna and Pfizer vaccines seem to each provide at least six months of immunity. The booster shot thing is still being studied.
The U.S. has one of the highest vaccination rates in the world. As of a couple days ago, over half of adults have gotten at least one vaccine dose.
That’s a fast ramp up. COVID is a fast-spreading disease that came on the global scene just 15 months ago. But over 132 million Americans have now had at least one dose of a vaccine with better than 90% efficacy. We have much reason to be thankful. President Trump’s Operation Warp Speed was an undeniable success.
So how close are we? The problem is that “herd immunity” is a fuzzy term. Back in December, Dr. Fauci and others were saying that if 60-70% of the population had immunity, that would suffice. Later, Dr. Fauci let that number creep up to “75, 80, 85%.” After taking flak, Fauci admitted that the upward revision was due to his thinking that the country could handle a larger number. Some are now openly speculating that herd immunity is unattainable.
It shouldn’t surprise us to find a range of views. There’s often not just one scientific view on something new like COVID. There can be multiple views held by multiple scientists, each influenced by a mix of data, interpretation, and preference.
We do know that we’ll have over 50% of the population fully vaccinated within a few weeks. How much that 50% figure rises, and how quickly, and what that will mean for public policy, remains to be seen.
No Solutions, Only Tradeoffs
As of this week, any adult in the U.S. can get the vaccine. So, can vaccinated Americans resume their former lives, or do they need to keep taking strict precautions?
For many, this is not an academic question. I have friends whose relatives got vaccinated many weeks ago — but still won’t see their vaccinated extended family members. Because the vaccines aren’t 100%. It’s better to be “safe.”
Actually, it’s better to lose your life than waste it. I’m not saying we should do stupid things that hasten our death. But we all recognize that things like driving on freeways, or flying on airplanes, elevate our mortality, but bring greater enrichment to our lives. If we die in transit, we accept that from God’s hand. We need the same honesty here. As the great Thomas Sowell often said, “There are no solutions, only tradeoffs.”
Get the vax? They say the fatality is only one in a million. Maybe adverse reactions are underreported. But President Trump regards it as a “great vaccine and safe vaccine.” He and Mrs. Trump took the vaccine in January, although both beat the disease only 3 months prior.
Don’t get the vax? There’s a better than even chance you’ll get COVID — in some form or another. It could be mild. It could be severe. It’s a disease that spreads until most people either get it or ward it off with prior immunity. Maybe all that Vitamin D, zinc, healthy diet, and exercise will keep you from experiencing symptoms. Or maybe it won’t. A lot of it depends on age. That said, we don’t yet know a lot about long term effects, from either COVID or the vaccine.
As Christians, we believe in liberty of conscience. “Each one should be fully convinced in his own mind.” (Romans 14:5).
Mask After Vax?
NBC’s Chuck Todd and Dr. Fauci had this interesting exchange this past Sunday:
TODD: Why does a vaccinated person have to wear a mask?
FAUCI: This is something that as we get more information it’s going to be pulling back that you won’t have to. But currently the reason is that when you get vaccinated, you are clearly diminishing dramatically your risk of getting infected. That’s one of the things we’ve got to make sure everybody understands. You dramatically diminish it. However, what happens is that you might get infected and get absolutely no symptoms, not know you’re infected and then inadvertently go into a situation with vulnerable people. And if you don’t have a mask, you might inadvertently infect them. Now, there’s a small risk of that, but it’s there.
Notice the huge initial caveat: “it’s going to be pulling back that you won’t have to.” Does that mean you’re telling me to do something that I soon won’t need to do? Wouldn’t it provide a greater motivation for on-the-fence, low-risk adults to get the vaccine if you just said they could more fully resume their lives?
What’s the End Game?
It’s difficult to make predictions, especially about the future. Within a few weeks, most U.S. adults will have joined the herd. Pretty soon those remaining either don’t want the vaccine or can’t take it due to health reasons. This first group — I doubt they care if others mask up or not. After all, they prefer the risk of COVID over taking the vaccine. Plus, there’s overlap between “no maskers” and “no vaxers.”
This second group — mercifully — is quite small. If we get to a high vaccination rate, they’ll be protected by the wider herd immunity. Israel just dropped their outdoor mask mandate with around 80% of their adult population vaccinated.
In the early days of COVID, I was in favor of masking — to the delight of some Stream readers and the annoyance of others. I figured it was a small price to balance economic freedom with public health, to keep more people working while minimizing the contagion. No solutions, only tradeoffs.
In the absence of vaccines, I reasoned it was everyone’s job to take care of everyone. Now, with the vaccines, most people can opt-in to a much greater level of protection than masks can provide. Others can opt-out, choosing to bear the risk, or at least assuming responsibility for that risk. Freedom comes with responsibility.
Private employers may continue requiring masks. Along with shoes and a shirt, that’s up to them. And some folks may choose to keep wearing masks well into the future. But in terms of public policy, as the vax rate rises, it’s hard to see continued support for restrictive measures (like restaurants at greatly reduced capacity — a cost burden to employers and an inconvenience to customers). On the contrary, I suspect the vax rate would rise faster if the public felt more assured in the transparency of the process and that their liberties would not be endlessly curtailed.
Shooting for 100% safety is unrealistic. There’s a level of risk that becomes acceptable. Get busy living or get busy dying.
Dr. Alex Chediak (Ph.D., U.C. Berkeley) is a professor and the author of Thriving at College (Tyndale House, 2011), a roadmap for how students can best navigate the challenges of their college years. His latest book is Beating the College Debt Trap. Learn more about him at www.alexchediak.com or follow him on Twitter (@chediak).