It is already January 20 here, but in the US, it is still very early in the morning, and the inauguration of President Biden awaits. So does the release of Covid-19 statistics for the day, and although numbers may be delayed until tomorrow, the US will likely record a tragic daily record of over 5,000 deaths in a day for the first time. Worldwide, over 2 million deaths. Why? Partly due to mistakes, and yet another looks set to occur with vaccines.
(updates to this page pending)
- The Stats
- Past Mistakes
- Vaccine Mistake?
Many reports state the US is the worst affected country in the world, but this is in many ways an exaggeration. not necessarily accurate. Despite all reports of how bad things are in the US, there are even countries with higher deaths per capita. The “over 5 thousand in one day” I foresee is also a little misleading, as numbers are always higher following the weekend as some numbers are delayed in being counted, and this was a long weekend. However, the underlying facts still are: the situation is serious and things are far from being under control, both in the US, and globally.
Good News Update: Jan 21, 6:30 am GMT. The figures for the US for January 20 did not reach my forecast > 5,000 (4,374 is the figure I have). If they are again under 5,000 tomorrow, it seems a positive sign!
Past Mistakes & Suprises
- Asymptomatic & Aerosol spread
- Re-opening Too Soon
- Politicisation of Masks and Distancing
- Covid-19 is not Binary
Asymptomatic Spread & Aerosol spread
Some initial mistakes were the underestimation of the ability of SARS-Cov2 to spread.
Re-Opening Too Soon.
A significant mistake by many countries was re-opening simply because case numbers had started to fall. I recall posting back in April 2020 how re-opening simply because numbers were falling was inviting the virus to simply resume spreading. I was surprised how long before the virus fully resumed, but even I could see it would. Of course, advisors in countries could also see it, but in the end there was often a belief that it must be that saving lives comes at a cost, and we must balance lives and the economy. Countries like New Zealand proved there is no balance, you must stop the virus to help both lives and the economy.
Politicisation of Masks and Distancing
Masks and other measures were twisted into civil liberties issue. Somehow it became like:
“Even if there are people firing bullets at random as I walk down the street, it is my choice to wear a bullet proof vest or not!”
This would be a fair argument, but the point lost is the reality becomes:
“If there are people firing bullets at random as I walk down the street, it is my choice to wear a bullet proof vest or not, and to also fire random shots at other people!”
Covid-19 is Not Binary
There are many discussions on the mortality rate of Covid-19, and whether the virus affects only the elderly of those with pre-existing conditions etc. What is clear from looking at the outcomes of medical staff, is that the more virus in the environment, there greater the age range affected and the more likely even young people may die. Covid-19 is not binary. The more virus, the worse the outcomes.
Vaccines: The False Assumption
Over and over the same assumption seems to be repeated: vaccines will prevent spread. This assumption is unproven, and while vaccines should reduce spread, they are not liked to prevent spread. Statements appear such as:
- Businesses may require their employees to be vaccinated to provide a safe environment are often repeated.
- Travellers may need to vaccinated in order to enable travel restrictions to be lifted.
Why Covid-19 is Different: Asymptomatic Spread.
Normally, to spread a disease, you must have a case of the disease. Generally, the more severe the case, the more infectious the person is during the infectious phase. But with Covid-19, people with cases so mild there are extremely mild or even undetectable symptoms, can still be significantly infectious. In fact there are reports that most spread of the virus occurs through asymptomatic spread as even though there is less spread per case, more people are asymptomatic than symptomatic.
What We Do Know.
There is significant data proving that several vaccines are highly effective at preventing cases of Covid-19 from resulting in symptoms. Technically, having the virus by no symptoms means a person is infected with SARS-Cov-2 virus, but does not have the Covid-19 illness. Vaccines can reach 95% efficacy in preventing the illness.
What We Don’t Know
What don’t know, is how effective the vaccines are at preventing infection with the virus. Normally an infections that does not result in symptoms is the dream. No symptoms means no consequences to being infected, plus no symptoms means not infectious to others. But not with Covid-19, because no symptoms can still mean infectious to others. It is believed less infectious, but how much less infectious is unknown.
Since Covid-19 has asymptomatic spread, not sick and not infectious become two different outcomes.
With Covid-19, we only know the vaccines effectiveness at ‘not sick’, and the ‘not infectious’ is, almost uniquely, not the same thing.
Does it matter?
Does it matter if the virus can still spread if everyone is vaccinated, so even if infected, people will not get sick? Answer: Yes. Because:
- Not every person can be vaccinated: Consider newborns for example
- If the virus is spreading in an uncontrolled manner, consider new mutations
- The result could even at best be annual injections for everyone, and it can take a year to inject an entire population.
- most ‘entire population’ vaccinations are given at specific ages only, so only a small portion of the population each year
Normally, the goal is to vaccinate a sufficient percentage of the population to achieve herd immunity. However, all calculations are always based on immunity as meaning: “cannot spread”. Since with almost every previous outbreak of disease “sick” = “can spread”, there is no need to spell out the whether the discussion is on “immunity to disease” or “immunity to spread disease”. They are one and the same.
Herd immunity cannot be achieved unless there is sufficient reduction is spread, not just illness. So far, there is little evidence of sufficient reduction of spread. Reduction yes, sufficient reduction, not necessarily.
The effective spread, or effective R number, must drop below 1.0. Without measures to prevent it, the mutation first detected in the UK, would take over, and has a spread of around 3.5. So reducing spread by even a factor of 3, still leaves the virus spreading, and infecting everyone.
Vaccines: The Mistake?
The mistake is the assumption that effectiveness in preventing illness, will equal effectiveness in preventing spread. Clearly, with Covid-19, this cannot be assumed, as already people who do not get ill, can still spread the virus.
This matters, because in a society where there is a need to remove restrictions, even despite lessons from removing restrictions too early before, simply having a large number of people vaccinated can mean restrictive measures are removed.
Hopefully, impatience does not again win, and while initial vaccines dramatically reduce loss of life, re-opening waits until there is confidence on the ‘R number‘ for the virus in vaccinated people. Hopefully, even if not the initial vaccines, there will soon be some that produce an R-number below 1.0, even without masks and social distancing.