Experts not optimistic about herd immunity in Alabama

[aubiefifty 16,737]

Experts not optimistic about herd immunity in Alabama

By Sarah Whites-Koditschek | swhites-koditschek@al.com

6-8 minutes

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With coronavirus cases spreading rapidly, Alabama continues pushing for a return to normalcy. Businesses are reopening and campuses are preparing for a fall semester. But what will it take to get back to normal?

One possible answer is herd immunity. That might be attempted either through a vaccine or through mass infections. Disease experts welcome the first, but say the second is improbable and dangerous.

“We may not be able to wipe out this virus in a year, but it is possible to wipe it out over time (with a vaccine),” said Dr. Pamela Foster, University of Alabama professor of community medicine and population health.

Herd immunity is when the majority of a population is immune and is therefore unlikely to spread a disease. Dr. Walter Orenstein, associate director of the Emory Vaccine Center, says 60 to 70 percent of the population would need to be immune to COVID-19 to achieve herd immunity.

That’s unlikely without a vaccine, said Orenstein. “My feeling is that we shouldn’t be hopeful, in the absence of the vaccine, that we’re going to get a high enough infection rate that the virus will wipe itself out.”

Alabama added over 2,000 coronavirus cases Thursday, a new daily record, as the state’s hospitals are nearing capacity with staffing and ICU beds.

Some Alabamians told al.com this spring that they wanted to reach herd immunity so Alabama can get back to regular life, including the head of the state dental board and regular office workers. Even this week, Senate President Pro Tem Del Marsh said he hopes more Alabamians would get sick so we could get to immunity.

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But new research shows that widespread outbreaks in other parts of the world resulted in less than 10 percent of the population testing for antibodies for COVID-19.

Without a vaccine, attempting herd immunity is a deadly and unlikely proposition, experts say.

High cost of herd immunity

If the majority of Alabamians got coronavirus, that would mean tens of thousands of deaths, according to Dr. Amber D’Souza, an epidemiologist at John’s Hopkins University. She says the disease’s mortality rate is an estimated one percent.

“A number (like) that would be very difficult to imagine and nothing like those of us alive today can imagine,” said D’Souza.

“Taking it on the chin can be a pretty dangerous approach,” said Dr. Stephen Kissler, a research fellow at Harvard’s TH Chan School of Public Health, who pointed to racial disparities in the health outcomes for people who become infected.

“That burden of herd immunity will be paid for with the health and lives of least privileged members of society,” Kissler said.

And then there’s the possibility of hospitals being overrun and lacking room for patients with emergencies, such as heart attacks or injuries from car accidents.

Experts point to countries like Sweden, which tried to reach herd immunity without a vaccine and has seen a spike in deaths compared to neighboring nations. Studies show just 7.3 percent of Swedes had antibodies from the disease at the end of April. In Spain, the data was lower at close to 5 percent.

“Despite the high impact of COVID-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity,” researchers reported in The Lancet medical journal Monday.

Vaccine challenges

Further complicating Alabama’s prospects for herd immunity, it is not clear how long coronavirus immunity lasts, or whether people can be infected twice.

That may mean any vaccine, if and when one becomes available, would need to be administered multiple times.

Public health systems would decide who would take priority for getting a vaccine, such as health workers and immunocompromised people, but access could be an issue, experts worry.

And surveys reflect that only about half of Americans would be willing to get a vaccine, making vaccine-produced herd immunity, by scientific standards, impossible.

Tamping down transmission

Still, some immunity is better than none, said Orenstein, if people get it safely, through a vaccine.

“Even if we don’t achieve herd immunity, if we have higher immunity than we have right now, we will tamp down transmission,” he said.

When a larger percent of the population is immune, less people are likely to spread COVID, if they come into contact with it, breaking the chain of transmission.

“Herd immunity gives you an opportunity to at least manage the disease,” said Foster in Alabama.

“Right now we’re out of control (and) overwhelming our system,” she said, referring to hospital staffing and ICU bed shortages that could result in hospitals not having enough room to take new patients.

Foster hopes a vaccine could be ready as soon as this fall.

Dr. D’Souza is hopeful a vaccine might be available by 2021.

Next best option

Gov. Ivey has encouraged, but not mandated masks in Alabama, although many city and local officials have stepped in and ordered residents to wear masks in public.

If everyone in Alabama wore a mask, it would reduce deaths by more than half, saving about 1,700 lives by November, the University of Washington’s Institute for Health Metrics and Evaluation estimates.

Beyond that there is the lockdown, which is being tried again from Australia to Spain. Even Texas and Florida have recently restricted some businesses, such as bars, to battle summer surges.

“At the moment, the only tool in the tool chest is isolation,” said Orenstein.

Alabama’s numbers have been growing rapidly ever since Memorial Day and since people emerged from the lockdown. The New York Times reported Wednesday that if Alabama were a country, it would now have the world’s eighth highest rate of spread.

So what happens if Alabamians decide the best course is drop all precautions and let the fittest survive?

“You can quote me saying ‘no, no, no, no,” said Foster. She called the “natural” route to herd immunity, without a vaccine, a “selfish approach” by relatively healthy people, fraught with bioethical issues.

“When you’re talking about beds being tied up in an ICU, then you have to decide who gets an ICU bed and who doesn’t. Would you want to be in that position?”

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[SaltyTiger 7,774]

3 hours ago, aubiefifty said:

Even this week, Senate President Pro Tem Del Marsh said he hopes more Alabamians would get sick so we could get to immunity.

Senate President Pro Tem Del Marsh can kiss my a$$. Do not want any family, friends or myself contributing to the "death spike" while we try to reach herd immunity. Think I will just wear a mask while hoping and praying for a vaccine in the near future.

[aubiefifty 16,737]

3 hours ago, SaltyTiger said:

Senate President Pro Tem Del Marsh can kiss my a$$. Do not want any family, friends or myself contributing to the "death spike" while we try to reach herd immunity. Think I will just wear a mask while hoping and praying for a vaccine in the near future.

you and i both salty......... and he reps part of the area around here.

[homersapien 11,357]

It's not just Alabama:

Stay away from South Carolina

 

Kathleen Parker

Columnist

July 10, 2020 at 6:14 p.m. EDT

PAWLEY’S ISLAND, S.C. — At times like this, I’m tempted to dig out my father’s doormat, which bore the words: “Go away.” A dedicated misanthrope, he at least maintained a sense of humor.

Today, as South Carolina’s covid-19 infection rate skyrockets, there’s not much to chuckle about. As of Friday, more than 75 percent of hospital beds were filled and one coastal hospital was considering seeking staffing help from the National Guard.

How did we get so sick so fast? In a word, tourism, especially in Charleston, erstwhile “Best City” in America, and north along the coast to Myrtle Beach — now among the unsafest places in the United States and, therefore, the world.

There, you’ll see very few people wearing masks, and social distancing is a joke.

Republican Gov. Henry McMaster, though he has urged citizens to wear masks in public, as he does, has stopped short of making them mandatory. As he has said, how could the state possibly enforce such a mandate?

Stubbornness and rebelliousness come naturally to my fellow South Carolina natives, a large percentage of whom rely on tourism to pay the bills. But summertime has brought fresh challenges along with rotating crops of close-contact human bodies. A quick survey of license plates along the Grand Strand is testament to the state’s appeal to vacationers.

Still, out-of-staters don’t get all the blame. Locals are guilty of not taking the virus seriously enough, in part because for a long while they seemed immune from the terrible outbreaks elsewhere. For several months, Georgetown County, where I’ve been hiding out since February, had just a handful of covid-19 cases and only the occasional death. Graduation, beach-week parties and Memorial Day weekend changed all that. Today, this county has an estimated 724 cases, while bordering Horry County, home to Myrtle Beach, has more than 5,200, with numbers increasing dramatically by the day.

South Carolina now has more cases per capita than most countries, and no one thinks things will get better any time soon. Some Northern states, including New York, have imposed a two-week quarantine for visitors returning from South Carolina. And we’re just getting rolling.

Over the July 4 weekend, around 4,000 boaters from 11 states convened on Lake Murray, due west of Columbia, for a pro-Trump boat parade. And now comes the annual windfall event — Myrtle Beach Bike Week. It was postponed in May because of the pandemic, but nothing will stop these engine-revving partyers now. Revelers are expected to fill Highway 17 as they gather for beach time, rallies and, reputedly, the best biker bars this side of the Mississippi. Wait until they get wind of the state’s order Friday to shut down alcohol sales at 11 p.m.

What is one to make of such insanity? Well, tracks, for starters. My moving van is almost packed. But a smart leader might recognize what these various in-denial groups share — a lust for freedom and distrust of government — and forge an appeal to those instincts. As Bike Week founder Sonny Copeland recently told the Daily Beast, “We don’t need the damn government to tell us what to do. . . . We’re smart enough to know how to take care of ourselves, distance when we ride, and we have common sense. . . . We’re not a bunch of teenagers who are going to hug and kiss on the beach. This is about riding motorcycles, being in the wind.”

Well, okay, let’s work with that. What’s needed is an alternative narrative that makes sense to that rebel-biker spirit. By not following health guidelines, which makes tighter restrictions more likely, conservatives are actually threatening freedom and weakening the underlying structures of the free market. Masks are economic drivers.

As a Christian matter, disregarding guidelines is the opposite of professed care for the common good. And what of the Christian belief that the body is a temple in which his or her Holy Spirit lives? Not caring for the self and the common good, thus, can be seen as un-Christian.

A comparison could also be made to another shocking, illness-related period in our history, when then-U.S. Surgeon General C. Everett Koop, a man of deep Christian faith, scandalized conservatives as the AIDS crisis intensified by urging non-monogamous, sexually active men and women to use condoms for HIV prevention.

The conservative Christian world nearly toppled from its axis.

Today, it’s shocking that such a minimal instruction was controversial. And, someday, our inheritors likely will be aghast that so many Americans refused to don a mask and social distance to protect themselves and others from a potentially life-threatening disease.