Hope is on the horizon.

But Covid-19 is a novel virus with new vaccines and treatments, so it is not a surprise that many people have questions, especially about what to do after getting vaccinated. My mother, who qualified for vaccination in category 1B, prompted this story the morning after her second vaccine dose when she sent me this text:

Like millions of senior citizens, my mother is anxious to get out of the house and hug her grandchildren. Many others may be feeling the same way: Senior citizens and those with medical conditions are classified as 1B. Qualifications vary state by state but generally include those greater than 65 years old or with chronic medical conditions.

One important thing for vaccinated people to understand is that immunity does not come immediately after vaccination. It takes time for your body to build up protection. The two mRNA vaccines approved in the U.S. both require two doses. The first shot primes the immune system to produce protective antibodies. The second dose kicks it into high gear.

Here is what we know about post-vaccine immunity with the two Covid-19 vaccines currently available in the U.S.: In phase 3 clinical trials, the Pfizer vaccine showed a 95% efficacy seven days after the second dose. The Moderna vaccine offers 94% immunity at least 14 days after dose number two.

Two weeks after completing the vaccination course, recipients can breathe a sigh of relief. Their risk of severe disease from Covid-19 is very low. But we must remember that the risk is not zero.

The Covid-19 vaccine protects us from getting the disease, but we do not yet know if the vaccine prevents transmission. There is a growing amount of encouraging evidence regarding the protective effect of the vaccine against transmission, but at this moment, we don’t currently know whether a vaccinated person can still transmit the SARS-CoV-2 virus to others.

No vaccine is 100% effective, and according to the current data, 5% of those getting a Covid-19 mRNA vaccine may still be at risk. Vaccine recipients should continue to wash their hands, wear a face mask in public, and practice social distancing.

At your vaccination appointment, you will receive a copy of your vaccination record. Apps and digital documents are coming, but for now, your safest move is to keep the vaccine record in a safe place where it won’t get lost. I recommend taking a picture for storage on your phone.

Here is what it looks like:

The waitlists for Covid-19 vaccination vary across the country. The Centers for Disease Control and Prevention provide an up-to-date resource to help people find a vaccine hub here. The waitlists are long, even for those who currently qualify. I recommend taking proactive measures and signing up now.

If you are feeling nervous about getting the vaccine, here is what it was like for me. The process was simple, painless, and life-saving.  

If you want to see what getting vaccine looks like, here you go.

The post You Got the Second Dose of the Covid-19 Vaccine. Now What? appeared first on Medika Life.

What is “herd immunity”?

The precise scientific term is “indirect protection” or “community immunity.” This is the protection against infection of a susceptible group of individuals when a sufficient proportion of the larger population is immune from the infection. When there are enough immune individuals, then sustained transmission is interrupted.

How many people need to get infected or vaccinated to achieve “herd immunity”?

This is not arbitrary. There is actually a formula, and it is based on the R0, or “R-naught,” which is the average number of persons that get infected by one infected person. The formula for the threshold of “herd immunity” is:

1–(1/R0)

Studies estimate that the R0 for SARS CoV-2 is between 2 and 3. Doing the math then, the estimated threshold of individuals that will need to get infected to achieve “herd immunity” is 50–67% of the population. Studies have estimated that less than 10% of the U.S. population has been infected with SARS CoV-2.

Do the math

In order to achieve “herd immunity” in the United States, between 165,000,000 and 221,100,000 people need to get infected by SARS CoV-2, according to the formula above. Assuming a case fatality rate of 0.5%, if we let the infection rip through society to achieve “herd immunity,” between 825,000 and 1,105,500 people will die. As of this writing, 219,499 have died. So, for those embracing “herd immunity,” it seems that they are OK with orders of magnitude more people dying.

Caveats to “herd immunity”

All of the above assumes that immunity to SARS CoV-2 is long-lasting. We don’t know that. All of the above also assumes that people interact with each other in a random fashion. That does not happen in America, given the vastness of our country and the variable population density. So, it will take a lot longer time — with much more death and destruction — to achieve “herd immunity.”

What about Sweden?

Ah yes, Sweden. The authors addressed the case of Sweden and its approach to the pandemic:

There are only rare instances of seemingly sustained herd immunity being achieved through infection. The most recent and well-documented example relates to Zika in Salvador, Brazil. Early in the COVID-19 pandemic, as other countries in Europe were locking down in late February and early March of 2020, Sweden made a decision against lockdown. Initially, some local authorities and journalists described this as the herd immunity strategy: Sweden would do its best to protect the most vulnerable, but otherwise aim to see sufficient numbers of citizens become infected with the goal of achieving true infection-based herd immunity. By late March 2020, Sweden abandoned this strategy in favor of active interventions; most universities and high schools were closed to students, travel restrictions were put in place, work from home was encouraged, and bans on groups of more than 50 individuals were enacted.

And you know how much of the population of Stockholm got infected with SARS CoV-2? It was estimated to be 8% in April 2020.

I am not arguing that we should completely lock down the country, and I recognize that this is an incredibly difficult situation. What would you choose: dying from Covid-19 or dying from starvation? My recent discussion about lockdowns further emphasizes this point.

That said, it bears repeating that this “strategy” — apparently embraced by the White House — of letting SARS CoV-2 freely propagate through the population to achieve “herd immunity” is a path lined with death, destruction, and misery. Do not let anyone convince you otherwise.

The post What Science Has To Say About “Herd Immunity” appeared first on Medika Life.

What is “herd immunity”?

“Herd immunity” is the concept in public health that, if enough people are immune to a particular infectious disease, then the disease will stop spreading among a population.

“Herd immunity” is the foundation upon which vaccination works: vaccinate enough people against the disease so that it stops spreading. This is how we have all but eliminated childhood diseases such as measles, mumps, rubella, and the like.

It’s easy to talk about “herd immunity” from a conference room. I’ve seen death from COVID-19 with my own eyes. It is horrific.

With COVID-19, there are those who are advocating the same thing without a vaccine: lift restrictions, have life return to normal, and enough people will get the disease to achieve “herd immunity.” Never mind that we still don’t know how long immunity to COVID-19 lasts.

Never mind that we know that you CAN get COVID-19 more than once. Never mind that other countries — most notably Sweden — have tried to do the same thing and have had significantly higher death rates.

Still, “herd immunity” is an abstract concept, and so let me put it in more concrete terms. The Washington Post did the math for us (emphasis added):

Estimates have ranged from 20 percent to 70 percent for how much of a population would need to be infected. Soumya Swaminathan, the World Health Organization’s chief scientist, said given the transmissibility of the novel coronavirus, it is likely that about 65 to 70 percent of the population would need to become infected for there to be herd immunity.

With a population of 328 million in the United States, it may require 2.13 million deaths to reach a 65 percent threshold of herd immunity, assuming the virus has a 1 percent fatality rate, according to an analysis by The Washington Post.

Think about that for a moment. As of the writing of this post, Johns Hopkins reports 183,203 deaths in the U.S. And so, for us to achieve “herd immunity,” 1,946,797 more people have to die. The number of deaths has to increase by nearly 12 fold to achieve this coveted “herd immunity.”

That is A LOT OF DEATH.

It’s easy to talk about “herd immunity” from a conference room. I’ve seen death from COVID-19 with my own eyes. It is horrific. It is an unspeakable tragedy. It is pain and distress that no one should have to experience.

That’s 2,130,000 family tragedies. That’s 2,130,000 husbands, wives, fathers, mothers, sons, daughters, nieces, nephews, grandchildren, and cousins who are lost to this pandemic. It’s easy to talk about it…but talk is very cheap.

I am neither naive nor ignorant about the challenges that come with locking down our economy and schools to crush the virus. I recognize that each comes with their own devastation (“would you rather die of starvation or die of COVID?”). There are no easy answers to this scourge, and I do not even begin to profess that I know what those answers are.

At the same time, I just want people to know what achieving “herd immunity” could look like: it could be a path littered with hundreds of thousands, if not millions, more deaths in this country.

The post To Those Talking About ‘Herd Immunity’: Do The Math appeared first on Medika Life.