Progress against COVID is going better than you think

We need a much broader definition of immunity

State health Secretary Mandy Cohen (top left) briefs N.C. Council of State members during a Feb. 1 virtual meeting. From left, top row, Cohen; Deputy State Budget Director Kristen Walker; Lt. Gov. Mark Robinson. Bottom row, State Auditor Beth Wood; State Treasurer Dale Folwell (Facebook screenshot)

At a virtual briefing with the Council of State, N.C. health Secretary Dr. Mandy Cohen provided sobering news. Roughly 9 million North Carolinians are eligible to get a COVID-19 vaccination (kids aren’t candidates for these shots), she said Monday. But the state is getting only 145,000 doses weekly from the federal government.

With roughly 1.1 million doses administered, unless supplies ramp up, it’ll take more than a year to get just a single dose in everyone’s arm. (State Treasurer Dale Folwell streamed the video on his office’s Facebook page.)

Council of State members lobbied for the allocations to shift to different people or providers. By getting first dibs on doses, Folwell said hospitals were crowding out family practices and independent pharmacies, where most of us usually get flu shots and other vaccines. Auditor Beth Wood defended giving hospitals priority, since that’s where frontline workers treat the sickest people. Joe Reardon, representing Agriculture Commissioner Steve Troxler, urged Cohen to set aside doses to be given at food processing facilities, where workers are in close quarters and shots would be easy to deliver. Lt. Gov. Mark Robinson wondered how health care workers would get vaccines to low-income people in remote areas who may lack internet access or basic transportation.

Cohen repeatedly said the problem was short supplies. Contact Washington and ask for more doses of the Moderna and Pfizer drugs. Hope that new types of vaccine, such as the single-dose Johnson & Johnson drug, are approved quickly by the feds and come on board. 

Be patient.

Cohen is right. Providers have the ability to handle twice as many doses as they’re giving now. They just don’t have the doses.

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But we’re actually closer to herd immunity than you might think. What if the share of North Carolinians who pose no risk of dying or being hospitalized from COVID is approaching 3 million, and growing? If officials respond with proper caution, reopening schools, businesses, and recreational facilities should be weeks, rather than months, away.

New York Times writer David Leonhardt published an eye-opening newsletter yesterday arguing that bureaucrats are understating how far immunity has spread. 

Agencies that approve vaccines focus on whether the percentage of people who get the vaccine and never contract COVID-19 or other diseases, period. But that’s the wrong way to view pandemic policy, he wrote: 

Here’s the key fact: All five vaccines with public results have eliminated Covid-19 deaths. They have also drastically reduced hospitalizations. “They’re all good trial results,” Caitlin Rivers, an epidemiologist at Johns Hopkins University, told me. “It’s great news.”

So if you get a vaccination, you may get sick. But you almost certainly won’t have to go to the hospital. And you won’t die.

Isn’t that what matters?

Plus, if you’ve already had COVID and recovered, you appear to be immune from reinfection, at least for several months.

Coronaviruses have been circulating for centuries. Most of them — the common cold, for example — are inconvenient, not debilitating or deadly. COVID-19 is particularly nasty because it’s, yes, novel, so our immune systems can’t battle it without help.

But once you’ve been infected or vaccinated — or if you already have COVID-19 antibodies in your system — you seem to pose an insubstantial risk of getting sick enough to require serious medical attention.

Let’s do the math. More than 1.1 million residents have been vaccinated. Another 761,000 cases identified. Nearly 9 million COVID tests administered, with a cumulative positive rate of roughly 10%. (To be sure, many people have been tested more than once.)

Lowballing the estimates, I’d suggest roughly a third of the state’s adults already have immunity. Or at least are at low risk of getting hospital-level sick before they get vaccinated.

We don’t know how much those who are immune can still spread the virus. Until we get herd immunity or effective therapeutics are widely available, following the old “3Ws” — wear a mask; wait 6 feet apart; wash your hands — remains wise. As does avoiding large indoor gatherings. “COVID parties” remain asinine.

It’s also encouraging to see that Democratic Gov. Roy Cooper and Republican Superintendent Catherine Truitt are, in her words, “sing[ing] from the same songbook” about reopening schools — as the General Assembly debates legislation which would do just that.

For now, the feds should approve the Johnson & Johnson vaccine right away. Treatments that have undergone rigorous safety testing in other nations should get on the U.S. market and go into Americans’ arms. People who’ve had COVID and recovered should feel more confident about resuming their lives — but getting a vaccine eventually, too.

And public officials should acknowledge and emphasize the risks of not resuming social and commercial life more than they have before.

 

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