Pandemic Perspective #39     January 9, 2021

COVID-19 – Still a mess!

            SARS-CoV-2 is providing humanity with more twists and turns than any novelist could dream up. Among a myriad of different kinds of tests none is reliably accurate. We don’t even know how many Americans have been infected. The official number cited by the Johns Hopkins Coronavirus Resource Center on January 8th was nearly 22 million, more than six percent of the population, but some epidemiologists state that the actual number may be ten times as high. (BTW: when you see a number that ends in zero you can bet that it is a guesstimate, not an estimate.) We don’t know if persons who have recovered from the infection will have permanent immunity or whether the vaccine will provide that either. Of course, with the number of vaccine candidates now more than 200 it will be a very long time before we know which one is best and how much protection each one will provide. Can a person be infected more than once? Yes, but the number is reassuringly low, at least at the moment!

            So is there any good news? Yes, namely that the first two vaccines that have been released have an effectiveness of about 95 percent – better than many vaccines, especially the one for influenza. In one trial thirty persons developed severe infection but they were all in the placebo group; none of those who received the actual vaccine became seriously ill.

            More good news is that by the end of 2021 most of the U.S. population will have received a vaccine. There has been a lot of criticism of state and federal authorities for their seeming sluggishness but in the larger picture the delay of a month or two in the face of the worst pandemic in a century is (in my humble opinion) acceptable. My reason for giving them some slack is not just the enormity of the task but that these vaccines require storage and transport at extremely low temperatures that most of the medical facilities in the country have never needed to consider.

            One final confounding issue: if you have had a documented infection with this coronavirus, should you still receive the vaccine? The prevailing opinion among virologists, immunologists and epidemiologists is yes. They note that some persons do not develop lasting immunity in the course of infection. Some scientists feel that the immunity produced by the vaccine is stronger and more consistent than that formed by natural infection. That is counter to what we know of most viral infections, a reminder that this virus is not like any other.

            The controversies and confusion that marked 2020 are not going to go away soon. We might shed our masks this year but not our wariness. Most of us will probably continue to limit interaction with persons beyond our circle of family and close friends. But we will do that in our our favorite restaurant!