Is a vaccine the only way to return to normal after COVID-19? New research into the virus suggests not — that the infection rate may drop to tiny levels before then.
Since the spring, scientists have known the virus’s infection fatality rate — how many people it kills compared to the number it infects — is under 1 percent, perhaps as low as 0.2 percent. That lower figure translates into one death for every 500 people infected.
We have also known that deaths are seriously skewed by age. The media says older people are at “more” risk from the novel coronavirus than younger people. That’s true, but it understates the reality. Most people do not realize that the risks to people over 80 are hundreds or thousands of times higher than those younger people face.
The fatality rate for children, meanwhile, is very small. In July, Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, said it’s about one in a million infected.
Of course, most of the media simply ignored Redfield’s comment — maybe because it would have made parents less afraid to send their kids to school.
But the fatality rate is only half the puzzle when scientists try to figure out what the final death toll from the coronavirus might be. And even with a small rate, the numbers are staggering. If the entire nation was infected, it would mean potentially 500,000 or more Americans dead.
But if the virus runs out of steam more quickly and the epidemic fades before everyone is infected, the number of deaths will be lower.
Epidemiologists call the level where the epidemic ends the “herd immunity” threshold. Herd immunity does not mean that the virus has completely disappeared, only that it can no longer infect a critical mass of people and become an epidemic again.
Figuring out when a virus has reached herd immunity is very tricky, even trickier than estimating the death rate. It depends heavily on the virus’s reproduction number, or R — how many people one infected person infects in turn.
The higher the R, the more quickly a virus will spread, and the more people must be infected before the epidemic breaks. Coronavirus seemed at first to be highly contagious, and most scientists initially believed that 60 percent to 80 percent of people might need to be infected before herd immunity was reached.
But the R for the coronavirus seems to vary wildly at different times and places. Also, some people may have some pre-existing immunity because of their exposure to other coronaviruses.
A growing number of scientists believe the threshold for herd immunity may be much lower. Some predict it might be 40 percent. Others say it could be as low as 20 percent — meaning that the epidemic will burn out after only 1 in 5 people is infected with and recovers from the virus.
And real-world evidence — from Sweden, from Sunbelt states like Arizona, and now from the Brazilian city of Manaus — provides very encouraging evidence that the immunity threshold may be well below 50 percent. Sweden, Arizona and Manaus don’t have much in common, but in all of them, the epidemic burned out relatively quickly, without hard lockdowns, and after a relatively low number of people were infected based on antibody tests.
If we can actually reach herd immunity after 40 percent or less of the population is infected, far fewer people will die than the early forecasts, even without lockdowns. And if the best-case estimates of 20 percent or less are correct, we may be closer to the end than the beginning of the coronavirus epidemic. It’s still too early to be certain — but maybe for the first time since March, we have real reason to hope.
The Centers for Disease Control and Prevention on Wednesday proposed guidelines for distributing a coronavirus vaccine in the United States if and when one is approved for public use.
The guidelines, unveiled during a presentation at the CDC's Advisory Committee on Immunization Practices meeting, would prioritize health-care workers, essential personnel and vulnerable Americans, like the elderly and those with underlying health conditions.
It would include all paid and unpaid people working in health-care settings. That includes hospitals, long-term care facilities, home-based care, outpatient centers and pharmacies. The CDC estimates there are between 17 million and 20 million health-care workers in the U.S.
Essential personnel, which the CDC estimates make up 60 million to 80 million of the population, working in food and agriculture, transportation, education, energy, wastewater and law enforcement would also be among the first to get the vaccine, according to the proposal.
About 100 million people with medical conditions and 53 million people over the age of 65 would get a vaccine.
There are currently no approved vaccines for the virus, which has infected 5.7 million Americans and killed at least 178,500, according to data compiled by Johns Hopkins University.
As public health officials and pharmaceutical companies race to find a safe and effective vaccine by the end of the year, scientists and infectious disease experts worry about who will get the vaccine first and how. The U.S. will initially have a limited supply of vaccine doses that won't be widely available until "several months" into 2021, according to Dr. Anthony Fauci, the nation's leading infectious disease expert.
Many experts have said the vaccine should go to the most at-risk groups first, including health-care workers, the elderly as well as poor and minority communities, which have been disproportionately impacted by the virus.
Earlier this month, President Donald Trump told reporters at a White House press briefing that a coronavirus vaccine should probably go to the elderly or those most vulnerable people first, though he added he would rely on a doctor's expertise for that decision. "We're actually making a list right now. Mostly nursing homes, retirement centers," he said on Aug. 14.
The CDC also noted in its guidelines Wednesday that it will be difficult to conduct vaccinations while also practicing social distancing.
The agency said health-care settings like provider offices or pharmacies could be better suited to provide vaccination. It may be difficult for health-care workers to reach rural areas, minorities and populations with limited access to health care, the CDC said.
The CDC also said it is preparing for the possibility of distributing different kinds of vaccines at once.
The U.S., as part of the Trump administration's Operation Warp Speed initiative, has already invested millions of dollars in six potential vaccines, including from drug companies Pfizer and Moderna, which entered phase three trials last months. There's a chance the vaccine could be ready around the same time...
It's been more than five months since nursing homes and long-term care facilities went on lockdown because of the coronavirus. However, a plan is moving forward to allow loved ones and visitors back in safely.
Sara and Fulton Suarez have been married for 49 years.
The couple's adventures and memories are endless, but Sara said the last five months, entirely apart from her husband, has been one of the hardest challenges in their decades-long love story.
"Just the fact we cannot see each other, and we cannot touch each other. I mean, if you touch your loved one, that fills you up so much, you know," Sara Suarez said.
WPTV first met Sara in March when she visited Fulton through a glass window at a nursing home in West Palm Beach. This was the only way to see him after the state banned visitors from long-term care facilities to protect the most vulnerable people from COVID-19.
Fulton suffered five strokes and has been in a nursing home for two years.
"It's really painful, really painful," Sara said.
A Florida task force met Wednesday again to layout new recommendations to start safely reuniting loved ones at these facilities. Essential caregivers would be allowed close contact during limited, scheduled visits while wearing personal protective equipment.
However, Florida's surgeon general is hesitant to offer up support.
"You may want to compromise, [but] this virus does not compromise. This virus is spread by the breath and masks do not completely eliminate this virus," said Florida Surgeon General Scott Rivkees.
Sara agrees safety is a top priority, but after Fulton was sent to the hospital twice in July, she is now renovating a room to bring her husband home.
"I think he deserves to be home with his family," Sara said. "We need each other, and that's why I'm working hard."
Once the governor receives the plan, he will then make his own recommendations to reopen long-term care facilities.
