A note from Chris: I asked my friend Mike Wilson if I could publish this recent Facebook post. He graciously accepted, so enjoy this sober and lucid look at the current state of COVID-19.
by Mike Wilson, Mathematician and Technology Consultant
As we deep dive into the data around COVID-19, sometimes we forget about the big picture. There are some important truths around this virus that I think are being lost in the current public discourse.
1. We are long past the point where eradication of the virus is an option. Even if we had the political will for another extended lockdown (which we don’t and won’t unless things get WAY worse than they are right now), we can’t possibly lockdown the virus into oblivion.
2. Herd immunity won’t save us anytime soon. Very few geographies are in the ballpark of infection percentages traditionally understand as necessary to achieve herd immunity. NYC and a few other cities might be closeish, but much of rural America has barely been touched by the virus. Additionally, while it’s safe to assume that someone who has been infected with COVID is going to have some level of immunity (otherwise convalescent plasma therapy wouldn’t be helpful), we know that antibody levels in the blood tend to decline over time. We don’t know how strong that effect will be for COVID, but it’s unlikely we’ll get enough people infected to burn this virus out in the near term (next 6 or so months).
3. We seem to be making some progress towards creating a vaccine with multiple trials being performed right now, but our history of success making vaccines for coronaviruses is pretty much zilch. Even if we get an effective vaccine, we’ll still need that produced and distributed at scale to augment any population level immunity that has been built through infection and that will take time. I think we’re still at *least* 6 months out and it’s possible we may never develop an effective vaccine. We also have to account for the fact that so much distrust has been built up that I think there is a substantial population of people who will refuse to take a vaccine that has been rushed into distribution with less testing than usual.
[This comment on Mike’s Facebook post is from Epidemiologist and Professor at Case Western, Catherine Stein, PhD]
“I hope you don’t mind if your epidemiologist “friend” emphasizes a couple of your points:
First vaccine development. Not only has there been little success in developing a vaccine for other coronaviruses, vaccine development in general has a low success rate. Think about the HIV scare a couple decades ago. They are STILL trying to find a vaccine for that. I study TB – a disease that kills a million people EVERY YEAR – and they are still trying to find a better vaccine for that. Every now and then, something makes it phase III trial ,and either fails or does so-so. IF they find a “successful” vaccine for COVID by next year, you should be very suspicious. For Pete’s sake, the antibody tests aren’t even valid.
Second, the messaging… we are talking about a disease with a >99% survival rate. But the way the media portrays it, we are all just waiting for our date with death. Why no focus on all the antibody positive people that never showed a single symptom? That’s good news! Why no focus on the fact that the majority of hospitalizations and deaths are in older individuals and/or with comorbidities. That’s called risk assessment.”
All in all, we have absolutely no near-term path to getting rid of the virus so be prepared for this to be here for awhile. It is something we are going to need to learn to live with. People are going to need to make the decisions for themselves about how much risk they are willing to take on. If you are out and about and social, it’s a virtual certainty that you will eventually get exposed to the virus. If you’re a homebody and practice strict distancing, you can probably avoid exposure for quite a long time. There isn’t a magic answer that is right for everyone and it isn’t appropriate for government to mandate a one-size-fits-all response.
In my view, the government’s role from a policy response is twofold.
First, we need clear and transparent information from our government entities. Most states have done an ok job at that with various levels of public information and dashboards available, but there are clear data quality issues that have to be fixed (counting a single person who tests positive more than once as new cases, mixing antibody and PCR tests, etc…) and in some cases, valuable context to explain what a particular data set means. Fortunately, data analysts like me, Dr. Frank Models, Brian Blackburn and others on Twitter like @EthicalSkeptic and @Justin_Hart have stepped in to help in those areas, but there is work to do at the state health department level in Ohio and across the country to clean things up.
Second, we have to monitor and protect our health care systems from being overwhelmed. Capacity issues created by COVID will increase COVID death rates and also the death rates for other medical issues. This was the original goal of flatten the curve and it remains an important goal.
We can help with the latter by continuing to maintain solid hygiene, continuing to practice some amount of social distancing and wearing masks in appropriate public spaces (cloth masks aren’t a magic talisman to ward off the virus, but they probably do help reduce the spread somewhat). I also think we should try to be kind to each other in understanding their situations. Some people can’t wear masks for various reasons. Some people will continue to be very afraid of social interactions that put themselves at risk.
That’s it. The virus will be with us for the near term and probably quite a bit longer. I tend to think that most people are too risk adverse right now compared to what the data suggests, but I think lack of well presented data and solid reporting from the media is to blame. In the end, it’s not my decision to make for them, fortunately. Be well, be safe, live your life.