When will the pandemic end? Will it ever end? – part I

There are a few new data points that I’m trying to absorb now, that might help answer the two questions in the title.

First, a recent study showed (and this only confirms other studies from as long ago as last summer) that the actual number of Covid-19 infections in the US is at least ten times larger than the reported number. In other words, a huge number of people were infected but never experienced symptoms, or at least they didn’t consider them serious enough even to get tested.

Of course, this is what the advocates of pursuing herd immunity (like the editorial page of the Wall Street Journal) have been pointing to all along as evidence that we should just let the virus rip until we have herd immunity (and of course, vaccinations will hasten that outcome). The estimate I heard was that about 120 million Americans – about one third of the population – have been infected already. So, far from hectoring people about wearing masks now, we should be opening up the bars, movie theaters and tatoo parlors, in order that as many younger, healthy people can become infected as possible, while focusing vaccinations on those most likely to require hospitalization if they get infected.

This view is supported by the remarkable story of India. Three months ago, the situation looked dire, as hospitals filled up and cases and deaths skyrocketed. Today, new cases and deaths have plummeted, even though mask-wearing and social distancing have also plummeted (if they were ever followed in the first place). Was this because India quickly rolled out the 6-700 million vaccinations that would assure herd immunity? No. It was because a huge number of people – probably much larger than in the US - experienced asymptomatic infection (and India’s population is on average young, which certainly helped).

However, this morning WaPo published a story that describes how a recent trail of the Novavax vaccine in South Africa found (even though this was not the goal of the trial) that people who had been infected by the “regular” variant of the coronavirus were just as likely to become infected by the new South African variant as those who had never been infected at all. In other words, the immunity conferred by infection with the regular variant doesn’t protect against this new variant (which has now been found in three states in the US, in people who haven’t been to South Africa recently) – even though at least the Novavax vaccine did seem to confer immunity to the variant.

And then there’s the case of the Brazilian variant, which is devastating the city of Manaus (and elsewhere). It almost certainly isn’t stopped by antibodies from previous infection from the regular strain of the virus; it’s unknown whether it will be stopped by vaccines. The first case of this variant was identified in Minnesota recently, although that was in a person who had recently returned from Brazil. However, given the very low rate at which the US is doing genetic sequencing of samples from infected people, there’s simply no way to know how far this variant may have spread in the US.

The UK variant, on the other hand, doesn’t seem to re-infect people who have had the regular version of Covid, but the problem with that variant is it a) spreads much more quickly than the regular version (as do both the South African and Brazilian variants), and b) may be more deadly, according to Boris Johnson.

And remember, these three variants will each take about three months before they appear in significant numbers in the US. Considering all of this, anybody who points to the fact that new Covid infections and deaths have very recently declined from their astronomically high levels of a couple weeks ago (although they’re still much higher than even at the height of the first and second waves) as evidence that we can ease up on all of the restrictions and mask-wearing – and perhaps not impose new restrictions in some cases – shouldn’t be believed.

Even more importantly, there’s reason to believe that appearances of new variants – each better able to spread and kill people than its predecessors – will only continue and accelerate in the future. So we could end up having a new wave or two, long after we thought we’d finally beaten the virus. More on that soon.

I would love to hear any comments or questions you have on this post. Drop me an email at tom@tomalrich.com.