A return to normalcy – meaning a life without social distancing and masks – seemed within reach in late spring.
When Spectrum News spoke to Dr Monica Gandhi in early June, the infectious disease doctor urged schools to consider allowing children to return to fall without masks, saying all it took was that adults around them are vaccinated.
Then came the highly contagious delta variant and the realization that many adults were not vaccinated.
Now, Dr Gandhi, professor at the University of California, San Francisco School of Medicine, says that before seeing “normal” again, children will also need to be vaccinated and must continue to mask themselves until this happens. .
“Unfortunately the delta, I think, has really changed the equation for the kids and for the country, and it’s so much more highly transmissible that we didn’t have the levels of immunity in our population to keep them safe. others. This means that we need higher and higher levels, ”said Dr Gandhi.
What would you like to know
- Experts say they don’t anticipate another devastating wave like we’ve seen with the highly contagious delta variant
- Immunity Induced by COVID Infection Offers Strong Protection to Some, and May Help Us Achieve Herd Immunity
- Experts say it’s still important to get the vaccine, even if you’ve had the virus
- COVID will probably never go away, but will become more manageable
But Dr Gandhi says a return to normal is finally in sight, in part because the FDA may soon authorize a COVID-19 vaccine for young children – and because the delta variant essentially forces higher levels of immunity in the whole population.
While “normal” is almost there, she says, it’s at a much higher cost than anyone willing to pay.
“The most painful way to get immunity is through infection naturally, the painful and unfortunately sometimes fatal way. Corn [even] If we don’t increase our vaccination rates, I think by the end of this year we will have enough immunity in our population, whether through vaccination or natural infection, ”said Dr Gandhi. “I think delta will be the variant to finish them all.”
Particularly because history shows that disruptive viruses eventually die off. “Usually, if you develop too many mutations, the virus actually becomes weaker than stronger. It’s kind of evolutionary biology, ”added Dr Gandhi.
Again, these are predictions, if we’ve learned anything from the coronavirus pandemic it’s that anything can happen.
Has the United States achieved “collective immunity”?
Collective immunity occurs when a sufficient amount of the population is immunized or protected against disease. After 20 months of roller coasters of increasing and decreasing coronavirus transmission, and over 65% of those 12 years and over fully vaccinated, many are asking the question, are we not there yet?
While Gandhi and other experts we’ve spoken to say the country is almost there, the country’s leaders tasked with pulling the country out of the pandemic will not answer the question.
“You know when you’re on herd immunity when the virus doesn’t have a chance to pass from person to person. But at the moment, we don’t know what that number is, ”said Dr Anthony Fauci, the country’s foremost infectious disease expert, during a briefing from the COVID-19 response team. the White House last week.
“And when you don’t know what the number is, what do you do? You vaccinate as many people as possible, as quickly and as quickly as possible. That’s what we should be focusing on, not one number in particular.” , added Dr Fauci.
Vaccines have been shown to be very effective in providing protection. Even among those who became infected after vaccination, called so-called “breakthrough” cases, the vast majority are protected against serious illness and death. But some research shows that the protection offered by natural immunity should not be ignored.
A study of workforce screenings that took place before the delta variant took hold, published coronavirus testing company Curative, found that those who have recovered from natural SARS infections- CoV-2 produced decent protection against reinfection.
The researchers say there was no significant difference in the incidence of infection between those previously infected and those vaccinated.
In fact, there was no re-infection among the 254 patients who had had previous infections, compared to four “breakthrough” cases in the vaccinated group of 739 patients. The researchers concluded that their results “should provide increased confidence that those previously infected are at a very low risk of repeat infections.”
Previously infected people should still be vaccinated
Yale Medicine immunologist Akiko Iwasaki said that natural immunity to the coronavirus must be included in the overall picture of protecting a population. To overcome the delta in particular, agrees Iwasaki, a very high level of immunity is required. “With the delta, you need 90% of people immune to build herd immunity.”
But a recent study she led – soon to be published in a peer-reviewed journal – argues for vaccination even if you’ve been infected before. Yale researchers found that those who had previously been vaccinated had the best protection against the coronavirus and its variants.
“The naturally acquired immunity is quite effective in preventing infections and illnesses,” Iwasaki said. “But there is a huge variation between people in the amount of immunity they generate with an infection. So with very mild disease we have very few antibodies and very little immunity to T cells. , whereas people who have had a more serious disease generate more antibodies and T cells. ”
The caveat, however, is that the immune response elicited is different in each person.
“Because of this variability, we just want to make sure that everyone is protected and that a vaccine can do it,” Iwasaki said. “Even if you already have very good immunity to the main infection, it can also decrease over time.”
“Second, the vaccines work. As our research has shown, the vaccine will raise this level even further, ”added Iwasaki. “So why not be even more protected if you have the chance?”
From pandemic to endemic
New York University population health epidemiologist Anna Bershteyn, who modeled the pandemic for New York City, says that with natural infection and vaccinations, the city is now about 83% immunity.
The goal to get past the delta and get back to normal, she says, is between 85 and 90 percent.
“When we get closer to collective immunity, we will be able to remove some of these layers. And we need to make smart decisions about which of those layers are the first to come off. The faster we progress with vaccination, the faster we can get there, ”said Bershteyn.
Dr Gandhi says his home state of California has achieved a necessary level of population immunity, with around 90 percent having some level of protection.
The infectious disease expert says the coronavirus is here to stay despite efforts to eradicate it. Gandhi says now is the time to follow the lead of other countries that have largely put the pandemic behind them, instead viewing the virus as endemic, or regularly found in circulation.
“Living with an infectious disease is very manageable if we can get it down to what we call control,” Gandhi said. “That’s another word for a low level. It is becoming endemic, but control means it does not disrupt our lives. We will always have to be vigilant, we continue to vaccinate and we continue to test and we continue to treat. people if we need them. “
It is time, she said, for the country’s leaders to offer the public hope – that the pandemic is coming to an end.
“What’s the end of the game?” She asked. “We didn’t get that message here.”