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Returning to “normal” in Oregon means reaching COVID-19 herd immunity

Returning to “normal” in Oregon means reaching COVID-19 herd immunity

 


Although it was a bumpy start, the COVID-19 vaccine is now consistently administered throughout Oregon. As of February 22 Over 270,000 Oregons Fully vaccinated – it is about 7% of the population.

However, to return to the “normal” state, businesses and schools are open without restrictions, without masks, and without social distance, so we need to increase that number. here we go.

“I know not only some people, but many people who are really tired of pandemics and all the restrictions. They want to have a magic bullet approach — vaccines are magic. I hope it will be a bullet, “said Chunhuei Chi, a professor of public health at Oregon State University.

However, vaccines do not solve all of the COVID-19 problems this week, this month, or even this year.

Overcoming a pandemic and returning to normal means gaining herd immunity. It’s a goal, spoken at a percentage, but it’s shared with dazzling expectations. But the way to get there is more complicated than simple numbers tell you.

What is herd immunity?

Herd immunity occurs when a sufficient number of people in a population are immune to the infection and are unlikely to continue to spread.

The virus must infect people in order to spread. If five people are infected with the virus and four of them are immune, the virus can only spread to one other person. With a mixture of people with sufficient immunity, no one can infect the virus. With enough immunity, the disease eventually disappears from the population, like smallpox.However, coronavirus Expected to get endemicThat is, it is expected to stick at a low level for quite some time.

Once herd immunity is reached, those who are most vulnerable to the disease (those without immunity) will not come into contact with people who are infected with the virus. They are protected by the greater immunity of the herd.

Herd immunity is usually given as a percentage of the population that needs immunity to provide protection for the community, or more reasonably as a percentage range.

How much do we know about it?

The term herd immunity has existed for over a century. Early on it was used by veterinarians.One of the earliest known references can be found at 1921 Report from Oregon State University (Currently Oregon State University) About van disease in cattle. Bang’s is a nasty infectious bacterial infection in which cattle miscarriage calves.Bacteria May spread to humans..

“Infectious miscarriage and infertility in cattle is estimated to cost the state more than $ 1 million a year ($ 14.5 million in today’s currency),” the report said, and the veterinary department “used much of that energy.” The building of herd immunity could eliminate the disease. “

In the decades that followed, the term became more widely used to talk about human infectious diseases.

How can I get immunity?

People gain immunity to the disease when the body produces antibodies that can fend off invading viruses, bacteria, fungi, or toxins. For COVID-19, your body first learns to fight it by being exposed to the coronavirus. There are two main ways this can happen.

It is still unclear how long innate and vaccine-derived immunity will last (more on this below).

Do I need a vaccine to get there?

Not technically. For most of human history, humans have acquired herd immunity without the use of vaccines. And in most of human history, people have been debilitated by numerous deaths and infectious diseases, from plague to polio to smallpox.

So you can get there by innate immunity — if you are willing to allow people to die preventable.

“I call it’herd immunity a difficult method,'” said Mark Slifka, a professor at Oregon Health & Science University who is doing vaccine-focused research.

With 1 count Over 1 million people in the United States Half of the population must die of COVID-19 before it can acquire innate immunity.

For vaccines, this does not have to occur.

“Doctors and medical scientists tell us that vaccines are the safest and most effective way to stop the spread of the virus,” Oregon said when state immunization rates began to rise. Health Director Patrick Allen said.

Are herd immunity goals the same for all illnesses?

No. The proportion of people who need immunity to reach herd immunity depends on the infectivity of the disease. The way epidemiologists calculate this is to determine the basic reproduction number. R0 (R-naught) or R value. This number answers the question: how many other people with each illness are expected to get infected if they do nothing to slow or stop the spread? Again, this is often shown as a range of numbers because the spread of the disease depends on factors such as weather and population density.

Illness like Ebola The R value is about 2. On average, one infected person infects the other two.For very contagious things like Whooping cough, One passes it to 15-17 others. If the R value is 1, the case numbers will be flat. Below that, the case number will drop.

There are other versions of using R-values.When you see Re Or Rt, It refers to the real-time spread rate of the disease – reflecting the use of masks, social distance, quarantine, etc. For the last few months, Oregon has been hovering at or just below. Re= 1 mark. This means that the COVID-19 rate flattened in real time and began to decline.

However, when calculating herd immunity, R0 It is used. To return to normal, you need to think about the disease that spreads under normal conditions.

“We don’t want to keep wearing masks. I want to go to a soccer match again someday. And since it shows you the level of immunity you need, you no longer have all these mitigating factors. You don’t have to be, “Slifka said. “You don’t have to wear a mask to stop measles, and because of the herd immunity to measles.”

How do you calculate herd immunity?

The basic calculation is relatively easy. It starts with an expression: 1- (1 / R)

For COVID-19 The halfway R value is 3.3...

Using this formula, the coronavirus herd immunity threshold is about 70%.

“If 70-85% of the country is vaccinated by the end of summer, by the middle of summer, I think it will be near normal to some extent by autumn,” said Dr. Anthony Fouch. At his first press conference as President Joe Biden’s Chief Medical Advisor on COVID-19, he said:

How does this work in Oregon?

With a population of over 4 million, the state must have a little less than 3 million COVID-19 immunity to reach herd immunity. In mid-February, about 150,000 coronavirus infections were confirmed. This will set the vaccination target at about 2.8 million people, reaching 70% of that.

The state’s average vaccination rate in early February is 16,000 per day and will arrive around Christmas this year. If the prorated rate goes up, this date will move forward.

However, achieving this goal will be more complicated than it looks. This vaccine is not approved for children under the age of 16 and teens. This is about 17% of the unvaccinated state population. Only a small number of Oregons cannot be vaccinated because of their underlying health condition.

This means that about 90% of healthy adult Oregons need to be vaccinated to reach their herd immunity threshold.

Why do you hear so many different estimates of herd immunity?

Over the past few months, Fauci and other public health authorities have given several different vaccination goals for herd immunity, usually between 65% and 85%. Due to the uncertainty associated with getting people to take action, authorities tend to set high goals when it comes to public health goals.

“Welcome to public health,” Slifka said. “If you want 75% of people to be vaccinated, you need to ask 80% or 90% of people to be vaccinated. Probably not reaching 90%, but you really need 75 Will reach%. “

In addition, there is considerable uncertainty. The exact infectivity of COVID-19 is unknown (there is an estimated range). There are adjustments that need to be considered when it comes to immunity, vaccine efficacy, and viral behavior. These have the effect of increasing the time it takes to achieve herd immunity.

  • Vaccine efficacy: The COVID-19 vaccine is best at 95% efficacy. This means that at least 5% must be added to the vaccination goal to achieve the herd immunity goal. In addition, it will be even higher depending on the combination of vaccines with low efficacy rates.
  • Vaccine Duration: One of the rush losses to develop and test a new vaccine for COVID-19 was the time required to determine how long the vaccine would provide protection. Both Moderna and Pfizer-BioNTech Already developing booster shots.. Some people may begin to lose vaccine immunity before the herd is protected. Slifka says an annual booster dose of these vaccines will probably be needed.
  • Duration of innate immunity: It is unknown how long the innate immunity obtained by catching COVID-19 lasts. Since humans usually maintain immunity to other coronavirus-induced illnesses (common colds) for about a year, Slifka believes that immunity to this virus will be similar.
  • Viral variants: Coronavirus mutations have already appeared and will continue to appear over time. Vaccines may not be effective against some variants. Others are more contagious.For example, the British variant Adds .7 R value for illness.. This difference in infectivity raises the herd immunity target from 70% to 75%.

Is there a way to speed up the process?

Okay! One way is to vaccinate people early. This can start to happen as vaccine production continues to grow and new vaccines are likely to come online in the coming months.Recent federal government Increased Oregon vaccine supply, So it’s already started.

Another factor that is unreliable by the authorities, but nevertheless unfolding in the background, is that the number of people naturally immune to COVID-19 is much higher than the official numbers indicate. about it. Testing in the United States is inadequate, with a primary focus on those who are symptomatic or who are known to be exposed to the coronavirus. Asymptomatic infected individuals are mostly underestimated.

According to the Centers for Disease Control and PreventionIn the United States, there are actually 4.6 times the official number of COVID-19 infections. These people are still in the vaccine pool because these cases are unknown. But it provides a little cushion and brings us closer to our goals.

What does life look like from now to “normal”?

In Oregon, mask obligations, social distance measurements, and other tactics designed to slow the spread of COVID-19 worked primarily. The real-time infection rate (R-value) of the virus is less than 1, and the number of daily cases in the state is gradually decreasing.

With the addition of the vaccine, the situation begins to get better.

“These things can work together,” Slifka said. “The overall idea is whether we keep a social distance in a very slow (spreading) place. Then we put vaccinations on it. We can drop down to .9, .8 … Maybe when you drop down to .2, it starts to burn out… it drops like a rock. ”

At that point, the state can begin to relax restrictions.

However, be careful. To resume, you need to manage the balance of the huge seesaw. If authorities relax the restrictions too much or too soon, the vaccine will not have time to make up for the difference. The case may start creeping up.

Looking to the future, top public health officials predict that the weight of the pandemic will begin to rise from mid to late summer.

“It’s an increment. It will take months to slowly resume normal activity,” said Chi of OSU.

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