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Herd immunity is a great hope for humankind, which proves elusive.

 


Long before herd immunity became a common obsession with humankind, the phrase referred to sick cows. More than a century ago, veterinarians observed that outbreaks of highly contagious bacterial infections that threatened cattle would die if a certain percentage of herds were burned, unless new animals were introduced. Soon, this concept was extended to various human outbreaks and became a staple of epidemiology.

Since the beginning of the pandemic, the potential time for the United States to reach Covid-19 herd immunity has been intensely debated among many armchair epidemists on Congressional hearings, television shows, and Twitter. In general imagination, this phrase is an abbreviation for the end of a pandemic. This is a finish line that allows the virus to suddenly subside and resume normal unmasked conditions.

But how relentless, unpredictable, Easy to mutate With the coronavirus proven, leading researchers are beginning to say that the more realistic expectations for Covid endgames are slow, gradual improvements, with many conflicts and retreats along the way. Powerful vaccines like Moderna and the partnership between Pfizer and BioNTech put the world in a much better position than it was six months ago. However, the virus has killed 3 million people worldwide and infected more than 140 million people. There is no sign of giving up, May circulate over the next few years. In other words, the end of the pandemic may become apparent in retrospect.

The idea behind herd immunity is intriguingly simple. When a certain percentage of people get immunized by vaccination or infection (probably 70% to 85% with this particular virus), the infection becomes more difficult and the protective effect protects a wider population. Equation 1-1 / R1 is the average number of new infections that R1 is likely to result from each case and requires basic algebra. But digging into the details quickly complicates this intuitive concept. “Everyone talks about herd immunity as this very important threshold, but it’s a very crude and difficult number to estimate,” says Nicholas Reich, a biostatistician at the University of Massachusetts Amherst. Various research groups around the world.

Humans are not cows. Rather than a simple fixed number, the proportion of the population required for herd immunity depends on the passage of time and location, depending on various factors such as the duration of immunity, people’s behavior, mitigation procedures and methods being performed. Varies.The virus mutates quickly and even Regional climate.. Looking at past vaccination campaigns gives us a cool view of our upcoming slogan. Smallpox is one of the only major human viruses that are officially infected. eradication..Rare cases of polio Still occurs In some countries.But measles It took years to completely conquer the United States with a powerful vaccine.

Whatever the theoretical number, it has increased in recent months with the increase in more infectious mutants, such as the current B.1.1.7 strain. Dominance in the United States Early in the pandemic, some optimistic studies often cited by opponents of shutdown argued that only 10% or 20% of the infected population could lead to herd immunity. Mainstream estimates were initially around 60% to 70%, but are on the rise over time. Recently, U.S. government officials have avoided quoting certain people and emphasized shooting guns immediately. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a briefing at the White House on April 12, “I want to keep people away from this notion of something that is very confusing.” He emphasized that it will be gradual until it reaches normal.

There is no doubt that widespread vaccination will slow down the pandemic, revitalize the economy and enable more normal social activity.The number of deaths and severe cases Plunge in Israel, It is leading the world competition to immunize its population.But in the larger and more diverse United States, vaccines Political polarized issues.. Although more than a quarter of the population is fully vaccinated, hesitation in the vaccine can prevent complete intake. (((Republican And White evangelical Christian Polls show that they are most likely to abstain. ) Vaccine supply is already in place Exceeding demand In part of the country.

“As we move forward, unfortunately, race, income and religion create pockets where people can’t be vaccinated,” said Ali Mokudad, an epidemiologist at the Institute for Health Metrics in Seattle. I will. “Automatically, outbreaks between these, or much higher infections between these groups, never reach herd immunity.” According to Bloomberg, the global vaccination campaign has almost begun. Not enough to cover only 6% of the world’s population. Vaccine tracker.. These doses are concentrated in dozens of rich countries. “Our side is exposed,” said Saad Omer, director of the Yale University Institute for Global Health, spent on global expansion given that the virus is not paying attention to borders. The cost is very low. “It bothers me to think that we have an immune bastion in the United States and can learn to live at the risk of importing variants.”

The recent vaccine retreat will be useless. In many countries, the use of AstraZeneca Plc’s adenovirus vaccine has been restricted after it has been linked. Rare blood clot..Johnson & Johnson’s shot distribution in the US Paused Authorities are investigating several similar coagulation events associated with the vaccine. Physicians who advise the Centers for Disease Control and Prevention will meet on April 23.

In the long run, the biggest wildcards are variants, especially those that reduce the effectiveness of the vaccine. After the results of a spectacular vaccine trial at the end of last year, “I thought I’d have a near-normal lifestyle by the second half of 2021,” said virologist David, who heads the Aaron Diamond AIDS Research Center at Columbia University. Ho says. Variant study. He still expects steady improvement, but the subspecies explosion “reduced my optimism” due to a quick conclusion to the pandemic.

Brazil’s rainforest city of Manaus shows how difficult it is for the virus to tackle submissions without high immunization rates. The city was hit hard early in the pandemic, with 76% infected by October, according to one study. It should have put it in the area of ​​herd immunity.But in December A deadly new wave struckDriven by, P.1 variant, This suggests that some people got sick twice. Ester Sabino, an infectious disease researcher at the University of São Paulo, said: The best vaccines are believed to provide stronger protection than innate immunity.

In optimistic scenarios, the coronavirus may lack a way to keep changing. However, complex medium-term situations can mean a bumpy and zigzag path to normal. It involves relaxing restrictions in several places while working on new ways to live in a world where the virus is still there. Eventually, the coronavirus becomes like the flu and can mutate steadily in ways that require a series of endless booster shots. Alternatively, SARS-CoV-2 may calm down and turn into another common cold.

With so many possible consequences, researchers say the best strategy is to focus on what is under our control: increasing vaccination. “From an immunology and vaccine perspective, it’s very easy. Vaccine as many people as possible,” says Professor Schoencrotti of the Lahora Institute of Immunology. “If 90% of the population can be vaccinated, everyone will be in better shape.”

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