Virus

Johns Hopkins
University & Medicine
Coronavirus Resource Center

Early Herd Immunity against COVID-19: A Dangerous Misconception

David Dowdy, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
Gypsyamber D’Souza, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health

We have listened with concern to voices erroneously suggesting that herd immunity may “soon slow the spread”1 of COVID-19. For example, Rush Limbaugh2 recently claimed that “herd immunity has occurred in California.” As infectious disease epidemiologists, we wish to state clearly that herd immunity against COVID-19 will not be achieved at a population level in 2020, barring a public health catastrophe.

Although more than 2.5 million confirmed cases of COVID-19 have been reported worldwide, studies suggest that (as of early April 2020) no more than 2-4%3–5 of any country’s population has been infected with SARS-CoV-2 (the coronavirus that causes COVID-19). Even in hotspots like New York City that have been hit hardest by the pandemic, initial studies suggest that perhaps 15-21%6,7 of people have been exposed so far. In getting to that level of exposure, more than 17,500 of the 8.4 million people in New York City (about 1 in every 500 New Yorkers) have died, with the overall death rate in the city suggesting deaths may be undercounted and mortality may be even higher.8

Some have entertained the idea of “controlled voluntary infection,”9 akin to the “chickenpox parties” of the 1980s. However, COVID-19 is 100 times more lethal than the chickenpox. For example, on the Diamond Princess cruise ship, the mortality rate among those infected with SARS-CoV-2 was 1%. Someone who goes to a “coronavirus party” to get infected would not only be substantially increasing their own chance of dying in the next month, they would also be putting their families and friends at risk. COVID-19 is now the leading cause of death in the United States, killing almost 2,000 Americans every day.8 Chickenpox never killed more than 150 Americans in a year.9

To reach herd immunity for COVID-19, likely 70% or more of the population would need to be immune. Without a vaccine, over 200 million Americans would have to get infected before we reach this threshold. Put another way, even if the current pace of the COVID-19 pandemic continues in the United States – with over 25,000 confirmed cases a day – it will be well into 2021 before we reach herd immunity. If current daily death rates continue, over half a million Americans would be dead from COVID-19 by that time.

As we discuss when and how to phase in re-opening,10 it is important to understand how vulnerable we remain. Increased testing will help us better understand the scope of infection, but it is clear this pandemic is still only beginning to unfold.

References

1. McKay H. Will “herd immunity” work against coronavirus? Fox News. https://www.foxnews.com/health/will-heard-immunity-work-against-coronavirus. Published March 23, 2020. Accessed April 23, 2020.

2. Two Stories Indicate Coronavirus Herd Immunity. Rush Limbaugh Show. https://www.rushlimbaugh.com/daily/2020/04/10/two-stories-indicate-coronavirus-herd-immunity/. Accessed April 23, 2020.

3. Flaxman S, Mishra S, Gandy A, et al. Report 13: Estimating the Number of Infections and the Impact of Non-Pharmaceutical Interventions on COVID-19 in 11 European Countries.; 2020. doi:10.25561/77731

4. Bendavid E, Mulaney B, Sood N, et al. COVID-19 Antibody Seroprevalence in Santa Clara County, California. medRxiv. April 2020:2020.04.14.20062463. doi:10.1101/2020.04.14.20062463

5. Reuters. Dutch study suggests 3% of the population has coronavirus antibodies. Mail Online. https://www.dailymail.co.uk/health/article-8224915/Dutch-study-suggests-3-population-coronavirus-antibodies.html. Published April 16, 2020. Accessed April 23, 2020.

6. ago RR-SW 8 days. Surprising number of pregnant women at NYC hospitals test positive for COVID-19. livescience.com. https://www.livescience.com/coronavirus-in-pregnant-woman-high-nyc.html. Accessed April 23, 2020.

7. Lucking L. Coronavirus antibodies found in 21% of New Yorkers in early testing. MarketWatch. https://www.marketwatch.com/story/early-antibody-tests-find-21-of-new-yorkers-have-had-covid-19-2020-04-23. Accessed April 28, 2020.

8. Katz J, Sanger-Katz M. N.Y.C. Deaths Reach 6 Times the Normal Level, Far More Than Coronavirus Count Suggests. The New York Times. https://www.nytimes.com/interactive/2020/04/27/upshot/coronavirus-deaths-new-york-city.html. Published April 27, 2020. Accessed April 28, 2020.

9. How “Chickenpox Parties” Could Turn The Tide Of The Wuhan Virus. https://thefederalist.com/2020/03/25/how-medical-chickenpox-parties-could-turn-the-tide-of-the-wuhan-virus/. Accessed April 23, 2020.

Mór Thököly wrote:5810/95

https://www.sciencemag.org/news/2020/05/finally-virus-got-me-scientist-who-fought-ebola-and-hiv-reflects-facing-death-covid-19#

‘Finally, a virus got me.’ Scientist who fought Ebola and HIV reflects on facing death from COVID-19
By Dirk DraulansMay. 8, 2020 , 5:00 PM

Virologist Peter Piot, director of the London School of Hygiene & Tropical Medicine, fell ill with COVID-19 in mid-March. He spent a week in a hospital and has been recovering at his home in London since. Climbing a flight of stairs still leaves him breathless.

Piot, who grew up in Belgium, was one of the discoverers of the Ebola virus in 1976 and spent his career fighting infectious diseases. He headed the Joint United Nations Programme on HIV/AIDS between 1995 and 2008 and is currently a coronavirus adviser to European Commission President Ursula von der Leyen. But his personal confrontation with the new coronavirus was a life-changing experience, Piot says.

This interview took place on 2 May. Piot’s answers have been edited and translated from Dutch:

“ON 19 MARCH, I SUDDENLY HAD A HIGH FEVER and a stabbing headache. My skull and hair felt very painful, which was bizarre. I didn’t have a cough at the time, but still, my first reflex was: I have it. I kept working—I’m a workaholic—but from home. We put a lot of effort into teleworking at the London School of Hygiene & Tropical Medicine last year, so that we didn’t have to travel as much. That investment, made in the context of the fight against global warming, is now very useful, of course.

I tested positive for COVID-19, as I suspected. I put myself in isolation in the guest room at home. But the fever didn’t go away. I had never been seriously ill and have not taken a day of sick leave the past 10 years. I live a pretty healthy life and walk regularly. The only risk factor for corona is my age—I’m 71. I’m an optimist, so I thought it would pass. But on 1 April, a doctor friend advised me to get a thorough examination because the fever and especially the exhaustion were getting worse and worse.

It turned out I had severe oxygen deficiency, although I still wasn’t short of breath. Lung images showed I had severe pneumonia, typical of COVID-19, as well as bacterial pneumonia. I constantly felt exhausted, while normally I’m always buzzing with energy. It wasn’t just fatigue, but complete exhaustion; I’ll never forget that feeling. I had to be hospitalized, although I tested negative for the virus in the meantime. This is also typical for COVID-19: The virus disappears, but its consequences linger for weeks.

I was concerned I would be put on a ventilator immediately because I had seen publications showing it increases your chance of dying. I was pretty scared, but fortunately, they just gave me an oxygen mask first and that turned out to work. So, I ended up in an isolation room in the antechamber of the intensive care department. You’re tired, so you’re resigned to your fate. You completely surrender to the nursing staff. You live in a routine from syringe to infusion and you hope you make it. I am usually quite proactive in the way I operate, but here I was 100% patient.

I shared a room with a homeless person, a Colombian cleaner, and a man from Bangladesh—all three diabetics, incidentally, which is consistent with the known picture of the disease. The days and nights were lonely because no one had the energy to talk. I could only whisper for weeks; even now, my voice loses power in the evening. But I always had that question going around in my head: How will I be when I get out of this?

After fighting viruses all over the world for more than 40 years, I have become an expert in infections. I’m glad I had corona and not Ebola, although I read a scientific study yesterday that concluded you have a 30% chance of dying if you end up in a British hospital with COVID-19. That’s about the same overall mortality rate as for Ebola in 2014 in West Africa. That makes you lose your scientific level-headedness at times, and you surrender to emotional reflections. They got me, I sometimes thought. I have devoted my life to fighting viruses and finally, they get their revenge. For a week I balanced between heaven and Earth, on the edge of what could have been the end.

I was released from the hospital after a long week. I traveled home by public transport. I wanted to see the city, with its empty streets, its closed pubs, and its surprisingly fresh air. There was nobody on the street—a strange experience. I couldn’t walk properly because my muscles were weakened from lying down and from the lack of movement, which is not a good thing when you’re treating a lung condition. At home, I cried for a long time. I also slept badly for a while. The risk that something could still go seriously wrong keeps going through your head. You’re locked up again, but you’ve got to put things like that into perspective. I now admire Nelson Mandela even more than I used to. He was locked in prison for 27 years but came out as a great reconciler.

I have always had great respect for viruses, and that has not diminished. I have devoted much of my life to the fight against the AIDS virus. It’s such a clever thing; it evades everything we do to block it. Now that I have felt the compelling presence of a virus in my body myself, I look at viruses differently. I realize this one will change my life, despite the confrontational experiences I’ve had with viruses before. I feel more vulnerable.

One week after I was discharged, I became increasingly short of breath. I had to go to the hospital again, but fortunately, I could be treated on an outpatient basis. I turned out to have an organizing pneumonia-induced lung disease, caused by a so-called cytokine storm. It’s a result of your immune defense going into overdrive. Many people do not die from the tissue damage caused by the virus, but from the exaggerated response of their immune system, which doesn’t know what to do with the virus. I’m still under treatment for that, with high doses of corticosteroids that slow down the immune system. If I had had that storm along with the symptoms of the viral outbreak in my body, I wouldn’t have survived. I had atrial fibrillation, with my heart rate going up to 170 beats per minute; that also needs to be controlled with therapy, particularly to prevent blood clotting events, including stroke. This is an underestimated ability of the virus: It can probably affect all the organs in our body.

Many people think COVID-19 kills 1% of patients, and the rest get away with some flulike symptoms. But the story gets more complicated. Many people will be left with chronic kidney and heart problems. Even their neural system is disrupted. There wf ill be hundreds of thousands of people worldwide, possibly more, who will need treatments such as renal dialysis for the rest other liives. The more we learn about the coronavirus, the more questions arise. We are learning while we are sailing. That’s why I get so annoyed by the many commentators on the sidelines who, without much insight, criticize the scientists and policymakers trying hard to get the epidemic under control. That’s very unfair.

Today, after 7 weeks,  I feel more or less in shape for the first time. I ate white asparagus, which I order from a Turkish greengrocer around the corner from my home; I’m from Keerbergen, Belgium, an asparagus-growing community. My lung images finally look better again. I opened up a good bottle of wine to celebrate, the first in a long time. I want to get back to work, although my activity will be limited for a while. The first thing I picked up again is my work as a COVID-19 R&D special adviser to von der Leyen.

The Commission is strongly committed to supporting the development of a vaccine. Let’s be clear: Without a coronavirus vaccine, we will never be able to live normally again. The only real exit strategy from this crisis is a vaccine that can be rolled out worldwide. That means producing billions of doses of it, which, in itself, is a huge challenge in terms of manufacturing logistics. And despite the efforts, it is still not even certain that developing a COVID-19 vaccine is possible.

Today there’s also the paradox that some people who owe their lives to vaccines no longer want their children to be vaccinated. That could become a problem if we want to roll out a vaccine against the coronavirus, because if too many people refuse to join, we will never get the pandemic under control.

I hope this crisis will ease political tensions in a number of areas. It may be an illusion, but we have seen in the past that polio vaccination campaigns have led to truces. Likewise, I hope that the World Health Organization [WHO], which is doing a great job in the fight against COVID-19, can be reformed to make it less bureaucratic and less dependent on advisory committees in which individual countries primarily defend their own interests. WHO too often becomes a political playground.

Anyway, I remain a born optimist. And now that I have faced death, my tolerance levels for nonsense and bullshit have gone down even more than before. So, I continue calmly and enthusiastically, although more selectively than before my illness.”

Spoiler:

Još jedan dan bez novih slučajeva infekcije

Od jučerašnjeg presjeka pa do 16:40 laboratorije Instituta za javno zdravlje završile su analizu 150 uzoraka među kojima nije bilo novih slučajeva infekcije koronavirusom.

Ovo je peti dan zaredom da u našoj zemlji nema registrovanih novih slučajeva obolijevanja od Kovid-19, ukupno dvanaesti.

Broj inficiranih od početka dešavanja nije promjenjen i iznosi 324, broj oporavljenih je 274, dok je trenutno oboljelih 42 i to po opštinama:

Podgorica: 20
Ulcinj: 10
Bar: 4
Gusinje: 3
Plav: 2
Nikšić: 1
Herceg Novi: 1
Bijelo Polje: 1

Pod nadzorom je trenutno 1192 osoba.

rumbeando wrote:U Crnoj Gori 5. uzastopni dan bez novozaraženih, imaju 42 aktivna slučaja u celoj državi (13% svih registrovanih):

Još jedan dan bez novih slučajeva infekcije

Od jučerašnjeg presjeka pa do 16:40 laboratorije Instituta za javno zdravlje završile su analizu 150 uzoraka među kojima nije bilo novih slučajeva infekcije koronavirusom.

Ovo je peti dan zaredom da u našoj zemlji nema registrovanih novih slučajeva obolijevanja od Kovid-19, ukupno dvanaesti.

Broj inficiranih od početka dešavanja nije promjenjen i iznosi 324, broj oporavljenih je 274, dok je trenutno oboljelih 42 i to po opštinama:

Podgorica: 20
Ulcinj: 10
Bar: 4
Gusinje: 3
Plav: 2
Nikšić: 1
Herceg Novi: 1
Bijelo Polje: 1

Pod nadzorom je trenutno 1192 osoba.

http://rtcg.me/koronavirus/crnagora/278587/jos-jedan-dan-bez-novih-slucajeva-infekcije.html

Pastir iz Nerežišća okupio nećake radi nasljedstva pa nehotice zarazio pola Brača

Kada se vratio iz splitske bolnice, gdje je bio tjedan dana na Odjelu kardiologije zbog problema sa srcem, više nije mogao sam ni hodati, imao je hodalicu i trebala mu je pomoć. Nećaci i njihove supruge, nećakinje i ostala rodbina izmjenjivali su se u njegovoj kući i dolazili ga njegovati

U Nerežišćima na Braču u subotu su epidemiolozi nastavili s uzimanjem uzoraka za testiranje na koronavirus. Razgovarajući s Bračanima, doznajemo kako su među 22 COVID-19 pozitivna otočanina automehaničar kod kojega polovica Brača popravlja svoja vozila, prodavačica u jednome mjesnom dućanu, trener sportskog kluba, zaposlenica najveće tvornice na otoku i još brojni drugi Bračani. Stoga ne začuđuje zabrinutost i strepnja koja je zahvatila otok.

U kontaktu s 37 ljudi

Prvi kod kojega je dijagnosticirana zaraza koronavirusom stariji je čovjek iz Nerežišća koji je sredinom travnja bio hospitaliziran u splitskoj bolnici. Tko je taj čovjek koji je prešao osamdesetu godinu, koji je bolestan i gotovo nepokretan, a koji je, i ne znajući da je inficiran i ne izlazeći iz kuće, uspio zaraziti toliko ljudi i biti u kontaktu s njih najmanje 37, koliko ih je u prvom valu testirano na korona virus?

Cijeli život živi u Nerežišćima. Nije se ženio, stari je momak, do prije koju godinu živio je s bratom, koji je također bio samac, ali je umro. Otad je sam. On je pastir, bavi se ovcama i kozama, ima stado, pašnjake, cijelog života vrijedno radi. Djece nema, ali ima veliku obitelj, dvije sestre i brata, petero nećaka i svi imaju svoje obitelji. Donedavno je bio vitalan. Kada se vratio iz splitske bolnice, gdje je bio tjedan dana na Odjelu kardiologije zbog problema sa srcem, više nije mogao sam ni hodati, imao je hodalicu i trebala mu je pomoć. Nećaci i njihove supruge, nećakinje i ostala rodbina izmjenjivali su se u njegovoj kući i dolazili ga njegovati. oni imaju svoje poslove i svi imaju obitelji. Nitko nije mogao na sebe preuzeti brigu za strica pa su tako svi dolazili – govori nam jedan prijatelj obitelji.

Naglašava kako čovjek nije znao da je bolestan i nitko ga ne krivi, kao ni članove njegove obitelji, uže i šire, koji su se zarazili dok su ga posjećivali i njegovali. Bolesnik za kojeg sumnjaju da je nulti pacijent bio je zbog problema sa srcem hospitaliziran u splitskom KBC-u od 11. do 17. travnja. Nije testiran kada je pušten kući jer nije imao simptome zaraze. Bio je na kućnoj njezi i čekao mjesto u Domu za stare i nemoćne u Supetru.

Prije no što je otišao u dom, a tada se još nije znalo da ima koronu, prošle subote pozvao je sve svoje nećake i nećakinje jer se na neki način htio s njima pozdraviti. Ja točno ne znam, ali govori se i kako ih je sve pozvao i kako bi im rekao što će kome ostaviti jer je stekao dosta toga u životu. U svakom slučaju, nakon toga otišao je u dom u Supetru. Srećom, sad su pravila da mora biti izoliran 15 dana i tamo je otkriveno da je pozitivan na COVID-19. Sutradan je utvrđeno da je pozitivna i njegova susjeda iz Nerežišća, također starija žena. Oni su oboje sada na Križinama, u COVID-19 ambulanti. Onda je u petak krenula lavina. Otkrilo se da mu je pozitivan nećak, žena mu, njihov sin koji je trenirao u Supetru, a pozitivan je i trener čija žena radi u Supetru pa je neki dan vozio na posao nju i gradonačelnicu, koja je sad u samoizolaciji. Pozitivna je i nećakinja iz Bola koja radi u Postirama. Nismo mogli vjerovati što se ovo događa. Brzinom svjetlosti se širi! Danas u Nerežišćima uzimaju novih 40 uzoraka – doznajemo od našeg sugovornika.
...

Germany : Translate “Oooops! What's going on there?

The RKI raises its estimate for the #Coronavirus -Reproduction number with a large set from 0.83 to 1.1.

At R =1.1 (the Chancellor said on April 15th), German intensive care medicine reached its capacity limit in October https://t.co/R7OSmWAIGY

— Fionna O'Leary, #FBPE (@fascinatorfun) May 9, 2020

While announcing the new estimated R value, Germany's Robert Koch Institute warned that the lower infection numbers prompted more statistical "insecurities." The report indicates a possibility of error between 0.9 and 1.34.

The indicated rise in R value comes less than a week since Germany eased many of its restrictive measures on Monday.