Laying It Out: Living with COVID was a bad idea then, and it’s a terrible idea now

By Medicine Hat News Opinion on May 8, 2021.

For more than a year we’ve heard leaders talk about “flattening” or “bending” the curve of COVID-19.

And before a year of living in a global pandemic, plus talking to epidemiologists, ER doctors, developmental biologists and more, it even made sense. “We have to live with the virus.”

At that point, when everyone from the World Health Organization to our Facebook friends lacked understanding, it sounded reasonable to assume we could avoid a spike and then keep cases at a low plateau.

But we’ve already curbed two waves only to learn “plateaus” aren’t a thing, and now we’ve been mired in a roller-coaster pandemic for 15 months, each peak worse than the last. And here we are again, beyond the 2,000 cases a day predicted by many, including developmental biologist Gosia Gasperowicz from the University of Calgary, who in February pleaded with Albertans and the UCP to reverse course on reopening so soon.

She said we could be done by Easter if we go for zero COVID cases, and that if we don’t, Easter would be right about when it starts getting extremely bad again, with strict restrictions (and plenty of death) to follow anyway. But that column has been written and her words fell on deaf ears.

I digress.

Well, here we are in May with schools closed, businesses restricted, socializing prohibited and frontline workers pressed to the max. And here we are in May with our leaders telling us we need to bend the curve.

This time is different, of course, because this time we have vaccinations. And this time, all we have to do is vaccinate enough people so when we flatten the curve, our herd immunity will finish the virus off.

The number thrown about is 70%. Once 70% of the population have their first shot, we will reopen and party like it’s 2019.

I hate to be the pooper of the festivities, but for a number of reasons, it’s not that simple.

When each vaccine is released we hear about its efficacy against symptoms, but the true effectiveness goes well beyond that. Being protected against symptoms is great but it has nothing to do with transmission – and we don’t actually know how effective vaccines are against transmission.

We know they will certainly lessen transmission, but according to Gasperowicz, in order for a 70% vaccine rate to effectively decline spread, transmission efficacy would have to be 97%. An article in Science News recently said early signs for Pfizer were it “may block infection” as it looks to be “about 90%” effective against transmission.

The discrepancy doesn’t seem like much, but if you’re going back to pre-pandemic society with packed bars and full stadiums, a minimum of 7% is a lot. The other figure that matters is contagiousness.

By now everyone should know what “R value” means. The figure refers to how many people, on average, someone infected with COVID is giving it to. If that number is below 1.0, the virus eventually dies off, but if that number is even the slightest bit over 1.0, cases grow exponentially.

The R0 of a disease, or R-naught, is what that R value would be if we did nothing. No restrictions, no vaccines, no anything. Gasperowicz says in order for vaccines alone to get the R value below 1.0, we would need 70% vaccinated, a 97% transmission efficacy AND the virus’s R-naught to be less than 3.0.

Gasperowicz told me COVID’s R-naught is likely at least 4.0, and a recent peer-reviewed study at the CDC’s Emerging Infectious Diseases pegs it as high as 5.7.

The point is, even with vaccines (and please, for the love of normalcy, get your damn shot) we can’t get rid of COVID by “bending” the curve, and it’s not just Gasperowicz saying so.

A Canadian Press article on Friday had experts suggesting herd immunity is unlikely.

Sarah Otto, a UBC professor and expert on the mathematical models of pandemic growth, says variants throw a curveball into what researchers know about vaccines. She says the 70% rate we’re hoping will work is without enough information to validate.

“We don’t yet know how effective vaccines are at reducing transmission from person to person and that matters a lot,” Otto said. “Before the pandemic, we didn’t have working vaccines for coronaviruses, so we don’t know exactly what the outcomes are going to be.”

We also don’t know how long vaccinations last, meaning we could be doing this every year while praying the lingering virus doesn’t mutate into a strain we aren’t protected against. This is our reality, and if this is a world you’re comfortable with, then status quo is probably fine.

But if you’d rather not play catchup with a deadly disease, the only way past it is to eliminate it. And regardless of what Premier Never-Right says, we absolutely could achieve COVID zero if governments in Canada agreed to do so – the examples around the world are well known.

The choice is ours. Keep trying to “live with” something clearly trying to kill us and see what happens, or do what it takes to be done with this once and for all.

If you’d prefer the latter, I’ll leave you with a link. Stay safe.