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So many unknowns, and a virus that wants to outwit us

Experts are guessing that anywhere from 70 to 90 percent of people need to be vaccinated to meet herd immunity efficacy against COVID-19. But no one really knows how the pandemic will play out, even under the best of vaccine rollout scenarios.

Richard Davis , a retired registered nurse and tireless advocate for access to health care, serves as Guilford’s health officer. A former Brattleboro Reformer columnist, he continues posting writing weekly on his Facebook profile (bit.ly/575_davis).

Guilford

World governments are trying to deal with the complexity of vaccinating enough of their populations to provide an adequate level of herd immunity to be able to declare that the COVID-19 pandemic is under control.

Having a Darwinian health-care system and a lack of federal leadership means the U.S. will most likely lag behind the rest of the world in vaccine rollout. Experts are guessing that anywhere from 70 to 90 percent of people need to be vaccinated to meet herd immunity efficacy.

One of the major problems that all countries face is the fact that no one really knows how the pandemic will play out, even under the best of vaccine rollout scenarios. In addition, there are many unknowns about how vaccines work and how the virus behaves.

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The vaccine rollout was rushed, but manufacturers are declaring their vaccines safe and effective. Not enough time has passed to have enough data to make an informed declaration.

If we assume that safety and efficacy persist there is another big issue that needs to be addressed: No one knows how long a vaccine will protect people from COVID-19. I am not an infectious disease expert, but without that critical piece of information, it seems that we will be living in a pandemic world constructed of best guesses.

All of the information I have been able to find indicates that the vaccine may confer immunity for a limited period of time. If we assume that time period is about a year, what does that mean in terms of the current vaccine rollout? Does it mean that if it takes a year to vaccinate a majority of Americans that we will have to start the process over again and continue indefinitely, as is the case with seasonal flu?

What about vaccination in the rest of the world? If a majority of countries do not synchronize their immunization programs, does that mean that we will never be able to control the spread of the virus worldwide? Does it mean that travel will have to restricted indefinitely, or that countries will just have to accept the inevitability of perpetual risk?

COVID 19 does not appear to be a seasonal occurrence but a forever virus, and that means that we will have to figure out an immunization strategy that offers vaccination indefinitely. If it takes a year for the initial rollout, how is it possible that we can actually control the spread of the disease?

It may be possible that vaccines will confer immunity for a year or two, or perhaps for a period of time that is long enough for herd immunity to be established. That would be a best-case scenario that does not seem likely.

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It looks to me like we will always be chasing our tails in an effort to get ahead of the virus. I would like to hear Dr. Fauci and other experts address the long-term strategy of vaccination and how we might control the pandemic over the next one to two years.

So far, we are receiving just bits and pieces of information about different vaccines and the hope for reaching herd immunity. We have not received any information describing how the vaccination plan will control the pandemic in the long run, and that scares me.

Add to the mix the uncoordinated and chaotic rollout of vaccine distribution. Once again, the federal government has left the details to the states, providing little or no financial or logistical support.

Biden transition officials hope that when the new presidential administration gets rolling, the federal government will provide national coordination of vaccine distribution and administration. But that will take time.

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Another troubling development is the mutation of the COVID-19 virus. Experts are saying they “think” that current vaccines will be effective against the new strains, but no one knows for sure.

They are basing their guesses on the fact that the new strains also have the spike protein on their surface. That spike protein is the target of vaccines. They do not know if the spike proteins on the mutants have characteristics different from the spike proteins that the vaccines were created for.

Viruses have outwitted the smartest of humans for centuries, and there is no indication that we will be able to gain a permanent advantage over these deadly entities.

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We have to be realistic and realize that the vaccine rollout may not be able to protect enough of us so that we can live in a post-pandemic world.

Masks, social distancing, and a large dose of common sense will be the best tools we have to protect all of us for a long time.

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Originally published in The Commons issue #594 (Wednesday, January 6, 2021). This story appeared on page C1.

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