Now that the vaccines are arriving, people are starting to dream.
They say things like, “The second time everyone in my family is vaccinated, we’re going on a big trip to Asia!” or ‘As soon as I and my five closest friends get the chance, I’m spending a weekend in a hut with them. No masks, no social distance. ”
While many of us think of the Covid-19 pandemic in binary terms – there is ‘life before I get the chance’ and ‘life after I get the chance’, experts warn us to think more gradually. Not everything will change when the syringe enters your arm.
“Realistically, it’s definitely not going to be an on / off switch on normal,” said Eleanor Murray, an epidemiologist at Boston University.
The best way to set realistic expectations about what life will look like in 2021 is to devise it in three phases. Phase 1 is what you can do safely if you and your close friends or family have been vaccinated. Phase 2 is what you can do safely if your city or state has reached herd immunity, where enough people are protected from infections so that the virus cannot easily cause new outbreaks. Phase 3 is what you can do once herd immunity is achieved internationally. (Note that there is a good chance that we will not reach the last phase in 2021.)
Much depends on the answer to an important question: Are the vaccines only good for preventing symptomatic diseases, or is it also good for preventing infection and transmission?
‘One can imagine a scenario where you are vaccinated and that you develop a protective immune response. You will not get sick, you will not die, but the virus will still be able to grow in your nose and transmit it to other people, ”said Barry Bloom, a professor of immunology and infectious diseases at Harvard.
Bloom and other experts are optimistic that the vaccines could reduce infection and transmission, but no one knows how much. “We just need more data on the transfer,” he said. “Hopefully it will come out of the trials in a few months.”
In the meantime, even vaccinated people have to assume that they can still become infected and transmit the virus. This means that they must continue to wear masks and take social distance when they are not vaccinated.
But as more and more people are vaccinated, the question will arise: what if you are among people who have all been vaccinated? This brings us to stage 1.
Phase 1: You and your good friends or family are vaccinated
Suppose you and your five best friends are vaccinated. Can you all rent a hut in the woods and spend a weekend together without masks or social distance?
The answer is: it will probably be good – with some reservations.
First, vaccines do not work immediately. “You have to wait at least two weeks after the first survey to see any form of protection, but actually you have to wait at least a week after the second survey,” said Angela Rasmussen, a virologist at Georgetown University.
Then there is the fact that the vaccine may not work equally well in everyone. Some people have health problems that prevent their bodies from having an equally successful immune response. “The fact is, I’m not entirely sure that everyone who receives the vaccine develops a protective response,” Bloom said.
The Pfizer / BioNTech and Moderna vaccines have shown 95 percent efficacy in preventing symptomatic two-dose trials. But it’s not 100 percent. There is still a chance that you could pick up the virus from one of your vaccinated friends and develop symptoms. Although the vaccinations are very good for preventing the serious symptoms that make people in the hospital, experts cannot rule out the possibility that you will develop milder symptoms, which could possibly become chronic or ‘long-term’.
The weekend getaway will therefore not be completely safe. But, Rasmussen said, “if your whole group of friends have all received the full vaccine treatment and at least a week has passed since their second shot, it’s probably good that you’re in a closed environment with them. interaction with the public. So maybe a holiday where you all get an Airbnb and hang out – but without bursting! – would be fine. “
Murray agreed that the risk would be relatively low, provided you and your friends have no underlying conditions and do not live with vulnerable unvaccinated people who want to protect you from infection. “But if you came back and went to the grocery store,” she said, “I would expect you to still wear masks.”
This is because there is a big difference between a closed bubble, where you know everyone is vaccinated, and being in the public domain, where you run the risk of infecting non-vaccinated people.
Asked if she would like to go to the cabin after the weekend trip, Murray said, “I’ll probably be comfortable,” but that’s because she does not live near dangers. parents or grandparents for whom she has to protect, and because she expects them to be in the last group of people to get the vaccine – at that point, herd immunity will have built up more, reducing the chances of any of her friends showing up at the cabin unknowingly infected.
Phase 2: Your city or state has reached herd immunity
In the public sphere, Americans must continue with masking and social distance until 75 to 85 percent of the population is vaccinated, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. He estimates that around that time, the US – which may come in mid-autumn – will achieve herd immunity. (However, this is only an estimate, and may change depending on the Covid-19 variant, the uptake of vaccines and other factors.)
Instead of pursuing national immunity at the same time, we are likely to see regions within the US cross the immunity threshold at different times. As each city or state announces that it is past the threshold, it is likely to gradually begin to bear back the requirements. We can see restaurants opening up for indoor eateries, but with servers still wearing masks.
“I think masks will probably be one of the last things to roll back,” Murray said, “because masks have no commercial cost for them. This is something that is useful and the economy does not necessarily cost something. As there is a lot of travel between jurisdictions, masks cannot be rolled back until the whole country has reached herd immunity.
Once a jurisdiction reaches immunity, people there will be able to return safely to places like schools and cinemas. The idea is that if, for example, 80 percent of people are vaccinated, it creates an “umbrella” of immunity, as Fauci put it, that “even the defenseless people who are not vaccinated, or those in whom the vaccine does not was not effective. ”
Rasmussen stressed that if we want not only 95 percent, but more 99 percent, to feel safe in public spaces, we need as many people as possible to be vaccinated, because that’s what stops the transmission of the community.
“You can have very good vaccinations, but they do not completely destroy these viruses unless they are taken very, very widely,” she said. ‘But people still do not think of vaccines as a population-level intervention. They think of it as an individual intervention. This is very exemplary of this pandemic. ”
From the beginning, health experts have tried to make the public understand that when it comes to the coronavirus, no one is really safe until everyone is safe.
Phase 2 is therefore not the time for international travel to countries that have not yet achieved herd immunity or that have little healthcare infrastructure.
If a large region in your country exceeds the immunity threshold, it is possible to travel within, for example, to see vaccinated relatives to a few states. But for your safety and for the sake of people abroad, it is best to make great international trips.
Phase 3: Herd immunity is achieved internationally
Let us get those expectations right away. The chances are high that we will only reach this stage in 2022 or later. This is because access to the vaccines around the world is not equal.
‘What we’re seeing is that the US, Canada and Europe are getting pretty good access to the vaccine, but if you’re hoping to go to Mozambique or something, a lot of the other countries can’t necessarily buy the vaccine. and it will be much longer for those countries, ”Murray said.
That is why it is so important to have groups like the Covax facility, a unique funding mechanism that gets 190 countries (of which 92 are low-income countries) to pool their resources to end the pandemic faster. It aims to deliver 2 billion vaccine doses to participating countries by the end of this year, regardless of their ability to pay.
How long it takes for different countries to achieve herd immunity will depend in part on how quickly they have access to vaccines and what part of their population is willing to take the chance. But as mentioned above, there is another important factor.
“It’s really going to come down to what we’ll learn over the next few months about how well the vaccine infection and transmission are doing,” Murray said, adding that she does not expect us to have an answer here until March. .
If it turns out that the vaccines prevent infection and transmission almost as well as they prevent symptomatic diseases, we can see that some countries are opening their borders to tourists who provide evidence of vaccination, in an effort to help the tourism sector and the wider economy to get going. .
‘If we do find out that it’s 95 percent of the infections, I would say yes, if you and all your friends are vaccinated, you plan to holiday in Fiji, go wild, spend your tourist dollars to help the economies of places who still can not afford the vaccine! Murray said. “But if it turns out that no … then it’s really inappropriate to go somewhere where they can not afford the vaccine and still spread diseases.”
In that scenario, we might have to wait until 2022 or later to travel to some countries again.
Remember for now that the best way to ensure that we can all return to normal faster is to keep up with the measures we know to limit the spread of the virus, such as masking and social distance. Yes, we are all sick of them. But the more we stick to it for the next few months, the sooner we can abandon them forever.
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