Whatever is the herd immunity level, it’s going to be substantially higher when you have a variant like B.1.1.7. —Michael Osterholm, PhD, MPH
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June 2021
The picture in the United States, he said, is vastly different from that in low- and middle-income countries, which he said are now his biggest area for concern. Ten countries—not coincidentally the wealthiest—have received about 80% of all the vaccine that’s available. And 30 countries have not seen a drop of vaccine, he said.
Spread of the variants in the 30 countries without vaccines is important on more than one level, he said. “It isn’t about just being humanitarian right now; it’s absolutely about what we’re going to do to prevent more variants from developing that will continue to threaten the security and integrity of our current vaccines,” Dr. Osterholm said.
From heart issues to mental health issues to “long COVID”—disabling symptoms six to eight weeks after initially mild cases—the effects of the virus can be devastating, he said.
Asked whether he sees the variants as an existential threat, Dr. Osterholm said, “My view of the world is limited in terms of where we’re going.” He said he’s optimistic that if the more severe variants don’t take hold, then the supply of vaccine won’t be an ongoing problem. The real problem is how many people actually get vaccinated and at what level the population will need to be vaccinated for true protection.
“If we in this country get only 65% to 70% vaccinated or protected through natural infection, we’re going to continue to see lots of transmission occur here, which will make it more difficult as a society to open back up and actually feel confident and comfortable,” he said.
But he said he puts B.1.1.7 in the “measles category” with regard to its ease of transmission and the high threshold needed for herd immunity. “Whatever is the herd immunity level, it’s going to be substantially higher when you have a variant like B.1.1.7,” he said.
Balancing Risks
Asked how to balance the risk of the virus with the risks of the response to the virus—in particular, the social isolation—Dr. Osterholm said the effects of the response could have been improved with better policy, comparing New Zealand to Minnesota, areas that have roughly the same population. New Zealand has been able to suppress the virus while keeping its economy largely open, he said. (Minnesota had about 7,000 deaths, as of the time of his talk.)
“Is their science that much better than ours? No,” he said. Instead, the difference has been in the way New Zealand was proactive in getting ahead of potential transmissions and in how the country isolated and quarantined those infected without shutting down the economy. Those quarantined were compensated for losses, inspiring willingness to comply with recommendations to limit virus transmission.
“We never really picked a point to say, ‘This is when we will or will not open up,’” he said. “Right now, everybody is opening up because it’s the only politically correct thing they can do without losing their jobs.”