Thread by @DrEricDing

Sobering—“It is already clear that the virus is changing too quickly, new variants are spreading too easily & vaccination is proceeding too slowly for herd immunity to be within reach anytime soon.”

➡️ Vaccine hesitancy hurts public health.🧵 #COVID19
nytimes.com/2021/05/03/hea…

2) I don’t like this— “daily vaccination rates are slipping, and there is widespread consensus among scientists and public health experts that the herd immunity threshold is not attainable — at least not in the foreseeable future, and perhaps not ever.”

3) “rather than making a long-promised exit, the virus will most likely become a manageable threat that will continue to circulate in US for years to come, still causing hospitalizations and deaths but in much smaller numbers.”

➡️I don’t like waving this surrender flag.

4) “Continued immunizations, especially for people at highest risk because of age, exposure or health status, will be crucial to limiting the severity of outbreaks, if not their frequency, experts believe.

5) “The virus is unlikely to go away,” said Rustom Antia, an evolutionary biologist at Emory University in Atlanta. “But we want to do all we can to check that it’s likely to become a mild infection.”

➡️No, I think we can do better with #ZeroCovid approach.

6) “The shift in outlook presents a new challenge for public health authorities. The drive for herd immunity — by the summer, some experts once thought possible — captured the imagination of large segments of the public.”

➡️putting all eggs into vaccine basket inadequate.

7) “To say the goal will not be attained adds another “why bother” to the list of reasons that vaccine skeptics use to avoid being inoculated.”

➡️ INDEED—this is why this “vaccine savior” singular push is tricky to communicate. We need both vaccines & #ZeroCovid approach.

8) “People were getting confused and thinking you’re never going to get the infections down until you reach this mystical level of herd immunity, whatever that number is,” Fauci said.
“That’s why we stopped using herd immunity in the classic sense,” he added.

9) Fauci: “I’m saying: Forget that for a second. You vaccinate enough people, the infections are going to go down.”

➡️ My take: This is true, but “down” for some (India and Brazil) is not adequately down for others. “Down” is too subjective. And allows authoritarians to dismiss.

10) HERD IS A MOVING TARGET: “Early on, the target herd immunity threshold was estimated to be about 60 to 70 percent of the population. Most experts, including Dr. Fauci, expected that the United States would be able to reach it once vaccines were available.

11) “But as vaccines were developed and distribution ramped up through the winter and into the spring, estimates of the threshold began to rise. That is because the initial calculations were based on the contagiousness of the original version of the virus…

12) “The predominant variant now circulating in the United States, called B.1.1.7 and first identified in Britain, is about 60 percent more transmissible.
As a result, experts now calculate the herd immunity threshold to be at least 80 percent…”

MY TAKE: likely 80-90% for #P1.

13) “If even more contagious variants develop, or if scientists find that immunized people can still transmit the virus, the calculation will have to be revised upward again.”

My take➡️ we need to get serious that we need both vaccines and a #ZeroCovid mitigation approach.

14) At this point, all creative approaches to get people to vaccinate are on the table… even comedy…

https://twitter.com/drericding/status/1389218431606657030

15) “How insulated a particular region is from the coronavirus depends on a dizzying array of factors.
Herd immunity can fluctuate with “population crowding, human behavior, sanitation and all sorts of other things,” said Dr. David M. Morens, a senior adviser to Dr. Fauci.

16) “The herd immunity for a wealthy neighborhood might be X, then you go into a crowded neighborhood one block away and it’s 10X.”
Given the degree of movement, a small wave in a region with a low vaccination level can easily spill over into where a majority of is protected.

17) “At the same time, the connectivity between countries, particularly as travel restrictions ease, emphasizes the urgency of protecting not just Americans but everyone in the world, said Natalie E. Dean. Any variants that arise in the world will eventually reach the US.” ⚠️

18) Let me repeat: •Any variants that arise in the world will eventually reach the United States”!

➡️So damnit, those living in cushy bubbles in Manhattan who think we don’t have to worry about 🇧🇷#P1 or 🇮🇳 #B1617 variants coming to the US (you know who you are!)—wake up!

19) The only one thing that annoys me as much as anti-mask/anti-vax people are those who are “don’t worry about variants / vaccines will solve it soon” folks who dismiss the seriousness of variants & and foolishly think #COVID19 is over in US. It’s not!

nytimes.com/2021/05/03/hea…

20) Also, #P1 is rising across many parts of the US, hence we need to vaccinate more than ever.

https://twitter.com/drericding/status/1388273359348174856

21) Unvaccinated people need to stop thinking they are invulnerable.

https://twitter.com/drericding/status/1390398765186666503