Now that vaccines are coming, people start to dream.
They say things like, “As soon as everyone in my family is vaccinated, we will have a big trip to Asia!” or “As soon as my five closest friends and I have the photo, I will spend a weekend in a cabin with them. Without masks, without social distance. “
While many of us are thinking about the Covid-19 pandemic in binary terms – there is “life before I get the injection” and “life after I get the injection” – experts are warning us to think more gradually. Not everything will change the second the syringe enters your arm.
“Realistically, it’s definitely not going to be a normal on / off button,” 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 think of it in three stages. Stage 1 is what you can safely do after you and your close friends or family are vaccinated. Stage 2 is what you can safely do when your city or state reaches herd immunity, where enough people are protected from infection so that the virus cannot easily trigger new outbreaks. Stage 3 is what you can do when collective immunity is achieved internationally. (Note that there is a good chance that we will not reach that last stage in 2021.)
Much will depend on the answer to a crucial open question: are vaccines good only at preventing symptomatic diseases or also at preventing infections and transmission?
“One can imagine a scenario in which you are vaccinated and develop a protective immune response. You won’t be sick, you won’t die, but the virus can still grow in your nose and spread to others, ”said Barry Bloom, professor of immunology and infectious diseases at Harvard.
Bloom and other experts are optimistic that vaccines help reduce infection and transmission, but no one knows how far. “We just need more data about the transmission,” he said. “Hopefully it will come out of testing in a few months.”
In the meantime, even vaccinated people must assume that they can still be infected and transmit the virus. This means that they need to continue wearing masks and distance themselves socially whenever they are around unvaccinated people.
But as more and more people are vaccinated, the question arises: and when are you among the people who have been vaccinated? This takes us to stage 1.
Step 1: you and your close friends or family are vaccinated
Let’s say you and your five closest friends have been vaccinated. Can you rent a cabin in the woods and spend a weekend together, without masks or social distance?
The answer is: there will probably be no problem – with a few caveats.
For one, vaccines don’t work instantly. “You need to wait at least two weeks after the first injection to see any protection, but in fact you need to wait at least a week after the second injection,” said Angela Rasmussen, a virologist affiliated with Georgetown University.
Then there is the fact that the vaccine may not work equally well for everyone. Some people may have health problems that prevent their bodies from developing such a successful immune response. “The fact is, I’m not absolutely sure that everyone who gets the vaccine develops a protective response,” said Bloom.
The Pfizer / BioNTech and Moderna vaccines showed 95 percent effectiveness in preventing symptomatic diseases in tests after two doses. But they are not 100 percent. There is still a chance that you will catch the virus from one of your vaccinated friends and develop symptoms. Although vaccines are very good at preventing the severe symptoms that lead people to the hospital, experts cannot rule out the possibility that you may develop milder symptoms, which can become chronic or long-lasting.
Therefore, the weekend getaway will not be entirely safe. But, Rasmussen said, “if your entire group of friends received the full vaccine regimen and at least a week has passed since the second injection, it’s probably okay for you to meet with them in a closed environment, where you” don’t is interacting with the audience. So maybe a vacation where you all have an Airbnb and go out – but without going to the bars! – would be fine. “
Murray agreed that the risk would be relatively low, as long as you and your friends don’t have underlying diseases and don’t live with vulnerable, unvaccinated people you want to protect from infection. “But when you get back and go to the supermarket,” she said, “I would hope you were still wearing masks.”
That’s because there is a big difference between being in a closed bubble, where you know everyone is vaccinated, and being in the public domain, where you risk infecting unvaccinated people.
Asked if she would make the weekend trip to the cabin, Murray said, “I would probably be comfortable,” but that’s because she doesn’t live close to anyone unvaccinated. parents or grandparents that she needs to keep safe, and because she expects to be in the last group of people to receive the vaccine – at that point the herd’s immunity will have increased, reducing the chances of any of her friends showing up in the cabin unintentionally infected.
Step 2: your city or state has achieved collective immunity
In public settings, Americans should continue masking and social detachment 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 this stage – which may occur in mid-autumn – the United States will achieve collective immunity. (This is only an estimate, however, and may change depending on Covid-19 variants, vaccine absorption rates, and other factors.)
Instead of achieving national immunity all at once, we are likely to see regions within the United States crossing the immunity limit at different times. As each city or state announces that it has crossed the threshold, it will likely begin to reverse the requirements gradually. We can see restaurants opening for indoor meals, but with waiters continuing to wear masks.
“I think masks are probably going to be one of the last things to be reversed,” said Murray, “because masks are not commercially costly for them. They are useful and do not necessarily cost the economy anything ”. Given that there are many trips between jurisdictions, the masks cannot be reversed until the entire country has achieved collective immunity.
Once the jurisdiction reaches immunity, people will be able to safely return to places like schools and cinemas. The idea is that if, say, 80 percent of people are vaccinated, it creates an “umbrella” of immunity, as Fauci said, that “would be able to protect even the vulnerable who have not been vaccinated, or those where the vaccine was not effective. ”
Rasmussen emphasized that if we want to feel not only 95 percent, but more than 99 percent safe in public spaces, we need as many people as possible to be vaccinated, because that is what prevents transmission to the community.
“You can have a lot of great vaccines, but they don’t completely eradicate these viruses unless they are widely used,” she said. “But people are still not thinking about vaccines as a population-level intervention. They are thinking of them as an individual intervention. It is an example of this pandemic ”.
From the beginning, health experts tried to make the public understand that when it comes to the coronavirus, no one is really safe until everyone is safe.
Stage 2, for this reason, is not the time for international travel to countries that have not yet achieved herd immunity or have little health infrastructure.
If a large region of your country exceeds the immunity limit, domestic travel – say, to see vaccinated relatives in some states – may be sufficient. But, for your safety and for the good of people abroad, it is better to avoid major international travel.
Step 3: herd immunity is achieved internationally
Let’s manage expectations right away. There is a good chance that we will not reach this stage until 2022 or later. This is because access to vaccines is far from being equal worldwide.
“What we are seeing is that the USA, Canada and Europe are having very good access to the vaccine, but if you expect to go to Mozambique or something, many of these other countries are not necessarily able to buy the vaccine and it will be much longer for those countries, ”said Murray.
That is why it is so important to have groups like the Covax Facility, a unique financing mechanism that has managed to get 190 countries (92 of which are low-income countries) to pool their resources to end the pandemic more quickly. The goal is to deliver 2 billion doses of vaccines by the end of this year to participating countries, regardless of their ability to pay.
How long it takes for several countries to achieve herd immunity will depend in part on how fast they can access vaccines and how much of their population is willing to get the vaccine. But, as mentioned above, there is another crucial factor.
“It will all come down to what we will learn in the coming months about how well the vaccine prevents infection and transmission,” said Murray, adding that he does not expect us to have an answer until March, at the very least. .
If it becomes clear that vaccines prevent infection and transmission almost as well as they prevent symptomatic diseases, we may see some countries opening their borders to tourists who provide vaccination vouchers in an effort to bring the tourism sector and the economy in general back. .
“If we find out that it prevents 95 percent of infections, then I would say yes, if you and all your friends are vaccinated, plan your vacation in Fiji, go crazy, spend your tourism money helping economies in places you haven’t yet you can buy the vaccine! ”Murray said. “But if it turns out not … then it would be really inappropriate to go somewhere where they can’t afford the vaccine and still spread the disease.”
In this scenario, we may have to wait until 2022 or later for travel to some countries to resume.
For now, remember that keeping up with the measures we know to contain the spread of the virus – such as masking and social detachment – is the best way to ensure that we can all get back to normal faster. Yes, we are all fed up with them. However, the more we get attached to them in the coming months, the sooner we can abandon them forever.
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