[Retric]

Vaccination is likely an option for long term COVID-19 herd immunity. The mutation rate is shockingly low, so a nationwide focus on containment was the best option early on. It’s still possible without wrecking the economy.

The US seems to be using the worst off all possible options. However, several countries have succeeded and demonstrate it’s possible to succeed.

[ArkVark]

Assuming we capture about 10% of COVID instances as actual cases, then the US is getting 770,000 new instances a day.

Stockholm burnt itself out with 20% of the population getting immunity (determined via antibody testing).

So (328,000,000 - 37,000,000) / 770,000 = 378 days until herd immunity, considering the existing cases.

What is more likely is that the case numbers will ramp up significantly though, to over 100,000 per day at some point. In that case the USA will have herd immunity within the year.

This is nothing new. Influenza hits about 20% of the population (60 million people) as well and then burns out for the season. We struggle yearly with keeping influenza out of nursing homes and with the surge of hospitalization that it creates.

The good news is that right now there are no excess deaths in the USA and that hospitals all over the country are handling the virus and not running out of space (more beds can be always be converted to ICU, ICU capacity is not infexible, same as is done for influenza).

[bonzini]

There are already hospitals in Texas and I think Florida that are rejecting patients because they are full, that's when fatality rate and excess mortality kicks in. What kills you isn't suboptimal care, it's the impossibility of getting any treatment.

[Retric]

Capturing 10% of cases would put the US CFR of ~0.4% which is completely unsupported. Increasing that to even 30% so a 1.2% CFR and your talking 3.1 years which is well past estimates for an effective vaccine.

PS: Influenza vaccines are common with 68% of people over 65 getting vaccinated in the US. Further at least half of all cases are asymptotic which ends up contributing significantly to herd immunity.

[zaroth]

20% of 328 million is 65.6 million. Divided by 770k is ~85 days.

It’s probably better to think of immunity as regional and also not binary (herd vs not herd).

States like MA and NY have a significant benefit from their population immunity levels, versus FL and TX less so. That is to say they have to do less (if not nothing) to keep their R0 below 1 and whatever cases do show up are less likely to spread widely.

Immunity benefits are cumulative to any policy measures put in place. You can try to slow down the rate (flatten the curve) which might not change the ultimate case count in the end, but can lower deaths through greater availability of care. At some point immunity and mitigation measures combined will get you below R0 of 1.

If you’re an island nation with enough testing for effective contact tracing and constant vigilance and willing to lockdown repeatedly, then the other option is trying to actually prevent any spread even without any immunity, but you have to be able to continue this process indefinitely until a vaccine is widely available.

[maxerickson]

~150 million US people get the influenza vaccine each year!

You seem to be playing match the numbers up where they fit and celebrate.

[ModernMech]

> hospitals all over the country are handling the virus and not running out of space

If true, what do you make of the following reports?

7/16 - "Manatee County's hospitals hit capacity as COVID-19 cases continue to surge" https://www.msn.com/en-us/health/medical/manatee-countys-hos...

7/16 - "ICU fills up at St. Luke's Nampa hospital, meaning patients must be diverted to Boise" https://www.msn.com/en-us/health/medical/icu-fills-up-at-st-...

7/6 - "Four Tampa-area hospitals at maximum ICU capacity" https://www.msn.com/en-us/news/us/four-tampa-area-hospitals-...

7/6 - "Hospitals in Florida, Texas and Arizona Are Almost at Capacity as Coronavirus Cases Surge" https://time.com/5863564/hospitals-capacity-coronavirus-surg...

[T-hawk]

I would make of it that these are outliers cherrypicked for the scare value in the headlines. The vast majority of hospitals everywhere are doing fine.

In New York, the hospitals are so far under capacity that they're running TV ads begging people to start coming back in for elective procedures.

[ModernMech]

Cases are surging in Florida and Texas, not New York. New York's wave is past. When New York's wave was at its peak, hospitals and doctors there were absolutely maxed out. There were first hand reports from doctors and nurses on the front line who said as much. If they had not undergone a complete lock down things would have been much worse.

Now we see new waves popping up elsewhere and surprise, their hospitals are filling. Hospitals are having a great time in places where they took the virus seriously. New York did not take it seriously at first and they suffered. Now Texas and Florida are not taking it seriously and they are suffering as well. And you're suggesting that we can just let the virus run rampant and we won't see our healthcare system buckle?

[saint_abroad]

> In New York, the hospitals are so far under capacity

Do you think 20% exposure (at a cost of 17.5k lives) buys you herd immunity?

Even in hotspots like New York City that have been hit hardest by the pandemic, initial studies suggest that perhaps 15-21%6,7 of people have been exposed so far. In getting to that level of exposure, more than 17,500 of the 8.4 million people in New York City (about 1 in every 500 New Yorkers) have died [...] To reach herd immunity for COVID-19, likely 70% or more of the population would need to be immune. https://coronavirus.jhu.edu/from-our-experts/early-herd-immu...

[rhino369]

That 70% is an early estimate of heard immunity while doing nothing differently than pre-covid.

The hope is that its more like 20% gets you herd immunity while practicing moderate social distancing. It's not too unreasonable. Japan has been able to avoid lockdowns and mass testing by mostly just using masks and avoiding very close conversations.

[toast0]

> The vast majority of hospitals everywhere are doing fine.

That's great if you need something done at a hospital that is not super time sensitive; it's not great if you're in the area where hospitals are overful and you have an urgent need.

Epidemic response needs to be done at a regional level in response to what's going on in that region, taking note of what's happening nearby as it might spill over, and learning from other areas within the country and worldwide to try to figure out what works best. It's totally reasonable, if the numbers support it, for some regions to be increasing restrictions and others to be decreasing restrictions. Clear communication from all levels of response would certainly help.

[ArkVark]

I can find you the same articles pre-2020 with the cause being influenza.

[ModernMech]

That doesn’t prove that hospitals aren’t filling up because of Covid...

[saint_abroad]

> Vaccination is likely an option for long term COVID-19 herd immunity.

To achieve herd immunity for measles at least 90-95% of the population need to be vaccinated. A disease like polio is less contagious, and 80-85% of the population would need to be vaccinated for herd immunity to work. https://www.ovg.ox.ac.uk/news/herd-immunity-how-does-it-work

It suggests our immunity to SARS-CoV-2 does not last very long at all — as little as two months for some people. If this is the case, it means a potential vaccine might require regular boosters, and herd immunity might not be viable at all. https://www.medrxiv.org/content/10.1101/2020.07.09.20148429v...

Can't get 80% people to wear a mask, much less seasonal vaccinations.