Covid Epi Weekly: A Week of Great Progress for Vaccines…But Also, Unfortunately, for the Virus

With the first doses delivered this morning, the first step on the road to immunity through vaccination has been taken. At the same time, we’ve seen a deeply discouraging lack of action to stop the pandemic. The coming weeks will be devastating, but I fear that numbness to suffering is spreading as rapidly as the virus.

First the good news. The FDA has provided good transparency about vaccines and the data is about as good as could be. The vaccines are highly effective, including for older people (though few frail elderly were included in the studies), and against severe infection. We haven’t seen any serious adverse events, but we need to track for this when millions are vaccinated.

The road ahead for vaccination will be bumpy. Production, supply, distribution, uptake, and possible adverse events—all present potentially huge challenges. New vaccines from other companies will likely be approved in the New Year. The vaccination campaign will be an enormous challenge, but if the communication is done well, it can succeed.

Unfortunately, we’re not there yet. It will be months before most people can get vaccinated. We must double down on protection protocols. The post-Thanksgiving surge is driving rates up, and December holidays could bring new horrors at the start of 2021. I fear we are numbing to the numbers.

Cases continue to increase, hospitalizations are at highest rate ever, and deaths are continuing to hit new highs. It’s horrifying to see a 13% test positivity rate nationally, with 40 states reporting positivity rates greater than 8%. Although cases in the Midwest are coming down, they’re still very high, and cases are increasing almost everywhere else.

It gets worse. Covid has exposed horrific disparities. In Rhode Island, more than 1 in 8 Hispanic/Latinx people has tested positive, which is nearly 4x the rate among white people (1 in 31). In the Dakotas, 1 in 8 Black people has tested positive. In South Dakota, 1 in 7 Native Americans has tested positive.

Global disparities will worsen in 2021. Countries in Africa have fragile health systems that can be quickly overwhelmed by Covid. As vaccination rolls out in richer countries in 2021, will healthy people in the US get vaccinated before health care workers and nursing home residents in Africa? That would be indefensible. There are just a few million health care workers in Africa. They should be at the front of the global line — there’s already a terrible shortage of health care workers on the continent.

As 2020 draws to a close, the next few months will determine our future. These are some of my takeaways from a year of horrors:

• We must remember that public health is fundamental to society
• Science is as vulnerable to politics as humans are to viruses
• We will look back and ask why we didn’t do more.
• We can control our health, but only if we work together. (Look at the enormous difference cooperation makes — see the two graphs below.)

We just released materials to promote safer holiday celebrations. By being careful now, we’ll have more to celebrate and less to regret in the new year. Being in a bubble or pod is an important concept, but each bubble is only as strong as its weakest part.

As German Chancellor Angela Merkel said, patience, discipline, and solidarity are key. These three characteristics are essential for a successful response. We are inextricably connected. Empathy gives us the sense of others’ suffering, joys, and losses. 

“The death of human empathy is one of the earliest and most telling signs of a culture about to fall into barbarism.”   — Hannah Arendt