Reality Check: Herd Immunity

Good morning, and happy “Bike to Work” week! (Many of us can do that on a stationary bike this year…) 

On Friday we looked at the world through rose-coloured glasses, focusing on some “Little Rays of Sunshine.” And I will continue to cover positive developments in the days ahead – but not today.

As more and more CdnPSE institutions come to terms with a predominantly online Winter 2021 term, I think it’s important that you have a clear-eyed view of what the rest of 2021 will look like. Join me today and tomorrow as I lay out the argument…

COVID on Campus

1,700 Locked Down in Manchester

A total of 1,700 students in 2 residence halls at England’s Manchester Metropolitan U have been told to self-isolate after 127 students tested positive. The Guardian

34 New CdnPSE Cases

Although the vast majority of COVID19 cases impacting CdnPSE faculty, staff and students are not being reported in the media at all, the few that DO make it onto my radar seem to be increasing…

Centennial College – 1 student (class also in isolation)

McGill U – 6 on campus (but 25+ in adjacent neighbourhoods)  

Mohawk College – 1 at Stoney Creek campus (their first)

Queen’s U – 4 Friday (10 since Sep 7) 

Western U – 10 Friday, 4 Saturday, 8 Sunday (~71 this month)

“It’s important for them to at least take responsibility for the things that are going on in their student body, whether or not they’re technically on campus, because I think that distinction is pretty useless.” – Jacob Rothery, Politics Student, McGill U

Winter 2021 Plans

In the past 3 days there has been a surge in new CdnPSE announcements about the Winter 2021 term…

uAlberta will offer a mix of in-person and remote instruction, “subject to evolving public health guidelines.” Details in mid-Nov.  uAlberta

Algoma U says it will resume “some” F2F teaching in January, but some classes will remain online. Algoma’s campuses face differing conditions in Sault Ste Marie, Timmins and Brampton, ON.  Sault Star

uCalgary will use “a blend of face-to-face and online modalities” in the Winter 2021 term.  LiveWire Calgary

uGuelph will continue to offer most courses through remote/alternative delivery. uGuelph

Humber College programs will continue to be “either fully online or have a mix of online learning and limited in-person components” for the Winter term. Details by Oct 31.  Humber

And while it’s not exactly Winter plans, it moves in the same direction…

Providence UC (Manitoba) announced on Friday it is encouraging all employees and students who commute from Winnipeg to work or study from home, effective today, for a minimum of 4 weeks. “The campus is closed only to commuters from the code orange regions identified by Manitoba Public Health.”  Providence

“This COVID19 pandemic is not here for three months, or six months where we are now, or even 12 months. It’s probably something we have to live with for some time to come.” – Donna Rogers, VP Academic & Research, Algoma U

The Second Wave is Here

The Northern Hemisphere

With new COVID19 infections surging higher than any time since May, several jurisdictions in the northern hemisphere are clearly entering their second wave of the pandemic (see Ontario graph as an example). The infection rate in England has hit 1 in 500, with the R number up for the third week in a row. The Netherlands is recording its highest new case counts since the start of the pandemic, while Spain is considering reimposing a lockdown on Madrid. New York state reported 1,005 new cases on Saturday alone. 

Canada

In Canada, Ontario reported 491 new cases on Sunday, as the province rolled out COVID19 testing in up to 60 select pharmacies, imposed a curfew on alcohol sales, and ordered strip clubs closed. Quebec reported 700 new cases Saturday and 896 on Sunday. The province has launched a hard-hitting COVID ad campaign to “put a human face” on the pandemic, and the health minister is insisting that Quebecers avoid social gatherings for the next 28 days. Even the Yukon has detected its first case in almost 2 months. 

Aerosol Transmission

Since Jul 7, I’ve been sharing examples of the growing evidence that COVID19 is not just transmitted via “respiratory droplets” (which have a 6-foot range in most circumstances) but that it can sometimes be “aerosolized,” floating in the air for hours and travelling considerably further. The World Health Organization changed its language to acknowledge that aerosol transmission “cannot be ruled out.” Like mask mandates, this topic has become hotly politicized in the US in recent weeks…

CDC Contradicts Itself

On Friday Sep 18, the US CDC revised its website to indicate that COVID19 could be airborne and spread beyond 6 feet in certain settings (such as in choir practice, buses, restaurants, or fitness classes), and recommended improved ventilation and the use of air purifiers. CNN brought the change to international awareness (and likely also to the attention of the Trump administration) two days later. The change would have major implications for public policy, school reopenings, indoor dining and more. The very next day, Monday Sep 21, the CDC retracted that guidance and revised the website yet again, to remove all reference to aerosol transmission, except to say that it was “under review.” A deputy director of the CDC insisted that the Friday update was “an early draft of a revision” posted in error. Washington Post

(I hope I’m not starting to sound like a conspiracy theorist. There seems to be plenty of evidence that the Trump administration has been interfering with CDC announcements, and contradicting the CDC director on masks and vaccine timelines.)

“Evidence [for aerosol transmission] has been accumulating for some time. Those of us who have been studying this were frustrated that the change was slow, but it finally came.” - Jose-Luis Jimenez, Chemistry Prof, uColorado Boulder

“Wait, WHAT? …It wasn’t error – it is politics at the agency, again. How can anyone trust this #publichealth agency after repeated missteps?” - Beth S. Linas, Epidemiologist, on Twitter

Either Way, It’s in the Air

The distinction between respiratory droplets and aerosols is a false dichotomy: “we’re always exhaling, in fact, a gas cloud that contains within it a continuum spectrum of droplet sizes.” The problem is that “airborne” means “something very specific, very resource-intensive, and very scary for hospitals and the people who work in them.” Airborne diseases require negative-pressure hospital rooms and high-filtration respirator masks. COVID19 is certainly not as contagious as measles, and most cases can be traced to droplet transmission – but not all. Whatever we call these small, floating droplets in the air, they are a potential vector for transmission of COVID19, and ventilation a crucial defense.  Vox

“Let’s not worry about whether you call it aerosol or whether you call it a droplet. It is in the air and you inhale it. It’s coming from our nose, from our mouth. It’s lingering in the air and others can inhale it.” – Lidia Morawska, Director of International Laboratory for Air Quality and Health, Queensland U of Technology

Extroverts will Kill us All

I’m exaggerating for effect, obviously… but prime settings for superspreader events bring people together indoors, in crowds, with poor ventilation, where they shout to be heard over background chatter or loud music, and remove their masks to eat or drink. (In many ways, PHOs should shut down karaoke bars, nightclubs, church choirs and pretty much every bar I can think of.) On-campus or off, openly or surreptitiously, undergraduates have an insatiable drive to socialize, and will be vectors of transmission across campus and across town…

Calm Before the Storm?

Although officials in London (Ontario) are relieved that there wasn’t another “fake homecoming” at Western this weekend, there were street parties near Laurier in Waterloo, in Sarnia, and at a car rally in Wasaga Beach. There is an inherent hypocrisy in ordering students to stop partying, while allowing pubs and clubs to continue operating, and students have called it out. Students also suspect that their peers will be back out partying once the initial shock of infections wears off. 

In virtually every jurisdiction worldwide, politicians and campus leaders are blaming students for indiscriminate partying and clubbing, but not everywhere…

The Right to Party in Florida

Florida governor Ron DeSantis announced on Thursday that he will seek a “bill of rights” for college students, to prevent their “draconian” expulsion for attending a party. He has also questioned the need for masks, and plans to block local governments from closing restaurants. “We can’t have these businesses dying.” Critics say DeSantis is pursuing “herd immunity policies.”  US News

“Maybe for a weekend or two they’ll stay in. They’ll take it slow, they’ll take it chill. But eventually they’ll get over it and they’ll wanna go out and party… and cases will go back up.” – Nicole Pickle, Student, Western U

“I understand that universities are trying to do the right thing, but I personally think it’s dramatically draconian that a student could get potentially expelled for going to a party. That’s what college kids do.” – Ron DeSantis, Governor, Florida

Immunity or Eradication?

COVID19 is spreading through human populations like wildfire, and only a complete lockdown, depriving the virus of oxygen entirely, will extinguish it. Instead, politicians imposed various partial measures, backed down to business lobby groups too early, lifted restrictions in response to public quarantine fatigue, leaving us exposed to a second wave…

<10% have been Exposed

A Stanford U study, recently published in The Lancet, analyzed blood samples from 28,500 US dialysis patients for COVID19 antibodies, and concluded (reweighting their sample to match the general public) that about 9.2% of Americans potentially had protection from repeat infection as of July. Published case counts (7 million US cases) likely underestimate actual infections, which could be 10x higher. Pursuing herd immunity in the US, as Senator Rand Paul has encouraged, would require at least 40% of the population to be infected (or at least 131 million – which would likely mean 3.8M American deaths). There is still insufficient scientific data to know how much protection the body’s immune response can provide to repeat COVID19 infection.  Newsweek

COVID19 Immunity likely Transient

The science is still evolving, since the disease is still new, but studies of analogous coronaviruses suggest that COVID19 immunity may last somewhere between 3-12 months – which would mean that annual vaccinations will be required (and would make “herd immunity” nearly impossible).  Salon

“I think right now the data really supports and is strongly pointing to, but not proving, to the possibility that protection is likely not to be lifelong.” - Charles Chiu, Professor of Infectious Diseases, UC San Francisco

Suppression is the Better Strategy

A new study out of uGeorgia, modelling the impact on the UK, concludes that “achieving herd immunity without overwhelming hospital capacity leaves little room for error,” and that “such fine-tuning of social distancing renders this strategy impractical.” Without any interventions, 77% of the UK population would be infected, causing about 410,000 fatalities. School closures and social distancing measures would reduce but not suppress the epidemic, and “premature reopening of schools after 100 days (while the virus is still circulating) triggers a second wave…. largely eroding any additional gains.” Moreover, “if immunity is not perfect, and there is a moderate to high chance of reinfection, then prospects for achieving herd immunity via natural infection are slim.” Only a suppression approach is plausible, halting local transmission by imposing a lockdown for several months (such as appears to have been done in China and South Korea).  PNAS

A Global Challenge

Even if a country manages to eliminate all cases of COVID19 within its borders, much like the fight against climate change, the pandemic knows no borders. As soon as citizens are allowed to return from abroad, or international tourists or students allowed to enter, or even shipments of refrigerated freight arrive, the pandemic can reignite… 

Securing 300M Doses for Canada

As of Friday, Canada has secured access to 6 leading vaccine candidates, from Sanofi, GlaxoSmithKline, Johnson & Johnson, Novavax, Pfizer, Moderna, and AstraZeneca, for a total of ~300M doses. (The contracts are contingent on the vaccines passing clinical trials and obtaining regulatory approval.) Canada is also contributing $440M to COVAX, a global procurement initiative backed by 190 countries “to ensure fair, equitable, and timely access to vaccines for less wealthy countries.” (The US is notable by its absence, of course.) As PM Trudeau said, “This pandemic can’t be solved by any one country alone because to eliminate the virus anywhere, we need to eliminate it everywhere.”  CBC

Poorer Nations Left Behind

Wealthy nations representing 13% of the world’s population have already secured 51% of the promised doses of 5 leading COVID19 vaccine candidates. Moderna has sold options for its entire production capacity to rich nations, and says it intends to make a profit from the vaccine. (It can produce only 475M doses, or 6% of the planet’s population.) Even if all 5 vaccines are successful, 61% of the world’s population will wait until at least 2022 to get a vaccine. More likely, they will wait much longer. “We need a People’s Vaccine, not a profit vaccine.” Oxfam

“The calculations expose a broken system that protects the monopolies and profits of pharmaceutical corporations and favours wealthy nations, while artificially restricting production and leaving most of the world’s population waiting longer than necessary for a vaccine.” - Oxfam

Tomorrow, we turn to the timeline for vaccination and the eventual end of the pandemic, based on the latest estimates. Meantime, stay safe and be well!

Ken

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Ken Steele is Canada's leading higher ed futurist and strategic consultant, through his company Eduvation. He delivers virtual presentations and facilitates virtual retreats or workshops centred on emerging trends, enrolment management, pedagogical innovation, and strategic planning. 

Ken has developed 9 new topics specifically to help institutions cope with the post-COVID19 “new normal.”

For more information, please reach out to [email protected]