29
Fri, Mar

The Miracle on 58th Street

LOS ANGELES

GELFAND’S WORLD--OK, so technically it was 58th and Vermont, but it was a real life miracle in its own way.

It involved waiting in line at a CVS store for a little longer than it took me to vote -- in this case about 45 minutes. Then a nice lady stuck a needle in my arm (after asking about allergies) and filled out the remainder of that little card you've heard about. In a week or so, I can feel much relieved over my reduced danger of suffering and dying from the Covid-19. 

In a way, it's a double miracle because the case totals have been falling enormously since the holiday peak, and seemingly on their own. All those scare tactics by the authorities seem to have worked. 

But today I'm celebrating the delivery of -- so far -- 125 million doses of vaccine into Americans. I realize that the current cliche is to talk about getting shots into arms, and I have the sore arm to illustrate that truism, but what's important is that more than 81 million of us have had the first dose, however they give it -- and that first dose probably confers pretty good resistance on a substantial number of us. The second dose does the final job for all but maybe one out of twenty people. 

I suppose we could pun about the final jab doing the final job, but "jab" is an English-ism that contrasts with our use of the word "shot," so let's just celebrate without inciting the grammar police. 

Why am I talking about miracles when what we are referring to is, after all, a fairly straightforward extension of already-current technologies? This is mostly true with the exception that there are obviously some new twists in the use of technology and -- crucially -- how it is being applied. You could read about mRNA in the first edition (1960s) of James Watson's The Molecular Biology of the Gene, but understanding of the immune system at the molecular level was still in the future when that book was written. 

Long known principles of molecular biology, a fairly new way of getting mRNA into the body without it immediately being chewed up by the body's defenses and -- presto -- you've got the hoped for end to the pandemic. 

It is remarkable how quickly it was accomplished. You can read Paul Offit's book Vaccinated to get an understanding of how long it traditionally takes to get a vaccine from the germ of an idea into production. There were attempts at developing vaccines against polio that failed before Salk's hard-won success, and developing vaccines for diseases such as rubella and mumps generally took multiple years. The fact that we have a couple or three vaccines that really seem to be working is remarkable and actually a bit lucky. The current mRNA technology goes back to earlier attempts based around a different epidemic. Luck and a lot of hard work were on our side this time. That and the worldwide determination to get a foot up on what otherwise might be another version of the 1918 flu. 

We have a right to hope. The big story right now is what studies from the vaccinated population in Israel are telling us. Until very recently, we didn't know whether the vaccine would prevent the spread of the disease from symptom-free carriers to other people. The statistics now suggest that the answer is Yes. It's not certain to the fifth decimal, but the numbers are encouraging. 

And with that information, we have every reason to ask everybody -- absolutely everybody -- to get the shots in the hope that we will make America Covid-free. 

So here we are, just a few dozen weeks away from that coveted relief from the danger. 

It seems like forever 

I think that when word of the epidemic first started to catch our attention right around February of last year, we tended to put it out of mind and then -- when a few governments started to attach restrictions to our lives -- most of us probably thought that we would have to put up with the problem for a whole month -- maybe two. Some of us pessimists thought this thing might go on for 4 or even 6 months. 

I don't think anybody actually thought it would kill half a million of us before the new year, but there it is. 

And then there was that strategy of flattening the curve. it referred to the fact that left unchecked, the epidemic would run wild, killing perhaps one in every 100 or 200 patients as it spread. And it was going too fast to control at first -- by the spring of 2020, the number of confirmed cases was doubling in less than a week. If this had not been slowed down, the disease would have visited potentially every living American long before now. 

So we were told to hunker down, stay out of crowds, try not to cough on other people, and when masks were becoming generally available, to wear one. Somebody figured out that if you weren't going to buy a mask from a surgical supply house, you could make one out of a piece of cloth. It actually became something of a cottage industry for a while. 

But the purpose was to slow down the spread of the virus in the hope that modern medicine, the pharmaceutical companies -- pretty much anybody who could find the cure or the prevention -- would succeed. 

Like I said, there was a bit of luck involved, but large scale testing showed that two vaccines worked just fine, in fact better than had been hoped. They were pushed out for a few weeks, and then the system stalled. It turns out that the tactic of shipping cases of vaccines out to the states worked only so-so, because the locals had neither the money nor the skilled staff to get everything going to the level we needed. 

It took big government and lots of money, as Josh Kovensky explains in an article from Talking Points Memo.  It's the magnitude of the national effort described by Kovensky that allows me to celebrate my anticipated status of "fully vaccinated" and to further anticipate that the majority of the American people will join me in that happy state. 

Addendum: An aside on the statistics 

You can follow the vaccination numbers both nationally and state by state in the website created by NBC News. The numbers I included above come from that site. There is a number for the total number of shots given and another number for the number of people who are considered fully vaccinated. For the most part (ignoring the relatively small number of people who got the one-shot vaccine), "fully vaccinated" means getting two shots of the same Moderna or Pfizer vaccine. 

The confusing part is in separating out the statistics for the population with at least one dose. It's a useful number in its own way, because we can figure that more than 80 million Americans have at least some immunity. The problem with that number is that it presumably includes both people with only one dose and people who are fully vaccinated. So don't worry about trying to do the math and subtracting A from B to see if it gives you C. 

Here's how I think about it: As the country gets vaccinated, an increasing number of us will have had both shots. Those people are no longer waiting in line, and the authorities don't have to worry about supplying them a dose. We should expect the number of fully vaccinated to increase every month, rising from the current 44 million up to 100 million, then 200 million, and so on towards perhaps 250 million or more. 

The number of people with only one dose will be about the same at any time and will depend only on the number of shots this country can give on a daily basis. Right now we are at about 2.5 million per day (on a good day) so the number of people getting that first dose might be half that number. Figure that in any month for the next five or six months, there will be something like 30 or 40 million people waiting for the second dose. That number should stay fairly level unless this country radically increases the rate of injections (say to 3.5 million per day) or until we run out of people to vaccinate. 

Figure that when there have been 600 million doses injected into American arms, we will be where we want to be. Either the vaccine will be working the way we want it to be, in which case we can all go back to Dodger Stadium to watch a game instead of getting stuck with a needle. (If it doesn't work the way we are hoping, we will have to think of something else.) Of course if some new mutant strain starts to go around, we will all probably have to go back for a third shot tailored to get that variety. 

So figure that we can inject another 475 million doses in 180 days, which is right on at 6 months. While this is happening, we should expect that the number of new cases slowly declines as the fraction of the population who are fully vaccinated rises towards completion.

 

(Bob Gelfand writes on science, culture, and politics for CityWatch. He can be reached at [email protected])

-cw

Get The News In Your Email Inbox Mondays & Thursdays