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Well, by now you know to cough into your elbow, wash your hands, stay at a distance from infected people, and wear, or don’t wear a mask, … the things our mothers told us when there was flu epidemic going around your elementary school. The whole mask thing is perhaps part charade, part virtue signaling, part courtesy, and part efficacious, all in equal parts. Wear one, don’t wear one, do wear one, wear one all the time, wear one in restaurants except when eating or drinking, but maybe you should, and … when wearing one, don’t contract other diseases like E. coli from wearing a mask and rebreathing your own exhaust. And whatever you do, stand 6 feet apart, or 9.5 feet, or… half a mile away. Experts, according to the British Medical Journal, cannot seem to decide.
For the sake of science and Dear Leader Fauci, I will skip over the whole mask and 6 feet social distancing thing, though I did enjoy reading the CDC study which concluded that even with a mask and standing 6 feet away, one should avoid being around any particular person for more than 17 minutes at a time – or cumulative during a day (though do they define a day as when the sun is up, between midnight on one day and midnight on the next day, or a 24-hour window, … ?). And for the sake of clarity, that is “17” minutes, and not 18. Fortunately, Apple has updated its Apple Watch software in record time to include an automatic 17-minute timer. After several weeks of diddling and another 28 thousand COVID-related deaths (because each death must be prevented), the Apple software was approved by the expeditious FDA and is now being rushed to hospitals so medical staff will receive it first. Oooops. That 17-minute rule was later modified to 15 minutes – cumulative time per day. Apple will have to modify their software and get FDA approval all over again. In the meantime, keep your distance, mark down the time you are with others, and keep a running tally. Tick, tick, tick. Gotta go.
Anyway, let’s get serious: COVID. It’s a killer, it spreads on the ethereal breeze (or wheeze) of others wafted along by the dulcimer wings of zephyrs or HVAC systems. My mother always told me to speak softly and to take a bath, and now I know why. You don’t want your exhales and contrails to be polluting the nasal passages of those around you. Things could be attached to them. Likewise for your breath. So don’t forget to brush your teeth (or only brush the ones you want to keep). Mom seemed to understand that good manners and body sanitation are important – especially for teenage boys.
OK, enough of this common sense, Mom-knows-best stuff. The question that we all must ask is this: How many Americans have actually been infected with COVID-19? Just like the annual flu, no one knows. But for the sake of “science”, let’s take a look at the science. A study organized by two doctors (one medical, the other a Ph.D. in Nephrology) at Stanford University and published in Lancet on October 24, indicates that maybe 30 million Americans were infected with Covid by the end of July. This was a very good study using thousands of samples taken from 1,300 US dialysis centers. The sample data was then adjusted to make it more representative of the US population at large (sex, age, race, ethnicity). Here is the conclusion:
“Seroprevalence of SARS-CoV-2 was 8.0% (95% CI 7.7–8.4) in the sample, 8.3% (8.0–8.6) when standardised to the US dialysis population, and 9.3% (8·8–9·9) when standardised to the US adult population. When standardised to the US dialysis population, seroprevalence ranged from 3·5% (3.1–3.9) in the west to 27.2% (25.9–28.5) in the northeast.”
So what does this mean? “9.3%” of the adjusted sample showed seroprevalence or Covid antibodies with a range of 8.8 to 9.9 percent at the 95% confidence interval (95% confidence is very good).
Now if one takes the results of the study and pairs it with the cumulative 3 million confirmed cases of COVID in the US in July, then we can see that there is a ratio of around 10:1 between infections and confirmed cases (9.3% times 330 million people equals ~30 million people divided by around 3 million cumulative confirmed cases). Studies like these are constantly ‘peer-reviewed’ and this one came in for some mild criticism, but it is considered to be sound. The 10 to 1 ratio, or a 9 to 1 ratio, take your pick, has also been confirmed by the CDC and elsewhere by other studies.
Today the US has around 17 million confirmed cases of COVID. Testing is now better and more prevalent than in July. If we were to just randomly reduce the ratio multiplier from 10 infections per confirmed case to say 7 because people are undergoing more and better testing, then we might be looking at somewhere between ~100 million and quite possibly as many as 170 million people who have contracted COVID in the US (7 times 17 million confirmed cases or 10 times 17 million cases). Again, we don’t know.
If this is true, then the US is about half to two-thirds of the way toward the edge of herd immunity, which various scientists claim is achieved when a population has undergone an infection rate of 66-80%. The exact level of herd immunity is uncertain due to each disease’s unique characteristics and contagiousness. Anyway, when and if America gets to herd immunity, it will be helpful. Mom might even give us a gold star and put it on the refrigerator.
Despite all the promise of a vaccine, an infectious disease does not go away. And until that vaccine is available, COVID will keep doing what it does: it will act like a pandemic. If the number of infected Americans reaches 200 million, which may happen in less than 3 weeks as 17 million confirmed cases becomes 20 million confirmed cases (indicating the total infections may be as high as 200 million in the US), it is possible COVID will be in the process of peaking before most of us get access to a vaccine. So a natural national immunity may happen simply on its own; Governor Cuomo or Newsom be damned.
COVID will never disappear, however, it will gradually find fewer bodies to infect, with or without a vaccine. Let’s hope for the best and in the meantime keep asking ourselves, “What would Mom tell us to do?” Most likely she would say, “Stay frosty.” Or perhaps that was my drill sergeant? I often confuse the two. Both spent a lot of time telling me about how to keep my things in order, exercise good hygiene, and avoid trouble. Funny that.Published in