Vaccines are one of the most important public health interventions seen in the last 200 years, impacting rates of many deadly diseases and contributing to improved population health outcomes. When learning about the impact of effective vaccines it is very common to see graphs such as this.
Based on Robert Redfield’s comments about masks being more effective than a vaccine, you would therefore expect to see similar patterns in places where mask mandates are in place. Instead, however…
Similar patterns are seen across locations in Europe and America, who have seen almost 70% of global Covid-19 cases and about 80% of Covid-19 deaths (taken from European Centre for Disease Control and Prevention as at 12 November 2020) despite extreme measures being enforced at enormous cost in many of these places. It is also despite the fact that world class health care is available in these locations, compared with large parts of the world who have seen far less transmission and death despite having limited health care resources.
Some populations, especially in parts of Asia who are being praised for the apparent success of their mask-wearing behaviours, actually have population level cross-reactive immunity. Yet the dogma has become “remain vigilant, do the right thing and the virus can be beaten”. In most cases this means surrender your freedom, your financial security, your mental and physical health in the new dogma of Covid Virtue.
Infectious disease control measures have never before related to “beating” a highly transmissible virus, rather containing it with reasonable and evidence based public health measures which aim to protect the vulnerable whilst simultaneously protecting communities against harm by critical analysis of the impact of mitigation measures. The Smallpox eradication program in 1970s knew how to do this – there was no fear, no panic and no enforced new dogmas – only supportive and evidence based public health.
It remains hard to fathom what took place in 2020 for so much established wisdom to suddenly vanish in favour of panic-induced groupthink where anyone questioning the narrative risks being ostracised and maligned. John Ioannidis, Sunetra Gupta, Michael Levitt, Scott Atlas and others who before 2020 were some of the world’s sharpest minds and leading scientists, are suddenly pariahs of groupthink. Their contributions to the pandemic will become historic not only because of their sound knowledge, but the courage they displayed.
Endemic equilibrium will eventually establish for this virus, as it has for the hundreds of other respiratory viruses we are affected by. This means the number of susceptible people reduces as the number of people who are protected increases. Protection may be from pre-existing immunity, infection-induced immunity, vaccine-induced immunity, or population level immunity where exposure of susceptible individuals is unlikely to occur. Other factors also play a part, for example seasonality. Coronaviruses survive better in cooler, drier environments, meaning we should expect transmission to ebb during summer months and flow during winter months, and we should expect locations with warmer and more humid climates to see less local transmission.
The below graph from Wikipedia shows endemic equilibrium establishing over time. The blue line represents those who are susceptible; green represents infected cases; and red represents those who are protected (resistant). In the case of Covid-19, those who are protected were thought initially to be 0 but it has become apparent over the months that this was not the case. Some populations appear to have population level immunity, whilst in susceptible populations, 80% of people do not become unwell.