Will COVID-19 Be Under Control by April?

An editorial in the Wall Street Journal published Feb. 18 by Dr. Marty Makary, a professor at the John Hopkins University School of Medicine, is raising hopes that the coronavirus pandemic is on the way out and that the U.S. could achieve herd immunity by April. In his editorial, Makary said health officials should level with the public about the good news instead of suppressing it in order to encourage the public to continue social distancing, wearing masks, practicing good hand hygiene and getting vaccinated.

“Scientists shouldn’t try to manipulate the public by hiding the truth,” Makary said. “As we encourage everyone to get a vaccine, we also need to reopen schools and society to limit the damage of closures and prolonged isolation. Contingency planning for an open economy by April can deliver hope to those in despair and to those who have made large personal sacrifices.”

Makary pointed to a 77 percent decline in new cases in the past six weeks, and argues that the number of cases is plummeting much faster than experts predicted because natural immunity from prior infection is far more common than can be measured by testing.

“At the current trajectory, I expect COVID will be mostly gone by April, allowing Americans to resume normal life,” said Makary, who is a surgeon, not an epidemiologist. His conclusions have been challenged by some epidemiologists.

Makary, for example, estimated 55 percent of Americans have natural immunity from prior infections and another 15 percent have been vaccinated. The CDC estimates 15-30 percent of Americans have had prior infections, and that only 5.9 percent of the population has received the two shots believed necessary for the highest level of protection. And it is not yet known if mild, asymptomatic infections result in lasting immunity to COVID-19.

The Johns Hopkins Bloomberg School of Public Health estimates that, depending how contagious an infection is, usually 50 to 90 percent of a population needs immunity to achieve herd immunity and end an epidemic.

Dr. Jennifer A. Dillaha, an infectious disease specialist who is medical director of immunizations for the Arkansas Department of Health, said that the downward trend in cases in Arkansas and the United States is good news, but it is premature to say whether the trend will continue and it’s too early to know even a general timeframe for when COVID-19 will no longer be spreading in our communities.

“This virus spreads easily and new variants have emerged, so it is imperative that we remain vigilant and follow all the steps that we know work: wear a mask, wash your hands frequently, maintain social distance, avoid crowds, and get vaccinated when it’s your turn,” Dillaha said. “These steps are the best measures we can take to keep the trend heading in the right direction. These numbers can go back up if we let our guards down. While our case numbers likely were affected by reduced testing associated with the winter weather, we were seeing the downward trend event before the recent storm. Hospitalizations also have fallen significantly, and that would not be affected much, if at all, by the wintry weather.”

Dillaha urged people to understand the vaccines have proven to be safe and very effective at preventing COVID-19 complications. “People should get vaccinated even if cases are significantly down because this is one more step we can take to ensure that they will not go back up again,” she said.

One recent study indicates just one shot of the two vaccines currently available in the U.S. may be highly effective. The Canadian study published in the New England Journal of Medicine states that even before the second dose, BNT162b2 (the Pfizer-BioNTech) was highly efficacious, with a vaccine efficacy of 92.6 percent, a finding similar to the first-dose efficacy of 92.1 percent reported for the mRNA-1273 vaccine (Moderna).

“With such a highly protective first dose, the benefits derived from a scarce supply of vaccine could be maximized by deferring second doses until all priority group members are offered at least one dose,” the study authors reported. “There may be uncertainty about the duration of protection with a single dose, but the administration of a second dose within 1 month after the first, as recommended, provides little added benefit in the short term, while high-risk persons who could have received a first dose with that vaccine supply are left completely unprotected. Given the current vaccine shortage, postponement of the second dose is a matter of national security that, if ignored, will certainly result in thousands of COVID-19–related hospitalizations and deaths this winter in the United States — hospitalizations and deaths that would have been prevented with a first dose of vaccine.”