Usually Roland and I are on the road at this time of year-- spending Christmas someplace where Christmas isn't celebrated or hasn't been turned into a commercial freak show-- Thailand, Bali, Mali, Sri Lanka, India, Morocco, Egypt, Israel, Senegal, Nepal... I'm sure you've noticed that this year is different. I'm handling it pretty well-- maybe my run-in with cancer a few years ago has given me a new perspective on life. I'm content to sit and blog and cook all day, go out for hikes in the hills, mask up and venture out to a grocery store every 10 days or so... But Roland is having a rougher time handling it. Yesterday, he left for a week to drive to the Navajo Nation and meditate in an isolated hogan he rented.
Pandemic-wise, Arizona is in bad shape-- they'll cross half a million cases tomorrow and the state is close to 68,000 cases per million residents. That's a lot worse than California (54,350 cases per million residents) or the national average (59,135 cases per million). He has a good N-99 mask he got for a trip to the Himalayas, a bottle of Xlear, Vitamin D, zinc chelates, his own bedding, and plenty of disposable one-use gloves. And, by the way, Roland-- a school teacher-- has every intention of getting vaccinated the second he can.
He thinks that once we're vaccinated, we're off to Rome or Marrakech or Bangkok. Me: not so fast. I've been wearing masks on planes for decades. Roland doesn't; he says it makes people nervous. But I'll wait a little while before I get on a plane again with God-knows-how-many Trumpists spreading COVID. I have a feeling that once people get vaccinated, they're going to think they're bullet-proof. But it doesn't work that way.
People will get vaccinated and stop wearing masks and... expect another wave. A few weeks ago, CNN asked their medical analyst Dr. Leana Wen, why vaccinated people still have to wear masks. She emphasized that "It's important to be clear about what we know and what we don't know about what the vaccine does. What we know is that the Pfizer vaccine is very effective at preventing symptomatic illness and severe disease. That means the vaccine appears to prevent people from getting sick enough that they develop symptoms, and very importantly, it prevents people from becoming so severely ill that they end up in the hospital... Here's what the studies don't yet show. They haven't looked at whether the vaccine prevents someone from carrying Covid-19 and spreading it to others. It's possible that someone could get the vaccine but could still be an asymptomatic carrier. They may not show symptoms, but they have the virus in their nasal passageway so that if they're speaking, breathing, sneezing and so on, they can still transmit it to others... The vaccine will protect you from getting ill and then ending up hospitalized. But it's possible that you could still carry the virus and be contagious to others. So those who get the vaccine should still be wearing masks and practicing physical distancing."
On Christmas Day, ABC News had two doctors explain why mask-wearing and social distancing will be imperative, at least for a while, even for people ho get vaccinated. Trump voters don't believe it, by medical experts have shown that "wearing a face mask can reduce an individual's risk of infection by 70%." There is a lot of fear in the public health community that the vaccines that have been approved may give people a false sense of security that masks are no longer needed. Note the word "false."
• Vaccination does not provide instant immunity. Pfizer/BioNTech and Moderna's vaccines require two doses administered weeks apart. Depending on the vaccine, it can take four to six weeks from initial dosing to achieve immunity and protection levels comparable to those in clinical trials. During this time it is still possible to contract an infection and fall ill.
• Vaccination trials did not track whether participants wore masks. While clinical trials have strict enrollment and monitoring criteria, it isn't clear whether those participating in the studies were provided guidance on mask usage. Given a lack of data, it is not clear whether vaccination efficacy had anything to do with vaccine trial participants adhering to public health safety measures, like wearing masks.
• The real world does not mimic a controlled clinical trial. Factors such as how the vaccine is stored, transported, administered and the medical health of an individual can determine real-world effectiveness of the vaccine. Clinical trials evaluated healthy individuals with stable preexisting diseases. As mass vaccination campaigns ensue, operational logistics along with an individual's unique medical conditions may affect overall immunity levels.
• The herd immunity threshold for COVID-19 is unknown. Herd immunity occurs when enough of the population is exposed to the virus, typically through vaccination, and limits the ability of the virus to spread. The percentage of population requiring immunization to achieve herd immunity varies by disease. For example, with measles, 95% of the population needs to be vaccinated in order to limit spread. According to the Centers for Disease Control and Prevention, the herd immunity threshold for COVID-19 has yet to be established.
• The duration of vaccine immunity is unknown. The Food and Drug Administration requires a median two months of safety and efficacy data following completion of the vaccination regimen for emergency use authorization. The length of vaccine coverage is yet to be determined and will be monitored as vaccination campaigns are rolled out. The good news is that our immune system's memory cells, which identify infections and mounts an immune response, persisted beyond six months in certain patients infected with COVID-19.
• It is unclear whether vaccines prevent transmission of COVID-19. In their clinical trials, Pfizer/BioNTech and Moderna, did not track cases of asymptomatic infections with COVID-19. This means the ability of the vaccine to decrease transmission was never evaluated. Future studies will need to evaluate whether vaccination decreases viral transmission before we can re-evaluate the role of public health measures.
Today, the U.S. reported 160,604 new cases, bringing the national total to 19,433,847. Of those 28,577 are life-threatening cases. The country has 58,545 cases per million residents. There are currently 5 states I wouldn't go to for fifty thousand dollars without a full hazmat suit-- too dangerous:
• North Dakota- 120,024 cases per million residents (worst place on earth)
• South Dakota- 110,088 cases per million residents (2nd worst place on earth)
• Iowa- 87,156 cases per million residents (4th worst place on earth; Andorra is #3)
• Nebraska- 83,733 cases per million residents
• Utah- 82,619 cases per million residents
I'm pretty certain that Tennessee will soon surpass Utah and Nebraska as a death-trap state 82,599 cases per million residents). All these states have governors and legislatures that scoffed at public health measures to prevent COVID from spreading uncontrollably in their states and each state is filled with pitiful morons who, despite the pandemic, voted to reelect Trump and voted for pandemic-denying Republicans across the board down-ballot. They may be getting what they chose... but it is still infecting people who did not make those same brain-dead/suicidal choices.