In an op-ed in the Wall Street Journal Marty Makary says that federal public health officials are overestimating the time it will take for the U. S. to achieve “herd immunity”:
Anthony Fauci has been saying that the country needs to vaccinate 70% to 85% of the population to reach herd immunity from Covid-19. But he inexplicably ignores natural immunity. If you account for previous infections, herd immunity is likely close at hand.
Data from the California Department of Public Health, released earlier this month, show that while only 8.7% of the state’s population has ever tested positive for Covid-19, at least 38.5% of the population has antibodies against the novel coronavirus. Those numbers are from Jan. 30 to Feb. 20. Adjusting for cases between now and then, and accounting for the amount of time it takes for the body to make antibodies, we can estimate that as many as half of Californians have natural immunity today.
The same report found that 45% of people in Los Angeles had Covid-19 antibodies. Again, the number can only be higher today. Between “half and two-thirds of our population has antibodies in it now,†due to Covid exposure or vaccination, Mayor Eric Garcetti said Sunday on “Face the Nation.†That would explain why cases in Los Angeles are down 95% in the past 11 weeks and the positivity rate among those tested is now 1.7%.
Undercounting or removing the many Americans with natural immunity from any tally of herd immunity is a scientific error of omission. When people wonder why President Biden talks about limiting Fourth of July gatherings, it’s because his most prominent medical adviser has dismissed the contribution of natural immunity, artificially extending the timeline.
which in turn motivated the question that is the title of this post. The honest answer is neither we nor the federal public officials nor, as far as I know, anyone else actually knows. What we do know is that about 8% of the population has been confirmed as having had COVID-19. There are significantly higher estimates of how many people have contracted the disease, for example, this one at News-Medical:
World health experts have long suspected that the incidence of COVID-19 has been higher than reported. Now, a machine-learning algorithm developed at UT Southwestern estimates that the number of COVID-19 cases in the U.S. since the pandemic began is nearly three times that of confirmed cases.
The algorithm, described in a study published today in PLOS ONE, provides daily updated estimates of total infections to date as well as how many people are currently infected across the U.S. and in 50 countries hardest hit by the pandemic.
As of Feb. 4, according to the model’s calculations, more than 71 million people in the U.S. – 21.5 percent of Americans – had contracted COVID-19. That compares with the substantially smaller 26.7 million publicly reported number of confirmed cases, says Jungsik Noh, Ph.D., a UT Southwestern assistant professor in the Lyda Hill Department of Bioinformatics and first author of the study.
but, that, too is just a guesstimate. I might have more confidence if I saw the actual algorithm used to produce the results. The true number (which has changed since I started writing this post) could be higher than that, lower than that, or about right.
Arguendo, let’s assume that the true number is something between 8% and 21.5%. Picking a number at random, let’s say 15%. How many of the remaining pool of 85% of the population would need to be vaccinated before herd immunity is achieved? We don’t know the answer to that, either:
The percentage of people who need to be immune in order to achieve herd immunity varies with each disease. For example, herd immunity against measles requires about 95% of a population to be vaccinated. The remaining 5% will be protected by the fact that measles will not spread among those who are vaccinated. For polio, the threshold is about 80%. The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known. This is an important area of research and will likely vary according to the community, the vaccine, the populations prioritized for vaccination, and other factors.
Taking the pessimistic estimate of 95%, that would suggest that as many as 80% of the population would need to be vaccinated. Taking the most optimistic possible view based on present knowledge it suggests that the number would be between 55% and 72%. Clearly, it makes a difference.