Dr. Marc Siegel: COVID and the 500,000 deaths milestone -- keep in mind the tale of two pandemics

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Dr. Marc Siegel on COVID-19 vaccine hesitancy and skepticism

Dr. Marc Siegel dispels rumors and discusses efforts to combat vaccine non-compliance on ‘Fox News @ Night.’

THEN

It was already the second year of masking and distancing and schools, restaurants, and businesses closing, and hospitals kept overflowing as the economy slowed to a crawl. Many people were slackers and refused to comply.

Here in New York, my Uncle Leonard had a bilateral ear infection requiring emergency surgery but the hospitals were full, and he died at home at age 9 months. That was seven years before my mother was born.

Lockdowns didn’t work very well to stem the tide, except in cities like St. Louis or San Francisco where there were still few infections at the time everything was closed. There was a big debate over streetcars and whether to keep them running or not. Some cities had them running with the windows open with mandatory social distancing.  

There was little understanding of what a virus was and many still thought the pandemic was caused by a bacteria.

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There was no successful vaccine though there was much talk of one and several were developed.  This virus mutated frequently and it spun off a deadly variant in the fall that caused the famous second wave. There was another wave the following spring but eventually, more contagious variants took over that were milder.

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The pandemic ended and the remaining strains transformed into a yearly outbreak that was less deadly. But over those two years, more than 50 million died and over 500 million were infected, more than a third of the world’s population at the time. The real (unreported) case numbers were likely far greater.

NOW

A hundred years later, another pandemic is taking place that threatens to equal the other. On February 22, the United States marked a grim milestone: 500,000 deaths since February 2020. But there are differences. For one thing, the new virus is a coronavirus that has a proofreading mechanism so there are fewer mutations.

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For another, it is more easily transmissible. But genetic variants are emerging here too, and sometimes, as in the case of Brazil, they infect and sicken a population that is on the road to recovery. 

Not all the variants are being detected because genetic sequencing is not commonplace, but luckily, we have the technology to re-engineer the new vaccines to cover them.

The genetic MRNA vaccines are a game-changer. They are incredibly safe and effective and by the end of February, we are now vaccinating close to two million people a day.

As we enter the last week in February, over 60 million people have been vaccinated.

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There are still many unanswered questions. Can we convince a high percentage of people to take the vaccine? Will most of the variants remain susceptible in the meantime?

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The pandemic is slowing down dramatically, new cases are down 70 percent over the past five weeks and that's too soon for the vaccines to already have had such a major impact.

Why is this happening?

For one thing, the holiday gatherings and rallies appear to be behind us. Rallies and riots and even celebrations like Mardi Gras were likely super spreader events.

There is also a growing natural immunity from those who have recovered from COVID, far more than the 28 million reported cases.  

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How many undiagnosed cases are there out there? When you consider the degree of asymptomatic spread being as high as 40 percent, and the fact that many people even with symptoms never get tested, plus the fact that a person can have antibodies and or T cell immunity from exposure to the virus and not know it, several experts have told me that it seems plausible that somewhere between 60 and 90 million people have developed some natural immunity to the virus.

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Keep in mind that CDC studies in the fall showed a seroprevalence of 1 to 23% but this percentage has clearly increased greatly with the huge winter onslaught.

There are other theories that could contribute to an immune blockade including memory T-cells from other coronaviruses or genetic resistance or the fact that coronavirus outbreaks generally peak in December, but the bottom line question – is natural immunity combined with masking, distancing, fewer gatherings and a growing number of immunized people contributing to the slowdown of cases? The answer is: yes.

People are eager to know the timetable. Will the positive trend continue? When will all this end? When can I take off my mask?

People are anxious for certainty and this is the one thing we lack.

We must be careful not to make unsubstantiated projections especially since we can’t predict exactly the impact the variants will have. False reassurances may undermine public compliance just when we need it the most.

The one thing we do have control over is the vaccine. Only mass vaccination may bring us to herd immunity by summer.

Only the vaccine will allow us to fully reopen our society. To beat the pandemic, do your part and get the shot.

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I only wish that my Uncle Leonard had lived to see this day to stand in line to get immunized.

Luckily for me, his sister has.

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