Are vaccines the light at the end of the tunnel?

[D C]

1 hour ago, cangelmd said:

The big thing we haven't known in the entire pandemic is how many people have actually had the disease (we also don't know how long immunity lasts, but for the purposes of argument let's assume long enough and that most people who were infected still have some immunity). What ever herd immunity is, it will require vaccination, but it will also be fueled by some level of natural immunity.

 

That is perhaps the biggest unknown factor of all.   For example, I have one friend who is married with 6 kids.  They all fell ill and only one of them was tested (positive).  No data on the other 7 of them.  That's a big family, but there are a lot of similar stories with other households.   

[TeeRick]

2 hours ago, D C said:

"And so what?"  Exactly. Once vaccinated, you're immune. 🙂

Some will willfully never be part of the immune herd

Some pockets will have extremely high immunity

Some pockets will have low immunity and may well continue to see cases

 

At some point we'll be at (or past) the point at which if the current state of covid was as bad as it ever got, we wouldn't have freaked out about it to begin with.  With deaths continuing to drop, we'll hopefully be there soon. 

OK if herd immunity is theoretically achieved at 70% fully vaccinated, what do we say about a ship that is 95-98% vaccinated?  Herd immunity on board?

[nocl]

2 hours ago, cangelmd said:

The big thing we haven't known in the entire pandemic is how many people have actually had the disease (we also don't know how long immunity lasts, but for the purposes of argument let's assume long enough and that most people who were infected still have some immunity). What ever herd immunity is, it will require vaccination, but it will also be fueled by some level of natural immunity.

 

I went back and looked at our state data - in Alabama we have basically had a flat line for hospitalizations and an almost flat line for deaths (the death curve is still almost imperceptively declining) since about March 18, two months. That's roughly 4 cycles of virus and includes an "event", spring break, which in Alabama is the same week of March for most schools and mid-April for the rest. You can see tiny blips in the cases following spring break and Easter, but these are tiny. There is only the tiniest of blips in the hospitalizations and none in deaths.

What this tells me is that we are close to having immunity in the most susceptible populations for death and severe disease and that we should see another stepwise drop in hospitalizations and deaths when children can be vaccinated, but we will never get to herd immunity as we see it in some viral diseases without a much higher vaccination rate. I actually think the herd immunity % vaccinated may be lower than some have postulated (more like 60-65%), but even that will require the vaccine to be mandated for some activities - school attendance, certain jobs maybe - and we are a ways from that happening.

As long as a lot of adults refuse vaccination and children can't get the vaccine, I think we are stuck here at around 350 hospitalized at any one time statewide and a death or two a day - but I think we may have interrupted the exponential chain of infection, at least until peoples' immunity starts to wane.

The best estimates I have seen based upon studies of antibodies in communities prior to the release of vaccines is that the actual count in the US is around 3X the official tested count.

 

One of the major problems with the protection from actually having COVID, is that the protections from having the original strain or even B.117 is that it does not protect very well from other strains like B.1.351, P1, and B.1.617.  So while the protection from having the illness does contribute it helps less if the other strains get widespread in the US.

 

 

[nocl]

6 minutes ago, TeeRick said:

OK if herd immunity is theoretically achieved at 70% fully vaccinated, what do we say about a ship that is 95-98% vaccinated?  Herd immunity on board?

If the cruise lines will actually commit to that.

[D C]

6 minutes ago, TeeRick said:

OK if herd immunity is theoretically achieved at 70% fully vaccinated, what do we say about a ship that is 95-98% vaccinated?  Herd immunity on board?

Hard to say. We need to get on board to find out first hand 😉

[TeeRick]

1 minute ago, D C said:

Hard to say. We need to get on board to find out first hand 😉

What I am pointing out is that many of us are waiting for 70% herd immunity in our communities as a safe goal to normalcy,  but ships with 95% fully vaccinated terrify us because it is not 100%.  As long as cruise lines and CDC and other local authorities agree on sensible plans for dealing with positives on board without the panic and vacation ending scenario, then everything will be fine.  We are way way past the Diamond Princess situation.

[markeb]

10 minutes ago, TeeRick said:

OK if herd immunity is theoretically achieved at 70% fully vaccinated, what do we say about a ship that is 95-98% vaccinated?  Herd immunity on board?

 

I don't think that herd immunity applies here, or that it's really relevant to a ship's population in the short term. The concept really applies to sustained transmission, so you should still have some expectation of an isolated case of disease or two over a long enough period of time, but you wouldn't expect an outbreak to propagate. At 70%, you could have more isolated cases requiring hospitalization, but you still shouldn't have sustained transmission. The size of the population, the incubation period, and the turnover of the population on 7 day intervals really complicates that discussion.

 

But especially at the high vaccine rates being suggested, unless there were somehow multiple infectious individuals to start an epi curve, as good as the vaccines appear to be, I wouldn't expect much of a disease burden on a 7 day cruise, and certainly not every 7 day cruise. The unknown remains the exclusion concept, and whether even PCR positives are going to impact return to port.

[Ride-The-Waves]

From the Mayo Clinic:   https://www.mayoclinic.org/herd-immunity-and-coronavirus/art-20486808

 

Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected — not just those who are immune.

Often, a percentage of the population must be capable of getting a disease in order for it to spread. This is called a threshold proportion. If the proportion of the population that is immune to the disease is greater than this threshold, the spread of the disease will decline. This is known as the herd immunity threshold.

 

What percentage of a community needs to be immune in order to achieve herd immunity? It varies from disease to disease. The more contagious a disease is, the greater the proportion of the population that needs to be immune to the disease to stop its spread. For example, the measles is a highly contagious illness. It's estimated that 94% of the population must be immune to interrupt the chain of transmission.

 

The 70 percent is not a valid "herd immunity" for COVID-19.  Everyone needs to be vaccinated which is exactly what the cruise lines are saying.

[Ride-The-Waves]

3 minutes ago, markeb said:

 

I don't think that herd immunity applies here, or that it's really relevant to a ship's population in the short term. The concept really applies to sustained transmission, so you should still have some expectation of an isolated case of disease or two over a long enough period of time, but you wouldn't expect an outbreak to propagate. At 70%, you could have more isolated cases requiring hospitalization, but you still shouldn't have sustained transmission. The size of the population, the incubation period, and the turnover of the population on 7 day intervals really complicates that discussion.

 

But especially at the high vaccine rates being suggested, unless there were somehow multiple infectious individuals to start an epi curve, as good as the vaccines appear to be, I wouldn't expect much of a disease burden on a 7 day cruise, and certainly not every 7 day cruise. The unknown remains the exclusion concept, and whether even PCR positives are going to impact return to port.

The crew does not change over every 7 days...

[TeeRick]

1 minute ago, markeb said:

 

I don't think that herd immunity applies here, or that it's really relevant to a ship's population in the short term. The concept really applies to sustained transmission, so you should still have some expectation of an isolated case of disease or two over a long enough period of time, but you wouldn't expect an outbreak to propagate. At 70%, you could have more isolated cases requiring hospitalization, but you still shouldn't have sustained transmission. The size of the population, the incubation period, and the turnover of the population on 7 day intervals really complicates that discussion.

 

But especially at the high vaccine rates being suggested, unless there were somehow multiple infectious individuals to start an epi curve, as good as the vaccines appear to be, I wouldn't expect much of a disease burden on a 7 day cruise, and certainly not every 7 day cruise. The unknown remains the exclusion concept, and whether even PCR positives are going to impact return to port.

mark, I was being a bit tongue-in-cheek with this herd immunity argument.  But thanks for responding!😀

[TeeRick]

It seems I have started a herd immunity firestorm while trying to be clever and humorous.  Sorry!

[nocl]

2 hours ago, Ride-The-Waves said:

The crew does not change over every 7 days...

But most likely tested every 7 days.

[4774Papa]

4 hours ago, TeeRick said:

What I am pointing out is that many of us are waiting for 70% herd immunity in our communities as a safe goal to normalcy,  but ships with 95% fully vaccinated terrify us because it is not 100%.  As long as cruise lines and CDC and other local authorities agree on sensible plans for dealing with positives on board without the panic and vacation ending scenario, then everything will be fine.  We are way way past the Diamond Princess situation.

Right, and assume that a negative COVID19 test is required before board, that further reduces the risk of the virus infecting the ship.

[NMTraveller]

5 hours ago, TeeRick said:

OK if herd immunity is theoretically achieved at 70% fully vaccinated, what do we say about a ship that is 95-98% vaccinated?  Herd immunity on board?

Super herd immunity 🙂

[Ken the cruiser]

37 minutes ago, NMTraveller said:

Super herd immunity

Sounds good to me! 😎

[ChucktownSteve]

I feel the CDC dropped the ball on this. They should not have removed the mask mandate outdoors until the Covid virus is 100% eradicated or we reach 100% herd immunity.

 

The CDC should mandate that all children over age 2 be vaccinated or wear a mask...especially on the playground or at camp.

 

The people driving alone in the cars, still wearing a mask, are smart and true patriots.

Edited May 19, 2021 by ChucktownSteve

[Ride-The-Waves]

14 hours ago, nocl said:

But most likely tested every 7 days.

Speculation?

[TeeRick]

11 hours ago, ChucktownSteve said:

I feel the CDC dropped the ball on this. They should not have removed the mask mandate outdoors until the Covid virus is 100% eradicated or we reach 100% herd immunity.

 

The CDC should mandate that all children over age 2 be vaccinated or wear a mask...especially on the playground or at camp.

 

The people driving alone in the cars, still wearing a mask, are smart and true patriots.

Steve,

Just to be extra careful the CDC should require 105% herd immunity and vaccine efficacy of 110% to allow cruises.  But of course a mask should also be doubled until we get to these numbers.  And that will not happen until we round up the vaccine hesitant scoundrels and put them in vaccine education camps.  And have the IRS give them daily vaccine fines.  But tax deductible ones.😀

[mimbecky]

On the morning news today, they said 3 cruise ships (2 Holland and 1 Princess) will be in port this week so that one of our Medical groups (Sharp Healthcare) can administer vaccines to crew members.  Pretty cool!

Follow up article

 Sharp HealthCare to vaccinate cruise ship staff Wednesday and Thursday (10news.com)

[nocl]

4 hours ago, Ride-The-Waves said:

Speculation?

For cruises out of the US the CDC requirements are for crew to be tested every 7 days.

[NMTraveller]

[cangelmd]

58 minutes ago, NMTraveller said:

Touché! “Much silent clapping”

[TeeRick]

The Novavax vaccine recent update.

https://www.medscape.com/viewarticle/950865?src=wnl_edit_tpal&uac=370300SV&impID=3369780&faf=1

[cangelmd]

32 minutes ago, TeeRick said:

The Novavax vaccine recent update.

https://www.medscape.com/viewarticle/950865?src=wnl_edit_tpal&uac=370300SV&impID=3369780&faf=1

I'm not sure where the breakdown in the supply chain exactly is, but we are on allocation for a number of reagents and supplies for all different, seemingly unrelated tests. We can't even get phosphate buffer! The problem seems to be with raw materials that are basically so cheap (or perhaps environmentally unfriendly) that they can only be produced in one or two areas of the world. As long as the pandemic rages on outside the US and Europe, we will have odd shortages.

A few years ago when that first devastating hurricane hit Puerto Rico, the entire US ran out of IV bags - there was only one major manufacturer of the bags and the plant was in Puerto Rico. Most people, outside of hospital pharmacists and those of us that sit on the hospital pharmacy committees, never even realized how much shuffling and switching, creative use of smaller and larger bags went on, just to get patients the plain salt water IVs they needed!

[DWhit]

OK, this is probably a stupid question but I have noted this thread has a lot of very intelligent folks participating so they will know the answer.  

 

My wife and I are booked on an RCI cruise from Bahamas next month and we have to take a COVID test to re-enter the USA after the cruise.  

 

Recently I donated platelets at the Red Cross, and they test all donations for Covid.  The test results came back "Reactive", which their literature said meant the first Covid test for the spike protein came back positive, while the second test for a different thing came back negative (most likely).  It said this result is consistent with someone who has been vaccinated (which applies to me,  i.e. I have beeen vaccinated but never had Covid).

 

My question is whether it is possible we could get some kind of positive test result on the return from the Bahamas because of the vaccine that would show positive for Covid and cause problems?  Is one kind of test better than another in this regard?   I would think this has been planned for, but you never know...