We Have Never Understood the Significance of Prevalence

I realize “we” is an overstatement, but a recent story about Americans who won’t eat out or fly until herd immunity arrives illustrates a very important point (boldface mine):

A growing share of Americans would feel safe resuming activities like dining out or flying within a few weeks of their second dose of COVID-19 vaccine, but about 25% to 30% would wait until the nation reaches herd immunity, according to a Harris Poll survey for USA TODAY.

Their attitudes bode well for what’s expected to be a historically robust recovery from the coronavirus recession. But the sizeable share of people who prefer to wait until at least 70% of the population is immune could mean a less roaring launch to the rebound as some activity shifts to late summer and fall from midyear.

Leaving aside the focus on the economy and not, let’s say, dead and disabled people, when you read the entire story, the prevalence of COVID-19 (how many people are currently infected) is nowhere to be found. That’s obviously not the only consideration, but if the prevalence is low–and I obviously hope it will be–then lots of activities become far safer.

There has been a real failure, going back to the initial policy wonks whose ideas were adopted in the fourteen day declines, to explain to people that part of assessing risk for behaviors needs to be based on prevalence. State and local governments, which devised various thresholds, only to ignore them, haven’t helped either.

For me, I’ll be far more focused on the prevalence of COVID-19–which, in D.C., is far too damn high–than my vaccine status (though I would love to get vaccinated). For example, I won’t return to the gym, which I really want and need to do, until I’m vaccinated and the prevalence is somewhere around one daily new case per 100,000 people (D.C. is currently around fifteen times higher than that) based on what was observed in Oslo, Norway last year.

I’m hopeful that, as vaccination increases, prevalence will continue to drop, but that’s not a given. As far as I can tell, most local officials aren’t even considering prevalence in their plans to reopen. That’s what should be driving policy and behavior until we are fully* vaccinated.

*For whatever definition of ‘fully’ floats your boat.

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4 Responses to We Have Never Understood the Significance of Prevalence

  1. C says:

    how do they imagine to get to 70% immunity before children under 16 can be vaccinated? That’s at least 20% of the population right there

  2. In my neck of the woods, everyone I know acts like it’s all over. Everyone I know has gone to Florida for a week or two, or even an entire month, or is planning to go for Easter week. I listen to them talk & I’m like … but COVID? Oh, it’s not a problem, it never really was, is the attitude I get.

  3. Ten Bears says:

    It’s taken a year to figure it out but I have found walking five miles a day with relatively light weights – I started with 2.5 lb wrist, 5 lb ankle and 10 lb torso, now walking with 5, 10 & 20 – with a few pushups, pullups and shoulder rolls is as effective a workout as 90 minutes in the weight-room/pool in the same amount of time, and so much more enjoyable. No interest in going back to a gym.

  4. Joe Shelby says:

    I hate to pull the “what about the children?” but, well, “what about the children?”

    This is still our biggest psychological blocker to going and doing ‘normal’ things (like our usual Memorial Day vacation to the Atlanta area). We’ll be vaccinated but the kid won’t. So as you point out, until prevalence is really down, the children are still at risk of spreading it…and early signs are B117 (the UK variant) is not as lax in infecting kids as its predecessors. We just had an kid test positive in my kid’s elementary school last week (my own kid is still virtual-learning from home, but that doesn’t mean she’s not concerned).

    So because the kids < 16 can't get vaccinated yet, they are still in danger so long as adults are still carrying and spreading this thing, and the odds grow that because it is still in deep community spread (with numbers going UP here in Loudoun and a massive daily test spike in NYC) we'll end up with vaccinated people still at least getting sick, even if not seriously so…at which point we still have a LOT of unknowns about lasting damage.

    So yeah, we're still on the fence of going anywhere, because *our* vaccinations aren't going to be enough to protect our kid from catching it in any social situation.

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