Back in March when the Covid-19 outbreak was in its early days, I

Author : torunlota

Publish Date : 2021-01-07 18:41:42

Back in March when the Covid-19 outbreak was in its early days, I asked my brother Steve to join me on The Vermont Conversation, a radio show and podcast that I host, to talk about what we could expect with this new virus. Steve Goodman, MD, MHS, PhD, is an associate dean at Stanford Medical School, where he is also a professor of epidemiology and population health and of medicine. When we spoke in March, Steve described the coronavirus as a tsunami about to overwhelm us. His words were prescient: nine months later, over 350,000 Americans have died from Covid-19 and at least 20 million people have been infected. Vermont, where I live, once an outlier with few Covid infections, now averages about 100 new cases and several deaths per day.
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I asked Steve for his thoughts on the Year of the Pandemic: where we are, how we got here, and how it ends. We spoke on December 30, 2020; you can hear our full discussion on the Vermont Conversation podcast. This partial transcript has been edited for length and clarity.
David Goodman, Elemental: President-Elect Biden said recently that the toughest days of the pandemic are ahead of us. That’s an extraordinary prediction from our nation’s incoming leader. What do you see as you look ahead?
Steve Goodman: The Covid-19 rates across the country right now are reaching peaks not seen before. The rates are starting to come down in a number of states, but they are coming down from very, very high levels. And the post-Christmas surge may be frighteningly large. It is clear that many families gathered indoors without masks and then went back to their communities, which is a potent way to spread the virus nationwide. There could be another Covid bomb that detonates just before Biden comes in.
We already have over 350,000 dead, with daily death tolls surpassing 3,000 people. How bad can it get?
We’re at a very high level but I think it is going to turn around in the next few months. We’re just beginning to see the first signs of that even if the Christmas surge temporarily reverses it. Biden’s team takes science seriously, will message consistently and forcefully about what should be done, and with more immunizations, we will have a countervailing force. A large percentage of deaths come from the elderly. Sixty percent of the deaths are in people 75 and older, 80% are in those 65 and older — and they only make up about 17% of the population, with a much smaller percent living in long-term care facilities. So if we just immunize the folks over 75 and those who live in long-term care facilities, we immediately reduce the number of deaths by 60–70%, taking pressure off the medical care system.
“There could be another Covid bomb that detonates just before Biden comes in.”
If we were to vaccinate everyone over 50 years of age, is that enough for us to then resume some semblance of normal life?
If death is the only metric and we could have everybody over 50 immunized tomorrow, then yes, we would probably be able to get back to normal life. But it’s a long way between now and then. And age and death are not the only factors here. It’s easily going to be six to nine months before we can get anywhere close to vaccinating the percentage of the population that would get us back to “life as normal.” Between now and then we’re going to have to continue to maintain virtually everything we’re doing now, including masking and distancing.
This epidemic is hundreds of micro-epidemics. It’s hyper-local. Vaccine uptake is going to vary, as is the degree of distancing and masking. So while we might be able to control the virus pretty well across the country, we’re still going to see hotspots. We also know that there’s a lot of hesitancy about the vaccines right now, especially in minority and high-risk communities. That may fade as millions get vaccinated, or it may increase if we start to see side effects that we’re not anticipating. It’s about continued messaging, surveillance, and trust within the communities that these vaccines, about which we don’t have full information, are on balance good for them.
The other critical thing that we don’t know is how long the vaccine protection lasts. We have good reason to believe it will last at least nine months to a year, but we don’t know that yet. There’s a lot to learn.

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