The Great Race: Vaccines vs Mutants
By Alec Pruchnicki, MD
It is hard to predict the future, but with COVID it is even more difficult. There is a race going on between the factors that will improve our situation and other factors that can make it a lot worse, and right now it’s a toss-up as to which trend will win.
First, the good news. From the start of January to the end of February there was a dramatic drop in cases of COVID in the U.S. In March this drop leveled off for a while but has recently started again. Even better, the death rate from the end of January to March 20th has gradually, but persistently, decreased. If vaccination rates increase, these rates may continue to drop.
But (and you knew there would be a “but”), these trends have certain weaknesses as indicators. There are parts of the country, like Texas and Florida, where precautions have been relaxed and there is a potential for worsening statistics and spread of the virus to the relatively safe areas throughout the rest of the country. If COVID is still present in these areas, not to mention among the population of Europe and the billions of unvaccinated people in underdeveloped countries, it could continue to mutate and produce more virulent strains that could overwhelm or evade the present vaccines.
Speaking of mutants, there are various strains of the virus from England, South Africa and, most recently, Brazil. They are believed to be more infectious than the original strain, and possibly more lethal. If these strains spread more rapidly than the present vaccines neutralize them, then all the recent positive statistics could worsen. Since these are strains that have developed only within the last year, there is no telling what strains will develop within the next six to twelve months.
What should we do while waiting to see whether vaccines or mutants win this race? The most important thing is to get vaccinated as quickly as possible with whatever vaccine is available. Significant side effects are present but are very rare, possibly affecting as few as one in 500,000 recipients. The virus has caused a mortality of one in 100, so there is an overwhelming benefit from vaccination.
Continue using non-pharmacological interventions (NPIs) like masks, social distancing, testing and tracing, and, when necessary, quarantine. Not only will these measures prevent your contracting one of the potentially lethal mutants if they actually spread, but NPIs will prevent your transmitting them, or even the original strain of COVID, to others. One unanswered question during this entire pandemic is whether there is a slight chance that individuals who are immune to the virus, due to vaccination or previous infection, might be able to carry it and infect others with a sneeze, a cough, or just conversation. NPIs are annoying and sometimes uncomfortable, but so are emergency rooms, hospitals and ventilators.
This virus is new. There’s no telling what permutations will occur in the future. Be as careful as possible. This race isn’t over.