Unfortunately, data from Europe is making it more and more clear that vaccination will not stop Covid, even if very high percentages of the population are vaccinated.
Case 1 – Ireland. 89% of Irish citizens age 12 and up are fully vaccinated. More than 80% of those vaccines were Pfizer or Moderna, with the remainder Astra Zenica or J&J. In other words, it’s a fairly similar profile to the US. Their vaccination drive peaked in July, or about four months ago, so vaccine effectiveness waning would be less than in the US. (You hear a lot about vaccine effectiveness waning at 6 months or later, but my take on the data is that the sharp dropoff starts at 4 months, or even 3.) Ireland also still has mask mandates for adults and restrictions on large indoor gatherings, unlike most of the US. In addition, there are vaccine mandates there to do just about anything indoors.
Despite the high rate of vaccination and other measures, Ireland’s cases per capita now exceeds the case levels the US experienced during its late summer Delta surge. Of course, US numbers are lower because, being a large country, our numbers average out when one part of the country is surging and another isn’t. In addition, Ireland is doing more testing than the US, and they haven’t yet seen a corresponding surge in deaths. Deaths are starting to tick up there, so it’ll be telling to see how that goes.
Case 2 – Iceland. Like Ireland, Iceland has a vaccination rate for ages 12+ of about 90%. Also like Ireland, Iceland is experiencing a major Covid surge. Iceland has a number of restrictions and Covid mitigations in place basically banning large gatherings. With the new surge, they are introducing new rules restricting gatherings to only 50 people, limiting opening hours for restaurants, and imposing % capacity restrictions on everything from swimming pools to ski areas to gyms.
(It is worth noting that Iceland, being a small remote island, doesn’t exactly have overflow capacity for its hospitals, so it’s reasonable for them to take measures that might not make sense in the continental US. Ireland’s relationship with the UK is . . . standoffish, and they don’t seem to be cooperating on Covid in any way, shape, or form, which no doubt forces them to also be more cautious, as a small island.)
Case 3 – King County. We have 84% of people fully vaccinated and 89% with at least one shot. I don’t think the Covid levels are particularly alarming around here, but the Seattle Times subjects us to regular hysterical headlines about hospitals being overwhelmed, and we have a mask mandate for indoors and larger outdoors gatherings. In any case, we’ve certainly had an ongoing surge for the last few months that never seems to end.
Perhaps most disturbingly, between 40 and 45% of recent deaths in King County are among the vaccinated. Now, with nearly 85% vaccinated over age 12 (72% of the total population), you’d expect a fair few deaths in the vaccinated population, but more than 40%?
Given the greater contagiousness of Delta and its greater severity, I do think the vaccine is likely making a huge difference. Unfortunately, I think, at 70% effective against contagiousness and 90% effective (at best – probably less for the people who need it most) against hospitalization, we’re not much better off than we were at the beginning, with the wild type, before the more contagious alpha variant. The new treatments from Pfizer and Merck and encouraging, however. Perhaps they will tip the balance. The 30,000 foot view for me, though, is that in addition to heart disease and cancer, which both kill about 600,000 people per year, we now have a third disease which will take a slightly lesser toll for the indefinitely future. Taking into consideration waning immunity, vaccine mandates, future variants, and better treatments, it seems likely we’ll be looking at around 300,000 deaths per year indefinitely (at least – more this year, but vaccines weren’t widely available until spring) and potentially a year or two reduced life expectancy. I don’t think this is the end of the world; we’ve gain a couple years of life expectancy since the 90s, and things weren’t so bad back then. It is what it is. I can only say that hospitals need to be increasing capacity, both in terms of beds and equipment, and staff. Doing so will take years, and there’s no time to start the work like the present.