Feb 2, 2021 – Groundhog Day, 2021

“If there is no viral replication, there can be no viral mutations.”

Anthony Fauci, January 31, 2021

This is the best answer I have seen yet to the question, “Why should I get the Covid-19 vaccine?” For all of the obvious reasons like, “I don’t want to die right now,” or “I don’t want the virus to spread to others,” and “I want to go to a Raven’s game and scream at the top of my lungs.” But Fauci’s reason is nuanced, succinct, and quotable.

If we succeed in immunizing enough people, viral replication slow and stops, and ipso facto, so do new mutations that are out to get us like Jason in Friday the 13th.

Let’s review what is known about the new mutations of the virus. These nasty mutants that are spoiling our mask burning party. They are:

B 117 (The UK Virus) this mutation causes the virus to apparently be more infectious but not more deadly. The fact of the matter is, however, that a more contagious virus which affects more people will end up being more deadly, because of the equation (death rate x population infected = number of deaths) The number of deaths goes up when the (population infected) goes up.  Consult your 7^th grade mathematics textbook for the “miracles of multiplication” section.

B 1351 (Hails from South Africa) First of all, how did it get here? How many people from South Africa have traveled to the US during the pandemic? Apparently, one too many. This virus is more deadly but apparently not more infectious.  Great. You can fit this into the previous equation where it says (death rate). The same rules apply from seventh grade.

P 1 (Hails from Brazil) the only country to surpass the US in bungling the outbreak. Who knows about this one? Apparently, nobody. We haven’t seen much info on this one yet but it’s about as welcome as a Baby Ruth bar in a swimming pool.

So are the mutants going to turn everyone’s spring into the Spring of 2020, the sequel. I think not. Here’s why:

1. Most experts believe that over 100 million people in the US have been infected, and most are likely immune to the wildtype virus (the one we all know and love) and have substantial immunity to mutant viruses as well

2. Vaccinations, despite getting off to a rocky start are beginning to become more available. Over the last few days, more than a million people across the country have been vaccinated every day. The current vaccines provide excellent immunity to the original virus and pretty damn good immunity to the Viruses from the UK, South Africa and maybe Brazil.

3. Over the next two months, probably 10 million more people will become infected with the virus from contact, and as many as 60 million more people will be vaccinated. Adding up the numbers 100 million current infections + 25 million current vaccinations + 10 million more acquired cases + 60 million more vaccinations = 195 million immune US residents. This is getting pretty close to what is required for herd immunity.

4. Currently the infection rate or R number is below 1 in all 50 states, which is indicative that the virus is contracting everywhere in the country. So, we are over the last peak.

I expect that we will see a steep decline in all measurements of viral activity over the next two months, including deaths, hospitalizations, testing positivity rate, R number, and new cases per 100,000 population. The x factor here is the penetration of new viral strains and their ability to infect more people.

This is where Tony Fauci comes in. If the virus can’t replicate, it cannot mutate. This is a call to arms for everyone to get vaccinated as soon as possible. If we can get ahead of the mutations by having a larger percentage of the population immunized, the virus mutated strains will have much less impact, and we decrease the possibility of having even worse mutations that could evade the vaccine.

For most of you, the problem is not the lack of desire to get the vaccine, but the lack of availability of the vaccine, locally. This is improving, and my advice is to be vigilant. Most patients who have signed up with the health department, or a hospital, or the Giant, have started to receive calls to schedule their appointment. Other venues will open up shortly and other vaccines will come to market, likely by March.

A brief word about the new vaccines that will become available soon. Johnson and Johnson has released data on its vaccine, which is not yet FDA approved. At first glance, the J&J vaccine does not look as impressive as the previous MRNA vaccines released over the last few weeks. It was about 72% effective in preventing infections compared to 95% for the Pfizer and Moderna vaccines. But 85% of the vaccinated population with the J&J vaccine avoided hospitalization, and no one that got the vaccine became critically ill or died. The Astra Zeneca vaccine has been approved by the European Union and will likely be approved here in the next 2 months. Data look similar to the J&J vaccine so far.

With all the bad news from the last year, we should all be thankful that these vaccines were produced with such speed, appear to be safe, and are very effective. Please take advantage of the opportunity to get one. This is war, and we need to win.

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