Chart 7: Cumulative Immunity by State
Poorer countries need more support. For countries with less access to vaccinations, much of the immunity is based on infection recovery. Therefore, variants like Lambda and potentially Omicron that have higher re-infection rates are particularly problematic. In addition, countries with less vaccine access tend to have younger populations. So far, COVID has killed an older population, on average. Variants that are more deadly to younger cohorts would be particularly problematic for countries with less vaccine access. Vaccinations remain, by far, the fastest, least deadly and least costly way to end the pandemic.
How Does This Pandemic End? Does it End?
We are getting close to the point where enough of the unvaccinated have gotten infected and either died or recovered with some level of immunity. The unvaccinated and previously infected immunity is not as durable as those who have been vaccinated, but, for most states, we should cross a point in Q1 where the combination of vaccinations and infection recoveries (what I am calling cumulative immunity) puts enough downward pressure on the virus to lower hospitalizations and deaths. But, if Omicron, with all of its mutations, is more successful at re-infection, and those reinfected have outcomes about as bad as the first round of infections, then there will be many more months of unvaccinated filling hospitals and morgues.
Those fully vaccinated, including booster, will do OK, unless a wildcard variant is better at breaking through. But even then, within about 120 days, a new and improved booster can be available in wealthier countries, and those previously vaccinated are likely to get their booster and maintain a high level of protection. Keep in mind, in this wave of 176,397 deaths, less than 15,000 of those are among those with two doses of vaccine. In terms of hospitalization and death, compared to unvaccinated, those fully vaccinated were 20 years older. Vaccines afford a lot of protection. For the vaccinated, the levels of hospitalizations and deaths are less than a bad year of the flu.
As the recent surge in cases in Europe shows, as long as a significant portion of the population is unvaccinated, SARS-CoV-2 cases can spread quickly without masking. Yes, Europe jumped the gun on removing mask mandates, but most European countries are in a better position to reinstate restrictions and control the pandemic. US deaths per million remains above other major democracies in Europe such as Germany, United Kingdom, Italy and France.