With the coronavirus mutating and vaccinations behind schedule, here's what we must do now

The news media is filled with articles regarding the new United Kingdom coronavirus mutation, which modeling has shown to be 56% more infectious. This mutation appears to be widespread in the United States, possibly emerging as early as October and now is spreading in multiple states. Similar to the original virus, this one has spread undetected because of inadequate testing. The United States is not leading but is 43rd in the world for genetic sequencing to detect new strains of the virus.

Too few of us comprehend that the devastation a virus inflicts on society is dependent upon both the virus’ infectivity along with its case fatality rate. Some epidemiologists theorize viruses with high case fatality rates may even do less damage to society because the virus’ ability to spread tends to decrease. Thus, the increase in the ability of this virus to spread is of utmost concern and testing is of paramount importance.

Unfortunately, during a time when vaccines are needed the most, the United States has again fumbled the implementation of an effective public health strategy. A blunder as critical as the initial testing shortages and the continued inadequate supply of PPE for all frontline workers.

Overpromised, underdelivered

We were promised that 20 million citizens in the United States would be vaccinated by the end of 2020, but only 12.4 million doses had been distributed, and only 2.17 million doses had been administered by year's end. This data has not been updated, and too many health departments closed over the holidays and on weekends. I am not sure that this is much of an excuse when we are commonly recording more than 3,000 deaths a day. I for one would not recommend closing front-line agencies, with the resultant loss of lives caused by even a single day delay in vaccine distribution and administration.

Obviously, much of the narrative earlier this year regarding Warp Speed’s preparation appears to be a sham.

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Health departments have also been underfunded and staffed for over a decade. The Associated Press reported Kentucky’s Lincoln Trail District Health Department has lost 49% of its staff, the decade prior to the pandemic. And now health department staff are under even greater stress with the anti-science backlash existing in much of rural America.

Thus, one of the major problems in our pandemic response is that there are not enough staff to coordinate and administer vaccinations. And staff will have to be doubled for the administration of the second dose, while at the same time still providing initial vaccinations.

Florida Gov. Ron DeSantis has floated the idea of only giving a single dose, and health care providers in England have been told to delay giving the second dose so more people can be vaccinated. Politically, this may be a good ploy, and it may well quell the unrest in the public, but it is not based on science.

The British Medical Association came out firmly against this, stating it is “unreasonable and totally unfair” and could cause “huge logistical problems.” Although twice as many people can be vaccinated, there appears to be little difference in total population immunity, since the effectiveness of the Pfizer vaccine appears to drop from 95% to 52%. Immunity from a single-dose regimen also would not be expected to last as long. Pfizer has stated there is no data showing single-dose immunity will last longer than 21 days.

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As early as April 7, 2020, analyses from Los Alamos National Laboratory provided data regarding the spread of the COVID-19 virus. Based on this data, the predicted percentage of immunity in the population to achieve herd immunity is between 80% to 85%. With the emergence of the new strain, this percentage will be even higher. Thus, we need to administer a highly effective vaccine to almost all of our population.

A healthcare worker prepares to administer the COVID-19 vaccine to Theodore McNeal, 73, a marine veteran that served in Vietnam, at the Robley Rex Veterans Affairs Medical Center on Wednesday. Jan. 6, 2021
A healthcare worker prepares to administer the COVID-19 vaccine to Theodore McNeal, 73, a marine veteran that served in Vietnam, at the Robley Rex Veterans Affairs Medical Center on Wednesday. Jan. 6, 2021

The United States needs to rise to the occasion and confront this pandemic. Let us not place political expediency above public safety. There needs to be a massive increase in our public health infrastructure, along with employment of additional personnel for vaccine administration, case tracking and testing. This virus will become endemic, it is highly infectious and currently has multiple animal hosts, so this commitment will have recurrent costs for decades to come. Until then, supplementing health department efforts with the National Guard may be necessary, and the public can stay safe by following public health advice.

Remember the Louisville Zoo’s snow leopards, which caught the virus that causes COVID-19. They are particularly good at enforcing social distancing, not so much at wearing masks. You need to do both.

Kevin Kavanagh is a retired physician from Somerset, Kentucky, and chairman of Health Watch USA. This column originally appeared in the Louisville Courier Journal.

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This article originally appeared on Louisville Courier Journal: With COVID-19 vaccinations behind schedule, here's what US must do now