COVID-19 Update: Dr. Fauci Says the U.S. Has the World's Worst Outbreak

08/12/2020 9:25 am EST

Focus: HEALTHCARE

Al Brooks, MD

Professional Trader, Author, Lecturer, Brooks Price Action, LLC and Brooks Trading Course

In the second part of this week’s Covid-19 update, we share the concerns of Dr. Anthony Fauci, discuss herd immunity, and the value of getting vaccinated.

Yesterday we discussed immunity, vaccines and the need for affective treatments. Today, we look into the tightrope Dr. Anthony Fauci is walking, herd immunity and the science behind wearing masks.

Dr. Anthony Fauci is in a difficult position because he has to be careful about what he says because he wants to keep his job. He made comments that speak for themselves last week in a Harvard School of Public Health interview.

Dr Anthony Fauci disagrees with Trump

Here are some of his quotes:

“[When asked if the US had the worst outbreak in the world] Yeah, it is quantitatively if you look at it. I mean the numbers don’t lie.”

“I mean when you look at the number of infections and the number of deaths, it really is quite concerning.”

“We can do much better, and we can do much better without locking down, and I think that strange binary approach, either you lock down or you let it all fly, there’s some place in the middle when we can open the economy and still avoid these kind of surges that we’re seeing.”

“Any demographic group that’s not seriously trying to get to the endgame of suppressing this, it will continue to smolder and smolder and smolder.”

“The unseemingly things that crises bring out in the world, it brings out the best of people and the worst of people and getting death threats to my family and harassing my daughters to the point where I have to get security. It’s amazing.” 

“I wouldn’t have imagined in my wildest dreams that people who object to things that are pure public health principles are so set against it and don’t like what you and I say, namely in the world of science, that they actually threaten you. I mean, that to me is just strange.”

“There is a degree of anti-science feeling in this country.”

“I think it’s not just related to science, it’s almost related to authority, and a mistrust in authority that spills over, because in some respects, scientists, because they’re trying to present data, may be looked at as being an authoritative figure.”

He was also interviewed by Bloomberg’s Balance of Power this week and he had a more sober assessment of his expectations for a vaccine. There are currently 35 vaccines in clinical trials. From what Dr. Fauci is saying, the politicians and media are far too optimistic. It appears that all of the vaccines are overrated and will disappoint most Americans. I assume these are his actual expectations, which are far worse than what the public has been led to believe:

“A 50 – 60% effective vaccine is totally value added if you complement it with public health measures. I’d love to have a 90% effective, but if we get a 50 – 60% effective, I will feel good about that.”

“If you get a vaccine, you will have at least several months protection to get you through a season… If it turns out you need to boost someone, that’s okay too.”

The American people are becoming comfortable with the thought that the disease might be around for a long time. I saw an interview with a guy on the street, and the reporter asked him why he wasn’t wearing a mask. He said, “Why bother? We’re all going to get it.”

How to achieve herd immunity?

To reach 70% and herd immunity, if 40% get vaccinated, we need some combination of the three following possibilities (remember, half of the vaccinated people are immune, so they contribute 20% of the 70%):

First, 50% of the population has to get infected, which means 160 million infections in the United States. But if the death rate is even only 0.5%, then 800,000 Americans will die. Deaths are not going to suddenly stop once there is a vaccine as many people will not get vaccinated.

Second, a much higher percentage of Americans needs to be vaccinated. That will happen over time once people see that the vaccine is not killing lots of Americans.

Finally, the effectiveness of vaccines must be significantly greater than 50%. Remember, “effective” means either not getting sick, or getting sick but not as sick as non-vaccinated Covid-19 patients. We need 50% of vaccinated people to not get sick at all. That would require an effectiveness of 70% or more because effectiveness includes both people not getting sick and people getting sick, but less sick than non-vaccinated people.

Masks could save 65,000 Americans by Christmas

There was a study in June, funded by the World Health Organization, that showed that masks might reduce infections by 65%. Obviously, N95 masks provide more protection and a single layer of cloth, like a bandanna, provides less.

One sad thought is that the half of the country not wearing masks could save 65,000 lives by the end of the year if they wore masks.

Benjamin Franklin wearing mask for Covid-19

How did I come to that conclusion? Remember, an infected person infects others, and at some point, there is a death. There are models that show that there will be 300,000 American deaths by the end of the year. That is about 140,000 more than today, and it is based on about half of the country wearing masks.

Of that 140,000, about two-thirds will be cause by non-mask wears. If they wore masks, their share of 100,000 would fall to 35,000. That means if they all wore masks, they would save more people in six months that what we lost in the Vietnam War.

Shouldn’t everyone want to be a part of saving 65,000 lives in five months? What a great accomplishment that would be! This should outweigh any reason to not wear a mask. But it is too theoretical for most people to consider. Also, it would require leadership, which we do not have. Easier to just let them die.

Currently, antivax is not a bad option

I am a physician and I think getting vaccinated is the right choice. The anti-vaxxers are pretty much opposed to all vaccines for a variety of reasons. In the case of the Covid-19 vaccine, the math is currently not much better for the vaccine crowd. But it will get better as the vaccines improve.

We will not have herd immunity until about 70% of the population is immune. They can get their immunity either by recovering from Covid-19 (though there is evidence a prior Covid-19 infection may not provide blanket immunity) that or by getting vaccinated.

There is a third theoretical possibility, but even if it turns out to be possible, the number of people getting it would be too small to factor into this discussion. I mentioned above that some drug companies are working on manufacturing antibodies. Theoretically, a person could become immune for a couple months or more if he received these antibodies through an IV injection.

How bad is the risk of not getting vaccinated?

We need 70% of the population to be immune for the pandemic to begin to slowly disappear. More and more people will keep getting infected until 70% of the population is immune. Then, each infected person on average will infected less than one other person because most of the people whom they encounter will be immune. That will result in the pandemic eventually disappearing.

One of the worst pandemics in history was smallpox in the colonial Americas. It might have killed 90% of native Mexicans. However, we know from past pandemics that probably less than 70% of the population will get infected with Covid-19. It could be only 30% to 50%.

Let’s look at the worst case for vaccines. Assume that only 40% of Americans get vaccinated and that the vaccine prevents the infection in only half of those. That means that 20% of the population could be immune through vaccination. It also means that the remaining 80% of the population would remain at risk of getting infected.

Remember, we need 70% of the population to be immune. Therefore, the other 50% would come from people getting infected. Some of that 50% will be from vaccinated people since only half of them will be immune.

Risk of infection might still be high after vaccination

While this math is not precise, a person not getting vaccinated will have about a 50% chance of getting infected. Of the vaccinated people, half will not be adequately immune and will get infected at about the same rate as non-vaccinated people. Since the population in general has a 50% chance of getting infected and a vaccinated person has a 50% chance of having the same risk as a non-vaccinated person, the risk of infection among all vaccinated people will be 25% (50% of 50%).

While that is twice as good as a non-vaccinated person, is it enough to persuade people to assume unknown risks from the vaccine? I believe those unknown serious risks will occur in fewer than 1% of cases, but since they are unknown, an anti-vaccine person can argue that they are much more common.

Looking at the math, I will get vaccinated

In any case, as a physician who makes decisions on math and data from controlled clinical trials, the math for the anti-vaxxers is not bad here. About half of them will get infected compared to about a quarter of vaccinated people. That difference is not great enough for me to forcefully argue that everyone should get vaccinated.

But if better vaccines come along that completely prevent infection in 70% or more of vaccinated people, and if the risk of serious complications is less than 1 in 1,000, then the arguments in favor of getting vaccinated will have a much stronger mathematical basis. I believe we will get there within a couple years, but by then, the pandemic should be over.

However, the virus might become endemic instead of pandemic. It might just hang around for a decade or more. Remember, our immunity might only protect us for six months or so. Maybe a year or two. I suspect that by next year, we will begin to see people who recovered this year from a bad case of Covid-19 get another very bad case of Covid-19. We might need vaccinations every six to 12 months for many years.

Al Brooks’ earlier special reports on the Covid-19 pandemic:

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