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On Nov. 9, 2020, just two days after the Associated Press called the 2020 presidential election for former Vice President Joseph R. Biden Jr., American pharmaceutical corporation Pfizer and German biotechnology company BioNTech announced that their COVID-19 vaccine had an efficacy rate of more than 90%.
Soon after, American pharmaceutical and biotechnology company and drugmaker Moderna announced on Nov. 16, 2020 that its COVID-19 vaccine had an efficacy rate of 94.5%. Johnson & Johnson’s vaccine — the only other COVID-19 vaccine to be approved for emergency use in the United States as of time of publication — was issued FDA emergency use authorization on Feb. 27, only requires a single dose and has an efficacy rate of 85% 28 days after vaccination.
Outside of the United States, other vaccines have received approval, such as Sputnik V in Russia, Iran and Argentina; Convidecia in China, Mexico and Pakistan; and AstraZeneca’s vaccine in Britain, the European Union and many other countries. AstraZeneca’s vaccine, which has been paused following reports of fatal brain hemorrhages and blood clots, is still awaiting FDA emergency approval.
In the U.S., the vaccine rollout is underway and millions of people are being vaccinated every day. At the time of publication, 12% of the U.S. population is fully vaccinated and 22% have at least one dose, while 11.9% of the population in the state of Michigan is fully vaccinated and 21.1% have at least one dose.
Michigan Medicine is participating in the vaccine rollout and is offering 4,400 first-dose appointments for the week of Mar. 15, 2021. As of March 16, Michigan Medicine’s cumulative dose total sits at 74,692. Gov. Gretchen Whitmer announced that all Michigan adults will be eligible for COVID-19 vaccinations beginning on April 5, 2021.
After a long partisan battle in Congress to pass his COVID-19 Relief Bill, President Joe Biden announced in his first nationally televised address as president on March 11 that all Americans will be eligible for COVID-19 vaccinations by May 1, an acceleration of the president’s original vaccination timeline. President Biden also tweeted reiterating statements he made in his speech, that he believes “there’s a good chance” that gatherings will resume on July 4.
U.S. COVID-19 cases have been dropping since mid-January, where the high on Jan. 8 surpassed 300,000 cases. On March 13, the U.S. reported 49,728 cases and the current 14-day change is a 19% decrease. This information, in combination with the increase in vaccinations, has led some to believe that the pandemic is ending, despite Dr. Anthony Fauci, chief medical advisor to the president, warning of another possible surge in cases, similar to the current one in Europe.
Given the uncertain nature of the pandemic and thus the future, The Michigan Daily sat down for interviews with Emily Martin, a key player in the University of Michigan’s COVID-19 response and an associate professor of epidemiology in the School of Public Health, and Susan Ringler-Cerniglia, a key player in Washtenaw County’s COVID-19 response and communications and health promotion administrator for the Washtenaw County Health Department.
The Michigan Daily: Will life ever go back to “normal”? If not, what will the “new normal” look like post-pandemic?
Susan Ringler-Cerniglia: I think there’s some things about normal that we’ve hopefully learned, from an infectious disease standpoint. I hope we’ve learned that things like hand washing, staying away from others and maintaining distance if you’re sick can have a really big impact. I hope we’re learning that we really can reduce and prevent transmission of infectious disease by taking some of those steps seriously.
Hopefully we’re more conscious of — certainly those of us that work in public health and population health fields are already very aware of — the impact of social vulnerabilities and the impact of things like the social determinants of health. I’m talking about how much money you make, the color of your skin, where you live geographically, whether or not you speak English as a primary language. Many of those things can have a big impact on your health and your ability to get access to care. The optimist in me hopes we are finally learning more about that and have some collective willingness to change it and make things systemically better.
TMD: Will COVID-19 ever go away entirely? Should we expect to be dealing with this virus for the rest of our lives? If so, what will that look like?
Emily Martin: I don’t think it’s going to go completely away, but there are a few options. It could stay around and end up becoming more common, but maybe not as severe and might end up looking sort of how the flu season looks where it comes and goes from year to year. And we’ve got strategies that we know that can protect us.
The vaccine, which continues to be a recommendation, protects vulnerable populations. It could also look something like measles does now, where almost everybody is vaccinated against it, which does an excellent job of keeping the virus at bay. But then you may have certain communities or regions where vaccination rates will fall off, and then you’ll start to see outbreaks and big clusters happen, bringing more vaccinations, and then you control those clusters and you’re able to get them to go away. This is also a potential future for this.
TMD: What qualifies as herd immunity? When do you expect the U.S. will reach herd immunity?
Ringler-Cerniglia: The state of Michigan has set a goal of 70% vaccinated by the end of this calendar year, and that’s being pushed up a bit to as soon as possible. I believe they set that 70% based on the fact that the experts believe it would start to provide a level of community protection, and certainly if we can get beyond that 70%, even better.
I think we’re still learning, we have a lot of information from the clinical trials about the vaccines and about the level of which they provide individual protection, now that they’re being used out in the real world. We will learn much more about their ability to prevent spread and to convey that herd immunity. So I think the answer to your question is we’ll still have to figure out.
TMD: When do you expect the entire world will reach herd immunity?
Martin: That’s tricky. So, herd immunity, in my mind, is defined as the point at which so many people are vaccinated or immune that the virus goes away without us having to do anything about it. We’re not having to test, trace and use masks and distance to make the virus transmission slow down; it naturally slows down. That’s a really high number, we’re looking at immunity probably up in the 80 to 90% range.
We’ve been able to do that with measles in the United States, but we haven’t been able to do that for diseases like measles and polio internationally very well. I can imagine that getting there is going to take a little while and it’s going to take a really focused global effort. We’re going to have to broaden our mindset, out of the U.S. model, and think about what we need to do to provide these kinds of resources and access to vaccinations worldwide in order to make that happen.
TMD: Should already-vaccinated people expect to receive additional vaccinations to protect from new variants and strains of COVID-19 or “booster” vaccinations to maintain their immunity? If so, when do you think they will be available to the general public?
Martin: I wouldn’t be surprised if we would ask people to get a booster vaccine about a year from now — this seems, to me, the likely timeline for that and I’m completely speculating about this.
Some of the considerations are the fact that strains could emerge that are very, very different from current strain so that they’re absolutely mismatched from the vaccine, and that’s something that we’d want to use a booster vaccine to cover. The other open question is (that) we just don’t know the duration of immunity after vaccination — these people haven’t been vaccinated for that long. If we find that the vaccination wears off over time, like the flu vaccine tends to do, then we’ll want to boost that once a year. It’s quite possible that we’ll end up in a scenario where this becomes a yearly vaccination.”
TMD: In the U.S., cases are dropping and millions of people are being vaccinated everyday — is this a sign that the pandemic might be gradually ending?
Ringler-Cerniglia: I think for us, locally, I can tell you we are making a lot of progress. According to what we know from Washtenaw County right now, about (74.1%) of our residents 65 and older have gotten at least one vaccine, and we’re more like (27.7%) overall. That’s some really good progress on vaccination considering how new the rollout is. If what we hope will be true is true with the vaccinations and we start to see a reduction in hospitalizations, deaths and spread as we get more people vaccinated, then it’s certainly easier to back off the other prevention strategies like the isolation, quarantine and all the other things that we’re doing right now to reduce spread.
TMD: What would officially mark the “end” of the pandemic? (i.e., few cases worldwide, or some kind of treatment that greatly reduced deaths/severe complications)
Martin: That’s a really good question — there’s a lot of really constant and globally understood rules about what starts a pandemic. I don’t think there are great rules about what ends a pandemic. I think the world is going to want to see hospitalization rates come down to a point where we’re not having these really incredible amounts of deaths and hospitalizations. I think at that point, then you’ll start to see the sense of the pandemic go away … that real urgency.
TMD: When can U-M students expect to have parties again?
Martin: I think we’re moving into a space where we’ll start seeing more experiences, but still in the model of having masks and some distance. I think we’re going to go through a period like that for probably nine months or so. Once we get out of that period then we’ll start to get to a situation where enough people are vaccinated, that if you walk into a room of people it’s likely that most of them are going to be vaccinated. When we get to that point, that’s when we’re going to start to see the masks and the distancing start to go away.
I think there’s a real desire to get together and kind of participate in all these activities like we used to, but actually I think once we all get back into that space, there’s going to be an adjustment period. The other day, at the grocery store, somebody came up right next to me, and I told him I wasn’t ready for that. I’ve had season tickets for basketball and football at Michigan for years — I’m used to sitting with people packed in all around — and suddenly, I don’t want to get too close to somebody at the grocery store. You can imagine it’s going to take people time to adjust to getting back into these spaces.
TMD: What about in-person classes? Attend a game in the Big House with a full crowd? Hang out on the Diag without masks?
Ringler-Cerniglia: It’s really difficult for us to put timelines together. It depends on our supplies from week to week. It’s very hard for us to say, ‘Oh, by this date we’re going to have everybody vaccinated, and two weeks after that it will be much safer to have gatherings.’ It’s very, very hard to put timelines to that.
There’s been announcements at the federal level from the president about opening eligibility broadly very soon, and hoping for some normalcy by summer. That eligibility doesn’t really mean much if it doesn’t mean we can actually give people the vaccine. We hope that we will be flush with vaccines in the coming month and we can really provide it to everybody that wants it. That will give us huge strides back toward normalcy and these things you’re talking about. Hopefully we can get together more safely, have in-person classes and not necessarily worry about the masks and the distance because we have so many people vaccinated.
TMD: Given President Biden’s vaccine announcement regarding opening eligibility to the vaccine starting May 1, do you expect the University of Michigan will require students to be vaccinated to attend class in the Fall of 2021? If so, will Michigan Medicine offer vaccines to students?
Martin: I know a lot of universities are discussing the challenges around requiring vaccination. From my understanding, it is a very complicated and very new regulatory landscape, to be able to do that and because of the specifics of how these vaccines were approved. It’s a really sort of complex regulatory thing to do from a legal perspective because these are emergency use authorization vaccines.
I don’t know that I’ve heard of any universities coming out with a mandate, but I could be wrong. In terms of if Michigan Medicine is going to offer it, I think that they think they’re offering basically as much vaccine as they can get their hands on. The hope is that students are going to have a lot of different ways and places to get vaccinated.
TMD: As the pandemic subsides, how does the University plan to facilitate students, faculty and staff transitioning out of virtual life and readjusting to normalcy with regards to mental health?
Martin: Amongst the faculty, there is definitely this understanding that we can’t just flip a switch and have everybody be ready to just revert back to life as it was. This is a significant event that’s happened in the lives of students, and even if it’s safe from a transmission perspective, to start interacting more, it doesn’t wash away the fact that there’s a lot of trauma that students have experienced and there’s a mental health burden that they’re carrying. We need to continue to commit to taking care of that aspect going forward, even when the virus dissipates.
TMD: On a larger scale, when the pandemic is all said and done, how do you think this period of isolation and quarantine will have affected our society and our collective mental health and well-being?
Ringler-Cerniglia: No doubt there’s a feeling of having gone through something, of having lived through history. In other words, (the pandemic) will be with all of us. I think it’s also a good reminder that we all need to understand that these pandemics and these types of events can happen, and be better prepared in terms of our public health infrastructure and our ability to collaborate, trust and work with each other to get through something like that. I think that we’ll find more willingness to do that. You know, not necessarily thinking short term like, ‘Oh, we got through this pandemic, and aren’t we glad we never have to do that again.’ No, we have to continually be investing in these resources and support our ability to coordinate a response because it’s going to be required of us again. I hope that we can look at it that way, as well as support each other through the very real impacts of what we’ve all gone through.”
Daily Staff Reporter Jared Dougall can be reached at jdougall@umich.edu.
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