Post #998: North Dakota hits 10 cases/ 100,000/ day!

Posted on February 7, 2021

And nobody notices!

The US is now seeing less than half the number of new COVID cases per day that it saw at the peak! Ditto!

Last week I submitting an Op-Ed piece to the Washington Post.  Limit of 750 words, so it was a challenge for a long-winded person.  Unsurprisingly, it was rejected.  Might as well copy it in below. 

But first, to make sense of this, you need to know that, going forward, North Dakota will receive exactly as much vaccine, per capita, as South Carolina.  Despite the fact that North Dakota currently has 10 new cases (/100K/day) and South Carolina has about 70 new cases (/100K/day) .

If that strikes you as an efficient way to allocate scarce vaccine, then don’t bother to read the rest of this.

Rejected Op-Ed follows.

North Dakota now has the lowest rate of new COVID-19 cases per capita in the continental U.S.  Less than three months ago, they were the nation’s COVID basket case.  The Midwest has the lowest per-capita rate of new COVID of any U.S. region.  Two months ago, that was the epicenter of the U.S. pandemic.  And now, new U.S. COVID cases have fallen more than 40 percent.  Three weeks after we hit our all-time high rate (so far).


Don’t those successes require some sort of explanation?  At the very least, whatever we think has caused them, don’t we want to do more of that?


What does the U.S. CDC have to say about it?  Nothing, as far as I can tell.  Instead, all we seem to hear from CDC is that we must vaccinate 70% of the population to bring the pandemic under control.  (And keep wearing masks.)


And here’s the problem.  That statement about vaccination is grossly incorrect.  And, per the examples above, it’s becoming increasingly obvious that it’s incorrect.  Those all happened well before any material fraction of the population developed immunity via vaccination.


To understand why the CDC statement on vaccines is incorrect, you have to grasp the basic arithmetic of pandemic control.  If each infected person would normally infect two others, you must interrupt half of those infection events to control the pandemic.  If three infections are normal, you must interrupt two-thirds.  Ten infections, 90 percent.  That’s more-or-less exactly how the CDC came up with 70 percent.


The arithmetic doesn’t care how you interrupt the chain of infections.  Textbook examples focus solely on vaccination.  As does the CDC.  But in the real world, and in the math, all factors that prevent infection are equal.  Herd immunity from vaccination, “natural” herd immunity from infection, and COVID hygiene (masking, distancing, etc.) all work.  It’s all good. 


The statement that “70 percent must be vaccinated to control the pandemic” is correct if and only if vaccination is the only means of interrupting transmission of the virus.  It’s the “stand alone” required vaccination rate.  And in the long run, once we drop all COVID hygiene, and post-infection immunity fades, that will be the correct target.


But right here, right now, the statement that “70 percent must be vaccinated to control the pandemic” is simply false.  It’s false because new cases will fall when the combined effect of vaccination, natural herd immunity, and COVID hygiene together push the effective viral replication factor below 1.0, and so get the new case counts to shrink.


I think people are probably smart enough to figure this out, eventually.  And where will that leave their confidence in the CDC if it continues to offer only a (well-intentioned) false narrative about vaccination, and nothing but a shrug of the shoulders regarding the current rapid decline in new cases? 

More to the point, where does that leave Federal policy?  The CDCs failure to put all three factors on a common footing results in less-than-optimal Federal policy.


First, once you acknowledge that the “natural herd immunity” population currently dwarfs the immune-via-vaccination population, our state-level vaccine allocation appears inefficient.  We’re aiming for equal rates of vaccination across states, when we should be aiming for equal rates of immunity.  The latter policy would shift vaccine toward states with a higher fraction of the population still at risk of infection.


Second, but similar, acknowledging all ways to interrupt virus transmission informs the likely need for additional resources to deal with the soon-to-be-prevalent U.K. variant of the virus.  States with the lowest total of vaccination plus prior infections are going to be most at risk for a fourth wave of COVID.


Finally, there’s the old-fashioned issue of hope.  The CDC’s insistence that “70 percent must be vaccinated to control the pandemic” translates roughly to “just another 200,000 deaths and we’ll be fine.”  That’s not exactly a statement of inspiration or urgency.  By contrast, if we’re already at the tipping point without vaccination, the additional impact of vaccination should be profound and nearly immediate, rather than months away.  The message could be “vaccinate to end the third wave of COVID now”.


It’s perfectly possible to believe in vaccination, masking up, and natural herd immunity.  I call upon the Dr. Walensky to adopt a more balanced view of these factors at the CDC, even if that requires acknowledging and quantifying exactly how poor a job has been done in preventing infections so far.