When will life return to what it was before pandemic?
Late July? Labor Day? They’re just guesses
When will everyone be able to go to the supermarket without giving any thought to the potential risk? When will the only concern at a crowded restaurant be whether you can get a table?
When will people get to laugh with friends in a bar?
Best case: Late July. Conservative estimate: Labor Day. Both are no more than guesses, based on some basic math, on when Wisconsin will have received enough vaccines to give two shots to 80% of the state’s adult population.
It doesn’t take into account the prospect of other vaccines, such as one from Johnson & Johnson, becoming available in the coming months.
But, for now, Pfizer has committed to delivering 200 million doses of its vaccine by May 31. Moderna has committed to delivering 200 million doses by June 30. Both require two shots.
Wisconsin makes up 1.8% — 1.77% to be more specific — of the country’s population. That means the state should expect a bit less than 7.1 million doses, or enough to vaccinate 3.5 million people.
Vaccinating 80% of the state’s adult population — those 18 and older — will require 3.6 million doses.
The late July estimate assumes that Pfizer will continue to deliver vaccines through June.
It also assumes there are no production glitches and that the state works its way through the logistical challenges of a massive vaccination program.
The 80% figure also is somewhat arbitrary. That’s the state’s goal and the estimate needed to develop so-called herd immunity — a term that was un
known to most people before the pandemic.
But there's a nuance to this. The estimate of 80% for herd immunity — and it's just an estimate — is based on the total population, not just adults. Wisconsin has 1.3 million people under 18. But the vaccines have not been approved for children.
(The vaccine developed by Pfizer and BioNTech is approved for people 16 and older.)
Laura Cassidy, a professor and director of epidemiology at the Medical College of Wisconsin, believes the state's goal of vaccinating 80% of the adult population by the end of June is achievable.
“It's an aggressive goal,” she said. “But given the right circumstances and people taking the vaccine, we can get there.”
A complicated future
When would day-to-day life resemble life before the pandemic?
“A lot of people think we could get there by the end of the summer,” Cassidy said.
That said, there are some caveats — and a few unsettling unknowns.
Immunity isn't assured immediately after the second dose. Five weeks can pass before someone has peak immunity. It varies from person to person. But that's a conservative estimate.
“It does take time,” Cassidy said. “But everything takes time. If you are training for a sporting event, it takes time.”
It means that someone who receives a second shot in the last week of June may not have peak immunity until August.
In the short term, it also means that many grandparents — at least those over 65 — still are several months away for being able to see their grandchildren.
For example, those vaccinated in mid-February would not get a second shot until mid-March. They then would need to wait for two to five weeks for full immunity to develop. And many of the 700,000 people in the state who are over 65 will not have gotten the first shot by mid-February.
There also is the unknown of new variants of the coronavirus discovered in Great Britain, South Africa, Brazil and now California. They are much more contagious. The vaccines also may be slightly less effective in combating them.
The variant from Great Britain — which is less deadly — is spreading rapidly through the United States and is expected to become the dominant strain.
The virus that causes COVID-19 does not mutate as fast as other viruses. Still, every time it replicates, there is an opportunity for it to mutate.
“There is always a chance that in the future another new variant might emerge, and we would have to check again whether the vaccine can be effective against that new variant,” said Ajay Sethi, an epidemiologist and professor at the University of WisconsinMadison.
Sethi is shying away from trying to estimate how long the vaccination program will take and when the state will reach the goal of herd immunity.
“I am much more comfortable calculating what's needed for herd immunity once we find the vaccine being able to put a dent in the transmission of cases,” he said.
Problems with supplies, logistics
Right now, the problems are the supply of the two vaccines and logistics.
“And we have a long way to go,” he said.
The rollout started with health care workers and people who live in nursing homes and assisted living centers. Both groups work or live in one place. The logistics for subsequent phases of the rollout will be more challenging.
Health systems will need to reach out to their patients, and other people will have to find out where they can get the vaccine and make appointments.
Cassidy, the Medical College professor, expects the rate of vaccinations to pick up.
“We have worked through a lot of the logistics,” she said.
Future glitches, though, are almost certain. “This is the first time we are ever doing something like this, and we are learning from it,” Sethi said. “But there is going to be some chaos or perceived chaos.”
As the vaccination push expands to more of the population, for instance, missed appointments could become a problem.
The same holds for people who are wary of the vaccine.
“It's an underlying issue,” Sethi said. “It's being addressed. It probably will reveal itself more when the supply exceeds demand.”
Masks, distancing will remain
Another concern is no one knows whether the vaccine prevents transmission.
“With the new strains out that are much more contagious, we don't want to let our guard down now,” Cassidy said. “The vaccine is only one part of the equation.” Sethi said the same.
“We shouldn't rely on the vaccine only,” he said. “Mitigation is really important. It's more effective in my mind, frankly.”
People still will need to take precautions such as wearing masks, maintaining social distancing and avoiding large crowds to keep the rate of new infections down.
Those measures have been proven to work, Cassidy and Sethi said.
Another unknown is the degree of immunity among the more than 500,000 confirmed cases of people in the state who have contracted the virus.
The actual number of people who have been infected with the virus is larger given that many people never show symptoms and do not get tested.
Their having at least some immunity to the virus could help slow its spread. But scientists don't know how long immunity lasts. And some people who have had COVID-19 don't develop enough antibodies to have immunity.
Research also has found that people who had mild symptoms generally have fewer antibodies, Sethi said.
For this reason, even people who have had COVID-19 would be wise to get the vaccine.
“The vaccine is a controlled dose with an expected outcome,” Cassidy said. “They know exactly how much to give.”
For now, vaccine rollout will hinge on supplies being available and working through the logistical challenges. It also will hinge on new variants of the virus not rendering the existing vaccine ineffective. And it will hinge on overcoming some people's wariness of the vaccine.
But with much work and some luck, the vaccination push holds the promise of ending a long and strange time in people's lives — potentially by the end of this summer, and maybe earlier.
The state's goal is vaccinating 80% of the adult population by June 30. But Sethi may have a better goal.
“I think the target is just keep vaccinating until you find out nobody wants it anymore,” he said.