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Covid Blog- Herd Immunity Orange County

By editor
April 19, 2021

A farmhand was helping the farmer with his herd of cows. The farmer asks, "How many cows are in my herd?"

“49,” says the farmhand.
"Ok then; round them up!"
"Ok,fine! You have 50," says the farmhand.
 
Now that I have you trying to figure this out, I will do something totally out of character for me. 
 
I will make a prediction. About Covid. 
 
This is risky because all the predictions about Covid by experts, epidemiologists, the CDC, WHO, and even the Geico Lizard have proven wrong.
 
For example: 
-It wasn't like the flu. 
-It didn't end in warm weather. 
-It didn't burn itself out after a year. 
-It didn't only kill frail seniors and diabetics.
-And the vaccine was not at all a piece of cake.

 
So here is the senior cynical doctor’s prophecy:

We will reach herd immunity this year. In 2021.
 
As a matter of fact, I see it by Halloween. Maybe even Labor Day.
 
When I say herd immunity, I mean enough people will become immune to Covid, rendering its spread unlikely. As a result, the entire community will be protected, even those who are not themselves immune.
 
A disclaimer, I am not the only forecaster to make this projection. But I do firmly believe it.
 
In January, as I was couch bound recovering from Covid, I spent time with my iPad aimlessly surfing. I started doing the math, and as the data is now more solid, the facts speak for themselves.
 
It seems the government experts are trying hard to downplay this scenario. It makes sense-they don't want us complacent. Ripping our masks off. Filling up restaurants. Just in case we NEVER reach herd immunity. 
 
Remember, these are the same people that said antibodies will not protect us.
And no test of cure is needed.
And only get tested if you have symptoms.
And that we need to close our schools,,.no I mean open the schools,,.no close...no....you get the idea. 
 
Now I have an alternate theory. 
First, I would like to pay homage to Monty Python and the genius of John Cleese. If you haven't seen it, please You Tube the “Pythons Ann Elk” skit on the theory on Brontosauruses.
 
Here is my theory  
AHEMMMM!
 
My theory--which belongs to me--is as follows...
 
This is how it goes--
 
The next thing I will type is my theory...
 
Ready???
 
My Theory by Dr Gregg DeNicola will begin now...
AHEMMMM!
 
We will reach herd immunity via natural antibodies against Covid, with additional antibody protection from vaccine programs.
 
That is my theory, which is mine, and belongs to me, and I own it. 
 
For any viral disease, immunity is afforded by antibodies. 
There are only two ways to get these gems in your system. You can make your own, however that would require you to actually contract Covid.
 
The antibodies are also obtained via a vaccine. 
Which are better? I refer you to hours of research on the WWW where you will find no clear answer. 
 
"Natural" antibodies appear to keep you Covid free 99% of the time you have them. 
Vaccine antibodies also appear to be working at a 99% clip. 
 
So, as your bartender says---"Pick your poison."
 
Although if you have had Covid, odds are you are protected- we just do not know how long the protection lasts. We've seen it last a month. We have seen it last 11 months. 

With the vaccine the CDC is hoping for a year efficacy but we don't have the data to support that. A yearly booster is likely.
 
So let’s do some math to validate my theory.
 
To achieve Covid herd immunity as defined earlier, the numbers vary from 50-80% by epidemiologists. Because of potency, penetrance, geographic spread, and different strains, each virus has a different percent.
 
Measles needs 90% herd immunity. Polio only 80%. 
 
Remember herd immunity does not eradicate the virus from the face of the earth. That has only happened once in history. The wonderful Dr. Edward Jenner and his Smallpox vaccine destroyed the Smallpox virus, with the last known case reported in 1977.
 
Since we do not know the exact percentage for Covid yet, let’s pick a reasonable 75%. 
 
In 2020 the US population was 331 million. Let’s say the 2021 US population will be 333 million.
 
That includes infants and children, who notoriously do not have antibodies, so this will require a higher number of adults to have antibodies.
 
333 million Americans, times 75%, means we need 250 million of us with antibodies at one time to achieve the Holy Grail of herd immunity.   
 
On April 1, we had 56 million Americans vaccinated.  
 
The CDC reports in the US, we average 3.1 million new vaccines a day (not the second shot). So by May 1, we should be at 150 million Americans vaccinated. 
 
Now let’s say for various reasons, we do not hit 150 million until July 4th. We also have to count the number of post-Covid patients with antibodies.
 
Sloan Kettering did a study on "seroprevalence" to estimate that in March we had up to 120 million Americans immune due to post-Covid antibodies. 
 
December 2020 had over 20 million documented Covid cases in the US. We are averaging 70,000 new cases a day currently. That means between April 1 and May 1 alone we will have around an additional two million Americans antibody protected. (Yes, nearly all Covid cases make antibodies.)
 
The wild card here is that these numbers are only for swab POSITIVE cases. Experts estimate that there are at least three additional cases never tested or reported for every swab positive patient.
 
You get it. The Mrs. has symptoms, gets PCR tested positive. The Mr. also has symptoms and says “no need for testing, I know I have it. I’ll just hunker down until I feel better.” Then their 2 kids with fevers refuse that "brain biopsy" swab. Four cases but only one positive swab.
 
The "untested" immune help offset the fact that of the 150 million vaccinated Americans we will get to by the summer will include a fair number of people who ALREADY have antibodies from a prior Covid infection.
 
So the math says of the 150 million people that will soon be vaccinated, perhaps only 66% had no antibodies. 
 
That makes 100 million protected from getting the vaccine.
 
NOW add the 120 million people the experts say are protected from natural antibodies post-Covid 
 
Add 30 million people who are protected but don't know it because they haven't (or won’t) be tested.
 
VOILA! 250 million protected Americans, the number for herd immunity. 
 
This doesn't even count continuing at three million vaccines a day, and the 70,000 new cases that are still occurring across the country getting natural antibodies.  I postulate herd immunity by Halloween is not only possible, but probable.
 
An example is the DeNicola Thanksgiving dinner in 2020. There were nine at the table. All tested PCR and antibody negative days before.  All nine were negative.
 
Today, just four months later, six of the nine have had Covid and have antibodies. Six of the nine also have had the vaccine. All nine are currently protected, either by natural or vaccine antibodies. This is happening all over the country.
 
The more people that contract Covid, the more protection we achieve.
The more people that get the vaccine, the more protection we achieve. 
 
Want to hear a joke about immunity?
Never mind, you've already “herd it.”
 
What herd immunity should mean is no more masks. Eating at a restaurant that has tables three feet apart. Salad bars back. Stadiums and concert halls full again.
 
We will know there is herd immunity when the 14 day rolling average of new cases and deaths take a sharp drop to below what a typical flu season has.
 
Yet, I suspect public health experts will still want masks and distancing practiced long after herd immunity has kicked in. Immunity is invisible, and our paranoia over any possible Covid spread will make returning to normalcy difficult. 
 
Yet my math says that we are far closer to herd immunity than the public health officials want to acknowledge. 
 
Yes, new mutations and strains may not respect the vaccines or antibodies.
Yes, some vaccines may wear off in three months without our knowledge.
Yes, natural antibodies may disappear in two months, leaving the post-Covid patient unprotected.
 
Yet despite those concerns, there will still be a steady flow of both natural antibodies and vaccines offsetting them. 
 
And we will reach herd immunity by Halloween.
 
That is my theory. Which is mine and belongs to me.
 
Gregg DeNicola MD
Chief Medical Officer
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth

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