By Sunita Sohrabji
SACRAMENTO, California – Can California safely fully re-open its economy June 15, even without reaching herd immunity, the point at which 60 to 70 percent of the population is resistant to the COVID virus and its variants? Perhaps, say public health experts, if people continue to wear masks and observe social distancing even after being fully vaccinated.
California Governor Gavin Newsom announced April 6 that all businesses can re-open and everyday activity can resume on June 15, if vaccine supply is sufficient for Californians 16 years and older who wish to be inoculated, and hospitalization rates remain stable and low.
“With more than 20 million vaccines administered across the state, it is time to turn the page on our tier system and begin looking to fully reopen California’s economy,” said Newsom in a press statement. “We can now begin planning for our lives post-pandemic.”
The governor did not lift the mask mandate.
About 34 percent of Californians — 21 million people — have received at least one dose of the vaccine and 19 percent are fully immunized. But there are wide disparities in vaccine distribution: comparing data from urban counties, more than 34 percent of residents in wealthy Marin County are fully vaccinated. In farming communities, such as Imperial, San Joaquin and Kern counties, fewer than 16 percent of residents are fully vaccinated, according to The Los Angeles Times COVID vaccine data tracker.
Moreover, children in the U.S. have not been vaccinated, but infections are increasingly showing up in younger people.
From the beginning of the pandemic, COVID experts have touted the need to reach herd immunity before relaxing constraints on businesses and COVID safety protocol. Immunity is gained by either getting vaccinated or being infected by COVID and developing antibodies.
“If you’re protected, you’re not going to be a host for potential genetic variants to grow,” explained physician Nirav Shah, Senior Scholar at Stanford University’s Clinical Excellence Research Center, at a recent briefing hosted by Ethnic Media Services. When variants find no suitable environment in which to grow, they simply die off, he said.
Herd immunity is especially important to protect the home-bound frail elderly. Only 56 percent of California’s elderly population are fully vaccinated: counties are getting creative and employing mobile vans, among other measures, to get older people vaccinated in their homes.
“They are very vulnerable. And so we need this level of herd immunity to protect them,” said Shah.
In a March 26 op-ed for The Wall Street Journal, Dr. Larry Brilliant — a former medical officer with the World Health Organization who worked to eradicate polio — along with W. Ian Lipkin, Lisa Danzig, and Karen Pak Oppenheimer wrote: “The idea of herd immunity against Covid-19 has achieved almost magical status in the popular imagination. Once we reach that threshold, many Americans believe we’ll be in the clear, and the pandemic will finally fade into history.”
“But we are unlikely ever to reach herd immunity with Covid-19—it’s not how this nightmare will end,” wrote Brilliant and his fellow authors.
Dr. Monica Gandhi, a professor of medicine at the University of California, San Francisco, said the state could safely re-open June 15, despite not having reached herd immunity. California is basing its models for re-opening based on Israel and the United Kingdom, she said, noting that Israel released its lockdown after 40 percent of its population was vaccinated and case rates remained low. It fully re-opened its economy as 55 percent of its population was vaccinated: cases continued to remain low.
“People have been critical of Gov. Newsom hurting the economy. But we need to put this in a holistic perspective: people’s businesses and livelihoods, the impact to school children, and the mental health implications of loneliness in isolation,” said Gandhi.
California has the lowest hospitalization rates of any state in the nation, she said, noting only 6 out of every 100,000 people have been hospitalized.
“Herd immunity does not need to be achieved before we re-open,” said Gandhi, adding that she is not critical of the governor’s decision. She added, however, that masks will need to be worn for another year.
Gandhi’s colleague, Dr. Tung Nguyen, who is also a professor of medicine at UCSF, envisions safely re-opening the state this fall, as more children are vaccinated. He said he is concerned about the number of new variants emerging in the state, which have proven to be more contagious and more lethal. Currently, the B117 variant from the United Kingdom — which is 60-70 percent more contagious and lethal than the traditional strain — is now showing up in more than 20 percent of new infections. The Centers for Disease Control are also concerned about the 1351 variant, first identified in South Africa, and the P1 variant from Brazil. A variant is also emerging from Denmark.
Last week, The Clinical Virology Lab at Stanford Health Care confirmed one case of India’s new ‘double mutant’ COVID variant, and seven possible cases among patients at Stanford Hospital’s various clinics around the San Francisco Bay Area. In Maharashtra, India, which is experiencing a re-surge of cases, the double mutant variant is showing up in one out of every five new infections.
“There is a fast replication of the variant and more variants will be coming. So far, vaccines have been protective, but it is just a matter of time before the virus can’t be controlled by the vaccines we have,” said Nguyen.
Like Dr. Gandhi, Nguyen emphasized that mask-wearing will be necessary for at least another year.