‘Covid zero’ isn’t happening


Receiving vaccines at a community center in the Bronx this month. James Estrin/The New York Times


‘Risk elimination? Impossible.’

Ten years ago, a deadly infectious disease killed more than 36,000 Americans. The next year, it killed 12,000 more. And over each of the following eight years, the same disease caused between 22,000 and 62,000 deaths.


That disease is influenza — also known as the flu — and it ranks among the 15 leading causes of death in the United States.


Talking about the effects of a typical flu is somewhat fraught these days. We are living through the worst pandemic in a century, one that is of a different order of magnitude from influenza. In the early months of Covid-19, some people who were trying to deny its severity, including President Donald Trump, claimed that it was barely worse than the flu. That’s false:

By The New York Times | Sources: Health agencies and hospitals


Soon, however, the flu will become a meaningful point of comparison.


In the coming months, Covid will probably recede, as a result of vaccinations and growing natural immunity. But it will not disappear.


“Some people have gotten this idea that we’re going to get to ‘Covid zero. That’s not realistic. It’s a fantasy.”

Dr. Amesh Adalja of Johns Hopkins University told me.


Not zero, but normalcy

Covid is caused by a coronavirus — known as SARS-CoV-2 — and coronaviruses often circulate for years, causing respiratory infections and the common cold. The world is not going to extinguish coronaviruses anytime soon, nor will it extinguish this specific one.


“The coronavirus is here to stay,”

as a recent article in the science journal Nature, by Nicky Phillips, concluded.


The reasonable goal is to make it manageable, much like the seasonal flu. Fortunately, the vaccines are doing that. In fact, they’re doing better than that. For fully vaccinated people, serious illness from Covid is extremely rare, much rarer than serious illness from the seasonal flu.


Israel, the country that has vaccinated the largest share of its population, offers a case study. One recent analysis looked at 602,000 Israelis who had received Covid vaccines and found that only 21 later contracted the virus and had to be hospitalized. Twenty-one is obviously not zero. Vaccines are almost never perfect. But the Covid vaccines are turning it into the sort of risk that people accept every day.


Here’s a useful way to think about Israel’s numbers: Only 3.5 out of every 100,000 people vaccinated there were later hospitalized with Covid symptoms. During a typical flu season in the U.S., by comparison, roughly 150 out of every 100,000 people are hospitalized with flu symptoms.


And yet the seasonal flu does not grind life to a halt. It does not keep people from flying on airplanes, eating in restaurants, visiting their friends or going to school and work.


The vaccines will not produce “Covid zero.” But they are on pace — eventually, and perhaps even by summer — to produce something that looks a lot like normalcy. The rare exceptions won’t change that, no matter how much attention they receive.


As Dr. Stefan Baral, an infectious disease expert, wrote on Twitter:


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