Thank you for this newsletter!! My son and daughter-in-law (both vaccinated) live on The West Coast with their 3 & 5 year olds. They were hoping to travel to the East Coast where we live, this July for a visit. They are still very nervous about putting their little ones who are very active, at risk, at the airport and plane. What is your professional opinion about the safety of flying with children in July assuming we continue to keep our numbers down. We flew to the West Coast recently and witnessed many families traveling, much to our surprise.
I have to say I’m not sure I can answer this question specifically. Not being a licensed healthcare practitioner, and knowing little about the specific healthcare situation of your son and daughter-in-law, or their children, I don’t think I can give medical advice in this regard.
That said, I think that in general the CDC now advises that it is acceptable for vaccinated people to travel. Small children are obviously not, at this time, vaccinated, and I think on the topic of the children coming, that’s something they need to talk to the children’s physician(s) about. While the risk to children is thought to be small, it is not nonexistent, and potential long-term negative outcomes are even more concerning if they should happen in children.
However, by July, the epidemic situation in the US could be very different, and it might be much safer to do this.
At any rate, I’m sorry that I can’t really be of more assistance. This is a difficult question and since children are involved I think it’s especially important to seek professional medical advice.
It's impossible to actually know (because enough testing has not been, and cannot be, done) but by this time, a very substantial percentage of Indians have also been infected and survived. You have to assume their at-least-partial immunity will also help to slow the spread until enough vaccine can be manufactured.
I have to hope, at least, that that will have an effect. I agree with you that the numbers we are seeing in India are an underestimate, but herd immunity is kind of a fantasy in a place with 1.4 billion susceptible hosts. Imagine, for example, that the threshold for some kind of herd immunity effect is just 50%, which is quite low and probably not realistic. That means there must have been 700 million infections in India to see that effect, with what I’d expect would be a minimum of 7 million deaths. I don’t think the underestimation is that substantial. And even then, there would be 700 million more susceptible hosts remaining, and I don’t think these people would be evenly distributed at random across the country.
So, my main point here is that even if the situation in India is underestimated, it is not going to have a big impact on a national scale on containment. There may be local effects, where specific places have reached a high prevalence of immunity, but given the density of India I am not sure this will prevent the virus from continuing to spread.
And then there’s the fact that natural immunity appears to be worse than vaccine-induced immunity, which would mean that even more infections would be needed to achieve some sort of herd immunity than vaccines would be needed. So, not great all around.
In natural settings, naturally-acquired population immunity only tends to have meaningful effects when the host population is a small, closed system. In large, open systems with many many susceptible hosts, it’s hard to get to levels of immunity that slow an epidemic.
But hey, I really do hope that I’m wrong about this in some way.
Hi John,
Thank you for this newsletter!! My son and daughter-in-law (both vaccinated) live on The West Coast with their 3 & 5 year olds. They were hoping to travel to the East Coast where we live, this July for a visit. They are still very nervous about putting their little ones who are very active, at risk, at the airport and plane. What is your professional opinion about the safety of flying with children in July assuming we continue to keep our numbers down. We flew to the West Coast recently and witnessed many families traveling, much to our surprise.
I’m glad you’re enjoying the newsletter!
I have to say I’m not sure I can answer this question specifically. Not being a licensed healthcare practitioner, and knowing little about the specific healthcare situation of your son and daughter-in-law, or their children, I don’t think I can give medical advice in this regard.
That said, I think that in general the CDC now advises that it is acceptable for vaccinated people to travel. Small children are obviously not, at this time, vaccinated, and I think on the topic of the children coming, that’s something they need to talk to the children’s physician(s) about. While the risk to children is thought to be small, it is not nonexistent, and potential long-term negative outcomes are even more concerning if they should happen in children.
However, by July, the epidemic situation in the US could be very different, and it might be much safer to do this.
At any rate, I’m sorry that I can’t really be of more assistance. This is a difficult question and since children are involved I think it’s especially important to seek professional medical advice.
It's impossible to actually know (because enough testing has not been, and cannot be, done) but by this time, a very substantial percentage of Indians have also been infected and survived. You have to assume their at-least-partial immunity will also help to slow the spread until enough vaccine can be manufactured.
I have to hope, at least, that that will have an effect. I agree with you that the numbers we are seeing in India are an underestimate, but herd immunity is kind of a fantasy in a place with 1.4 billion susceptible hosts. Imagine, for example, that the threshold for some kind of herd immunity effect is just 50%, which is quite low and probably not realistic. That means there must have been 700 million infections in India to see that effect, with what I’d expect would be a minimum of 7 million deaths. I don’t think the underestimation is that substantial. And even then, there would be 700 million more susceptible hosts remaining, and I don’t think these people would be evenly distributed at random across the country.
So, my main point here is that even if the situation in India is underestimated, it is not going to have a big impact on a national scale on containment. There may be local effects, where specific places have reached a high prevalence of immunity, but given the density of India I am not sure this will prevent the virus from continuing to spread.
And then there’s the fact that natural immunity appears to be worse than vaccine-induced immunity, which would mean that even more infections would be needed to achieve some sort of herd immunity than vaccines would be needed. So, not great all around.
In natural settings, naturally-acquired population immunity only tends to have meaningful effects when the host population is a small, closed system. In large, open systems with many many susceptible hosts, it’s hard to get to levels of immunity that slow an epidemic.
But hey, I really do hope that I’m wrong about this in some way.