There are over 17 million confirmed covid-19 cases in the US and over 300,000 dead, a staggering number thanks to our idiot president’s refusal to acknowledge the disease and take strong action early on. That works out to about 5% or the population or one in twenty who have tested positive. I read sometime ago that half the population knows at least one person personally who has tested positive and one third knows someone who has died.
Since I live alone and have been able to minimize contact with people, I was not surprised that until recently, I did not know anyone in either category. But last week a friend who lives nearby said that she had tested positive and had been isolating for the required period and then tested negative. She had no idea how she got infected because she had been working from home and only gone in to work about once a week and nobody else in her workplace had tested positive. But of course she has to do some shopping and the like and that may be how she got it.
I received a notification from my health insurance company that said that when the vaccines are available, they will be made available to us through the pharmacy chain that they work with and that it will be free of charge. But of course they do not know at this time when that will be.
Since the supplies are limited, once the people who are top priority get it and it becomes available to the rest of us, there will have to be some decision rules to determine the order. Right now the priority categories are broad but they will have to become more fine-grained. For example, though I am in the high risk category because of age, I am low risk in terms of my lifestyle. While older people who live in nursing’s are very high risk and should get the vaccines as soon as possible, it would make more sense to prioritize people who have to work in grocery stores and the like, whatever their age, over people like me because they are in constant contact with a large number of people and are more likely to both contract and spread the virus.
The rapid rise in infections is because more young people are getting infected. On the other hand, mortality rates rise rapidly with age and for men more than women.
For every 1,000 people infected with the coronavirus who are under the age of 50, almost none will die. For people in their fifties and early sixties, about five will die — more men than women. The risk then climbs steeply as the years accrue. For every 1,000 people in their mid-seventies or older who are infected, around 116 will die. These are the stark statistics obtained by some of the first detailed studies into the mortality risk for COVID-19.
So decisions will have to made based on whether the goal should be to minimize the infection rate or the death rate. This is where medical ethicists get to really earn their salaries. Once the high risk categories have been vaccinated, the order of the rest may have to be based on a lottery of some kind, perhaps based on their birthdays, like the Vietnam war draft was. That would be somewhat equitable.
It would help if everyone took as many precautions as possible until everyone is vaccinated. But some still continue to defy common sense. Trump still has not come out strongly urging everyone to get vaccinated but at least his vice president Mike Pence is going to get publicly vaccinated on Friday. It will be interesting to see how the anti-vaxxers respond,