扭时报:群体免疫比你知道的更接近

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yzout
楼主 (文学峸)

We’ve known from the beginning how the end will arrive. Eventually, the coronavirus will be unable to find enough susceptible hosts to survive, fading out wherever it briefly emerges.

 

To achieve so-called herd immunity — the point at which the virus can no longer spread widely because there are not enough vulnerable humans — scientists have suggested that perhaps 70 percent of a given population must be immune, through vaccination or because they survived the infection.

 

Now some researchers are wrestling with a hopeful possibility. In interviews with The New York Times, more than a dozen scientists said that the threshold is likely to be much lower: just 50 percent, perhaps even less. If that’s true, then it may be possible to turn back the coronavirus more quickly than once thought.

 

The new estimates result from complicated statistical modeling of the pandemic, and the models have all taken divergent approaches, yielding inconsistent estimates. It is not certain that any community in the world has enough residents now immune to the virus to resist a second wave.

 

But in parts of New York, London and Mumbai, for example, it is not inconceivable that there is already substantial immunity to the coronavirus, scientists said.

 

“I’m quite prepared to believe that there are pockets in New York City and London which have substantial immunity,” said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. “What happens this winter will reflect that.”

 

 “The question of what it means for the population as a whole, however, is much more fraught,” he added.

 

Herd immunity is calculated from the epidemic’s so-called reproductive number, R0, an indicator of how many people each infected person spreads the virus to.

 

The initial calculations for the herd immunity threshold assumed that each community member had the same susceptibility to the virus and mixed randomly with everyone else in the community.

 

“That doesn’t happen in real life,” said Dr. Saad Omer, director of the Yale Institute for Global Health. “Herd immunity could vary from group to group, and subpopulation to subpopulation,” and even by postal codes, he said.

 

For example, a neighborhood of older people may have little contact with others but succumb to the virus quickly when they encounter it, whereas teenagers may bequeath the virus to dozens of contacts and yet stay healthy themselves. The virus moves slowly in suburban and rural areas, where people live far apart, but zips through cities and households thick with people.

 

Once such real-world variations in density and demographics are accounted for, the estimates for herd immunity fall. Some researchers even suggested the figure may be in the range of 10 to 20 percent, but they were in the minority.

 

Assuming the virus ferrets out the most outgoing and most susceptible in the first wave, immunity following a wave of infection is distributed more efficiently than with a vaccination campaign that seeks to protect everyone, said Tom Britton, a mathematician at Stockholm University.

 

His model puts the threshold for herd immunity at 43 percent — that is, the virus cannot hang on in a community after that percentage of residents has been infected and recovered.

 

Still, that means many residents of the community will have been sickened or have died, a high price to pay for herd immunity. And experts like Dr. Hanage cautioned that even a community that may have reached herd immunity cannot afford to be complacent.

 

The virus may still flare up here and there, even if its overall spread is stymied. It’s also unclear how long someone who has recovered may be immune, and for how long.

 

Virus-Resistant Communities?

The coronavirus crashed this year’s Purim celebrations in the Orthodox Jewish neighborhoods of New York City, tearing through the parades and masquerades in Brooklyn on March 9 and 10.

 

Schools and synagogues soon shut down to quell the spread, but it was too late. By April, thousands in the Brooklyn communities were infected, and hundreds had died.

 

“It’s like a black hole in my memory because of how traumatic it was,” said Blimi Marcus, a nurse practitioner who lives in Borough Park, which was hit hard by the virus.

 

But all that has changed now, Ms. Marcus added: “The general feeling is one of complacency, that somehow we’ve all had it and we’re safe.”

 

Is it possible that some of these communities have herd immunity? In some clinics, up to 80 percent of people tested had antibodies to the virus. The highest prevalence was found among teenage boys.

 

But people at clinics are more likely to be showing symptoms and therefore more likely to be infected, said Wan Yang, an epidemiologist at Columbia University’s Mailman School of Public Health in New York. Random household surveys would probably find lower rates — but still well above the 21 percent average reported for New York City, she said.

 

Researchers in Mumbai conducted just such a random household survey, knocking on every fourth door — or, if it was locked, the fifth — and took blood for antibody testing. They found a startling disparity between the city’s poorest neighborhoods and its more affluent enclaves. Between 51 and 58 percent of residents in poor areas had antibodies, versus 11 to 17 percent elsewhere in the city.

 

The lowest-income residents are packed tightly together, share toilets, and have little access to masks. “These factors contributed to a silent infection spread,” said Dr. Jayanthi Shastri, a microbiologist at Kasturba Hospital in Mumbai who led the work.

 

Most researchers are wary of concluding that the hardest-hit neighborhoods of Brooklyn, or even those in blighted areas of Mumbai, have reached herd immunity or will be spared future outbreaks.

 

But models like Dr. Britton’s hint that it’s not impossible. Other researchers have suggested, controversially, that herd immunity can be achieved at rates of immunity as low as 10 or 20 percent — and that entire countries may already have achieved that goal.

 

Criticism trailed Sunetra Gupta, a theoretical epidemiologist at Oxford University, after a widely circulated interview in which she said that London and New York may already have reached herd immunity because of variability among people, combined with a theoretical immunity to common cold coronaviruses that may protect against the new one.

 

“That could be the explanation for why you don’t see a resurgence in places like New York,” she said.

 

Most experts reject that notion. Several studies have shown that certain immune cells produced following infection with seasonal coronaviruses may also recognize the new coronavirus.

 

But “where is the evidence that it’s protective?” asked Natalie Dean, a biostatistician at the University of Florida.

 

These cities have not returned to pre-pandemic levels of activity, other experts noted.

 

“We are still nowhere near back to normal in our daily behavior,” said Virginia Pitzer, a mathematical epidemiologist at the Yale School of Public Health. “To think that we can just stop doing all that and go back to normal and not see a rise in cases I think is wrong, is incorrect.”

 

A second wave might also hit groups or neighborhoods that were spared by the first, and still wreak havoc, she said. Immunity is a patchwork quilt in New York, for instance: Antibodies were present in 68 percent of people visiting a clinic in the Corona neighborhood of Queens, for instance, but in just 13 percent of those tested at a clinic in the Cobble Hill section of Brooklyn.

 

But another group, led by the mathematician Gabriela Gomes of the University of Strathclyde in Britain, accounted for variations within a society in its model and found that Belgium, England, Portugal and Spain have herd immunity thresholds in the range of 10 to 20 percent.

 

“At least in countries we applied it to, we could never get any signal that herd immunity thresholds are higher,” Dr. Gomes said. “I think it’s good to have this horizon that it may be just a few more months of pandemic.”

 

Other experts urged caution, saying these models are flawed, as all models are, and that they oversimplify conditions on the ground.

 

Jeffrey Shaman, an epidemiologist at Columbia University, said it wasn’t clear to him that Dr. Gomes’s model offered only one possible solution. And he was suspicious of the big ranges among the four countries.

 “I think we’d be playing with fire if we pretended we’re done with this,” Dr. Shaman said.

 

The new models offer food for thought, he and other experts said, but should not be used to set policy.

 

“Mathematically, it’s certainly possible to have herd immunity at these very, very low levels,” said Carl Bergstrom, an infectious disease expert at the University of Washington in Seattle. “Those are just our best guesses for what the numbers should look like.”

 

“But,” he added, “they’re just exactly that, guesses.”

 

Imperfect Immunity

But what about immunity at levels lower than those needed for herd immunity?

 

“Definitely the disease would not spread as well if it gets back into New York,” said Joel Miller, a mathematical modeler at La Trobe University in Australia. “The same level of behavior change will have more effect on the disease now than it did four months ago.”

 

Thinking of a city or country as composed of subgroups, demarcated by age, race and level of social activity, might also help governments protect those with the least immunity.

 

That perspective also might help put a renewed focus on groups who require the higher levels of immunity, because of greater exposure levels and other inequities, including Black and Latino residents, said Dr. Manoj Jain, an infectious disease expert at Emory University. “That’s where this info is very useful,” he said.

 

The models also suggest a vaccination strategy: Rather than uniformly vaccinate all groups, governments could identify and immunize those most likely to be exposed in “superspreader” events.

“Getting those people vaccinated first can lead to the greatest benefit,” said Dr. Michael Mina, an immunologist at Harvard University. “That alone could lead to herd immunity.”

 

Vaccination schemes for other pathogens have successfully exploited this approach. For example, when children were given the pneumococcal vaccine in the early 2000s, rates of bacterial pneumonia in the elderly rapidly dropped because of a “herd effect.”

 

Vaccines that offer just 50 percent protection are considered to be moderately effective, but at that efficiency, even a low herd immunity target would require that a large proportion of the population be immunized, Dr. Bergstrom noted.

 

If there are early reports of side effects that may scare away some people, he said, “we’d do well to start thinking about all that now.”

 

Back in Brooklyn, fewer than 1 percent of people tested at neighborhood clinics over the past eight weeks were infected with the virus. But there are still handfuls of cases, Ms. Marcus said, adding that her 10-year-old niece was in quarantine because a counselor at her day camp had tested positive.

 

“Sometimes that’s all you need, right?” she said. “I’m still hoping we don’t see what we had in March and April, but I’m not so sure that we’ve seen the end of it.”

老玩家
有些“科学家”其实真不行.本玩家早就根据数据分析指出20%人群有抗体后病毒传染率就大减了.50%还是BS.LOL

这么多数据在那里稍微做点统计分析就可得出可信度比较好的结论,但是还有不少傻瓜在BS全民免疫要65%才行,LOL

老玩家
最近分析了人口TOP100的县的新冠抗体比率.很明显.高于20%的没见反弹,反弹严重地区全低于10%,无一例外.LOL

NY特别是NYC的疫情非常稳定的原因决非是他们防疫做得好,而是经过第一轮大传染后,人口新冠抗体比率已经非常高了。FAUCI博士说NY防疫做得最好说法是错的,要么他在玩政治,要么他还完全没搞懂啦,LOL

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greennew
武汉是做得好,还是感染的比率足够高了?截止8月18日,武汉共有两名确诊个案,连续10天没有新增个案。

老玩家
中国是靠隔离来控制疫情,和群体免疫效果根本不是一件事。两者无可比性,LOL
老玩家
武汉有抗体比率比美国低很多如像美国那样染上病毒的人不隔离可自由行动,疫情无疑会大反弹。LOL
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greennew
坐等其他州感染数量达标,赶超纽约?
老玩家
第二波过去后,有几个州可能会到15%抗体率.但是现在很多(FL,CA等)还是在10%以下.不太理想。LOL
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indexguy
死人已经是常态了,二十多天死了两万,屁措施也沒有。死剩下的就是强者。
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OceanSound
好久没看排行榜了。 刚才去看一下,美国已经十七万四千。今年年景不好,不看奥运金牌榜, 改看新冠感染榜。大家多多保重。
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pickshell
有原文链接嘛?不知他们这样说的依据是什么 ?

依据worldometers数据,现在美国总感染人数已达5,652,700,还在以每天近4万速度增加,因此而死亡人数达174,935。

目前具免疫抗体真实数据%无法统计,先抛开这不论,群体免疫最起码条件应是:不隔离,全民不戴口罩,全面复工开学和聚会等,每天新增数量仍降到很低才算,可目前看到的并不是这样啊。

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greennew
What if ‘Herd Immunity’ Is Closer Than Scientists Thought?

What if ‘Herd Immunity’ Is Closer Than Scientists Thought?

In what may be the world’s most important math puzzle, researchers are trying to figure out how many people in a community must be immune before the coronavirus fades.

https://www.nytimes.com/2020/08/17/health/coronavirus-herd-immunity.html

M
Michelangelo
请问西班牙意大利反弹怎么回事
老玩家
这两国人口抗体比率都不到13%,西班牙其实疫情没大反弹,阳性率稍高于5%,确认上升是测多了。LOL

第一波时阳性率30-40%,现在5-10% ,确认数上升明显是因为测的人数大增所致。阳性率稍高于WHO的REOPEN 标准,意大利就更不用说了LOL

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pickshell
谢谢,看来“群免”目前仅是种假设理论模型,更多是wishing和可能猜测,与现实存在很大距离。
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greennew
你这么说就没法了,确诊多了,都是因为测试量大,每天公布的数据还有任何意义吗?西班牙5,6月只有100-500,最近达到了6千多。

老玩家
难道西班牙第一波阳性率30-40%现在只有5%多点还不说明问题吗?LOL

如果不懂阳性率是什么物理意义,那我们之间对知识的理解程度相差太大,没有讨论问题的基础的嘛,LOL

老玩家
对!如实际感染人数大大高于测试能力,每天公布感染人数误导疫情无意义,LOL

有意义的是公布每天的阳性率,而非大大地低估了的不准确的确认人数。完全不可靠的疫情数据比没数据还没用。LOL

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greennew
我没有看到过哪里公布每天测试量,阳性率从哪里得出?

好了,我到此为止了。

老玩家
每天测了多少人数据每个州都公布,全国的数据也有啊,LOL

美国COVID RAW数据很公开& DETAIL的,任何人只要花时间都可以查到的。要不然本玩家怎么能算疫情嘛,花点实际去研究一下RAW DATA比听假疫情新闻强多了嘛,LOL