Top members of President Joe Biden’s COVID response team are warning internally that the U.S. may not reach herd immunity until Thanksgiving or even the start of winter—months later than originally calculated—according to two senior administration officials.
In an interview with CBS News this week, Biden hinted at some of these concerns, saying it would be “very difficult” to reach herd immunity—a population-wide resistance to the virus—“much before the end of the summer” with the current daily rate of approximately 1.3 million vaccine doses. Other top officials working on the federal government’s COVID-19 response say the are uneasy about vaccine supply long term and the impact on herd immunity, and have begun to explore ways to expand U.S. manufacturing capacity, potentially through new partnerships with outside pharmaceutical firms.
Beyond supply issues, though, top health officials say they are increasingly worried about the United Kingdom and South African COVID-19 variants, the likelihood that more variants will emerge in the coming months, and the possibility that those variants will evade the vaccines. There is some evidence to suggest that both the Pfizer and Moderna vaccines protect against the B117 United Kingdom variant, though a recent study shows a new mutation could make the vaccines less effective. Data gathered by the Novavax and Johnson and Johnson clinical trials in South Africa suggest their vaccines are less effective against the variant spreading rapidly in the country. And South Africa recently said it was halting the rollout of the AstraZeneca vaccine because evidence from clinical trials suggested the vaccine did not work well against the variant.
Together, the recent data has alarmed health officials in the Biden administration who are now raising questions about what more can be done to not only shorten the herd immunity timeline—not just to return Americans to some sort of normalcy but also to ensure the country does not experience another surge in COVID-19 hospitalizations and deaths. Officials have spent the last several days discussing ways to ramp up genome sequencing to track variants and how to push out the message that Americans need to more closely follow public health guidelines to reduce transmission as B117 variant cases begin to increase.
Dr. Anthony Fauci, who has previously calculated that about 75 percent of the U.S. population would need to get vaccinated to reach herd immunity, said in an interview that he is still “cautiously optimistic” that the country can achieve that goal by the beginning of the fall.
“I still think that is possible,” Fauci said. “As I’ve said before, once we get into mass vaccination when the general public starts getting it by the end of the spring—April, May, June …and we get past any vaccine hesitancy, then we should be able to reach that 70 or 75 percent mark. We’re going in the right direction.” Fauci caveated that prediction by underscoring the fact that he has ongoing concerns about the new COVID-19 variants.
In a press conference Monday, Fauci said that modeling indicates the B117 variant “could become dominant by the end of March.” “That’s the sobering news,” he said. “The two things that we can do is, A, make sure we adhere to the public health measures ... and, B, get as many people vaccinated as quickly as we possibly can.” Vaccine rates have begun to improve across the country in recent days. And the Biden administration continues to announce increases in the number of doses states are receiving each week.
Still, Centers for Disease Control Director Dr. Rochelle Walensky said Monday that the proliferation of variants “remains of great concern and is a threat that could reverse the recent positive trends we’re seeing.” As of this week, 699 variant cases have been confirmed across 34 states, with 690 of these cases being the B117 variant, the variant first reported in the United Kingdom, Walensky said.
“The virus is going to continue to mutate no matter what we do. The types of mutations we'll see will change as more people are immunized. And natural immunity will continue to put evolutionary pressure on the virus. So, we'll see different types of mutations that may help it escape vaccine protection or become more transmissible,” said Rajeev Venkayya, president of Takeda Pharmaceuticals’ vaccine business. “I think the number one thing that's going to affect supply [and access], right now is having more vaccines, demonstrating proof of efficacy and safety. And there, I think the story is very, very promising.”
With the threats of the new variants becoming more clear, the message among Biden officials and health experts alike is clear: Return back to basics. Follow the public health guidelines the CDC has recommended for the past year—masks, social distancing, and limited indoor contact.
“The more transmissible those strains of viruses, the higher threshold you need for herd immunity. The B117 variant … is very concerning,” said Tom Frieden, former director of the CDC. “The good news is that even with B117 as a dominant variant in the UK and elsewhere … cases plummeted when people stop having contact, when people wore masks, when you have people not sharing indoor air with people not in your household. That is the key. We need to give a viral enemy less chance to speak.”
Yet many cities across the country are moving in the opposite direction, and are beginning to loosen restrictions. In New York and New Jersey, for example, officials have begun to allow for increases in indoor dining and other indoor events such as weddings. Iowa’s governor just lifted the state’s mask mandate.
Walensky pushed back against those new guidelines Monday, telling reporters that she discouraged any move to loosen masking guidance. “We’re still at over 100,000 cases a day,” she said. “I think we have yet to control this pandemic. We still have this emerging threat of variants. And I would just simply discourage any of those activities. We really need to keep all of the mitigation measures at play here if we're really going to get control of this pandemic.”
Atul Gawande, a former member of President Biden’s transition COVID-19 advisory board, said in an interview that vaccination is not the only way to combat the new variants.
“We're going to need more than the vaccines when it comes to the strains. We have a very high rate of viral circulation. So, we're going to continue to generate new strains. The fact that we've already seen strains that have some diminished effectiveness for the vaccines suggests where we could be up against,” Gawande said. “We're going to have a year where it's going to take a long time not just to get to people. We're going to have significant pockets of the population that will not yet have received the vaccine, either because they don't want it or they want to or they want to wait. We're going to have significant circulation. The variants are increasingly defeating the monoclonal antibodies.”