Estimated immunity rises but potential for 'stratified society' looms

April 21, 2021
Hand holding a vaccine card and a piece of paper that says a person has COVID antibodies.
Woman holds a vaccination card with pink stickers belonging to one person and a paper stating a different person has COVID-19 antibodies from an infection. Photo by Sarah Pack

COVID-19 infections are up another 8% in the Tri-county area compared with last week, which also saw an 8% increase over the previous week. That combination just turned a key measure — the trajectory of cases — from yellow to red in the latest update from the MUSC COVID-19 Epidemiology Intelligence Project.

About 1,155 cases of COVID-19 were reported in Berkeley, Charleston and Dorchester counties combined over the past week, compared with about 1,070 the week before. Despite the increase, project leader Michael Sweat, Ph.D., called the level of cases moderate. “We’re kind of in a plateau, and this is also what’s happening nationally – about 20 cases per day for every 100,000 people.”

He thinks the reason numbers aren’t surging as things open up is that more and more people are getting vaccinated. This week, the age of people eligible for a coronavirus vaccine dropped to 16.

But a recent national poll found one in four Americans would refuse a vaccine if it were offered to them. That's similar to what Sweat’s team found in a survey of the Charleston area. “We picked up about 30% of people who were reluctant and about 15% were hardcore.”

Sweat said that has big implications going forward. “We're going to potentially end up with a stratified society — the vaccinated people and the non-vaccinated. It's polarizing, with a political overlay. It’s rapidly bringing up complicated and heated issues.”

Dr. Michael Sweat 
Dr. Michael Sweat

For example, Sweat said, a cruise line might try to restrict some trips, only allowing people who have been vaccinated. Or a restaurant might have a night where it only allows the vaccinated.

But that can be risky – not medically, but financially, and even ethically. “If you enforce only vaccinated people coming versus all the people you're going to alienate, it puts them in a very awkward sort of policing role,” Sweat said.

“Businesses are going to have to figure out what's fair and legal. I think science is colliding with our values around independent decision-making. It's going to be a tough slog to go through.”

That slog could get pretty personal, too. “You're going to see people being cut out of social and family events, people not being able to travel. Those people will continue to be at risk of getting sick.”

And that’s just within the U.S., which is doing relatively well with its vaccine rollout. Some countries haven’t vaccinated anyone yet. Others are struggling.

“Look at Africa or Latin America where the worst epidemic in the world is happening. India could potentially be a massive disaster. I worry about these things because the economic impact of all that is serious. It could lead to refugees and collapsing economies.”

But Sweat tempered his assessment with some good news. More than 50% of American adults have had at least one COVID vaccination.

Meanwhile, the pandemic has sped up the development of technology that lets scientists quickly pivot as the virus mutates. So as long as they keep sequencing for variants, they could theoretically keep up with the coronavirus by tweaking the vaccines.

There’s also encouraging news for South Carolina. Sweat’s team now estimates statewide immunity has risen to about 67%. You can get county-by-county information on the epidemiology project’s website.

But Sweat is concerned about what may lie ahead. “There's a real worry if we can't get enough people vaccinated, we'll never get to herd immunity. It just makes you concerned that we'll never really get this down and totally under control, and we'll kind of be fighting these fires for a long, long time.”

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