COVID and the road ahead

Global cases of COVID-19 are dropping while variants of the disease keep spreading

UC Santa Cruz professor of ecology and evolutionary biology A. Marm Kilpatrick

The pandemic-fatigued American public is looking for answers to a long list of burning questions: Is the outlook for the next few months going to be sunny, or bleak? Can we safely visit our aging parents or grandparents after they are vaccinated? Can the vaccines protect us against the troubling new COVID variants that are arising around the globe? 

UC Santa Cruz infectious disease expert A. Marm Kilpatrick explored these pressing issues on February 16 during his second Zoom-based lecture on COVID since July, when he called for caution and personal responsibility as ways for communities to protect themselves from the disease. 

The talk was moderated by Beth Shapiro, UCSC professor of ecology and evolutionary biology.

The Kraw Lecture is part of a popular series of science and technology talks made possible by a gift from UC Santa Cruz alumnus George Kraw (Cowell '71, history and Russian literature). 

“The big, obvious question is, what about the vaccines, and do they protect us against these new variants, and the answer is a qualified ‘yes,’” said Kilpatrick, UC Santa Cruz professor of ecology and evolutionary biology, during his presentation, COVID-19 vaccines, variants, and more: Our latest understanding of the science of COVID-19, and the road ahead. 

That word "qualified" spoke volumes. Kilpatrick emphasized that scientific knowledge on most variants is still limited, and that more of these things keep arising on the scene. Meanwhile, ominous headlines continue popping up on news feeds, including a report about a laboratory study suggesting that COVID’s South African variant—which has been detected in the United States—may reduce protective antibodies brought forth by the Pfizer/BioNTech vaccine by as much as two-thirds. 

However, the same study, referenced in a February 17 Reuters story, found the vaccine “was still able to neutralize the virus and there is not yet evidence from trials in people that the variant reduces vaccine protection.”

Some variants are more transmissible—and possibly deadlier—and require higher immunity or more restrictions to avoid them, including mask use and social distancing. But Kilpatrick said he remains confident that vaccines will keep the public safe in spite of the troubling variations. 

“Most scientists believe that there's still going to be substantial protection, especially against severe disease,” said Kilpatrick, speaking of variants in general, and the vaccines currently available in the U.S. 

The variants were the "wild card" in Kilpatrick’s presentation, and he laid out the factors that will determine what happens in the next three months, the next sixth months, and more than a year from now. 

It all depends on whether the population can take sensible measures to protect itself while awaiting vaccination—and whether those vaccinations can overtake or keep pace with the variants now spreading at a rapid rate. 

“The U.S. must vaccinate people as fast as possible and keep transmission low until we do so with masks and distancing and ventilation," Kilpatrick said. "We still need to know whether the variants can cause severe disease in people that are vaccinated. We don’t think so, but we don’t have as good data as we would like.”

He emphasized that those who have already had COVID-19 should still make sure to get vaccinated, because vaccine-derived immunity appears to be superior to immunity derived from infection. 

“As a quick aside, I know that some people are already making tables of different vaccines and saying, ‘Which one should I get? Johnson & Johnson or Moderna or the Pfizer?' So what I want to say, overall, is that all the vaccines that are going to be licensed here in the U.S. and other countries will provide at least some protection and often very high protection against [serious COVID-19 infection], and the ones we’re considering here have provided substantial protection against all currently known variants.”

Kilpatrick said socially distancing and masks remain necessary, even after vaccination, because vaccination isn’t 100% effective in blocking infection, so people who have received the vaccine could become infected and transmit the virus to someone else. In addition, scientists still don’t have a clear idea of how long vaccination protection against disease lasts. 

“We know protection against disease lasts at least two or three months, probably longer,” he said, but added that it’s still an open question. 

Asked if this was the beginning of the end, and if the next few months would bring relief from the pandemic, edging the nation to some semblance of normalcy, Kilpatrick said that depended, in part, on how fast companies can make and deploy booster vaccines that block infection from new variants. 

He predicted that all people who want vaccines in the United States will get them within the next six months to a year, greatly reducing severe illness but not stopping all infection. Unfortunately, during the same time period, many developing countries will actually not have access to vaccines, because most of the rich countries will have bought up all the doses. 

"That's a real challenge, and as a result of that, the virus will continue being transmitted in these countries and we'll get new variants popping up," Kilpatrick said.

Relaying a question from the audience, Shapiro asked if it was safe for families—including non-vaccinated children—to visit aging parents or grandparents who’d been vaccinated, especially in cases when families would need to fly to see these relatives. 

“That’s a little bit of a tough question,” Kilpatrick said. “Life is all about risk and reward.” 

While the vaccinated senior’s chance of getting “any sort of symptomatic infection” is greatly reduced, “the chances are probably not zero, but it’s a very low number.”

However, the travelers must take into consideration that the vaccinated senior citizen could infect family members “by being a carrier but not getting sick themselves." Kilpatrick said the data suggests such an occurrence is “relatively low,” but it’s still worth considering this risk factor. 

“My mother has been vaccinated now, " Kilpatrick said. “She’s 78, so she’s in that high-risk category.” He’s going to hold off on hanging out with her until he gets vaccinated to reduce the risk of becoming infected and transmitting the virus. 

Asked about the safety of reopening schools this spring, Kilpatrick weighed the considerations. For one, there is a very low risk of COVID-19 infection causing severe disease in children. The real risk is to teachers and the possibility that children would bring disease home to unvaccinated parents or grandparents. 

He said that data indicate that school reopening in cases where the campuses and resources allow for social distancing and ventilation and include mask-wearing is quite safe. 

“But in some campuses that is not possible, " he said. “Some buildings have really crappy ventilation and no windows.” 

All in all, Kilpatrick expressed optimism that the United States would draw closer toward its goal of getting the epidemic under control in the coming months. But it’s far too early to start celebrating. 

“By experience, we’ve learned that precise, long-term predictions are difficult or risky," he said. "Things are changing literally every day.”