'The pathogen decides': Doctor says pandemic will end eventually, but it's not up to us

Dr. Del Rio says in the meantime, we can manage how bad it gets, predicting many vaccine mandates in our future.

ByKate Larsen KGO logo

Saturday, August 14, 2021

Doctor says 'the pathogen decides' when pandemic will end

A USCF doctor explains the shift he sees happening from trying to end COVID-19, to managing it, because herd immunity is likely no longer reachable.

SAN FRANCISCO (KGO) -- In June, UCSF paused its monthly Medical Grand Rounds for the summer. But today, as cases soar, they brought it back.

"As far as COVID stood on June 1, San Francisco was running about 10 cases a day. Today, that number is 250," said Dr. Bob Wachter, Chair of the Department of Medicine at UCSF.

The 75 minute zoom presentation with experts from across the country covered the fourth U.S. surge, the Delta variant, vaccines, boosters, and kids returning to the classroom. But there was also a larger conversation about looking to the future.

"I think we need to start shifting our thinking from eradication and disease elimination and COVID anytime soon, to more disease management, the way we think about flu," said Dr. Carlos Del Rio, executive associate dean of the Emory School of Medicine and Grady Health System in Atlanta.

The first six months of the year the U.S. was in a race - vaccines versus the virus. At first, data indicated that well-vaccinated populations like California, were outrunning the virus. But the Delta variant pushed COVID past us to the finish line. Herd immunity is now no longer a realistic goal.

So what is next?

VIDEO: Doctors explain 3 factors behind surge in San Francisco COVID cases

San Francisco surpassed the nation's 7-day rolling average case rate, even though 78% of the population is fully vaccinated. Here's what doctors say contributed to the surge:

The good news is, "pandemics end," according to Dr. Del Rio. "They end when the pandemic ends. It's not up to us, politicians, you don't decide - the virus or the pathogen decides," he explained.

But before the pandemic ends, he says we can control the immediate impact of the virus through our behavior.

Dr. Del Rio, an infectious disease specialist, says societies where people embrace masking and other protective measures will have fewer outbreaks. Behavior choices that increase transmission will result in more COVID-19 cases. Vaccines are part of this behavior that drives down serious infection rates.

As we look to the future he says, "I think is going to require lots of vaccination mandates, lots of ongoing vaccination. It's not just a one way vaccination, there's new generations happening. I think about you know how many years we continue to vaccinate against polio and measles, despite the fact that we don't have the disease. So we need to remember that this may become part of our routine immunization scheme going forward for many years until we finally control this."

Dr. Del Rio is also worried that if we don't address health equity issues locally and globally, by improving vaccine rates in underserved minority communities, the pandemic is going to hang around even longer.

"I think health inequities are going to be a major factor in determining how we end this pandemic," he said.

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