March 4, 2021 - What Will April 9 Look Like?

What Will April 9 Look Like?

March 4, 2021

Alabama’s Covid cases have plateaued recently - 922 cases (incl. 22 probables) and 5,879 tests, a 15.7% positivity rate for the day and 19.4% 7- day moving average. Hospitalizations are a different matter, however, reaching the lowest levels since last Memorial Day - 544 patients in 104 reporting hospitals, or 5.23 patients per hospital. The death rate remains stubbornly high with 65 more reported today, equalling the daily average in January, our deadliest month.

The big news of the day was Governor Ivey’s decision to extend her mask order for another month through April 9. Restaurants will be permitted to operate without limits at tables, provided that tables are separated by partitions or 6 feet. Gov. Ivey has shown independent leadership by doing what is best for the State in the face of criticism from her Lt. Governor and other leaders in her party. She deserves our gratitude. “There’s no question that wearing masks has been one of my greatest tools in combating the virus,” she said at a news conference this morning. Governor Jim Justice of West Virginia is one fellow Republican who agreed with her, saying, “I don’t know really what the big rush to get rid of the mask is, because these masks have saved a lot, a lot of lives.”

It is worth taking a moment to consider what Alabama will look like when the mask order expires on April 9. To begin with, the adult population of Alabama (under 18 years old) is approximately 3,795,000 individuals. About 235K Alabamians have tested positive during the last 3 months, and let’s assume those people are not eligible for vaccination. Let’s also assume, for the sake of discussion, that 25% of adults will refuse to get vaccinated. That would leave 2,670,000 eligible adults who want to be vaccinated. So far, 1 million shots of 2-dose vaccines have been given, enough to fully vaccinate 500K Alabama adults. That leaves 2,170,000 eligible adults who are still seeking the vaccine.

Alabama is currently on pace for 24K doses per day of the Pfizer and Moderna vaccines, but that pace is accelerating, especially with the federal direct-to-pharmacy program. If Alabama increases its rate of vaccination to 30K doses per day, then approximately 960K more doses of those 2-dose vaccines will be administered by April 9, enough to fully vaccinate 480K more adults. In addition, Alabama received 42K doses of the J&J vaccine this week, and let’s assume Alabama’s allocation of the J&J vaccine increases by 20% going forward. If so, then 268K adults will get the one-dose J&J vaccine by April 9 - totaling 748K vaccinations combined with the Pfizer and Moderna products.

Bottom line: if my assumptions are correct, approximately 1.25 million people will be vaccinated by April 9 (i.e. the equivalent of 500K people who have received the vaccine before today, plus 748K more between now and April 9), leaving 1.42 million eligible Alabama adults still seeking vaccination. Also, by April 9, we can expect almost 1.5 million Alabamians will be immune, including 1.25 million vaccinated people and 235K people who were recently infected.

Dr. Suzanne Judd, an epidemiologist at UAB, argues that, actually, 5 times more people have been infected than is known from confirmed tests - for example, many asymptomatic carriers are unaware they were even infected, and many mildly symptomatic people don’t get tested. If Dr. Judd is correct, then perhaps 1,175,000 Alabamians were infected by the virus during the last 3 months, instead of 235K people, as assumed in my analysis. If so, then far more Alabamians will be immune by April 9 - perhaps as many as 2 million.

To achieve herd immunity, it is commonly assumed that 70% of the total population must develop immunities either by way of vaccination or natural infection - in Alabama, that number is 3.4 million people. Even if Dr. Judd is correct that 1.175 million people are immune through natural infection, we still have a long way to go to reach herd immunity, especially considering Alabama’s high rate of vaccine hesitancy. Frankly, it is inconceivable to me that herd immunity can be achieved before next fall, when children become eligible for vaccination.

So, what will April 9 look like? In all likelihood, between 1.2 million and 2 million Alabamians (depending on whether you agree with Dr. Judd) will be immune by then, but we will still be far short of herd immunity. In fact, herd immunity may not be in the cards before next fall. If you are not vaccinated before the mask order expires on April 9, you would be wise to continue wearing a mask. Totals:

2/17 - 679

2/18 - 1198

2/19 - 847

2/20 - 774

2/21 - 857

2/22 - 677

2/23 - 1453

2/24 - 1247

2/25 - 890

2/26 - 739

2/27 - 834

3/2 - 652

3/3 - 2733

3/4 - 922