Ending COVID-19 restrictions on gatherings can increase the risk of a surge in cases. Noam Galai/Getty Images
  • New research concludes that the safest way to relieve pandemic restrictions is by tying increased freedom to vaccination rates — and moving too quickly carries the risk of new variants and overwhelmed healthcare systems.
  • Officials across the globe have struggled with rolling back COVID-19 restrictions without suffering a “rebound” in viral cases.
  • If cases are low enough then health officials can test-trace-isolate to stop local spreads.

A new study finds the most effective way to boost freedoms and protect against overwhelming new COVID-19 surges, is to tie the lifting of restrictions directly to the pace of vaccinations.

According to researchers, the rate of vaccination is key to ending the necessary restrictions that have had significant social and economic consequences but also stop the spread of the virus.

Officials across the globe have struggled with rolling back COVID-19 restrictions without suffering a “rebound” in viral cases.

Vaccination progress key to safe reopening

Scientists at the Max Planck Institute for Dynamics and Self-Organization in Germany used mathematical modeling of medical and vaccination data from the United Kingdom and other European countries to find the optimal pace restrictions could be lifted during vaccine rollout to reduce risk of “rebound” COVID-19 surges that overwhelm healthcare.

After analyzing many different scenarios, they concluded that further severe waves could only be avoided if restrictions are lifted no faster than the pace dictated by vaccination progress.

The findings suggest lifting restrictions too fast, even after vaccinating 80 percent of the adult population, could bring new variants and surging cases that overwhelm intensive care units.

“This analysis speaks to what most of us have been suspecting for a long time,” Dr. Shereef Elnahal, president and CEO of University Hospital in Newark, New Jersey, told Healthline. “Which is that, unless you really get enough of society to compel vaccination at this point…we’re really not going to be ending this pandemic.”

Current U.S. approach is not ideal

Dr. Richard Parker, chief medical officer of healthcare data and software company Arcadia, said the United States is presently approaching pandemic restrictions by allowing each state to do whatever it deems appropriate, with some relying on CDC guidance more than others.

He added that even within states, there’s variation in approach between counties, cities, and towns.

“The current approach is not the safest,” explained Parker. “Everyone following the same rules — for example, as they do in England, would be better from a public health perspective.”

He emphasized that we need low enough case rates so that test-trace-isolate can stop local spreads, and we need to keep the virus’ reproduction number below 1.0.

According to Parker, this research is “entirely theoretical” and not yet tested under real conditions, but it’s a good starting point for policy discussions.

Danger of infection greatest for unvaccinated

Elnahal confirmed that although vaccinated people who contract COVID-19 can still spread it, the risk is especially strong for the unvaccinated.

“It’s just a case that every unvaccinated person presents a risk not only to themselves but to everybody around them, including vaccinated people,” he said.

Elnahal explained that the vaccinated are much less susceptible to infection, and being vaccinated greatly reduces the likelihood of infection, hospitalization, and death. But some immunocompromised people may be at greater risk — even if they’re vaccinated.

“But it is the case that vaccinated people are still at risk from unvaccinated people,” he confirmed.

Elnahal added this is why efforts around vaccine verification are so important. Verifying someone’s vaccine status means venues like movie theaters, restaurants, or bars that have made the decision to verify vaccination are much safer.

We must be willing to accept some risk, says expert

Dr. Jeremy Levin, chairman and chief executive officer of Ovid Therapeutics, said it’s difficult to make decisions on reopening since experts are still learning about how the disease spreads.

“The fact of the matter is that we are in a situation where we do not yet know enough about the spread of the disease,” said Levin. “But what we do know, and by the spread I mean the variants that are being generated, is the price to society of not having a decision in this could be higher than what we’re seeing.”

Levin added that we must be willing to accept some risks, but that risk can be reduced by ensuring as much vaccination as possible. He pointed out that other diseases have been defeated by vaccination.

“For example, we’re all vaccinated against smallpox — all of us,” he said. “And small pox is gone. We were nearly all vaccinated against polio — polio has nearly gone.”

Levin emphasized that some diseases can only be eradicated by consistent effort.

“We have ensured that children are vaccinated [against] measles,” he said. “However, against measles, mumps, and rubella, we know when we don’t do that, it comes back.”

We can’t rely on naturally acquired immunity

Asked what role naturally acquired immunity could play in relieving pandemic-related restrictions, Levin was skeptical.

“It is highly unlikely we’ll ever achieve 100 percent vaccination given the concerns that some segments of the population have expressed,” said Levin.

Levin said it’s essential that vaccination proceed completely independent of any assumption of having been previously infected.

“If you were testing uniformly across the nation, you could adjudicate who has or who hasn’t had infection,” he said. “But because testing is so haphazard and so disorganized, you can’t.”

The bottom line

New research concludes that the safest way to relieve pandemic restrictions is by tying increased freedom to vaccination rates.

Experts say that the unvaccinated present a risk to themselves and others, and vaccine verification is essential to prevent disease spread at public venues.

Moving too quickly to roll back regulations carries the risk of a surge of COVID-19 cases that can lead to new variants and overwhelmed healthcare systems.

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