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Episode 095: Is Herd Immunity Here for COVID?

The Paradocs Podcast with Eric Larson

Release Date: 08/12/2020

Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi show art Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi

The Paradocs Podcast with Eric Larson

  Vaccine mandates, mask mandates, boosters, and variants have been a constant source of debate and controversy with the pandemic. My guest today is Dr. Monica Gandhi, an expert in immunology and infectious disease who runs the HIV clinic at UCSF. She has been a fairly prominent voice in support of the mask and vaccine mandates in her home state of California and city of San Francisco. She returns from her visit in June for SARS-CoV-2 in which she guessed that it wouldn't evade the vaccine or prior infection (spoiler alert: she was right). Do Vaccine Mandates Make Sense? Dr. Gandhi is...

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Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover show art Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover

The Paradocs Podcast with Eric Larson

  What happens when you take Go Fund Me and put it into an ecosystem of likeminded folks who want to build a community to care for each other's health care expenses? You get which draws upon some of the concepts of crowd funding for one time health care expenses within its community. By taking people from all over the country and putting them into a community where there are expectations of caring for others, Crowd Health offers a solution to paying for health care expenses without breaking the bank. Is Crowd Health Insurance? If you've been paying attention to the US health care...

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Episode 152: The COVID Drawdown show art Episode 152: The COVID Drawdown

The Paradocs Podcast with Eric Larson

  Today we are going to discuss the COVID drawdown. Essentially, this is what must inevitably happen for us to return to lives of normalcy where we have typical interactions with others at family gatherings, sporting events, concerts, and business meetings. Unless we are prepared to radically change the way we live our lives and choose isolation (which probably has far greater physical and mental health detriments) then we have to consider how the drawdown occurs and what conditions ned to be present for it to happen. What HaS TO HAPPEN FOR THE DRAWDOWN TO OCCUR? We've talked to...

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Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg show art Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg

The Paradocs Podcast with Eric Larson

  One of the scariest times for many workers is being presented with a bill for medical services. Even if they have insurance "coverage", the deductible or co-pay might be more than they can afford. For hourly workers in entry level jobs or low skilled positions, medical bankruptcy is a real fear. While barely making ends meet an additional bill for an ER visit or doctor's office stop can send you to collections and destroy your credit. Unfortunately, a lot of Americans are in this exact spot as they earn a living working these low paying jobs but have little medical security even if...

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Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno. show art Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.

The Paradocs Podcast with Eric Larson

When you run a business, one person you usually meet and hire is a health insurance broker. In theory, these brokers work with the employers to secure the best deals for health insurance to meet the company's health care objectives. However, in practice, the brokers serve as a sales force for the insurance companies who lavish them with bonuses, trips, and gifts. The seedy underbelly of the health insurance broker industry is that they are really not working to save money or get deals for their clients - the checks are written by the insurance carriers and that's who they answer to. Who do...

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Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD show art Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD

The Paradocs Podcast with Eric Larson

  Not only has the COVID pandemic politicized our country - it has led to a lot of misinformation and a shutdown of communication. For instance, is there really asymptomatic spread of COVID? Or just pre-symptomatic and symptomatic spread? That might seem like splitting hairs but it can have a profound effect on policy for quarantining and testing. We've talked about this before on the show as well as general discussions on COVID policy which can be found , , and . 12 Myths and 12 Facts About COVID-19 If there is one certainty during this confusing pandemic it is that there are plenty of...

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Episode 148: Urgent Care as Primary Care with Dr. Juliet Breeze of Next Level Medical show art Episode 148: Urgent Care as Primary Care with Dr. Juliet Breeze of Next Level Medical

The Paradocs Podcast with Eric Larson

  There are a lot of urgent care clinics all over the country. But few of them, to my knowledge, also operate as regular primary care clinics. But that is exactly what is happening today in the Houston, Texas area with the emergence of Next Level Medical. If you think about it, it makes perfect sense to leverage all the facilities needed for a primary care clinic - exam rooms, physicians, etc. and use it to deliver regular and sometimes non-urgent care. We've discussed before that lower the cost of care with transparency so this seems like the next logical step with urgent care. We...

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Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD show art Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD

The Paradocs Podcast with Eric Larson

  The COVID pandemic has brought on all sorts of changes to the way we live our lives. From wearing masks, working from home, stay at home orders, and restrictions on social interactions, the virus has caused untold disruption to the way our society functions. Although the changes COVID has brought to our schools and the lives of our school age children, it is perhaps less appreciated what changes have occurred for our infants. It is a well known fact that our environment and meaningful stimulation is necessary for normal intelligence and brain development. Infants are completely...

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Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson show art Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson

The Paradocs Podcast with Eric Larson

  Imagine yourself in California at a clearing in a large forest. And it’s on fire. There are three groups of people standing before you. A large group is screaming and running around pointing at the fire. They’re yelling that we need to do something, anything we can to stop the fire. Meanwhile, there is another group (not as large) with their backs to the fire. They are mocking and ridiculing the group running around panicking. They tell them to calm down and to stop ordering people around. They insist there isn’t anything wrong at all. Of course, the largest group of people are...

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Episode 145: Surgery without Insurance with Dr. Keith Smith show art Episode 145: Surgery without Insurance with Dr. Keith Smith

The Paradocs Podcast with Eric Larson

  A lot has happened since we last met with Dr. Keith Smith from the back in 2018. . We also spoke about how the system was rigged to enrich the hospital systems, insurance carriers, and PBMs (what's new right?). So what's happened since then and how has the center done with the pandemic? Is the Surgery Center of Oklahoma Thriving or Just Surviving? Not surprisingly, Dr. Smith says that the center is doing just fine and has increased its market share from other states. Additionally, the international community from Canada is now being allowed to come back into the US for their...

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One of the most commonly used expressions regarding the current COVID pandemic is herd immunity. Policy makers, epidemiologists, and lay people are obsessed with reaching the mythical herd immunity as soon as possible so that we can put this pandemic to bed. It is hoped that the development of a vaccine will get us the herd immunity of 60-80% far quicker than waiting to reach it through natural infections. Not only would that leave behind a lot of devastation and death but would also take maybe as long as 5 years.

However, my guest today says that we may soon be approaching the herd immunity threshold because it really isn't 60-80%. Dr. Gabriela Gomes, a professor of mathematics specializing in infectious modeling, says that her group's modeling leads them to believe we only need to reach between 10-20% infections to actually achieve herd immunity. If she and her group are correct, then many places in the US and world have probably already achieved the herd immunity and can now begin rethinking the need for mitigation procedures.

Dr. Gomes' hypothesis is that her model assumes a variable level of heterogeneity of individuals in their susceptibility to becoming infected with disease. Although her group does not try and figure out what those factors are it simply looks at the current infection and others like malaria and finds that we cannot treat everyone as if they have an equal chance of 'catching' COVID. This is why they find that most models used assuming everyone is equally likely to catch a disease is not robust and fails to catch up with the actual data.

So what does this mean if true? Not only that we will see the virus start to lose its pandemic steam by the end of this year but it will provide us with better strategies of whom to protect and target with vaccines. Perhaps we would shift our focus to vaccinate those who are more at risk of bad outcomes if we now know that a massive outbreak threatening the community is less likely to occur versus a wide scale vaccination program targeting everyone. a

Professor Gabriela Gomes teaches at the University of Strathclyde in Glasgow, Scotland. She and her fellow researches believe their modeling for COVID shows that the actual herd immunity threshold is between 10-20%.
show notes

Individual Variation in Susceptibility or Exposure to SARS-COV2 Lowers the Herd Immunity Threshold: The paper written by Gomes, et al discussing the individual variation in populations which dramatically affects the herd immunity threshold in disease.

The Tricky Math of Herd Immunity for COVID-19: A lay article written in Quanta Magazine discussing the issue of herd immunity.

@mgmgomes1: Twitter for Professor Gomes.

Gomes, PhD Website

Episode 091: COVID and Back to School

Episode 087: Deception on the Coronavirus from our leaders.

Episode 086: How the Coronavirus epidemic ends

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