key: cord-297202-oup8ptya
authors: Beer, Martin; Doherr, Marcus; Osterrieder, Klaus; Pfeiffer, Dirk; Trimpert, Jakob
title: SARS‐CoV‐2 vaccination—A plea for fast and coordinated action
date: 2020-07-01
journal: Zoonoses Public Health
DOI: 10.1111/zph.12740
sha: 
doc_id: 297202
cord_uid: oup8ptya

nan

The cataclysmic consequences of the pandemic spread of SARS-CoV-2 are mind-numbing. Measures that include social distancing and stringent lockdown scenarios that seemed unthinkable in democratic societies two months ago have become a reality. Control of COVID-19 will ultimately require adequate levels of herd immunity. If we assume that the level of herd immunity to halt the spread follows the 1 − 1/R 0 rule (Anderson, Heesterbeek, Klinkenberg, & Hollingsworth, 2020) and given conservative estimates for the basic reproduction number R 0 = 3 (Sanche et al., 2020) at least two-thirds of the world's population must mount an effective immune response against the virus to prevent recurrent outbreaks. Even then, SARS-CoV-2 would still be present and likely for the duration.

Flattening the epidemic curve will inevitably slow the development of herd immunity by means of natural infection. That, in turn, would result in the need to continue the current measures for months or years-with all the societal, economic and health consequences-until effective vaccines are in widespread use. Yes, an R t < 0.2 would halt the spread of SARS-CoV-2 in a given population at time t, but any re-introduction of the virus could catapult us back to where we were. Re-introduction is virtually unavoidable in our globally connected societies, there will always be remaining pockets of virus somewhere. It is wrong to create the illusion that strict distancing and lockdown with the sole objective to reduce R t until the virus is eliminated from a given population is the solution to the problem-it becomes a problem in itself.

Unless serological surveys suggest a much higher-than-expected silent exposure of the human population to SARS-CoV-2, there is no reasonable scenario to reach the required level of herd immunity under the 'reduce spread' paradigm that many countries have emulated. For example, if we take Europe's population of approximately 750 million, it would require a constant infection rate of 678,000 individuals per day for two years to achieve the required herd im-

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