Michigan needs to lock down.
Vaccines alone can’t stop this surge—the math just doesn’t work.
COVID-19 cases continue to surge in Michigan. As I wrote in The Washington Post a few weeks ago, Michigan’s COVID spike should serve as a warning to the rest of the country. The toxic brew of the more transmissible, more deadly B.1.1.7 variant, aggressive reopening by governors and mayors, and over-optimism about the penetration of vaccines is placing this nation on the verge of a fourth, deadly surge.
Governor Gretchen Whitmer (whom, for full disclosure, I ran against in the 2018 primary) was a beacon of science-driven action through the first year of this pandemic. Resisting the pressure that drove other governors to ignore or downplay the pandemic, she ordered aggressive lockdowns last spring, resisted premature reopening in the summer, and again ordered lockdowns in the fall as cases spiked. Right-wing anti-science terrorists were so dismayed by her leadership that they hatched a foiled kidnapping plot against her. But she did the right thing—her actions saved lives.
That’s why her response to the present surge—the worst Michigan has yet seen—has been so perplexing. On Friday, rather than a mandatory lockdown of the most dangerous activities, like indoor dining, high school sports, or casinos, she called for a voluntary pause. She also implicitly shifted blame by calling on the Biden administration to surge vaccinations to Michigan.
First let’s consider this “voluntary pause.” Policy choices by government executives are as much about action as they are about the message those actions send. And Michiganders can’t help but process her inaction here in the context of her past leadership: By keeping high-transmission activities open, despite warning Michiganders off their use, she’s implicitly saying that this surge isn’t as bad—it doesn’t warrant the same actions.
But this surge is as bad. Michigan is nearing pandemic-wide highs in cases and hospitalizations. Many hospitals are nearing capacity. Deaths are climbing. And because B.1.1.7 is particularly transmissible and virulent, it's unsurprising that the victims are younger people who have yet to be vaccinated.
This surge, like the surges Michiganders faced before, requires the same action. And here’s the most perplexing thing: you could argue that the economic consequences of a shutdown would be lower now than they were for Michigan’s previous shutdowns. Why? Spring is in full bloom. The kinds of outdoor activities that weren’t possible just two months ago are more preferable now. And with vaccines on the way, it’s not like there’s no end in sight. A simple approach might be to reopen certain activities after certain vaccine benchmarks are met—when it’s truly safe to go back inside.
Instead of a lockdown, Governor Whitmer is arguing that more vaccines are the answer to quelling this surge. Certainly, over the long term, vaccines are key to getting us past this pandemic once and for all. But vaccines are a tool for preventing major surges; they’re less effective in responding to them.
The general consensus among epidemiologists is that, to reach herd immunity, a community would have to vaccinate 75% of its population. In Michigan, that’s roughly 7.5 million of the state’s 10 million residents. At the moment, about 23% are already vaccinated. We have to vaccinate an additional 5.2 million Michiganders.
Michigan’s previous goal had been 50,000 vaccinations per day. In the midst of this surge, Governor Whitmer doubled that goal to 100,000. Even if the Biden administration agreed to surge—to say 200,000 daily vaccinations—it still wouldn’t quell the surge in time.
Let me break down the math. But first, let’s make some assumptions that would work in favor of a vaccine surge. Let’s say: (1) we actually had the infrastructure on the ground to coordinate the deployment of that many vaccinations immediately; (2) there was no vaccine hesitancy and there was a willing recipient for every single vaccine; and (3) instead of a two-shot regimen, we surged the one-shot Johnson & Johnson regimen (more on the federal pause on Johnson & Johnson in Thursday’s Incision) or surged one shot of either Pfizer or Moderna as the UK did, delaying the second shot to maximize one-shot coverage.
Even with those assumptions, and starting with the 23% vaccination coverage we have today, vaccinating 5.2 million people to get to 75% vaccination would take us 26 days. Oh, and don’t forget that it takes 10 days for the body to produce the protective antibodies that mediate vaccine immunity. So it would take 36 days to reach herd immunity.
And that’s the best case scenario. Vaccine hesitancy remains high in Michigan. It’s also unclear that Michigan’s vaccination infrastructure could handle such a surge. A surge in Johnson & Johnson vaccines is unlikely given the safety pause and the company’s production challenges. Using the faster of the two-shot vaccines adds another 21 days to that time: 57 days until herd immunity. Of course, state officials could also consider delaying the second shot of the Pfizer or Moderna vaccines to maximize one-dose coverage as they have in the UK, though this is not how the vaccines are recommended, and it’s unclear how the public would respond.
So we’re looking at nearly two months before we reach herd immunity with a vaccine surge—one month if we pulled out all the stops. As we should know by now, that’s a lot of time for SARS-CoV-2 to spread—particularly for the B.1.1.7 variant. At the current rate, cases have been doubling in Michigan every two weeks. Hospitalizations have surpassed their highest point throughout the entire pandemic. We don’t have that kind of time.
Make no mistake—we should surge vaccines to Michigan and Governor Whitmer is smart to ask the Biden administration for additional vaccines. In fact, the state could even consider delaying second doses of Pfizer and Moderna to maximize first-dose coverage. But it still won’t be enough without being accompanied by a mandatory pause on the highest risk activities to quell this surge. The two are not mutually exclusive. And responding to a call for one by pushing the other simply isn’t based in science.
There is no doubt that this surge is handing Governor Whitmer some tough political choices. People are sick and tired of this pandemic and all the limitations it presents. Businesses are struggling for having been forced to shut down for so much of 2020. And there’s no doubt that another lockdown would inflame Michigan’s right-wing anti-science extremists.
And yet making the tough calls is exactly what Governor Whitmer did so well this time last year. Michigan needs that Governor Whitmer again now.