Oct. 22, 2022 | Vince Lara-Cinisomo
Alicia Kraay’s study shows getting vaccine boosters and using non-pharmaceutical interventions can reduce cumulative deaths from COVID-19.
In a recent publication, Kinesiology and Community Health assistant professor Alicia Kraay and her collaborators write that combining boosters and non-pharmaceutical interventions results in a 30 percent decrease in cumulative deaths due to COVID-19, with potential for greater impacts if variant-adapted boosters are used.
Non-pharmaceutical interventions, or NPIs, include wearing a mask and social distancing, but also “surface decontamination and improved hygiene,” said Kraay.
According to Kraay’s publication, “The role of booster vaccination and ongoing viral evolution in seasonal circulation of SARS-CoV-2” in the journal The Royal Society, a rise in COVID-19 infection rates are expected this fall as the use of NPIs is relaxed.
“This year, we expect a fall surge, in part because we expect the transmission rate to be seasonal,” she said. “And we’ve also seen people have relaxed NPIs.”
Kraay attributed the decrease in NPIs in part to pandemic fatigue.
“Also, people’s different perception of safety now that vaccination is more widespread,” she said. “Some of the initial strategies that were proposed are simply not sustainable in the long term. It’s not really possible for elementary schools to do virtual learning only for the next 10 years. And there are issues with feasibility in certain contexts like elementary schools, with adequately distancing young children and getting perfect mask compliance.”
But Kraay wanted to emphasize that the important thing about NPIs is they’re not all or nothing.
“You don’t just tell people, ‘Oh, you need to stay at home now because cases might be increasing, and you should do nothing. That’s, I think, what happened at first early in the pandemic,” she said “You’re not going to get high compliance if you make recommendations like that. And it’s also not scientifically appropriate because not every type of interaction has the same level of risk. I think in order to get NPI compliant, it’s being clear about when NPIs are needed and when they’re not and what type is the most effective.”
Kraay, an infectious disease epidemiologist who did her undergraduate work at North Carolina-Chapel Hill and got her Ph.D. at Michigan, recommends wearing a mask in crowded situations you cannot avoid, and limiting appearances at large gatherings.
In terms of boosters, Kraay said ongoing safety studies will be important to ease concerns about vaccine safety, especially among parents.
“It’s going to be important to understand more about the impact of boosters,” she said. “In my paper, we assumed that boosters could reduce risk of infection. But the booster data hasn’t been fully analyzed yet. Seeing what happens with these variant-specific boosters and are there impacts in reducing transmission, and really quantifying how much it can help if you get boosted … at the population level, I think it could be useful.”
One thing Kraay remains uncertain about is whether the current pandemic has made the United States, and the world, for that matter, better prepared to handle the next global health crisis.
“I think we definitely have a better public health infrastructure, [but] I think there are still challenges from the health care access perspective. We know that there’s been a lot of new sources of funding that have been created to allow researchers to respond quickly to emergent priorities. We also know the way that vaccine development was streamlined is a major achievement.
“We have a better capacity to forecast infectious disease patterns over time. And we have new positions that have been created in pandemic preparedness at academic institutions throughout the country. There are challenges with health care access that I think still need to be worked out, [such as] health care access for marginalized populations. I do think we are in a better position just in terms of being able to respond from a public health and testing perspective, hopefully being able to respond more quickly from a vaccination perspective. The challenge still remaining of how to treat the people who do get sick is what I see going forward.”
And although President Biden declared the pandemic over in September 2022, Kraay isn’t as certain.
“COVID as we knew it in February and March 2020 is over,” she says. “I think that it’s true that our experience of COVID-19 has dramatically changed now. But I don’t think that we’re all the way to the point that it’s just in the background. It’s something that we definitely need to monitor. And we’re just not there yet.”
Editor’s note:
To reach Vince Lara-Cinisomo, email vinlara@illinois.edu.
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