Dr. Scrase sees some signs for optimism - Albuquerque Journal

Dr. Scrase sees some signs for optimism

Dr. David Scrase, a medical doctor and secretary of Human Services for the state, is optimistic that New Mexico will be in a much better place on COVID-19 in the coming months. (Jim Thompson/Albuquerque Journal)

Dr. David Scrase is optimistic when he looks at the numbers. Not cavalier. Not without caveats. And certainly not caution to the winds.

But optimistic that New Mexico will be in a much better place on COVID-19 in coming months. The summer might even look normal, albeit probably with masks and some level of social distancing.

For Scrase, a medical doctor, secretary of Human Services and a top adviser on COVID to Gov. Michelle Lujan Grisham, the optimism is based on a combination of medicine and math that includes the number of people vaccinated, the number of confirmed COVID cases and some sophisticated modeling for the state by Presbyterian that shows about 2.1 undiagnosed infections for every known case.

“So if we have 8.5% of the population who have (or have had) known infections, when you add in the undiagnosed that would make a total of 26% of us infected. If we vaccinate 50% of New Mexicans and add the 26% of us infected, we’d have herd immunity.”

“There is a magic number between 60% and 80%,” Scrase says, “that leads to a dramatic drop in infections. Plus with summer and outdoor activities, hopefully some halcyon days with much greater resistance to the virus by fall.”

Now for the caveats.

First would be that a variant of the virus that is much more contagious and/or vaccine resistant could take hold. That would change the trajectory towards herd immunity.

Second, his example above is to illustrate a trend. He points out that you can’t simply add up the numbers because there is an unknown overlap in the number of people who have had the virus – whether their cases were confirmed or unconfirmed – and who also are vaccinated. That reduces the total number of people with immunity.

The current guidance by the Centers for Disease Control recommends people who have had COVID be vaccinated once they have recovered because it is possible “although rare” for someone who has had the virus to be reinfected.

The CDC also says “experts do not yet know how long you are protected from getting sick again….” (Perhaps it is worth noting that we don’t yet know how long vaccine immunity lasts, either.)

Acknowledging the caveats, how do the actual numbers look in New Mexico?

As of Thursday we had about 184,000 confirmed cases – and more than 3,600 deaths. Applying the 2.1 factor of undiagnosed cases would boost the number of people with some immunity due to infection to about 540,000. According to the state’s vaccine dashboard, about 338,000 people had received at least one dose with 181,000 having received both.

Federal agencies such as the Veterans Administration and Indian Health Service have separately received nearly 149,000 doses in New Mexico, according to the state’s vaccine website.

More good news here: While the vaccines now being given here are a two-shot series for maximum efficacy, a growing number of news reports cite studies that show even the first dose provides a significant level of protection.

Scrase said in an interview that we are starting to see the impact of vaccinations in daily case counts, hospitalizations and deaths – all down significantly from a month to six weeks ago.

“Every time 100 people get vaccinated, 90 to 95 are taken out of the pool who could be infected with the virus,” he said. “And based on a study out of Israel it now appears if you’ve been vaccinated you probably aren’t transmitting the virus.

“It makes sense because that’s what other vaccines do. It’s why health care workers get flu vaccines. Not only does it reduce cases because it protects the person vaccinated, but also the person they would have given COVID to. It interrupts that chain.”

Scrase said that over the past four weeks “we have seen the decrease in cases that our modeling attributes to vaccine alone. It started at 10% in one week, then went to 12%, then to 16% and to 20% going into this week. The decrease in cases is much bigger than the percentage of the population getting vaccinated.”

The state is vaccinating about 60,000 people a week right now, a number capped by available supply.

“I believe our delivery system is up to the task of giving every single vaccine that comes across the state line,” he said. “I think we could do double the amount we are doing now if we had the supply.”

Scrase says he is hopeful two new vaccines, AstraZeneca and Johnson & Johnson, will soon be available in addition to the Pfizer and Moderna vaccines currently being given here.

There has been some concern about the Johnson & Johnson vaccine, which requires just one shot, because it produced lower effectiveness rates in trials.

But Scrase said he believes it is a very good vaccine with “excellent results in preventing serious illness and death. And that’s the real point of a vaccine,” he said.

He said people deserve to know which vaccine they are getting but, “My advice to anybody who gets to the front of the line is to take whatever vaccine is available. We can prevent death. We can prevent hospitalization. And those are the big payoffs for a vaccine. Not that you’ll never have a cold.”

The governor on Wednesday announced additional reopening in New Mexico, including a less restrictive Turquoise category. More openings likely mean more opportunities for infections – one reason for still pushing masks and social distancing.

Experts generally agree that even as COVID recedes, it will not disappear. Like the flu, which killed between 22,000 and 62,000 Americans annually over a recent eight-year span, we will have to live with it and manage risk through vaccinations and precautions.

Scrase’s bottom line given the trends:

“If you’re wearing a good mask and following other COVID-safe practices you would be welcome to join me in being optimistic about what we’ll see over the next six months. If you don’t, you might not have the same grounds. We all have to do that until we get to that place.”

UpFront is a front-page news and opinion column.


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