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      COVID-19 herd immunity: where are we?

      brief-report
      Author(s): 1 , 2 , , 3 ,
      Publication date (Electronic):
      Journal: Nature Reviews. Immunology
      Publisher: Nature Publishing Group UK
      Keywords: Viral infection, Vaccines

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          Abstract

          Herd immunity is a key concept for epidemic control. It states that only a proportion of a population needs to be immune (through overcoming natural infection or through vaccination) to an infectious agent for it to stop generating large outbreaks. A key question in the current COVID-19 pandemic is how and when herd immunity can be achieved and at what cost.

          Abstract

          During the current COVID-19 pandemic, the concept of herd immunity has become a topic of much debate. This Comment examines the factors that determine it, discusses how far we have come and considers what it will take to reach herd immunity safely.

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          Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

          Seth Flaxman, Swapnil Mishra, Axel Gandy … (2020)
          Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, allowing for the time lag between infection and death. We use partial pooling of information between countries, with both individual and shared effects on the time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data and enables more-timely estimates. Our model relies on fixed estimates of some epidemiological parameters (such as the infection fatality rate), does not include importation or subnational variation and assumes that changes in Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that-for all of the countries we consider here-current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions-and lockdowns in particular-have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.
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            Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19

            Takuya Sekine, André Perez-Potti, Olga Rivera-Ballesteros … (2020)
            Summary SARS-CoV-2-specific memory T cells will likely prove critical for long-term immune protection against COVID-19. We here systematically mapped the functional and phenotypic landscape of SARS-CoV-2-specific T cell responses in unexposed individuals, exposed family members, and individuals with acute or convalescent COVID-19. Acute phase SARS-CoV-2-specific T cells displayed a highly activated cytotoxic phenotype that correlated with various clinical markers of disease severity, whereas convalescent phase SARS-CoV-2-specific T cells were polyfunctional and displayed a stem-like memory phenotype. Importantly, SARS-CoV-2-specific T cells were detectable in antibody-seronegative exposed family members and convalescent individuals with a history of asymptomatic and mild COVID-19. Our collective dataset shows that SARS-CoV-2 elicits robust, broad and highly functional memory T cell responses, suggesting that natural exposure or infection may prevent recurrent episodes of severe COVID-19.
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              Is Open Access

              Estimating the burden of SARS-CoV-2 in France

              Henrik Salje, Cécile Tran Kiem, Noemie Lefrancq … (2020)
              France has been heavily affected by the SARS-CoV-2 epidemic and went into lockdown on the 17 March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find 3.6% of infected individuals are hospitalized and 0.7% die, ranging from 0.001% in those 80ya. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 2.90 to 0.67 (77% reduction). By 11 May 2020, when interventions are scheduled to be eased, we project 2.8 million (range: 1.8–4.7) people, or 4.4% (range: 2.8–7.2) of the population, will have been infected. Population immunity appears insufficient to avoid a second wave if all control measures are released at the end of the lockdown.
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                Author and article information

                Contributors
                Arnaud Fontanet: arnaud.fontanet@pasteur.fr
                Simon Cauchemez: simon.cauchemez@pasteur.fr
                Journal
                Journal ID (nlm-ta): Nat Rev Immunol
                Journal ID (iso-abbrev): Nat. Rev. Immunol
                Title: Nature Reviews. Immunology
                Publisher: Nature Publishing Group UK (London )
                ISSN (Print): 1474-1733
                ISSN (Electronic): 1474-1741
                Publication date (Electronic): 9 September 2020
                Pages: 1-2
                Affiliations
                [1 ]GRID grid.428999.7, ISNI 0000 0001 2353 6535, Emerging disease epidemiology unit, Institut Pasteur, ; Paris, France
                [2 ]GRID grid.36823.3c, ISNI 0000 0001 2185 090X, PACRI unit, Conservatoire National des Arts et Métiers, ; Paris, France
                [3 ]Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, Paris, France
                Article
                Publisher ID: 451
                DOI: 10.1038/s41577-020-00451-5
                PMC ID: 7480627
                PubMed ID: 32908300
                SO-VID: 338b37b3-888a-4e52-b757-3cd8b173501c
                Copyright © © Springer Nature Limited 2020
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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                Subject: Comment

                Keywords: viral infection,vaccines
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                Keywords: viral infection, vaccines

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