The vaccine as fire hose

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The vaccine news continues to seem very encouraging. Britain started its mass vaccination effort today, and the U.S. isn’t far behind.

But there is still one dark cloud hanging over the vaccines that many people don’t yet understand.

The vaccines will be much less effective at preventing death and illness in 2021 if they are introduced into a population where the coronavirus is raging — as is now the case in the U.S. That’s the central argument of a new paper in the journal Health Affairs. (One of the authors is Dr. Rochelle Walensky of Massachusetts General Hospital, whom President-elect Joe Biden has chosen to run the Centers for Disease Control and Prevention.)

An analogy may be helpful here. A vaccine is like a fire hose. A vaccine that’s 95 percent effective, as Moderna’s and Pfizer’s versions appear to be, is a powerful fire hose. But the size of a fire is still a bigger determinant of how much destruction occurs.

I asked the authors of the Health Affairs study to put their findings into terms that we nonscientists could understand, and they were kind enough to do so. The estimates are fairly stunning:

  • At the current level of infection in the U.S. (about 200,000 confirmed new infections per day), a vaccine that is 95 percent effective — distributed at the expected pace — would still leave a terrible toll in the six months after it was introduced. Almost 10 million or so Americans would contract the virus, and more than 160,000 would die.

  • This is far worse than the toll in an alternate universe in which the vaccine was only 50 percent effective but the U.S. had reduced the infection rate to its level in early September (about 35,000 new daily cases). In that scenario, the death toll in the next six months would be kept to about 60,000.

It’s worth pausing for a moment on this comparison, because it’s deeply counterintuitive. If the U.S. had maintained its infection rate from September and Moderna and Pfizer had announced this fall that their vaccines were only 50 percent effective, a lot of people would have freaked out.

But the reality we have is actually worse.

How could this be? No vaccine can eliminate a pandemic immediately, just as no fire hose can put out a forest fire. While the vaccine is being distributed, the virus continues to do damage. “Bluntly stated, we’ll get out of this pandemic faster if we give the vaccine less work to do,” A. David Paltiel, one of the Health Affairs authors and a professor at the Yale School of Public Health, told me.

There is one positive way to look at this: Measures that reduce the virus’s spread — like mask-wearing, social distancing and rapid-result testing — can still have profound consequences. They can save more than 100,000 lives in coming months.

The Virus

  • In the past seven days, 15,813 people in the U.S. died from the virus, breaking a record that had stood since mid-April.

  • Gov. Andrew Cuomo said New York would restrict indoor dining if hospitalization rates didn’t stabilize. New York City could lose indoor dining as soon as Monday.

  • Once Pfizer delivers its first 100 million vaccine doses to the U.S., the country may not get another batch until June. That’s because the Trump administration passed on a deal last summer to secure more shots, and the European Union bought them.

The Presidential Transition

The social life of forests: Do trees communicate and cooperate with one another? It appears so. Read the story in the Magazine, or listen to it on a special episode of “The Daily.”

A debate: One former head of Medicare calls Xavier Becerra “a great fit” to lead the Department of Health and Human Services, The Washington Post reports. In his Times Opinion column, Ross Douthat says the nomination is a warning sign that Biden will abandon the moderate approach that offers his best chance for political success.

Lives Lived: As a pro wrestler, Pat Patterson knew how to delight fans. As an executive of World Wrestling Entertainment, he introduced the Royal Rumble, a last-man-standing free-for-all that has been popular ever since. When he announced in 2014 that he was gay, Patterson’s fans remained loyal. He died at 79.


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Bob Dylan has sold his catalog of more than 600 songs to Universal Music for an estimated $300 million. It may be the biggest acquisition of one songwriter’s publishing rights, and it’s another landmark for Dylan, who in 2016 won the Nobel Prize in Literature.

Universal will now collect fees any time Dylan’s songs are sold, streamed, covered by another musician or used in ads and movies. That makes Dylan’s catalog especially lucrative: Other artists have recorded his songs more than 6,000 times, and they have appeared often in movies, including “The Big Lebowski” and “Bad Santa 2.”

The deal is the latest in a string of such purchases: In October the DJ Calvin Harris sold his publishing catalog for an estimated $100 million, and last week the singer-songwriter Stevie Nicks sold a majority stake of her catalog for an estimated $80 million.

As streaming comes to dominate the music market, more investors are snapping up music copyrights. “Streaming has changed the landscape, from a licensing and royalty perspective,” one expert told The Washington Post. “Even though there’s eye-popping price tags, if you look at the returns in five, 10, or 20 years, these are viewed as very good investments.”

What to Cook

The pangram from yesterday’s Spelling Bee was headpiece. Today’s puzzle is above — or you can play online if you have a Games subscription.

Here’s today’s Mini Crossword, and a clue: GPS suggestion (5 letters).


Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. Marc Lacey, The Times’s national editor, will be the new assistant managing editor for Live, where he will lead a team focused on briefings, blogs and chats.

You can see today’s print front page here.

Today’s episode of “The Daily” is about Trump’s immigration legacy. On the latest “Sway,” Kara Swisher interviews the chief executive of Cameo, the marketplace for personalized celebrity shout-outs.

Claire Moses, Ian Prasad Philbrick and Sanam Yar contributed to The Morning. You can reach the team at themorning@nytimes.com.

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