'Vaccinate the super spreaders first'

The Dutch Council for Public Health recommends that the government first vaccinate the elderly and other people with a weak immune system against the covid-19 causing SARS-CoV-2 coronavirus. Is that sensible? No, says a physicist who made an epidemiological analysis. Is it better to vaccinate the (generally very healthy) superspreaders first, no matter how unethical it sounds?

Spread of SARS-CoV-2 mainly through superspreaders and in superspreading events
Massive outbreaks of SARS-CoV-2 mainly occurred at indoor mass gatherings [1]. Infamous cases included auditions of choirs, church services, Friday prayers in mosques, nightclubs, slaughterhouses, indoor parties and political gatherings. Or in nursing homes with vulnerable people. Often times, this epidemic started in one infected person who attended several such occasions: the superspreader. For example, a South Korean infected woman infected dozens of people in both a hospital and a church service [2].

Extinguish the curve: why the superspreaders should be tackled
Humanity is better off without the SARS-CoV-2 virus and other viruses that thrive on humans. A vaccine, certainly one in rapid succession, so relatively poorly tested for side effects as is now being marketed by the pharmaceutical companies Pfizer and Moderna, is a rather drastic way of eliminating this virus worldwide. If there are other, less invasive methods to get the transmission rate R well below 1 (ie to ensure that less than 1 person is infected per infected person, so that the epidemic will die out), these are preferable. Preventing superspreading events, such as banning all large gatherings indoors, is not a lot of fun, and a serious violation of the constitutional freedom of association, but it is effective. Another measure that would prove very successful is the vaccination of super spreaders. In the case of covid-19, these are people with a lot of social contacts, people who work with vulnerable groups (hospital staff and nursing homes) or people who work in covid-19 sensitive areas (such as slaughterhouses). For example, we get the epidemic under control much faster with a smaller amount of vaccines.

How do we track down the super spreaders?

SARS-CoV-2: is it ethically responsible to vaccinate healthy people earlier if we stop the epidemic sooner?
Source: USA government (state.gov)

Most people have a relatively small number of contacts. A small number of people have a huge number of contacts. Israeli physicist Shlomo Reuvin developed an effective way to track down these potential superspreaders: ask a large number of people who their acquaintances are. A small number of people turn up much more often than others. It is precisely these people who must first be vaccinated, says Reuvin, and not lonely elderly people. In his calculation models, a much smaller percentage of vaccinations already turned out to have an enormous effect: if most superspreaders are vaccinated, the epidemic appears to be a drastic decrease in R even with a low vaccinated percentage of the population, think of ten to twenty percent exhibit. With what we now know about the SARS-CoV-2 virus, we can vaccinate these super spreaders in a targeted manner. The 'indirect vaccination obligation', advocated within the VVD, is indeed an infringement of constitutional freedoms (physical integrity, in this case), but would in fact be extremely effective in stopping superspreading events.

Also see: Covid-19: the nonsense of the five-foot rule

Sources
1. Such is the impact of superspread events, MauriceDeHond.nl (Mari de Hond), 2020
2. 'Superspreader' in South Korea infects nearly 40 people with coronavirus, LiveScience, 2020
3. Shlomo Reuvin et al., Efficient Immunization Strategies for Computer Networks and Populations, ArXiv pre-print server, 2003
4. Minister De Jonge: 'No indirect vaccination obligation', Parool, 2020

1 thought on “‘Vaccineer eerst de superspreaders’”

  1. Niet eerst de ouderen vaccineren, daar heb je niets meer aan. We moeten eerst denken aan de mensen die het land moeten leiden in deze moeilijke tijden. Dus eerst kabinet, 1e en 2e kamer, OMT, RIVM, koninklijk huis, journalisten, NOS medewerkers (zodat we altijd over het correcte nieuws kunnen beschikken) en nog zowat van die lieden. Het liefst zou ik al die personen in een live uitzending op TV willen zien, terwijl ze een voor een gevaccineerd worden. Ik ben 74, ik kom over 10 jaar wel eens terug. Dus mijn vaccin schenk ik met liefde aan Hugo de Jonge en ik hoop dat er nog 11 onbaatzuchtige NLers zijn die dat willen doen, dan heeft Hugo elke maand een spuitje.

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