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COVID-19: Reopening The Country and Community Immunity

These are remarkable times. I'm thankful to bear witness to society coming together - at both individual and collective cost - to flatten the curve during the Coronavirus Pandemic. And now, there's great excitement as we discuss reopening the country, and restarting our economy. I think now is the perfect time, however, to discuss one true fact.

As we reopen the country, as we reopen the economy, as we get back to normal --we will see more cases of Coronavirus. The reason why we'll see more cases is because, as a community, we lack immunity to this new (or “novel”) virus.

The Impact of "Herd" Immunity

Immunity - in this case - is someone's ability to resist infection. And more specifically, if they're exposed to the infectious agent (in this case the virus) their body kills it - so they neither suffer from the illness nor are able to transmit that to someone else. We know what happens when there's a new infection like the “novel” (or new) Coronavirus that very few have developed immunity to. If you have one person who has the disease and is contagious, it rapidly spreads through the population.

Check out this graphic illustration below. The TOP SECTION illustrates the current situation.

The people in red are those with a virus - those that are contagious. The people in blue are those at risk for infection because they do not have immunity. In this situation, the virus (red) spreads rapidly through the population. This is what has happened with COVID-19.

In contrast, if you have an infection and many in the community are immune, you put distance between those that have the virus and are contagious and those who are at risk.

Now, check out the BOTTOM SECTION of the graphic above.

The people in red are still those with the virus who are contagious. The people in yellow this time are those that are immune. You can see they block (or protect) those that are still at risk in blue. The virus spreads slowly. When this type of immunity occurs in a population (or group of people), it is called "herd immunity".

How Community Immunity Develops

There are two ways to develop immunity.

The first way is to have the illness and recover. Your body produces antibodies to fight off the illness and those antibodies stay with you. Now, we've discussed previously the new interest in antibody testing -but also the challenges that come with that testing - specifically reliability. Just this week, the World Health Organization (WHO) was clear to state to all that antibodies in the blood have not yet proven immunity and therefore have not yet proven to be protective against future infection. More research is needed.

RELATED ARTICLE: COVID-19 Testing: What Test Are Available

The second way to develop immunity is by vaccine. The concept here is we create a vaccine that has a low dose or weak form of the virus, and the body mounts a response. Research is needed to know exactly how to create this vaccine, but also to document the response to the vaccine to ensure that the vaccine produces immunity in recipients.


Because we lack widespread immunity in the population, we can't afford to stop emphasizing physical distance as a buffer to COVID-19 spread. As we get back to life, continue social distancing, continue to wash your hands, and for now -- mask up. We will get through this together. COVIS-19 will lose.

If you have questions, reach out. If the information is valuable, feel free to share.

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Cory Calendine, MD is an Orthopaedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopaedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.  

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