Coronavirus Herd Immunity Fallacy

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A Stampede of Conflicts

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I don’t envy those responsible for making deci­sions about whether the nation should hunker down or roam free. Having everyone stay at home weighs the economy down. Even “the city that never sleeps” was on lockdown. Having the unvac­cinated popula­tion roam about rapidly spreads the coro­na­virus. This has led to a preponderance of mixed messages:

  • In early March, the U.S. President claimed that testing is “going very smooth,” that “anybody that needs a test can get one.” Later that week, Health and Human Services Secretary Alex Azar said: “You may not get a test unless a doctor or public health official prescribes a test.”
  • Americans were first told that wearing masks in public was unnecessary. They are only beneficial for healthcare workers. Then we are told that the public can wear them voluntarily to reduce spread of the virus.
  • The N95 mask was hailed as the standard for protec­tion against COVID-19. Then the public is told they can wear DIY masks with bandanas and rubber bands.
  • Within two weeks, with local ordinance variance, maximum gathering size dropped from 100 to 10 to zero.
  • When first implemented, shelter-in-place was touted as the means to slow the spread of the corona­virus. As the economy tanks, there is talk about allowing certain business sectors to gradually reopen.
  • The U.S. President has stockpiled 29 million unproven anti-malaria pills (also used off-label for lupus) as a possible COVID-19 vaccine. Top health officials say more promising vaccines are in clinical testing.
  • With a verified vaccine many months away, people are weighing herd immunity. Some would say this corresponds with lifting the stay-at-home order.
  • “I cannot impress upon people more, we’re not going back to normal, we're going back to a new normal, with adaptations and modifications until we get to immunity, until we get to a vaccine. We'll get there,” says California Governor Newsom.
Coronavirus Herd Immunity Fallacy

Lack of clarion leadership has led multiple governors to form reopening alliances. To suppress the appearance of a coup d'état, President Trump relinquished decisions about reopening states to corresponding governors. This is authority governors feel they had all along. How might this reopening look?

Basic guidance includes conversations between government and businesses on how essential they are and whether they can adapt to social distancing. The Whitehouse suggests that states sustain a 14-day period with no increase in COVID-19 deaths and hospitals returning to pre-coronavirus conditions. This includes having no PPE shortages. Additionally, states should be able to track and isolate areas where the virus exists. But since reopening is up the governors, these are suggestions that few are following.

In Georgia and South Carolina, governors announced they will ease restric­tions despite neither of them meeting White House recom­menda­tions of a two-week downward trend in cases before lifting measures. Despite the fact that the U.S. Supreme Court is convening remotely in response to social distancing, the Wisconsin Supreme Court has overturned the state’s stay-at-home order, ruling it “unlawful” and “unenforceable.” More states are easing restrictions.

Laurie Garrett, the author of “The Coming Plague,” outlines a 36-month recovery requiring a number of miracles. At the top of the list is development of a universal inexpensive vaccination not requiring refrigeration or needles. It must then be administered to the global population. In the absence of such ideal circumstances, COVID-19 will linger indefinitely.

Some unmasked citizens in Texas, Maryland, Indiana, Nevada, and Wisconsin are taking their frustration to the streets. In another bizarre turn of events, President Trump defended the mounting series of protestors against coronavirus restrictions:

I really believe that they’re being unreasonable,” Trump said, citing the Democratic governors of Michigan and Virginia. “There are a lot of protests out there. And I just think that some of the governors have gotten carried away.”

Attorney General William Barr said the Department of Justice (DOJ) will consider taking legal action against governors who continue to impose stringent rules for dealing with the coronavirus that infringe on constitutional rights even after the crisis subsides in their states. If governors keep states shut down and protestors bring lawsuits against the states, the DOJ may enjoin themselves to the protestors.

Then President Trump announced termination of the U.S. Government COVID-19 Task Force in May. Trump conceded that “there’ll be more death” as the country opened but added “the virus will pass, with or without a vaccine.” It appears the populous is heading towards a herd immunity experiment.

What Is Herd Immunity?

Even though elephants are strong animals, they have predators. Young elephant calves can succumb to lions, wild dogs, and even river torrents. Instinctively, the adults in a herd surround calves to form a barrier of protection.

Early research shows a large number of people may have had mild symptoms or no symptoms at all—and this group might be spreading the coronavirus more than previously thought. When everyone around you is a potential COVID-19 carrier, there is a high proba­bility of infection. Herd immunity occurs when some­one without the virus is surrounded by a barrier of those who are immune. There are two ways for the barrier to acquire immunity:

  1. Many people contract the disease and in time build up an immune response to it (natural immunity).
  2. Many people are vaccinated against the disease to achieve immunity.

In the absence of a vaccine, the only option seems to be exposure of the virus to 70 to 95 percent of the popula­tion. Theoretically, those who contract the virus and recover have anti­bodies that have success­fully fought it off. So implementing herd immunity as a solu­tion might involve ending stay-at-home orders and sending people out with masks that provide little protection. The effects might over­whelm hospitals and lead to high death rates.

Herd immunity
Herd Immunity: Red dots represent unvac­cinated popula­tion without antibodies. They may be carriers or susceptible to the virus. Green repre­sents those infected with the virus. Yellow dots on the right repre­sent persons with resis­tant antibodies from prior infection or vaccination.

To visualize this, picture some­one without immunity as a red dot surrounded by yellow immune dots. If the red dot can’t connect to any other red dots, there is herd immunity. Eventually, in theory, the virus dies out.

In the case of COVID-19, this is not an iron-clad theory. We do not yet know whether those who recover will ever contract it again or whether a different strain of this virus, against which people do not have antibodies, will resurface. In fact, scientists are trying to figure out why hundreds of people in South Korea and China who recovered are testing positive for the coronavirus.

Gideon Meyerowitz-Katz of Science Alert makes the point: “If 70 percent of your popula­tion is infected with a disease, it is by defini­tion not preven­tion. How can it be? Most of the people in your country are sick!” Katz continues: “If 70 percent of an entire popula­tion gets sick, that means that between 0.35–0.7 percent of everyone in a country could die, which is a catas­tro­phic outcome.” Emphasizing the need to stay at home, he concludes: “Until we have a vaccine, anyone talking about herd immunity as a pre­venta­tive strategy for COVID-19 is simply wrong.”

June 19, 2020 – Sweden’s hopes of getting help from herd immunity in combating the coronavirus received a fresh blow, when a new study showed fewer than anticipated had developed antibodies. Sweden surpassed 5,000 deaths from the coronavirus. —Reuters

Instead of forced lockdowns, Sweden is taking the herd immunity approach. Masks are not manditory and seldom seen in public. The death rate in Sweden is significantly higher than many other countries in Europe, with 2,500 dead by early May 2020. Most are elderly.

Whether motivation for states to open up businesses without a vaccine is motivated by economics or a herd immunity trial is up for debate. As it applies to COVID-19, herd immunity is a non-starter. The World Health Organization (WHO) said in a scientific brief that, “There is no evidence yet that people who have had COVID-19 will not get a second infection.”

A failing that fuels indecisiveness over staying at home or going outside wearing quality masks in public is the shortage of masks for healthcare workers. The pandemic is sucking up N95 and surgical masks at an insatiable rate. The limited evocation of the Defense Production Act underway will still leave a PPE shortage. Some hospital workers are reusing single-use masks and resorting to other makeshift options.

In public settings, extended use of N95 (or similar) masks sans appropriate ventilation has a risk of suffocation. This danger increases among young children and those with weak lungs. The general population lacks sufficient training on mask maintenance and safety. It is no wonder why the message to the public swings between remaining indoors or exiting with ineffective equipment and robust social distancing.

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References
  1. 5 mixed messages from Trump that have marred his administration's coronavirus response. abcnews.go.com
  2. U.S. Governors Defy Trump by Forming Regional Alliances. foreignpolicy.com
  3. Trump completes reversal, telling govs 'you are going to call your own shots' and distributes new guidelines. cnn.com
  4. Some US state leaders move toward reopening while death toll nearly doubles in a week. cnn.com
  5. US is unprepared to protect residents from virus while states are reopening, former acting CDC director says. cnn.com
  6. As coronavirus restriction protests take place across U.S., Trump defends demonstrators. latimes.com
  7. Barr Threatens Legal Action Against Governors Over Lockdowns. bloomberg.com
  8. Trump pivots hard away from fight against unvanquished pandemic. cnn.com
  9. Wisconsin Supreme Court strikes down state's stay-at-home order. cnn.com
  10. Part 4: Entire CNN coronavirus town hall (May 7). cnn.com
  11. What Is Herd Immunity and Could It Help Prevent COVID-19? healthline.com
  12. What is Herd Immunity and How Can We Achieve It With COVID-19? jhsph.edu
  13. Recovered coronavirus patients are testing positive again. Can you get reinfected? cnn.com
  14. Here's Why Herd Immunity Won't Save Us From The COVID–19 Pandemic. sciencealert.com
  15. What is herd immunity and why some think it could end the coronavirus pandemic. cnn.com
  16. WHO says no evidence shows that having coronavirus prevents a second infection. cnn.com
  17. The Defense Production Act Won’t Fix America’s Mask Shortage. wired.com
  18. Which is the best option, lockdown or herd immunity? We're about to find out. theguardian.com
  19. As some leaders weigh pursuit of ‘herd immunity’ from coronavirus, experts warn risks are too high. abcnews.go.com
  20. Sweden was supposed to remind me of 'normal' but instead felt reckless. cnn.com
  21. Fauci says Covid-19 vaccine may not get US to herd immunity if too many people refuse to get it. cnn.com
  22. We're wasting time talking about herd immunity. cnn.com
  23. Any attempt to get coronavirus herd immunity would lead to massive death tolls, Fauci warns. cnn.com
  24. The truth about 'herd immunity' cnn.com
Kevin Williams is a health advocate and writer of hundreds of articles for multiple web­sites, including: A Bit More Healthy, KevinMD (WebMD), and Sue’s Nutrition Buzz. He is a prior 15-year con­sul­tant for Neutrogena Research and Scientific Affairs.

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