[Let “natural herd immunity” as a pandemic relief strategy be
extinguished with the end of 2020. ] [[link removed]]

THE WORST IDEA OF 2020  
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Brian Resnick
January 30, 2021
Vox
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_ Let “natural herd immunity” as a pandemic relief strategy be
extinguished with the end of 2020. _

Former White House coronavirus adviser Scott Atlas argued that
infections among young people were “a good thing.” ,

 

It’s year-end-list season. Usually, the Vox science team has some
fun and compiles a year-end list of bad ideas in health and science
that ought
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the end of the year. In the past, we’ve targeted homeopathic
medicine
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declared it was time to end the relevance of the fatally flawed
Stanford Prison Experiment
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and dispelled myths about climate change
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This year, though, we have only one target for intellectual
demolition.

With the end of 2020, let’s leave behind the idea of using herd
immunity acquired through natural infections as a means of combating
the Covid-19 [[link removed]] pandemic.
That’s a lot of words to describe a simple, terrible idea: that we
could end the pandemic sooner if more people — particularly young,
less-at-risk people — get infected with the coronavirus and develop
immunity as a result.

As a response to a pandemic, the idea is unprecedented. “Never in
the history of public health has herd immunity been used as a strategy
for responding to an outbreak, let alone a pandemic,” World Health
Organization Director-General Tedros Adhanom Ghebreyesus said
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October. “It is scientifically and ethically problematic.”

And yet it held sway — at the White House, in particular.

Former White House adviser Scott Atlas (who is a neuroradiologist, not
an epidemiologist) was particularly vocal about pursuing more
infections. “When younger, healthier people get infected, that’s a
good thing,” Atlas said in a July interview with San Diego news
station KUSI-TV
[[link removed]].
“The goal is not to eliminate all cases. That’s not rational,
it’s not necessary if we just protect the people who are going to
have serious complications.”

RELATED
Herd immunity, explained
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Let’s be clear, it’s not a “good thing” when young people get
sick. For one, some of these young people may die, more may get
severely ill, and a not-yet-understood proportion of them could suffer
long-term consequences. The more people infected, the more chances for
rare, horrible things to happen, like a 4-month-old developing brain
swelling after testing positive for Covid-19
[[link removed]].
For that reason, among others, attempting to keep infections to only
young or lower-risk people is a foolhardy game to play.

Why building up herd immunity through natural infections is a bad idea

There’s an almost-understandable case for why some people would push
for a herd immunity strategy. We are isolated from those we care
about, businesses are hurting, education has suffered, and so has our
mental health. What if we could just get back to some parts of normal
life and contain the risks to those who are least likely to get hurt?

This thinking has proved reckless. Sweden, a country that pursued a
more permissive strategy
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it came to social distancing, has a much higher death rate than
fellow Scandinavian countries.
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And look at what happened in Manaus, Brazil: The city of around 2
million people experienced one of the most severe, unchecked Covid-19
outbreaks in the world
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Researchers now estimate that between 44 and 66 percent of the
city’s population was infected
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the virus, which means it’s possible herd immunity has been achieved
there (another estimate pegged the infection rate at 76 percent
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But during its epidemic period, there were four times as many deaths
as normal
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Manaus for that point in the year.

More typically, the term “herd immunity” is referred to in the
context of vaccination campaigns against contagious viruses such as
measles. The concept helps public health officials think through the
math of how many people in a population need to be vaccinated to
prevent outbreaks. It’s not meant to be applied to control a
pandemic through natural infection. Here are five reasons why:

* Even if we could limit exposure to the people least likely to die
of Covid-19, this group still can suffer immense consequences from the
infection — such as hospitalization, long-term symptoms, organ
damage, missed work, high medical bills, and yes, death.
* Herd immunity is a very high bar to reach from natural infections.
There’s no single, perfect estimate of what percentage of the US
population has already been infected by the virus. But by all
accounts
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it’s nowhere near the figure needed for herd immunity to kick in.
The CDC now estimates
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there have been 91 million SARS-CoV-2 infections in the US — around
27 percent of the population (though this may be an overestimate
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take around 60 percent of the population to achieve herd immunity.
That’s a rough guess; it could be higher
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So, we’re about halfway there. Who wants to double the destruction
already caused by this virus? In the US, more than 330,000 people have
died. (Plus, herd immunity doesn’t work on a nationwide basis but a
community-by-community basis. In other words, some communities are
still much more vulnerable than others.)
* Scientists don’t know how long naturally acquired immunity to
the virus lasts, or how common reinfections might be. If immunity
wanes and the reinfection rate is high, it will be all the more
difficult to build up herd immunity.
* By letting the pandemic rage, we risk overshooting the herd
immunity threshold. Once you hit the herd immunity threshold, it
doesn’t mean the pandemic is over. “All it means is that, on
average, each infection causes less than one ongoing infection,”
Harvard epidemiologist Bill Hanage told me. “That’s of limited use
if you’ve already got a million people infected.” If each
infection causes an average of 0.8 new infections, the epidemic will
slow. But 0.8 isn’t zero. If a million people are infected at the
time herd immunity is reached, per Hanage’s example, those
already-infected people may infect 800,000 more.
* A herd immunity strategy is likely to harm some groups more than
others. There are multiple reasons why someone could experience a
severe case of Covid-19. It’s not just age — conditions such as
diabetes and hypertension also exacerbate risk. So do societal factors
including poverty, working conditions, and incarceration.

In the US, severe Covid-19 deaths have disproportionately impacted
minorities and less-advantaged populations. Encouraging herd immunity
through coronavirus infections risks further isolating these
already-marginalized communities from society, since they may not feel
safe in a more relaxed environment. Or, even worse, we risk
sacrificing their health in the name of reaching a level of population
immunity sufficient to control the virus.

Soon, herd immunity will be a good thing — because of vaccines

Thankfully, we now have a means of building up herd immunity without
the risks conferred by infections: vaccines. Unlike the immunity
conferred by an actual viral infection, immunity obtained via vaccine
doesn’t come with the cost of sickness and death. Vaccines are safe.
And while they won’t turn the pandemic around overnight, they will
help end it.

We still have to do some difficult waiting. Vaccine rollouts will be
slow. Throughout 2020, “herd immunity” was used as a shorthand
stand-in for “let the pandemic spread.” There was also persistent
and erroneous wishful thinking
[[link removed]] by some
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said herd immunity had already been reached, or could be reached
sooner than scientists say, or could be reached without incurring
horrible losses. Yes, the economic restrictions of the pandemic were,
and still are, painful. But also true: the government could have done
more to help.

Soon, herd immunity will become a good-news phrase as we build toward
it collectively — and safely — through vaccines. As the vaccines
get distributed, herd immunity will develop in a controlled, ethical
manner. The pandemic will wane.

And as it does, let’s not forget: The calls to build up herd
immunity through infections were a terrible, terrible idea. Let’s
not repeat them in the future.

_Brian Resnick is a science reporter at Vox.com, covering social and
behavioral sciences, space, medicine, the environment, and anything
that makes you think "whoa that's cool." Before Vox, he was a staff
correspondent at National Journal where he wrote two cover stories for
the (now defunct) weekly print magazine, and reported on breaking news
and politics._

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