The White House has recently revealed it’s strategy to handle the coronavirus epidemic; let it rip. Embracing a “herd immunity” approach, the White House hopes that enough people will become infected by the virus and subsequently immune, that it will effectively stop the virus from spreading. But that strategy is dangerous, and with more and more evidence pointing to the fact that immunity is not lasting with COVID-19, that would mean letting the virus rip through the population over and over. It’s inhumane, especially in a country whose healthcare is expensive and out of reach for many, and where people can lose their homes and livelihoods if they miss work for illness. On top of those cold hard realities, the idea of letting an indeterminate number of people die as part of a targeted strategy is horrifying. So why is the White House embracing it?
What is the ‘Herd Immunity’ Strategy?
Herd immunity is the theory that if a large enough percent of a population or, “herd,” is infected with a virus and gains immunity, the vulnerable will be protected. Usually, herd immunity is achieved through vaccines. Mayo Clinic writes, “Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected — not just those who are immune.
Often, a percentage of the population must be capable of getting a disease in order for it to spread. This is called a threshold proportion. If the proportion of the population that is immune to the disease is greater than this threshold, the spread of the disease will decline. This is known as the herd immunity threshold.
What percentage of a community needs to be immune in order to achieve herd immunity? It varies from disease to disease. The more contagious a disease is, the greater the proportion of the population that needs to be immune to the disease to stop its spread. For example, the measles is a highly contagious illness. It’s estimated that 94% of the population must be immune to interrupt the chain of transmission.”
Example of herd Immunity Strategy with COVID-19
There are real-world examples of countries that embraced this strategy to handle the coronavirus; namely, Sweden. They chose to allow the virus to spread unchecked, encouraging the population to continue going about their normal lives without social distancing or masks.
It has been disastrous, although the Swedish government has been selling it as a success. The country of 10 million people has lost to date nearly 6,000 people. Their death rate has been 58.36 per 100,000 citizens. Neighbors with comparable living styles, economies, and technology like Finland and Norway, by contrast, have death rates of 6.24 and 5.09 respectively. Finland and Norway both took active mitigation approaches.
But perhaps such a staggering death rate would be worth it if it meant they could be done with the virus and move on with life. So what has actually happened? They continue to grapple with the virus. Per Time, ” it simply hasn’t worked. In April, the Public Health Agency predicted that 40% of the Stockholm population would have the disease and acquire protective antibodies by May. According to the agency’s own antibody studies published Sept. 3 for samples collected up until late June, the actual figure for random testing of antibodies is only 11.4% for Stockholm, 6.3% for Gothenburg and 7.1% across Sweden. As of mid-August, herd immunity was still ‘nowhere in sight,’ according to a Journal of the Royal Society of Medicine study. That shouldn’t have been a surprise. After all, herd immunity to an infectious disease has never been achieved without a vaccine.”
Why is the White House Embracing This?
Under President Donald J. Trump, the White House is rejecting the scientific consensus to focus on what lines up with their ideologies. The New York Times reported confirmation that the Trump administration was going this route. Per Time, “This approach, roundly rejected and discredited by scientists worldwide, is at the heart of a controversial new statement, titled the Great Barrington Declaration, written by three academics with views far outside the scientific mainstream—Jay Bhattacharya, Martin Kuldorff, and Sunetra Gupta. Senior Trump administration officials told the New York Times that the White House is endorsing the declaration.”
The Barrington Declaration encourages people to return to work, school, and social events like normal. This approach would appeal to the Trump administration which has made clear over time that their biggest concern is not preventing loss of life, it’s safeguarding the economy. They argue that a suffering economy leads to real-life suffering among the population. Unfortunately, the United States’ sputtering approach to slowing the virus has caused hemorrhages to spring up in the economy; job loss has been staggering, and people are suffering financially as medical bills pile up and unemployed workers compete with record numbers of peers for fewer jobs as businesses contract to keep from shuttering their doors.
Would it Work?
As evidenced by Sweden and elsewhere, the answer to that question is likely no. According to Time, “Scientists estimate that a large fraction of the population, 50% or more, would need to be immune to reach herd immunity against COVID-19. Let’s be clear: The only way to achieve this without huge costs in terms of illness and deaths would be through vaccination with safe, effective COVID-19 vaccines. It cannot be reached by natural infection and recovery. Too many people would die or become disabled; hospitals, clinics, and morgues would be overwhelmed; and even if some people developed immunity, it would probably just be temporary so there would continue to be ongoing waves of deaths and illness. The experience of the city of Manaus, Brazil gives an indication of what the toll of the virus is when it is left unchecked: 66% of the city was infected and an astonishing 1 in 500 people died of COVID-19.
A recent study from Stanford University suggests that only about 9% of the U.S. population has antibodies to the new coronavirus. Basic math shows that around 156 million more Americans would need to get infected to reach the 50% threshold for herd immunity from natural infection. You’ve seen the devastation caused by 7.7 million cases, so just imagine the impact of another 156 million cases.”
The New York Times paints a grim projection of the death toll needed to achieve herd immunity by natural infection; “And what will be the cost? Even if herd immunity can be achieved with only 40 percent of the population infected or vaccinated, the I.H.M.E. estimates that a total of 800,000 Americans would die. The real death toll needed to reach herd immunity could far exceed one million.”
Experts Recommend Continuing to ‘Flatten the Curve’
With an estimated 40% of Americans having comorbidities that make them at high risk of death if they contract COVID-19, the Barrington Strategy is a hard sell. Even if the Trump administration could get people on board with the, “let grandma die,” approach to the pandemic, we’d be doing it again in a few months when the next wave occurs as immunity wanes. Eventually, everyone vulnerable to the virus will have died. At what horrifying and unimaginable cost?
So what is the alternative? We continue to flatten the curve. A phrase that suggests slowing the spread of the virus enough to avoid overwhelming the healthcare system, “flattening the curve,” should have been the goal in the United States since March. A cohesive federal strategy requiring state compliance could have limited death tolls. Back in July, studies were released that showed the simple act of mandating masks could cut deaths by a whopping 67%. In other countries where hard shut-downs were enacted, death rates dropped precipitously. With the Trump administration unwilling to take either approach, states have been hacking piecemeal at their virus mitigation and the result is a staggeringly high death rate and what appears to be the start of a third wave, although experts warn that we have never effectively completed the first wave.
Will the US Accept the ‘Let Them Die’ Strategy?
Almost certainly they will not. And the herd immunity approach would require the participation of all healthy citizens and the compliance of those at risk staying completely isolated. That’s an impossible ask for an administration which has a trust issue with its citizenry. Even if the Trump administration could convince people to leave grandma and their vulnerable relatives to die, healthy adults would continue to avoid the virus for fear of racking up heath-related debt or losing time at work. Knowing these factors, the White House’s strategy is unfathomable. It seems a desperate bid to appeal to a base of Trump voters who want to see life return to normal and don’t care what the scientists say. If the White House’s goal is to limit economic depression and get people back to work, places like New Zealand, China, and Australia show us how it can be done.