Deliberate Efforts to Achieve Herd Immunity to COVID Are Dangerous

The following essay is reprinted with permission from The Conversation, an online publication covering the latest research.

White House advisers have made the case recently for a “natural” approach to herd immunity as a way to reduce the need for public health measures to control the SARS-CoV-2 pandemic while still keeping people safe. This idea is summed up in something called the Great Barrington Declaration, a proposal put out by the American Institute for Economic Research, a libertarian think tank.

The basic idea behind this proposal is to let low-risk people in the U.S. socialize and naturally become infected with the coronavirus, while vulnerable people would maintain social distancing and continue to shelter in place. Proponents of this strategy claim so-called “natural herd immunity” will emerge and minimize harm from SARS-CoV-2 while protecting the economy.

Another way to get to herd immunity is through mass vaccinations, as we have done with measles, smallpox and largely with polio.

A population has achieved herd immunity when a large enough percentage of individuals become immune to a disease. When this happens, infected people are no longer able to transmit the disease, and the epidemic will burn out.

As a professor of behavioral and community health sciences, I am acutely aware that mental, social and economic health are important for a person to thrive, and that public health measures such as social distancing have imposed severe restrictions on daily life. But based on all the research and science available, the leadership at the University of Pittsburgh Graduate School of Public Health and I believe this infection-based approach would almost certainly fail.

Dropping social distancing and mask wearing, reopening restaurants and allowing large gatherings will result in overwhelmed hospital systems and skyrocketing mortality. Furthermore, according to recent research, this reckless approach is unlikely to even produce the herd immunity that’s the whole point of such a plan.

Vaccination, in comparison, offers a much safer and likely more effective approach.

An uncertain path to herd immunity

Herd immunity is an effective way to limit a deadly epidemic, but it requires a huge number of people to be immune.

The proportion of the population required for herd immunity depends on how infectious a virus is. This is measured by the basic reproduction number, R0, how many people a single contagious person would infect in a susceptible population. For SARS-CoV-2, R0 is between 2 and 3.2. At that level of infectiousness, between 50% and 67% of the population would need to develop immunity through exposure or vaccination to contain the pandemic.

The Great Barrington Declaration suggests the U.S. should aim for this immune threshold through infection rather than vaccination.

To get to 60% immunity in the U.S., about 198 million individuals would need to be infected, survive and develop resistance to the coronavirus. The demand on hospital care from infections would be overwhelming. And according to the WHO estimated infection fatality rate of 0.5%, that would mean nearly a million deaths if the country were to open up

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The idea of herd immunity to manage covid-19 should ring alarm bells

And yet, many prominent epidemiologists, public health researchers and physicians are pushing back against the concept. NIH Director Francis Collins condemned covid-19 herd immunity-based responses calling them “fringe” and “dangerous,” while WHO Director General Tedros Adhanom Ghebreyesus called it “scientifically and ethically problematic.” Currently the theory of herd immunity is used in public health settings when immunity can be acquired through a vaccine, such as measles or polio, but not when it requires people to contract a disease to develop immunity.

While herd immunity is the theory behind vaccine programs, the concept originated in veterinary medicine and livestock management in the late 19th and early 20th century. This matters because in this setting, economics rather than ethics served as a guiding force. In some cases, it was cheaper to slaughter diseased or suspected animals to prevent the rest from getting sick than expose an entire herd to a disease that could kill or reduce the value of livestock. While this may have helped halt damaging animal diseases, it would be unacceptable for human public health programs. Revisiting the history of managing the spread of animal disease explains why the theory of herd immunity, absent a vaccine, is a deeply troubling approach to managing the spread of covid-19.

At the end of the 19th century, over 1.5 million livestock farms existed with billions of dollars’ worth of cattle, swine, sheep, poultry and goats. In 1884, concerned that deadly infections such as contagious bovine pleuropneumonia and foot and mouth disease threatened the livelihood of farmers and American food security, Congress and President Chester A. Arthur established the Bureau of Animal Industry (BAI) at the USDA through legislation.

This new bureau was tasked with researching animal diseases and granted regulatory authority to prevent, contain or eradicate livestock diseases. Keeping livestock animals free of disease and death ensured a steady supply of meat, milk and eggs for Americans, and protected producers’ incomes.

Not all livestock diseases killed infected animals or rendered them unusable for food production. New York dairy farmers first documented an infectious-disease now known as brucellosis in the 1850s. They noted that the disease would roll through communities every few years causing pregnant heifers and cows to lose their calves. This led to a decrease in milk production — but most infected cows recovered and returned to normal production for the rest of their lives. Owners worried about their bottom line at that moment but did not want to slaughter potentially productive animals. Instead, they hoped to prevent the disease through sanitary measures and treatments.

Cases of cattle brucellosis were reported across the country in dairy cattle and an increasing number of range herds. Through the use of establishing herds for observation and testing, by the early 20th century the bacterial cause of the disease was identified and a test for exposure was developed — but neither a vaccine nor treatment had been discovered.

And so, researchers and farmers offered advice about how to minimize the impact of brucellosis on cattle. At

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U.S. again tops 60K new COVID-19 cases; Surgeon General Jerome Adams rejects ‘herd immunity’

Oct. 21 (UPI) — U.S. Surgeon General Dr. Jerome Adams joined other top health experts Wednesday in opposing a dangerous “herd immunity” strategy, as the United States again added another 60,000 COVID-19 cases.

According to updated data from Johns Hopkins University, there were 60,300 new cases nationwide on Tuesday — the third time in the past week that the level has topped 60,000.

Deaths in the United States also increased on Tuesday, the data showed, to more than 900. Since the start of the pandemic, there have been 8.28 million cases and about 221,100 deaths nationwide.

Wednesday, Adams joined Dr. Antony Fauci and other top health officials in opposing a herd immunity strategy, which is purportedly being considered by the Trump administration. Adams said pursuing such a strategy, which effectively allows the coronavirus to spread unchecked, would result in an unacceptable death toll.

Adams tweeted that there’s no “example of a large-scale successful intentional infection-based herd immunity strategy” and warned that the course would “lead to many complications/deaths.”

The strategy reasons that letting the virus spread would infect large populations, who would then develop a natural immunity to COVID-19 and thereby reduce the number of people who can be infected afterward. Eventually, the theory goes, the virus would run into a dead end.

“Large numbers of people would need to be infected to achieve herd immunity without a vaccine,” Adams wrote, warning that such a path could “overwhelm” healthcare systems.

Fauci, director of the National Institute of Allergy and Infectious Diseases, rejected the idea of herd immunity last week, calling it “ridiculous” and “total nonsense.”

Most scientists say there would be no feasible way to isolate and protect vulnerable Americans who face a greater risk of death from COVID-19 in such a scenario.

Researchers at the University of Washington say a herd immunity strategy would likely lead to tens of thousands of additional deaths by the start of 2021.

Child cases have increased by almost 15% — 84,000 cases — in the first two weeks of October, according to an update from the American Academy of Pediatrics and Children’s Hospital Association.

Since the start of the crisis, about 740,000 children have tested positive in the United States — almost 11% of total cases, it said. The overall infection rate is 986 per 100,000 children.

Though severe illness and deaths still appear to be rare among children, the groups urged authorities to “provide detailed reports on COVID-19 cases, testing, hospitalizations and mortality by age and race/ethnicity so that the effects of COVID-19 on children’s health can be documented and monitored.”

The Centers for Disease Control and Prevention said Tuesday there have been about 300,000 deaths more than normal so far this year due to the pandemic.

In a typical year, the CDC said, there are about 1.9 million deaths from all causes between February and October. This year, COVID-19 has pushed that figure to near 2.2 million, an increase of 14.5%.

About 200,000 of the extra deaths may be attributed to

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Health experts say ‘herd immunity’ strategy would kill thousands

Public health experts are growing alarmed that the Trump administration is increasingly embracing scientists who argue against lockdowns and restrictions as a means to control the coronavirus pandemic.

Those scientists maintain that the costs of locking down society and closing schools and businesses outweighs their benefits in combatting the virus. In a document known as the Great Barrington Declaration, signed earlier this month, they embrace a concept known as “herd immunity,” in which a population builds up enough resistance to a pathogen that it runs out of victims to infect.

On a call with reporters on Monday, two senior White House officials cited the declaration, authored in part by an economist with close ties to Scott Atlas, the radiologist who has become one of Trump’s chief advisors on the coronavirus pandemic.

But to public health experts, allowing the virus to run its deadly and devastating course is an unacceptable option that would lead to hundreds of thousands of deaths beyond the 217,000 Americans who have already succumbed to the disease.

“If you just let things rip and let the infection go, no masks, crowd, it doesn’t make any difference, that quite frankly, George, is ridiculous,” Anthony FauciAnthony FauciTrump fields questions on coronavirus, conspiracy theories in combative town hall Chris Christie says he ‘was wrong’ not to wear face mask at White House Overnight Health Care: Georgia gets Trump approval for Medicaid work requirements, partial expansion | McConnell shoots down .8 trillion coronavirus deal MORE, director of the National Institute of Allergy and Infectious Disease, told George StephanopoulosGeorge Robert StephanopoulosSix takeaways from Trump and Biden’s dueling town halls Biden draws sharp contrast with Trump in low-key town hall Biden leaves door open to adding Supreme Court justices MORE on ABC’s “Good Morning America” on Thursday.

“You’ll wind up with many more infections of vulnerable people, which will lead to hospitalizations and deaths. So I think we’ve just got to look that square in the eye and say it’s nonsense,” Fauci added.

In a statement Thursday, groups like the National Association of County and City Health Officials, the American Public Health Association, the Association of Schools and Programs of Public Health and the Public Health Institute condemned the declaration and the flaws in its arguments.

“Covid-19 carries a much higher risk of severe disease and death than other infections where herd immunity was attempted before a vaccine was available,” the groups said. “It is illogical to ignore public health and scientific evidence when so many lives are at stake.”

Some experts pointed to an underlying flaw of the declaration: An assumption that someone who has recovered from the coronavirus will become immune to reinfection in the future.

“We just don’t really understand coronavirus immunology well enough to know whether this is going to be a minor, moderate or major concern,” said Michael Osterholm, director of the Center for Infectious Disease Research and Prevention at the University of Minnesota. “We have learned so much about Covid-19 over the course of

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