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The idea of using herd immunity to tackle the COVID-19 pandemic comes up time and again. But Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, argued against relying on a herd immunity strategy to protect us from COVID-19 in a recent interview with Good morning america.
Herd immunity is an important concept in public health that describes a situation where enough people in a certain community are vaccinated against a particular disease that the disease cannot spread within the community, SELF explained previously. That protects people who are vaccinated, as well as those who are not vaccinated, from becoming infected. Achieving herd immunity is crucial to protecting against many diseases because due to factors such as insufficient access, age, underlying conditions or allergies, there will always be people who cannot receive the vaccine and could be left vulnerable.
When it comes to COVID-19, people mistakenly use the concept of herd immunity to argue that allowing the virus to spread uncontrollably through a community would be a “compassionate” approach to controlling the pandemic. This idea is central to the Great Barrington Declaration, which advocates a concept called “targeted protection.” This concept includes protecting those most vulnerable to severe COVID-19 outcomes without specifically requiring lockouts or stay-at-home orders for the rest of the public. The statement does not mention masks or social distancing.
But many leading experts agree that such an approach would be disastrous for many reasons. On the one hand, the statement assumes that people who are not at increased risk of serious complications from COVID-19 will contract the infection and develop a natural immunity against it. But we don’t know exactly what type of immunity COVID-19 actually provides or how long it lasts. Some reported cases of reinfection in the US and abroad suggest that having COVID-19 once is not a guarantee of long-term protection in all cases.
“That statement has a couple of things that I think are misleading people,” Dr. Fauci said in the interview. There is a hidden implication there that if we just let people get infected and only care about protecting the “vulnerable”, there are still a large number of people, and there is no guarantee that we can actually protect them.
“Approximately 30% of the population have an underlying condition that makes them more susceptible to the adverse effects and outcomes of serious illness with COVID-19,” explained Dr. Fauci. So simply “letting things break” (as Dr. Fauci put it) without imposing social distancing, stay-at-home orders or masks is “frankly, ridiculous,” he said. “There will be so many people in the community who cannot be sheltered, who cannot be protected, who will get sick and suffer serious consequences.”
To date, more than 220,000 people in the US have died from COVID-19, and we are averaging nearly 60,000 new cases each day, according to data from the Centers for Disease Control and Prevention (CDC). With a herd immunity approach, there could be one million deaths in the U.S. and 13 million deaths worldwide according to the most optimistic estimates, explained Christopher LJ Murray, MD, director of the Institute for Metrics and Evaluation of the Health (IHME) of the University of Washington. . Of course, death is the most serious potential complication of COVID-19. But those who do not die from COVID-19 can still have serious health consequences and long-term effects from the virus.
Knowing how easy it is for the virus to spread makes it extremely difficult to protect even the most vulnerable. For example, there are now more than 160 cases and multiple deaths associated with a single Maine wedding that occurred last August. Those numbers include people who did not attend the wedding, but who are close contacts and tertiary contacts of the wedding guests. In one case, a wedding guest infected his father, who later came into contact with another of his sons who worked in a rehabilitation center. That person later infected other employees and residents at the facility. One way or another, the virus often returns to those who are most at risk, especially when people don’t take precautions that we know can make a difference, like avoiding crowds and wearing masks.
“This idea that we have the power to protect the vulnerable is total nonsense because history has shown that this is not the case,” continued Dr. Fauci. “If you talk to someone who has experience in epidemiology and infectious diseases, they will tell you that it is risky and you will end up with many more infections of vulnerable people that will cause hospitalizations and death.
To achieve true herd immunity, we need a vaccine. Until that happens (and, honestly, probably even afterwards), we should embrace public health tools like masks, social distancing, ventilation, and hand washing. Sometimes that can also include temporary requests to stay at home. But completely ignoring all of our public health strategies under the deception that we can protect the people who are most vulnerable to COVID-19 would do far more harm than good. “We have to look that square in the eye and say it’s silly,” said Dr. Fauci.
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