The Coronavirus “herd immunity” strategy of the Great Barrington Declaration is a nightmare

It has been eight, long and devastating months in the United States since the epidemic began. A staggering number of people have fallen ill and been hospitalized, and hundreds of thousands have died. People have become detached from caring for them, businesses are losing out, education is suffering, and so is our mental health.

It is understandable, then, why the mob is tempted by the idea of ​​ending the epidemic by building immunity. Crowd immunization advocates, who want to reopen all schools and businesses and resume sports and cultural activities, say they want to ease the burden of the epidemic: “Allow those who are not vulnerable to immediately resume life as normal.” Should. ” Reading a document called The Great Barrington Declaration, the latest ship for this hope is that life could return to normal for some before the virus spreads to the community.

The authors of the declaration – a trio of scientists from Harvard, Stanford and Oxford, whose opinions, we should say, are out of the mainstream – call their approach “centralized prevention.” The big idea is that while we protect older, more vulnerable people, we can spread the virus to younger, healthier people.

The declaration attracted 10,000 signatures (although the names of the signatories were not disclosed) and on the right and its fans at the White House, where epidemic consultant Scott Atlas (who is a neurodiologist, epidemiologist) has previously suggested this is a good thing to do. Is. “When young, healthy people get infected, that’s a good thing,” he said in a July interview with the San Diego local news station.

And yet there are ample reasons to fear that this “focused prevention” strategy of allowing young and healthy people to increase immunity to the sick virus will never work. And it can bring devastating unintended consequences.

Natalie Dean of Florida’s Biostatistian University told me earlier this year, “It only predicts this level of control that you can carve out people at really high risk.” Society does not nicely differentiate itself into risk groups. We have infected the elderly with outbreaks that started in small populations.

The Barrington Declaration is getting a lot of attention in the news and through viral social media posts. It has caused alarm among scientists who see through its thin scientific logic. One group has written a counter piece Lancet.

A group of scientists representing mainstream thinking wrote in a letter to him in the John Snow Memorandum (known as the “father” of modern epidemiology) that “it is practically impossible and very immoral to isolate large sections of the population for so long.”

It is unethical for many, many reasons. Here’s why.

Herd immunity through natural infections is unethical as deprived people are at risk of becoming very ill.

There are multiple parameters that put someone at risk for a serious Covid-19. It’s not just age. Conditions such as diabetes and hypertension are at increased risk. So do social factors like poverty, working conditions and imprisonment.

Severe covid-19 and coronavirus deaths have inconsistently affected minorities and are less beneficial in the United States. This mob immunization strategy is at risk that either this will also isolate already marginalized communities from society because they do not feel safe in a more relaxed environment. Or worse: we risk sacrificing their health in the name of building enough population immunity to control the virus.

Bill Hennessy of Harvard epidemiologist Bill Henness points out the overall inequality here: the mass immunity acquired by natural infection will come at an unfair price for some of the most vulnerable groups in the country.

“Some groups have a higher risk of infection than others – and they are primarily ethnic. [and] “We are effectively forcing those people to endure the risk of infection and the epidemic,” says Hengage, “ethnic minorities and primarily poor people with less good housing.

I think of my grandmother, who recently died in the last years of her life in a nursing home at the age of 18, where she spent most of her time in her room due to Covid-19 precautions. When I called, she would say, “I’m very lonely here.” Older people should not write, keep separate and forget.

Or as stated in the John Snow Memorandum (signed by Hang): “Such an approach risks exacerbating the socio-economic inequality and structural discrimination already plagued by the epidemic.”

Crowd immunity from natural infections is also a scientifically bad idea

Typically, the term Hurl immunity is considered in the context of a vaccination campaign against an infectious virus such as measles. This concept helps public health officials think mathematically how many people in the population are vaccinated to prevent an outbreak.

The World Health Organization’s director-general, Tedros Breebrias, said this week that “an epidemic that has never occurred in the history of public health has been used to respond to an outbreak, to spread an epidemic.” “It’s scientifically and morally problematic.”

Let’s count the reasons.

1) Even if we limit the chances of death from Covid-1 to people, this group can still suffer many consequences from infection – such as hospitalization, long-term symptoms, organ damage, missed work and high medical bills. The long-term health consequences of the virus have rarely been studied. When we expose young, healthy people to the virus (on purpose!), We don’t know what the consequences will be.

2) We have a long length Way to go. U.S. There is no complete estimate of what percentage of the population is already infected with the virus. But, by all accounts, she is nowhere near the figure needed to kick off livestock immunity. Overall, a new one Lancet The study – which draws its data from a sample of dialysis patients – suggests that less than 10 percent of people across the country have been exposed to the virus. No one knows the exact threshold percentage for herd immunity to kick in a meaningful way to help end the epidemic. But the general estimate remains around 60 percent.

So far, more than 200,000 people have died in the United States. There is a high probability of death if the virus spreads to the true herd immune system. “The cost of mob immunity [through natural infection] Says Hangez.

Look at what happened to Manaus, the Amazonian city of Brazil’s nearly 20 million people, which erupted in the world’s most serious covid-19 outbreak.

Researchers now estimate that a percentage of the city’s population and with 66 percent of the population are infected with the virus, which means that animal immunity is possible there. (This research has yet to be peer-reviewed.) But during their epidemic period, there were four times more deaths than usual at that time in the year.

3) Scientists do not know how long the natural immunity to the virus lasts or how normal the reproduction may be. If the immune system is weakened and resuscitated, it will be more difficult to boost herd immunity in the country. In the spring, Harvard epidemiologists directed the scenarios. If the immune system lasts for a few years or more, the Covid-19 may fade within a few years, according to their published analysis. Science (Too long to start if you ask me). If the immune system is weakened within a year, Covid-19 can make a sharp annual comeback until an effective vaccine is widely available.

At the same time, we do not know how long the immunity given by the vaccine will last. But, at least one vaccine comes without the cost of increased illness, hospitalization and long-term complications.

If the immune system does not survive, “Such [focused prevention] The strategy does not end the covid-1p epidemic, but it does cause recurrent epidemics, as it was a condition of many infectious diseases before the advent of vaccination, “says John Snow Memorandum.

4) By letting the epidemic spread, we put the threshold of the flock’s immune system at excessive risk. Once you press on the range of the flock’s immune system, it doesn’t mean the epidemic is over. After reaching the threshold, “it means that, on average, each infection causes less than one ongoing infection,” says Henez. “It is of limited use if you have already infected one million people.” If each infection causes, on average, 0.8 new infections, the epidemic will slow down. But 0.8 is not zero. If one million people became infected at the time the flock reached immunity, according to Henaz’s example, already infected people could infect 800,000 more.

There are a lot of strangers here too. One is the type of immunity provided by a natural infection. “Immunity” is a catchphrase that means a lot of things. This means that a second virus infection can provide real protection. Or does it mean that reinstatement is possible but less serious? You can, potentially, get infected a second time, never feel sick (thanks to a quick immune response), and it can still pass the virus to another person.

Scientists who advocate constant distance have never argued for endless lockdowns.

The mainstream scientific consensus to fight the epidemic never calls for an endless lockdown and endless gloom for our economy.

Instead, health experts have argued that first we need to conduct community transmission of the virus, and then keep a new outbreak from interventions such as aggressive testing, contact tracing, and universal masking, better indoor ventilation and social distance. .

But we never managed to get the virus to the levels it could contain. (It’s not impossible; other countries like South Korea and Japan have.) So here we are.

The last thing that really fools me about the Great Barrington Declaration is that it avoids discussing how the government can do more to help those affected by the epidemic downstream economic impact. Instead of forcing restaurant renters to choose between their livelihoods and put their customers and employees at risk, they would have been paid to stay closed by the government. Instead of letting people face the complete mental insecurity of the missing paycheck, unemployment insurance benefits by Congress and the White House could have been extended to now (they have not received).

For many reasons, the Great Barrington Declaration – like all the mob’s immune proposals – seems to be sacrificing the health of young people and the health of marginalized people. Don’t give up. There is no easy way.

Help keep Vox free for all

Millions turn to Vox every month to understand what happens in the news, from the coronavirus crisis to the racial divide, which is probably the most consequential presidential election of our lifetime. Our goal has never been more alive than this moment: to empower you through understanding. But our exclusive brand of open journalism takes resources. Even when the economy and the news advertising market improve, your resource will be an important part of sustaining our resource-intensive work. If you have already contributed, thank you. If you don’t have, please consider helping everyone make sense of a growing chaotic world: Contribute less than $ 3 today.