The dangerous fringe theory behind the push toward herd immunity
Resumption of normal
life in the United States under a herd immunity approach would result in an
enormous death toll by all estimates.
Derrick Z. Jackson for the Environmental Health News
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| Belgian artist Jan Brueghel, "The Triumph of Death," 1597 |
More than 6,200
scientists, health professionals, and research organizations say this is
inhumane and have signed a memorandum rejecting
herd immunity as a legitimate strategy.
The John Snow
Memorandum, signed by the Union of Concerned Scientists (and individually by my
wife, a physician and epidemiologist at the Harvard School of Public Health),
warns that many factors render herd immunity a "dangerous fallacy
unsupported by scientific evidence."
Chief among them are
that the coronavirus is much deadlier than
the seasonal flu, and it remains unclear how long any immunity lasts after one
recovers from an infection. That makes it likely that a herd immunity strategy,
according to the memo, will surely cause a huge number of preventable deaths,
run the risk of triggering recurrent epidemics, and potentially "overwhelm
the ability of healthcare systems to provide acute and routine care."
The upwelling of concern
behind the memorandum is the legitimacy being given in key corners of the White
House to herd immunity, as represented in a new, high-profile document called
The Great Barrington Declaration.
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| Trump advisor on the pandemic, Dr. Scott Atlas |
The declaration claims,
with not a single fact or scientific study to back it up, that "current
lockdown policies are producing devastating effects on short and long-term
public health."
Paternalistically
oblivious to systemic and political reasons why Black, Latinx, and Indigenous
people die from COVID-19 at higher rates than White people, the declaration
says lockdowns are a "grave injustice" to the working class and
school children and that keeping lockdowns in place until there is a vaccine
"will cause irreparable damage, with the underprivileged
disproportionately harmed."
Given all that so-called
injustice, the authors say everyone who is "not vulnerable" should be
free to move about the country and dance, sing, and play with the virus. They
slyly skirt the notion that herd immunity is really about reopening the economy
at all costs—which many governors did with catastrophic spikes in coronavirus cases.
Instead, they say:
"Schools and
universities should be open for in-person teaching;"
"Extracurricular
activities, such as sports, should be resumed;"
"Young low-risk
adults should work normally, rather than from home. Restaurants and other
businesses should open. Arts, music, sport and other cultural activities should
resume."
Herd immunity’s
unacceptable toll
Resumption of normal
life in the United States under a herd immunity approach would result in an
enormous death toll by all estimates. Former CDC director Tom Frieden estimates that
another 500,000 people would have to die to achieve 60 percent herd immunity.
"And that's the best-case scenario," Frieden wrote in a Washington
Post op-ed. "The number of deaths to get there could be twice as
high."
Frieden said that is the
best-case scenario because no one really knows if the actual percentage needed to
see the virus peter out is to have it infect more
like 65, 70, or
even 75 percent of the
population. Even if immunity could be miraculously achieved at 50 percent, an
estimate published in Nature
Reviews Immunology places the range of sacrifice somewhere between
500,000 and 2.1 million deaths.
That makes it little
wonder that Anthony Fauci, the most respected scientist advising the Trump
administration on the pandemic, called herd immunity for the coronavirus
"total nonsense."
Fauci is backed up by
the likes of National Institutes of Health Director Francis Collins, who said
herd immunity is a "dangerous" and "fringe" component of
epidemiology. Ashish Jha, dean of the Brown University School of Health called herd
immunity "junk science."
The head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said this month that the only acceptable form of "herd immunity" is achieved through vaccination. "Herd immunity is achieved by protecting people from a virus, not by exposing them to it," the secretary general said.
"Never in
the history of public health has herd immunity been used as a strategy for
responding to an outbreak, let alone a pandemic . . .Allowing a dangerous virus
that we don't fully understand to run free is simply unethical. It's not an
option."
Nowhere does the Great
Barrington Declaration acknowledge that 60 percent of
adults in the United States have at least one chronic medical condition that
makes them more vulnerable for worse outcomes from COVID. That means that only
40 percent of adults would have the privilege of resuming normal breathing
among work colleagues and shouting and singing in sports and worship.
Nor does the declaration
acknowledge a study in The
Lancet that finds that less than 10 percent of people in the United
States currently have the antibodies for the coronavirus. As proponents of herd
immunity wax poetically about letting the virus loose among children and young
adults, a grim reality is that one out of every five COVID
deaths has occurred among people under the age of 65.
The herd immunity
approach is also inherently racist, given the context of the systemic health,
employment, residential, and environmental injustice inequities that make
people of color more susceptible to the virus.
Even though the virus is
raging throughout nearly the entire nation, with cases increasing in 42 states
and Guam, according to the October 22 tracking by
the New York Times, any public health response to the virus must
factor in the impact on people of color.
According to the
Centers for Disease Control and Prevention (CDC), the COVID hospitalization
rate for Latinx, Indigenous Americans, and African Americans, when adjusted for
age, were all more than four times higher the hospitalization rate for white
Americans, and the age-adujsted death rate for all three groups are triple the
rate for white Americans, according to the APM Research Lab. The
lab says that if racial death rates were equal, nearly 22,000 Black people and
about 11,400 Latinx would still be alive today.
And while proponents of
rushing children back into classrooms say we can do so because young kids
rarely get sick from coronavirus, nearly four out of every five children who do die are
African American, Latinx, or Indigenous, according to the CDC, double their
combined share of the US population.
Herd immunity is the
national de facto strategy
Somehow, none of that
has culled herd immunity from being considered as a legitimate approach for
fighting COVID-19. Rather, the Great Barrington Declaration has much in common
with the Trump administration's approach to the coronavirus, which has led to
more people dying from COVID-19 in the United States than in any other nation
on Earth.
A de facto herd immunity
approach is the only thing that can explain the push by governors of so many
states to reopen bars,
restaurants, beaches, bowling alleys, and gyms in states even as the virus has
raged and case numbers have been increasing. It is the only thing that can
explain the federal designation of meatpackers as essential workers and state
demands that teachers go back into classrooms despite outbreaks and deaths
related to those professions.
It also explains how so many
of the nation's most respected scientific voices have been silenced. Despite
the virus's current "uncontrolled spread" in 34 states and Puerto
Rico, according to October 21 tracking by CovidExistStrategy.org,
the White House has pushed aside Fauci, Coronavirus Task Force Coordinator
Deborah Birx, Surgeon General Jerome Adams, and Robert Redfield, the head of
the Centers for Disease Prevention and Control.
In their place, the administration has handed the pandemic podium to Scott Atlas, a radiologist and conservative pundit with no background in infectious disease science or epidemiology in measuring disease prevalence.
Inhumanely ignoring the more than half of US adults having a pre-existing
condition that could compromise them for COVID-19, Atlas blithely praises herd
immunity, saying, "We
can allow a lot of people to get infected. Those who are not at risk to die or
have a serious hospital-requiring illness, we should be fine with letting them
get infected."
He pooh-poohs expanded
testing, saying, "you are destroying the workforce." Twitter recently
took down one of Atlas's tweets for falsely claiming, "Masks work?
NO" and then lying that the WHO says widespread mask use is "not
supported." The first sentence of the WHO's webpage on masks
says, "Masks are a key measure to suppress the spread of COVID-19 and save
lives."
Atlas denies that the
White House has a "wide-open strategy of achieving herd immunity."
But there's little doubt that the White House is wide open to the idea. Last
week, Atlas appeared on Fox
News to say the thrust
of the Great Barrington Declaration "is exactly aligned with the
president." That was seconded by a senior administration official
who told reporters in a
conference call that the Great Barrington Declaration "is endorsing what
the president's policy has been for months."
The freezing out of
scientists on the Coronavirus Task Force reached deep space levels this week (a
metaphoric minus 455 degrees Fahrenheit), with multiple buckets of ice dumped
on Fauci. Atlas diminished Fauci as "just one person" on the force,
offering only a "limited approach." President Trump called Fauci a
"disaster," claiming, "People
are tired of hearing Fauci and these idiots, all these idiots who got it
wrong."
Many thousands of lives
can still be saved
Atlas's malpractice
already merits his dismissal. He should be forced to step down because his
disregard for science will surely lead to incalculable disaster if a herd
immunity approach becomes official government policy. Calls for his ouster have
already begun even from inside the task force. According to
the Washington Post, Birx went to Vice President Mike Pence to
suggest removing Atlas. All Pence reportedly did was ask Birx and Atlas to work
out their problems on their own.
There is no time left
for such discord within the task force and for discordant messages to come from
the White House on how people should protect themselves from COVID-19. The
thousands of scientists and public health professionals who signed the John
Snow Memorandum say "it is critical to act decisively and urgently,"
to launch a "robust" response on the level of New Zealand, Vietnam,
or Japan—all of which have shown success in containing the virus and keeping
the numbers of cases and deaths relatively low.
The approach that has
been proven effective starts with face coverings and social distancing and
reducing the temptation we all will feel during the oncoming winter holidays to
have extended family gatherings.
Researchers from MIT and
the Vancouver School of Economics estimate in a
working paper that, if the United States had established a national mask
mandate in mid-March, between 19,000 and 47,000 lives could have been saved by
the end of May.
Now that the nation's
death toll approaches a quarter million lives lost, and is projected to reach
nearly 400,000 by February 1, according to the Institutes for Health Metrics
and Evaluation at the University of Washington, the institute estimates we
could avoid 74,000 new deaths with universal mask use.
Importantly, masks
protect others, including the most vulnerable among us. This week, the Washington
Post reported how coronavirus outbreaks among college students
partying in unmasked packs in LaCrosse, Wisconsin was found to have led to 19 deaths so far of people
over the age of 60. Before that, the city had gone without a single
pandemic death in its nursing homes.
That is on the heels of
the wedding in Millinocket, Maine, that resulted in an outbreak that killed eight elderly people,
none of whom attended the event, and the 500,000-person Sturgis, South Dakota,
motorcycle rally that is now tied to the
massive coronavirus outbreak in the Upper Midwest and Mountain States. The
Germain IZA Institute of Labor Economics estimates that the illness generated
from the rally will cost the
nation $12.2 billion in health care costs.
Atlas and the proponents
of the Great Barrington Declaration have not yet said why this is just fine.
That is why they must be unmasked for the charlatans that they are.
Derrick Z. Jackson is
on the advisory board of Environmental
Health Sciences, publisher of Environmental Health News and The
Daily Climate. He's also a Union of Concerned Scientist Fellow in climate and
energy. His views do not necessarily represent those of Environmental
Health News, The Daily Climate or publisher, Environmental Health Sciences.
This post originally ran
on The Union of Concerned Scientists
blog and is republished here with permission.