Why do experts say we need to stop talking about herd immunity

Ali Mockdad is tired of hearing about herd immunity.

A former official with the Centers for Disease Control and Prevention, Mokkad spent years training counterparts in their countries on how to respond to infectious disease outbreaks and develop vaccination programs. As the idea of ​​natural herd immunity has gained traction, Mocked has not been embarrassed with his disdain.

He said adopting a strategy of natural herd immunity – in which coronaviruses would be allowed to spread, especially among young people, until enough of the population became immune to the virus so that further spread was unlikely – disastrous Will happen.

“It’s criminal and it’s immoral,” said Mokkad, now a professor of global health at the University of Washington. “It means that we let many people die instead of protecting ourselves. This is not acceptable. “

Most infectious disease specialists have been vocal critics of a herd immunity approach, but in recent weeks, the idea has taken a leap into national consciousness. Last month, after the White House published a controversial online statement by three scientists, known as the Great Barrington Declaration, that spared immediate pushback from epidemiologists and public health experts, the White House openly immune Strategy adopted.

As an increase of coronovirus has been reported in most states and hospitals for Kovid-19 across the country, experts say natural herds prove ideas about immunity to be dangerous and dangerous, which is already the government’s highest There is a public health message inconsistent with levels.

“We still have a long way to go for herd immunity, lacking a vaccine,” Mokdad said. “If we talk about herd immunity at the current mortality rate that we see from infections, then we’re talking at least 1.2 million deaths.”

For this coronavirus, it is estimated that about 60 to 70 percent of the population will need to be immune to reach herd immunity, although Mokkad and others have stated that the threshold may be even higher.

There are two main ways that a population can achieve high levels of immunity: either enough people have become infected with the virus and their immune system has developed antibodies to protect against future infections, or is an effective vaccine.

Nevertheless, even in hard-hit areas of the country – such as New York City, which was the epicenter of the epidemic in the spring, or South Dakota, which imposed some restrictions to prevent the spread of the virus and hospitalization. The people of the state have seen. More than 50 percent in the last week alone – collectively considered to be less immune than the level required to perform slow transmissions.

The main premise laid out by the Great Barrington Declaration is that lockdown restrictions, which are not only financially harming businesses, schools and other parts of the local economy, but also cause physical and mental harm. Scientists proposed a strategy of “focused protection” aimed at shielding people who are over 70 years old – and who already have conditions that put them at high risk – while returning the rest of the population Allows for normal life.

The idea is that for people who are less at risk of becoming seriously ill with Kovid-19, the lockdown ban may cause more harm than the virus, according to one of J. Bhattacharya, a professor of medicine at Stanford University and co. – Officer of declaration.

But critics of the announcement said that the most effective way to protect those who are vulnerable is to control the amount of community dissemination.

“Everyone agrees that we should do everything for our safety, but it’s scientifically clear that right now, in the United States and most other places, if not all, we have vulnerable people without control.” There are no tools to protect, a professor of epidemiology at Harvard TH Chan School of Public Health, Mark Lipsich said in a podcast discussion about herd immunity hosted by the Journal of the American Medical Association on Friday.

Lipsch, along with 79 other public health researchers, epidemiologists and virologists, published a paper in the medical journal The Lancet on 14 October. 14 denying the declaration and termed natural herd immunity a “flawed” strategy. The letter is known as the John Snow Memorandum, named after an English physician who is considered the father of modern epidemiology.

A professor of medicine at Johns Hopkins University, Drs. Stuart Ray said that instead of discussing a herd immune response, which he called “a distracting fantasy,” states should focus on strategies, such as working, such as adopting a mask mandate, to reduce social distance. To encourage. , Preventing large gatherings and teaching good hand hygiene.

Adopting a herd immune strategy also ignores other risks of Kovid-19, Ray said, including reports of people who experience lethargic symptoms for weeks or months after infection. The exact extent of these “long-hulls” is not known, meaning that scientists are quick to say that the risk of developing serious complications is low enough to allow a viable response to herd immunity.

“If we allow uncontrolled proliferation, we are allowing some people to develop complications, the severity of which we do not fully understand,” Ray said. “Just because we think there may be a trap, does not mean that we should meet a criterion.”

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