Corralling the Facts on Herd Immunity

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Yves here. While much of the material in this article is familiar to Naked Capitalism readers, it’s useful to have it all in one piece, as well as having updates on some topics, such as the high death cost of Sweden’s low-intervention Covid-19 policy. It’s also suitable for sending to friends and family members who may be behind the curve on the “herd immunity” topic.

One issue the article finesses badly, however, is the percentage of people who have to have been infected or successfully vaccinated for Covid-19 infections to slow to a halt. The highest level they suggest is 70%. However, one solid study found that the uncontrolled R0 for Covid 19 is over 5, which means the level of the population that would need to be vaccinated or previously infected would be 85%. Another issue the article breezes past is how long those who’ve been vaccinated or infected are immune. Recall that coronavirus antibodies don’t appear to confer long-lasting immunity. For the common cold, it’s only six month, and for the longest-lived, MERS, it’s 34 months.

By Aneri Pattani, a Correspondent at Kaiser Health News, who previous reported for Spotlight PA, The Philadelphia Inquirer, WNYC (New York City’s NPR station) and The New York Times. She was a 2019 recipient of the Rosalynn Carter Fellowship for Mental Health Journalism. Originally published at Kaiser Health News

(KHN illustration; NIAID)

For a term that’s at least 100 years old, “herd immunity” has gained new life in 2020.

It starred in many headlines last month, when reports surfaced that a member of the White House Coronavirus Task Force and adviser to the president, Dr. Scott Atlas, recommended it as a strategy to combat COVID-19. The Washington Post reported that Atlas, a health care policy expert from the Hoover Institution of Stanford University, suggested the virus should be allowed to spread through the population so people build up immunity, rather than trying to contain it through shutdown measures.

At a town hall event a few weeks later, President Donald Trump raised the idea himself, saying the coronavirus would simply “go away,” as people developed “herd mentality” — a slip-up that nonetheless was understood to reference the same concept.

And as recently as last week, Sen. Rand Paul (R-Ky.) sparked a heated debate at a committee hearing when he suggested that the decline in COVID cases in New York City was due to herd or community immunity in the population rather than public health measures, such as wearing masks and social distancing. Dr. Anthony Fauci, the top U.S. infectious disease official, rebuked Paul, pointing out that only 22% of the city’s residents have COVID antibodies.

“If you believe 22% is herd immunity, I believe you’re alone in that,” Fauci told the senator.

All this talk got us thinking: People seem pretty confused about herd immunity. What exactly does it mean and can it be used to combat COVID-19?

An Uncertain Strategy With Great Cost

Herd immunity, also called community or population immunity, refers to the point at which enough people are sufficiently resistant to a disease that an infectious agent is unlikely to spread from person to person. As a result, the whole community — including those who don’t have immunity — becomes protected.

People generally gain immunity in one of two ways: vaccination or infection. For most diseases in recent history — from smallpox and polio to diphtheria and rubella —vaccines have been the route to herd immunity. For the most highly contagious diseases, like measles, about 94% of the population needs to be immunized to achieve that level of protection. For COVID-19, scientists estimate the percentage falls between 50% to 70%.

Before the COVID pandemic, experts can’t recall examples in which governments intentionally turned to natural infection to achieve herd immunity. Generally, such a strategy could lead to widespread illness and death, said Dr. Carlos del Rio, an expert in infectious disease and vaccines at the Emory University School of Medicine.

“It’s a terrible idea,” del Rio said. “It’s basically giving up on public health.”

A new, large study found fewer than 1 in 10 Americans have antibodies to SARS-CoV-2, the virus that causes COVID-19. Even in the hardest-hit areas, like New York City, estimates of immunity among residents are about 25%.

To reach 50% to 70% immunity would mean about four times as many people getting infected and an “incredible number of deaths,” said Josh Michaud, associate director of global health policy at KFF. Even those who survive could suffer severe consequences to their heart, brain and other organs, potentially leaving them with lifelong disabilities. (KHN is an editorially independent program of KFF.)

“It’s not a strategy to pursue unless your goal is to pursue suffering and death,” Michaud said.

What’s more, some scientists say natural immunity may not even be feasible for COVID-19. While most people presumably achieve some degree of protection after being infected once, cases of people who recovered from the disease and were reinfected have raised questions about how long natural immunity lasts and whether someone with immunity could still spread the virus.

Even the method scientists are using to measure immunity — blood tests that detect antibodies to the coronavirus — may not be an accurate indicator of who is protected against COVID-19, said Dr. Stuart Ray, an infectious disease expert at the Johns Hopkins University School of Medicine.

With so many unanswered questions, he concluded: “We can’t count on natural herd immunity as a way to control this epidemic.”

Vaccines, on the other hand, can be made to trigger stronger immunity than natural infection, Ray said. That’s why people who acquire a natural tetanus infection, for example, are still advised to get the tetanus vaccine. The hope is that vaccines being developed for COVID-19 will provide the same higher level of immunity.

But What About Sweden?

In the political debate around COVID-19, proponents of a natural herd immunity strategy often point to Sweden as a model. Although the Scandinavian country imposed fewer economic shutdown measures, its death rate is less than that in the U.S., Paul said at Wednesday’s Senate hearing.

But health experts — including Fauci during the same hearing — argue that’s a flawed comparison. The U.S. has a much more diverse population, with vulnerable groups like Black and Hispanic Americans being disproportionately affected by the coronavirus, said Dr. Jon Andrus, an epidemiology expert at the George Washington University Milken Institute School of Public Health. The U.S. also has greater population density, especially on the coasts, he said.

When compared with other Scandinavian countries, Sweden’s death toll is much higher. It has had 5,880 deaths linked to COVID-19 so far, according to data from Johns Hopkins University. That’s nearly 58 deaths per 100,000 residents — several times higher than the death rates of 5 or 6 per 100,000 in Norway and Finland. In fact, as a result of COVID-19, Sweden has recorded its highest death toll since a famine swept the country 150 years ago. And cases are on the rise.

Despite that level of loss, it’s still unclear if Sweden has reached the threshold for herd immunity. A study by the country’s public health agency found that by late April only 7% of residents in Stockholm had antibodies for COVID-19. In other Swedish cities, the percentage was even lower.

Those findings mirror other studies around the globe. Researchers reported that in several cities across Spain, Switzerland and the U.S. — with the exception of New York City — less than 10% of the population had COVID-19 antibodies by June, despite months of exposure and high infection rates. The results led commentators in the medical research journal The Lancet to write, “In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable.”

Herd Immunity Is Still Far Off

The bottom line, medical experts say, is that natural herd immunity is an uncertain strategy, and attempts to pursue it could result in a slew of unnecessary deaths. A vaccine, whenever one becomes available, would offer a safer route to community-wide protection.

Until then, they emphasize there is still plenty to do to counter the pandemic. Wearing masks, practicing social distancing, hand-washing and ramping up testing and contact tracing have all proven to help curb the virus’s spread.

“As we wait for new tools to be added to the toolbox,” Andrus said, “we have to keep reminding ourselves that there are measures in this very moment that we could be using to save lives.”

KHN reporter Victoria Knight contributed to this article.

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48 comments

  1. Drake

    The main question I have after reading this is the degree to which the presence of antibodies alone is a measure of immunity. And in both directions—that is, do measurable levels of antibodies reliably confer immunity, and does the absence of antibodies alone mean that you are not immune? Various entities in the article equate the two, and my understanding is that this is pretty simplistic.

    Reply
    1. rusti

      measurable levels of antibodies reliably confer immunity

      With the disclaimer that I have zero expertise on the subject, it seems a bit arbitrary to say “measurable” since there’s always a level of test sensitivity. There’s also a very complicated role that T-cells play, so I think the answer that immunologists always give is “well, maybe, sorta!”

      There was an interesting discussion of this with UCSD Immunologist Shane Crotty that touched on these issues. If I recall correctly, he said there’s not really a scientific consensus on this and he takes issue with the conclusions people draw from the one study everyone cites about the immunity from common cold infections.

      One interesting point he made is that there’s some energy/resource cost associated with antibody production, so it’s natural that for a virus that doesn’t cause serious disease it’s probably not a great trade-off to keep higher ambient levels long after exposure. He also said that usually an immune response should induce some B-cell production and not T-cells alone, which seems to go against the magic T-cell theory forwarded here by Karolinska Institutet.

      Reply
      1. Ignacio

        Above the levels of sensitivity, –there are various types of tests with different sensitivities– is already measurable within an interval of Ab concentrations of some orders of magnitude. We shouldn’t go nihilistic. Some of the methods allow titrating very low basal Ab levels indeed. But, of course Ab concentrations, at some point may wane to undetectable levels. It has been well documented in many cases that immunity correlates with effectively measured antibody titres (basal and peak levels).

        Reply
    2. TimH

      Herd immunity hasn’t worked for the common cold, because viruses continually adapt and mutate. Yet it is meant to work for Covid. Seems wishful, not pragmatic.

      Reply
      1. Clive

        The same can be said for the prospects of any vaccine.

        And while a superficial comparison with the common cold is very valid, at the same time we’re not constantly suffering from the common cold. We get one when there’s a mutation which is sufficiently different to fool our immune response into not recognising it from when it’s encountered similar (but not sufficiently similar) to what we’ve had, but fought off, before.

        And repeat after me: not all (as in, everyone’s) immune responses are the same. Because of a (possibly) genetic accident, my immune response to viral infections is almost infallible. I get one cold a year, maybe only every two years. I’ve had the ‘flu twice in my entire life (I’m pushing 50). The price I pay (and it’s a steep one) is immune diseases caused by an over-zealous immune response.

        Reply
      2. Yves Smith Post author

        No, the cold is the most common coronavirus, and coronaviruses don’t mutate anywhere near as quickly as the winter flu virus does. It is literally that getting the common cold confers only about six months of immunity.

        It is the winter flu that mutates so often that it’s hard to develop immunity.

        Reply
        1. Clive

          All literature I’ve read states common cold rhinoviruses (HRV) mutate rapidly and easily e.g. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0010588

          Similar to many other RNA viruses, the error-prone rhinoviral polymerase can accumulate a large number of nucleotide mutations over a very short period of time, a feature that favors viral adaptation. The error rate of picornavirus RNA polymerases has been estimated to range between 10−3 and 10−4 errors/nucleotide/cycle of replication. This variability is a driving force for virus evolution and results in a large genetic and phenotypic diversity illustrated by the very high number of different HRV serotypes identified to date (http://www.picornaviridae.com/enterovirus/enterovirus.htm). As for other RNA viruses, the adaptive immune-mediated positive selection, which targets the capsid region for rhinoviruses, is probably one of the main HRV evolutionary forces at both the intra- and inter-host levels. The in vivo selection of resistant variants during exposure to anti-VP1 agents confirms the virus ability to rapidly mutate the capsid protein while still conserving replicative fitness.

          Antibody response based immunities are inevitably short-term but T-cells are suspected to provide the key to long-term immunity including viral mutations although the mechanisms and degrees are currently poorly understood https://www.frontiersin.org/articles/10.3389/fimmu.2018.00678/full

          I’m not sure why the Kaiser Health News piece never mentioned them, they don’t usually play a game of partial reporting of selected evidence.

          Reply
    3. Ignacio

      Definitions of immunity are various:

      Sterilizing immunity: protects from infection. This doesn’t last for very long for common cold CoVs but I think not known for SARS CoV 2. Associated with (high) titres of Abs in the upper resp. mucosa (IgA and/or IgG) that may wane relatively rapidly compared with blood Abs. Whether if you have been infected with SARS CoV 2 you will develop sterilizing immunity and for how long it lasts is not known to my knowledge.
      Protective immunity: You can become infected but do not develop disease or very mild disease or the disease does not to progress to the lungs or in the worst case you don’t develop severe Covid-19 disease. In some cases despite having immunity you could spread disease though probably less easily if your upper resp. tract becomes infected. Associated with adaptive cellular and humoral response to previous infection. Supposedly longer lasting than sterilizing immunity.

      Reply
      1. Clive

        This is, from what I’ve researched, the definitive study on the subject. A big problem, as usual, though, is small sample sizes. However, given the difficulty in the experimental protocol and the time-consuming nature of the reanalysis, it’s the best we’ll get for a while:

        https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2931235-6

        (NB: CAUTION! A 15Mb download from a slow-ish server!)

        A Twitter precis for the laity https://twitter.com/profshanecrotty/status/1306302606881558528

        Reply
  2. cnchal

    > . . . A vaccine, whenever one becomes available, would offer a safer route to community-wide protection.

    In the brawl last night, Trump asked, rhetorically, do you trust Pfizer, Johnson & Johnson then said I do.

    My instinct was hell no. The hopium that a vaccine rushed out the door in a race to maximize profits by the pharma greed heads will work is delusional.

    Jawb one is don’t get it. Everything else flows from that. Mask on, get away from me, never ever a restaurant or bar, or be part of a crowd of any size for any reason. These tactics form a strategy that should lead to a succesful outcome of jawb one. Still, there is no guarantee.

    For those with a defective logic function and think it’s no big deal, perhaps in five years when the results of repeated infections and taking crappy vaccines over and over again lead to moar deaths for the lucky ones and permanent health problems for the survivors, which is my baseline expectation, you will come around and adopt jawb one as a guiding principle.

    I have come around to Clive’s way of looking at it. Collectively, humanity is too stupid to eradicate it, so deal with it.

    Reply
    1. Clive

      I can’t really claim any credit or wisdom — I learnt it all from my mother-in-law. Often, when trying to resolve some problem or other, after looking into it I identify the options, let’s call them Option A, Option B and Option C. I’ll ask my mother-in-law to do Option A as it seems the least-worse (but by no means consequence-free). “Oh, no, I don’t think so, I don’t like that at all” will come the reply. “Okay, then” I’ll say, “Option B will work, it might not be pretty, but it will work”. “Oh definitely not Option B, there’s no way I’m ever doing that…

      (alert, possibly despairing, readers will know what’s coming next)

      “Fine”, I’ll conclude, “It’ll just have to be Option C”. “Absolutely not, Option C is terrible, I don’t know how you could suggest anything like that” will be my mother-in-laws intended final word on the subject.

      At which point, the previously hidden option can’t help but emerge. Which is, of course, do nothing and live with whatever problem started the whole thing off originally.

      I often cite my longsuffering mother-in-law when I need to illustrate a certain pattern of thinking or decision-making. I’d hate for anyone to get an impression that she is a stupid or ignorant person, this is far from correct. She has an innate common sense approach to most of life’s questions and has through careful action and thoughtful consideration of key decision points in one’s life, secured a comfortable and productive existence. A lot more intellectual types than her fail to manage this. However, my mother-in-law is a good case-study in a propensity to drift into Deus ex machina hopefulness when confronted by an intractable problem. In that, she reflects a common — perhaps a significant majority — of how people process these sorts of issues.

      If I’m being critical, Aneri Pattani in the normally excellent Keiser Health News got a bit of a dose of that, too in the original article. The premise was, here’s the science, here’s what it says, that’s it, the matter’s all settled, so there you go, that’s that sorted. But there is no possibility the argument can ever be concluded with a piece which not once mentions, as all Herd Immunity proponents I know leap at the chance of doing, “T-cell immunity”. Pattani kind of covers it in this section:

      What’s more, some scientists say natural immunity may not even be feasible for COVID-19. While most people presumably achieve some degree of protection after being infected once, cases of people who recovered from the disease and were reinfected have raised questions about how long natural immunity lasts and whether someone with immunity could still spread the virus.

      But it’s drowning (what else could it do?) in all those “…some scientists” and “may not’s” and “most people…” fence-sittings. “Presumably”, indeed. Pattani is channelling her inner my mother-in-law, looking at what is to hand (scientific evidence), not really liking what there is in front of them, but “with so many unanswered questions”, while hoping something else — more, or better, science — may come along, has to resort to the previously-absent and quite possibly magical solution, a vaccine, to swoop in and save the day.

      Pattani is humming another tune from the Siren call of the self-appointed and self-selecting fact-checker and just the latest in a long, long line of opinion leaders who postulate that “science” will come along, tie up all the nasty COVID-19 loose ends in a little pink bow, drop the nicely packaged-up definitive and unquestionable answer in our laps and that will be the end of the matter.

      It won’t. It’s thinking like that — that “science” will somehow resolve the really unpleasant choices before us — that got us into this mess in the first place.

      Reply
      1. Moe Knows

        Clive, my fine fellow do you think you could repeat that in a podcast. And maybe a bit more? 20 minutes or so? As to your reflections, you never fail to inspire. Thank you.

        Reply
      2. Synoia

        Herd Immunity as a solution:

        We have tried that, both in the 1340s and around 1665.

        I believe the correct sentence is: I have heard some have immunity.

        And the Operative action to achieve herd immunity is: Bring out your dead!

        Reply
      3. GramSci

        “It won’t. It’s thinking like that — that “science” will somehow resolve the really unpleasant choices before us — that got us into this mess in the first place.”

        How true! It’s hard not to imagine that this whole mess started with some scientist hunting bats in a cave in Yunnan, hoping to win a Nobel by saving humanity from the
        Great Undiscovered Coronavirus.

        Reply
    2. TroyIA

      The hopium that a vaccine rushed out the door in a race to maximize profits by the pharma greed heads will work is delusional.

      Pfizer will be cashing in on a vaccine but Johnson & Johnson as well as Astra Zeneca and GlaxoSmithCline have stated they will be providing their vaccines on a non-profit basis.

      As far as taking a vaccine that is approved by the FDA I say no thanks but if the very same vaccine is deemed safe and effective by the EU, Japan and China then sign me up.

      Reply
  3. Carolinian

    So which is it?

    A new, large study found fewer than 1 in 10 Americans have antibodies to SARS-CoV-2

    Or

    Even the method scientists are using to measure immunity — blood tests that detect antibodies to the coronavirus — may not be an accurate

    Just asking. The doubters also question the PCR test which some say not only detects the RNA of currently active virus but also of the virus you had two months ago. If that’s true and if it’s also true that many get Covid without even knowing it then a reported surge of cases could have to do with an increase in testing. Surely the best measure is death rate even if it is a lagging indicator. And as the article admits Sweden’s deaths per 1 million are below the US and also several other European countries. No, Sweden isn’t demographically the same as the US but it also isn’t the same as Norway and Denmark and has a large immigrant population. Belgium, which I believe still has the highest death rate in Europe, also has a large immigrant population. At any rate you can’t argue demographics on one hand and ignore it a couple of sentences later.

    Happy to be contradicted because I have no facts on my own–just what I read.. But I’m not sure the above makes its case either.

    Reply
    1. TimR

      Problem with death rate is that they changed the death certificate reporting guidelines for covid. Long established protocols thrown out and new methods adopted. So it’s apples and oranges to compare covid death rate to any other illness. The system appears to be rife with misclassification, just judging as an outside observer looking in.

      Reply
  4. The Rev Kev

    Personally I am glad that the same type of thinking about how ‘herd immunity’ will save our economies was not so widespread decades ago. Would we have said just let smallpox just burn itself out? Here is an image of smallpox at work as recently as 1973 by the way-

    https://en.wikipedia.org/wiki/Smallpox#/media/File:Child_with_Smallpox_Bangladesh.jpg

    So what about now. Measles is making a comeback as a lot of people are refusing to vaccinate their children, even though they are safe as they themselves were vaccinated as children. Should we try for herd immunity here as well? Have measles parties once again? It would save a lot of money and you could shrink how much public health a country needs.

    I can think of 10 reasons why we fight diseases and viruses and I am not about to say any different with Coronavirus-

    https://www.mdlinx.com/article/10-dreaded-diseases-back-from-the-brink/lfc-3380

    Reply
    1. JeffK

      Agreed, thanks for the small pox image – that will stick with me forever. But it makes me wonder: if the demographics of SARS-Cov 2 mortality were different, i.e those less than 5 years old had the highest mortality, would we even be talking about herd immunity? In this case the virus would threaten our species existentially. Are we talking about herd immunity because the underlying (taboo) thought is that the elderly are expendable and are not useful?

      Reply
    2. Basil Pesto

      my hypothesis: if covid-19 had, say, a severe dermatological symptom à la smallpox, it would be taken far more seriously by the masses. Seeing is believing, I guess.

      Reply
  5. rusti

    In fact, as a result of COVID-19, Sweden has recorded its highest death toll since a famine swept the country 150 years ago. And cases are on the rise.

    It continues to be bizarre to live here and see outsiders using us as a punching bag for everyone to project their frustration and political squabbles onto.

    A much more interesting thing to highlight would be to ask what the heck has been happening here since late June? Almost no one wears masks, schools for kids below 16 have literally never been closed, gyms have never been closed. People of all ages are staring to observe basic social distancing norms even less than they did before but our per-capita 7-day rolling average of new cases is lower than Denmark, the UK and France by my calculation. The intensive care wards in my region (the second largest outside of Stockholm) have no COVID-19 patients for the first time since March.

    My suspicion is that it’s primarily driven by people going on vacation after midsummer, driving the Rt value down. But the comparison with Denmark is still surprising since they have some masking requirements and people literally strip off their masks when they cross the border on the train. The one thing that’s eminently clear to me is that virtually no one is asking this question in an intellectually honest way. Rand Paul is a disingenuous moron and there’s a lot of virtue signalers on the left promoting hygiene theater.

    Reply
    1. Carolinian

      What’s the idea claiming to be an expert on Sweden just because you live there?

      I’m just another commenter confused by the many contradictory “facts” that seem to surround this crisis. But think I can repeat what was said three months ago: we’ll know what it was all about when it’s over. And if it’s over much sooner than many of the experts predicted here’s hoping they step up for the mea culpa.

      As for Sweden, perhaps all can agree that it hasn’t turned out to be nearly as bad as many predicted months ago. Same for the US (where 2 million dead was one estimate).

      Reply
    2. Moe Knows

      Well doing any kind of study on Sweden requires including those aspects of the exceptionally strong social safety net in place. Stress is always a big factor in getting infected and the progression of a disease. My problem with any country or part thereof is the part of only killing off 5% (or whatever it is – varies from place to place) of the population. How exactly is that decided? Who dies who doesn’t. This strikes me as a dangerous path to tread.

      Reply
    3. Yik Wong

      Population Density in Demark is 5 times Sweden’s, but then Hong Kong and Singapore are 120 to 140 times more dense… so that alone can’t be it. Danes were 25th in alcohol consumption, vs. Sweden at around 50, lots of social habits to overcome, so the surprise is why Denmark isn’t higher, particularly as it’s a North Europe throughway, not so Sweden. The Danes must be doing something right, but not all of them. I’d be interested to know the age/population density for Sweden now, after nursing homes have had their purge, Sweden has a word for it: Ättestupa. That should save the commonweal a pretty penny on elderly care. Anyway, the fat lady hasn’t even begun to finish her aria.

      Reply
  6. LilD

    Bloomberg’s Authers note today is on this topic. I get the email, don’t know where to point… key paragraphs

    The theoretical basis for hope lies in heterogeneity. Not all people will be equally susceptible to the virus, and there is now a debate over why some are so much worse affected than others. Whether prior exposure, possibly to other coronaviruses, could help some people to resist Covid-19 is now the subject ofintense research. Similarly, not all people will be equally exposed. Some naturally come into contact with far more people than others do, during the course of their daily lives. These people are more likely to have had it already, and won’t therefore infect anyone else in a second wave. This paper by Patinkin of David Capital explains the argument clearly.

    https://assets.empirefinancialresearch.com/uploads/2020/07/David-Capital-Partners-LLC-Letter-on-COVID-19-2020-Q2.pdf

    The mathematics are head-spinning. Gabriela Gomes of the University of Strathclyde in Scotland, one of the most respected mathematicians in the field, explains the ideas behind heterogeneity and its lowering of the threshold for herd immunity in this podcast. You can also see her discussing her models and how their predictions are working out as part of a video presentation for Boston University here.

    https://youtu.be/MPva_ho_mWc

    I’m not Completely convinced but there is some reason for optimism

    Reply
  7. Blue Pilgrim

    How does Atlas pushing his right wing POV make him an expert any more than those always insisting Iraq had WMDs made them experts on the subject? One might expect an expert would at least have good credentials in epidemiology, virology, and immunology, not just some neuroradiology. Ask the scientists at Stanford about him.

    Immunity, whether to infection or disease, and to spreading, varies by the pathogen and the individual’s immune system. Typhoid Mary was ‘immune’ and never got the disease, but had no trouble spreading it. A vaccine might stop someone from getting sick, or severely so, but not stop them from being infected — and immunity may not last long. Nobody knows how this will work out over time because Covid-19 hasn’t been all around for a long time yet. This is not rocket science, but much more complicated and difficult, and politics cannot answer the questions. Go to microbe.tv web site, especially TWiV podcasts, and virology.blog, for more information from real experts.

    Reply
  8. Cuibono

    not to nitpick but is 10x “several”?
    hat’s nearly 58 deaths per 100,000 residents — several times higher than the death rates of 5 or 6 per 100,000 in Norway and Finland. I

    Reply
  9. JohnT

    Ms. Aneri Pattani espouses the corporate line about the herd immunity threshold, Sweden and the immune system. But there are deep flaws in her argument. Let’s lay these out.
    1. Herd Immunity and the immune system – Ms. Pattani seems to be of the opinion that herd immunity is conferred by antibodies, thus her quoting Anthony Fauci about the 22% antibodies (of what virus it is not known since no SARS-COV2 virus has ever been isolated) being detected in the population of New York City. Those who have an understanding of the modern immune system know that has the innate, adaptive, interferon, neural, biome and virome all working together to keep a person healthy. Only the adaptive immune system has antibodies. It is only one of a number of means for human beings to deal with any “virus”. I will quote from Oxford’s Dr. Sunetra Gupta and her team’s paper, 2 The impact of host resistance on cumulative mortality and the threshold of herd immunity for SARS-CoV-2″ to highlight how flawed is Dr. Fauci’s thinking is in relation to herd immunity:

    “These results help to explain the large degree of regional variation observed in seroprevalence and cumulative deaths and suggest that sufficient herd-immunity may already be in place to substantially mitigate a potential second wave.…Equally, seropositivity measures of 10-20% are entirely compatible with local levels of immunity having approached or even exceeded the HIT, in which case the risk and scale of resurgence is lower than currently perceived.”

    . I would even add that if one does a rough calculation by using population, COVID-19 Deaths, and IFR to find HIT. If one takes the deaths in US (because at least we can be sure that the people died) which is at 206k and then we use the CDC’s infection fatality rate from May 2020 which was 0.26% in May but is now far lower given the present IFRs by age (0-19: 0.00003; 20-49: 0.0002; 50-69: 0.005; 70+ years: 0.05470), you get 79.2 million infected leading to an implied HIT of 26.4%. If you calculate the overall rate for the new IFRs you arrive closer to 20%. I am really perplexed as to people to whom she quotes for their estimates about when we will achieve herd immunity since their estimates are off by a factor of three. If you want to have a real idea about herd immunity, you need look no further than Farr’s law which has for more than 100 years actually shown that once peak infection has been reached then it will roughly follow the same symmetrical pattern on the downward slope. Without fail, every country in the northern hemispheres have been at or near zero deaths for months. You have three key factors: deaths, infection fatality rate which allows one to estimate the number of people actually infected and the overall population. Deaths has been near zero for months, so either the infection fatality rate would need to move lower (meaning that more people are supposedly infected) or the population has suddenly dropped. If more people are supposedly infected and the majority of those are asymptomatic because hospitalisations and deaths are still low (meaning that the infection fatality rate is lower than it was in May), would that not imply that people are already immune from the covid-19? I mean, it is basic math!

    2. Ms. Pattani then tries to argue against the example of Sweden. It is rather amusing since as someone who used to live in Sweden in the 1980s, it is clear that Ms. Pattani doesn’t know a lot about Sweden nor does the so called health experts including Dr. Fauci once again that she uses to try and reinforce her argument. It seems that the experts that she refers to have not been to Sweden since the 1980s when it was a very homogenous population with a relatively homogeneous population. If you want to make a comparison of what Sweden is today, in Europe it is more like Amsterdam than her Scandivanian neighbours with significant african, arab and eastern european populations. As well she brings out the data that has already been refuted many times arguing about Sweden’s per capita death rate. Of course if you actually look at the numbers in death by age, you discover that only 4% of covid-19 deaths were people under 60 years of age. Another 6% were people between 60-70. The other 90% were people above 70. And of the 96% above the age of 60% who died, 70% of those were in closed senior care facilities. So the per capita death rate has no meaning when they are being purposely left to die similar to what happened in NYC. So what we have in Sweden is a diverse population who was able to interact more or less normally related to a disease with a low infection fatality rate that has achieved herd immunity already when it hit 17% of the population based on Nobel Laureate Michael Levitt’s and other researchers estimates.

    Whether one does the math, or just looks at the facts on the ground, this idea of requiring 60% of the population to be infected to achieve herd immunity is just silly. It is rather obvious that in relation to whatever seasonal flu caused the symptoms associated with covid-19, that it has already passed through the population.

    Reply
    1. TimR

      Excellent points. And in addition: I’ve read testimonials from people whose parents died in nursing homes, about the real cause of death being intense neglect from terrified staff (early on when fear was highest). That is, their elderly mother with dementia would only have brief visits from heavily covered staff to deposit food, and otherwise lie in bed all day in isolation, developing bedsores, depression and other complications of neglect. Then, these kinds of deaths would be markef as “covid” when they’re obviously a form of euthanasia, intentional or not.

      So to your point, if those kinds of deaths are heavily boosting the covid stats, then the covid stats are garbage.

      Reply
      1. Yik Wong

        Why? Are they not due to Covid? This thinking is like saying Civilians who die from starvation induced by a war are not victims of that war.

        Reply
        1. TimR

          Well yes, indirectly. But if more deaths are being caused by hysteria and fear of Covid, than by Covid itself; and if “indirect” deaths are being counted as “direct” deaths, feeding the cycle of fear and hysteria; then obviously we need to address our excessive RESPONSE to Covid, much more so than Covid itself (the science of which is even debatable, virology being such an arcane black art, according to critics I’ve read.)

          The OP pointed out that nursing home deaths are spiking the stats. Well, it seems very likely to me that those deaths in particular are likely to be from extreme neglect— a form of euthanasia or eldercide— rather than Covid directly. Thus the whole stats for Covid really begin to fall apart.

          Reply
          1. Yik Wong

            Counting deaths is easy. Not so impairments. We will not know the total cost of Covid for another 10, 20, or even 50 years, we just know it’s going to be expensive, and not just in monies..

            Reply
    2. Nathan

      If those that take precautions are significantly less likely to contract covid, then maybe herd immunity is happening but only for those who do not take precaution? That would at least affect the basic math that you are suggesting JohnT.

      Reply
    3. Ignacio

      I think you (and Gupta), make some confused assumptions.

      You first para, in an indirect way, suggests that the innate system provides immunity to some unknown percentage of the population that should be added to ‘Ab based’ immunity. I don’t think so. I would reframe it to say that the innate system does not prevent infection, it is triggered AFTER infection and then, yes helps to protect from severe outcomes particularly in the younger populations, but it doesn’t prevent virus spread, neither deaths mainly in the older population etc. The same innate system was present in the first wave and will be present in the second wave so there is a long stretch to affirm that innate immunity will contribute to herd immunity in second or third waves. If I understand correctly, the paper by Gupta et al. a epidemiological modelling paper, seems to make the assumption that the innate system will help reduce the R0 in future waves. IMO, he overplays it. I instead would consider that the innate immune system is a constant and wouldn’t change the R0 significantly in second or third waves. Any significant change in the R0, apart from the many other factors that Gupta’s model ignores, like preventive measures –social distancing, masks, awareness, testing and isolation, seasonal differences in succeptibility– etc. in second or third waves will depend mostly on the increase of immunity thanks to the adaptive immune response. He mentions cross-protection but if anything, cross-protection from common cold CoVs must be waning with time –since preventive measures are reducing the incidence of common cold by a lot– so this will possibly have a negative effect in future waves. So Fauci’s claim that Abs are a good indicator for herd immunity stays correct (even if there are other indicators that might help such as cellular adaptive responses).

      Then, your second paragraph makes claims that are simply wild, with assumptions on numbers of deaths as driven by herd immunity while ignoring again the most relevant stuff: social distancing, masks, awareness, testing and isolation, seasonal differences in succeptibility etc.

      Reply
  10. jonhoops

    “Whether one does the math, or just looks at the facts on the ground, this idea of requiring 60% of the population to be infected to achieve herd immunity is just silly. It is rather obvious that in relation to whatever seasonal flu caused the symptoms associated with covid-19, that it has already passed through the population.”

    Keep wishing… those 800 deaths a day would seem to contradict your rosy assertions.

    Reply
  11. Sean

    Antibody analysis as a proxy for exposure has issues as milder cases have weaker antibody responses that dissapear quicker and some cases may just get t-cell responses. But if tcell responses have been added and last longer then new cases would be less deadly on reinfection – this was why so many native americans died to diseases that were not deadly to europeans. Immune system has other responses besides absolute antibody immunity.

    I’ve seen solid data that antibody prevalence will never rise above 20% because they fade over time but many people would have already had it and now have tcell responses to weaken susceptibility in the future.

    Reply
  12. Sancho Panza

    I tested negative for antibodies but believe I am immune to the virus. Why? I play basketball five or six time a week in gyms and pubic parks; no masks, no distancing, and no virus. I am middle aged and have had no illness or symptoms. One park I frequent regularly has 200 people or so, all ages and backgrounds…socializing, roller skating, playing basketball, soccer, grilling…all no masks and no distancing and we have not heard of one outbreak as a result. It’s a wonderful sight in the face of the media fear blitzing. Could it be that being social, getting outdoors, and exercising are helping our terrain? I also socialize with my 80 year old parents…we don’t mask but we try to stay outside. Thankfully they have not taken ill either. My experience is not simply anecdotal…it’s more scientific than locking oneself inside and taking cover…I am out there potentially exposing myself and not getting ill…and so are these other people. I could have natural immunity or t cell immunity or the virus simply isn’t all that it’s made out to be. As John Rappaport says, we are stuck on this idea of one virus, one illness, one vaccine. Reality may be different.

    Reply
    1. Yves Smith Post author

      You assumptions are faulty. Open air environments are recognized as presenting vastly lower transmission risk than indoors. That is why NYC allowed outdoor dining, for instance while keeping many other restrictions in place, like keeping salons and gyms closed.

      Basketball gyms also have extremely high ceilings, which would reduce density of any droplets/aerosols, and the rapid pace of the game means you would not be in close proximity to any one person for very long.

      Reply

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