May 2, 2020
The Long Haul
Day 44
Herd immunity is a dangerous, deadly, irresponsible concept. If it becomes public policy a million Americans, most of them old, poor and disenfranchised, will die needlessly.
Politicians who embrace the concept should be removed from office. Businesses that embrace the concept should be boycotted. Protesters who ignore the facts in favor of their narrow self interest should be publicly shamed.
Seniors need to step up. They have enormous political and economic clout. It is time to stand tall and be heard. Call your congressman or woman, the governor and state reps. Tell them herd immunity is not a solution and a non-stop trip to defeat at the polls in November.
Herd immunity is an epidemiological concept. It describes the point at which people are immune and an infectious disease has nowhere to go so it dies out. There are only two sure-fire paths to immunity: be infected and survive or be vaccinated.
There is no vaccine for Covid-19. So the only way to achieve herd immunity is for a sufficient number of us to get sick and survive. Unfortunately many, perhaps, millions will die if this is our policy.
The numbers explain why this is so scary. Herd immunity for Covid-19 is thought to be between 60 and 70 percent. The death rate across all ages and demographics is between one half and one percent. There are about 328 million Americans so at a 60 percent infection rate and a half percent death rate about one million people will die. If you use the higher estimate more than two million Americans will have to die before herd immunity is achieved.
But Covid-19 is not an equal opportunity infection. It seeks out the elderly, the sick, the poor, the homeless and minorities disproportionally.
The CDC in March reported that 80 percent of all Covid-19 deaths had been among people 65 and older. Most agree Covid-19 infection rates and death data worldwide is sketchy. No-one however refutes the notion that seniors are the most vulnerable and most likely to die from the virus.
Covid-19 likes clusters. Social distancing and stay-at-home orders have worked, they slowed community spread through the general population. But the crafty disease thrived in places where people were forced to live and work together, in clusters. Nursing homes and assisted living facilities, meat packing plants, prisons and public housing became the first Covid-19 killing fields.
Covid-19 is not just an urban killer. New York and New Jersey were simply the first, easy pickings for the coronavirus. There are clusters in rural America also. For example the Navajo in New Mexico, Arizona and southern Utah are a big target. Some see Navajo Nation as the next epicenter of the disease.
The pursuit of herd immunity would be devastating for the Navajo.
There have been 2,141 cases and 36 deaths reported among the Navajo as this is written. The largest hospital serving Navajo nation is in Gallup, New Mexico. It had just six ICU beds when the virus hit. The staff there rallied early and are fighting back.
An old friend is a long-time family doc in Gallup. She described the beginning of the outbreak:
“The combination of a big detox/homeless shelter for alcoholics in Gallup and the living situation of many Navajo was like a pile of kindling. The virus was the match that lit the fire. Navajo’s who do not live in government housing typically live in little clusters of isolated houses with no running water and lots of people to a house.”
She added: “The virus got into the homeless shelter, 170 people were exposed and now more than half of those that can be located are positive. The rest have probably gone back to the reservation where the disease is spreading. Four hotels have been rented to house the homeless and others who can not safely isolate in their own homes.”
The Netherlands briefly flirted with a national policy that embraced herd immunity. In mid March Prime Minister Mark Rutte said the virus would be allowed to roam the population in a controlled manner until herd immunity was achieved. He backed away from the concept but the policy has its champions in the land of canals and tulips.
Alex Friedrich, a virologist based in the Northern Netherlands, Put it this way: “Herd immunity can never be a public health strategy. It can never be controlled and it means people will die and if you are not careful a lot of people will die.”
Some supporters argue that herd immunity should be pursued only after a vaccine is developed. But Friedrich believes treatment will emerge first and at least for a while be much safer and more accessible.
He said: “...you need to produce it (vaccine) for billions of people on the planet which takes time and then you have to administer it.“
There are risks, he added. “If you are giving vaccine to healthy people all over the world you need to be very, very sure that it is safe.”
Other supporters argue that vulnerable populations must simply be quarantined until herd immunity is reached. This is folly. If you isolate a significant part of the population herd immunity can never be achieved. The numbers do not work.
We all need to be exceedingly careful when we emerge from ourhomes but no-one can stay locked down forever.
The Covid-19 debate is being poorly framed at the moment. We are being asked to choose between out health and the economy. For many the debate is intensely personal as it is a choice between life and death.
More of the same is the only acceptable public policy. Test, test, test, trace and isolate until there is a treatment and a cure. This will take patience and public and private investment, lots of it.
The health of all Americans needs to drive public policy. Nothing less is acceptable.
Be safe!
The Long Haul
Day 44
Herd immunity is a dangerous, deadly, irresponsible concept. If it becomes public policy a million Americans, most of them old, poor and disenfranchised, will die needlessly.
Politicians who embrace the concept should be removed from office. Businesses that embrace the concept should be boycotted. Protesters who ignore the facts in favor of their narrow self interest should be publicly shamed.
Seniors need to step up. They have enormous political and economic clout. It is time to stand tall and be heard. Call your congressman or woman, the governor and state reps. Tell them herd immunity is not a solution and a non-stop trip to defeat at the polls in November.
Herd immunity is an epidemiological concept. It describes the point at which people are immune and an infectious disease has nowhere to go so it dies out. There are only two sure-fire paths to immunity: be infected and survive or be vaccinated.
There is no vaccine for Covid-19. So the only way to achieve herd immunity is for a sufficient number of us to get sick and survive. Unfortunately many, perhaps, millions will die if this is our policy.
The numbers explain why this is so scary. Herd immunity for Covid-19 is thought to be between 60 and 70 percent. The death rate across all ages and demographics is between one half and one percent. There are about 328 million Americans so at a 60 percent infection rate and a half percent death rate about one million people will die. If you use the higher estimate more than two million Americans will have to die before herd immunity is achieved.
But Covid-19 is not an equal opportunity infection. It seeks out the elderly, the sick, the poor, the homeless and minorities disproportionally.
The CDC in March reported that 80 percent of all Covid-19 deaths had been among people 65 and older. Most agree Covid-19 infection rates and death data worldwide is sketchy. No-one however refutes the notion that seniors are the most vulnerable and most likely to die from the virus.
Covid-19 likes clusters. Social distancing and stay-at-home orders have worked, they slowed community spread through the general population. But the crafty disease thrived in places where people were forced to live and work together, in clusters. Nursing homes and assisted living facilities, meat packing plants, prisons and public housing became the first Covid-19 killing fields.
Covid-19 is not just an urban killer. New York and New Jersey were simply the first, easy pickings for the coronavirus. There are clusters in rural America also. For example the Navajo in New Mexico, Arizona and southern Utah are a big target. Some see Navajo Nation as the next epicenter of the disease.
The pursuit of herd immunity would be devastating for the Navajo.
There have been 2,141 cases and 36 deaths reported among the Navajo as this is written. The largest hospital serving Navajo nation is in Gallup, New Mexico. It had just six ICU beds when the virus hit. The staff there rallied early and are fighting back.
An old friend is a long-time family doc in Gallup. She described the beginning of the outbreak:
“The combination of a big detox/homeless shelter for alcoholics in Gallup and the living situation of many Navajo was like a pile of kindling. The virus was the match that lit the fire. Navajo’s who do not live in government housing typically live in little clusters of isolated houses with no running water and lots of people to a house.”
She added: “The virus got into the homeless shelter, 170 people were exposed and now more than half of those that can be located are positive. The rest have probably gone back to the reservation where the disease is spreading. Four hotels have been rented to house the homeless and others who can not safely isolate in their own homes.”
The Netherlands briefly flirted with a national policy that embraced herd immunity. In mid March Prime Minister Mark Rutte said the virus would be allowed to roam the population in a controlled manner until herd immunity was achieved. He backed away from the concept but the policy has its champions in the land of canals and tulips.
Alex Friedrich, a virologist based in the Northern Netherlands, Put it this way: “Herd immunity can never be a public health strategy. It can never be controlled and it means people will die and if you are not careful a lot of people will die.”
Some supporters argue that herd immunity should be pursued only after a vaccine is developed. But Friedrich believes treatment will emerge first and at least for a while be much safer and more accessible.
He said: “...you need to produce it (vaccine) for billions of people on the planet which takes time and then you have to administer it.“
There are risks, he added. “If you are giving vaccine to healthy people all over the world you need to be very, very sure that it is safe.”
Other supporters argue that vulnerable populations must simply be quarantined until herd immunity is reached. This is folly. If you isolate a significant part of the population herd immunity can never be achieved. The numbers do not work.
We all need to be exceedingly careful when we emerge from ourhomes but no-one can stay locked down forever.
The Covid-19 debate is being poorly framed at the moment. We are being asked to choose between out health and the economy. For many the debate is intensely personal as it is a choice between life and death.
More of the same is the only acceptable public policy. Test, test, test, trace and isolate until there is a treatment and a cure. This will take patience and public and private investment, lots of it.
The health of all Americans needs to drive public policy. Nothing less is acceptable.
Be safe!
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