Science! (Herd Immunity)
the impediment to a goal of "herd immunity" would be the fact that the vast majority of people are not going to want to "volunteer" to become infected. We currently don't have a good grasp of how many people who survive COVID-19 will be permanently and seriously affected. Who are the people who are going to risk permanent heart, lung or brain damage in the service of herd immunity?
So what we'd likely have if the states allowed people to do as they please and let the infection rate increase, is "freedom" for the 1/3 or so of the population who would engage in risky behavior, and worse isolation and more danger for the 2/3 who want to try and protect themselves from the virus. We'd have soaring infection rates among the people who want to gather in churches, bars, restaurants and movie theaters without distancing and masks, and the rest of us would be trapped in our homes, leaving only for groceries while we try to keep from getting sick.
Is there new data demonstrating the longevity of immunity in people whove survived COVID-19? My understanding is that we don't know how long a recovered patient will have any kind of immunity.
max_weisenfeld said:
We don't have herd immunity to polio, we have a vaccine.
We don't have herd immunity to smallpox, we have a vaccine.
Isn't herd immunity defined as having a certain percentage of the population immune to a disease - regardless of how it was achieved?
i.e. the goal of vaccinations is to achieve herd immunity, isn't it?
(these are rhetorical questions. the answer to both is yes.)
Perhaps this is in the video I haven't watched, rather then the statement I did read, but, if we're being scientific about it, some questions I'd expect answers to:
- what percentage of the population do they believe needs to be immune to covid before we can reach effective herd immunity, and what data is this based on?
- what percentage of people do they believe have been infected to date, and over what geograhic area (eg are they looking at this by country, by zip code, by some other geographic grouping?)
- what do they believe the long term effects of contracting covid are, how frequently do they think these manifest, and can they give an estimate for how many people they believe will end up with severe long term effects if we pursue a "herd immunity" strategy?
- The current death rates are far lower than they were in the spring. Most reporting I've read attributes this to advances in understanding how to care for covid patients -- do they agree? If they do, this puts a great deal of focus on our health care systems. How many people do they believe will need this kind of intensive medical care under their proposed strategy, how much do they estimate that will cost, and how does that compare to having everyone wear masks, social distance, and so reduce the number of people needing hospitalization?
- How long do they believe immunity lasts post covid (to Mr. Incredible's question), and what is their basis for this belief?
Just some immediate questions that come to mind....
drummerboy said:
max_weisenfeld said:
We don't have herd immunity to polio, we have a vaccine.
We don't have herd immunity to smallpox, we have a vaccine.
Isn't herd immunity defined as having a certain percentage of the population immune to a disease - regardless of how it was achieved?
i.e. the goal of vaccinations is to achieve herd immunity, isn't it?
(these are rhetorical questions. the answer to both is yes.)
But that is not what they are proposing, is it?
max_weisenfeld said:
drummerboy said:
max_weisenfeld said:
We don't have herd immunity to polio, we have a vaccine.
We don't have herd immunity to smallpox, we have a vaccine.
Isn't herd immunity defined as having a certain percentage of the population immune to a disease - regardless of how it was achieved?
i.e. the goal of vaccinations is to achieve herd immunity, isn't it?
(these are rhetorical questions. the answer to both is yes.)
But that is not what they are proposing, is it?
No it's not - but herd immunity is not the the real issue - it's the process that we use to get there that's the issue.
drummerboy said:
No it's not - but herd immunity is not the the real issue - it's the process that we use to get there that's the issue.
The proposal is more like "thinning the herd" than merely herd immunity.
Yeah, well "natural herd immunity", if you can call it that, necessarily involves human sacrifice.
I found this to be more respectful than the words I would have used here. One could even argue that we don't even have herd immunity to influenza. How many people become ill because of the flu and wind up with lasting debilitation or dying of a complication? Tens of thousands a year die in spite of regular flu shots. Yeah, herd immunity.
max_weisenfeld said:
We don't have herd immunity to polio, we have a vaccine.
We don't have herd immunity to smallpox, we have a vaccine.
Herd immunity to a deadly disease is not a goal, it's a capitulation. The failure of the US government to adequately manage the pandemic has caused a great deal of unnecessary economic fallout, but the answer is not to just throw up our hands and surrender. I am disappointed that so many intelligent people, such as the speakers in this video, cannot get their politics and fear out of the way and try to focus on helping others.
ETA The part of the economics they are wrong on specifically is the cost of healthcare for the overwhelming numbers of people who are going to get infected in order to develop what they dubiously call herd immunity.
I haven't even begun on the ethics of their proposal
I don't understand this negative attitude towards herd immunity. That's the goal of every vaccination effort.
People are confusing the process to get there with the end goal.
drummerboy said:
I don't understand this negative attitude towards herd immunity. That's the goal of every vaccination effort.
People are confusing the process to get there with the end goal.
no one is confused. We're just not writing out the whole phrase of "herd immunity without a vaccine" or "herd immunity by contracting the virus." We know the difference.
I have a negative reaction to people who think achieving it doesn't take actions they deride as "heroic" like people doing all the isolation and protective techniques. Blithely suggesting that only a small percentage of people would actually die, etc. The economy needs to recover. We need to get back to normal life....
I don't understand this negative attitude towards herd immunity. That's the goal of every vaccination effort.
Like everyone else on this thread, I'm far from having any expertise here, just a lay person living though a historic pandemic with a strong vested interest in trying to get better informed. Based on articles like this one in (The Atlantic, July), I think herd immunity is a bit more complicated. For a vaccine, where everyone is getting exposed to the same immune-triggering agents, herd immunity is static and something that can be calculated. It's the measure of what percentage of a population needs to be vaccinated to stop outbreaks.
In a situation where a virus is spreading uncontrolled through a population, herd immunity is dynamic and highly variable. It can be higher in some populations and lower in others, and very difficult to predict. Predictions on what percentage of the population need to be immune to stop this outbreak vary wildly, from as low as 20% to 70% or more. And we don't know how long immunity lasts, or what kinds of long term effects there are from being infected. Further, few places are even at the 20% infected rate -- getting there means accepting a staggering number of preventable deaths.
But the discussion of herd immunity is a bit misleading, because the goal is to stop the spread, not go get to a certain percentage of immune people. With a vaccine, the strategy is herd immunity. Without a vaccine, where the threshold for effective immunity is variable and unpredictable, the strategy is to change behavior so that the virus can't spread quickly enough to be an outbreak (eg R0 below 1). That doesn't have to mean the kind of drastic lock-downs we had in the spring, provided we can actually know where the virus is spreading. If the incidence of infection is low enough, I'd guess you probably wouldn't even need social distancing and masks -- but the second we detected a cluster those would have to come back.
We are still in a state where the infection rates are high, and so masks and social distancing are very important. We are also still pretty far from having enough testing going on that we can even tell what the true incidence of infection is. Maybe a safe and effective vaccine is really close, but maybe it's not. Rather than wait for that, we really need to dramatically up our testing capacity and strategy and consistently adopt behavior that slows the spread, so we can get to a place where the majority of people can resume normal life the majority of the time.
bikefixed said:
I found this to be more respectful than the words I would have used here. One could even argue that we don't even have herd immunity to influenza. How many people become ill because of the flu and wind up with lasting debilitation or dying of a complication? Tens of thousands a year die in spite of regular flu shots. Yeah, herd immunity.
max_weisenfeld said:
We don't have herd immunity to polio, we have a vaccine.
We don't have herd immunity to smallpox, we have a vaccine.
Herd immunity to a deadly disease is not a goal, it's a capitulation. The failure of the US government to adequately manage the pandemic has caused a great deal of unnecessary economic fallout, but the answer is not to just throw up our hands and surrender. I am disappointed that so many intelligent people, such as the speakers in this video, cannot get their politics and fear out of the way and try to focus on helping others.
ETA The part of the economics they are wrong on specifically is the cost of healthcare for the overwhelming numbers of people who are going to get infected in order to develop what they dubiously call herd immunity.
I haven't even begun on the ethics of their proposal
There's a lot of diseases we keep from becoming outbreaks despite not having herd immunity. In the US, for instance, we avoid malaria outbreaks through mosquito control, not through having a population immune to malaria. We avoid cholera outbreaks through proper water and sanitation systems. We aggressively respond to salmonella outbreaks to keep those from becoming large. The goal is preventing spread, with population immunity only one possible technique.
So, I’m sure you’ve all read that the famous Declaration has been signed by some fake ‘scientists’: https://www.theguardian.com/world/2020/oct/09/herd-immunity-letter-signed-fake-experts-dr-johnny-bananas-covid
It would be mildly amusing if it weren’t so serious. (I really don’t think much of this inserting fake names as a Uni prank, I don’t think others are very amused either)
It’s one thing to talk ‘herd immunity’ & ‘isolation’ about in the almost-abstract when you’re relatively healthy even if vulnerable. My BIL is recovering from cardiac surgery and my sister fell and cracked some ribs. They’ve been in their household bubble for months and won’t break it now apart from essential tasks, but my sister mentioned yesterday that she noticed her confidence and reflexes are affected. And now I’ve had my surgery I’m immune-compromised and unable to do housework etc for weeks, but my co-resident has his head in the clouds most of the time, and forgets the most basic cleaning & sanitising tasks let alone timely laundry, catering, bedmaking etc. We’ll be running back in hospital for other conditions while COVID is still simmering in the background around us - or are we meant to sacrifice ourselves for the Budget and Greater Good, as per ‘Yes, Minister’??
(ETA: we support safely staged resumptions of business, wider events and people movements. It seems like every time things ‘go back back to normal’ somewhere, there’s an outbreak and tightening of rules. We handle clean water resources, town gas leaks, mass food poisoning and extreme weather events better)
apparently these Barrington guys have been let into the White House
(If that was mentioned earlier, sorry)
https://www.buzzfeednews.com/article/stephaniemlee/herd-immunity-bhattacharya-atlas-barrington
terp,
I know we have different standards regarding Trump, but the mere fact that they are advising him should be more than enough to tell you their ideas are terrible.
It's just a good rule of thumb that has served well these past 4 years.
As PVW said, the idea is to stop the spread, and the BIG difference between herd immunity through vaccine and herd immunity through infection, is that the latter gives you people who are also infectious - thus continuing the spread - but the former does not. When we get flu jabs, we don’t have to hide in a room for 10 days to stop everyone else from catching it from us. We can walk out of the pharmacy or doctors office and carry on with our lives. We don’t suffer the disease itself, and we don’t spread it.
ridski said:
As PVW said, the idea is to stop the spread, and the BIG difference between herd immunity through vaccine and herd immunity through infection, is that the latter gives you people who are also infectious - thus continuing the spread - but the former does not. When we get flu jabs, we don’t have to hide in a room for 10 days to stop everyone else from catching it from us. We can walk out of the pharmacy or doctors office and carry on with our lives. We don’t suffer the disease itself, and we don’t spread it.
Much more succinct.
ridski said:
As PVW said, the idea is to stop the spread, and the BIG difference between herd immunity through vaccine and herd immunity through infection, is that the latter gives you people who are also infectious - thus continuing the spread - but the former does not. When we get flu jabs, we don’t have to hide in a room for 10 days to stop everyone else from catching it from us. We can walk out of the pharmacy or doctors office and carry on with our lives. We don’t suffer the disease itself, and we don’t spread it.
but "continuing the spread" is the whole point of the Barrington plan. It's not a problem, but a central feature.
They are part of the Republican plan to infect as many people as possible. They’re going on statistics, which shows African Americans and Latinos are more likely to die from Covid. They behave like mad men, but they know what they’re doing. They don’t really care if the disease wipes out the majority of the people they dislike.
drummerboy said:
but "continuing the spread" is the whole point of the Barrington plan. It's not a problem, but a central feature.
What it boils down to is that there’s more money to be made in treating infected people than in vaccinating them.
The ETA: Sure this is foil hat stuff, but it’s not like Trump hasn’t been golfing with the CEO of Regeneron or anything.
Instead of being called "Science!", this thread would more properly be called "Same Old 'Libertarian' Solution, Now With 'Scientific' Words".
drummerboy said:
apparently these Barrington guys have been let into the White House
(If that was mentioned earlier, sorry)
https://www.buzzfeednews.com/article/stephaniemlee/herd-immunity-bhattacharya-atlas-barrington
Makes sense. They've merely gussied up the "herd immunity" mindset that the White House has pushed before.
That BuzzFeed article is another good one. Some details from it to back up what others have been saying here:
The letter calls for nursing homes to have frequent testing and staffers with “acquired immunity,” and for retirees living at home to have supplies delivered. But it is light on specifics, saying that “a comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.”
This language doesn’t come anywhere near acknowledging how challenging it would be to implement such a plan, outside experts say.
Isolating people who have preexisting conditions that make them especially susceptible to the virus would mean isolating nearly half the adult population. Isolating older Americans, who have the relatively highest risk of death, would mean isolating an overlapping group of tens of millions. Only about 13% of Americans over the age of 64 were in a nursing home or other senior living setting in 2015, meaning the vast majority are embedded in communities. About 64 million Americans lived in multigenerational households as of 2016.
What the Great Barrington Declaration also does not acknowledge is that young, healthy adults who get infected can spread the virus to middle-aged and older Americans, which appears to have happened this summer. Young people themselves may die of COVID-19 at much lower rates than older people, but a not insignificant portion get sick enough to become hospitalized, straining the healthcare system that much more. And “long-haulers,” many of them young and formerly healthy, can for months experience debilitating effects that are not yet understood.
“They’re not going to be able to age-target,” Gonsalves said. “They’re not going to be able to protect these hundreds of millions of vulnerable people.”
PVW said:
There's a lot of diseases we keep from becoming outbreaks despite not having herd immunity. In the US, for instance, we avoid malaria outbreaks through mosquito control, not through having a population immune to malaria. We avoid cholera outbreaks through proper water and sanitation systems. We aggressively respond to salmonella outbreaks to keep those from becoming large. The goal is preventing spread, with population immunity only one possible technique.
The infectious diseases you mention here have all been made easier to control once we learned how to intervene in the mode of transmission.
Kill mosquitos and other animals that are vectors for stuff. Rats and mice, etc.
Cleaning up sources that are feasible to clean, like water supplies. Legionella is another one. Cruise ships and their virus problems. Washing foods, sanitary practices in kitchens, etc.
But these illnesses that aren't yet nailed down are tougher to limit except by isolation and protective measures until we find a straightforward approach that doesn't paralyze society. Vaccines are the key sometimes, but things like influenza still manage to do their damage year after year. Too bad we haven't found an effective HIV vaccine yet.
Washing our hands has been a part of our world for thousands of years but how the hell do we prevent the spread of this virus with something easier than masks and isolation? Even those are things that the privileged have easier access to. Air purifiers - expensive but they can help in many cases if you can afford them. Problems like this are just dandy fodder for a bitterly divided country like ours.
All this almost makes one wonder how, when MOL has its own Science & Technology section, this discussion ended up in Soapbox.
DaveSchmidt said:
All this almost makes one wonder how, when MOL has its own Science & Technology section, this discussion ended up in Soapbox.
You're assuming that it was actually intended to be about SCIENCE!
jamie said:
National mask mandate would be a start! Can anyone point to a scientific study that says this wouldn't make a difference?
Completely agree, but, honest question, does the President have the authority to issue a national mask mandate?
I am not sure if this falls under some reserved power to the states and governors.
Seems like the governors are particularly empowered in this regard, but not sure if that is only because a Trump has abdicated responsibility.
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The declaration states: "Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed."
However, their plan to push people toward 'herd immunity' without a vaccine will also result in the underprivileged disproportionately harmed:
The privileged will be able to hide from the virus longest, or receive better treatment if they become ill. The overflowing hospitals will have the 'underprivileged' (along with the medium-privileged) dying in the hallways again.