The idea of using herd immunity to address the COVID-19 pandemic comes up again and again. But Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, argued against relying on a herd immunity strategy to protect us from COVID-19 in a recent interview with Good Morning America.
Herd immunity is an important concept in public health that describes a situation in which enough people in a certain community are vaccinated against a particular illness that the illness isn’t able to spread within the community, SELF explained previously. That protects the people who are vaccinated as well as those who aren’t vaccinated from becoming infected. Achieving herd immunity is crucial for protecting against many illnesses because, due to factors like insufficient access, age, underlying conditions, or allergies, there will always be people who can’t receive the vaccine and could be left vulnerable.
When it comes to COVID-19, people erroneously use the concept of herd immunity to argue that allowing the virus to run unchecked through a community would be a “compassionate” approach to controlling the pandemic. This idea is central to the Great Barrington Declaration, which argues for a concept called “focused protection.” This concept includes protecting those most vulnerable to severe COVID-19 outcomes while specifically not requiring lockdowns or stay-at-home orders for the rest of the public. The declaration makes no mention of masks or social distancing.
But many top experts agree that such an approach would be disastrous for many reasons. For one thing, the declaration assumes that people who aren’t at a higher risk for severe COVID-19 complications would get the infection and build up a natural immunity to it. But we don’t know exactly what kind of immunity having COVID-19 actually provides or how long it lasts. A few reported cases of reinfection in the U.S. and abroad suggest that having COVID-19 once is not a guarantee of long-term protection in all cases.
“That declaration has a couple things in it that I think are fooling people,” Dr. Fauci said in the interview. There’s a hidden implication in there that if we simply let people get infected and only worry about protecting the “vulnerable,” that’s still a huge number of people—and there’s no guarantee that we’d actually be able to protect them.
“There’s about 30% of the population that has an underlying conditions that makes them more susceptible to getting the adverse events and outcomes of serious disease with COVID-19,” Dr. Fauci explained. So just “letting things rip” (as Dr. Fauci put it) without enforcing social distancing, stay-at-home orders, or masks is “quite frankly ridiculous,” he said. “There will be so many people in the community that you can’t shelter, that you can’t protect, who are going to get sick and get serious consequences.”
To date, more than 220,000 people in the U.S. have died due to COVID-19, and we’re averaging nearly 60,000 new cases every single day, according to data from the Centers for Disease Control and Prevention (CDC). With a herd immunity approach, there could be a million deaths in the U.S. and 13 million deaths globally according to even the most optimistic estimates, explained Christopher L.J. Murray, M.D., director of the University of Washington’s Institute for Health Metrics and Evaluation (IHME). Of course, death is the most serious potential complication of COVID-19. But those who don’t die from COVID-19 can still have serious health consequences and long-term effects from the virus.
Knowing how easy it is for the virus to spread makes it exceedingly difficult to protect even those who are most vulnerable. For instance, there are now more than 160 cases and several deaths associated with a single Maine wedding that occurred this past August. Those numbers include people who didn’t attend the wedding themselves but who are close contacts and tertiary contacts of wedding guests. In one case, a wedding guest infected their parent who then had contact with another one of their children who happened to work at a rehabilitation facility. That person then infected other employees and residents at the facility. One way or another, the virus often finds its way back to those who are most at risk—especially when people don’t take the precautions we know can make a difference, such as avoiding crowds and wearing masks.
“This idea that we have the power to protect the vulnerable is total nonsense because history has shown that’s not the case,” Dr. Fauci continued. “If you talk to anybody who has any experience in epidemiology and infectious diseases, they will tell you that’s risky, and you’ll wind up with many more infections of vulnerable people, which will lead to hospitalizations and death.”
To achieve real herd immunity, we need a vaccine. Until that happens (and honestly, likely even after), we need to embrace public health tools like masks, social distancing, ventilation, and handwashing. Sometimes that might include temporary stay-at-home orders as well. But to completely ignore all of our public health strategies under the delusion that we can protect the people who are most vulnerable to COVID-19 would cause far more harm than good. “We have to look that square in the eye and say it’s nonsense,” Dr. Fauci said.
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