
Delaying Herd Immunity Is Costing Lives - walterbell
https://www.aier.org/article/delaying-herd-immunity-is-costing-lives/
======
Rebelgecko
>Nursing homes should be isolated together with some of the staff until other
staff who have acquired immunity can take over

Just this one sentence has a lot to unpack. How do we know that a staff member
immune to COVID? My understanding is that an antibody test is correlated but
not necessarily indicative of immunity. What does this mean for staff members
that aren't immune? Will they be furloughed indefinitely or fired? Should
there be financial incentives to deliberately infect yourself?

~~~
seppin
Also there's substantial proof COVID19 antibodies don't last forever, in some
cases only a few months.

This article is riddled with questions.

~~~
timr
No. All recent data points to long-lasting immunity. A normal, gradual decline
in antibody response is coupled with longer-lasting B- and T-cell response.

[https://threadreaderapp.com/thread/1285618977654407169.html](https://threadreaderapp.com/thread/1285618977654407169.html)

[https://www.medrxiv.org/content/10.1101/2020.07.14.20151126v...](https://www.medrxiv.org/content/10.1101/2020.07.14.20151126v1)

~~~
seppin
How does that explain repeat illness (not via testing but someone that is in
hospital once month and back the next?)

~~~
timr
To date, there has been one documented case of re-infection. From everything
we know, this very rare.

There are many reasons a person with a severe illness might have to return to
a hospital (e.g. lung damage from ventilators), but this has no relationship
to repeated infection from the same virus.

~~~
seppin
Multiple (confirmed) cases, meaning there are many more that are missed.
[https://www.statnews.com/2020/08/28/covid-19-reinfection-
imp...](https://www.statnews.com/2020/08/28/covid-19-reinfection-
implications/)

------
legerdemain
This is the same load of horsefeathers that is on display in every popular
narrative arguing for herd immunity.

The author writes: "We need to shield older people and other high-risk groups
until they are protected by herd immunity." I've read this sentence almost
verbatim literally dozens of times over the last few months. Those who promote
this meme either offer no explanation for how this can be done, or offer a
hand-wavy and anemic explanation of what is really a titanic effort on an
untried scale. The oldest members of our society either live with their
families or are attended by medical caretakers, who are an obvious source of
infection. We can't put our elderly into Bubble Boy-style hospital wards or
ship them to Old People Island. If we all go back to work and school, we can't
help dramatically increasing the risk to the elderly from increased social
mingling and network effects.

The author offers the wan suggestion that the institutionalized elderly could
be attended by a rotating cast of medical staff who are somehow certifiably
safe. "Immunity passports" have been a conservative meme since the start of
the epidemic, when we had zero evidential foundation for such a belief. The
body of evidence for COVID immunity remains mixed. Six months in, we are
starting to see cases of apparently incontrovertible reinfection. The question
whether one can be immune and yet still infectious remains open. The
enthusiasm for the "immunity passport" meme among a segment of commentators
really feels like a spectator's desire to see some dog-eat-dog competition in
the labor force.

But all this, of course, is predicated on a third meme, which is that the
effects of COVID are possible death for the very old and "water off a duck's
back" for everyone else. No. A number of college athletes are currently
grounded with pericarditis, a risky diagnosis with an indefinite time course.
Unlike our Swiss cheese understanding of practical COVID immunity, our picture
of COVID complications is becoming clearer, and it includes common incidence
of dangerous internal inflammation, reduced lung function, and chronic
fatigue. If we're concerned about the drag on our economy, let's consider what
kind of drag a chronically ill labor force will generate. This is the scenario
in third-world countries, where infectious diseases like malaria and AIDS eat
into labor productivity and sap the average life expectancy.

In other words, this is a dangerous complex of memes that show up in tandem
and aren't particularly affected by gathering evidence. It is externally
motivated and could very well endanger each of us individually.

~~~
lbeltrame
Regarding the so called long term effects: is there any research that tells us
_how prevalent_ they are?

A lot of people mention cases like these, I'd like to see some figures, also
taking into account that pulmonary problems and fatigue, for one, are common
to other diseases (even treatable ones).

To be clear: I have no interest in downplaying severe effects of this
infection. But I want to look at the whole picture.

~~~
legerdemain
Here's a two-month-old summary of a few studies from JAMA Cardiology.[1] The
most-quoted result is the Puntmann, et al., which has been amended after
scrutiny, but showed pretty much the same pattern of results. Googling "COVID"
\+ "cardiomyopathy" offers some more leads. For example, [2].

[1]
[https://jamanetwork.com/journals/jamacardiology/fullarticle/...](https://jamanetwork.com/journals/jamacardiology/fullarticle/2768915)

[2]
[https://www.medpagetoday.com/infectiousdisease/covid19/88060](https://www.medpagetoday.com/infectiousdisease/covid19/88060)

~~~
lbeltrame
Thanks.

Note that the JAMA editorial acknowledges the need for further studies,
because the numbers are very small (compared to the known number of patients):

> We wish not to generate additional anxiety but rather to incite other
> investigators to carefully examine existing and prospectively collect new
> data in other populations to confirm or refute these findings.

Which is AFAICS the crux of the matter. No one knows how widespread these
problems are.

~~~
legerdemain
Not to diminish the need for further research, but [1]. I encourage you to
consider the growing number of cases of cardiomyopathy in college athletes,
who are presumably in the invincible 18-21 age range and also not particularly
numerous as a population.

[1]
[https://en.m.wikipedia.org/wiki/Further_research_is_needed](https://en.m.wikipedia.org/wiki/Further_research_is_needed)

------
WildParser
The author missed that the whole narrative around herd immunity is based on
very very weak papers. The growth dynamics of COVID-19 is following very
precise mathematics. Like any seasonal virus it starts strong - and trickles
down slowly.

Not doing containment while it is growing will make the situation a lot worse.

Spreading the virus deliberately to get some immunity will make the situation
worse.

Using non-functional lockdowns that only slow down the descend and spread the
virus more evenly also make things worse.

------
lkrubner
In the USA, it is estimated that herd immunity would lead to 2.1 million
deaths:

330,000,000 ÷ 100 x 65 = 214,500,000 ÷ 100 = 2,145,000

That's 330 million people, 65% exposed, and 1% death rate.

Keep in mind that 9% of people have suffered a crippling illness that lasts
several months. That's 19,305,000 people with a crippling multi-month illness.

Aiming for herd immunity is pure madness.

~~~
arcticbull
A few key things you're leaving out.

1\. The mortality rate for children is lower than even the flu, and this is
likely to do with age-related ACE2 expression. This is fact, and hopefully it
leads to something that can help us lower the mortality rate in older folks,
too. [1] They can of course spread it to older folks, though.

2\. Mortality rate among the young is in line with the flu.

3\. Mortality rate in older folks is terrible, and needs to be managed, but it
can be managed. Those folks, and those with immune issues can and must be
protected at all costs.

These three things together mean the death rate of such a strategy is nowhere
near 1%.

> 330,000,000 ÷ 100 x 65 = 214,500,000

Serology studies pin the number closer to 0.6%, but of course that doesn't
make the decision any less difficult -- although that is heavily, heavily age
dependent.

What you're neglecting otherwise is the thrust of the article: lockdowns are
temporary and the disease won't be stopped by lockdowns. Even under the most
optimistic projection for vaccination, we may be hurtling towards the 65%
number in the US one way or the other.

This article basically documents Sweden's approach. There hasn't been a COVID
death in Sweden since August 24th, and at the moment, they continue to see
~150 new cases per day.

[1]
[https://www.uth.edu/news/story.htm?id=b40ccaec-50c5-465c-b2d...](https://www.uth.edu/news/story.htm?id=b40ccaec-50c5-465c-b2d5-a911c0344614)

~~~
kjs3
_Mortality rate in older folks is terrible, and needs to be managed, but it
can be managed._

Yeah...I keep seeing this handwave from the "I should be able to do whatever I
want" crowd. How exactly can it be managed? Basically it's "if you have any
possible risk factor, you should lock yourself away so me and my friends
aren't inconvenienced by your existence". Ignoring the fact (and the
associated abdication of responsibility) that there's no established risk
assessment beyond "if you're an oldster, stay home", and it's not clear why
the many otherwise low risk are getting sick and dying. They are apparently
the cost of partying on weekends.

~~~
arcticbull
As opposed to 100% of people locking themselves away? The reality is people
won’t do what you’re asking. The evidence is in the infection curve. We have
to manage the society/neighbors we have not the people we wish we had.
Further, a few months later everyone can come out and play.

~~~
lbeltrame
> a few months later everyone can come out and play.

I'm not so sure. Governments can't admit that fighting such a contagious virus
with non-pharmaceutical interventions is extremely difficult on the long run.
You're just buying time for a cure (not necessarily a vaccine: drugs work,
too).

~~~
AstralStorm
In case of this virus, probably not a vaccine. Or not alone. And any vaccine
would need some period of widespread testing, comparable to how long it took
to devise flu vaccines.

This one can jump species, reinfection cases have been described already, and
coronaviruses in general are known to cause seasonal infections.

~~~
arcticbull
There have not been any re-infections. Any people who tested positive a second
time saw either false positives or residual viral fragments.

