The further to the left or the right you move, the more your lens on life distorts.

Thursday, April 30, 2020

Anti-Herders

Team Apocalypse has established a position on reopening the country that is analogous in many ways to the position taken by anti-vaxxers. Team members are fervent in their belief that the country should not be reopened, and reject any notion that there are epidemiological realities that demand that herd immunity* occur (at least until a vaccine** is developed). They tell us with emotion that all they care about is the health and safety of people, while they allow their irrational fear to put the health and safety of the very same people in jeopardy.

To achieve their goal of keeping the country closed down, they use the strategy that has been applied for decades by the Left. Any person who opposes their anti-reopening view is branded "uncaring about human life" or worse, a person who puts "money ahead of lives" or has "blood on his/her hands." It's an effective attack, but it's total B.S. And when a medical doctor offers a view that differs from the Team's chosen experts (Dr. Anthony Fauci is one of those experts), he or she is branded either: (1) someone who doesn't understand epidemiology, (2) someone who is a "country doctor" and doesn't have the experience to comment, or (3) someone with a dishonest agenda.

Dr. Martin Kulldorff is a Professor at Harvard Medical School, but I'm certain that some members of Team Apocalypse will dishonestly accuse him of faults (1) and (3) noted in the preceding paragraph. Kulldorf writes:
Climate scientists are frustrated by people who do not believe in climate change. In epidemiology, our frustration is with anti-vaxxers. Most anti-vaxxers are highly educated but still argue against vaccination. We now face a similar situation with ‘anti-herders’, [aggressive members of Team Apocalypse] who view herd immunity as a misguided optional strategy rather than a scientifically proven phenomenon that can prevent unnecessary deaths.

Because of its virulence, wide spread and the many asymptomatic cases it causes, Covid-19 cannot be contained in the long run, and so all countries will eventually reach herd immunity. To think otherwise is naive and dangerous. General lockdown strategies can reduce transmission and death counts in the short term. But this strategy cannot be considered successful until lockdowns are removed without the disease resurging.

The choice we face is stark. One option is to maintain a general lockdown for an unknown amount of time until herd immunity is reached through a future vaccine or until there is a safe and effective treatment. This must be weighed against the detrimental effects that lockdowns have on other health outcomes . The second option is to minimise the number of deaths until herd immunity is achieved through natural infection. Most places are neither preparing for the former nor considering the latter.
Kulldorff goes on to recommend what I and many others have suggested for the past month: Institute broad-based and simple basic health measures (e.g., social distancing, handwashing, masks) for all. Isolate seniors, who are most vulnerable statistically, but let the rest of the country go back to work and play. He writes:
While the appropriate magnitude of countermeasures depends on time and place as it is necessary to avoid hospital overload, the measures should still be age-dependent ...

Among anti-herders, it is popular to compare the current number of Covid-19 deaths by country and as a proportion of the population. Such comparisons are misleading, as they ignore the existence of herd immunity. A country much closer to herd immunity will ultimately do better even if their current death count is somewhat higher. The key statistic is instead the number of deaths per infected. Those data are still elusive, but comparisons and strategies should not be based on misleading data just because the relevant data are unavailable.

While it is not perfect, Sweden has come closest to an age-based strategy by keeping elementary schools, stores and restaurants open, while older people are encouraged to stay at home.
Every person who joins the herd is helping those who have yet to contract the virus. And as the herd grows, it becomes a natural 'vaccine' that will be available in a matter of months, not years. It's worth noting that just under half of the younger members of the herd will not even know that they have had the virus; another non-trivial percentage will have minor symptoms akin to the common cold, while still another percentage will have symptoms similar to the common flu. A very small percentage of younger people will get very sick, but that's happening right now under a draconian shutdown that works against herd immunity. Remember, older people with co-morbidities, the most at-risk group, can and should be separated from the mainstream while the COVID-19 threat persists.

Kulldorf skewers Team Apocalypse when he concludes:
The current one-size-fits-all lockdown approach is leading to unnecessary deaths. Protecting older people and other high-risk groups will be logistically and politically more difficult than isolating the young by closing schools and universities. But we must change course if we want to reduce suffering and save lives.
The more I watch and listen to the members of Team Apocalypse, the more I come to understand that reducing suffering and saving lives may be one but certainly not the only goal many of the team members have.

FOOTNOTES:
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* Herd immunity is a well understood and scientifically proven epidemiological event that occurs when a percentage of the population has become infected with a virus, has developed antibodies to combat the virus, and therefore reduces the virus' ability to spread from host to host. In essence, herd immunity 'immunizes' an entire population.
** A prediction: If by some miracle a vaccine is available in, say, September, many on Team Apocalypse will tell us that it hasn't been tested thoroughly enough or vetted widely enough and is therefore unsafe. The goal is to keep the country as closed down as is possible—thereby encouraging fear, anger and economic dislocation—at least until the presidential election in November.