Health experts dispute ‘natural infection’ theory

They say it doesn’t make sense, risks too many lives

There has been no more controversial COVID-19 pandemic theory than herd immunity through “natural infection,” the idea that lifting all coronavirus restrictions and letting the virus run through the lower-risk under-60 population is the best way for people to become immune.

Gov. Ron DeSantis hasn’t openly espoused it, but almost all of his actions over the past year, including pushing for Florida to be “open” and dismissing local mask mandates, could be considered in alignment with the theory. On March 18, DeSantis held his second roundtable with some of its biggest proponents and touted their comments as proof he had deftly handled the pandemic.

Yet, health experts in Florida have pushed back against the ideas proposed by DeSantis’ panelists, including their hostility to masks, social distancing, and most anti-COVID measures. And they warned that Floridians — and hordes of spring break visitors — are letting up on those practices as vaccines become more available.

“The virus is very good at finding vulnerable populations,” said Jason Salemi, a researcher at the University of South Florida who

created his own COVID19 dashboard. “This virus is going to do whatever we allow it to do.”

‘That plan does not make sense’

During DeSantis’ event, panelist Scott Atlas said, “I don’t know why this idea that herd immunity, which is a biological phenomenon, from enough people that get infected and/or have vaccination protection has become controversial.”

Atlas, a former President Trump advisor and senior fellow at the Hoover Institution of Stanford University, was condemned by the Stanford Faculty Senate last year for “promot[ing] a view of COVID-19 that contradicts medical science.”

The other three DeSantis panelists, Sunetra Gupta, an epidemiologist at Oxford University; Jay Bhattacharya, professor of medicine at Stanford University; and Martin Kulldorff, a professor of medicine at Harvard Medical School, were the authors of the Great Barrington Declaration, which openly called for herd immunity through natural infection.

“The most compassionate approach … is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk,” they wrote in October.

The declaration was blasted by the scientific community. In an open letter to the medical journal The Lancet signed by more than 80 researchers, Deepti Gurdasani of Queen Mary University of London called the theory “a dangerous fallacy unsupported by scientific evidence . ... It is not feasible to restrict uncontrolled outbreaks to particular sections of society.”

But the theory found a willing audience in DeSantis.

There was “much more evidence that natural infection provides immunity than ... from vaccines,” Kulldorff told the governor on March 18.

Gupta told DeSantis she “would recommend to most non-immune persons they shouldn’t wear masks or engage in social distancing.”

A spokesperson for DeSantis did not respond to a request for comment on whether the governor agrees fully with the panelists.

Sarah St. Louis, president of the Central Florida Medical Society, a professional organization for African American doctors, responded that “as a physician and healthcare professional, and also as a scientist, the majority of us would think that that plan does not make sense.”

Pushing for natural immunity “puts a lot of people’s lives at risk,” St. Louis said. “Opening up the community completely and having absolutely no rules or restrictions, for the simple gratification of a group of people that don’t feel that the virus will affect them, is really putting selfishness before human basic rights and health care.”

Melissa Levine, director of the Center for Leadership in Public Health Practice at the University of South Florida and a former Virginia state health commissioner, agreed.

“Herd immunity from natural means is very risky,” Levine said. “Because if you take a large population of younger people in that group, there are going to be people at higher risk for serious disease, and potentially even death. Not as great as older folks, but they’re still at risk, and we can’t predict who those people necessarily will be.”

While the mortality rate is highest for those ages 65 and above, more than 13,000 people 45 and younger have died of COVID in the U.S., according to the Centers for Disease Control and Prevention. And the mortality rate increases for younger people who are Black or Hispanic.

“Every population is important,” St. Louis said. “It’s not that we are focusing on one group over another, we’re trying to protect all groups.”

An ‘experiment’

Atlas also praised Florida as an “experiment, because of Gov. DeSantis here,” in comparing it an “open state” versus other states with continued lockdowns, mask mandates and other COVID restrictions.

“When you look at things like excess mortality rate, which is the number of deaths over what you would have expected that year … it turns out Florida beat 70% of the states,” Atlas argued. “These other states did severe lockdowns. And when you look at Florida compared to California … California did 50% worse than Florida, because of its severe lockdowns.”

Health experts in Florida, however, pushed back at the idea that the state was completely open when DeSantis himself had locked down the state for a month last April. In addition, some of the largest counties, including Orange, MiamiDade, Hillsborough and Pinellas, as well as cities such as Tampa, Miami Beach and Orlando, have had mask mandates and other COVID restrictions to this day.

“A lot of people, when they were comparing states, [said], ‘State X was wide open, state X was really closed,’ ” Salemi said. “[But] there were mask mandates in Florida.’’

DeSantis’s lockdown came after Orange and other counties had announced shutdowns of their own, and the state’s Department of Business and Professional Regulation banned selling alcohol in bars twice for several months.

But since then, DeSantis has expressed regret for lockdowns, saying “they’ve done great damage to our country” and vowing never to do it again. He’s also promised no further limiting of dining and retail capacity and has weakened local mask mandates by waiving all fines.

DeSantis defended his approach, pointing to the fact that Florida ranks 29th in terms of infections per capita, 27th in deaths per capita, and 37th in the percentage of excess deaths, according to the CDC.

“I would say in general, Florida’s kind of middle of the pack,” Salemi said. “But the goal we’re striving for should not be ‘middle of the pack’, or how we’re doing relative to everybody else, but what’s the best decision for my state, my community, my city.”

Miami Beach Mayor Dan Gelber blamed DeSantis’ “open” rhetoric for the influx of spring breakers into his city, leading him to declare a state of emergency and potentially contributing to the plateauing infection numbers in the state.

“I’m not a fan of the way he’s handled this,” Gelber told Politico. “When you have a sense of the chaos here, no one — not one of the visitors — are thinking about wearing a mask.”

‘We missed the ball’

The panelists at DeSantis’ roundtable also questioned the efficacy of mask-wearing, despite multiple studies showing it’s one of the best ways of preventing virus transmission.

Bhattacharya said he believed mask-wearing was actually “harmful” because people end up taking more risks, while Gupta said it “had a negative impact in all kinds of ways.”

St. Louis, though, said the state “missed the ball on the efficacy and the importance of these measures, because we didn’t institute these rules from the get-go back in 2020.”

“Is everyone going to do it perfectly? No,” she said. “There are still people walking around with the mask beneath their nose . ... But it can be effective, and it can decrease numbers. And I do think that it’s still necessary.”

DeSantis waived all local mask fines last month, saying that he believes mandates don’t work. But he’s also gotten criticism for holding maskless indoor events himself and for rhetoric such as calling Florida “an oasis of freedom” from COVID restrictions at a CPAC event in Orlando where mask-wearing was spotty at best.

“We could have done much better, in my opinion, if we didn’t have such [antimask] messaging, particularly from leadership,” Levine said. “And I was sad to see things like masks became politicized. Because they’re not political issues, they’re public health issues.”