The Plain and the pandemic
Virus estimated to have impacted 90% of community
LANCASTER, Pa. — Late last spring a covid-19 wave tore through the Plain community when they resumed church services, infecting an untold number of Amish and Mennonites in Lancaster County.
The administrator of a medical center in the heart of the Amish community in New Holland Borough estimates as many as 90% of Plain families have since had at least one family member infected, and the religious enclave achieved what no other community in the United States has: herd immunity.
“So, you would think if covid was as contagious as they say, it would go through like a tsunami; and it did,” said Allen Hoover, an Old Order Mennonite and administrator of the Parochial Medical Center, a clinic that primarily serves the Plain community.
Public health officials and epidemiologists didn’t dispute the widespread outbreak Hoover described. But they voiced concern a misplaced perception of herd immunity in a population that makes up 8% of Lancaster County may compromise the effort to turn the tide on the pandemic.
As Hoover observed, faith in herd immunity has prompted members of the Plain community to relax on key mitigation efforts such as masking and social distancing, and they may see little reason to be vaccinated.
Additionally, it’s unknown whether achieving herd immunity last year would be beneficial now.
Six infectious disease experts with whom LancasterOnline spoke expressed unease with a reliance on the notion the Plain community achieved herd immunity. And they pointed out that if not the case, past infections and existing antibodies may provide limited protection.
“Herd immunity is only true at a given point in time,” said Eric Lofgren, an infectious disease epidemiologist at Washington State University. “It’s not a switch that once it gets thrown, you’re good. It’ll wear off.”
This collision of science and personal experience could leave Lancaster County vulnerable just as county health officials seek to make progress vaccinating residents against covid-19.
“You can have a long period where you think everything is OK, but you have this whole population that’s susceptible,” said David Lo, professor of biomedical sciences and senior associate dean of research at the University of California, Riverside.
Lo added, “All it takes is one person who’s contagious to give you this sudden outbreak.”
‘THERE’S A REAL RISK OF HAVING AN OUTBREAK’
Hoover agreed with these epidemiologists.
He acknowledged face masks and social distancing have been critical for mitigating the spread of covid-19; he wears a face covering when interacting with non-Amish. But he also knows many in the Plain community don’t take the same precautions.
“As a general rule, we want to respect those around us,” said Hoover, who has been the medical center’s administrator since 2004. But because of perceived immunity, Hoover said, the Plain community believes public health directives don’t “apply to us.”
It’s a perspective Hoover understands but doesn’t share.
“We should be careful that we’re not the cause of it spreading,” Hoover said.
The Parochial Medical Center isn’t the only medical provider catering to the Plain community, but with 33,000 active patients, it is arguably the largest.
The Plain community in Lancaster County, which includes both Amish and Mennonites, isn’t insignificant. Combined, it represents nearly 8% of the county’s population of just more than 545,000 residents, according to estimates from Elizabethtown College’s Young Center for Anabaptist and Pietist Studies.
The dearth of covid-19 testing among the Plain doesn’t just mean a lack of scientific certainty.
“The reason it’s important is because it’s unlikely that 100% have had the disease,” said David Dowdy, a professor in the epidemiology department at Johns Hopkins Bloomberg School of Public Health.
Under the right conditions, a single infected individual can trigger an outbreak.
Take what happened at Disneyland. Two decades ago, measles was declared eradicated in the United States because of an effective national vaccination campaign. But that didn’t stop an outbreak from infecting 150 people in