• Herd im­mu­nity strat­egy en­dorsed by White House “ridicu­lous.”

USA TODAY US Edition - - FRONT PAGE - Elizabeth Weise Con­tribut­ing: Karen Wein­traub Health and patient safety cov­er­age at USA TO­DAY is made pos­si­ble in part by a grant from the Masimo Foun­da­tion for Ethics, In­no­va­tion and Com­pe­ti­tion in Health­care. The Masimo Foun­da­tion does not pro­vide ed­ito

The idea that the pub­lic can in­fect its way out of the COVID-19 pan­demic is “a dan­ger­ous fal­lacy un­sup­ported by the sci­en­tific ev­i­dence,” 80 re­searchers said Wed­nes­day in a let­ter pub­lished in the Lancet.

They strongly de­nounced the idea, ad­vo­cated by the White House, of achiev­ing “herd im­mu­nity” against the virus by let­ting healthy peo­ple with a low risk of se­ri­ous ill­ness get in­fected.

A com­mu­nity is con­sid­ered to have herd im­mu­nity when enough peo­ple build up pro­tec­tion against a pathogen, ei­ther through nat­u­ral in­fec­tion or a vac­cine. For ex­tremely con­ta­gious viruses such as the measles, about 90% of the pop­u­la­tion must be pro­tected to pre­vent trans­mis­sion.

There are more than 7.9 mil­lion cases and more than 217,000 deaths in the USA, ac­cord­ing to Johns Hopkins data. Five states had a record num­ber of deaths in a week, and 12 states set records for new cases in a week, a USA TO­DAY anal­y­sis found.

A mem­o­ran­dum pub­lished Oct. 4, called the Great Bar­ring­ton Dec­la­ra­tion, called for the world to em­brace herd im­mu­nity for COVID-19 as a way to pro­tect the vul­ner­a­ble while al­low­ing economies to thrive.

The dec­la­ra­tion came out of a meet­ing hosted by the lib­er­tar­ian-lean­ing Amer­i­can In­sti­tute for Eco­nomic Re­search. Its web­site says it has more than 9,000 sig­na­tures, though most names are not pub­lic. “The most com­pas­sion­ate ap­proach that bal­ances the risks and ben­e­fits of reach­ing herd im­mu­nity, 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,” the dec­la­ra­tion says.

Ac­cord­ing to The New York Times, a se­nior ad­min­is­tra­tion of­fi­cial, speak­ing anony­mously, said Mon­day that the pres­i­dent has long sup­ported the idea.

“It’s just ridicu­lous,” said Yvonne Mal­don­ado, an epi­demi­ol­o­gist and in­fec­tious dis­ease spe­cial­ist at Stan­ford Univer­sity Med­i­cal School. “Ev­ery­thing they say (in the dec­la­ra­tion) is ei­ther mis­in­for­ma­tion or an out­right lie.”

Thomas File, pres­i­dent of the In­fec­tious Dis­eases Society of Amer­ica, de­nounced the dec­la­ra­tion Wed­nes­day, say­ing it was “re­leased with­out data or ev­i­dence.”

Herd im­mu­nity can’t work for sev­eral rea­sons, Mal­don­ado said. First, no one knows how long some­one who’s had COVID-19 re­mains im­mune.

“We know that the nat­u­ral his­tory of coro­n­avirus infections is that peo­ple can get re­in­fected over and over again,” she said. In one case, a 25-year-old man from Ne­vada was in­fected in late March and five weeks af­ter re­cov­er­ing was di­ag­nosed again with a slightly dif­fer­ent ver­sion of the virus.

The idea that it’s pos­si­ble to iso­late high-risk peo­ple is ab­surd, Mal­don­ado said.

“Over 40% of the U.S. pop­u­la­tion has some risk. I don’t know how you are go­ing to keep 40% of the pop­u­la­tion away from the other 60%,” she said.

Though younger peo­ple are at “min­i­mal risk of death,” as the dec­la­ra­tion reads, it’s by no means a zero chance.

Try­ing to reach herd im­mu­nity would re­sult in a much higher death rate than the USA is ex­pe­ri­enc­ing, said Ge­orge Ruther­ford, an in­fec­tious dis­ease spe­cial­ist at the Univer­sity of Cal­i­for­nia-San Fran­cisco.

“What we’re talk­ing about here is a dis­ease in which you prob­a­bly need to get some­where in ex­cess of 60% of peo­ple with per­ma­nent – not tem­po­rary – im­mu­nity,” he said. “It’s just not at­tain­able with­out a much greater mor­tal­ity than we’ve had so far.”

An­thony Fauci, head of the Na­tional In­sti­tute of Al­lergy and In­fec­tious Dis­eases, told a col­lege class at the Mas­sachusetts In­sti­tute of Tech­nol­ogy last month that it’s not clear what per­cent of the pop­u­la­tion would need to be in­fected to pro­vide herd im­mu­nity from COVID-19, though it’s likely to be 50% to 75% of the pub­lic.

“We’re not any­where near there yet,” he said. “If al­ready, 200,000 peo­ple have died and you want to let things go to get herd im­mu­nity, you’re go­ing to get a lot of suf­fer­ing and a lot of deaths. If we get herd im­mu­nity, let’s get it with a vac­cine and not by let­ting every­body get in­fected.”

By def­i­ni­tion, when herd im­mu­nity is reached, infections should de­cline. Even in the hard­est hit ar­eas of New York City, where one-quar­ter to onethird of residents may have been in­fected in the spring, in­fec­tion rates are rising.

“That’s the only thing you need to know that herd im­mu­nity has not been reached,” said Wil­liam Han­age, a Har­vard epi­demi­ol­o­gist.

In ar­eas where the virus raged ear­lier in the year, lower rates of in­fec­tion are the re­sult not of herd im­mu­nity but changes in peo­ple’s be­hav­ior, said Stephen Kissler, a re­search fel­low in the Depart­ment of Im­munol­ogy and In­fec­tious Dis­eases at Har­vard T.H. Chan School of Pub­lic Health.

“It is crys­tal clear that there are still enough sus­cep­ti­ble peo­ple in the pop­u­la­tion even in ma­jor parts of New York City to sus­tain out­breaks,” he said. “What we do see are vast dif­fer­ences in peo­ple’s re­sponses to the pan­demic and the pre­cau­tions peo­ple are tak­ing.”

Crit­ics said that in­stead of push­ing for herd im­mu­nity, the Trump ad­min­is­tra­tion should pro­mote pub­lic health mea­sures known to be safe and ef­fec­tive: wear­ing masks, wash­ing hands, avoid­ing large groups, main­tain­ing so­cial dis­tance and pro­vid­ing eas­ily ac­ces­si­ble test­ing and con­tact trac­ing.

The Lancet let­ter, called the “John Snow Mem­o­ran­dum,” notes coun­tries that mounted a ro­bust pub­lic health re­sponse to the virus, in­clud­ing Ja­pan, Viet­nam and New Zealand, ef­fec­tively con­trolled trans­mis­sion.

“We can­not af­ford dis­trac­tions that un­der­mine an ef­fec­tive re­sponse,” said the 80 sig­na­to­ries.

John Snow, a Vic­to­rian physi­cian, is con­sid­ered the fa­ther of epi­demi­ol­ogy. He tracked the source of a Lon­don cholera epi­demic to a con­tam­i­nated wa­ter well in 1854. He re­moved the pump han­dle, so no one could get wa­ter from the well – a con­tro­ver­sial move at the time – and the epi­demic ended.

Mon­day, World Health Or­ga­ni­za­tion head Te­dros Ad­hanom Ghe­breye­sus called herd im­mu­nity not just un­sci­en­tific but un­ac­cept­able. “It’s not a choice be­tween let­ting the virus run free and shut­ting down our so­ci­eties,” he said.

Herd im­mu­nity, Ghe­breye­sus said, is pos­si­ble only through vac­ci­na­tion, which safely pro­tects a large enough por­tion of the pop­u­la­tion to keep the virus from spread­ing. Let­ting the virus cir­cu­late unchecked would mean un­nec­es­sary infections, suf­fer­ing and death. “Never in the his­tory of pub­lic health has herd im­mu­nity been used as a strat­egy for re­spond­ing to an out­break, let alone a pan­demic,” Ghe­breye­sus said. “Al­low­ing a dan­ger­ous virus that we don’t fully un­der­stand to run free is sim­ply un­eth­i­cal.”

BRYON HOULGRAVE/USA TO­DAY NET­WORK

Pres­i­dent Don­ald Trump says he was cured of COVID-19 and “im­mune” from the virus, though med­i­cal pro­fes­sion­als say there is no guar­an­tee of that based on science.

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