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Comment and Health

It is bad science to say covid-19 infections will create herd immunity

By Graham Lawton

14 October 2020

Crowds of people on the move

Letting covid-19 circulate freely through crowds could lead to millions of deaths

Shutterstock/R. Classen

AS I write this, my 19-year-old son is self-isolating in his university room with symptoms of covid-19, awaiting test results. He is quite poorly, though overwhelmingly likely to make a full recovery. But I worry that he will be one of the few young adults who get seriously ill听or even die, or end up with
long-term health problems.

To some, however, his illness is听welcome; in fact, they wish it on听all of his peers. According to the听signatories of an open letter called the , lockdown measures are doing more harm than good and we should open up society and let the virus rip.

OK, that is a bit of an exaggeration. The declaration 鈥 named after the US town where it was signed 鈥 advocates a strategy called 鈥渇ocused protection鈥 under which the most vulnerable people shield and everybody else 鈥渟hould immediately be allowed to resume life as normal鈥. This will then allow听herd immunity to build up.

The declaration publicly exposed a scientific disagreement that has been simmering for months. On one side are mainstream scientists who reluctantly see restrictions on freedom as the only way to keep a lid on the pandemic while we wait for vaccines; on the other, the libertarians who see the damage done to economies and individual lives as too high a price.

The mainstream media lapped up the disagreement narrative, but completely missed the fundamental problem with the declaration: its extremely dubious claims about herd immunity. This is central to the strategy, but the document badly fluffs the science.

Herd immunity is conceptually simple. If enough people become immune to an infectious agent, the entire herd is protected because infectious people rarely encounter a non-immune person, and so transmission fizzles out.

The level of individual immunity required to attain herd immunity depends on how infectious the virus is, as measured by R, the average number of people that each infectious person infects. The classic example is measles, which has an R number of around 15 and a herd immunity threshold of 95 per cent. The numbers for the coronavirus SARS-CoV-2 are about 3.5 and 60 to 70 per cent.

Herd immunity has only ever been attained by vaccination. But听the declaration advocates naturally acquired immunity. In听other words, letting between two-thirds and three-quarters of the population catch the virus.

There are a number of issues with this, not least collateral damage. Even if the death rate is under 1 per cent, letting the virus听run free will hospitalise and听kill millions.

But there is another crucial scientific detail that the declaration 鈥 along with most discussions of herd immunity 鈥 misses. We can鈥檛 take it for granted that widespread individual immunity will automatically create herd immunity.

Herd immunity can only be built if the immune response totally prevents individuals from picking up and transmitting the virus. That sometimes happens, but often doesn鈥檛. A lot of the time,听an immune response stops us from falling ill if we reacquire the virus, but doesn鈥檛 prevent onward transmission. The same is听true of vaccines.

We don鈥檛 yet know whether natural immunity to SARS-CoV-2 (or the experimental vaccines) will听halt transmission. Until we do,听assuming that herd immunity will automatically appear is unscientific and, frankly, irresponsible.

There are many other reasons to听be sceptical of the declaration. It听doesn鈥檛 even mention the debilitating, lasting effects of 鈥渓ong covid鈥, for example. But they are of secondary significance to the fundamental hole at its heart: the mystifying and dangerous failure to properly grasp the concept of herd immunity. Get well soon, son.

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