[Update, March 18: After the release of terrifying projections from modeling work conducted at Imperial College London, The British primer minister seems to have soured on the whole herd immunity approach* and has sort of slithered onto the “contain/mitigate” bandwagon, albeit some would argue, only after (not unlike his transatlantic Special Relationship-ee) incurring unconscionable delay. Coupled with the cratering of the nation’s currency (which hit a 35 year low against the USD) on Wednesday, the “go it alone/to hell with Europe” former colonial power seems to be in the same hot water much of the world, apparently though not China, South Korea, Singapore or Taiwan at the moment, finds itself in. Oh, what a difference thirty odd days make.]
The World Health Organization has questioned the British government’s policy of allowing Covid-19 to infect a large proportion of the country’s population in order for “herd immunity” to emerge.
At a population at just over 66 million such an experiment could, at least in theory, lead to over 40 million infections and 500,000 to 800,000 deaths, depending on the severity of illness and the ability of the National Health Service to respond. Many Britons understandably responded with incredulity-- and gallows humor type zingers.
“Would certainly solve the pension problem,” wrote GMB at the Independent.
“Smacks of eugenics/Darwinism of which we know Johnson/Cummings are big fans,” wrote ManicMogg on the Guardian’s site.
"I suspect this little plot was hatched at Davos or Bilderberg," said Paw in the weekend Observer.
Two thumbs up, however, from a former Axis power at the Evening Standard: “Our experts in Germany apparently mostly think it would work, but approximately 2 percent of the population, mostly elderly, would die. Such a proposal would be considered outrageous and completely irresponsible in Germany. Sorry.”
And what seemed like a reality check, “Here’s the news, we were self banning mass gatherings anyway. It’s an insane experiment which goes against the isolation procedures that every country that has successfully repressed the virus, have imposed.”
On Sunday a bonafide epidemiologist weighed in. "When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire," penned Dr William Hanage, a professor of the evolution and epidemiology of infectious disease at Harvard. "The most fundamental function of a government is to keep its people safe. It is from this that it derives its authority, the confidence of the people and its legitimacy. Nobody should be under the illusion that this is something that can be dodged through somehow manipulating a virus that we are only beginning to understand. This will not pass you by; this is not a tornado, it is a hurricane."
“This virus hasn’t been in our population for long enough for us to know what it does in immunological terms,” explained WHO spokeswoman Margaret Harris to BBC Radio. “We can talk theories, but at the moment we are really facing a situation where we have got to look at action,” she said when asked about the British policy. “We want all the things you need to do to be done together,” including large-scale testing for the virus and tracing contacts, she added.
Patrick Vallance, the government’s chief scientific adviser, is reported to have said it was desirable for around 60% of Britain’s population to be infected with Covid-19 so that “herd immunity” can emerge in the population to protect the country in the longer term.
The theory has been presented as the basis for the British government’s refusal to take steps such as closures of large scale events, schools, bars and other venues which have been rolled-out across Europe aimed at stemming infections. The comments from Ms Harris as a group of leading scientists wrote to the Times newspaper demanding the government release scientific models and evidence for its policy.
“There is no clear indication that the UK’s response is being informed by the experiences of other countries in containing the spread of Covid-19,” the letter, signed by six infectious disease experts including long time Lancet editor, stated. “Transparency is essential to retain the scientific community, health care community and the public’s understanding, co-operation and trust,” the letter added. An editorial in the Financial Times called Britain’s counter-virus strategy a significant gamble. Read it here.
Still, is it possible that the idea is not as “crackers,” as my late former colleague and friend Dr. Charles Farthing, would have said, as it sounds? In the Sunday Observer, chief political observer Andrew Rawnsley, reports to be mostly impressed by the very serious discussions taking place in cabinet office briefing rooms.
"Sir Patrick has lucidly explained what the strategy is designed to achieve,“ he writes. ”It expects those on whom the disease has mild effects, the great majority, to be gradually exposed to the virus, building up ’herd immunity.’ Over time, this will lower the risk of infection for the vulnerable. While this is going on, they will do what they can to protect those for whom the coronavirus could be fatal. Perhaps the most important advice given by the government last week was the simplest. That was to tell people who have flu-type symptoms, however slight, that they should stay at home for seven days.’"
“That’s not trivial,” said one of those involved in the decision. “That is a significant amount of social distancing.”
"Faced with an invisible menace with extremely visible impacts, a clamour for instant and total shutdowns is understandable. But it comes accompanied by the danger that knee jerk responses by frantic governments can end up doing more harm than good. One scientist drew my attention to the Fukushima nuclear plant disaster in Japan in 2011. Later studies found that around 20 people died from radiation. Many more, about a thousand, lost their lives as a result of the decision to evacuate: casualties of car crashes, heart attacks and other medical emergencies triggered by trying to clear the area in a rush. Sometimes the obvious reaction to a crisis will not be the correct one."
Many lives (not to mention a world economy and people’s life savings) may depend on getting this right.
* Somewhere in between the two extremes of “Everyone to the pubs” and “Lock ’em up!” is an admittedly tantalizing middle ground, also from the Imperial College number crunchers, akin to what might be thought of as a series of carefully timed booster shots, what they are calling a policy of "adaption." The thinking is that, after an initial period of very strict measures (which as of this writing sounds like what will be a difficult to fathom much less enforce 12 week lock down), social distancing (plus school and university closure, if used) would then be loosened, opened up even, and only re-initiated when weekly confirmed case incidence in ICU patients threatens to exceeds a certain threshold. This would then alternately be relaxed and tightened again, in pulses, until over many months the much sought after “herd immunity” had been achieved, only in this way with much less dire consequences.
Mike Barr is a long time POZ contributor, scribe for the Act Up/T+D Committee & Treatment Action Group, and pharmaceutical ghost writer né alternative health aficionado. He is a licensed acupuncturist and herbalist in NY and NJ, tending to folks in Union Square, Boerum Hill and Hoboken. Reach out to him at evacupuncturist at that Google mail service or at rootresolutionhealth.com.