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Herd immunity is easier said than done. A portion of the people who become infected require medical intervention, and many parts of the US medical system are in

by skuhn 6y ago

Herd immunity is easier said than done. A portion of the people who become infected require medical intervention, and many parts of the US medical system are inadequate to meet this need. It will take years to get to herd immunity levels through any kind of controlled infection alone, and many will die. Take a look at the forecasts of hospital bed utilization if 20, 40, 60% of the population were to be infected over a 6, 12, or 18 month period: https://projects.propublica.org/graphics/covid-hospitals https://projects.propublica.org/graphics/covid-hospitals Anywhere on those maps that show red indicates people dying due to hospital resource exhaustion, either from COVID-19 or unrelated health issues. To a lesser degree this is happening in yellow areas as well. And ProPublica is only considering beds! Medical personnel, supplies and equipment are finite resources as well. Personnel cannot handle 18 months of 200% bed utilization, and they don't have the PPE they need as it is. There is no easy fix to this situation; we are facing the kind of problem that is best met with thorough preparation, but unfortunately we don't have that. The government can print money, and implement programs to distribute food and other necessities. They can't print tests or masks or vaccines -- once the resources are put in place, it simply takes time. Realistically, it will be a long time before even one of those three things is in a good place. Probably not this year. A more achievable goal than herd immunity is to find a workable way to reduce the number of viral carriers and limit transmission while we wait for the tests, masks and vaccines that we need to get society back on track. That requires leadership and coordination, but it especially requires us to accept the seriousness of the situation and behave responsibly.

lostapathy 6y ago
The big question about natural herd immunity is really how far the disease has already spread and what that means for true IFR. If New York has "survived" this wave tolerably and 20% of people are immune, they may well be a quarter of the way to herd immunity. Which is still a lot of suffering to go, but it's also not going to take 18 months of 200% hospital bed utilization either.
- rallison 6y ago
  1) The healthcare system barely handled the load, and that was with heroic efforts to reposition ventilators and build up temporary capacity. We barely handled it because most of the country was not nearly as hard hit, so we could still shift resources around. If everywhere was hit this hard at the same time, that would be a different story. It would need to be spread out more than you imply if we wanted to have all of the country trying to stay just below capacity. 2) New York City has lost .2% of their entire population to get to that ~20% number. Extrapolated out, that's once again back to the 1-2 million deaths range for the country to hit herd immunity.
  - steveeq1 6y ago
    There's no way that it will reach 1-2 million. My guess is that it will be the same thing like swine flu 10 years ago. The media will print out a sensationalized number, and the real numbers will end up being 10x fewer when calculated honestly.
    - rallison 6y ago
      The 2009 H1N1 Pandemic killed in the ballpark of 10k people in the US. I don't recall ever seeing mainstream news outlets reporting in the ballpark of 100k recorded deaths. It's been 7 weeks since the Imperial College model that predicted up to 2.2 million deaths in the US, that used an infection fatality rate of 0.9% as an assumption. The best science still has us in the 0.5% to 1% range for IFR, still putting us in the 1-2 million range if let ourselves get to herd immunity levels without a vaccine. I think we'll avoid getting to 1-2 million, but it'll be because we take actions along the way to push some/most infections to post-vaccine or post-effective treatments. > Try to reach it without a vaccine, and millions will die. https://www.nytimes.com/2020/05/01/opinion/sunday/coronavirus-herd-immunity.html https://www.nytimes.com/2020/05/01/opinion/sunday/coronaviru...
      - steveeq1 6y ago
        We are going to have nowhere near 1-2 million deaths from this. and the IFR range is around 0.2%, not 0.5 - 1%. And of course we will get herd immunity soon, with the way exponentials work. We are re-opening the economy! We will reach herd immunity far quicker than we will get a vaccine.

by skuhn 6y ago

lostapathy 6y ago

The big question about natural herd immunity is really how far the disease has already spread and what that means for true IFR. If New York has "survived" this wave tolerably and 20% of people are immune, they may well be a quarter of the way to herd immunity. Which is still a lot of suffering to go, but it's also not going to take 18 months of 200% hospital bed utilization either.

rallison 6y ago
1) The healthcare system barely handled the load, and that was with heroic efforts to reposition ventilators and build up temporary capacity. We barely handled it because most of the country was not nearly as hard hit, so we could still shift resources around. If everywhere was hit this hard at the same time, that would be a different story. It would need to be spread out more than you imply if we wanted to have all of the country trying to stay just below capacity. 2) New York City has lost .2% of their entire population to get to that ~20% number. Extrapolated out, that's once again back to the 1-2 million deaths range for the country to hit herd immunity.
- steveeq1 6y ago
  There's no way that it will reach 1-2 million. My guess is that it will be the same thing like swine flu 10 years ago. The media will print out a sensationalized number, and the real numbers will end up being 10x fewer when calculated honestly.
  - rallison 6y ago
    The 2009 H1N1 Pandemic killed in the ballpark of 10k people in the US. I don't recall ever seeing mainstream news outlets reporting in the ballpark of 100k recorded deaths. It's been 7 weeks since the Imperial College model that predicted up to 2.2 million deaths in the US, that used an infection fatality rate of 0.9% as an assumption. The best science still has us in the 0.5% to 1% range for IFR, still putting us in the 1-2 million range if let ourselves get to herd immunity levels without a vaccine. I think we'll avoid getting to 1-2 million, but it'll be because we take actions along the way to push some/most infections to post-vaccine or post-effective treatments. > Try to reach it without a vaccine, and millions will die. https://www.nytimes.com/2020/05/01/opinion/sunday/coronavirus-herd-immunity.html https://www.nytimes.com/2020/05/01/opinion/sunday/coronaviru...
    - steveeq1 6y ago
      We are going to have nowhere near 1-2 million deaths from this. and the IFR range is around 0.2%, not 0.5 - 1%. And of course we will get herd immunity soon, with the way exponentials work. We are re-opening the economy! We will reach herd immunity far quicker than we will get a vaccine.