6 ms·

Why would any country want herd immunity from infection when nearly every developed country has demonstrated the virus can be contained without such a large los

Why would any country want herd immunity from infection when nearly every developed country has demonstrated the virus can be contained without such a large loss of life? It's not as if the specter of maxed out hospitals on the news for months on end is going to help the economy.

MereInterest 6y ago
Exactly. Absent a vaccine, herd immunity is the failure condition that occurs when a virus has infected as many people as it can within a population. It is the default baseline against which all interventions should be compared.
- claudeganon 6y ago
  If immunity to the disease is not long-lasting (> 3 months), herd immunity is likely impossible. There are plenty of viruses that can reinfect people who have recovered from them (Coronaviruses being a common example of these) for which we have no herd immunity.
  - gridlockd 6y ago
    Immunity isn't a binary, neither is herd immunity. While there are reports of reinfection, those cases are quite rare. Even a modest degree of immunity can significantly lower spread. In France, Spain, Germany, you still have hundreds of cases every day, but they don't grow to thousands of cases anymore.
    - claudeganon 6y ago
      > While there are reports of reinfection, those cases are quite rare. The disease hasn’t been around long enough to make this claim. > Even a modest degree of immunity can significantly lower spread. In France, Spain, Germany, you still have hundreds of cases every day, but they don't grow to thousands of cases anymore. This is true, but depends on the duration of immunity and a more uniform global response (or very tight border and quarantine adherence). Ongoing, sporadic COVID crises would still be pretty disruptive unless we have highly effective therapeutics.
      - tripletao 6y ago
        Sweden has roughly 80k confirmed coronavirus cases in 10M people. Assuming equal probability of first and second infection (which I believe undercounts second infections, since some people have more opportunity for exposure than others due to their jobs and lifestyles), and assuming equal probability of first and second detection (which again I believe undercounts), we should have something around 10M*(80k/10M)^2 = 640 confirmed reinfections. So where are they? Are you claiming that these hundreds of confirmed reinfections simply haven't been reported? Note that the number of actual reinfections would be orders of magnitude higher; the calculation above already assumes underascertainment by a factor of ~100x. You can redo this math in any moderately hard-hit region, though I chose Sweden here because their rate of infections vs. time has been more constant (eliminating the possibility that all the infections happened in a brief early peak, after which everyone acted more carefully so there's no longer any opportunity for reinfection). I'm not saying that reinfection is impossible, just that so far, if it exists, it's very rare. And please don't cite the Vox article. In normal times, it would be criticized as "science by press release" or worse, a single anecdotal case written up as definitive for the popular press, with no case history and no publication to review. Maybe the author's patient really did get reinfected and it's common (but that seems vanishingly unlikely to me per above), or maybe the patient was reinfected but it's rare like getting chickenpox twice, or maybe the patient just had one long infection and tested false-negative (which is very common generally) in the middle. But since the author has disclosed nothing but the shocking headline result, we can't know. So I believe you are sowing public panic without evidence. While it is impossible to directly demonstrate that immunity for a disease discovered X months ago lasts longer than X months, it is reasonable to expect that in this case. Maybe you think that at worst, if you're wrong, then you're telling a noble lie--but the public health authorities who said masks don't work (remember that?) did too, and look how that ended up. I can easily imagine Trump on television a year from now explaining that because people got reinfected, the vaccine is obviously a scam. Abandoning the truth in favor of a perceived noble goal has unpredictable but generally bad effects, and I wish people would stop. Or if you actually believe what you're writing, I'm not sure what to say--please read the scientific literature (and not the popular media, which has been horrible in all directions), dust off your high school biology, and make your best assessment based on that. I think you'll find that while the coronavirus is a very serious problem, it's not the near-apocalyptic one that your comments seem to imply.
  - abainbridge 6y ago
    Is there any evidence you can re-contract Covid-19? If not, I'd fall back to the following argument: Some health care workers have been exposed regularly for six months by now. It'd be very news worthy if someone was confirmed to be re-infected. Given I haven't seen that news, I think I can conclude that immunity lasts at least six months in working age people. Also, if I understand correctly, it has recently been shown that people who were infected with SARS 17 years ago still have memory T cells for SARS. (And, I think SARS is one of the viruses most closely related to Covid-19, and therefore there's reason to expect a long immunity period for it too). "Memory T cells induced by previous pathogens can shape the susceptibility to, and clinical severity of, subsequent infections. <snip> We then showed that SARS-recovered patients (n=23) still possess long-lasting memory T cells reactive to SARS-NP 17 years after the 2003 outbreak." - from https://www.nature.com/articles/s41586-020-2550-z https://www.nature.com/articles/s41586-020-2550-z
    - claudeganon 6y ago
      There’s initial evidence of reinfection and limited immunity that are under further investigation: https://www.vox.com/2020/7/12/21321653/getting-covid-19-twice-reinfection-antibody-herd-immunity https://www.vox.com/2020/7/12/21321653/getting-covid-19-twic... https://www.theguardian.com/world/2020/jul/12/immunity-to-covid-19-could-be-lost-in-months-uk-study-suggests?CMP=share_btn_tw https://www.theguardian.com/world/2020/jul/12/immunity-to-co...
      - __blockcipher__ 6y ago
        There is no credible evidence of re-infection. The isolated cases can be explained away in a bayesian sense by PCR false positives or false negatives. It’s the usual base rate neglect fallacy. The idea of reinfection contradicts decades of well established immunological principles. It also ignores the fact that we have a close relative of SARS-2 to study. That relative is SARS-1 and we have detected strong t cell activation after 17+ years. Therefore immunity is enduring and long lasting. SARS-2 is substantially structurally similar to SARS-1. Alternatively, take a statistical argument. There have been millions of cases around the world. SARS-2 is highly infectious for those who are susceptible. Therefore we would have thousands if not more well-documented, inarguable cases of reinfection. We don’t have those. All we have is a bunch of articles from heavily biased sources like Vox that have a vested interest in pushing the “doomer” narrative. Why haven’t we seen widespread reinfection if it is truly possible?
lambdaba 6y ago
I know it certainly appears like a suboptimal strategy, but it assumes that the measures did indeed do what they were expected, that's contentious (we can discuss why, but I think it's obvious). In a risk-benefit analysis, it leaves future (speculative) advances in treatment VS acquiring herd immunity as quickly as possible and with minimal actual damage, for this it makes sense to maximize exposure for the less at risk. Also, the summer is a better season to get infected, at least because of generally better immune system function (because of better vitamin d status).
- __blockcipher__ 6y ago
  Not just Vitamin D, but to a lesser extent nitric oxide as well. Anyway to state your excellent point in a different way: “contain until vaccine” is a strategy based around a temporally unbounded future event. When has it ever made sense to bet the farm on a highly uncertain future event? This world would be so much better off if we never knew that SARS-2 existed and therefore did not engage in any artificial suppression of natural transmission.
  - tenuousemphasis 6y ago
    Yeah much better for hospital ICUs to be overrun with patients across the entire world all at once. Great thinking.
    - __blockcipher__ 6y ago
      Hospitals/ICUs being overrun in the United States is not realistic. I'm not equipped to discuss the medical capacity of other countries, but Sweden did fine.
duxup 6y ago
>the virus can be contained without such a large loss of life? Generally speaking: But then you have to keep containing it right? There's not a magical end of containing unless the virus just goes away / a vaccine is available ... that doesn't seem to be a thing yet. I'm not all for just letting the chips fall where they may, but success at preventing exposure to your population vs heard immunity means the folks who haven't been exposed have to keep avoiding it.
- toast0 6y ago
  > But then you have to keep containing it right? If you don't have herd immunity, then you need to be continually surveilling for it, and when it's present, switch to containment. Containment is easier when the number of cases is small though. If you get a handful of cases, contact trace and make general advisory news releases. If you get more than 20 cases, ask people to wear masks. If it gets worse, then you have to take bigger steps.
- intotheabyss 6y ago
  A lot of assumptions here. Immunity may not even be long lasting. I live in a country where we've largely stopped community transmission, and now we can open back up with masks for all to keep it that way until we all get vaccinated next year. America's strategy (or lack thereof) is simply negligence.
  - __blockcipher__ 6y ago
    Please stop repeating the “there might not be long term immunity” meme. It is unfounded and contradicts decades of established immunological principles. Memory T-Cell reactivity to SARS-1 has been shown to persist across decades. The latest study showed strong activity after 17+ years. SARS-2 is incredibly structurally similar to SARS-1. Even if we pretend t-cells don’t exist, immunological memory is a thing. Once circulating antibodies have completely faded after months, there still remain memory b cells which persist across decades and will ramp up antibody production all over again when exposed to SARS-CoV-2. Therefore the subsequent infection is addressed more quickly and more powerfully, leading to lower peak viral load and therefore theoretically lowered transmissibility and vastly improved individual outcomes. So if we pretend half the immune system doesn’t exist, then you can get reinfected months later but you will spread way less and not be at any significant personal risk of bad outcome. Herd immunity works. It’s a natural phenomenon that has been unjustifiably demonized.
ppod 6y ago
Cases are low and falling in New York, Sweden, London, Italy, Spain, despite varying and loosening social distancing measures. How do you explain that? Those places already have herd immunity. Serotesting for antibodies misses t-cell immunity and other forms of resistance, and variation in spreading patterns makes the herd immunity threshold lower than we thought. This is the only plausible explanation and nobody wants to admit it.
- dragonwriter 6y ago
  > Those places already have herd immunity. No, they don't, or they wouldn't have new cases, even without even somewhat looser mandatory controls than other places. What they have is some degree of immunity in the population (not herd immunity) plus (in some subset of those places) some degree of contact tracing backed by targeted mandatory, or at least voluntary, quarantines/isolation of the exposed, and (in large part because of the intense impacts each has had) voluntary general distancing.
  - gridlockd 6y ago
    > No, they don't, or they wouldn't have new cases, even without even somewhat looser mandatory controls than other places. That's not what herd immunity means. The Herd immunity threshold is attained when the R factor drops below 1, assuming otherwise uninhibited spread. The threshold for herd immunity for COVID-19 has been estimated at 50-80%, but that is assuming an R0 that is likely overestimated. Given that spread is still mitigated by certain interventions, and since we don't know the impact of those interventions on R, nor do we know R0, we don't know if we have herd immunity. However, we do have R below one in many European countries.
  - ppod 6y ago
    You sound very confident. There are some epidemiologists at the University of Oxford who disagree with your definitions. https://www.medrxiv.org/content/10.1101/2020.07.15.20154294v1 https://www.medrxiv.org/content/10.1101/2020.07.15.20154294v...
  - tripletao 6y ago
thatoneuser 6y ago
Consider the size and population of the developed countries. Aside from ya communist boi China, they're all quite small in size and population compared to say the US or India or Brazil. In these countries it may be the only option, as bleak as that is. Unless a miracle cure shows up soon.

MereInterest 6y ago

Exactly. Absent a vaccine, herd immunity is the failure condition that occurs when a virus has infected as many people as it can within a population. It is the default baseline against which all interventions should be compared.

claudeganon 6y ago
If immunity to the disease is not long-lasting (> 3 months), herd immunity is likely impossible. There are plenty of viruses that can reinfect people who have recovered from them (Coronaviruses being a common example of these) for which we have no herd immunity.
- gridlockd 6y ago
  Immunity isn't a binary, neither is herd immunity. While there are reports of reinfection, those cases are quite rare. Even a modest degree of immunity can significantly lower spread. In France, Spain, Germany, you still have hundreds of cases every day, but they don't grow to thousands of cases anymore.
  - claudeganon 6y ago
    > While there are reports of reinfection, those cases are quite rare. The disease hasn’t been around long enough to make this claim. > Even a modest degree of immunity can significantly lower spread. In France, Spain, Germany, you still have hundreds of cases every day, but they don't grow to thousands of cases anymore. This is true, but depends on the duration of immunity and a more uniform global response (or very tight border and quarantine adherence). Ongoing, sporadic COVID crises would still be pretty disruptive unless we have highly effective therapeutics.
    - tripletao 6y ago
      Sweden has roughly 80k confirmed coronavirus cases in 10M people. Assuming equal probability of first and second infection (which I believe undercounts second infections, since some people have more opportunity for exposure than others due to their jobs and lifestyles), and assuming equal probability of first and second detection (which again I believe undercounts), we should have something around 10M*(80k/10M)^2 = 640 confirmed reinfections. So where are they? Are you claiming that these hundreds of confirmed reinfections simply haven't been reported? Note that the number of actual reinfections would be orders of magnitude higher; the calculation above already assumes underascertainment by a factor of ~100x. You can redo this math in any moderately hard-hit region, though I chose Sweden here because their rate of infections vs. time has been more constant (eliminating the possibility that all the infections happened in a brief early peak, after which everyone acted more carefully so there's no longer any opportunity for reinfection). I'm not saying that reinfection is impossible, just that so far, if it exists, it's very rare. And please don't cite the Vox article. In normal times, it would be criticized as "science by press release" or worse, a single anecdotal case written up as definitive for the popular press, with no case history and no publication to review. Maybe the author's patient really did get reinfected and it's common (but that seems vanishingly unlikely to me per above), or maybe the patient was reinfected but it's rare like getting chickenpox twice, or maybe the patient just had one long infection and tested false-negative (which is very common generally) in the middle. But since the author has disclosed nothing but the shocking headline result, we can't know. So I believe you are sowing public panic without evidence. While it is impossible to directly demonstrate that immunity for a disease discovered X months ago lasts longer than X months, it is reasonable to expect that in this case. Maybe you think that at worst, if you're wrong, then you're telling a noble lie--but the public health authorities who said masks don't work (remember that?) did too, and look how that ended up. I can easily imagine Trump on television a year from now explaining that because people got reinfected, the vaccine is obviously a scam. Abandoning the truth in favor of a perceived noble goal has unpredictable but generally bad effects, and I wish people would stop. Or if you actually believe what you're writing, I'm not sure what to say--please read the scientific literature (and not the popular media, which has been horrible in all directions), dust off your high school biology, and make your best assessment based on that. I think you'll find that while the coronavirus is a very serious problem, it's not the near-apocalyptic one that your comments seem to imply.
- abainbridge 6y ago
  Is there any evidence you can re-contract Covid-19? If not, I'd fall back to the following argument: Some health care workers have been exposed regularly for six months by now. It'd be very news worthy if someone was confirmed to be re-infected. Given I haven't seen that news, I think I can conclude that immunity lasts at least six months in working age people. Also, if I understand correctly, it has recently been shown that people who were infected with SARS 17 years ago still have memory T cells for SARS. (And, I think SARS is one of the viruses most closely related to Covid-19, and therefore there's reason to expect a long immunity period for it too). "Memory T cells induced by previous pathogens can shape the susceptibility to, and clinical severity of, subsequent infections. <snip> We then showed that SARS-recovered patients (n=23) still possess long-lasting memory T cells reactive to SARS-NP 17 years after the 2003 outbreak." - from https://www.nature.com/articles/s41586-020-2550-z https://www.nature.com/articles/s41586-020-2550-z
  - claudeganon 6y ago
    There’s initial evidence of reinfection and limited immunity that are under further investigation: https://www.vox.com/2020/7/12/21321653/getting-covid-19-twice-reinfection-antibody-herd-immunity https://www.vox.com/2020/7/12/21321653/getting-covid-19-twic... https://www.theguardian.com/world/2020/jul/12/immunity-to-covid-19-could-be-lost-in-months-uk-study-suggests?CMP=share_btn_tw https://www.theguardian.com/world/2020/jul/12/immunity-to-co...
    - __blockcipher__ 6y ago
      There is no credible evidence of re-infection. The isolated cases can be explained away in a bayesian sense by PCR false positives or false negatives. It’s the usual base rate neglect fallacy. The idea of reinfection contradicts decades of well established immunological principles. It also ignores the fact that we have a close relative of SARS-2 to study. That relative is SARS-1 and we have detected strong t cell activation after 17+ years. Therefore immunity is enduring and long lasting. SARS-2 is substantially structurally similar to SARS-1. Alternatively, take a statistical argument. There have been millions of cases around the world. SARS-2 is highly infectious for those who are susceptible. Therefore we would have thousands if not more well-documented, inarguable cases of reinfection. We don’t have those. All we have is a bunch of articles from heavily biased sources like Vox that have a vested interest in pushing the “doomer” narrative. Why haven’t we seen widespread reinfection if it is truly possible?

lambdaba 6y ago

I know it certainly appears like a suboptimal strategy, but it assumes that the measures did indeed do what they were expected, that's contentious (we can discuss why, but I think it's obvious). In a risk-benefit analysis, it leaves future (speculative) advances in treatment VS acquiring herd immunity as quickly as possible and with minimal actual damage, for this it makes sense to maximize exposure for the less at risk. Also, the summer is a better season to get infected, at least because of generally better immune system function (because of better vitamin d status).

__blockcipher__ 6y ago
Not just Vitamin D, but to a lesser extent nitric oxide as well. Anyway to state your excellent point in a different way: “contain until vaccine” is a strategy based around a temporally unbounded future event. When has it ever made sense to bet the farm on a highly uncertain future event? This world would be so much better off if we never knew that SARS-2 existed and therefore did not engage in any artificial suppression of natural transmission.
- tenuousemphasis 6y ago
  Yeah much better for hospital ICUs to be overrun with patients across the entire world all at once. Great thinking.
  - __blockcipher__ 6y ago
    Hospitals/ICUs being overrun in the United States is not realistic. I'm not equipped to discuss the medical capacity of other countries, but Sweden did fine.

duxup 6y ago

>the virus can be contained without such a large loss of life? Generally speaking: But then you have to keep containing it right? There's not a magical end of containing unless the virus just goes away / a vaccine is available ... that doesn't seem to be a thing yet. I'm not all for just letting the chips fall where they may, but success at preventing exposure to your population vs heard immunity means the folks who haven't been exposed have to keep avoiding it.

toast0 6y ago
> But then you have to keep containing it right? If you don't have herd immunity, then you need to be continually surveilling for it, and when it's present, switch to containment. Containment is easier when the number of cases is small though. If you get a handful of cases, contact trace and make general advisory news releases. If you get more than 20 cases, ask people to wear masks. If it gets worse, then you have to take bigger steps.
intotheabyss 6y ago
A lot of assumptions here. Immunity may not even be long lasting. I live in a country where we've largely stopped community transmission, and now we can open back up with masks for all to keep it that way until we all get vaccinated next year. America's strategy (or lack thereof) is simply negligence.
- __blockcipher__ 6y ago
  Please stop repeating the “there might not be long term immunity” meme. It is unfounded and contradicts decades of established immunological principles. Memory T-Cell reactivity to SARS-1 has been shown to persist across decades. The latest study showed strong activity after 17+ years. SARS-2 is incredibly structurally similar to SARS-1. Even if we pretend t-cells don’t exist, immunological memory is a thing. Once circulating antibodies have completely faded after months, there still remain memory b cells which persist across decades and will ramp up antibody production all over again when exposed to SARS-CoV-2. Therefore the subsequent infection is addressed more quickly and more powerfully, leading to lower peak viral load and therefore theoretically lowered transmissibility and vastly improved individual outcomes. So if we pretend half the immune system doesn’t exist, then you can get reinfected months later but you will spread way less and not be at any significant personal risk of bad outcome. Herd immunity works. It’s a natural phenomenon that has been unjustifiably demonized.

ppod 6y ago

Cases are low and falling in New York, Sweden, London, Italy, Spain, despite varying and loosening social distancing measures. How do you explain that? Those places already have herd immunity. Serotesting for antibodies misses t-cell immunity and other forms of resistance, and variation in spreading patterns makes the herd immunity threshold lower than we thought. This is the only plausible explanation and nobody wants to admit it.

dragonwriter 6y ago
> Those places already have herd immunity. No, they don't, or they wouldn't have new cases, even without even somewhat looser mandatory controls than other places. What they have is some degree of immunity in the population (not herd immunity) plus (in some subset of those places) some degree of contact tracing backed by targeted mandatory, or at least voluntary, quarantines/isolation of the exposed, and (in large part because of the intense impacts each has had) voluntary general distancing.
- gridlockd 6y ago
  > No, they don't, or they wouldn't have new cases, even without even somewhat looser mandatory controls than other places. That's not what herd immunity means. The Herd immunity threshold is attained when the R factor drops below 1, assuming otherwise uninhibited spread. The threshold for herd immunity for COVID-19 has been estimated at 50-80%, but that is assuming an R0 that is likely overestimated. Given that spread is still mitigated by certain interventions, and since we don't know the impact of those interventions on R, nor do we know R0, we don't know if we have herd immunity. However, we do have R below one in many European countries.
- ppod 6y ago
  You sound very confident. There are some epidemiologists at the University of Oxford who disagree with your definitions. https://www.medrxiv.org/content/10.1101/2020.07.15.20154294v1 https://www.medrxiv.org/content/10.1101/2020.07.15.20154294v...
- tripletao 6y ago

thatoneuser 6y ago

Consider the size and population of the developed countries. Aside from ya communist boi China, they're all quite small in size and population compared to say the US or India or Brazil. In these countries it may be the only option, as bleak as that is. Unless a miracle cure shows up soon.