Herd immunity and COVID-19: Experts warn against letting ‘things rip’ – Detroit Free Press

Masked University of Michigan students walk around campus in Ann Arbor on Tuesday, October 20, 2020 after Washtenaw County Health Department issued a Stay in Place order for University of Michigan undergrad students due to the rising number of COVID-19 cases on campus.(Photo: Ryan Garza, Detroit Free Press)

As COVID-19 case numbers continue to go up and up and up in Michigan and nationally a debate is brewing about whether it's time to abandon effortsto contain the spread of the virusand insteadembrace a strategy of trying to reach herd immunity through infection.

With other diseases, such as smallpox, polio and measles, vaccines helped the U.S. reach herd immunity, which occurs when the vast majority of a population is immune to a disease, makingthe likelihood of its spread to vulnerable people less likely.

But because there is no coronavirus vaccine on the market yet, the only way to reach herd immunity would be to allow COVID-19 to spread unchecked through the population infecting most of the nation's 330 million people, and likely hospitalizing and killing millions along the way.

Most leading health officials including some from Michigan have called the idea unethical at bestand akin to mass murder at worst.

The death toll would be "enormous," said Dr. Anthony Fauci, the nation's leading infectious diseases doctor and director of the National Institute of Allergy and Infectious Diseases, if the U.S. tried to achieve herd immunity through infection.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, says vulnerable populations would be at risk if a herd immunity strategy is tried.(Photo: AP)

"If you just let things rip and let the infection go ... that quite frankly is ridiculous," Fauci said inan Oct. 15interview on Good MorningAmerica. "There will be so many people in the communitythat you can't shelter, that you can't protect, who are going to get sick and get serious consequences. So this idea that we have the power to protect the vulnerable is total nonsense because history has shown that that's not the case.

"And if you talk to anybody who has any experience in epidemiology and infectious diseases, they will tell you that that isrisky, and you'll wind up with many more infections of vulnerable people, which will lead to hospitalizations and deaths."

Yet it's a strategy endorsed by a group of infectious diseases doctors and epidemiologistswho signed the Great Barrington Declaration earlier this month, calling for young, healthy people to resume life as usual whileurging older people with chronic conditions that put them at higher risk of complications or death from COVID-19 to stay home. The group calls it: Focused Protection.

President Donald Trump has said repeatedly that the nation ought to fully reopen, students shouldreturn to school and has been skeptical about the effectiveness of masks. He also said "herd mentality" may be the way forward during an ABC News town hallevent in September.

Trump also has saidthe U.S. is "rounding the corner" with the COVID-19 crisis and that the viruswill eventually disappear even without a vaccine, despite raging outbreaks in most states, including Michigan, which announced3,381 new cases in a combined Sunday/Monday count, and 29 new deaths bringing the statewide total to161,907 confirmed cases since March and 7,211 deaths.

Hospitalizations are rising, too.

The Michigan Department of Health and Human Servicesreported 1,479 adults were hospitalized statewide Monday withCOVID-19 or // suspected COVID-19 cases, as were 10 children. That's more than double the number of people who were hospitalized with coronavirus two weeks ago in Michigan, when the Michigan Health and Hospital Association reported that hospitalizations already were up 80% in the state.

The percentage of positive COVID-19 tests is climbing as well. The seven-day average percentage of positive tests in Michiganrose to 5.6% from Oct. 19-25, compared with 3.8% in the week from Oct. 5-11, according to state data.

Alex Azar, secretary of the U.S. Department of Health and Human Services, said"herd immunity is not the strategy of the U.S. government with regard to coronavirus"during an Oct. 2 hearing before the U.S. House Select Subcommittee on the Coronavirus Crisis.

U.S. Department of Health and Human Service Secretary Alex Azar speaks during a COVID-19 briefing at the Centers for Disease Control and Prevention headquarter campus in Atlanta, Wednesday, Oct. 21, 2020.(Photo: Alyssa Pointer, AP)

We may get herd slowing of transmission as we perhaps have seen inthe New York area and other concentrated areas. Our mission is to reduce fatalities, protect the vulnerable, keep coronavirus cases down to the lowest level possible, he said.

Dr. Anurag Malani, an infectious diseases specialist at St. Joseph Mercy Hospital in Ann Arbor, said theidea of pursuing herd immunity through infection is not "a viableor smart option."

"Estimates are probably 10% of the U.S. has had COVID," he said. "So that means, 90% has not, and that means that there's really a lot of vulnerable people that are out there."

And as many as 40% of Americans have pre-existing health conditions that put them at high risk for severe illness from COVID-19 or death, Malani said, noting that even when people survive the disease, many are reporting lingering long-term health problems.

"Herd immunity really shouldn't beachieved by exposing people to the virus," he said."We don't know the long-term ramifications."

Dr. Adnan Munkarah,Henry Ford Health System's executive vice president and chief clinical officer, also is opposed to the idea, calling it a "very concerning proposal."

"You can go for a herd immunity, but the question is at what expense and how many people are we going to letdie before we develop the herd immunity?" he asked.

"Are we willing to lose hundreds of thousands of people for that,to get that herd immunity?Aren't we better off protecting the population?We have many vaccines that are under trials. I am very optimistic that we'll have a couple of these that will show effectiveness, implement the vaccine, and let's get our immunityin a way that continues to protect our population health community, rather than lose a lot of people during that journey."

It's a position the World Health Organization also supports.

Tedros Adhanom Ghebreyesus, Director General of the World Health Organization warned against the idea that herd immunity might be a realistic strategy to stop the pandemic, dismissing such proposals as "unethical." At a press briefing on Monday, Oct. 12, 2020, WHO director-general Tedros Adhanom Ghebreyesus said health officials typically aim to achieve herd immunity _ where the entire population is protected from a virus when the majority are immune _ by vaccination. Tedros noted that to obtain herd immunity from measles, for example, about 95% of the population must be vaccinated.(Photo: Salvatore Di Nolfi, AP)

"Herd immunity is a concept used for vaccination, in which a population can be protected from a certain virus if a threshold of vaccination is reached," said WHO Director-GeneralDr. Tedros Adhanom Ghebreyesus in an Oct. 12 news briefing.

But attempting to create herd immunity by infecting large portions of the population "means allowing unnecessary infections, suffering and death." He called it "scientifically and ethically problematic."

Among the concerns is that the virus is so new, scientists don't know yet how long immunity lasts, and there have been a few documented cases of reinfection, and little is known about the long-term problems associated with COVID-19.

The best approach,Ghebreyesus said is to control transmission to save as many lives as possible.

"Its not a choice between letting the virus run free and shutting down our societies," he said. "This virus transmits mainly between close contacts and causes outbreaks that can be controlled by implementing targeted measures:... Find, isolate, test and care for cases, and trace and quarantine their contacts.

"This is what countries are proving works, every day."

Contact Kristen Jordan Shamus: kshamus@freepress.com. Follow her on Twitter @kristenshamus.

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Herd immunity and COVID-19: Experts warn against letting 'things rip' - Detroit Free Press