Pursuing herd immunity is a non-strategy that could cause massive deaths without boosting the economy. A Trump adviser could push for this.


The White House may be considering a controversial and deadly path through the coronavirus pandemic: collective immunity before a vaccine is ready.

The Washington Post reported Monday that Scott Atlas, a neuroradiologist who joined the Trump administration as the senior pandemic adviser earlier this month, urged the president to take the laissez-faire approach of the Sweden.

Herd immunity is the point that a population reaches when enough people become immune to a virus to prevent it from continuing to spread.

The most obvious path to this threshold is mass vaccination. But five officials recently told the Post that Atlas, who is a health policy fellow at the conservative Hoover Institution at Stanford University, urged Trump to seek herd immunity before a vaccine is available, such as Sweden did. This would happen by reopening businesses and allowing the virus to spread among young and healthy people, while keeping the elderly or vulnerable at home.


Scott Atlas, senior researcher at the Hoover Institution, speaks with President Trump during a COVID-19 briefing on August 12, 2020.

Jabin Botsford / The Washington Post via Getty Images

“This is simply not true,” Marc Lipsitch, an epidemiologist at Harvard TH Chan School of Public Health, said on Twitter Monday. “Collective immunity is neither a strategy nor a solution. It is submission to a preventable virus. ”

Indeed, experts say without a vaccine, the only means of herd immunity is massive death and disease crippling the economy – far beyond what the United States has already endured. Moreover, Sweden has already shown the world that this anti-strategy does not work.

Sweden’s deadly experiment did not save its economy

Coronavirus from Sweden

People chat and drink in Stockholm, Sweden, April 8, 2020.

Photo AP / Andres Kudacki

Shortly after The Post released its report on Monday, Atlas released a statement denying any push for a collective immunity strategy.

“There is no policy of the President or this administration aimed at obtaining herd immunity,” he said. “There has never been such a policy recommended to the President or anyone from me. ”

However, collective immunity has already been put in place at the White House, according to a previous Post report: President Trump suggested it during a situation room meeting on March 14.

“Why don’t we let this take over the country? Trump reportedly asked Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

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Anthony Fauci listens to President Trump speak to reporters at the White House on April 7, 2020.

Puce Somodevilla / Getty

According to the Post report, Fauci initially did not understand what Trump meant by “washing.” But when he realized, he became alarmed.

“Mr. President,” Fauci replied, according to the Post, “a lot of people would die”.

Yet in some ways Sweden has taken the approach Trump was asking for: unlike most countries in the world, the country has never locked down. Shops, bars and restaurants remained open. The students went to school. And Sweden ended up with many more deaths than neighboring countries that have closed their doors: its per capita deaths are more than five times higher than Denmark’s, almost 10 times higher than Finland’s and 11 times higher. higher than those of Norway.

The strategy does not appear to have helped the Swedish economy either: the country suffered a larger drop in GDP than its neighbors.

The United States is far from immune to herds

So far, more than 6 million people in the United States have tested positive for COVID-19. That’s a huge number, but not enough to come close to collective immunity.

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Michael Neel, funeral director for All Veterans Funeral and Cremation, wears full PPE as he gazes at the American flag on the casket of George Trefren, a 90-year-old Korean War veteran who died of coronavirus at a home in retreat in Denver, Colorado, April 23, 2020.

Rick Wilking / Reuters

“There are still over 90% of Americans who are still prone to catch this virus,” the adm told reporters on Wednesday. Brett Giroir, a pediatrician overseeing coronavirus testing efforts in the United States. “Now it’s different in parts of New York and parts of New Jersey and Detroit. But overall, the virus is in a target-rich environment.

Already, more than 183,000 people have died in the United States.

It is not known exactly how many more people would need to be infected to gain protection through herd immunity. Epidemiologists calculate this number based on a metric called R0 (pronounced R-nothing) – the number of people to whom an average infected person transmits a pathogen. For the coronavirus, it’s about 2 to 2.5.

This means that around 50 to 70% of the population should be immunized to stop the spread of the virus. In the United States, that’s about 165 to 230 million people. With the death rate from COVID-19 estimated to be around 1%, that means herd immunity could cost the United States up to 2.3 million lives.

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Gravediggers lower the coffin of a person who is believed to have died of COVID-19, as mourners wearing face masks gather in the special section of a cemetery on the outskirts of St. Petersburg, Russia, on May 13, 2020.

Anton Vaganov / Reuters

Still, some research has suggested that the herd immunity threshold could be as low as 20% of the population, since some groups of people have more people-to-people contact than others. If only these groups achieved herd immunity, it could significantly reduce the possibilities of the virus spreading. But even in this optimistic scenario, around 600,000 people would still die.

Young people are not isolated and are not immune to serious illness

The Swedish approach to partial herd immunity, which would be favorable to Atlas, is to keep vulnerable people at home while allowing the virus to spread among young and healthy people, who face a risk. less death.

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A young woman gestures as a crowd of young people wait to hear President Trump deliver an “address to young Americans” at Dream City Church in Phoenix, Ariz. On June 23, 2020.

REUTERS / Carlos Barria

But even that would result in mass death at the best of times. If 20% of people under 65 in the United States contracted the coronavirus at a death rate of 0.5% (which is lower than the current case fatality rate of 0.8% in the United States for this group) , about 275,000 of them would die.

This optimistic scenario – if you can call it that – is unlikely, as young, healthy people always interact with vulnerable people: family members, teachers, co-workers, neighbors at the grocery store.

“Even though we may have a mild case, we must always remember that there may be another person – who could be young or old – who could have a serious condition and could even die,” Tedros Adhanom Ghebreyesus, Managing Director from the World Health Organization, said in a briefing Monday. “Accepting that someone is dying because of their age is moral bankruptcy at its peak, and we shouldn’t allow our society to behave that way. We have to take care of each other.

Moreover, even if the government could prevent the virus from infiltrating high-risk populations and fewer young people die than expected, herd immunity would still be expensive. Some young people end up with debilitating symptoms of long-term coronavirus: fatigue, difficulty breathing and kidney damage to name a few.

And many young people fall sick enough to be hospitalized; if massive waves of infection become large enough to overwhelm hospitals, it leads to preventable deaths.

“Humans are not herds,” said Mike Ryan, WHO’s executive director of health emergencies, in May. “I think we have to be very careful when we use terms in this way around natural infections in humans, because it can lead to very blunt arithmetic that doesn’t put people, life and suffering at the center of. this equation.

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