"Herd immunity" means sacrificing some of the most vulnerable in society
Is “herd immunity” the only way to overcome Covid-19? A group of scientists that wrote an open letter last week certainly think so. In the letter they stated that, “those who are at minimal risk of death live their lives normally to build up immunity through natural infection”.
The so-called Great Barrington Declaration said this “compassionate approach” offers “focused protection” for those at higher risk.
The authors also wrote that it was harder to protect large numbers of older people in the community, but suggested that individuals could shield themselves.
But retired GP and Doctors in Unite union member Dr Jonathan Fluxman said it amounts to “social apartheid”.
“It’s condemning vulnerable people to be shut away indefinitely from society,” he told Socialist Worker. “That’s a pretty dreadful thing to ask of people. It’s reprehensible.
“I’m 64. I want to be able to go out and ride my bike and go to the shops. I don’t want to be forced to stay indoors.”
Importantly, he added that the idea that you can prevent any infections by shielding vulnerable people is “rubbish”.
“You can’t seal away millions of people from their families and say there won’t be any infection,” he said. “Look at care homes. Those are places where we have tried to shield the most vulnerable, and there have been big outbreaks.
“It shows that you just can’t do it— it’s not feasible.”
Aside from the imprisoning of millions of older and vulnerable people, Jonathan questioned the usefulness of applying herd immunity to Covid-19.
“In theory herd immunity will ultimately work,” he said. “You do need a majority of the population to acquire some level of immunity to seriously interrupt transmission of a virus.
“But the concept of herd immunity has always been applied to vaccination programmes. It has never been applied to an outbreak of a highly infectious and deadly new disease which we know little about.”
Herd immunity is based on calculating how much of the population needs to be immune to prevent outbreaks of a disease.
During the coronavirus pandemic, scientists have often referred to the “R” number. This indicates how many people someone with the virus will infect.
The R number must be below one in order to prevent a rapid spread of disease. So with highly infectious diseases such as measles, a high level of immunity is needed in the general population. Children in Britain receive jabs to immunise them against the disease.
But Covid-19 is very different.
“We don’t know enough about the immune response,” Jonathan explained. “It looks like once infected you do have a decent level of immunity for a good while, but for how long we don’t know.
“Antibody levels are falling quite a lot after 6-8 months. There have now been cases reported of people being re-infected. It’s a small number, but that’s worrying.
“And given what we know about how many cases don’t show symptoms, we don’t know how many people have been re-infected.”
Those in favour of the herd immunity approach use the high number of asymptomatic cases to bolster their argument. A study from University College London last week suggested that an overwhelming majority of people who contract the virus don’t have symptoms.
It looked at over 36,000 people who tested positive between April and June. Some 86.1 percent didn’t report “core” symptoms of the virus when they took their test.
The argument goes that many people don’t really suffer from the virus— especially if they are younger—and won’t die. So it sounds like it would be relatively safe to let the virus spread among such people, to boost immunity levels as a whole.
But Jonathan said there are risks even for young and healthy people. “About 10 percent of people, maybe as high as 20 percent, suffer from ‘long Covid’,” he said. “They have persistent and debilitating symptoms such as fatigue, headache, brain fog, aches and pains.
“All major organs seem to be able to be infected by the virus. There are young professional athletes who have heart and lung damage, and are completely incapacitated. They can’t even walk to the front door.
“So although the death rates of, say, university students are very low, we don’t know what the long Covid rates are for young people.”
Britain is in the grip of a second wave of coronavirus and the Tories don’t want to take the blame. The flip side of minimising the impact of the pandemic is trying to blame ordinary people for the rise in cases.
The Tories subsidised us to tempt us to pubs and restaurants in the summer—and now say irresponsible socialising has driven up cases. They dithered about whether to promote mask‑wearing—then blamed people for not wearing them.
“If the government’s message had been consistent from the start, people would follow it,” said Jonathan. “If they had said, ‘Masks are important—everybody please wear one,’ then everybody would have accepted that.
“But there hasn’t been consensus on masks. We are told they work in certain circumstances but aren’t needed in schools and workplaces. It’s nonsense.
“If you have all these contradictory messages, then you have people who say, ‘Why should I do it. They don’t know what they’re talking about.’ And then you open the door to all these conspiracy theories.”
Instead of blaming ordinary people, Jonathan said the blame lies with the “disorganised, incoherent and illogical” Tory response.
“This is science and biology,” he said. “The virus doesn’t give a shit about what you think. If you walk onto the factory floor or into an office with the virus and there’s poor ventilation you’re going to infect workers around you.”
The Tories will float more illogical ideas allegedly to tackle the virus while continuing to resist taking measures that we really need.
Jonathan said their “ideological bullshit” is falling apart. But he said this won’t be enough to force a change in direction.
“You can’t trust this government,” he said. “They will not save us, they’re only interested in saving themselves and their friends.
“It’s up to us and communities to argue, campaign—and take measures up ourselves.”
Tories’ drive to return to ‘normal life’ puts profit first
Many ordinary people understandably do not want more lockdowns and restrictions, and the pressures they bring. At the same time, they don’t want to risk serious ill health or death.
But it isn’t true that our only options are letting the virus rip or lockdown. Jonathan pointed out that, in many countries, the virus has been more effectively contained.
“It’s interesting how a lot of the so-called developed world, particularly Italy, Spain, France, the US and Britain, has done really badly,” he said.
Jonathan said the politics and ideology behind government responses to the virus is a key factor in explaining the varying death rates.
“Some countries have taken the Donald Trump view that the virus is not a problem,” he said. “Trump says if you are strong and macho you can beat the virus—while the bodies pile up around him.
“In contrast, many Far Eastern countries always took the virus seriously. In Japan, everybody wore masks, and there are good test and trace and isolate and support systems.
“They were able to very quickly contact and isolate cases to prevent outbreaks spreading more widely in the population.”
Sometimes this has been helped by experience. Previous pandemic outbreaks in Japan mean there is more awareness of the importance of safety measures such as wearing masks. And test and trace systems have already been developed to contain viruses.
Jonathan said failures to contain coronavirus can’t be explained by lack of knowledge or even lack of money.
“Countries with lots of resources and those with very few have all relied on tried and tested epidemiological methods of controlling infectious diseases,” he said.
“It was never a question of, ‘This is a new pandemic and we don’t know what to do.’ It is very clear what works.”
In Britain however, the Tories refuse to entertain the idea that a solution not based on private companies is possible.
“The problem with test and trace in this country is it’s privatised, centralised and opaque,” said Jonathan. “The government is giving contracts to people who know nothing about public health let alone the technicalities of testing and data management.
“It’s ‘public health 101’ in the containment of infectious diseases that you need community-based services. You need this for contact tracing and to support people who have to isolate.”
Part of the reason why some countries have managed to keep the virus levels relatively low is because of this focus on community-based solutions. Jonathan said, “This approach works—and is low-cost.
“In Britain we had three quarters of a million people volunteer to help early on in the pandemic. Where are those people? Has the government used them? No.”
Jonathan said that a system could be set up “in a matter of two or three weeks” that would function “ten times as well” as the current set-up. The block is Tory ideology.
“The government is ideologically committed to neoliberalism and centralised control,” Jonathan said.
“They hate local government. They’ve strangled local services and local authorities are in a dreadful state in trying to deliver services let alone deal with a pandemic.
“Boris Johnson has spoken about how important private enterprise is in getting us out of this pandemic. All that private enterprise has done is dig us deeper into the hole.”
Now instead of keeping people safe, the government is prioritising trying to keep as much of “normal life” going as possible to preserve profits.
“Workplaces are the big areas where infection is spreading,” said Jonathan. “Public Health England’s latest report shows the number one area for outbreaks is educational establishments—workplaces for many people.
“All other workplaces are second. But for the government, work and school are sacrosanct. They must not be disturbed, no matter how much transmission there is.”
Jonathan Fluxman is a retired GP and a member of Doctors in Unite. He is also working with the Covid Clinical Assessment Service