It's UnHerd Of...

Well... it seems Nobel prize-winning biologist Professor Michael Levitt agrees that strict lock-downs are not the way to go - they do not allow herd immunity to be developed. Countries that have adopted strict lock-downs, such as Australia and Austria, have had a lot of social disruption without much benefit in terms of immunity. The main issue is - how are the future waves of infection (and, yes, there will be future waves) going to be handled?

And now the new waves of infection are starting again. In Germany, infections are rising again after restrictions have been eased. China has had a new outbreak. As we alluded to in this blog, there will have to be a re-imposition of social distancing measures and lock-downs. There will be a feeling of déja-vu. But it will be harder the second time around. People will say 'but we endured a lock-down the first time with the promise that the virus would be stopped in its tracks... we've been good... why hasn't the virus been stopped? why are we being punished again?'.

These are very good questions. What answers will the politicians and (mainstream) epidemiologists give? Whatever their response, it will not be satisfactory. They have known that in the absence of herd immunity and/or an effective vaccine, each new major outbreak will be (almost) like the first time all over again. And this is just the second wave. What about the third, fourth and fifth waves?

Herd immunity will of course be developed, due to new waves of infection, but at a slower rate than if social distancing measures had not been too strict. But it will take several rounds of lock-downs. The big questions are - how will economies weather these challenges? And how long will it take them to recover?

It remains to be seen.

The Spock Principle

In the Star Trek movie The Wrath of Khan, Mr Spock sacrifices himself to save the ship. When asked by Captain Kirk why he did it, Spock answers "The needs of the many outweigh (the needs of the few), or the one". (The middle part is actually spoken by Kirk.) This selfless act allowed the majority to survive at the expense of the few (or the one, in this case).

Which brings us to the current COVID-19 pandemic...

Different countries have chosen different methods of dealing with the virus. Some countries - Sweden being the foremost example - have opted to go for herd immunity. This is where enough of the population is infected and most recover, presumably developing a natural resistance to the virus. Yes there will be a significant number of deaths, particularly among the elderly and people with weak immune systems. Sweden's modelling assumes that for every confirmed case of COVID-19, there are at least 75 undetected cases. When new infection hotspots arise, the virus doesn't have the opportunity to travel too far, because most people have developed the resistance - essentially stopping the virus spreading. Yes, some people will still get the virus, but its spread will be contained.

Other countries such as Australia, which caught the virus early, have opted for early stringent social distancing and lock-downs. This has had the effect of containing the spread of the virus. By keeping the transmission rate at less than 1, the virus will eventually die off. The transmission rate is - on average - how many people a person with the virus infects. If an infected person infects - on average - less than one other person, then the infection hotspot will die out because the propagation of the virus will quickly diminish.

Countries which have been hard-hit with the virus, I suspect, are somewhere in between. They are countries such as Italy, Spain, the UK, Russia, the USA, etc. They have enacted social distancing measures, but have a large number of infections. I also suspect that their undetected infection rate is similar to Sweden's. So they've probably developed a degree of herd immunity, and future outbreaks will be less severe.

Countries like Australia, I believe, have been too effective with their social distancing measures. Why too effective? Because there has been essentially no herd immunity developed. By shutting down the country for a few months, the virus has been contained. But what happens when life goes back to "normal" and borders are re-opened? There will be more infections. And because there is little herd immunity (let's call it community immunity), the consequences of these outbreaks could be just as severe as the first one. To contains the virus (again), authorities will have to shut down the country (again). There will not be the required community immunity to buffer the spread of the infection. Australian authorities are already talking about a second and third wave of the virus. If the same lock-down measures are enforced for each wave, I put it to you the economy will be destroyed! And what if there are fourth, fifth, and sixth waves of infection??

You see, while allowing a country to develop community immunity, there will necessarily be a higher death rate initially. But enough people will develop resistance to the virus to make future outbreaks far less severe. The transmission rate will be kept less than 1 naturally, because most people will not get sick even if exposed to the virus. But countries that have adopted Australia's model are in a far more precarious situation because the only way they can keep the transmission rate below 1 is to socially isolate the population every time there is an outbreak. This is not a sustainable solution.

We have to invoke the Spock Principle here... the good of the many outweighs the good of the few... short term pain for long term gain. Yes there will be a higher death rate initially, but the population as a whole will benefit, until a vaccine is developed. In the meantime, we can protect the old and vulnerable, for example by having additional restrictions on retirement homes. This will obviously not be popular, but it is one way we can sort of have our cake and eat it too.