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Herd immunity is back. This article quotes its proponents, and then yours truly and @gregggonsalves on why in the absence of a clear way to protect the vulnerable from a raging storm of infection among the less vulnerable, it is a very dangerous idea 1/n https://thehill.com/policy/healthcare/519727-trump-health-official-meets-with-doctors-pushing-herd-immunity
Want to note that this latest suggestion has a new tweak. While herd immunity is the point at which the infection starts to infect fewer people because there just aren't many left that aren't immune, the proposal here is to get to endemic transmission. What's the difference? 2/n
Endemic transmission means the virus is always there, transmitting at a prevalence determined by the 'resupply of susceptibles' (either generated by waning immunity or new potential hosts being born) 3/n
True, the more innocuous betacoronaviruses are in the endemic category. However older people have extensive immunity to those other viruses, built up over many infections over their lifetime. That is not the case here and will not be if endemic transmission is the result 4/n
Instead, older or more vulnerable populations will remain at risk. Nursing homes will be exposed to outbreaks that will happen with a rate depending on what that eventual endemic prevalence turns out to be. What it is, we don't know. Are you not comforted yet? 5/n
But surely vulnerable populations can be protected? Well I cannot imagine anyone being confident that frequent testing will avoid introduction of the virus into a protected population *right now* 6/n https://www.nytimes.com/interactive/2020/10/02/us/politics/trump-contact-tracing-covid.html
Talking about this proposal stops us having sensible conversations about eg schools, or the value of PPE and testing in the community. There are ways to mitigate the pandemic that are *not* based on uncontrolled outbreaks or endless shutdowns. We should talk about them 7/n
But instead I am explaining, again, that even if the risks of infection are low for one person, they aren't necessarily so for the person they infect, or the person they infect or... you get the picture. We should be past this. We're not 8/end
