Is COVID strategy moving towards herd-immunity?!

[Veri]

Belgium is an interesting outlier. In terms of cases/deaths per million pop they are doing very bad. Might just be "world champions".

I haven't heard mentions of an official herd-strategy but according to my contacts there, the quarantine was quite 'flexible'. Not much enforcement for masks, small bars still open, small concerts, etc. If my contacts are any indication, people had a very relaxed "don't care" attitude. All that would add up to a 'masked' form of herd-strategy.
Or maybe it's about different reporting rules like @Racheski mentioned.

Any belgians around here?

'masked' form of herd-strategy, hahah pun intended or? Anyway I'm from Belgium and honestly a lot of "our people" are going on holidays and have a pretty relaxed attitude. Sure, many folks I know take it very seriously but I'm afraid a big part of the population mostly thinks in a "I do me, you do you" kind of way. Once our numbers got better I think the easing of the measures was way too optimistic. But you can't keep people in lockdown either.. it's a slippery slope. I hope as summer advances our numbers go down again. Belgians should try and think more of the big picture, rather than their "summer holidays" right now, is that really the most important?
But anyway, it is a certainty our numbers are inflated because we do a lot of testing and count a lot of if not most deaths in elderly/retirement homes as corona victims. From the start our politicians wanted transparency rather than obscuration and now we've become the face of bad corona measures in international news but honestly, it is more complicated than that. Can't compare one country to another 1:1.

 

[mansr]

We had a relatively strict lockdown which was decently followed and at the beginning of July, we were having only a very low number of cases. That lead to an easing of the lockdown, and the current bounce, which seems to mostly hit a different target. I don't have the time to get into detailed numerical analysis, but current cases seem to be around 20 to 30 times **less** likely to end up in intensive care.

Here in the UK, lots of restrictions were lifted a month ago. Since then, new cases have gone up a bit while hospital admissions have continued to go down. That suggests to me that the increase in cases is mostly among people who are not getting very ill, meaning it's nothing to worry about.

 

[lashto]

'masked' form of herd-strategy, hahah pun intended or?

unless stated otherwise, everything I write is (well) intended

Can't compare one country to another 1:1.

can't compare two countries, can't compare two stats, can't ...
And now we have a EU-wide heat wave. Can't see a single mask on those beaches. Grrr...

 

[Vasr]

We had a relatively strict lockdown which was decently followed and at the beginning of July, we were having only a very low number of cases. That lead to an easing of the lockdown, and the current bounce, which seems to mostly hit a different target. I don't have the time to get into detailed numerical analysis, but current cases seem to be around 20 to 30 times **less** likely to end up in intensive care.
...
What we have to keep in mind is that we are dealing with a coronavirus that (except for mortality and morbidity) behaves very much like the common cold coronaviruses. That, btw, isn't very positive in terms of immunization and eradication... Governments definitely need to plan and be ready but a lot of the rest is mostly posturing, one way or another.

The most insidious aspect of Covid-19 is that it isn't fatal enough (like AIDS) to get all to be aware to practice mitigation and prophylactic measures, no questions asked (and without irresponsible activities) and it isn't benign enough that one can simply pretend "grin and bear it" will work.

People are confusing rising number of cases with rising herd immunity as in a post earlier. In AIDS epidemic, we had rising numbers with no immunity as an extreme case. This, unfortunately, is being used to justify more spreading.

What seems to be working right now is not herd immunity but herd segmentation - people with vulnerabilities die and stop spreading, people who get it symptomatically and survive become a lot more cautious about exposing themselves or exposing others lowering spread, people with risk factors self-quarantine or follow strict measures lowering spread.

The rest party on and keep the spread going until they fall into one of the three categories above.

 

[lashto]

The most insidious aspect of Covid-19 is that it isn't fatal enough (like AIDS) to get all to be aware to practice mitigation and prophylactic measures, no questions asked (and without irresponsible activities) and it isn't benign enough that one can simply pretend "grin and bear it" will work.

People are confusing rising number of cases with rising herd immunity as in a post earlier. In AIDS epidemic, we had rising numbers with no immunity as an extreme case. This, unfortunately, is being used to justify more spreading.

What seems to be working right now is not herd immunity but herd segmentation - people with vulnerabilities die and stop spreading, people who get it symptomatically and survive become a lot more cautious about exposing themselves or exposing others lowering spread, people with risk factors self-quarantine or follow strict measures lowering spread.

The rest party on and keep the spread going until they fall into one of the three categories above.

I'd say you have a winner with "herd segmentation"

 

[maty]

Is COVID strategy moving towards herd-immunity?!

Maybe in Georgia (US) YES.

https://twitter.com/i/web/status/1290656843031879682

 

[EdW]

Here in the UK, lots of restrictions were lifted a month ago. Since then, new cases have gone up a bit while hospital admissions have continued to go down. That suggests to me that the increase in cases is mostly among people who are not getting very ill, meaning it's nothing to worry about.

I hope you’re right. We had a rough start in the UK with a very high mortality rate partly due to bumbling bureaucracy (polite version) and partly down to bad luck. But there is some light at the end of the tunnel:
Minimising the death toll:
1. The repurposing of hexamethasone to reduce lung inflammation damage
2. The large scale use trials (at 172 UK hospitals for some months) of blood plasma from previously infected patients
3. Interferon beta via an inhaler (synairgen)
Numerous vaccines
1. Front runners: Oxford/Astra Zeneca and Johnson&Johnson
2. Well on the way: BioNTech/Pfizer and Imperial College self amplifying RNA vaccine
3. Others: Valneva
to name just a few. With a little luck, one or some of them will work and will be safe for mass scale deployment. We know of course that Russia is developing a vaccine (Mr Putin’s own work?) but I reckon it will contain a lot of ‘borrowed’ western IP
So maybe things aren’t so bad if we remain careful in the coming few months.

 

[Racheski]

Is COVID strategy moving towards herd-immunity?!

Maybe in George (US) YES.

https://twitter.com/i/web/status/1290656843031879682

View attachment 76754

Not everywhere though...some mayors actually listen to their public health officials. All Chicago Public Schools will be online until further notice.
https://www.nytimes.com/2020/08/05/world/coronavirus-covid-19.html?action=click&module=Top Stories&pgtype=Homepage#link-5cf31fb9

 

[Putter]

Here in the UK, lots of restrictions were lifted a month ago. Since then, new cases have gone up a bit while hospital admissions have continued to go down. That suggests to me that the increase in cases is mostly among people who are not getting very ill, meaning it's nothing to worry about.

While you guys in England have been more sensible than we in the U.S., I'm a little skeptical because it feels like deja vu from here. We had an initial drop after lockdown and reopening. Cases may be going down because younger people like those in the Georgia school are getting it and haven't transmitted it yet to older adults who will have severe symptoms.

Unlike us, you have the advantage of universal healthcare with a hospital system that isn't fragmented and almost scattershot and has a policy of 80% salary for sick leave due to corona virus which aids in the isolation. Here many people working in 'essential' jobs have no sick leave and can't afford to take off work. This may sound political, but AFAICT are the facts on the ground.

 

[mansr]

I hope you’re right. We had a rough start in the UK with a very high mortality rate partly due to bumbling bureaucracy (polite version) and partly down to bad luck.

It was bad in April and May. Now the death rate is declining.

 

[onion]

Herd immunity is happening. And it's happening at around 20-30% infection rate. Look at the developing countries that were unable to 'afford' lockdown measures or abandoned them when the costs became too great - Central African Republic, Afghanistan, Pakistan, French Guyana, Mauritania, Egypt, Haiti, Armenia etc. They all follow the typical Gompertz curve with a constant growth upslope, linearly decreasing growth-rate downslope and persistent decline thereafter. This is absolutely typical for respiratory virus epidemics and is nothing special.

A serosurvey from Afghanistan suggests 31.5% antibody positive. Other than a sample survey in the slums of Mumbai (that yielded a prevalence of 58%), this is what we are seeing across the planet. For countries where the epidemic rages, the antibody-positive population hits 20-30% approximately and is associated with a steep decline to practically zero. This is herd immunity.

The T-cell mediated immunity is a plausible mechanism for why antibody-positive prevalence is so low in countries where the epidemic has passed. In my opinion, it's also plausible that the virus may mutate to a form that could infect previously T-cell-immune patients resulting in a 'second wave'. There's not a lot we can do to control that.

The other thing is that the virus undoubtedly is less lethal and pathogenic than it was in March and April. The picture below illustrates the difference between Florida and New York State. A decline in morbidity and mortality should prompt Governments to adjust their policy response as the risk:reward ratio for draconian interventions like lockdown have changed.

 

[A Surfer]

Interesting. Yes, I have been saying all along that herd immunity clearly is developing, and as indicated it will take time. The sad thing is that everybody seems to be counting on a vaccine when in reality vaccinations have highly variable efficacy rates. Not to mention that if the virus mutates significantly it will render vaccines ineffective. Seems like putting our eggs all in one basket. No matter how you slice the cake, we are going to have to become more risk tolerant or suffer the catastrophic consequences of destroying the globally enmeshed economic order that basically supports life as we know it. And that is true for societies that are not as deeply entwinned in global capitalism as many still benefit indirectly.

 

[lashto]

the official numbers from Sweden, hope the link works. On the right side you have Daily-NewCases on top, Daily-NewIntensiveCare middle and Daily-Deaths bottom. It does not look bad at all considering that they had ~zero quarantine.


@onion those are some interesting numbers. Looks like the poor countries which can't afford to do anything else might make it a herd-strategy for everyone. When >75% of the world's population does herd-strategy (as in no-money-'strategy'), it'll be very hard to isolate and do something different anywhere.

And a somewhat related article which makes the point that there will not be waves of infection but a single "forest fire". Also links to a study which says that it's not going to be seasonal either (at least not this year.)

 

[A Surfer]

Indeed, this virus is out there and never going to be eliminated. It will likely moderate in terms of effect over the years, but it will remain a threat much like serious illness as a result of flu. We somehow found a way to live with the real and present threat of flu so I absolutely believe that over time we will be able to do so with Covid utilizing various tools and sociological controls.

 

[mansr]

Indeed, this virus is out there and never going to be eliminated.

What makes you say that? Some viruses (e.g. the Spanish Flu) show up, cause a bit of trouble, then vanish again. Others (e.g. the swine flu of 2009) stay around for a long time. Both of those examples are an influenza A(H1N1) virus. I don't know what factors decide the long-term outcome, much less how they apply to covid-19. Do you?

 

[Vasr]

Looks like the poor countries which can't afford to do anything else might make it a herd-strategy for everyone. When >75% of the world's population does herd-strategy (as in no-money-'strategy'), it'll be very hard to isolate and do something different anywhere.

What is really happening is that some of these poorer countries have become petri-dishes for herd immunity experiments (for lack of choice) and they are managing it by manipulating statistics just so there isn't massive social unrest. That well-quoted Bombay slum measurement does not mention that they have stopped reporting death numbers since July.

And this is not even considering the secondary but not necessarily fatal effects of the virus on survivors of which very little is known other than anecdotal reports.

Other than a heavy dose of fatalism or a vested need to push herd-immunity as a solution, I don't see a justifiable case for herd-immunity as a solution.. yet.

Most of the cherry-picked statistics quoted in this thread can also be attributed to growing awareness and self-discipline and self-quarantining not necessarily the level of lockdown. So you have to separate those variables before one can come to a conclusion.

Here is the bottom-line: Higher the level of self-discipline and self-moderated prophylactic measures, less of a mandated lock-down you need. In that equation, the richer, self-indulgent nations fare very badly.

 

[onion]

The fear-mongering I hear is that the case fatality rate for Covid-19 is 1%. Pakistan has a population of 212m. It has recorded 5865 deaths so far. How many deaths has it truly had? It certainly cannot be 2m dead as there would have been visual evidence that would play on our news 24/7. I could imagine that they have undercounted deaths by up to a factor of 10. This would still leave Pakistan with a vastly better survival rate than the UK.

Other than a heavy dose of fatalism or a vested need to push herd-immunity as a solution, I don't see a justifiable case for herd-immunity as a solution.. yet.

For western countries, this completely underestimates the costs of lockdown and social distancing. In the UK for example, there have been around 15000 excess deaths with Covid-19 not on the death certificate. Of the 47k Covid-19 deaths, some died with Covid-19 rather than due to it. The deaths from cancer will be a national disaster for the next two years to come. A large minority of the population are scared to leave the house. The effects of home confinement on physical health and mental well-being are only just beginning to play out. And this is before the economic impacts are truly felt. Most about-to-be-made-redundant furloughed workers are unaware of the certain joblessness they will face.

For children, they have missed so much schooling and social interaction. Their social interactions are now governed by fear of the virus. They are not seeing people's faces due to masks. Again I am certain this is storing up tremendous psychological harms for the future.

If the virus is less deadly now, absolutely none of these immense harms are justified. Just because you don't see something doesn't mean it isn't there.

 

[Wes]

Herd immunity is happening. And it's happening at around 20-30% infection rate. Look at the developing countries that were unable to 'afford' lockdown measures or abandoned them when the costs became too great - Central African Republic, Afghanistan, Pakistan, French Guyana, Mauritania, Egypt, Haiti, Armenia etc. They all follow the typical Gompertz curve with a constant growth upslope, linearly decreasing growth-rate downslope and persistent decline thereafter. This is absolutely typical for respiratory virus epidemics and is nothing special.

A serosurvey from Afghanistan suggests 31.5% antibody positive. Other than a sample survey in the slums of Mumbai (that yielded a prevalence of 58%), this is what we are seeing across the planet. For countries where the epidemic rages, the antibody-positive population hits 20-30% approximately and is associated with a steep decline to practically zero. This is herd immunity.

The T-cell mediated immunity is a plausible mechanism for why antibody-positive prevalence is so low in countries where the epidemic has passed. In my opinion, it's also plausible that the virus may mutate to a form that could infect previously T-cell-immune patients resulting in a 'second wave'. There's not a lot we can do to control that.

The other thing is that the virus undoubtedly is less lethal and pathogenic than it was in March and April. The picture below illustrates the difference between Florida and New York State. A decline in morbidity and mortality should prompt Governments to adjust their policy response as the risk:reward ratio for draconian interventions like lockdown have changed.

View attachment 76843

Nothing you cite supports the claim that Herd immunity is happening.

Don't conflate sero-positivity with herd immunity.

 

[onion]

Please explain an alternative mechanism for how countries that 'let the epidemic rip' end up with a Gompertz curve, other than herd immunity.

Countries are hitting a wall after 30% seroprevalence (or less in some cases). This low % after the epidemic has passes after the epidemic passes. That strongly suggests that herd immunity is associated with a seroprevalence of 20-30%. Countries should significantly loosen their controls if they have hit this threshold; if their new cases are minuscule; and if their hospital admission rates, ICU rates and deaths are not climbing.

 

[Vasr]

Don't conflate sero-positivity with herd immunity.

Pretty typical (il)logic of the "let us go herding" arguments.

The other is that the number of deaths (for which there is considerable evidence of being significant) and anything that brings it up is fear-mongering because it is low enough to expose everybody to prevent immense and disastrous deaths and mayhem (for which there is nothing more than anecdotal evidence) from a lock-down (which ironically is only needed if people aren't going to be self-disciplined).