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"Only Realistic Option" Says Foreign Affairs

Herd Immunity Is the Only Realistic Option.. The Question Is How to Get There Safely  say Foreign Affairs authors Nils Karlson, Charlotta Stern, and Daniel B. Klein.

Their articles is entitled Sweden’s Coronavirus Strategy Will Soon Be the World’s

Swedish authorities have not officially declared a goal of reaching herd immunity, which most scientists believe is achieved when more than 60 percent of the population has had the virus. But augmenting immunity is no doubt part of the government’s broader strategy—or at least a likely consequence of keeping schools, restaurants, and most businesses open. Anders Tegnell, the chief epidemiologist at Sweden’s Public Health Agency, has projected that the city of Stockholm could reach herd immunity as early as this month. 

In the United States, which has by far the highest absolute number of reported COVID-19 deaths, several states are easing restrictions at the urging of President Donald Trump, who despite bashing the Swedish model, is pushing the country toward something very similar.

Lockdowns are simply not sustainable for the amount of time that it will likely take to develop a vaccine. Letting up will reduce economic, social, and political pressures. It may also allow populations to build an immunity that will end up being the least bad way of fighting COVID-19 in the long run. 

Sweden is a special country characterized by high levels of trust—not just between people but between people and government institutions. Swedes were primed to take voluntary recommendations seriously in a way that citizens of other nations may not be.

Uniquely Sweden

“The Swedish experience cannot be extrapolated to support a swift reopening elsewhere,” Goldman Sachs said in a note. “Its population density is about half that of Italy, and Sweden has a high proportion of single-occupancy households, and a relatively low proportion of multi-generational households.”

Open Questions

Discover asks Is Herd Immunity Our Best Weapon Against COVID-19?

One of the big open questions right now is whether recovered coronavirus patients are immune from contracting the disease a second time. “We don’t know yet if having the virus protects you from getting it again,” says Jared Baeten, a professor of medicine and global health at the University of Washington. The World Health Organization has emphasized that we do not know if people who recover from COVID-19 are capable of getting sick again with the virus. “Individual immunity is not yet proven, much less herd immunity,” Baeten says.

When a vaccine does become available, we will only be able to achieve herd immunity if the vast majority of people get vaccinated, Baeten says. Dudley agrees: “The vaccine is our best hope to improve herd immunity [and boost] the number of people that can resist the infection when they’re exposed,” she says.

Sweden Revises Covid Strategy After Deaths of Elderly Spiral

Sweden’s death rate is about 32 per 100,000, compared with 24 in the U.S. and roughly 9 in neighboring Denmark., but most of Sweden's deaths are in nursing homes.

Bloomberg reports Sweden Revises Covid Strategy After Deaths of Elderly Spiral

Sweden will adjust a key corner of its strategy for dealing with Covid-19, after the death rate at care homes spiraled out of control.

Earlier this month, Sweden said prosecutors had started an investigation into the high death rate at a care home. Half of those over 70 years old who have died from Covid-19 in Sweden lived in nursing homes, according to national statistics at the end of April. As of Monday, the country had registered 3,256 Covid-19 related deaths.

Denmark is now in the second phase of reopening its economy. What’s more, recent data even suggest its infection rate is falling, and its death rate so far is less than a third Sweden’s.

Economically Speaking

Sweden kept more of its economy open but Sweden unlikely to feel economic benefit of no-lockdown approach says the Financial Times.

The European Commission forecasts that Sweden’s GDP will fall by 6.1 per cent this year.

The Riksbank, the country’s central bank, has an even gloomier outlook, estimating that GDP will contract by 7-10 per cent, with unemployment peaking at between 9 and 10.4 per cent. These are disastrous figures for the Scandinavian country.

“It is too early to say that we would do better than others. In the end, we think Sweden will end up more or less the same,” said Christina Nyman, a former deputy head of monetary policy at the Riksbank who is now chief economist at lender Handelsbanken.

Supply Chain

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Sweden is dependent on the rest of Europe for parts, and global supply chains are in disarray.

And while Sweden did not officially close, store traffic is way down. In addition, Sweden has few multi-generation homes and less population density than neighboring countries. 

Debate Still Rages

All things considered, Sweden did not do as brilliantly as widely acclaimed. 

Yet, the debate still rages.

Dangerous Misconceptions

Johns Hopkins calls Early Herd Immunity against COVID-19 A Dangerous Misconception

We have listened with concern to voices erroneously suggesting that herd immunity may “soon slow the spread”1 of COVID-19. For example, Rush Limbaugh recently claimed that “herd immunity has occurred in California.” As infectious disease epidemiologists, we wish to state clearly that herd immunity against COVID-19 will not be achieved at a population level in 2020, barring a public health catastrophe.

Although more than 2.5 million confirmed cases of COVID-19 have been reported worldwide, studies suggest that (as of early April 2020) no more than 2-4% of any country’s population has been infected with SARS-CoV-2 (the coronavirus that causes COVID-19). Even in hotspots like New York City that have been hit hardest by the pandemic, initial studies suggest that perhaps 15-21% of people have been exposed so far. In getting to that level of exposure, more than 17,500 of the 8.4 million people in New York City (about 1 in every 500 New Yorkers) have died, with the overall death rate in the city suggesting deaths may be undercounted and mortality may be even higher.

Some have entertained the idea of “controlled voluntary infection,” akin to the “chickenpox parties” of the 1980s. However, COVID-19 is 100 times more lethal than the chickenpox. Someone who goes to a “coronavirus party” to get infected would not only be substantially increasing their own chance of dying in the next month, they would also be putting their families and friends at risk.

To reach herd immunity for COVID-19, likely 70% or more of the population would need to be immune. Without a vaccine, over 200 million Americans would have to get infected before we reach this threshold. Put another way, even if the current pace of the COVID-19 pandemic continues in the United States – with over 25,000 confirmed cases a day – it will be well into 2021 before we reach herd immunity. If current daily death rates continue, over half a million Americans would be dead from COVID-19 by that time.

Things That Are Clear

  1. Social distancing works. This is debated but there is no debate. Without human interaction, the virus would not spread.
  2. Anyone who gets their Covid-19 advice from Rush Limbaugh is truly a sorry case. 

Legitimate Debate

  1. There is a legitimate debate about what it will take to reach herd immunity, assuming it works as believed.
  2. Meanwhile, there is an ongoing debate about the economic costs of the shutdown, how fast there may a vaccine, what measures are "reasonable", etc.

Unfortunately, the spread of truly ridiculous ideas drowns out the legitimate debate over what needs to happen and how fast.

I do not know, but nor do the experts.

Closing Permanently

It's easy for the scientists who have a job to make recommendations about how fast things should proceed, but what do we do with the millions of small businesses owners who are wiped out.

For discussion, please see Closing Permanently "Thank You From the Bottom of Our Hearts"