The Real Issues Concerning COVID-19—Part II

The goal of this series of posts is to explore ways to strike a workable balance between the dueling concerns about health and the economy that are raging. We must deal with the Gordian Knot that while businesses need to reopen, reopening businesses is futile if customers are unwilling to engage with the businesses. Let’s lay the groundwork for that discussion by noting how we got to where we are and then sorting out where we are.

To scare people enough to get them to follow NPI suggestions and orders, the government officials, with the aid of experts and the mainstream media, launched a massive and biased publicity campaign using the scariest numbers to which credible academics would affix their names. More honest and realistic messaging, however, likely would not have worked as well in getting people to follow recommendations and orders. Governments must work with the overly fearful[i] and innumerate[1] citizenry they have, not the citizenry they wish they had.

Consequently, a good case can be made that the deceptive and hyperbolic fear campaign was warranted. Bereft of reliable data concerning the virus (other than it was deadly and coming), full of uncertainty as to how Americans would adhere to NPI orders or recommendations, and confronted with the possibility of inestimable horrors, doing nothing would have been untenable in America’s fearful and disunited society. The campaign met its objective of preventing hospitals from being overwhelmed—even in the hardest-hit New York City. Achieving that objective likely saved many lives and kept doctors from having to decide who lives and who dies, as was the case in Italy. (The NPIs have and will continue to cause deaths as well, but whether the lives taken by the NPIs will exceed the lives saved by the NPIs is academic at this point.)

The stated objective of the NPIs was to “flatten the curve” (slow the pace of infections) so (1) hospitals would not be overwhelmed, (2) the number of people infected during the winter would be reduced (in hopes that warmer summer weather would suppress the virus while scientists gathered and analyzed data to device more informed strategies to deal with the virus when as it spreads across the population). Note, however, that flattening the curve had mostly to do with when the maximum number of people would get infected, not if.  It was and is assumed that the virus will continue to spread across the population until enough people are infected to achieve herd immunity. Although one should acknowledge that NPIs might cause there to be fewer deaths if treatments and devices are found to lessen the severity of illnesses and/or reduce its mortality. While the need to get started on vaccines was a topic of conversation, virtually, no one expressed confidence that a vaccine would be invented, tested, approved, and administered within a year, and experts knew that a vaccine might not happen.[ii]

As discussed in Part I, sheltering in place waiting on a vaccine to save the day wasn’t, isn’t, and won’t be a sound strategy. On the contrary, among other things, doing so would cause many illnesses, financial ruin, spousal and child abuse, and deaths. A very relevant example is that people who shield themselves from viruses and bacteria are weakening their immune systems, i.e., making themselves more vulnerable to illnesses[iii] and not doing their part to achieve herd immunity for many diseases, including the possible winter wave of COVID-19.[2]

Looking at vaccines in the context of “herd immunity” is essential. Is herd immunity a big deal? Yes:

“With all respiratory diseases, the only thing that stops the disease is herd immunity. About 80% of the people need to have had contact with the virus…”[iv]

According to theory, vaccines are a relatively low-risk way to help achieve herd immunity. However, in terms of the health and wealth of a population, the sooner the herd immunity exists, the better. Given that, if there are other low-risk ways to reach herd immunity, waiting for anything, including a vaccine, is a bad idea. That would be true even if there were no high costs inflicted by imposing NPI on people who, with very little risk, could help gain herd immunity sooner, be more productive, enjoy camaraderie, and have more fun. As discussed above, however, being isolated in a relatively sterile lonely house, however, does inflict high costs.

While herd immunity is the best weapon available to defeat COVID-19,[v] consider these important facts about herd immunity:

  • For the pandemic to be put to rest, from 50%[vi] to 80% of the population will need to have been infected,
  • The sooner a herd immunity level of infections is achieved, the sooner it will be reasonably safe for vulnerable people to get back out into the world and enjoying their lives,[2] and
  • By staying at home, people who have a tiny chance[vii] of having severe effects from a COVID-19 are unnecessarily delaying the process of both getting on with their lives, getting the economy back on track, and getting the pandemic behind us—provided the exceptionally vulnerable continue to follow NPI practices until it is reasonably safe to do so.

Given that the goal is to achieve herd immunity, the longer most people stay at home, the more slowly the country will reach “herd immunity,” which, save a miracle, is the ultimate goal of all efforts to deal with the pandemic. It stands to reason that the likelihood of being infected decreases as the percentage of infections increases, i.e., the benefits from more people being infected begin before herd immunity is reached.

So how do we cause young healthy people comfortable enough to engage in commerce? We’ll begin sorting that out in Part III of this series.

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[1] If one does not understand the concept of odds or is not proficient in its application, one can have no clue what to make of risks. Stupidly avoiding small risks and stupidly taking large risks are both counterproductive and dumb. Suffering from innumeracy results in dangerous mistakes and causes people to favor foolish government policies.

[2] People who are exceptionally venerable COVID-19 should not be expected to expose themselves to exceptionally dangerous risks, including exposure to the herd.


[i] “Safety has become a cultural obsession to the point that many institutions and policymakers have adopted the ideal of a “harm-free” world as a realistic objective, a fantasy perhaps most strikingly expressed through intolerance toward risk and accidents” “The Paradox of Our Safety Addiction” and “”If we can save just one life!” is a terrible justification for change.”

[ii]Don’t bet on vaccine to protect us from Covid-19, says world health expert” and “Why a coronavirus vaccine may never be found.”

[iii]LIVE Local doctor from Accelerated Urgent Care gives his take on COVID 19 in Kern County” @17:50 and @33:55

[iv]Epidemiologist: Coronavirus could be ‘exterminated’ if lockdowns were lifted.”

[v]If the virus keeps spreading, eventually so many people will have been infected and (if they survive) become immune that the outbreak will fizzle out on its own as the germ finds it harder and harder to find a susceptible host. This phenomenon is known as herd immunity.” [This MIT article is sowing unwarranted fear about the state of affairs (i.e., following the establishment line), but provides a credible explanation of herd immunity.)

[vi]Reaching Herd Immunity Would Require Significant Deaths. Some Experts Think It’s Inevitable.”

[vii] “Preliminary evidence suggests that, particularly in young individuals, many, perhaps most do not develop enough antibodies to be detected, but nevertheless clear the virus with full recovery.”  “Perspectives on the Pandemic | Dr. John Ioannidis Update: 4.17.20 | Episode 4.” @33:39

2 thoughts on “The Real Issues Concerning COVID-19—Part II”

  1. Harvey, as always, your missive is thought provoking and interesting. The one argument that I would offer to lowering the curve of infection, even though most will possibly get the virus anyway, is the longer we can put off the sickness, the more time the medical community has to discover a therapy that minimizes the virus effects. If more people are on the back end of the curve and doctors find a therapy, be it blood plasma with antibodies or drugs that prevent it’s growth, many more people will not only live, but probably have a better quality of life due to less damage to their body. This doesn’t address the economy issues, but I think must be part of the equation.
    Thanks,
    Wright

    1. That is an excellent observation. That was what I was trying to get at when I said, “Although one should acknowledge that NPIs might cause there to be fewer deaths if treatments and devices are found to lessen the severity of illnesses and/or reduce its mortality.”

      It’s always to make things even clearer. Thank you.

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