The stupidity of herd immunity

And the futility of responsible government

In February we wondered whether the myth of herd immunity was being disproven, and while there is still hope that such an unraveling is occurring, it may not be happening fast enough.

However two political scandals underway in the UK and Brazil perhaps foreshadow a greater reckoning elsewhere in the world when it comes to holding the incompetent responsible for their irresponsible behaviour.

For example, when can we consider the pursuit of “herd immunity” to be equivalent to mass murder? Too extreme? Mass manslaughter perhaps?

Was herd immunity something that was even understood by the fools who promoted it as a path to overcoming the pandemic?

The result of their faulty logic (of which they were far from alone) has been catastrophic.

Pursuing herd immunity without a vaccine had never been used for any infectious disease in the past. The consequences of this strategy would be devastating.

Dominic Cummings’ testimony has confirmed how government decisions resulted in one of the highest death rates in the richer world and prolonged economic restrictions. In many ways, the testimony merely affirms what many public health experts suspected at the beginning of the pandemic. In those early days, many of us wanted to understand what the government’s assertion that it was “following the science” really meant. But there was no transparency. We couldn’t tell who was a member of the Scientific Advisory Group for Emergencies (Sage), nor exactly what the government was planning to do. Instead, we had to piece together a picture of what was happening in No 10 and within Sage from conversations with colleagues and journalists.

Cummings’ testimony has exposed how a vacuum of political leadership shaped England’s pandemic response. Relatively less wealthy countries such as Senegal, Greece and South Korea did astonishingly well at managing infections because of their leadership. In contrast, Cummings noted: “It’s completely crackers that someone like me should have been in there, just as the same as it’s crackers that Boris Johnson was in there.” The careful, considered leadership of the Scottish first minister, Nicola Sturgeon, who set up a Scottish Covid-19 advisory group in early April 2020, which operated transparently and published minutes, contrasts starkly with Johnson’s aversion to detail and hard work.

The most frustrating – and darkly predictable – aspect of Cummings’ testimony was his assertion that herd immunity was indeed England’s strategy from February into March, a combination of what the prime minister saw as the simplest solution, as well as the early advice from Sage that this was the only option on the table. Johnson was more concerned with the effects of Covid-19 on the economy and not overreacting, while a careful reading of Sage minutes shows that the group saw the infection as uncontrollable. The reliance on complex theoretical modelling over the principles of basic infectious disease prevention was a problem; so was groupthink within Sage itself.

How did these bozos get into office again?

Meanwhile, in Brazil

As the pandemic continues to rage through the country, claiming around 2,000 lives a day, the inquiry offers the chance to hold President Jair Bolsonaro’s government to account. (Sort of.) It’s also a great distraction from grim reality. Livestreamed online and broadcast by TV Senado, the inquiry is a weirdly fascinating display of evasion, ineptitude and outright lies.

Here’s one example of the kind of intrigue on offer. In March last year, as the pandemic was unfurling, a social media campaign called “Brazil Can’t Stop” was launched by the president’s communications unit. Urging people not to change their routines, the campaign claimed that “coronavirus deaths among adults and young people are rare.” The heavily criticized campaign was eventually banned by a federal judge, and largely forgotten.

I think we underestimate the schism that this pandemic is creating and will leave behind as people have taken radically different interpretations of what has happened during this collectively traumatizing event. The trauma in Brazil seems far more pronounced, yet it reflects a similar tension, and desire for justice elsewhere.

President Jair Bolsonaro apparently intended to lead the country to herd immunity by natural infection, whatever the consequences. That means — assuming a fatality rate of around 1 percent and taking 70 percent infection as a tentative threshold for herd immunity — that Mr. Bolsonaro effectively planned for at least 1.4 million deaths in Brazil. From his perspective, the 450,000 Brazilians already killed by Covid-19 must look like a job not even half-done.

Spelled out this way, the effort looks shocking. But to Brazilians living under Mr. Bolsonaro’s rule it’s hardly surprising. After all, the president seemed to do everything he could to facilitate the spread of the virus. He has spent the last year speaking and acting against all scientifically proven measures to curb the spread of the virus. Social distancing, he said, was for “idiots.” Masks were “fiction.” And vaccines can turn you into a crocodile.

Granted in Brazil this was the President, but wherever we live, there’s somebody saying something similar. In my own case it is my provincially elected representative.

Whether it is denying the pandemic, or believing herd immunity was possible, the net result was mass death and suffering.

It seems ever more clear that herd immunity, through obstruction, disinformation and negligence, was always the aim. The bitter irony is that it may be impossible to attain. In Manaus, where 76 percent of the population had been infected by October, the result was not herd immunity: It was a new variant.

The inquiry, slowly and steadily, is unveiling a classic supervillain plot, at once nefarious and absurd, deadly and appalling. Whether the villain meets his comeuppance is another story.

Tragically these villains will probably not face justice, not that it matters much given the damage that has been done.

However what we may meet is the P1 variant, which was incubated by this villain in his demented experiment towards attaining the non-existent herd immunity.

The largest outbreak of the P1 variant outside of Brazil was in British Columbia here in Canada. A lockdown in BC has helped limit its spread, but the province is now eager to reopen.

Here in Ontario there are many who envy what’s going on in BC, but we should be cautious as the B.1.617 variant which is currently devastating India is rapidly spreading across Canada and the US.

In the US the rate of vaccination has achieved a momentary lull, although the warm weather is almost certainly another factor. Yet the next challenge will be to reach the people who are vaccine resistant before new variants potentially reignite the pandemic in middle America.

Unfortunately however when it comes to accountability, the US would rather look to China rather than reflect on their own incompetence.

Once and if the dust from this pandemic settles, the experiences and voices of patients can and should remain paramount. While we should mourn the dead, we should also honour the living who’s pandemic experience will leave them with significant scars and for some disability.

Let’s hope for the rest of us our primary pandemic experience is inconvenience rather than a lifetime of medical complications.