The “Herd Mentality” is Not a Public Health Strategy..
...and it's Worse Than the Simple Math Suggests
Last night Strange and I tuned into the presidential debate, like many other Americans. Our family has decided (like many readers of this site) who we will support, but it feels like the duty of any responsible American to tune into some basic events – the State of the Union, the Presidential Debates, and statements from the Oval Office. I love America, but now I wonder if it’s ethical to host another debate. Trevor Noah points out that Chris Wallace was prepared for a normal debate. He was clearly out of his league when it came to hosting anything with our Despot-in-Chief.
There have to be some things that we can come together around, as a country. Denouncing white supremacists should be one of those basic values that we should all share. It shouldn’t be hard to denounce white supremacists. It was clearly hard for Trump to denounce white supremacists.
Trump also revealed that he still lacks a comprehensive approach to the COVID-19 pandemic that has left more than 200,000 Americans and a million world citizens dead, beyond what he referred to as the “herm mentality.” Thus far, I’ve been right about my COVID-19 predictions. I was right about hydroxychloroquine, I was right about Diamox, I was right about the impact of bringing students back to campus, I was right that public officials poor behavior would contribute to the continued spread of disease, and I am about to be right about something else I wrote about several months ago – the lasting long-term health impact of COVID-19 on public health. The warning signs are here and they are more dire than the basic math would have any of us believe.
Last night, the president lied about the timeline of a vaccine. So, it’s important to understand the true consequences of the public health policy he has embraced and not hang our hats on the hope of a vaccine appearing in the next few weeks.
To recap briefly, the president has sidelined respected pubic health experts like Anthony Fauci and is now listening to Scott Atlas, a neuroradiologist whose own colleagues have denounced him as a fraud. Atlas is pushing a new narrative, suggesting that if Americans can develop “herd immunity”, the virus will go away. Trump has embraced this new world view, suggesting that the virus will disappear if we embrace “herd mentality.” Trump is not a fool. This is his public health policy.
Herd immunity is a great concept for immunization, but not a great strategy for a disease that kills people. Rachel Maddow recently offered some math to highlight what this means. She even considered a “best case scenario” and still predicted 2 million dead. I think it’s worth considering the math based on the most current data.
Starting with the basic math, the situation is bleak. The Mayo Clinic reports that for herd immunity to be effective, at least 70% of the population would need to be infected.
The current US population is 328,200,000. 70% of that is 229,740,000 people. The current mortality rate is 2.86%, which means we need to strap in for a potential 6,570,564 deaths. “Herd immunity” only works if we’re willing to accept 6.5 million dead Americans. That alone should be enough to stop any decent person in their tracks. The true future picture is likely much more grim.
This math only works if the healthcare infrastructure is not overwhelmed. When the COVID-19 pandemic started, my university’s hospital limited visits and cleared out all non-urgent patients and procedures to make room and limit risk. Since, the hospital has re-opened to more patients and we are back at capacity. When I log in to the medical record, I receive alerts that the hospital is full again. But, these patients are different that our pre-COVID patients. They waited to receive care and are sicker. They stay in the hospital longer and need more complicated care. They use more resources. These are resources that now won’t be available in the case of a COVID surge.
If we take a “herd immunity” approach, there will not be room in the hospital to take care of people and deaths will surge. The public must be prepared for that consequence of supporting the president in this.
Our hospital has sent out another recent danger signal that we should take seriously. To enter the hospital, I now have to enter through the Emergency Department. The patients in the waiting room look different. There are more of them. They look sicker. I saw a woman covered in a blanket, sweating and shivering. I’d never seen that before. Usually patients get back to a treatment room quickly. Not now.
Our hospital now reports that 20% of patients are leaving the emergency department without being seen because it’s too busy and the wait is took long. These patients didn’t come to the emergency department because they were well. No one wakes up and thinks they might pay a visit to the emergency room for fun. They came because they had something they thought was life-threatening and left because they thought they couldn’t be helped. What happened to them?
The math with a 2.86% mortality rate only works if the healthcare system is not stressed past capacity. As I predicted months ago, the system is now overwhelmed by people seeking care for things they are delaying. If we continue down this path, the death rate will rise. We may be looking at 8,000,000 dead Americans under a herd immunity strategy. Has there ever been something that resulted in 8,000,000 dead Americans? Are we willing to accept that?
It’s not a viable pubic health strategy. It’s not a strategy that anyone with any scientific or medical knowledge would endorse. Its a plan of the greedy, the lazy, the overwhelmed, and/or the ill-informed.
Don’t fall victim to the herd mentality. Wear your mask.