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This is a very interesting article  in which herd immunity as seen in Sweden is compared to containment.  For those who don’t know herd immunity is expected in Stockholm in about 2 weeks and then shortly thereafter in the rest of Sweden. If herd immunity can be achieved safely it has obvious advantages over containment with the possible destruction of the economy and the resulting ravages of addiction, suicide, domestic violence and economic ruin that occur with lockdown quarantine.  Herd immunity relies on voluntary less severe social distancing that allow the economy to function.  Herd immunity is safely possible if three conditions are met.

  1. The elderly with comorbidities who are at significant risk of death are isolated and protected until herd immunity is achieved and
  2. Proven effective treatments such as hydroxychloroquine-azathramycin-zinc, plasma from recovered patients and now remdesivir are made available to the few non vulnerable people who become significantly ill, thus lowering the already very low death rate among them to even lower levels – near of even below flu level risks.
  3. Testing for infection with COVID-19 is readily available so that those with symptoms can be immediately tested, and if positive, can be immediately started on treatment to mitigate their risk.

In theory, the first two of these goals should be achievable now. And the third, testing, should be freely available within a few weeks.  And this strategy should improve even more as more treatments become available.  A herd immunity strategy is even more potentially important since there is no guarantee we will get an effective vaccine any time soon, if ever.  Herd immunity then becomes our best protection against a renewed outbreak.  And if a renewed outbreak occurs,  quarantining on the levels recently employed will probably not be possible without the complete destruction of the world’s economy, social order and health.  However once herd immunity is achieved the isolation of the vulnerable eldery-ill can be gradually relaxed since the virus will have disappeared.

It is interesting that the author of this paper cautiously endorsing herd immunity is from the CDC which is normally very conservative about such matters and might be expected to be skeptical of herd immunity. 

The radical quarantining that was employed was based on models that were found to wildly overstate the risk of COVID 19 that would’ve engendered collapse of the health system. In the US there is tremendous excess health system capacity so that collapse of the health system is not a risk.  That being the case, the above two measures, if carried out successfully, would be expected to be able to allow herd immunity to work with continued prudent social distancing but without devastating prolonged lockdown quarantining.