Debate over "herd immunity" intensifies as scientists disagree over how to get there

"Herd immunity" is considered the "end game" in confronting any contagious disease. It is the tipping point, when enough people have been exposed to the virus, it runs out of fuel and can no longer spread efficiently from one person to another. To get to that point, experts estimate, 60% to 70% of Americans would have to be vaccinated against or infected by COVID-19.

But a group of scientists is arguing the best way to get to herd immunity is to end the lockdowns and let the coronavirus run its natural course in young and healthy individuals while protecting seniors and those at risk.

The Great Barrington Declaration, an online plan signed by just over 30,000 medical practioners, 10,000 scientists and more than 550,00 "concern citizens," argues the best way to achieve herd immunity is not to stay in lockdown, while waiting for a vaccine.

"Current lockdown policies are producing devastating effects on short and long-term public health," the declaration reads.  "The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection."

You can read the plan at www.gbdeclaration.org.

NYU emergency medicine physician Dr. Saleena Subaiya and her husband Columbia University infectious disease specialist Dr. Lawrence Purpura have read the plan, and firmly disagree with the idea of letting younger people get infected as a way to achieving herd immunity.

They call it reckless.

"I've seen 30-year-olds die from this virus," Dr. Subaiya says. "I hate to say that I've watched young 30-year-olds die, alone, without their parents, in an emergency department. I think there is no number of people that should be allowed to die for the rest of us to be safe."

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Subaiya argues there are simple, lowrisk precautions that can be taken to avoid spreading the virus.

"You wear a mask; it's preventable," she says.  "You keep your distance; it's preventable.  Why should anyone suffer?  Why should anyone die? "

The Great Barrington Declaration claims older people with underlying health conditions have a more than thousand-fold vulnerability to death than young.

"Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza," the group writes.

Dr. Purpura is studying COVID long-haulers, who have still not recovered months after their infections.  He worries middle aged adults may think they are at lower-risk and safe to resume their normal lives, when they may not be.

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"The truth is, a lot of people in their 30's and 40's may not know if they have underlying diabetes or underlying high blood pressure," Dr. Purpura says.  "If you look at obesity rates through out our nation, they're incredibly high in this so-call 'low risk' group."

Still, the scientists behind the "Focused Protection" plan argue shielding vulnerable groups like seniors and those in long-term care facilities, while letting children and healthy adults get back to normal life, is a more humane approach than a shutdown.
Yet, Purpura and Subaiya argue there are too many unknowns, and the stakes are too high.

"It's unacceptable the cost of 'not knowing' is human life, that is the cost of us making a mistake," Subaiya says. "So, the abundance of caution is wear a mask, and stay six feet apart. That is all you have to do."

A group of 4,800 scientists opposed to the Great Barrington Declaration have published and signed The John Snow Memorandum, or www.johnsnowmemo.com.

"Any pandemic management strategy relying upon immunity from natural infections for COVID-19 is flawed," the memorandum reads.  "Uncontrolled transmission in younger people risks significant morbidity(3) and mortality across the whole population. In addition to the human cost, this would impact the workforce as a whole and overwhelm the ability of healthcare systems to provide acute and routine care."

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