It might have been a cruel-but-rational strategy if you were prepared to
accept the increased mortality among vulnerable demographics. (I wouldn't
be.) (But I'm in a vulnerable demographic…)

But anyhow in recent days I've started seeing reports of permanent effects
among "recovered" victims: cognitive impairment, permanent lung damage,
etc.  Which makes the herd-immunity approach even less attractive.

On Wed, Apr 22, 2020 at 7:42 AM Srijith Nair <[email protected]> wrote:

> Got to say I am trying to understand the herd immunity concept as well and
> falling short with COVID-19.
>
> With a basic reproductive rate of around 3, it has been calculated that
> about 70% of population need to be infected. With a fatality rate of
> 0.5-1%, about 0.35-0.7 percent of a country's population will die! That
> seems a bit...hmm..bad!
>
> The biggest assumption we seem to make with the herd immunity approach is
> that surviving infection once creates immunity in the host. With COVID-19
> that seems to be still a rather big unknown and seems to completely
> undermine the approach towards herd immunity.
>
> The way I see it, herd immunity would work well only when we have a
> vaccine (and second best when we have clear proof of immunity after
> infection, but at the cost of rather high number of fatality) and not as a
> preventive measure.
>
> Talking of the Dutch approach, I find it rather astounding that the PM
> says two things in the same breath - we don't seem to know what kind of
> contribution children have made to spread of the virus, the study results
> will come out in June but hey, let us start the primary school (which is
> the least affected by a month or two of missed or virtual schooling) in
> May, because.... (I live in Amsterdam, have primary school going kids so I
> find this whole approach very weird, especially given that before the
> school closed there were 3 confirmed cases of kids/parents who kept coming
> to school with early symptoms!)
>
> Regards,
> Srijith
>
> On Wed, Apr 22, 2020, at 2:42 PM, Alaric Snell-Pym wrote:
> > On 22/04/2020 12:11, Amit Varma wrote:
> > > On Wed, Apr 22, 2020 at 4:28 PM Udhay Shankar N <[email protected]>
> wrote:
> > >
> > >>
> > >> I assume you mean that it is not a good thing to actively work
> towards.
> > >> This also presumes that teh authorities can affect this outcome one
> way or
> > >> another.
> > >>
> > >
> > > Well, the idea is to delay and mitigate till a vaccine is ready, while
> > > treatment protocols that will lower mortality also evolve at the same
> time.
> >
> > Also, controlling the spread means that the number of people seriously
> > ill at any one time isn't greater than the local health service capacity
> > to give them quality care.
> >
> > One big unknown that's making it hard to say what's right to do - and
> > therefore giving licence to various nutjobs to claim that any given
> > strategy is wrong with great certainty - is that we don't really know
> > how many people are infected.
> >
> > *MAYBE* COVID is highly contagious but not very serious, with only a
> > fraction of people showing anything more than a mild cough, and a tiny
> > fraction getting seriously ill. It's already been spreading for months,
> > and we only noticed it when enough people had it to make a notable
> > number of people properly sick. We've all mainly had it already and
> > we're nearly at herd immunity and all this lockdown stuff is barely
> > necessary as we're unlikely to overrun health services unless we let it
> > get REALLY out of hand; the worldwide confirmed-infected and
> > confirmed-dead-of-covid rate is mainly just rising as more testing rolls
> > out and we've already plateaued, with the lockdowns just flattening out
> > the tail end of the rise to the plateau a bit.
> >
> > *MAYBE* it's actually pretty rare, and the published infection figures
> > from various nations are nearly all the people who have it, because
> > almost all people who have it show enough symptoms to get noticed and
> > tested, and quite a high fraction of them get seriously ill. In which
> > case, we're sitting on a ticking time bomb of it getting out of hand in
> > the population.
> >
> > There's some evidence for the former due to a few random population
> > sampling exercises, but the only way to really know either way is to
> > test as many people as possible. And to avoid bias in the testing, test
> > the population at random, rather than just people who start coughing, as
> > otherwise we won't know how many people are asymptomatic carriers. Test
> > people who died of lung failure, so we know whether to count them or not.
> >
> > > Also, it is impossible in India, except for privileged elites like us,
> to
> > > separate the vulnerable from the non-vulnerable. So many poor in
> congested
> > > cities, more co-morbidities than other nations, and a horrendous
> healthcare
> > > system -- there would have been carnage. (There still might be carnage
> down
> > > the road.)
> >
> > :-(
> >
> >
> > --
> > Alaric Snell-Pym   (M7KIT)
> > http://www.snell-pym.org.uk/alaric/
> >
> >
> > Attachments:
> > * signature.asc
>
>

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