The Best Op-Ed On Covid
This piece by John M. Barry of the Tulane University School of Public Health and Tropical Medicine in The New York Times on October 20 is hands down the best summary of the coronavirus crisis and our response to it that I have read. Allow me to summarize.
The Great Barrington Declaration is a proposal from some scientists to shift to the concept of herd immunity via natural virus transmission (i.e., not via a vaccine). They propose to protect the most vulnerable through “focused protection” and allow the rest of us to get sick. Other scientists oppose this idea of forced herd immunity. Which plan would have been best given that we basically picked neither while Sweden chose a modified Barrington plan?
Here’s the problems that Barry outlines with the Barrington plan for America.
First, natural herd immunity would cause a lot of illness. This is indisputable. If you believe that covid is no worse than the flu, that might not alarm you. But that does not seem to be the case. Many recovered covid patients have lasting sequelae including heart and brain effects.
Second, the Barrington plan does not specifically relate how to protect the vulnerable. If they are in nursing homes, they can be readily quarantined, but what if they live with their school age grandchildren? How does that work when the grandchildren are part of the strategy to spread the illness?
Third, if we attempted herd immunity the natural way, how many people would die? The estimates exceed half a million although we may well get there anyway given our progress to date at mask wearing and social distancing.
Fourth, it is not at all clear how many people must be infected to get to herd immunity and how long it would take. It may need to be 60% of the population which would take well into next year. Mitigation now and the development of herd immunity via a vaccine as soon as possible might be a better plan.
But the real question is an unanswerable one. What percentage of those infected will have long-term sequelae and what would be the cost of those secondary effects? Of course, the secondary effects of a partially closed economy must be factored in as well.
People I know point to Sweden and its approach of relative openness as the right way to go, but according to Barry the Swedish death rate is higher than Denmark’s and Norway’s and the Swedish economy still took a major hit.
The real mixed up thinking is that the choice is between a total lockdown and natural herd immunity. As this blog has advocated, this is just not true. We could do the mitigation strategies of Fauci and still open up a large part of the economy although perhaps not concerts, sporting events, bars and restaurants. There are compromises that must be made. The U.S. could have done as well as South Korea and Taiwan through limited economic controls and extensive testing, tracing and quarantining.
The U.S. could have done better, but not under this president. (See the new Alex Gibney documentary on HuLu called “Totally Under Control”). That legitimate scientists disagree and think that national herd immunity via viral spread to the “less vulnerable” is the way to go is nonsense. What that might look like is New York City in April and no one wants that.
To my friends who are convinced this is all a plot to take away our rights, unseat Trump, and have a liberal takeover of the country, get a grip. This came from China. If anyone is plotting anything, it’s the Chinese and I doubt they planned this. More likely is that someone in Wuhan screwed up big and the Chinese won’t own up to what was going on in that virus lab.
Governments all over the world were presented with an unwanted challenge. Some, many in Asia, did well. Others, like ours, did poorly. There is no doubt in my mind that without the virus, Trump would have coasted to re-election. With it, it’s a toss up. But one thing I am sure of, he had no plan, he wasn’t up to the task, and he still isn’t.