How to End the Guess-If-I’m-Infected Strategy, and Keep the Vulnerable Much Safer

Or, Why All Schools, Colleges, and Universities should Open as Soon as Possible and Students Stay in School to Complete the Work they Missed

The law of the survival of the fittest is simple: the strong survive.  The weak die.

The dying of the weak protects the herd by ending the propagation of defects and weak genetic information being spread throughout the herd.

During a pandemic, fighting the law of the survival of the fittest is like trying to sweep back the ocean or fight gravity.

This is hard news for the control-freaks, the arrogant men and women who believe (merely because they choose to) they can stop the survival of the fittest during a pandemic.

Yes, mass immunity will stop the virus and stop the law of the survival of the fittest — by a majority of the population with antibodies — either by vaccine or naturally occurring herd immunity.

Ironically, the believers that they can fight the strongest survive law of nature prior to a vaccine, posit their position as moral one — and those who do not believe in the humanist desire and ability to defeat nature, are well, immoral in the extreme.

And now that the Wuhan virus is even more contagious, the failure of the we-can-protect-everyone-if-we-all-just-stay-home is  abundantly clear — it did not and has not and will not work very well, as Scott Gottlieb, the former head of the FDA recently said:

“While mitigation didn’t fail, I think it’s fair to say that it didn’t work as well as we expected. We expected that we would start seeing more significant declines in new cases and deaths around the nation at this point, and we’re just not seeing that,” Gottlieb said, in response to a question about the pandemic’s future course.

And for political, economic, cultural, and just basic human reasons, ‘slow the spread’ and the don’t-go-to-work, be happy-unemployed and stay-at-home indefinitely, that mitigation “strategy” cannot continue.

It is increasingly being ignored (see increased traffic on the roads) indicating a shrinking adherence and support for mitigation.

And today Gov. Cuomo announced this piece of data that clearly shows the limits of stay-at-home for mitigation, from CNBC:

Most new Covid-19 hospitalizations in New York state are from people who were staying home and not venturing much outside, a “shocking” finding, Gov. Andrew Cuomo said Wednesday.

The preliminary data was from 100 New York hospitals involving about 1,000 patients, Cuomo said at his daily briefing.

It shows that 66% of new admissions were from people who had largely been sheltering at home.

Six weeks ago, the British Lancet, which is the Brit equivalent of the New England Journal of Medicine, predicted self-quarantine, stay-at-home, and ‘slow the spread’ would be a difficult strategy to succeed, especially if the infectious rate of the virus increased — which it has done now.  At the upper end of the infectious rates, more than 90% of contacts with the infected had to be traced.  This is simply not a credible possibility.  Here is there kicker:

R0 values of 2·5 or 3·5, if there were 40 initial cases, contact tracing and isolation were only potentially feasible when less than 1% of transmission occurred before symptom onset.

This means that at higher infectious rates (measured by R0 values) the only way contact tracing will succeed with 40 initial cases (and we are far, far past that now) containment will succeed only, and only if 1% of transmission in all cases being traced, occurred before isolation.  But in a virus that spreads through asymptomatic infection, it is simply a mathematic impossibility for “only 1% of transmission occurred before symptom onset.”

The upshot of the Lancet story is that stay-at-home, self-quarantine and ‘slow the spread’ may give people a false sense of security, but it will not help the long-term credibility of those advocating its never-ending, let’s extend-it-some-more because it isn’t working and it won’t work.

The reality is that people will just ignore the mitigation the longer it’s imposed on the country in general, and specifically, the longer it’s imposed on places without the infection gaining ground.

Protecting the most vulnerable will depend on herd immunity, either through a vaccine or enough of the population becoming ill and building their own anti-bodies to create a percentage of the population that can not be re-infected, so the virus circulation is stopped.

To wit, a former Trump WH staffer texted me:

The problem is that 100M Americans are high-risk (over 65 = 60M, and at least one chronic condition = 40M). So trying to segregate them is next to impossible.

The Wuhan virus is still spreading.

It will continue to spread, per Gottlieb again:

the “doubling time has come down dramatically,” — the number of days it takes for the epidemic to double in size. But he warned, “We may be facing the prospect that 20,000, 30,000 new cases a day diagnosed becomes a new normal and a thousand or more deaths becomes a new normal as well.”

Continuing mitigation in the face of continued spread is to continue to fail at protecting the weak, which is what is happening now.

Nothing, not slow the spread or social distancing or lock-downs or stringent nursing home procedures, nothing will stop this virus until there is herd immunity.

Herd immunity is the only end game here — either via a never-made-before-for-coronavirus-vaccine or via herd immunity by antibodies.

It is the only scientifically proven methods of ending the pandemic — vaccine-induced immunity or immunity through becoming sick and your body producing antibodies.

Now that the fearful and the ignorant can ignore the World Health Organization’s disinformation strewn statement that there are no proof antibodies confer immunity, and oh, about a million years of human history fighting virus has been scientifically proven to be accurate (in an actual study for the worried who believed the WHO) — perhaps we can now get on with the regularly scheduled program of the only known way to end a pandemic, which is herd immunity.

But there will be death.

There will be hundreds of thousands of Americans who will die because they are old or they are weak and suffering chronic conditions — and about 100 million Americans fall into those two categories.

In this regard, Dr. Michael Osterholm has worked tirelessly for his entire career — for literally decades — to try and prepare the United States for a pandemic and he predicts that notwithstanding ‘slow the spread’ and social distancing and masks and hand washing  — 800,000 Americans will die by the time we have herd immunity from the Wuhan virus.

But there is a bright side: it’s unprecedented and very good news indeed that this virus does not — in the main — kill the young, in fact, the infected young most often do not show any or very mild symptoms.

We are very lucky indeed that this pandemic is not like the 1918 pandemic.  It killed both the old and young, while today’s pandemic kills mostly the old.

And we should use this characteristic of the Wuhan virus against it.   We should use it to our advantage to fight it.

There is a ready reservoir of youth that can withstand the infection without severe illness — they will form the buttress, the foundation of global and American herd immunity.

Those vulnerable who are in proximity to those going to school should make arrangements to self-quarantine themselves until the school-aged have been infected and have immunity.

Once the school-aged and college and university-aged have immunity, they can come back into contact with the vulnerable.

Then, the current crapshoot of guess-if-I’m-infected will end.

The rule will be simple, those with immunity can interact with the vulnerable of the population — making the vulnerable much safer than interacting with those who may-or-may-not be infected and contagious — its a game of roulette that will likely end in only one way.

Here is how Ben Shapiro described what some Israeli scientists are calling a “controlled avalanche:”

…if we assume the worst — no therapeutics that seriously knock down the infection fatality rate, no vaccines for 18 months or more and an economy that simply cannot function at one-quarter or even half of the normal capacity — then we are forced to a simple conclusion: In the absence of any significant change to the status quo, we must pursue a strategy of the so-called controlled avalanche.

That strategy has been coined by Israeli scientists, who suggest that the best strategy for reducing deaths while achieving herd immunity would be to tranche populations and then expose the least-vulnerable populations to COVID-19 in order to let them develop antibodies — in essence, performing with public health the same function ski resorts perform when they create small avalanches in order to avoid a major avalanche.

Now many will say, if we just had tests for everyone to test every day, we could solve this guessing game.

If.

But we don’t have enough tests and we won’t, ever.   Yes, there will be more tests in the fall, but not enough.

Immunity is much safer and faster and will work long-term for both those with immunity and those who are vulnerable.

The risk to the vulnerable goes down as the infected go up and those with antibodies interact with the vulnerable, instead of the, hey, I’m-not-really-sure-if-I’m-infected, but let’s give it a shot anyway strategy — that is now, by default, in effect widescreen in the United States.

And before I get a lecture about how inaccurate antibody testing is, please read this.

It is for all of the foregoing that schools and colleges and universities should be opened as soon as possible, with classes restarted to finish the school work students have missed in the great pandemic of 2020.

This policy will also serve as a Plan B against a catastrophic failure of a timely vaccine, or even one that works.

The last time a vaccine for a coronavirus was attempted was for SARS and after four years, the effort ended without a vaccine — some say there was no market so the testing funding dried up, some say it was because it was too difficult and would likely not have succeeded, some say it was ended because the SARS virus burnt itself out.

But it should be noted, a vaccine against any coronavirus has never been produced.

And here is some head-snapping news from the LA Times, which points up the risks of relying on a viable vaccine:

The 33-page report was posted Thursday on BioRxiv, a website that researchers use to share their work before it is peer-reviewed, an effort to speed up collaborations with scientists working on COVID-19 vaccines or treatments. That research has been largely based on the genetic sequence of earlier strains and might not be effective against the new one.

Scientists with major organizations working on a vaccine or drugs to combat the coronavirus have told The Times that they are pinning their hopes on initial evidence that the virus is stable and not likely to mutate the way the influenza virus does, requiring a new vaccine every year. The Los Alamos report could upend that assumption.

The mutation identified in the new report affects the now-infamous spikes on the exterior of the coronavirus, which allow it to enter human respiratory cells. The report’s authors said they felt an “urgent need for an early warning” so that vaccines and drugs under development around the world will be effective against the mutated strain.

So, there is that.  Imagine early next year and we have a vaccine that works — against an old version of the Wuhan virus — the one that makes people sick in January 2021 in this example, the vaccine won’t work against.   This is a very real possibility.

Protect the vulnerable, send the young back to school to build a bulwark of herd immunity who can interact with the vulnerable, and reduce their risk of the guess-if-I’m-infected-game now widescreen.

A now for something different, but interesting, see the Russian poster below — its caption says Hero Medics.

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