Female house: trump taken with herd immunity approach

Female house: trump taken with herd immunity approach

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Respected scientists argue in Great Barrington declaration for targeted protection of at-risk groups and against strict measures

Nothing more will come of the relationship between the White House and the WHO. The US President’s office says it likes the idea of herd immunity. The approach is entirely in line with Donald Trump’s strategy, the Washington Post reports. WHO chief Tedros Adhanom Ghebreyesus finds the approach "ruthless".

"Allowing a dangerous virus that we don’t understand to the whole to circulate freely is simply ‘unethical’. This is not an option", said the secretary general of the World Health Organization (WHO) last week. Herd immunity is a concept used for vaccination to protect against a particular virus when a threshold of vaccination is reached, Ghebreyesus told media representatives. In the case of measles, he said, it is 95 percent. If they are vaccinated, then the remaining 5 percent are also protected. For polio, it is 80 percent.

The basic approach, however, is that protection takes precedence over risk.

Herd immunity is achieved by protecting the population from a virus, not by exposing them to it. (…) Never in the history of public health has herd immunity been used as a strategy to respond to an outbreak (of infection, erg. d. A.), let alone a pandemic.

Tedros Adhanom Ghebreyesus

According to insider information from various media (Newsweek, New York Times and the Washington Post), the White House, on the other hand, is very enthusiastic about the "Great Barrington Declaration" (in German here). In the declaration it is propagated that the achievement of a herd immunity "can be supported by a vaccine". This is "but not dependent on".

"Targeted protection" in the USA?

The brutal aspect connected with the goal of herd immunity, the risk for the weaker and older ones, is countered in the explanation by giving priority to the deterrent option of the "lockdown policy with devastating short- and long-term effects" One-feeling juxtaposed:

Our goal, therefore, should be to minimize mortality and social harm until we achieve herd immunity. 

The most compassionate approach, balancing the risks and benefits of achieving herd immunity, is to allow those at minimal risk of death to live normal lives so they can build up immunity to the virus through natural infection, while those at greatest risk are better protected. We call this Focused Protection.

Great Barrington Declaration

For the "targeted protection" concrete examples are the use of caregivers "with acquired immunity", PCR testing of employees and caregivers, home food deliveries, meeting family members outdoors rather than indoors – all not new and obvious. These measures should have been common practice in nursing homes for a long time.

How much they can protect the weak, pre-diseased, elderly in a society when the risk of infection is increased by more infections is questionable simply because only a fraction of these at-risk groups live segregated in a home. According to the U.S. Department of Health and Human Services (CDC), 47.2% (of 3,142 U.S. counties) the risk that Covid-19 will take a severe course.

The realization of the "targeted protection" is a major problem with the plan, which the White House likes so much because it is "supports exactly what the president’s policy has been in recent months" (WaPo). However, it is also the policy of the latter that health care for the less well off should be as generous as possible.

The political background of the Great Barrington Declaration fits in with this orientation, which is based on as little state protection and as much freedom as possible, as well as on as low costs as possible for companies. It comes from a meeting hosted by the think tank American Institute for Economic Research (AIER). The AIER stands for libertarian and neoliberal views.

The authors of the declaration have a serious scientific reputation, Martin Kulldorff, is a professor of medicine at Harvard University, Sunetra Gupta teaches "theoretical epidemiology" in Oxford, Jay Bhattacharya is a professor at Stanford University Medical School, an epidemiologist, specialist in health and economics and health policy.

The New York Times reports that Sunetra Gupta and Gabriela Gomes, who were also among the "Architects" paid to the declaration, reportedly believe that herd immunity has been achieved with as little as 10 to 20 percent of the population being infected.

The risks

This is a very low number, which is usually set at a higher level. British professionals as z.B. Robert Lechler, the Prasident Academy of Medical Sciences, or Michael Head, global-health researcher at Southampton University, state that between 60 and 70% were needed. Both emphasize to the Guardian the increase in mortal risks for the elderly and vulnerable. As a corona policy that relies on relaxations aimed at herd immunity is confronted with the problem of overloading hospitalers.

There is a study published in PNAS at the end of September that deals with problems of practical implementation of herd immunity strategies. The authors Tobias S. Brett and Pejman Rohani mathematically play out the course of events in the UK (summary here).

In short, they conclude that the only way to avoid overloading the health care system is to reduce the reproduction rate relatively quickly to between 1 and 1.2, otherwise hospital beds (and probably nursing staff) would be insufficient. So it had to be constantly readjusted with decreases in social distancing to stay at this value… The authors of the study consider this to be practically true for the rest of the world "not feasible".

Also, herd immunity adherents have yet to deal with another uncertainty. Although Trump claims that he is now "immune" but whether this is true for the rest of the world is still a matter of debate among scientists.

The fact that it is very difficult to achieve natural herd immunity without risking overburdening the health care system has always been clear, says Christian Althaus of the University of Bern. The idea was raised in the spring by business circles and has enjoyed some popularity in the media to this day. That’s why the federal Covid 19 task force recently took up the ie.

In its publication, the task force points out that the concept of herd immunity is based on an unproven amption. It is not yet known whether people who have been infected with coronavirus are subsequently immune. Especially in mild infections it is questionable how long the immune protection lasts.

The virus is not yet known in its entirety, as the WHO chief describes it, and knowledge about the antibodies does not yet provide any certainty, which is indicated by cases of renewed infections, as well as by different observations on the degradation or. Persistence of antibodies. Research on naturally acquired permanent immunity to Covid-19 is apparently not yet ready to support a policy of herd immunity, concludes a review article in the FAZ.

For Trump, it’s all about re-election. He wants to get away from the image that he made a wrong corona policy. That’s where the simple and "empathetic" The Great Barrington Declaration fits the bill perfectly.

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