Photo: Simon Mortimer, Creative Commons license 2.0

You might recall that a bit over a week ago, Health and Human Services Secretary Alex Azar met with three advocates of "herd immunity," the pseudoscientific idea that if we just keep the most vulnerable people safe, we can let COVID-19 run wild through the rest of the US population until enough people get infected that the coronavirus won't be a bother anymore. At the time, Azar insisted that "Herd immunity is not the strategy of the US government with regard to coronavirus," and wasn't that a great comfort, because it sure LOOKS like Donald Trump and his pals are out to personally infect as many Americans as possible.

With that denial as context, it should be no surprise that just a week later, on a briefing call Monday, a "senior administration official" told reporters that hell yeah, herd immunity is totally what the administration has been pursuing for months, although maybe it would be a stretch to call it a "strategy." The Washington Post has the triumphant not-quite-an-announcement:

"We're not endorsing a plan. The plan is endorsing what the president's policy has been for months. The president's policy — protect the vulnerable, prevent hospital overcrowding, and open schools and businesses — and he's been very clear on that," the official said.

"Everybody knows that 200,000 people died. That's extremely serious and tragic. But on the other hand, I don't think society has to be paralyzed, and we know the harms of confining people to their homes," the official added.

Translation: We've been letting the pandemic spread, and now we've found a fringe belief that will justify the administration's lack of any plan at all. It's a lot like how Pee Wee Herman fell off his bike and said "I meant to do that," if Pee Wee Herman had let 215,000 Americans die and an untold number suffer permanent lung injuries and other disabilities, in the never-released Pee Wee Killed Your Nana, Heh-Heh.


Shortly before meeting with Azar last week, the three viral amigos encapsulated their not terribly scientific arguments in a document they called the "Great Barrington Declaration," after the Massachusetts home of the libertarian think tank/investment fund that hosted a conference where the thing was unveiled. Because everyone knows that the best public health measures are guided by the invisible hand of the free market. And if that hand wants to unplug Nana's ventilator, well, she had a good run, didn't she?

The document claims that since most COVID-19 deaths occur among old people and folks with a range of risk factors, then the smart way to deal with the virus is to somehow seal those folks off from the rest of us and then let the virus run wild, for prosperity. But because "herd immunity" may already have negative connotations, particularly around "thinning the herd," the authors make up a neat new term: "Focused Protection." Doesn't that sound great? The document emphasizes how compassionate the authors are, noting that waiting for an effective vaccine would take too long for anyone to tolerate in complete lockdown (not that anyone is advocating a complete lockdown now).

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.

The document even has some very broad suggestions for how people at higher risk could be kept safe-ish from the surging viral cases that would result.

By way of example, nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.

We can see how the Trump administration would find that very attractive, since the "comprehensive and detailed list" is left to be developed later. And no, none of the people in Trumpworld have put forward any sort of actual proposed regulations or legislation that would pay for any measures to keep vulnerable people safe. They just say that's what they're doing, and isn't saying it good enough?

Needless to say, once we've theoretically siloed off all the people at most risk of dying from COVID-19, the declaration doesn't call for anything more than "hand washing and staying home when sick" for everyone else, because masks and social distancing might slow the rate of infection, and we want a huge portion of the population to be infected so they can develop those antibodies that will make us all safe unless they don't.

Why yes, the declaration does leave a few things out, like any actual scientific evidence, any mention of possible drawbacks, and a few niggling details, like the fact that young, otherwise healthy people have died (but not that many, so no big deal!) or that many people who survive COVID-19 suffer lasting health effects, like disabling heart or lung problems. But they're not dead, and that's just peachy. Oh, yeah, and it's not even clear whether being infected results in lifetime or just seasonal immunity.

For your sideshow enjoyment, Britain's Sky News notes that, before the names of the statement's signers were redacted, the "medical practitioners" who had signed on to the declaration included "Dr. I.P. Freely, Dr. Person Fakename and Dr. Johnny Bananas," as well as one wag who claimed to be "Dr. Harold Shipman" — the name of a mass-murdering general practitioner who killed over 200 patients before his 1998 arrest. The "practitioners" also included a raft of homeopaths and more than 100 self-described "therapists" of various sorts, including massage therapists, hypnotherapists, and "one Mongolian Khöömii Singer who describes himself as a 'therapeutic sound practitioner'."

The vast majority of real medical and public health experts are aghast at the proposal, and argue that trying to infect our way out of a pandemic could lead to hundreds of thousands, possibly millions of additional deaths in the US, but they don't have Donald Trump's ear.

And besides, he's already done such a great job of doing nothing to stop the spread of the virus that there's no real difference between administration policy so far and hoping for herd immunity. Wearing masks and taking simple precautions, after all, are tyranny. That's what we herd, at least.

[WaPo / CNN / WaPo / Great Barrington Declaration / Photo: Simon Mortimer, Creative Commons license 2.0]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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