‘herd immunity’ coronavirus plan is not scientific

The suggestion of herd immunity is based on the hypothesis  that if 50 % of people ( all less than 40 years with least mortality) are infected, epidemic can not only be contained but the probable chances of another wave of infection can be prevented. However, vulnerable people should not be exposed to Covid-19 right now in the service of a hypothetical future.  

Scientists are considering the idea of achieving "herd immunity" with the objective of managing the outbreak and preventing a catastrophic second round of epidemic in the winter season. Their argument is that if immunity can be developed in the younger population, the entire population as a whole can be protected by means of generating herd immunity. 

We  discuss that vaccines lead to the development of herd immunity but, an active infection is not a vaccine. We are dealing with an actual pandemic which can make a large population very sick with some leading to eventual death. In spite of the low mortality rate, a small fraction of a very large number is still a large number.

At the peak of the outbreak the number of people needing critical care would be greater than the number of beds available. this coupled with the fact that people who are badly ill tend to remain so for a long time, will further worsen the situation and increase the disease burden.

We have witnessed second wave in flu pandemics. However, it is important to note that this is not a flu pandemic, hence, flu rules do not apply in the current situation and I would again reiterate that vulnerable population should not be exposed to virus. It  has become clear through modeling and observational studies that transmission can occur even before the development of the symptoms.

Consider the case of South Korea where a combination of intense surveillance and social distancing, seems to have achieved some control over the virus. We can adapt best practices from South Korea, Singapore, Hong Kong and Taiwan, all of which have so far done a good job in mitigating the worst outcomes despite having reported cases early in the pandemic, even with South Korea suffering a substantial outbreak.

At this time the focus of the policies should be slowing the outbreak to a (more) manageable rate.  In this scenario, strong social distancing seems to be a strong alternative. Anyone who can work from home, should. People who do not yet work from home should be encouraged to do so. Employers should guarantee sick pay, including for contacts of known cases, and offer support in every way to discourage the practice of “presenteeism”. It is strongly recommended to not shake hands. Not with anyone. You should wash your hands for 20 seconds several times a day and whenever you enter your home (or someone else’s home). Stop all large gatherings. Make people aware about masks and how they should be reserved for the medical professionals who need them. We should have started the practice of social distancing and public awareness about use of masks weeks ago.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA