Covid-19: Figuring it out as we go

By KAY MATTHEWS

Last week Democracy Now! held a debate between a Harvard PhD epidemiologist advocating the so-called “herd immunity” approach to the Covid-19 pandemic and a Harvard internal medicine MD who defended the status quo, i.e., economic shut-downs, isolation, contact tracing, etc., to stop its spread. Before I get into the details of the arguments, I must say Amy Goodman and Nermeen Shaikh conducted a terrible interview: Amy’s bias against the epidemiologist was on full display, asking loaded questions and misrepresenting his position, while Normeen asked about 10 questions all at once and expected a coherent answer.

Martin Kulldorff, the epidemiologist, rightly chastised them both but was able to lay out his argument in a reasonable fashion. As one of the signatories of the Great Barrington Declaration that argues for easing shut-downs for less vulnerable populations, he made it clear that he was not advocating for what Donald Trump is pushing—unchecked circulation of the virus—but a more cautious approach. He began his response with this statement:

“The lockdown and the response that we have done in the world towards the pandemic is the worst assault on the working class in half a century. One feature of COVID-19 is that while anybody can be infected, there’s a huge difference in risk by age. And it’s not just twofold or fivefold or tenfold. It’s not even hundredfold. There is a more than a thousandfold difference in risk by age for mortality of COVID-19.”

He went on to point out that this is not really a debate about “herd immunity”, which exists as a matter of science. The question is how to minimize mortality and how to protect the most vulnerable communities instead of forcing the working class to build the immunity that will eventually protect everyone in the community. He expressed that children should be allowed to go to school “to let them live their lives, to get their education, to have proper physical health and mental health.”

He also clarified that it was necessary to “flatten the curve” so as to not overwhelm the health care system, but that “to try to suppress and eliminate a disease that cannot be eliminated, that cannot be eradicated, is very misguided, and it leads to — or it has in the United States —leads to much higher mortality than there should have been if we had done a focused protection strategy instead.”

The MD, Dr. Abraar Karan, who has worked with Covid patients as a public health specialist, seemingly agreed with Kulldorf that it’s a false dichotomy to debate whether to impose extreme lockdowns or “let the virus rip” as herd immunity. But he did question the idea that vulnerable populations such as the elderly can be protected when many of them live in crowded, intergenerational households and that this “novel respiratory pathogen” has also affected younger and middle aged people who may suffer long term neurologic affects. Kulldorf’s response was, we know so little about this virus: one year’s worth of “long term effects.”

So how do we make a science based, informed decision about how to proceed as we enter a time when there are new outbreaks of the virus all over the country (and other countries as well) that rival the initial numbers of early 2020. The October 19 Naked Capitalism reprinted an article by Hassan Vally, a professor at LaTrobe University, that examines the recent guidelines put forward by the World Health Organization (WHO) that at first glance seem to be advocating against lockdowns as the primary measure of control of the virus. But as Vally explains, WHO is saying that short-term lockdowns are a good tactic in situations where transmission is spiraling out of control, there is a threat of the health system being overwhelmed and, as the special envoy on COVID-19, David Nabarro said, “buy you time to reorganize, regroup, rebalance your resources.”

Vally then guides the reader through the other strategies beyond short-term lockdowns:

1. Testing, contact tracing, and isolation: “every jurisdiction that has enjoyed success in controlling the virus has excelled in these three interlinked tasks.”

2. Responding to clusters: “identifying and testing people up to three degrees of separation from a known case.”

3. Educating the public: Delivering the message of social (I prefer the word “physical”) distancing and good hygiene to all members of the community requires money and effort from health authorities and community leaders.

4. Wearing masks.

Donald Trump just held a rally in Carson City, Nevada where he mocked Joe Biden for vowing to “listen to the scientists” on the Covid-19 pandemic: “If I listened totally to the scientists, we would right now have a country that would be in a massive depression.” We are, of course, close to that already. But his solution, unlike those posited above, is actually the herd immunity that the WHO, Kulldorff, and Karan all decry: no social distancing, no masks, no testing, no contract tracing, and no isolating, just indoor crowds shouting “lock her up” (this time about Michigan Governor Gretchen Whitmer). The virus is not going to go away once Trump is defeated, but maybe those people seriously trying to save lives, livelihoods, and our mental health, will be the ones setting policy.

5 comments

  1. Thank you for bringing out this information. I was unfamiliar with the arguments for a middle ground approach. And for your observations of Amy Goodman’s interview behavior.
    When progressives act like rude jerks who have only mouths and no ears, they exacerbate the morass that the media has become–and they bear remarkable resemblance to the Current Occupant.

  2. You are correct in calling out that DN debate as being particularly poor. Despite that, I’m convinced you couldn’t hear the GBD position as well as you might think likely because they did such a poor job of presenting it for their listeners.

    If you want to hear more details about the poverty of the herd immunity position, and the primary problem GBD has – being a lack of data to support the proposal you would be better off listening to a podcast run by some virologists on the East coast. Probably TWIV 675 or even 673 when they first deconstructed it. https://www.microbe.tv/twiv/ I can’t recommend their podcast enough to get a feel for the state of the Covid world as the science and medicine changes it seems every week. Although really when you look at the larger picture the rules for safer pandemic era behavior were known and identified over a hundred years ago during the misnamed ‘Spanish’ flu pandemic.

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