At times throughout the spring, summer, and fall, Republicans pushed the idea that the only way to fight COVID-19 was to surrender. That is, to just let it infect Americans until the nation achieved “herd immunity.” The problems with this approach were … everything. First off, we still don’t know if mild or asymptomatic infection with COVID-19 provides long-lasting protection from the disease, meaning that herd immunity might not even be possible. Second, removing social distancing guidelines so that people would become infected more rapidly would result in massive overcrowding of hospitals across the nation, creating an epic health care collapse that drives the fatality rate of the disease through the roof. And finally, even trying for herd immunity on a nationwide basis would inevitably result in millions of deaths.
That didn’t stop even people who should know better from returning and returning to this idea under what seems to be a shared delusion that somehow it is possible infect tens of millions of people with coronavirus in a short time, while ignoring all the hospitalizations and deaths that cannot be avoided. The fact that this keeps coming up as a supposedly serious proposal is shocking.
But the fact that the man appointed as science adviser in Donald Trump’s Department of Health and Human Services actively pushed for more Americans to be intentionally infected to bring on herd immunity … is not as shocking as it should be.
Here’s a fun statistic: As we’ve learned more above COVID-19 over the last 10 months, the case fatality rate in many nations has dropped from around 3.5% to 1.5%. That improvement comes partially from increased knowledge about how to treat patients undergoing prolonged intubation and the use of anti-inflammatory steroids in the treatment of patients receiving breathing assistance. But the biggest reason that number has changed is simply that testing has, in many areas, finally reached numbers that are almost adequate. More mild and asymptomatic cases are being added to the total of positive cases. We’re not getting better at treating COVID-19 so much as we’re getting better at finding cases that didn’t require treatment.
At the same time, what all that increased testing is showing is that early speculation about the number of mild and asymptomatic cases was wildly wrong. Estimates right up until recent months have often suggested that the “true” fatality rate of COVID-19 is somewhere below 1%, on the assumption that there were five or even 10 undetected, asymptomatic cases for every case that was showing up on the radar. This was false.
We now have more than enough large population tests to know that this is not the case. Cases of COVID-19 so mild as to be either asymptomatic or pass as sniffles attributable to something like seasonal allergies make up about 15-25% of cases, not the 90%+ some early sources suggested. Test as you like, but there is no massive number of undetected cases out there. When North Dakota’s data says that 11% of the people in that state have tested positive for COVID-19, it’s probably because about 11% of people in that state have had COVID-19. Not 50%. Certainly not 100%. Very likely not even 20%. And that’s in spite of testing that is still decidedly inadequate.
The herd immunity types are correct in saying that the great majority of current fatalities are among the elderly. However, despite all apparent advances, the fatality rate for untreated COVID-19 remains around 10%, essentially the same as the disease’s hospitalization rate. In other words, about 85% of those hospitalized for COVID-19 will survive. Those same people, deprived of hospitalization, will die.
Here’s a table first put together back on March 6.
| 0.5% CFR | 1.0% CFR | 2.0% CFR | 4.0% CFR | |
|---|---|---|---|---|
| 10% POPULATION | 163,000 | 327,000 | 654,000 | 1,308,000 |
| 25% POPULATION | 408,000 | 817,000 | 1,635,000 | 3,270,000 |
| 50% POPULATION | 817,000 | 1,635,000 | 3,270,000 | 6,540,000 |
| 75% POPULATION | 1,226,000 | 2,453,000 | 4,905,000 | 9,810,000 |
Despite the 311,225 deaths tallied at WorldOMeters, the data shows that only 5.8% of the population has tested positive for COVID-19. That means that, 10 months later, the United States still has not entered the range of infection listed in the chart above. And thank God for that, because at the current case fatality rate of 1.8%, even touching a 10% infection rate nationwide would mean 602,000 deaths.
Only reaching 10% nationwide would not mean 602,000 deaths, because reaching 10% infection rate could not be done in anything less than another 10 months without exploding the healthcare system. The death rate wouldn’t be 1.8%. It wouldn’t even be 3.5%. The more cases there are, and the more rapidly they come in, the closer the rate of death would approach the current hospitalization rate. Just getting to a nationwide 10%, unless it took place over a period as long as it took to get us where we are now, would result in millions of of deaths. Millions. And that’s still not even close to herd immunity.
What would pushing for intentional herd immunity do? It would so overload the national health care capacity that within a very short period the 924,107 hospital beds in the United States would barely be a blip compared to the numbers struggling with simultaneous infection.
Forget the chart above. The real price of reaching herd immunity in anything less than a decade would be ten of millions of deaths. And of course, no one expects that immunity to COVID-19 would last for decades so … congratulations. We’ve just walked through all the steps again to show why reaching herd immunity isn’t just a bad policy, but an impossible policy that cannot help but kill millions without ever reaching the described goal.
And now … Paul Alexander.
Paul Alexander was a senior advisor for the HHS assistant secretary for public affairs Michael Caputo. He has previously appeared on Daily Kos for his starring role in attempting to censor statements from Dr. Anthony Fauci, and for putting a lid on scientists at the Centers for Disease Control and Prevention (CDC) who attempted to share genuine information with the public.
But, as Politico reports, it turns out that Alexander did far more than just kill Americans by depriving them of the information they needed to keep themselves and their families safe. He also pushed for killing more Americans directly.
In a series of emails, Alexander declares “there is no other way” to deal with COVID-19 than pushing Americans to get infected so that we can achieve herd immunity. "Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk … so we use them to develop herd … we want them infected …"
We want them infected. To pick on deaths alone, here’s what Johns Hopkins shows in the data for COVID-19. While the rate of deaths is certainly much greater in the oldest cohorts, it’s far from zero in any group. Those under 24 make up about 1% of all deaths. Apparently Alexander is ready to let them go. Those under 55 make up about 6%. That’s a sacrifice that Alexander was obviously willing to make.
But just like the rate of deaths, those numbers would not remain the same if Alexander’s “we want them infected” plan was carried out. As CDC numbers show, the differences in the rate of death by age group is much higher than the rate of hospitalization. So are the rate of ICU admissions. In fact, 1 in 3 children hospitalized with COVID-19 were eventually admitted to the ICU, which is the same rate seen in adults. It’s only that final stage, surviving the ICU, that really makes the difference. That’s why someone at age 60 may be only four times more likely to be hospitalized for COVID-19 than an 18-year-old, but they are 30 times more likely to die.
Now … follow Alexander’s suggestion and flood the nation with COVID-19, resulting in ICUs filled to the brim coast to coast. That doesn’t just mean that tens of millions will die who might have lived, it means that most of those who will die will be the younger people who would have survived hospitalizations. What herd immunity would do most effectively would be to help level the playing field by making the rate of deaths among younger patients much closer to that of older patients.
Alexander was hand-picked to head HHS communications not by Roger Stone protégé Caputo, but by Donald Trump. He was repeatedly allowed to alter recommendations from the CDC, including changing guidelines on CDC’s website, because it was well understood that he had Trump’s support. Alexander was key to pushing false information that pushed schools and businesses to open, or to stay open, despite an obvious threat. And he did it all because that’s what Trump wanted. There’s no reason to believe that “we want them infected” was not also Trump’s personal command.
In September, Caputo took an abrupt leave of absence after accusing scientists of “sedition” for refusing to suppress mortality figures and warning that “left wing hit squads” were on the loose. That was also Alexander’s cue to exit stage far right after yet another batch of emails showed that he was fighting to hide information on the risk to children because it “hurt the President.”
Donald Trump has killed hundreds of thousands of Americans who didn’t need to die in this pandemic. But it seems that he didn’t kill nearly as many as he wanted.
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