Herd Immunity as a Coronavirus Pandemic Strategy

Jay, when you hear Mark's comment, and I'm sure you've read the John Snow memorandum, that logistically, logistically, this simply is not possible in a country of 360 million, testing relatively still unavailable in certain places, a tremendous amount of political discord.

Do you think it is logistically possible?

Let me start by noting a couple of things.

One, that the lockdowns themselves have created intermixing between the vulnerable and non-vulnerable.

They've essentially caused economic dislocation where young people have moved back in with parents, they've closed universities, sent young people to live back home, and created situations where this kind of mixing that where vulnerable people would be exposed has occurred.

That lockdowns have also, they're not universal lockdowns.

We've asked essentially poor people, minorities, urban workers, even vulnerable ones, older ones, a 63-year-old bus driver, a Costco clerk, you know, 60-year-old Costco clerk with diabetes, to go work and expose themselves.

Lockdowns themselves, in fact, create vulnerable people and put them in places where they are going to be at risk.

Let me just, let me take another tack at the premises.

The premises of the Great Depression Declaration, contrary to what Mark just said, are actually scientifically based.

I mean, we have scientific documentation for every single one of the comments, the premises that I said, the age stratification of the risk, the lockdown.

So I think the question is not science.

The question is what should we do in the face of the science that we all agree on? Then finally, let me just talk about, in direct answer to your question, can we protect the vulnerable? And I think the answer

is

yes, if we try.

We have relied on this crutch of reducing community spread as a way to protect the vulnerable, and that's clearly failed, right? You cited the really sad facts about this epidemic.

Those are, we've essentially had a lockdown policy.

And you can say it didn't work perfectly, but any public health intervention needs to take into account the environment it actually is going to be implemented in, not pretend like we are going to have it work perfectly.

That includes the focus of protection as well.

So let me talk a little bit about specific strategies that we had in mind that we suggested.

And actually, I invite your listeners and others to suggest more, because I think public health folks are very creative about these things if we put our minds to it.

So I think it depends on where people live.

So if people live in nursing home settings, for instance, well, what are the problems there? Mark suggested one, testing, right? So I think we can deploy testing, but not just PCR testing, which is delayed, but like rapid antigen tests and other tests in those settings so that when visitors come, they can check to see.

We can deploy PPE there so nursing home residents can have access to sort of high quality PPE as needed.

We should provide mechanisms so that people who get sick in nursing homes can be segregated out and get better.

Jay, when you hear Mark's comment, and I'm sure you've read the John Snow memorandum, that logistically, logistically, this simply is not possible in a country of 360 million, testing relatively still unavailable in certain places, a tremendous amount of political discord.

Do you think it is logistically possible?

Let me start by noting a couple of things.

One, that the lockdowns themselves have created intermixing between the vulnerable and non-vulnerable.

They've essentially caused economic dislocation where young people have moved back in with parents, they've closed universities, sent young people to live back home, and created situations where this kind of mixing that where vulnerable people would be exposed has occurred.

That lockdowns have also, they're not universal lockdowns.

We've asked essentially poor people, minorities, urban workers, even vulnerable ones, older ones, a 63-year-old bus driver, a Costco clerk, you know, 60-year-old Costco clerk with diabetes, to go work and expose themselves.

Lockdowns themselves, in fact, create vulnerable people and put them in places where they are going to be at risk.

Let me just, let me take another tack at the premises.

The premises of the Great Depression Declaration, contrary to what Mark just said, are actually scientifically based.

I mean, we have scientific documentation for every single one of the comments, the premises that I said, the age stratification of the risk, the lockdown.

So I think the question is not science.

The question is what should we do in the face of the science that we all agree on? Then finally, let me just talk about, in direct answer to your question, can we protect the vulnerable? And I think the answer

is

yes, if we try.

We have relied on this crutch of reducing community spread as a way to protect the vulnerable, and that's clearly failed, right? You cited the really sad facts about this epidemic.

Those are, we've essentially had a lockdown policy.

And you can say it didn't work perfectly, but any public health intervention needs to take into account the environment it actually is going to be implemented in, not pretend like we are going to have it work perfectly.

That includes the focus of protection as well.

So let me talk a little bit about specific strategies that we had in mind that we suggested.

And actually, I invite your listeners and others to suggest more, because I think public health folks are very creative about these things if we put our minds to it.

So I think it depends on where people live.

So if people live in nursing home settings, for instance, well, what are the problems there? Mark suggested one, testing, right? So I think we can deploy testing, but not just PCR testing, which is delayed, but like rapid antigen tests and other tests in those settings so that when visitors come, they can check to see.

We can deploy PPE there so nursing home residents can have access to sort of high quality PPE as needed.

We should provide mechanisms so that people who get sick in nursing homes can be segregated out and get better.