Getting to Herd Immunity

 

In order to get back to normal, we need an actual plan. A plan starts with the following steps:

1: Figure out where you want to get to; the goal.
2: Figure out how you can get there.

Here is my plan.

The Goal is simple enough — we need to get back to normal life, for a huge range of reasons. But in order to get there, we need to achieve what is called “Herd Immunity.” Herd Immunity is achieved when enough people are already immune so that an illness cannot explode in a population. According to the Wall Street Journal Friday, we get to herd immunity with between 40-70% of the population. According to other sources, we might need more than that. Once we have herd immunity, the risks of someone who is “at risk” go down – way down. Normality can be achieved when we have it.

How to Get There: We must find out who is immune. We do not need certainty – this is statistics, after all. If we had a test that showed that a person is 90% certain to be immune, then that is data. It is not perfect data, but it is data we can use, uncertainty and all.

Immunity is known through detection of antibodies. The presence of a certain kind of antibody (IgG) will tell you whether your body has immunity to Coronavirus. (The length of that immunity is not known for sure yet, but according to the same WSJ article, it is between one year and the rest of your life).

In recent days, companies have started offering tests that will tell you whether you have the infection (IgM), and whether you have the antibodies for immunity (IgG). These are fingerprick tests that take 10 minutes and can theoretically be done anywhere. They say they are better than 90% for false results.

Whether from this company or another, everyone – not just medical professionals – should be tested. It is the only way to know whether it is safe to be up and about. It is the only way, for example, for a medical volunteer to know whether they are at risk themselves, or at high risk of infecting others. I strongly urge everyone to ask their doctor or other health care professional to order and use Corona tests. Once we reduce the uncertainty, we reduce the fear. And we increase safety and all the good things that come from a resumption of normal life – the things that come with herd immunity.

Thanks for reading.

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  1. Boss Mongo Member
    Boss Mongo
    @BossMongo

    iWe, concur.

    But, I dislike “herd immunity.”  “Herd” implies a group of creatures with broad, flat teeth for grinding grass, multiple stomachs, and eyes set wide on the skull for the greatest field of vision to look for approaching predators.

    I much prefer “pack immunity.” 

    ‘Murica.

    • #1
  2. kidCoder Member
    kidCoder
    @kidCoder

    The ray biotech link is dead.

    • #2
  3. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    kidCoder (View Comment):

    The ray biotech link is dead.

    Not good.

    • #3
  4. Bishop Wash Member
    Bishop Wash
    @BishopWash

    kidCoder (View Comment):

    The ray biotech link is dead.

    Just has some extra bits after the last slash. Delete those and the link works.

    • #4
  5. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Bishop Wash (View Comment):

    kidCoder (View Comment):

    The ray biotech link is dead.

    Just has some extra bits after the last slash. Delete those and the link works.

    Thank you.

    Correct URL:

    https://www.raybiotech.com/covid-19-igm-igg-rapid-test-kit

    • #5
  6. Joseph Stanko Coolidge
    Joseph Stanko
    @JosephStanko

    Makes sense to me, we might learn that a lot of people have already had it without knowing b/c they had mild cases or were asymptomatic.

    • #6
  7. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    • #7
  8. TeamAmerica Member
    TeamAmerica
    @TeamAmerica

    You’re talking about using the Critical Path Method to get back to normalcy, which is a good idea, but I thought a shortage of tests was a continuing major problem.

    • #8
  9. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    The post infection ab test is critical for analyzing the epidemic.  We have had these convalescent serum tests for 100 years.  Now we have PCR which is useful in acute cases, especially since we have anti-virals that work.  There has been a lot of hysteria, some of which is driven by politics especially Trump hate. Even Italy indulged by describing Trump’s ban on flights from China as “racist” and having a “Hug a Chinese Day.”

    I guess that was not a good idea.  We will see pretty soon what the real CFR is and then we can open the economy.  I expect that will be by Easter.  The crazy behavior by two female Democrat House members today will not change that.

    • #9
  10. Aaron Miller Inactive
    Aaron Miller
    @AaronMiller

    iWe: According to the Wall Street Journal Friday, we get to herd immunity with between 40-70% of the population. According to other sources, we might need more than that. Once we have herd immunity, the risks of someone who is “at risk” go down – way down.

    How does that work? If 60% of the general population comprised of various demographics likely to survive are introduced to the virus and consequently develop antibodies for it, the remaining people — such as the elderly and folks with abnormal blood pressure — still wouldn’t have the antibodies necessary to improve their defenses. 

    Theoretically, more infected people means more data to observe the virus and to test treatments. That would help vulnerable groups with information… but would simultaneously increase their odds of contracting the virus before treatments are ready. The more common the illness, the more likely it will slip through precautions; especially since vulnerable people cannot generally remain secluded forever. 

    Antibodies don’t spread naturally like contagions. Widespread exposure doesn’t directly help the most vulnerable. And if recent weeks of statistical overload has taught us anything, it’s that more data does not automatically improve understanding. If physicians swim in a sudden abundance of data, it does not follow that they will be able to process and interpret that data at an agreeable rate. 

    I’m not saying it’s a terrible idea. But let’s not let optimism drift into wishful certainty.

     

    • #10
  11. Judge Mental, Secret Chimp Member
    Judge Mental, Secret Chimp
    @JudgeMental

    Aaron Miller (View Comment):
    How does that work?

    With a large enough percentage of the population immune, the virus can’t get a foothold in the society, making the unprotected people less likely to come into contact with it.

    • #11
  12. Aaron Miller Inactive
    Aaron Miller
    @AaronMiller

    Judge Mental, Secret Chimp (View Comment):

    Aaron Miller (View Comment):
    How does that work?

    With a large enough percentage of the population immune, the virus can’t get a foothold in the society, making the unprotected people less likely to come into contact with it.

    It gets stopped sooner by antibodies among the least vulnerable. Gotcha. Thanks.

    • #12
  13. MISTER BITCOIN Inactive
    MISTER BITCOIN
    @MISTERBITCOIN

    https://m.washingtontimes.com/news/2020/mar/26/widespread-isolation-and-stopping-all-human-intera/

    By scott atlas md of Hoover institute 

    he discusses why 100 percent ideal is not desirable and counter productive 

    he also discusses the diamond princess case. 
    most infected were over age 60

    • #13
  14. Joseph Stanko Coolidge
    Joseph Stanko
    @JosephStanko

    TeamAmerica (View Comment):

    You’re talking about using the Critical Path Method to get back to normalcy, which is a good idea, but I thought a shortage of tests was a continuing major problem.

    Yes but I think we’re talking about 2 different kinds of tests.  The test that exists but is in short supply involves swabbing the nose and throat and then checking for signs that someone is shedding the coronavirus and therefore is currently infected.

    This post is about a new test under development, a blood test to see if you have antibodies.  If you had coronavirus 3 months ago, and have since recovered, the first test would return false, whereas this new test would return true.

    • #14
  15. CarolJoy, Above Top Secret Coolidge
    CarolJoy, Above Top Secret
    @CarolJoy

    Aaron Miller (View Comment):

    iWe: According to the Wall Street Journal Friday, we get to herd immunity with between 40-70% of the population. According to other sources, we might need more than that. Once we have herd immunity, the risks of someone who is “at risk” go down – way down.

    How does that work? If 60% of the general population comprised of various demographics likely to survive are introduced to the virus and consequently develop antibodies for it, the remaining people — such as the elderly and folks with abnormal blood pressure — still wouldn’t have the antibodies necessary to improve their defenses.

    Theoretically, more infected people means more data to observe the virus and to test treatments. That would help vulnerable groups with information… but would simultaneously increase their odds of contracting the virus before treatments are ready. The more common the illness, the more likely it will slip through precautions; especially since vulnerable people cannot generally remain secluded forever.

    Antibodies don’t spread naturally like contagions. Widespread exposure doesn’t directly help the most vulnerable. And if recent weeks of statistical overload has taught us anything, it’s that more data does not automatically improve understanding. If physicians swim in a sudden abundance of data, it does not follow that they will be able to process and interpret that data at an agreeable rate.

    I’m not saying it’s a terrible idea. But let’s not let optimism drift into wishful certainty.

     

    However there is a treatment that is ready. Actually there are two. One is the anti malarial drug; the other is the high dosage Vitamin C given through an IV.

    Each day, some other group of clinicians or doctors writes up their success with the anti malarial. The latest bit of research I read had to do with a patient in France who was almost 90 and was in extreme distress, but he  ended up recovering due to the administration of chloroquine and several other drugs used in conjunction with it.

    Here in the USA, the chloroquine is used with something called Kaletra, and this combination is impressive enough that Elon Musk is interested in it.

    ####

    • #15
  16. CarolJoy, Above Top Secret Coolidge
    CarolJoy, Above Top Secret
    @CarolJoy

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    • #16
  17. MISTER BITCOIN Inactive
    MISTER BITCOIN
    @MISTERBITCOIN

    CarolJoy, Above Top Secret (View Comment):

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    In an emergency we don’t have the luxury of waiting for perfect information 

    • #17
  18. MISTER BITCOIN Inactive
    MISTER BITCOIN
    @MISTERBITCOIN

    CarolJoy, Above Top Secret (View Comment):

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    this is part of the scientific method. Conduct experiments to get closer to the right answer. 

    the Facebook response is very lazy 

     

     

    • #18
  19. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    MISTER BITCOIN (View Comment):

    CarolJoy, Above Top Secret (View Comment):

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    this is part of the scientific method. Conduct experiments to get closer to the right answer.

    the Facebook response is very lazy

    Well, she wasn’t exactly objecting to experiments.

    • #19
  20. Mendel Inactive
    Mendel
    @Mendel

    Two points:

    The antibody tests will be a real game changer when they finally hit mass production and distribution (my former lab has set up a homebrew system and has already started testing local hospital staff). However, we shouldn’t get our hopes up too much that an unexpectedly large percentage of the population is already immune. The Oxford paper making the rounds a few days ago was based on very optimistic assumptions with no basis (nor claim for basis) in real data.

    Remember that even if the actual number of people currently/previously infected is 100x as many as been identified by testing, that would still be only about 3-4% of the entire population. That’s still a long ways away from herd immunity.

    The other problem is that while herd immunity is the ideal end state, the present goal is to get uncontrolled spread of the disease under control. That means slowing down the rate of infection. And slowing down the rate of infection means it might take a looooong time to get to herd immunity.

    I think the truth is that no public health community really has a good plan yet about how to get to herd immunity without the risk that virus spread gets out of control again.

    • #20
  21. Sisyphus (Rolling Stone) Member
    Sisyphus (Rolling Stone)
    @Sisyphus

    Mendel (View Comment):
    I think the truth is that no public health community really has a good plan yet about how to get to herd immunity without the risk that virus spread gets out of control again.

    China seems to be getting the numbers they want by expelling anyone who will nay say them from the country. Xi is seizing the perfect opportunity to “quietly” adjust his awkward demographic challenges. Too many old people. Too many poor people. Too many non-Hans. Too many surly journalists.

    • #21
  22. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    CarolJoy, Above Top Secret (View Comment):

    Aaron Miller (View Comment):

    iWe: According to the Wall Street Journal Friday, we get to herd immunity with between 40-70% of the population. According to other sources, we might need more than that. Once we have herd immunity, the risks of someone who is “at risk” go down – way down.

    How does that work? If 60% of the general population comprised of various demographics likely to survive are introduced to the virus and consequently develop antibodies for it, the remaining people — such as the elderly and folks with abnormal blood pressure — still wouldn’t have the antibodies necessary to improve their defenses.

    Theoretically, more infected people means more data to observe the virus and to test treatments. That would help vulnerable groups with information… but would simultaneously increase their odds of contracting the virus before treatments are ready. The more common the illness, the more likely it will slip through precautions; especially since vulnerable people cannot generally remain secluded forever.

    Antibodies don’t spread naturally like contagions. Widespread exposure doesn’t directly help the most vulnerable. And if recent weeks of statistical overload has taught us anything, it’s that more data does not automatically improve understanding. If physicians swim in a sudden abundance of data, it does not follow that they will be able to process and interpret that data at an agreeable rate.

    I’m not saying it’s a terrible idea. But let’s not let optimism drift into wishful certainty.

     

    However there is a treatment that is ready. Actually there are two. One is the anti malarial drug; the other is the high dosage Vitamin C given through an IV.

    Each day, some other group of clinicians or doctors writes up their success with the anti malarial. The latest bit of research I read had to do with a patient in France who was almost 90 and was in extreme distress, but he ended up recovering due to the administration of chloroquine and several other drugs used in conjunction with it.

    Here in the USA, the chloroquine is used with something called Kaletra, and this combination is impressive enough that Elon Musk is interested in it.

    ####

    Remdesivir is an anti-viral that is effective and may be the best treatment for advanced cases. Hydroxychloroquine and Azithromycin combination has been successful. I know nothing about “IV Vitamin C.”

    • #22
  23. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    Mendel (View Comment):

    Two points:

    The antibody tests will be a real game changer when they finally hit mass production and distribution (my former lab has set up a homebrew system and has already started testing local hospital staff). However, we shouldn’t get our hopes up too much that an unexpectedly large percentage of the population is already immune. The Oxford paper making the rounds a few days ago was based on very optimistic assumptions with no basis (nor claim for basis) in real data.

    Remember that even if the actual number of people currently/previously infected is 100x as many as been identified by testing, that would still be only about 3-4% of the entire population. That’s still a long ways away from herd immunity.

    The other problem is that while herd immunity is the ideal end state, the present goal is to get uncontrolled spread of the disease under control. That means slowing down the rate of infection. And slowing down the rate of infection means it might take a looooong time to get to herd immunity.

    I think the truth is that no public health community really has a good plan yet about how to get to herd immunity without the risk that virus spread gets out of control again.

    “Herd immunity” is only until a successful vaccine is available.

    • #23
  24. MarciN Member
    MarciN
    @MarciN

    Quarantining a place such as New York City or Lombardy or Wuhan makes the situation worse for many reasons. The longer the quarantine is in place, the sicker and the more numerous the infected people inside it become. It’s a vicious circle of the worst kind.

    Everything about being locked inside a quarantined place works against the human being’s own immune system. There’s limited opportunities for exercise, fresh air, fresh food, and socializing. For upper respiratory diseases, lack of exercise may be the worst effect of the quarantine because it is exercise that gets the secretions in the lower lungs to circulate such that the other body systems can get rid of them. But the worst of all of the quarantine side effects is the tremendous anxiety it causes. That anxiety interferes with people getting the good-quality sleep they need, and it lowers their resistance generally. Sustained high anxiety is extremely harmful to human health.

    I found this paragraph in the Wikipedia entry on tuberculosis very interesting, emphasis added:

    When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0.5 to 5.0 µm in diameter. A single sneeze can release up to 40,000 droplets. Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection).

    People with prolonged, frequent, or close contact with people with TB are at particularly high risk of becoming infected, with an estimated 22% infection rate. A person with active but untreated tuberculosis may infect 10–15 (or more) other people per year. Transmission should occur from only people with active TB–those with latent infection are not thought to be contagious. The probability of transmission from one person to another depends upon several factors, including the number of infectious droplets expelled by the carrier, the effectiveness of ventilation, the duration of exposure, the virulence of the M. tuberculosis strain, the level of immunity in the uninfected person, and others. The cascade of person-to-person spread can be circumvented by segregating those with active (“overt”) TB and putting them on anti-TB drug regimens.

    Quarantining a city creates a situation in which “prolonged, frequent, or close contact” is almost unavoidable. South Korea wisely did not do this, which is one reason–the second reason was the universal use of face masks–for South Korea’s success in handling this outbreak. By not imposing a citywide or countrywide extended quarantine, South Korea reduced the chances for “prolonged, frequent, or close contact,” which ultimately made their herd healthier and better equipped to handle the virus in those who did become sick from it. Why we followed China’s failure instead of South Korea’s success will be the question asked most often by historians.

    A little quarantining–closing schools, for example–is helpful. Too much makes the situation worse, especially for those trapped inside them.

    • #24
  25. MichaelKennedy Inactive
    MichaelKennedy
    @MichaelKennedy

    Aaron Miller (View Comment):
    How does that work? If 60% of the general population comprised of various demographics likely to survive are introduced to the virus and consequently develop antibodies for it, the remaining people — such as the elderly and folks with abnormal blood pressure — still wouldn’t have the antibodies necessary to improve their defenses. 

    A lot of this is the chances of contagion.  The cruise ship passengers were locked up in a ship with infected other passengers and crew, yet only 20% converted to positive and only 8 died.  It has been written long ago that certain infectious diseases require minimum populations unless they have animal vectors. and reservoirs. Smallpox is limited to man and requires a population of 250,000 to survive. Malaria has a reservoir in birds.  This new virus may have an animal reservoir but, if not, may require a minimal “naive” population of those without immunity.  Eventually, like flu, a vaccine will enlarge the immune population.  That will make transmission harder.

    • #25
  26. iWe Coolidge
    iWe
    @iWe

    MichaelKennedy (View Comment):
    “Herd immunity” is only until a successful vaccine is available.

    Vaccines also are about herd immunity. Vaccines are not universally distributed, and they do not “stick” with all patients. Lots of vaccinated people end up not being immune – it is about 60-95% getting immunity, this immunizing the herd even if the vaccinated individual is still vulnerable.

    • #26
  27. MISTER BITCOIN Inactive
    MISTER BITCOIN
    @MISTERBITCOIN

    Saint Augustine (View Comment):

    MISTER BITCOIN (View Comment):

    CarolJoy, Above Top Secret (View Comment):

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    this is part of the scientific method. Conduct experiments to get closer to the right answer.

    the Facebook response is very lazy

    Well, she wasn’t exactly objecting to experiments.

    why did she say bad news?

    • #27
  28. MISTER BITCOIN Inactive
    MISTER BITCOIN
    @MISTERBITCOIN

    MarciN (View Comment):

     

    I found this paragraph in the Wikipedia entry on tuberculosis very interesting, emphasis added:

    When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0.5 to 5.0 µm in diameter. A single sneeze can release up to 40,000 droplets. Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection).

    People with prolonged, frequent, or close contact with people with TB are at particularly high risk of becoming infected, with an estimated 22% infection rate. A person with active but untreated tuberculosis may infect 10–15 (or more) other people per year. Transmission should occur from only people with active TB–those with latent infection are not thought to be contagious. The probability of transmission from one person to another depends upon several factors, including the number of infectious droplets expelled by the carrier, the effectiveness of ventilation, the duration of exposure, the virulence of the M. tuberculosis strain, the level of immunity in the uninfected person, and others. The cascade of person-to-person spread can be circumvented by segregating those with active (“overt”) TB and putting them on anti-TB drug regimens.

    Quarantining a city creates a situation in which “prolonged, frequent, or close contact” is almost unavoidable. South Korea wisely did not do this, which is one reason–the second reason was the universal use of face masks–for South Korea’s success in handling this outbreak. By not imposing a citywide or countrywide extended quarantine, South Korea reduced the chances for “prolonged, frequent, or close contact,” which ultimately made their herd healthier and better equipped to handle the virus in those who did become sick from it. Why we followed China’s failure instead of South Korea’s success will be the question asked most often by historians.

    A little quarantining–closing schools, for example–is helpful. Too much makes the situation worse, especially for those trapped inside them.

     

    good points

    s korea did isolate Daegu and that crazy church/cult

     

    • #28
  29. Saint Augustine Member
    Saint Augustine
    @SaintAugustine

    MISTER BITCOIN (View Comment):

    Saint Augustine (View Comment):

    MISTER BITCOIN (View Comment):

    CarolJoy, Above Top Secret (View Comment):

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    this is part of the scientific method. Conduct experiments to get closer to the right answer.

    the Facebook response is very lazy

    Well, she wasn’t exactly objecting to experiments.

    why did she say bad news?

    I said “bad news.” The bad news was that she said something about us not knowing much about antibodies providing immunity.

    • #29
  30. Judge Mental, Secret Chimp Member
    Judge Mental, Secret Chimp
    @JudgeMental

    Saint Augustine (View Comment):

    MISTER BITCOIN (View Comment):

    Saint Augustine (View Comment):

    MISTER BITCOIN (View Comment):

    CarolJoy, Above Top Secret (View Comment):

    Saint Augustine (View Comment):

    Someone on Facebook who knows medical vocabulary words say the accuracy numbers from Ray Biotech look great, and it seems like a good idea in theory.

    The bad news: She says we don’t know how many antibodies are necessary for immunity.

    If there are antibodies, then it means the person has had the disease and so they will have immunity to it.

    I don’t think that there is a need to know the number of antibodies.

    this is part of the scientific method. Conduct experiments to get closer to the right answer.

    the Facebook response is very lazy

    Well, she wasn’t exactly objecting to experiments.

    why did she say bad news?

    I said “bad news.” The bad news was that she said something about us not knowing much about antibodies providing immunity.

    The only place where that might be important that I can see is the blood plasma approach.  It would determine whether one donor can treat one person or ten.

    • #30
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