The antiviral drug remdesivir is the first and only drug approved for COVID-19 treatment in the U.S. USA TODAY

Critics contend that the declaration is arguing against a straw man (a large, general lockdown); I would contend it’s the critics who are the ones aiming at a straw man of unfettered activity.

The difference of one word can be huge. In the case of “herd immunity,” the pertinent words are “or” versus “and.” Herd immunity is the point at which enough people become immune to the virus that the outbreak dies out.

Optimistic models predict[1] herd immunity for COVID-19 might occur when 40% of the population has been infected; other estimates are 60% to 70%[2]. Actual prison data[3] suggest transmission slowed when 60% were infected.

Regardless, we have a ways to go[4].

In the days before vaccines, herd immunity was how viral epidemics died out. Vaccines were a game changer, but even vaccines vary. Measles vaccines are really good and are long-lasting. Influenza vaccines help save lives but immunity is shorter, flu viruses mutate, and thus vaccines are repeated annually. We don’t know, yet, how well COVID-19 vaccines will work, even if they will.

In response to government lockdowns, the Great Barrington Declaration[5] is a statement by public health experts from Harvard, Stanford, Oxford and elsewhere encouraging governments to promote herd immunity by lifting restrictions on the young and healthy and focusing protection on the elderly. At latest count, organizers say that more than 11,000 medical and public health scientists and 30,000 medical practitioners and over 500,000 concerned citizens have signed the declaration.

Recently several articles, some in the medical literature[6], decry relying on “herd immunity” and predict increased deaths if that were the main policy. 

OPINION: Herd immunity rests on naive and faulty logic. In practice, people will die.[7]

No government has stated that achieving herd immunity is its policy.

However, those who acknowledge the importance of herd immunity are not recommending “herd immunity” instead of vaccines. The declaration is not about allowing younger people who are less at risk to just run around willy-nilly without concern for the elderly and compromised.

Critics contend that the Great Barrington Declaration is arguing against a straw man (a large, general lockdown); I would contend it’s the critics who are the ones aiming at a straw man of unfettered activity, laissez faire.

Even a recent New York Times essay[9] criticizing “herd immunity” recognizes that “restrictions to limit death cause real harm, by no means limited to: serious stress on the economy, increases in domestic violence and drug abuse, declines in tests that screen for cancer and on and on. Those living alone suffer real pain from isolation, and the young have every reason to feel bitter over the loss of substantive education.”

No one wants to get sick or cause illness in others. The question is what can be done to minimize the problems that arise from the various economic shutdowns while waiting for an effective vaccine and herd immunity to develop.

WATCH: How achieving herd immunity works[10]

Like many areas of public policy, the devil is in the details.

The declaration states that protecting the vulnerable should be the central aim of public health responses. Nursing homes should continue to stringently protect their residents, and retired people should be very careful.

We should continue to social distance, wear masks where physical distancing in large groups isn’t possible, wash hands, self-quarantine if sick or at risk from underlying conditions, and selectively close when necessary.

However, for those at minimal risk, our public policy should allow them to live as normally as possible. For example, schools should be open to in-classroom teaching, with precautions and exemptions for any elderly teachers of those with underlying conditions. 

The sooner we have a vaccine and herd immunity, the better for all. It is not either/or, but both.

Dr. Greg Ganske is a retired plastic surgeon and was a congressman representing Iowa from 1995 to 2002.

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