Trump's Approach to Herd Immunity Would Result in 26 to 32 Million American Deaths

 

It has just been revealed that the White House is pushing a plan for the pandemic that will result in 25 to 30 million American deaths. In this post, I lay out the recently discovered facts about the Administration's plans, and the true American carnage that these plans will lead to. Finally, I will suggest actions that you, the reader, can take to stave off this monumental catastrophe.

The Plan 

In August, Scott Atlas, M.D. joined the White House staff as a special advisor to President Trump on the pandemic. Dr. Atlas is not an epidemiologist (a specialist in how diseases spread), nor is he a specialist in infectious diseases of any sort. He is a neuroradiologist, who specializes in imaging of the brain and branches of the nervous system, and the diagnosis and description of abnormalities in these areas. All of which gives him next to nothing in the way of pandemic expertise; however, as his Wikipedia entry notes, Dr. Atlas has been a medical advisor to Republican politicians, and wants to eliminate Obamacare--and that seems to be enough for the President.

The Washington Post and Yahoo News reported yesterday that Dr. Atlas has been pushing--and the Administration is supporting--an approach to the COVID-19 pandemic that involves an extremely crude implementation of a "herd immunity" strategy. To understand just how bad this approach is, let us consider just what herd immunity is.

Herd Immunity: The Good, the Bad, and the Hideously Ugly

The basic idea behind herd immunity is that, if enough people are immune to a given disease, then that disease cannot "reach" the people who are not immune. 

For example, let's take you, the reader. Let us say you have never had COVID-19 and have no immunity to it. If enough people around you do have immunity to COVID-19, then the disease simply cannot get to you. Hurrah! 

According to Noreen Iftikhar, M.D., for most diseases, "80 to 95 percent of the population must be immune to the disease to stop its spread." Okay. But wait . . . how do people become immune?

Basically, there are only two ways for people to become immune to a disease:

1. People might have been immunized (basically, vaccinated) against the disease. 
2. People might have acquired immunity because they have had the disease and developed antibodies to it. 

That's it. The immunization route would be great, but unfortunately we do not have a vaccine, and as of right now, we'll be lucky to get an effective and safe vaccine sometime in 2021.

The acquired immunity route requires that large numbers of people become infected with the disease; this is a crude approach, something like "infect them all, let God sort them out." I'm calling this bad. However, the hideously ugly part kicks in when we are dealing with a disease that is as deadly as COVID-19 is.

The True Case Fatality Rate of COVID-19

I am sure that some of my readers are of the opinion that COVID-19 "isn't that bad," and is about as lethal as the flu (0.1 percent lethality). I am sure that some other of my readers are thinking that they heard the fatality rate is "about 1 percent." All of these readers are 'way, 'way off.

When a pandemic is over and done, epidemiologists look at the number of people who died from the disease, and divide that by the number of people who ever had the disease, to derive the case fatality rate. But you should not use this method when you are in the middle of a pandemic, because you will underestimate the actual fatality rate--perhaps by a great deal. 

For a pandemic that is in progress, like the COVID-19 pandemic, the closest approximation we can get to the true case fatality rate is the Closed Cases Method. This method divides the number of deaths by the total number of closed cases (all cases that have resulted in death, recovery, or discharge from the hospital). Using the Closed Cases Method on data from the United States as of today, we see that the best approximation we have for the case fatality rate of COVID-19 is 5 percent. 

Five percent. Perhaps that is not impressive to you. But 5 percent is 50 times worse than the fatality rate of the seasonal flu, and much more than the fatality rate of the dreaded Spanish Flu of 1918 (between 2.5 percent and 3 percent).

Now let's see what happens when you apply that 5 percent fatality rate to a crude, acquired immunity approach to herd immunity in the United States.

The Mathematics of Millions of Deaths

In 2019, the population of the United States was 328.2 million. As I mentioned earlier, 80 percent to 95 percent of a population have immunity for herd immunity to kick in. That means 262.6 million to 311.8 million Americans must have immunity to achieve herd immunity.

But wait: Trump's new pandemic advisor, Dr. Atlas, wants to achieve herd immunity, not through immunization in the near future, but through infection right now. What does that look like when the disease has a fatality rate of 5 percent? Like something out of apocalyptic nightmare, that's what.

Applying the 5 percent fatality rate to the number of Americans that would have to be infected to achieve herd immunity results in a staggering number of deaths: 13.1 million to 15.6 million deaths. to be exact.

That's right: the best case scenario, applying a strategy of mass infection leading to herd immunity the hard way, we will see between 13.1 million and 15.6 million Americans die.

But wait. It gets much, much worse.

You see, that 5 percent fatality rate only applies to a situation where our hospitals are all functioning within capacity, not in an overload situation where patients must be turned away because there simply is not any room in the hospital for them. The entire American hospital system only has a capacity of under a million staffed beds. When you start talking about 260+ million people infected with COVID-19, of whom about 20 percent (52 million plus patients) require hospitalization, then you are talking the entire American hospital situation in overload situation. We're talking millions upon millions of patients receiving no hospital treatment at all. 

When that happens, we are not talking a 5 percent fatality. We are talking at least a 10 percent fatality rate--or more.

The result? Between 26 million and 32 million American deaths.

The cost in human suffering and death is beyond one human being's capacity to comprehend. I can calculate the numbers. But when I think of the meaning behind those numbers, I am horrified almost out of my wits.

What the Reader Can Do to Avert This

In the face of this potential monumental catastrophe, an American Holocaust worse than anything that the nation has ever suffered, the reader actually has some options other than despair. I strongly recommend that the reader do each of these things:

1. Contact your Senators and Representatives in Congress, right now--really, today--and tell them that you expect them to vigorously reject the Administration's plan to implement any sort of strategy involving mass infection leading to herd immunity. Tell them that to do otherwise will lose your vote, now and forever. (At the risk of mentioning the obvious, this is life and death, folks.)
2. Practice the most rigorous precautions that you ever had, and then some: masks, social distancing, washing everything in sight. Why? Because some people will follow the Administration's directions as they push their fatal approach, and you need to protect yourself from those people.
3. Prepare for conditions to get more than a bit gnarly. Store food, enough for weeks, even months. Why? Because if, despite all these warnings, the White House does force its fatal strategy on the people, it may not be safe to shop, and my guess is that no one will be delivering food for awhile.
4. Surely someone reading this will be able to pass a message to someone who knows someone who knows someone in the White House who can get this post, with the following Memo, before the President.

May peace be upon us all.

- - - - -

Memo to President Trump

Consider what the economy would look like in the scenario described in this post, one in which a "mass infection" approach to herd immunity results in 26 million to 32 million American deaths.

Consider a country with 26 million to 32 million fewer consumers. A country where the survivors struggle to survive without going outside to buy anything. A country with 26 million to 32 million fewer workers. Even the stock market will tank below Great Depression levels.

In this scenario, one need not be concerned about the election. One will need to be concerned about pitchforks and torches, and massive hordes descending upon the White House, hordes so huge that no fence, no troops, and no bunker can offer protection.

Wise men will choose carefully here.

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Permission is hereby granted to re-post or quote this blog entry, if and only if Mark Koltko-Rivera, Ph.D., is credited as the author. 

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