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White House Appears to Endorse Herd Immunity Strategy for COVID-19

— "We know the harm of confining people to their home"

MedpageToday
Graveyard of crosses and coronaviruses

WASHINGTON -- The Trump administration Monday appeared to endorse a strategy of herd immunity for the COVID-19 pandemic without waiting for vaccines to be rolled out, with one White House official saying that "we cannot eliminate all cases, so what we do is focus on saving lives."

Two administration officials held a press call -- speaking on condition of anonymity -- to discuss the , which was issued on Oct. 4. The declaration states,"Current lockdown policies are producing devastating effects on short and long-term public health," and argues that keeping lockdown measures in place "until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed."

However, the officials didn't indicate when a formal policy would be issued or what it would look like; the federal government's ability to overrule public health measures taken by the states and local governments is severely limited.

In fact, the unusual format for announcing the shift in policy -- not offered as a prelude to an executive order or presidential address, as is typical for White House "backgrounders" -- may suggest the press call was merely a trial balloon to gauge public response.

"Risks and Benefits" of Herd Immunity

"The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk," the declaration says. It also argues that while vaccines can "assist" in developing herd immunity, society should not depend on them.

It concludes with this: "Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sports, and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity."

On the press call, the White House noted that the declaration -- which says it was issued in "Great Barrington, United States" (presumably Great Barrington, Massachusetts) -- was signed by "over 8,000 public health officials all over the world as well as thousands of doctors and 300,000 citizens." Those initially signing the declaration included H. Cody Meissner, MD, professor of pediatrics and expert on vaccine development at Tufts University in Boston; Sylvia Fogel, MD, a psychiatrist and instructor at Harvard Medical School in Boston; and Nobel laureate Michael Levitt, PhD, a biophysicist at Stanford University in California. But that some of the signatories appear to be false, including "Dr. Person Fakename" and "Dr. Johnny Fartpants."

The administration officials also noted that "over the weekend, WHO [World Health Organization] officially changed their policy and strongly stated that prolonged lockdowns must end because of their significant harms. This worldwide endorsement by the science community at the highest levels aligns very strongly with what the president has said for months -- strongly protect the high-risk elderly and vulnerable and open schools and restore society to function. That policy stems very directly from his initial statements back in March when he said 'The cure cannot be worse than the disease' and has been followed with dozens of statements endorsing this policy."

WHO: Herd Immunity is "Scientifically and Ethically Problematic"

However, on Monday, that the WHO was not endorsing anything like the Great Barrington document. "Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic. It is scientifically and ethically problematic," he said.

"First, we don't know enough about immunity to COVID-19," he said. "Most people who are infected with the virus that causes COVID-19 develop an immune response within the first few weeks, but we don't know how strong or lasting that immune response is, or how it differs for different people. We have some clues, but we don't have the complete picture. There have also been some examples of people infected with COVID-19 being infected for a second time."

"Second, the vast majority of people in most countries remain susceptible to this virus. Seroprevalence surveys suggest that in most countries, less than 10% of the population have been infected with the COVID-19 virus," he continued. "Letting the virus circulate unchecked therefore means allowing unnecessary infections, suffering, and death. And although older people and those with underlying conditions are most at risk of severe disease and death, they are not the only ones at risk. People of all ages have died."

Unemployment and Suicide Rates

On the call, the officials stressed the negative health effects of the lockdown. "Two or three days ago, data came out that 46% of the top six cancers in the U.S. were not diagnosed compared to last year ... Many of these people will come back with more advanced disease," one official said. "We know that half of childhood immunizations were not done; we know that 40% of acute stroke patients were so afraid that they did not come in and seek help via an ambulance. So opening schools, opening colleges, and opening healthcare is very critical when you understand the policy the president has understood from early in March."

"These lockdowns are specifically destructive to working-class people and lower socioeconomic classes and minority populations," he added. "This is extraordinarily harmful." The administration instead wants to focus on the "vulnerable" -- specifically seniors, including both those in nursing homes and those who visit senior centers.

The second official said, "One thing we're seeing in the economic data.... Older literature finds that a 1% increase in unemployment is associated with a 1% increase in suicides. This is very much concentrated at the lower end of the income distribution given the pattern of job losses in March and April."

During a question-and-answer session, one official was asked about the "super-spreader" event at the White House to introduce Supreme Court nominee Amy Coney Barrett, and what the infections that occurred following the event said about current mitigation efforts. "We have a very safe environment here ... and even with that environment and significant mitigation steps that we all obey religiously, the virus is not totally eliminated," the official said.

He added, "I think Americans should be cautiously optimistic about what's going on here -- not understating the danger to the high-risk people ... But I don't think society has to be paralyzed and we know the harm of confining people to their home and, by the way, inside the home is where most of these cases spread ... We have to get schools open and workplaces open ... because we're destroying people."

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    Joyce Frieden oversees ֱ’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.