And, a couple of weeks from now, when that state achieves the lowest rate in the nation, will people finally pay some attention to how they achieved that? And will our public health officials then stop lying about it?
And I am going to tell you which state, and what lie?
This post is prompted by two things.
Fauci shifts the goalposts:
70% 75% 80% 85% 90% required to achieve herd immunity.
First, there’s this short piece of reporting in Axios. In a nutshell, it’s about our most respected public health official deliberately playing games with a key COVID-19 number. And, worse, admitting to a reporter that he did that.
The number in question is the percent of the population that must be immune to COVID-19 before we achieve herd immunity. That value that’s most frequently floated is 70 percent. I characterized that figure earlier as “slapdash” (Post #901), meaning that it’s both highly uncertain not very well thought-through. So it’s not like I’m wedded to that value.
But now that we have a vaccine, and a whole lot of people have already had COVID-19, we find Dr. Fauci changing his tune on that. Deliberately. With no basis in fact. Instead of a target of 70 percent immune, the new party line is that we need 90 percent of the population immune to COVID-19 in order to achieve herd immunity.
So, the number changed. It changed for no fact-based reason. The Axios reported asked a polite version of the question that needs to be asked: Were you lying before, or are you lying now? And Fauci’s answer is the polite version of, I was lying before, trust me now.
As as person who spent a decade as a health policy analyst for the Federal government, I was horrified. Not with the idea that the number in question is uncertain. But with the idea that a key scientific official would deliberately choose values with an eye toward manipulating public opinion, and then publicly admit to doing that.
And so our public health bureaucracy serves up yet another round of “Forget what I said, listen to what I’m saying now”.
You don’t need masks. Masks are required. There is no aerosol transmission of COVID-19. We must take precautions against aerosol transmission. Fomite (inanimate object) transmission is an important disease vector. Fomite transmission never or rarely happens outside of the hospital setting. We need 70% immune for herd immunity. We need 90% immune for herd immunity.
With this last development, it’s almost as if they aren’t taking the concept of herd immunity very seriously.
Nobody seems to be taking herd immunity seriously.
I don’t have comments on this blog, and I don’t encourage email. I might get two emails a year, from this blog.
But I got two emails, just this past week, from complete strangers, on my simple calculation showing that North Dakota probably has achieved herd immunity. Not via vaccines, but via rampant COVID-19 spread. Both of these readers had done the same back-of-the-envelope calculation I had (Post #901, Post #921, and more broadly, the table in Post #925), both had gotten zero traction on it, and both noted the complete and total lack of media coverage of this issue. The issue being that herd immunity can be acquired from widespread infections, and not just from vaccines.
Look around. Google “North Dakota herd immunity”. You’ll see talk about vaccines, and vaccines, and vaccines. About how you can’t achieve herd immunity without vaccines. Oh, and did I mention that vaccines are required to achieve herd immunity?
(I need to add a small caveat here. There was, early on, some discussion of natural herd immunity occurring within some small neighborhoods in New York City that had been hardest-hit by COVID. (See this NY Times reference. Or this NY Times reference.) But as far as I can tell, that discussion took place half-a-year ago and hasn’t been brought up since.)
The first hit you’ll get, anywhere, that discusses the likelihood that North Dakota is already at or near herd immunity, purely from infections, is this blog. And that’s just pitiful, given that on a good day I might have 30 readers. And given how important this issue is.
And so, for reasons I cannot quite fathom, nobody is willing to talk about the potential for naturally-acquired herd immunity — herd immunity via rampant infection — to be the main driving force in the abatement of the COVID-19 third wave.
Plausibly, people can’t separate the policy from the science here. Maybe any discussion of this has been poisoned by the Looney Tunes in the current administration who pushed “herd immunity” as a policy. That is, who would have made that their deliberate choice for dealing with the pandemic. To the point where when I say “natural herd immunity”, maybe all that most people hear is some variant on “death panels”.
But I’m not talking about this as a health care policy. I’m trying to get people to pay attention to it, as a fact. I don’t think anybody set out to give North Dakota COVID herd immunity via a strategy of widespread sickness and death. I don’t think that was ever an explicit policy choice. But that doesn’t mean that it didn’t happen. And that we can’t take away some lessons from it.
There are maybe four things about this situation that drive me absolutely crazy.
First, the idea that we must have vaccines, to achieve herd immunity, is simply false. As a matter of arithmetic, I mean. The correct statement is that a certain fraction of the population has to be immune, to achieve herd immunity. The virus is indifferent to whether that immunity comes from a vaccine, or from a prior infection.
As a matter of policy, I’m strongly pro-vaccine. As a matter of policy, I’m strongly anti-natural-herd-immunity. I’ve made that clear in many posts on this website. But as a matter of science, it doesn’t make one damn bit of difference how you acquire antibodies to COVID-19. As far as we know, infections and immunizations count exactly the same on the herd immunity scorecard.
Second, the calculation of the high fraction of the population that has already been infected is not rocket science. Anybody can do the same back-of-the-envelope calculations that I did, in the posts cited above. I am absolutely sure that (e.g.) Dr. Fauci’s staff can do that calculation. Arguably better than I can. So it’s not as if our Public Health establishment could possibly be unaware of the issue.
Third, I understand why our Public Health establishment won’t talk about this. Just read what Fauci said. Charitably, they consider it their mission to get people vaccinated against COVID-19. They certainly don’t want people in North Dakota to slack off on vaccines, even if North Dakota has in fact achieve herd immunity already. So they just aren’t going to raise the possiblity.
Less charitably, if the rest of the country goes the way of North Dakota, that will, in some sense, make the vaccines obsolete before they are distributed. Not from the standpoint of protecting an individual — if you haven’t been infected, you remain at risk until vaccinated. But from the public health herd immunity standpoint. If large quantities of vaccine arrive only after the pandemic has run its course, that’s going to be another black eye on an already badly-beaten-up U.S. public health establishment.
Fourth, given that, I guess I understand why the CDC can’t bother to check it empirically, despite how cheaply they could do that. Instead of estimating the fraction of ND residents who have survived COVID-19, pick a small random sample and give them a blood antibody test. Given how important the whole herd immunity question is, failing to do that seems like an amazingly stupid omission.
If it’s true that (say) 70% of the North Dakota population has survived a COVID-19 infection, it wouldn’t take much more than a random sample of 100 people to prove that to within a reasonable margin of error. (If the true rate were 70%, the 95% confidence interval would span roughly 60% to 80%, with a sample of 100 people. That’s plenty good enough to make the point that ND is at or near herd immunity.)
Early on, CDC funded testing of huge samples of individuals, trying to get a handle on what the true infection rate was. In Virginia, for example, they collected and tested blood from 5000 people. Large sample sizes were needed, at that time, in part because the actual infection rates were in the low single digits. (And so, that’s just statistics). And in part because they wanted some degree of accuracy.
So CDC spent millions of dollars, early-on, to pin the true infection rate. But now, you’d need just a tiny sample to pin down the rate, given how many people have been infected. An investment of just a few tens of thousands of dollars could begin to settle this issue. And, coincidentally, begin to tell us a lot about where herd immunity sets in. But for some reason, doing this simple, cheap analysis doesn’t seem to be on anybody’s agenda.
Fifth, I don’t understand why the mainstream media aren’t addressing this issue. Because if herd immunity is the driving force behind the ebb of the third wave, that’s exceptionally good news.
Let me just illustrate. Assume for a minute that I’m right, and North Dakota’s infection rate has fallen because they hit herd immunity. Then:
- That’s as bad as it will ever get in North Dakota. They are now seeing the light at the end of the tunnel.
- That’s probably as bad as it can get anywhere in the U.S.. So fears of mass graves and so on are probably unfounded, if rapidly-spreading infection is self-limiting.
- That probably means that America, as a whole, is over the hump on COVID-19. Once California peaks (if it hasn’t already), then half of people in the US will be living in states where more than half the population has already survived a COVID-19 infection.
To answer the question: North Dakota.
As of today, North Dakota has the 4th lowest rate of new COVID-19 infections /100,000/day (seven-day moving average) among all U.S. states.
And this is why I don’t think the mainstream media can ignore this issue much longer. Because if the current trend persists, somewhere around the second week of January, North Dakota will have the lowest rate in the U.S. And when (well, if) that happens, I think people are going to notice.
Right now, you can pretend that ND is just another state in the crowd. But once it becomes the state with the lowest rate, I think that’s going to make the news. Given that it was once — six weeks ago! — the state with the highest rate — ever!
Source: Data reported as of 12/27/2020, via NY Times Github COVID data repository. Thick dark line is ND. Spike on ND line on right side of graph is an artifact of a one-time change in data reporting.