Monty Python and the quest for herd immunity

Like the Holy Grail, ‘herd immunity’ often seems to involve miraculous powers, and its advocacy to contain the Covid-19 pandemic has far more to do with faith than evidence.

King Arthur and the Knights of the Round Table has been a boys’ own story enjoyed for generations.  The knights created an oasis of chivalry, bravery and service in Camelot, and were united in their quest for the Holy Grail.  The grail, sometimes said to be the cup Christ drank from at the last supper, has miraculous powers, including for example bestowing eternal youth on its holder.  More recently Monty Python transformed this book of derring-do into a riotous comedy.

Herd immunity refers to a situation where the proportion of immune individuals in a population is sufficiently high to produce a decline in the incidence of infection.  Individuals have become immune either through vaccination or through the presence of antibodies from past exposure to the virus.  Once a certain proportion of the population has become immune this indirectly helps those who might still be susceptible because there is a reduced risk of contact.

Herd immunity is a grand phrase, sometimes justified by the results such as the elimination of that centuries-old scourge of humankind smallpox.  A more prosaic phrase such as reduced risk is usually more appropriate.  For example in contagious diseases such as measles and whooping cough, mass vaccination has radically reduced the number of cases, but not yet been sufficient to eliminate them.

Historically, herd immunity was important in contacts between European colonists and indigenous populations, who were suddenly exposed to diseases with which they had had no previous contact, and the spread of disease was often more deadly than the force of arms.

All major modern cases of herd immunity are due to extensive vaccination programs.  The proportion of immune individuals needed to produce a large fall in the incidence of the disease varies, according to some it has to be over 90 per cent immune to keep measles at bay, but for others, it may be lower at 60 or 70 per cent.

The amazing thing in the current pandemic is that some people are advocating herd immunity in the absence of a vaccine.  Former NSW Liberal Minister Pru Goward was quite explicit: she thought that Australia could not remain in hibernation for months on end, and ‘accepting as we now do that a vaccine might never be possible’ wants instead of staged herd immunity.

Some version of vaccine-free herd immunity – despite later official denials – seems to have played a role in the British Government’s thinking at a crucial time, delaying their eventual lockdown response.  A recent documentary quotes Italy’s Health Minister saying that Boris Johnson told Italy’s prime minister the UK had been aiming for coronavirus herd immunity.  Sir Patrick Vallance, the chief scientific adviser to the UK government, said publicly on March 13 that he believed the UK would be able to achieve herd immunity.  Later in the month, the British Government took much more drastic steps, but too late to put the pandemic back in its box.

Sweden also pursued a strategy of what it hoped would be a managed spread.  However, by May 20, it had had 3743 deaths from the coronavirus and a much higher fatality rate than its Nordic neighbours.  In Sweden 371 people per million had died, far higher than Denmark’s 95, Finland’s 54 and Norway’s 43.  The progress this heavy toll made toward herd immunity was slight – by the end of April just seven per cent of Stockholm’s population had Covid-19 antibodies, a far lower figure than officials had anticipated, and there are now some statements of official remorse.

The Economists who say Ni – Always look on the bright side of death

Elsewhere advocates of herd immunity do not seem to have shaped actual policies, but they have often been strong voices from the sidelines, especially those bemoaning the economic damage wrought by lockdown responses.

Prominent academic economist Gigi Foster is one such: ‘Has anyone thought about how would you get a measure of the traded lives when we lock an economy down?  What are we sacrificing in terms of lives?  If you do that kind of calculus you realise very quickly that even with a very, very extreme epidemic in Australia, we are still potentially better off not having an economic lockdown in the first place because of the incredible effects that you see not just in a short-run way but in many years to come.’

She seems to be saying that a lockdown would never be justified, that it always would produce more suffering than an extreme epidemic.  At the least, this is an article of faith rather than a judgement relying on any evidence.

This reliance on dogma rather than evidence often characterizes the contributions of economists.  For example, the Wall St Journal’s Holman W Jenkins asserted ‘Sweden’s neighbours are not avoiding the same deaths with their stronger mandates, they are delaying them, to the detriment of other values.’  He did not feel compelled to offer any evidence, and so far nothing to justify this certainty has been forthcoming.

These economists stress the costs of a lockdown, but often proceed as if the economy would otherwise still hum along, with good investment opportunities in funeral parlours.  In contrast, a group of over 100 Australian economists wrote an open letter decrying the morally objectionable indifference to the loss of life, but also making the key argument ‘We cannot have a functioning economy unless we first comprehensively address the public health crisis.’

‘What has the government ever done for us?’

Australia has so far had great success in containing the pandemic, with a total of 102 deaths and a fatality rate of four per million population.  If Australia’s fatality rate had been the same as Britain’s, for example, there would have been over 13,000 deaths by now.

Perversely Australia’s very success has made it possible for a small cabal of critics to argue that the measures were unnecessary, a little like saying that since we have safely landed it shows we never needed a parachute.  For example ‘Tony Abbott’s former economist’, Andrew Stone, said the shutdown was wrong as the threat posed by the coronavirus was not as large as first feared.

The Australian’s economics editor Adam Creighton has been a faithful conduit for such views.  He described the letter from the economists cited above as bizarre, and said there was no evidence government measures had worked.  Instead, he posits that Australia’s relative success may be due to ‘Australia’s weather, relative population density or island geography.’

Creighton also quotes Nobel Prize-winning biologist Michael Levitt, who said the response was ‘massively’ damaging the economy and decried the ‘panic’ stemming from ‘incorrect numbers’.  He said the damage from the lockdowns ‘will exceed any saving of lives by a huge factor’.  Professor Levitt said ‘herd immunity’ was the right policy and Britain ‘was on exactly the right track before they were fed wrong numbers’

Again the most notable feature of this biologist’s socio-economic assertions is the lack of any supporting evidence.

Merlin Finds the Magic Trade-Off

For the last few months, two different disasters have dominated the news.  The first is about the spread of the pandemic; the second about the collapsing economy.

All policies involve trade-offs, but the difficulties in the current situation are acute, with very high stakes – deaths and recession – and two very different goals seemingly competing to be the priority.  Perhaps most importantly, the decision-making is occurring amid great uncertainty, without clear knowledge of what policy-makers can control and what they can’t, where the risk of unintended consequences is particularly high.

From almost the beginning of the pandemic, people have been looking forward to it being over.  Scott Morrison fantasised that the economy would then ‘snap back’.

Australia currently has very low rates of domestic transmission of the virus, and properly, attention has turned to when and how to re-open social and economic life.  But that does not mean the pandemic is finished.

Indeed globally there are still over 100,000 new cases every day, so at the very least international movements will not be snapping back.  Within Australia, there are likely to be clusters of outbreaks, so that disruptions at local levels will keep on happening.  The months ahead, balancing competing priorities, are likely to be messy.

It will be a future with tracking, testing, quarantine and social distance, but it will be aimed at containing the virus, not allowing it to spread in search of some holy grail of herd immunity.

What would herd immunity without a vaccine involve?  Let’s assume sixty per cent of the population having the anti-bodies will be sufficient, and let’s assume the fatality rate for those affected will be 0.5%.  Then herd immunity in a population the size of the US would require around 200 million people to be infected, which would mean around one million deaths.  In Australia 15 million would need to be infected, leading to about 75,000 deaths.

It must be remembered that we have known of this virus for less than half a year, and there is still so much unknown.  These assumptions may be too optimistic.  The proportion needing to have the antibodies may be considerably higher.  The fatality rate is the best guess at the moment.  We do not know how long immunity will last or short of fatalities whether there will be other lasting effects on those contracting the virus.

But we know enough to know that the prospect of herd immunity without mass vaccination is a cruel hoax, one which should have no part in any debate grounded in evidence rather than dogma.

It is a dead parrot.

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Rodney Tiffen’s books include Rupert Murdoch. A Reassessment and Disposable Leaders. Media and Leadership Coups from Menzies to Abbott.

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14 Responses to Monty Python and the quest for herd immunity

  1. Avatar Bill says:

    Excellent piece John. And despite being a serious issue, I have to confess when I read your reference to Monty Python that immediately came to me was the classic Holy Grail ‘bring out your dead’ scene. Sorry, dark humour for dark times. https://youtu.be/Sh8mNjeuyV4

  2. Avatar Yi Baizi says:

    Do we even know natural immunity is protective? Aren’t the worse cases of COVID-19 caused by the normal activity of our immune system responding to SARS-CoV-2, not directly by the virus itself? It would be like having an autoimmune disease that is set off whenever one meets a pathogenic fragment of SARS-CoV-2 or mutation thereof.

    And don’t we also now know there is permanent scarring and damage of organs especially the lungs from COVID-19? Wouldn’t surviving after natural immunity still leave one with chronic conditions that may or may not lead to years of medical needs or a shortened lifespan?

  3. Avatar Jocelyn Pixley says:

    Economic activity is inseparable from a major, fast-catching pandemic. A lot of economists and other babblers refer to ‘the economy’ as a ‘thing’ but, despite scare tactics about AI, humans are always needed: e.g. hospitals; land regeneration; schooling. Some of the ‘spreaders’ were the well-off returning to Australia after skiing, others were casuals with no job security. People get very sick at the least; reports are still coming on this. One under-reported fact is the overseas tourist industry collapsed during the mega-bushfires in Australia. A macabre reason why Morrison takes CV-19 praise, it is perhaps why other countries said unproven “immunity” from anti-bodies might work.

  4. Avatar Harold Zwier says:

    A walk through the pandemic in the footsteps of Monty Python? How Joycean for Bloomsday.

  5. Avatar George Wendell says:

    Thank you for your article Rod Tiffen.

    It appears to me that the argument around lock downs and social distancing has been polarised: one side constitutes the genuine health professionals driven by the science, verses those who have gained voice through the media to push the case for the billionaires who feel their profits are far more important than human lives. This has been completely obvious in the USA where Trump as president (no less) has been pushing the case for his billionaire Republican supporter friends and himself: get back to work or simply face poverty, the wheels of neoliberal capitalism must continue to turn and exploit the workers even if they die. His poorer and feeble-minded followers don’t even see this, and I would not be surprised if the earlier hard right wing demonstrators who cried “freedom” were not astro-turfed groups concocted to fool Trump supporters and the public at large. Unfortunately many Americans do not know what freedom is, since we usually actually get freedom for the greater number of individuals through some form of constraint. In this case social distancing (restraint) saves lives (freedom to live).

    What concerns me the most now is opening up to world travel again since in every country that has faced lockdown and shut borders, natural selection will ensure that newer more resistant hybrids of the virus will have developed in every isolated pocket of the world. The fact is that it is only social distancing, cleaning surfaces, using masks and natural geographical isolation, that has slowed down the infection rate, the virus has not been eliminated and we do not have a vaccine. Given the rapid rate of reproduction of virus in host cells, much time has passed where mutations have most likely taken place, some increasing the ability of the to virus to survive.

    My view is that all of these isolated strains of virus with possible mutations will mix up when greater world travel begins, and we will mostly likely get some super-hybrids than may be far more destructive than the original virus, or may need more than one vaccine

    I wonder if anyone else has similar views on this?

    • Avatar Yi Baizi says:

      My mind runs on a darker shade than yours, George. I cannot fathom any US politician or bureaucrat of any significance didn’t think about the giving-smallpox-to-Native Americans stories, and certainly it would have been screaming when the NYT splashed the statistics of COVID-19 deaths being disproportionately represented by black Americans on its front page. That and also having wedged themselves politically by ridiculing the Wuhan lockdown and labelling the PRC totalitarian for a month.

      I think you’re right about hybrids, or just more mutations (but maybe the new strains won’t be as pathogenic or contagious) so travel bubbles are needed.

    • Avatar Gavin O'Brien says:

      George,
      I totally agree with your remarks. The idolatry of the mighty economy as almost a living thing is absolutely mind blowing. For centuries the world lived without economists .What worries me is the post modernist rejection of science, whether it be the Pandemic or the far more serious long term issue of human induced climate change . At times I feel the Chief Medical Officer’s statements are being impacted by immense pressure from Government politicians, vested interests such as big business and the sporting codes who are more worried about plunging profits then they are about people’s health and well being.
      A super hybrid strain of COVID-19 is too scary to even think too much about

  6. Avatar Michael Thomson says:

    Your article offers lots of criticism and nothing that is useful.
    What is your proposed way forward if there is no viable vaccine, which is the most likely scenario? You appear to have none.
    COVID-19 is clearly NOT nearly as dangerous as was first feared. Infection rates and morbidity rates are comparable to or less than those of a mild to normal seasonal flu. We accept that natural ‘herd immunity’ for traditional Coronaviruses is the only way forward as there has never been a successful vaccine for the ‘common cold’ which is itself a Coronavirus. It is thought that the high incidence of asymptomatic infections suggests a level of natural immunity already.
    You are the one spreading unsupported dogma. Others have the unenviable responsibility of having to choose a way forward that is the lesser of evils. In the absence of a vaccine natural immunity is all we have and that implies a form of herd immunity that depends on actually catching the bug – which as it happens is not particularly dangerous, especially for the young who are the most affected by lock-down.
    Massive increases in depression, anxiety and suicide associated with economic collapse are the cost of an enduring lock-down. That much is certain.
    You are a dangerous fool. The consequences of your drivel, if followed, are impoverishment and systemic collapse.

    • Avatar Kieran Tapsell says:

      Your argument seemed to me to have a reasonable basis until I got to the last two sentences. Why did you have to ruin it with a Trumpean blast?

    • Avatar George Wendell says:

      @Michael Thomson

      When those that post here merely resort to insults, they lose their credibility. That’s just ad hominem attack. It doesn’t convince anyone other than those susceptible to immature playground name calling.

      It is a well known political ruse of those who only see profits as being far more important than people. Donald Trump uses ad hominem in just about every one of his comments. He uses it in election campaigns too. While I accept isolation and lockdown have caused damage to the economy and mental health, there is nothing very convincing or evidence based in your comments either. I just here economy for you is more important than the deaths of people from viruses. Yet we are simply not a situation of control with this virus yet, and as correctly claimed by Tiffen we won’t be until there is a vaccine or another drug that can inhibit the way the virus spews its RNA into host cells. Modern herd immunity requires a vaccine, get it?

    • Avatar Gavin O'Brien says:

      Micheal,
      I refer to my comment above. Your remarks are totally irresponsible in the extreme. A total collapse of society such as happend periodically to past civilizations when afflicted by Bubonic Plague and similar Pandemics, is a terrible price to pay just to avoid a so called economic collapse. Anxiety , depression, suicide and other mental illnesses caused by the fear of ones family members or friends horrifically dying in total isolation from their loved ones, is a far worse catastrophe than people losing jobs or fortunes because of a madly unequal economic system based on greed and unsustainable exploitation of the limited resources of the planet now crashing in flames. I have little doubt that this Pandemic and other recent examples of a similar Virus outbreaks are signs that the environment we depend on for our very existence is seriously out of kilter. This is a warning we ignore at our peril.

    • Avatar Gavin O'Brien says:

      Micheal,
      I don’t know your age, but assume you are young. My wife and I and many of our friends are in our 60’s and 70’s. Many of us are now enjoying the fruits of our labour in retirement We have spent our lifetimes working hard to ensure young people have accesses to the technology the likes of which Arthur C. Clarke wrote about when we were your age. Maybe you are immune from this scourge , we are not!

    • Avatar Mark Freeman says:

      I’m surprised Michael your comment passed moderation though I consider that a good thing. I will avoid suggesting foolishness on your part but rather, suggest you suffer from the cognitive dissonance so common in this matter.

      On one hand there are countries like ours and say Vietnam that took action early – in relation to their infection spread – and suffered relatively few infections and deaths. Other countries acted late and with inconsistent method and inadequate health systems. They have much higher death rates. It’s easy from our distance to see these deaths and serious illnesses as abstract numbers. They aren’t. They are highly traumatic for those communities and will leave a bad legacy for a long time.

      There have been lots of associated problems particularly economic. If you search, even in this site I think, you’ll find plenty of credible analysis that effective suppression is much less damaging and enables quicker rebound. Australia low case and death rate is indisputably a sign of success. Of course it’s come at a cost. It’s a disaster, what do you expect ? Look back in a year from now and compare social and economic recoveries around the world and rethink your view.

    • Avatar Glenn says:

      ‘…comparable to or less than those of a mild to normal seasonal flu…’

      Well let’s put that puppy to bed

      https://public.flourish.studio/visualisation/1879130/?fbclid=IwAR0kyFbYn_7bgfRtwldiQZ6lze59YeHpw-3uk8CgyQhjDHPCwAgPMo-CQ14

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