Since January, the COVID-19 pandemic has swept the globe, with 170,000 infected as of the writing of this article. With China's cases reaching a plateau, the World Health Organisation has declared Europe to be at 'the epicentre of the pandemic'.
Heeding lessons from the Wuhan response, Italy and Spain have entered lockdowns, while the US, Australia and New Zealand have all introduced drastic border control measures. Meanwhile, the UK government stands firm by their grand plan: do nothing. Wash your hands twice and sing Happy Birthday. Oh, and don't go on cruises!
In technical language, the UK's plan is called 'herd immunity' - 'indirect protection that occurs when a large percentage of a population has become immune to an infection'. This plan is ridiculous. It exposes the incompetence of a government and the selfishness of a prime minister. Here's why.
The value of human life
Herd immunity is generally applied in the context of available vaccines. Without a vaccine, as is the present case, the population is expected to suffer the full (and currently uncertain) consequences of the disease, before becoming immune. Preliminary studies of patients in Asia have begun to show the possibility of long term side-effects, even after recovery. A study by the Hong Kong Hospital Authority found significant decreases in the lung capacities of several discharged patients. While the sample size is small and potentially unrepresentative, even the slightest risk, when applied to millions of people, should be prevented at all costs.
What's more, there's no guarantee that herd immunity will eradicate coronavirus. Historically, only two diseases have ever been eliminated through this strategy - rinderpest and smallpox. Both were achieved with the development of vaccines. Prior to vaccines, both were around for thousands of years and remained unhindered by 'natural' herd immunity. There is no empirical basis for herd immunity to eradicate COVID-19 without a vaccine.
And that's the issue with the UK government's approach: they are toying with human lives.
Let's say the plan goes ahead. In order for herd immunity to be effective, the number of infected individuals must reach the 'Herd Immunity Threshold' (HIT), derived from a disease's degree of infectiousness. For SARS, the estimated range was 50-80% of a population. For coronavirus, the government's estimation is 60%. For the UK, that's 39 million people. Taking even a conservative estimation of COVID-19 mortality rates, the result is over half a million deaths. Unacceptable. Unacceptable because even one unnecessary death is too many, unacceptable because there exists a clear and viable alternative.
This beautifully written article and diagram outline why.
Source: Tomas Pueyo analysis over chart and data from the Journal of the American Medical Association
The argument is premised on 2 figures: official cases and true cases. The former represents the number of patients diagnosed by authorities, while the latter includes those who may have mild symptoms and but have yet to seek treatment, thus remaining unknown to authorities. True cases can only be determined retrospectively.
On 23 January, when Wuhan had only 444 official cases, the Chinese government shut the city down. Looking backward, we now know that the true cases on that date was ~12,000 - a multiple of 27x. That's the first key takeaway: it is not 'too early' to act.
Upon the city's lockdown, official cases continued climbing for 12 days before reaching a peak on 4 February. Buuuut. But. Due to the delay between the onset of symptoms (in a true case) and diagnosis (in an official case), the number of true cases dropped instantly after lockdown measures. The second key takeaway is just that simple: lockdown works.
Of course, the question toiling through Boris Johnson's mind is: 'at what cost?'. The political cost of an overreaction. The economic cost of GDP growth. But what is the cost of human life? That it's too early to sustain measures or that immunity prevents the disease from coming back pales in comparison to the irreversible damage that a herd immunity strategy would cause.
3 days ago, Boris Johnson stated defeatedly that more will 'lose loved ones'. If he gets off his high horse and begins acting like a leader, then maybe we won't have to.