What Is "Herd Immunity"? Not What You Think It Is.

A simple graphic illustration of "flattening the curve," spreading out the incidence of disease in an attempt to not overwhelm a country's medical care facilities. "Protective measures" means social distancing, frequent hand-washing, quarantine of known cases and the like. It does not mean vaccination. (source)

by Thomas Neuburger

The phrase "herd immunity" is being used a lot these days to describe how our species will deal with the ravages of disease caused by COVID-19. Most people, I'm afraid, think of "herd immunity" as a process by which "the herd" — us humans — will catch the disease from others, develop the antibodies needed to ward it off in the future, and go on our way knowing we can't catch it again or transmit it to others. Thus, as this immunity spreads society protects itself.

For people who think this way, the main COVID-19 problem is how to "flatten the curve" — to make the spike in serious cases as low and spread out as possible so that our medical care facilities are not overwhelmed while the rest of us become immune. The graph at the top illustrates this concept.

The assumption in this thinking is that the immunity of the bulk of the population will eventually protect the most vulnerable, the one's most likely to become seriously ill and possibly die. Seen in this way, developing "herd immunity" as quickly as is reasonable is our best shield against COVID-19.

Great Britain, under the leadership of Boris Johnson, is banking on just that. As Umair Haque writes, "According to Robert Peston, one of the UK’s top journalists, Britain’s leaders’ brilliant idea is … 'to allow the virus to pass through the entire population so that we acquire herd immunity.' Other journalists have noted the same thing." Summarizing, he adds that "they think that everyone getting sick ... confers resistance on a nation."

In short, according to this thinking, everyone getting sick is a good thing for the country.

Herd Immunity Depends on Vaccination

Unfortunately, this isn't how "herd immunity" works. It actually works this way:

Herd immunity describes how a population is protected from a disease after vaccination by stopping the germ responsible for the infection being transmitted between people. In this way even people who cannot be vaccinated can be protected. For example, the bacteria meningococcus and pneumococcus can cause blood poisoning (septicaemia) and meningitis. In most people the bacteria live harmlessly in the throat and do not causes disease, but sometimes they get into the bloodstream leading to these severe infections. They can live harmlessly in the throat of one person but if they spread to someone who is particularly susceptible (such as a young baby) they can cause severe disease. By being vaccinated an individual is not only protected from being infected themselves but they then also cannot pass this infection onto other people, where it may cause severe disease. However, for herd immunity to work a large proportion of the population need to be vaccinated. [emphasis added]

The following diagram illustrates how a communicable disease passes through an unvaccinated population versus a vaccinated one:

People are shown as circles. Infectious agents (germs) spread between the people in orange, although they do not get severe disease. When the infection reaches people who are highly susceptible (red) they get the disease and can be very sick or die.

In the lower panel, the people in green have been vaccinated. This now protects those in yellow as well, who had previously got the infection and possibly the disease. Although the figure only shows a few people being vaccinated, in reality many people have to be vaccinated for herd immunity to work.

There's another useful diagram here.

In short, many people getting sick doesn't prevent the rest, including most vulnerable, from also getting sick; only vaccination does that. For some diseases, the percentage of population that needs to be vaccinated is large; for others, the percentage of vaccinations can be smaller:

The more contagious it is then the more people need to be vaccinated for herd immunity to work. For example, measles is very contagious. Before the use of the measles vaccine, every person with measles would infect another 10-15 people and so the disease would spread very quickly. To achieve herd immunity for measles at least 90-95% of the population need to be vaccinated. A disease like polio is less contagious, and 80-85% of the population would need to be vaccinated for herd immunity to work. Although this is lower it is still a very high proportion, especially given that some people cannot be vaccinated for medical reasons. [emphasis added]

For many diseases — tetanus, for example — vaccination protects only the vaccinated individual, since tetanus is harbored in the soil and can be "caught" by anyone. Fortunately, COVID-19 is not this type of infection.

Magical Thinking

The conclusion we should draw from all this is that the "wait it out" strategy — get the disease as late as possible so that, if you get really sick, there will be a hospital bed for you — is not much protection at all.

If you get really sick, health care will obviously help, but there really is no cure for COVID-19 at the moment. Health care will keep you from dying of secondary causes — additional diseases you might come down with if your immune system is compromised, for example — but if COVID-19 wants you, the only prevention is to not get sick with it in the first place.

Placing one's hopes, or a society's hopes, in a misunderstood version of "herd immunity" is an exercise in magical thinking. If you're in charge of a society's response and this version of herd immunity is your answer, it's an exercise in malicious thinking.

Vaccine Availability

The second conclusion applies to society as a whole. Allowing COVID-19 to spread through a population in the absence of a vaccine is a death sentence for many individuals; if a person is likely to die if they get it early, they're just as likely die if they get it late. This puts a premium on the speed at which a vaccine is developed — and made available. (A vaccine is no good if it's not available, for cost reasons, for example.)

Which leads to a corollary: There is no neoliberal solution to this problem. The profit system is exactly the wrong way to deal with the threat posed by COVID-19. The minute testing and vaccination is subject to profit constraints, the solution begins to fail, since people are less likely to be tested and vaccinated. That puts everyone — the whole herd, as it were — at risk.

The best solution to this problem is also the most moral — test everyone for free; vaccinate everyone for free. Do it fast and do it now.

The privatizers will try, of course, to get their profit-seeking hands on both the tests and the vaccine. They may even succeed. But if they do, COVID karma, unlike climate karma, will be instant. Deaths won't just rise in a decade or two, or in their grandchildren's generation; they'll rise in earnest immediately, and the dead will have the names of their killers written on their foreheads for everyone else to see — "Thank you, Biologics.com. I died for you."
 

Lee Camp says, "Evil people have plans"; Ian Welsh offers the example of "burning down the house" or the society to rack up short-term profits

"Bad people have plans! They always have a fucking plan! Good people don't have plans, or missions, or agendas. They just stumble through life, thinking, 'We'll all treat each other right if given the chance.' Evil people have dry-erase boards, and PowerPoint presentations, and iPad apps, to keep track of just how evil's coming along . . . Good people don't have PowerPoints. Good people have doughnuts, and word jumbles."

-- Lee Camp

"If you tell me I have to double the profit of Hermès, I will do it tomorrow. But then you'd have no Hermès left in five years."

-- Hermès CEO Patrick Thomas, quoted by Ian Welsh in
his blogpost "Burning down your house to generate heat"

"Whenever greed becomes a primary motivator, and an acceptable primary motivator in a society, the society burns itself down."

-- Ian Welsh, in the above-linked blogpost

by Ken

I thought of transcribing more of this latest "Moment of Clarity" from Lee Camp, but while Lee is both amazingly funny and amazingly wise when transcribed, the written transcript doesn't have the same impact as when, for example, he talks about the Koch brothers' shenanigans in Wisconsin, and how, step by step, those shenanigans were designed to lead to the Koch brothers being able to stifle political opposition and buy up more and more of American. "Now that's what I call a fucking plan!" And what were "non-evil people" thinking during this time? "Man, do I like ravioli! Especially in cream sauce. If I work an extra hour at the shop, I bet I can buy two cans of ravioli instead of just the uno."

For the record, though, here's where he winds up:

Bad people have plans. We don't have plans. I don't have a plan. You don't have a plan. Your plan was: "I'm going to watch Internet videos." Meanwhile, Halliburton's plan was to cause a military coup in the sovereign country of Eritrea, a place neither you nor I ever knew existed, but they knew, because they also have maps. They have dry-erase boards and fucking maps. I'm just saying, the good people on this planet are never going to get the upper hand until we get some fucking office supplies up in here.

Which leads me this extraordinarily important blogpost by our friend Ian Welsh, which I've been wanting to write about for days now. It introduces us to an example if ever there was one of bad people having plans. He introduces us to the concept of a company, or indeed a society, burning the house down to make profits.

Ian begins by drawing on his experience "some years ago" working for a large insurance company where he wound up witnessing what he describes here as "the first cashing out moment" -- "a transfer from the past and future to the present" with the result: "Going forward every future policy holder would pay more money for their policies in order that the current generation could take out value."

I was originally hired to help deal with a class action suit, but soon found myself working on something different, demutualizing the company. Mutual insurance companies are owned by their customers, not by shareholders. This has a number of advantages, but it means you don’t have shares, and thus buying out other companies requires cash, and you yourself can’t be bought. You also can’t give stock options to your executives (not a small matter, these days).

Mutual companies also have one big social benefit: they provide insurance cheaper, because they don’t have to pay dividends or stock options and they return profits beyond those expected to the policy owners. (Stock options supposedly don’t have a price, but they do in effect, both because of the rampant use of company profits for buybacks and because of how they change company behavior.)

Demutualization requires a vote by the shareholders. There was never any question that it would pass, however, since it amounted to cashing out a lot of money. For big policy owners the take could be in the millions, for smaller ones ten to twenty thousand wasn’t uncommon.

This part is important, so pay attention: this was the first cashing out moment, and what it was was a transfer from the past and future to the present. Going forward every future policy holder would pay more money for their policies in order that the current generation could take out value.

The company's shares were initially priced at $18 and over a two-year period rose to around $40. The CEO, having bought $5 million worth of shares, "did very well" --

But the real change was driven by what is called "'market’ discipline". Suddenly we needed to make 15% profits every year.

Insurance isn’t a business where you should be making that sort of profit. Virtually no business is, but insurance in particular should be stodgy and boring and conservative, because its job is to be there when the customer takes their losses.

To friends who asked about the company back then, he described it as "being run reasonably well, considering," but --

"They're burning down the house to make the profits."

What do I mean by that? They were pushing out senior junior employees. In the pension department, for example, almost all of the senior customer service reps were gone within two years. Why? Because the new regime expected insane numbers from them. Those numbers could only be produced by, well, lying to management.

Meanwhile, every month the sales numbers were being manipulated more and more, with sales which hadn’t actually completed being moved forward as if they had been. Jobs were taylorized and de-skilled, so that employees had no real knowledge of the process, this in a company with the highest average face amount (amount covered, like a million dollars or 10 million) in the industry.

Products were designed overly fine, so that if customers missed a single payment by even a week, they would likely go into default, but those losses wouldn’t show up for years, since it would take time for the defaults to occur.

And the company went out and bought a big, moribund insurer, with an extraordinarily sick corporate culture and then struggled to make it work.

Bottom line: that company couldn’t make 15% without cutting corners which shouldn’t be cut. You can provide worse customer service to multi-million dollar clients for a few years, but eventually your rep catches up with you.

And sure enough, he writes, "it came home to roost, and [clients] stopped sending us as much new business." And when "the shit hit the fan in 2008 . . . all the corners they had cut came back to haunt them."

When you have a good company, product or service, you can always cash it out. You just cut corners for years, and cruise on your reputation. And for years, it works, until it doesn’t.

Which brings him to the current example of the still-family-controlled Hermès company resisting being bought out by a conglomerate, the context of the quote I pulled out above from CEO Patrick Thomas, which I think is worth hearing again:

"If you tell me I have to double the profit of Hermès, I will do it tomorrow. But then you'd have no Hermès left in five years."

There’s a man who gets it.

Here’s the rule, whenever greed becomes a primary motivator, and an acceptable primary motivator in a society, the society burns itself down. It extracts money by destroying actual long term value. This has been going on in the West, with its most extreme forms in the US, for over 30 years.

But as a society, what you get is money while destroying actual value. The society as a whole is poorer than it would have been otherwise.

An actual capitalist society (which we do not live in) makes cashing out very difficult. You don’t want people creating money by destroying value, and you don’t want viable ongoing concerns arbitrarily destroyed or weakened. Whenever a company is bought out by borrowing the money, then making that company take on a loan to pay back the original loan and then another loan to pay the buyers even more money, money has been extracted while value has been destroyed (layoffs and other cost cutting inevitably follow).

As a society, allowing this sort of behaviour is death. You must make sure that people do better by adding value than by destroying it. Forceful short term extraction of money destroys value. The only profits that most people should see are long term profits. Want to get rich? Great. Either create something genuinely new under the sun (and no, Facebook is not something genuinely new, it is merely the winner in a market someone was going to win) or stick it out for a good twenty to forty years, taking your legitimate profit each year.

When you make it possible for people to get rich by destroying jobs that actually create value, by destroying companies which are actually viable, you are destroying your own society’s prosperity.

This last stretch contains a lot to take in -- at least it did for me -- but I don't see how the point could be made either more clearly or more concisely. That's why I didn't either abridge it or go in and attempt any "highlighting." As an explanation of how we have straitjacketed our economy, with future prospects looking almost unimaginably grim, it's all a highlight, or not a highlight, but . . . well, you know what I mean.

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Too Bad The GOP Filibustered The Windfall Profits Tax Three Years Ago-- Watch Oil Prices Go Through The Roof

As of last November, the single biggest source of petroleum for American consumers was Canada... followed by Mexico and then Saudi Arabia, the same three-- in the same order-- from which we also get most of our crude oil imports. Libya isn't on the list of the 15 biggest exporters to the U.S. of either crude or of petroleum.

And the U.S. actually exports some of the oil it drills for domestically-- Texas, Alaska, California and Louisiana are big producers-- which helps explain, perversely, how even a very temporary shut down of Libya's exports into the global chain will have an impact on the U.S. Worldwide demand is not elastic; it doesn't go up and down with supply, at least not on a dime. So when Libyan supplies to, say, Italy, for whom Libya is like Canada and Mexico, are taken out of the world oil market, Italy needs to get it someplace else, in effect driving up demand... and prices (here). Markets work that way... especially if the powerplayers want them to.

Common wisdom is that crude in this country spiked over 7% yesterday (to $96.48 a barrel) because of violence and instability in the Middle East and in Libya in particular-- with oil traders fretting. But were they-- or were they just cashing in? It was the crazy radicals in the Middle East who drove the price of oil higher and the stock market lower. I got back from Mexico yesterday and had to fill up my car-- thankfully a Prius. Prices seemed t have jumped close to a dollar a gallon and "everyone" says prices are heading to $5.00/gallon. But the gas I bought was bought and refined and resold months ago. Somebody's taking the opportunity to make a very big profit-- and calling it fretting and screaming the sky is falling while raking in a fortune.

Three years ago, "Senate Republicans successfully filibustered 2 energy bills that would have imposed a windfall profits tax and ended $17 billion in tax breaks for oil companies. In one, 47 Democrats and 3 Republicans voted to shut off debate, far fewer than the 60 needed and cloture failed 50-44, without even a single Democrat crossing the aisle, not even Mary Landrieu, Blanche Lincoln or Mark Pryor, normally Big Oil big shills. The other cloture attempt also failed 51-43, although this time Landrieu was sticking up for the oil lobbyists who treat her as well as they treat Republicans. Six Republicans actually crossed the aisle-- this was before the Koch Bros had organized the teabaggers as a potent force for corporatism. At the time, in the middle of the presidential campaign (neither Obama nor McCain was in DC that day and neither voted, in effect canceling out each others' yea and nay) the Christian Science Monitor pointed out that "the issue of which party is doing the most to ease the impact on American families [of record high gasoline prices], is eclipsing all other issues as a top political concern. Lawmakers on both sides of the aisle say they expect such high-profile votes on the issue to continue until the fall election."

"Today, Republicans will have a simple choice: Will they continue to stand with [President] Bush, [Vice President] Cheney, and the modern-day oil barons? Or will they join us on the side of struggling American families who deserve better?" Senate majority leader Harry Reid said before the Tuesday morning vote.

Since Mr. Bush came to office in 2001, gasoline prices have more than doubled and oil companies have made more than half a trillion dollars in profits, Democrats say.

The proposed Consumer-First Energy Act would create a 25 percent windfall profits tax on companies that don't invest in renewable fuels or electricity production. It also would zero out some $17 billion in tax breaks for the oil industry and use the revenue to help consumers by investing in an Energy Independence and Security Trust Fund. The bill aims to curb speculation by hiking up margin requirements for those investing in futures trades and banning traders from using offshore futures markets to evade regulation.

This morning Ed Potosnak, progressive candidate running for the New Jersey House seat currently occupied by oil company shill Leonard Lance (right), told me that "The rising cost of gas at the pumps not only puts a strain on our budgets, but also threatens our recovery from the Bush Recession. When fuel prices rise we often are fed a plausible reason-- lower temperatures are driving up demand, natural disasters, floods, etc... Meanwhile oil companies rake in record profits and their investors too. Enron took advantage of energy markets to drive futures prices higher, costing consumers billions. We can not afford to continue to let this happen. Consumers need protections from the energy market market manipulations that lead to high fuel prices. Without clear rules, and enforcement, our families and businesses will continue to be subject to erratic energy prices driven by greed and recklessness."

And Qaddafi may well wind up making wretched profiteers like the Koch Bros and their cronies tens of millions of dollars. His next move could well be sabotaging Libya's oil industry and sowing chaos. According to a Time reliable source Qaddafi "has ordered security services to start sabotaging oil facilities. They will start by blowing up several oil pipelines, cutting off flow to Mediterranean ports. The sabotage, according to the insider, is meant to serve as a message to Libya's rebellious tribes: It's either me or chaos."

My Libyan source said that Gaddafi has told people around him that he knows he cannot retake Libya with the forces he has. But what he can do is make the rebellious tribes and army officers regret their disloyalty, turning Libya into another Somalia. "I have the money and arms to fight for a long time," Gaddafi reportedly said.

Watch the stoopid:

McCONNELL LEADS TWO MORE SUCCESSFUL FILIBUSTERS AGAINST RENEWABLE ENERGY AND A WINDFALL GAS PROFITS TAX

Two pro-environment Mainers fought Susan Collins today

This morning the Senate was all set to consider HR 6049, the Renewable Energy and Job Creation Act which passed the House on May 21 with a healthy bipartisan majority; 263-160. At that time thirty-five Republicans joined every Democrat (except Texas' arch-reactionary Nick Lampson) in passing the bill which would have amended the Internal Revenue Code of 1986 to provide incentives for energy production and conservation. Realizing it would have easily passed the Senate as well, Bush's chief obstructionist, Mitch McConnell (R-KY), led a disgraceful filibuster to keep the bill from being voted on. Every single Democrat, plus Lieberman and 3 Republicans voted for cloture in order to call a vote. 44 reactionary Republicans were able to prevent the vote. Many are fake moderates who portray themselves as friends of the environment and make believe they are serious about solving the energy crisis but were happy to support McConnell and Bush again. We expect die-hard anti-environmental corporatists, like Jim Inhofe (R-OK), Elizabeth Dole (R-NC), John Cornyn (R-TX) and Lamar Alexander (R-TN) to vote against their constituents and for the special interests. They always do. But it is somewhat less comfortable for the fake moderates to explain votes like this.

Although Olympia Snowe of Maine voted with the Democrats to shit down the filibuster, Maine's far more right-wing and far more corporate-leaning other senator, Susan Collins, was in rubber stamp mode today and went along with McConnell and the extremists. Ditto for John Sununu (R-NH) and Norm Coleman (R-MN). We called Congressman Tom Allen, who fought to pass H.R. 6049 in the House and who has been one of Congress' strongest advocates for sane conservation policies. He was disappointed that Collins joined the wingnuts on this one. But he pointed out another factor in the bill beyond conservation and energy concerns. "In killing this legislation, they blocked extension of the teacher expense deduction that saved Maine’s 17,000 teachers $3.4 million last year. Today’s roadblock killed an extension of the child tax credit for almost 38,000 Maine children, as well as investment of $18 billion in incentives for renewable energy research. This is a clear example of why we need a working majority in the U.S. Senate that puts America’s middle class first."

And this wasn't the only successful filibuster of a popular bill this morning. S-3044, the Consumer-First Energy Act of 2008, sought to provide energy price relief and hold oil companies and other entities accountable for their actions with regard to high energy prices. This is commonly referred to as the Windfall Profits Tax Bill and again, McConnell and a gaggle of corrupt Republicans, fat with bribes from gas and oil companies, were able to filibuster it to death. (In this case, reactionary fake-Dem, Mary Landrieu of Louisiana, a recipient of gigantic oil and gas donation, joined the filibuster. She was the only Democrat who did. Olympia Snowe and a small handful of Republicans voted with the Democrats. One was Gordon Smith who is in a desperate battle with progressive Democrat Jeff Merkley to retain his seat. Recalling that Smith had voted to oppose windfall profits taxes twice in 2005, we asked Jeff why he thought Smith-- who has accepted over a quarter million dollars from oil and gas interests-- had voted with the Democrats this morning.

"Gas prices in Oregon are the 7th highest in the nation and families are feeling squeezed. For nearly eight years Smith has voted with Bush 90% of the time and has been in the pocket of big oil campaign contributors, supporting billion dollar bailouts and opposing a windfall profits tax. While Smith has fostered our dependence on foreign oil and delivered billion dollar giveaways to big oil, I championed the most aggressive climate change legislation in the nation. Now Smith is running scared, flip flopping on important issues to pretend he's a moderate."