Most Deaths And Serious Illnesses From Trump's New Pandemic Plans Will Come AFTER The Election, When It Won't Matter To Him At All

Last week we took a look at how Trump's new anti-science advisor, Scott Atlas, has conspired with Trump to follow the dismally-failed Swedish 'herd immunity' model, even as doctors in Sweden are warning other countries that their approach-- Trump's newest experiment with American lives-- is killing people needlessly. Yesterday, Derek Thompson tore into Atlas and his deadly plans at The Atlantic. He wrote that "A new philosophy of COVID-19 is circulating through the Republican Party and conservative media. If you look closely, you might notice that it resembles an early philosophy of COVID-19 that circulated through the Republican Party and conservative media: If young people get this disease, it won’t be so bad-- and it might even be good. Scott Atlas, the new White House science adviser and Trump-whisperer, seems to be the ringleader of this emergent corona-stoicism. A neuroradiologist and senior fellow at Stanford University’s conservative Hoover Institution, Atlas is not an expert in epidemiology or infectious diseases. As a Fox News regular, his relevant credentials seem to be more televisual than scientific."

A little note before moving forward. Sweden has the 15th biggest population is Europe-- and the 10th biggest number of COVID cases and 9th biggest number of COVID deaths. With 8,462 cases per million residents, only Spain has been hit harder. Whatever it was that went so terribly wrong in Sweden-- the whole herd immunity theory-- is what Atlas, Trump and the Republican Party want to import to the U.S. They want everyone who is young and healthy to go out and get COVID-19.

“It doesn’t matter if younger, healthier people get infected,” Atlas said in a July interview with San Diego’s KUSI news station. “I don’t know how often that has to be said. They have nearly zero risk of a problem from this… When younger, healthier people get infected, that’s a good thing.”

The reality is that... a 25-year-old who contracts this disease is approximately 250 times less likely to die than an infected 85-year-old, according to the most sophisticated estimates of infection-fatality rates. For every 1,000 people infected with COVID-19 under the age of 35, the average expected death count is just under one. These facts might give you the impression that, as Atlas said, “it doesn’t matter if younger, healthier people get infected.”

But it does. It really does. Here’s why.

Many young people navigating this pandemic are asking themselves a two-part health question: What are the odds that I get infected? And if I do get infected, is that really a big deal?

Much of my reporting has focused on the first question. To summarize that work in a sentence: People are at highest risk of infection in communities with a sizable outbreak, when they spend long amounts of time in closed, unventilated spaces where other people close by are talking or otherwise emitting virus-laden globs of spit, and everything is worse when people aren’t wearing masks. This advice is easy to give, because the best practices hold across the board, for everybody.

“What’s the big deal?” is a harder question, because the person-to-person outcomes of this disease are so maddeningly variable. The most universal answer must begin with the observation that death is not a synonym for risk.

COVID-19 presents an array of health challenges that are serious, if not imminently fatal. The disease occasionally sends people’s immune system into a frenzy, wreaking havoc on their internal organs. Several studies of asymptomatic patients revealed that more than half of them had lung abnormalities. A March study published in the Journal of the American Heart Association found that 7 to 20 percent of sick patients showed heart damage associated with COVID-19.

As my colleague Ed Yong explained, many COVID-19 patients experience protracted illness. These “long-haulers” suffer from a diabolical grab bag of symptoms, including chronic fatigue, shortness of breath, unrelenting fevers, gastrointestinal problems, lost sense of smell, hallucinations, short-term-memory loss, bulging veins, bruising, gynecological problems, and an erratic heartbeat. And according to the neuroscientist David Putrino, chronic patients are typically young (the average age in his survey is 44), female, and formerly healthy.

We don’t know how many long-haulers are out there. But by combining the conclusion of several well-regarded studies, we can arrive at a decent estimate.

For men in their 30s, like me, about 1.2 percent of COVID-19 infections result in hospitalization, according to a July study published in Science. Once the disease has progressed to this point, the risk of chronic illness soars. Research from Italy found that roughly nine in 10 hospitalized patients said they still had symptoms after two months. A British study reported a similar risk of long-term illness.

Now the math: When you multiply the hospitalization rate for 30-something men (about 1.2 percent) by the chronic-illness rate of hospitalized patients (almost 90 percent), you get about 1 percent. That means a guy my age has one-in-100 chance of developing a long-term illness after contracting COVID-19. For context, the estimated infection-fatality rate for somebody in their 60s is 0.7 percent, according to the same study in Science.

You might be used to thinking of 30-somethings as safe and seniors as at risk in this pandemic. But if a man in his 30s and a man in his 60s both contract COVID-19, it is more likely that the 30-something will develop a months-long illness than that the 60-something will die, according to this research. (The calculation above doesn’t even include the countless long-haulers who never went to the hospital.)

More frightening than what we’re learning now is what we cannot yet know: the truly long-term-- as in, decades-long-- implications of this disease for the body. “We know that hepatitis C leads to liver cancer, we know that human papillomavirus leads to cervical cancer, we know that HIV leads to certain cancers,” Howard Forman, a health-policy professor at Yale, told James Hamblin and Katherine Wells of The Atlantic. “We have no idea whether having had this infection means that, 10 years from now, you have an elevated risk of lymphoma.”

Why would Scott Atlas, the White House, or anybody for that matter dismiss the threat to young people? One answer is that they want to convince Americans that if a bunch of teens and 20-somethings get infected, the U.S. will move closer to the ultimate goal of achieving “herd immunity.” Briefly, that means the point at which a disease, like COVID-19, can no longer trigger an epidemic outbreak, because enough of the population has already developed immunity. Atlas has argued that, if herd immunity is an inevitable destination, we should perhaps put our foot on the accelerator.

But the case for herd immunity rests on two dubious assumptions. The first is that the disease isn’t risky to the people it doesn’t kill-- which we know to be false.

“If you’re signing up for herd immunity, you’re also signing up for a huge number of hospitalizations, and a substantial fraction of those people will be sick for months,” says Marm Kilpatrick, an infectious-disease researcher at  UC Santa Cruz. “Do the symptoms last three months? Six months? Three years? Nobody knows, but I wouldn’t want my pandemic plan to be, Let’s have hundreds of thousands of young people with lifelong illnesses. I wouldn’t want to tell 30-to-50-year-olds that we’ve signed them up for a high risk of heart disease and chronic organ damage.”

The second dubious assumption is that it’s easy to distinguish between the high-risk group and the low-risk group.

“The most simplistic way to protect the vulnerable is to divide the population by age, but you can’t choose an arbitrary cutoff and say ‘Let’s protect everybody under age 65,’ because nothing magic happens at age 65,” says Andrew Levin, an economist at Dartmouth. “The average person who is 64.9 years old has the exact same health risks as somebody who is 65. So it’s very difficult to divide populations into safe and not-safe categories.”

Besides, the U.S. is not, for the most part, spatially segregated by age. Restaurants and stores serve old and young patrons, and there are tens of millions of multigenerational households. Evidence that young and old people mingle constantly can be seen in the recent COVID-19 death data: A southern surge that started among young people spread to older populations, who died in disproportionate numbers. “There is the assumption that we can start cocooning the elderly, but we have no new innovation here,” says Natalie Dean, an assistant biostatistics professor at the University of Florida. “Are they saying we should try harder to protect old people? What does ‘trying harder’ even look like, compared to now? I just don’t understand the argument.”

Herd immunity is an inoperable plan, teetering on a false assumption of elderly-cocooning, which encourages young people to play craps with the long-term health of their internal organs. The choice is yours. You can listen to the scientists. Or you can roll the dice with your guts.

Trump Prepares To Kill 2.1 Million Americans With Another Quack Approach To The Pandemic

These 2 + Trump are why Florida is doing so poorly in terms of COVID

In Pittsburgh yesterday, Biden noted that Trump is a threat to the safety of all Americans-- a "toxic presence"-- who has encouraged violence in the nation’s streets while utterly failing to deal competently or even honestly with the pandemic. "I want a safe America," he said, "safe from COVID, safe from crime and looting, safe from racially motivated violence, safe from bad cops. Let me be crystal clear-- safe from four more years of Donald Trump."

Sweden has 10,109,718 residents, 15th largest population in Europe. But Sweden had a theory-- herd immunity-- and it resulted in the country having the 10th most cases, the 9th most deaths and 8,346 cases per million Swedes, far more than any other European country larger than a postamgestamp other than Spain. By that metric, Sweden has done worse than even the most hard hit countries-- Russia, U.K., France, Italy, Germany, Belgium...

Trump didn't hire the Demon Sperm lady as his new pandemic advisor-- but close enough. Meet Scott Atlas, a neuroradiologist from Stanford’s conservative Hoover Institution, who joined the White House earlier this month as a pandemic adviser. Yesterday Washington Post reporters Yasmeen Abutaleb and Josh Dawsey wrote that Atlas likes the deadly Swedish approach, "which would entail allowing the coronavirus to spread through most of the population to quickly build resistance to the virus, while taking steps to protect those in nursing homes and other vulnerable populations." That part about "taking steps to protect those in nursing homes and other vulnerable populations" was not done by Sweden and it is inconceivable that it would be seriously tackled by the Trump regime, although Abutaleb and Dawsey reported that the regime "has already begun to implement some policies along these lines, according to current and former officials as well as experts, particularly with regard to testing."

Sweden’s handling of the pandemic has been heavily criticized by public health officials and infectious-disease experts as reckless-- the country has among the highest infection and death rates in the world. It also hasn’t escaped the deep economic problems resulting from the pandemic.

But Sweden’s approach has gained support among some conservatives who argue that social distancing restrictions are crushing the economy and infringing on people’s liberties.

That this approach is even being discussed inside the White House is drawing concern from experts inside and outside the government who note that a herd immunity strategy could lead to the country suffering hundreds of thousands, if not millions, of lost lives.

“The administration faces some pretty serious hurdles in making this argument. One is a lot of people will die, even if you can protect people in nursing homes,” said Paul Romer, a professor at New York University who won the Nobel Prize in economics in 2018. “Once it’s out in the community, we’ve seen over and over again, it ends up spreading everywhere.”

Atlas, who does not have a background in infectious diseases or epidemiology, has expanded his influence inside the White House by advocating policies that appeal to Trump’s desire to move past the pandemic and get the economy going, distressing health officials on the White House coronavirus task force and throughout the administration who worry that their advice is being followed less and less.

Atlas has refused to speak with anyone on the record and Sweden has taken extraordinary efforts to avoid reporting numbers in the last week, as it always does when numbers spike. "Atlas," wrote Abutaleb and Dawsey, "has fashioned himself as the 'anti-Dr. Fauci,' one senior administration official said, referring to Anthony S. Fauci, the nation’s top infectious-disease official, who has repeatedly been at odds with the president over his public comments about the threat posed by the virus. He has clashed with Fauci as well as Deborah Birx, the White House coronavirus response coordinator, over the administration’s pandemic response. Atlas has argued both internally and in public that an increased case count will move the nation more quickly to herd immunity and won’t lead to more deaths if the vulnerable are protected. But infectious-disease experts strongly dispute that, noting that more than 25,000 people younger than 65 have died of the virus in the United States. In addition, the United States has a higher number of vulnerable people of all ages because of high rates of heart and lung disease and obesity [42.4% of Americans are obese-- more so in Trump states-- and 9.2% of Americans are severely obese], and millions of vulnerable people live outside nursing homes-- many in the same households with children, whom Atlas believes should return to school."

“When younger, healthier people get the disease, they don’t have a problem with the disease. I’m not sure why that’s so difficult for everyone to acknowledge,” Atlas said in an interview with Fox News’s Brian Kilmeade in July. “These people getting the infection is not really a problem and in fact, as we said months ago, when you isolate everyone, including all the healthy people, you’re prolonging the problem because you’re preventing population immunity. Low-risk groups getting the infection is not a problem.”

...Trump has previously floated “going herd” before being convinced by Fauci and others that it was not a good idea, according to one official.

The discussions come as at least 5.9 million infections have been reported and at least 179,000 have died from the virus this year and as public opinion polls show that Trump’s biggest liability with voters in his contest against Democratic nominee Joe Biden is his handling of the pandemic. The United States leads the world in coronavirus cases and deaths, with far more casualties and infections than any other developed nation.

The nations that have most successfully managed the coronavirus outbreak imposed stringent lockdown measures that a vast majority of the country abided by, quickly ramped up testing and contact tracing, and imposed mask mandates.

Atlas meets with Trump almost every day, far more than any other health official, and inside the White House is viewed as aligned with the president and White House Chief of Staff Mark Meadows on how to handle the outbreak, according to three senior administration officials.

In meetings, Atlas has argued that metropolitan areas such as New York, Chicago and New Orleans have already reached herd immunity, according to two senior administration officials. But Birx and Fauci have disputed that, arguing that even cities that peaked to potential herd immunity levels experience similar levels of infection if they reopen too quickly, the officials said.

Trump asked Birx in a meeting last month whether New York and New Jersey had reached herd immunity, according to a senior administration official. Birx told the president there was not enough data to support that conclusion.

Atlas has supporters who argue that his presence in the White House is a good thing and that he brings a new perspective.

“Epidemiology is not the only discipline that matters for public policy here. That is a fundamentally wrong way to think about this whole situation,” said Avik Roy, president of the Foundation for Research on Equal Opportunity, a think tank that researches market-based solutions to help low-income Americans. “You have to think about what are the costs of lockdowns, what are the trade-offs, and those are fundamentally subjective judgments policymakers have to make.”

It remains unclear how large a percentage of the population must become infected to achieve “herd immunity,” which is when enough people become immune to a disease that it slows its spread, even among those who have not been infected. That can occur either through mass vaccination efforts, or when enough people in the population become infected with coronavirus and develop antibodies that protect them against future infection.

Estimates have ranged from 20 percent to 70 percent for how much of a population would need to be infected. Soumya Swaminathan, the World Health Organization’s chief scientist, said given the transmissibility of the novel coronavirus, it is likely that about 65 to 70 percent of the population would need to become infected for there to be herd immunity.

With a population of 328 million in the United States, it may require 2.13 million deaths to reach a 65 percent threshold of herd immunity, assuming the virus has a 1 percent fatality rate, according to an analysis by the Washington Post.

It also remains unclear whether people who recover from covid-19 have long-term immunity to the virus or can become reinfected, and scientists are still learning who is vulnerable to the disease. From a practical standpoint, it is also nearly impossible to sufficiently isolate people at most risk of dying due to the virus from the younger, healthier population, according to public health experts.

Atlas has argued that the country should only be testing people with symptoms, despite the fact that asymptomatic carriers spread the virus. He has also repeatedly pushed to reopen schools and advocated for college sports to resume. Atlas has said, without evidence, that children do not spread the virus and do not have any real risk from covid-19, arguing that more children die of influenza-- an argument he has made in television and radio interviews.

Atlas’s appointment comes after Trump earlier this summer encouraged his White House advisers to find a new doctor who would argue an alternative point of view from Birx and Fauci, whom the president has grown increasingly annoyed with for public comments that he believes contradict his own assertions that the threat of the virus is receding. Advisers sought a doctor with Ivy League or top university credentials who could make the case on television that the virus is a receding threat.

Atlas caught Trump’s attention with a spate of Fox News appearances in recent months, and the president has found a more simpatico figure in the Stanford doctor for his push to reopen the country so he can focus on his reelection. Atlas now often sits in the briefing room with Trump during his coronavirus news conferences, even as other doctors do not. He has given the president somewhat of a medical imprimatur for his statements and regularly helps draft the administration’s coronavirus talking points from his West Wing office as well as the slides that Trump often relies on for his argument of a diminishing threat.

Atlas has also said he is unsure “scientifically” whether masks make sense, despite broad consensus among scientists that they are effective. He has selectively presented research and findings that support his argument for herd immunity and his other ideas, two senior administration officials said.

Fauci and Birx have both said the virus is a threat in every part of the country. They have also put forward policy recommendations that the president views as too draconian, including mask mandates and partial lockdowns in areas experiencing surges of the virus.

Birx has been at odds with Atlas on several occasions, with one disagreement growing so heated at a coronavirus meeting earlier this month that other administration officials grew uncomfortable, according to a senior administration official.

One of the main points of tension between the two is over school reopenings. Atlas has pushed to reopen schools and Birx is more cautious.

“This is really unfortunate to have this fellow Scott Atlas, who was basically recruited to crowd out Tony Fauci and the voice of reason,” said Eric Topol, a cardiologist and head of the Scripps Research Translational Institute in San Diego. “Not only do we not embrace the science, but we repudiate the science by our president, and that has extended by bringing in another unreliable misinformation vector.”

Why Sweden Failed The Test-- And Why Republican States Are Following Them To Perdition

End of the Line by Nancy Ohanian

A few weeks ago we took a quick look at how the transformation of Sweden's Social Democratic party from a socialist to a neo-liberal monstrosity led to a catastrophic approach to the pandemic. Discounting the postage-stamp sized countries, Sweden has been the worst-hit of the Western European nations by the pandemic. It's the only European country whose people are suffering at a rate even approaching a modestly hit American state, say Kansas (8,090 per million residents) or Wisconsin (7,580 per million residents).

• Sweden- 7,737 cases per million Swedes
• Spain- 6,700 cases per million Spaniards
• Iceland- 5,654 cases per million Vikings
• Belgium- 5,529 cases per million Belgians
• Ireland- 5,222 cases per million Irishmen
• Portugal- 4,796 cases per million Portuguese
• U.K.- 4,356 cases per million Brits
• Italy- 4,048 cases per million Italians
• Switzerland- 3,897 cases per million Swiss
• Netherlands- 3,039 cases per million Hollanders
• France- 2,717 cases per million Frenchmen
• Germany- 2,433 cases per million Germans
• Denmark- 2,296 cases per million Danes
• Austria- 2,201 cases per million Austrians
• Norway- 1,668 cases per million Norsemen

And though Sweden has the 15th largest population among European countries, the Swedish COVID death rate ranks 5th, again, excluding the postage stamp-sized countries.

• Belgium- 846 deaths per million residents
• U.K.- 669 deaths per million residents
• Spain- 608 deaths per million residents
• Italy- 580 deaths per million residents
• Sweden- 559 deaths per million residents
• France- 462 deaths per million residents
• Netherlands- 358 deaths per million residents
• Ireland- 355 deaths per million residents

And, for sake of comparison, the U.S. rate-- which is rising rapidly, far more rapidly than in any European country-- is 438 deaths per million residents.

Yesterday 25 Swedish doctors and scientists signed an OpEd published by USA Today, Sweden hoped herd immunity would curb COVID-19. Don't do what we did. It's not working. Although they don't admit it, the U.S. states-- particularly Florida, Georgia, Tennessee, South Carolina and Missouri-- doing worst in this second spike of the first wave are almost all using Sweden as a model. It's a failed, discredited model and the Sweden scientists are warning other countries to steer clear of it.

Sweden has often been considered a leader when it comes to global humanitarian issues, regarded as a beacon of light in areas such as accepting refugees and working against global warming. In the COVID-19 pandemic, Sweden has also created interest around the world by following its own path of using a “soft” approach-- not locking down, introducing mostly voluntary restrictions and spurning the use of masks.

This approach has been perceived as more liberal and has shown up in “Be Like Sweden” signs and chants at U.S. protests. Wherever measures have been lenient, though, death rates have peaked. In the United States, areas that are coming out of lockdown early are suffering, and we are seeing the same in other countries as well.

The motives for the Swedish Public Health Agency's light-touch approach are somewhat of a mystery. Some other countries that initially used this strategy swiftly abandoned it as the death toll began to increase, opting instead for delayed lockdowns. But Sweden has been faithful to its approach.

Why? Gaining herd immunity, where large numbers of the population (preferably younger) are infected and thereby develop immunity, has not been an official goal of the Swedish Public Health Agency. But it has said immunity in the population could help suppress the spread of the disease, and some agency statements suggest it is the secret goal.

An unnerving death rate

Further evidence of this is that the agency insists on mandatory schooling for young children, the importance of testing has been played down for a long time, the agency refused to acknowledge the importance of asymptomatic spread of the virus (concerningly, it has encouraged those in households with COVID-19 infected individuals to go to work and school) and still refuses to recommend masks in public, despite the overwhelming evidence of their effectiveness. In addition, the stated goal of the Swedish authorities was always not to minimize the epidemic, but rather slow it down, so that the health care system wouldn’t be overwhelmed.

Several authorities, including the World Health Organization, have condemned herd immunity as a strategy. "It can lead to a very brutal arithmetic that does not put people and life and suffering at the center of that equation,” Dr. Mike Ryan, executive director of WHO's Health Emergencies Program, said at a press conference in May.

Regardless of whether herd immunity is a goal or a side effect of the Swedish strategy, how has it worked out? Not so well, according to the agency’s own test results. The proportion of Swedes carrying antibodies is estimated to be under 10%, thus nowhere near herd immunity. And yet, the Swedish death rate is unnerving. Sweden has a death toll greater than the United States: 556 deaths per million inhabitants, compared with 425, as of July 20.

Sweden also has a death toll more than four and a half times greater than that of the other four Nordic countries combined-- more than seven times greater per million inhabitants. For a number of weeks, Sweden has been among the top in the world when it comes to current reported deaths per capita. And despite this, the strategy in essence remains the same.

Learn from Sweden's mistakes

It is possible that the Public Health Authority actually believed that the Swedish approach was the most appropriate and sustainable one, and that the other countries, many of which went into lockdown, would do worse. Perhaps this, and not herd immunity, is the main reason the authorities are desperately clinging to their strategy. Or perhaps an unwillingness to admit early mistakes and take responsibility for thousands of unnecessary deaths plays into this resistance to change. Nevertheless, the result at this stage is unequivocal.

We do believe Sweden can be used as a model, but not in the way it was thought of initially. It can instead serve as a control group and answer the question of how efficient the voluntary distancing and loose measures in Sweden are compared to lockdowns, aggressive testing, tracing and the use of masks.

In Sweden, the strategy has led to death, grief and suffering and on top of that there are no indications that the Swedish economy has fared better than in many other countries. At the moment, we have set an example for the rest of the world on how not to deal with a deadly infectious disease.

In the end, this too shall pass and life will eventually return to normal. New medical treatments will come and improve the prognosis. Hopefully there will be a vaccine. Stick it out until then. And don’t do it the Swedish way.

Back To School With Betsy And Donald by Nancy Ohanian

Monday's and ---> Tuesday's reports showed the dozen worst one-day case increases in the U.S. almost exclusively in states were right-wing ideology has crowded out science:

• Florida +10,347 ---> +9,440
• California +8,814 ---> 10,278
• Texas +7,925 ---> 9,992
• Louisiana +3,186 ---> 1,698
• Georgia +2,452 ---> 3,413
• Alabama +1,880 ---> +1,467
• Tennessee +1,639 ---> 2,190
• Arizona +1,559 ---> +3,500
• North Carolina +1,478 ---> 1,626
• South Carolina +1,459 ---> 1,892
• Mississippi +1,251 ---> 1,635
• Ohio +1,230 ---> 1,073

Why The U.S. Is Failing In Confronting The Pandemic-- Is It All Bad Leadership?

The other day, the very Trumpist governor of West Virginia was complaining about South Carolina. West Virginians, apparently, like going down to Myrtle Beach as their vacation spot of choice. Increasingly, according to Gov. Justice, they're coming back with COVID-19. Although there has been some monkeying around with reporting, generally West Virginia has had a very easy pandemic-- just 2,222 cases per million residents. Only Vermont, Alaska, Montana and Hawaii have lower numbers. But West Virginia has begun spiking in the last 10 days. Thursday there were 119 new cases. Yesterday it was another 157. But South Carolina is far worse off. There are a rapidly growing 10,181 cases per million (higher than the national average). Thursday there were 1,782 new cases, 9th worst in the country and it was 1,728 yesterday. Their hospital system is breaking down, the worst outcome for the Herd Immunity strategy favored by right-wing ideologues like Governor Henry McMaster. "We’re going to be worse than New York. But at least in New York, people took the virus seriously. Here, we’re in a war zone that people refuse to accept," a Charleston emergency room nurse told Pilar Melendez of the Daily Beast.

South Carolina’s current surge of cases is so bad that it’s currently one of the top three worst coronavirus outbreaks in the world. In a New York Times study of the number of daily infections between June 28 and July 5, Arizona and Florida are the two most impacted areas in the world-- followed by South Carolina, the country of Bahrain, and Louisiana. Hospitals are overwhelmed, understaffed, and short on supplies-- unable to keep up with what researchers believe is the “tipping point” before the state loses control of the pandemic.

“We’ve completely lost control of the situation in South Carolina-- and it’s completely embarrassing,” Helmut Albrecht, chairman of the Department of Internal Medicine at the University of South Carolina in Columbia and Prisma Health, told the Daily Beast. “In the medical community, we feel like we are getting completely dumped on.”

Some doctors insist the surge in South Carolina was inevitable, given the state officials’ response to the virus. Aside from closing schools, in the first month or so of the coronavirus’ spread in South Carolina, there was very little in the way of a statewide effort to slow the pathogen. As late as the end of March, the Republican-led state government was actively discouraging local public health efforts. “We affirm that local governments cannot exercise the emergency powers delegated to the governor by the general assembly,” Attorney General Alan Wilson stated on March 27. The general assembly is South Carolina’s state legislature.

...Myrtle Beach, a popular tourist destination along South Carolina’s coast, seems to be one of the biggest problem zones in the Palmetto State. A spring-break destination with a large elderly community, Myrtle Beach has contributed to increasing COVID-19 cases nationwide-- including 50 cases around Philadelphia.

  An internal state report obtained by ABC News foreshadows that South Carolina’s COVID-19 outbreak has no end in sight. The July 4 report, which warned of the state’s hot-spot status, particularly in coastal counties, said that in Horry County, where Myrtle Beach is located, “cases continue to sharply rise” with “widespread travel to the area contributing to cases.” In Charleston, there is “no sign of cases slowing down,” according to the report.

Locals, however, refuse to let the pandemic that has killed more than 131,000 people nationwide ruin their summer.

“We’re making no changes. Everything is going according to plan,” Copeland, 61, said about the 81st Annual Myrtle Beach Bike Week.  

Badge of Honor by Nancy Ohanian

South Carolina doesn't even have a mask mandate. Anyone who tells you they're doing down there early has a death wish. On Thursday we looked at what a catastrophe the herd immunity strategy has been for Sweden and its clueless neo-liberal prime minister, Stefan Löfven, who has steered his country over a cliff. Friday Axios' Caitlin Owens looked into how much of the U.S. has been dragged into the failed herd immunity strategy by Trump and the foolish governors who take their cues from him, like McMaster. "By letting the coronavirus surge through the population with only minimal social distancing measures in place," she wrote, "the U.S. has accidentally become the world’s largest experiment in herd immunity. Letting the virus spread while minimizing human loss is doable, in theory. But it requires very strict protections for vulnerable people, almost none of which the U.S. has established. Cases are skyrocketing, with hospitalizations and deaths following suit in hotspots. Not a single state has ordered another lockdown, even though per capita cases in Florida and Arizona have reached levels similar to New York and New Jersey’s in April."

• Most states never built up the testing, contact tracing and isolation systems it would take to prevent the virus from spreading widely, and and health care workers are once again facing shortages of protective medical gear.
• The Trump administration is generally ignoring or downplaying soaring caseloads across the South and West, and is pushing schools to fully reopen in the fall.
• In Florida, where infections, hospitalizations and deaths are surging, Gov. Ron DeSantis “has repeatedly ruled out a sweeping mask mandate or taking the state back into a lockdown to stem the virus, although local governments have acted on their own,” per Bloomberg.

"Separating older, sicker people from younger, healthier ones while the virus burns through the latter group could be a way to achieve herd immunity-- assuming immunity exists-- without hundreds of thousands of people dying.

But the U.S. hasn’t adopted such a strategy with any planning or foresight. Although younger people make up a larger portion of coronavirus cases now than they did earlier in the pandemic, vulnerable people still go to work or live with non-vulnerable people.

Frontline workers have generally been left unprotected, contributing to disproportionate caseloads, hospitalizations and deaths among people of color.

Even nursing homes are still vulnerable to outbreaks. Nursing home deaths have continued to climb in Florida, Georgia, Texas, South Carolina and California, The Atlantic recently reported.

...Sweden embraced the model and, as the NYT reported earlier this week, saw thousands more deaths than its neighbors with nothing to show for it economically.

In the next post this morning, we're going to take a look at how this is playing out electorally.

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."