Enough With the Herd Immunity Mansplaining

What people who throw around ‘herd immunity’ often don’t understand is ‘herd’ or ‘immunity’

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There’s a lot of Twitter mansplaining about herd immunity. Here’s what it means. I actually think it means one of several things depending on who says it.

  1. The first thing it means is “This is too hard. I give up. We might as well just get it, dear, and get it over with.” Tired of missing your football games? Aching to go to the BBQ? Believe in herd immunity. This reaction isn’t just understandable. It’s predictable. Of course it happens when no one provides a credible light at the end of the tunnel. If you won’t give me a strategy or one I believe, I will make one up.
  2. The second thing it means is “Having studied epic graphs for two months now, I declare myself an expert.” A variation of this is that people like my tweets when I talk about herd immunity. Nothing makes me feel more alive than relevance! Yes, there are curves in some cities where the outbreak happens over weeks that flatten out. Since many in this group have already ruled out masks and social distancing, it must be herd immunity. Besides, this group saw a pre-print that’s a study on T-cell cross-immunity. Well, they didn’t see the study. They saw an article about it. Okay, they didn’t see an article, but someone tweeted about it. Same difference. Anyone can put two and two together. Must be herd immunity. What the group can’t explain is when there is fast spread with high exposure in a town, in a prison, or on a cruise ship. But whatever.
  3. Another thing herd immunity means is “I personally feel safe.” These are people who only understand one word of the phrase “infectious disease.” Fifty percent isn’t bad. These people also believe a combination of “If I got it, I would never spread it,” “It only spreads with symptoms,” “Fuck other people if they can’t make it,” and “Lock up the oldies.” Maybe all, maybe one in particular.

Yes, risk managers have demonstrated that people always believe they need to be protected from other people’s dumb behavior, but no one thinks anyone ever needs to be protected from theirs.

“It only spreads with symptoms” comes from the wonderful confirmation bias of the web. “I found a column in ‘Freedom Brigade Science(ish)’ that says exactly what I think! It’s an 80-word opinion piece attached here.”

The survival-of-the-fittest argument put forward by “Kirk Cousins, PhQB,” is put forward by the guy who points out to his friends, “Have you noticed we don’t know many people dying from Covid-19?”

Ask a doctor or nurse at the nearest ICU what percentage of people there have Hispanic surnames. Things have changed from March. Those who can distance are—and are hanging out with people who can.

But what about the busboy at the bar? The farmworker? All those people you hang out with, Kirk, who have no choice but to be near you or work to serve you. Are they not the fittest? It’s not that you don’t know them. It’s that you never learned their names.

And then there’s the “Just protect the old people.”

  1. I have a lot of aunts in their seventies and eighties. They’re perfectly healthy. They would like to hug or see their grandkids again. You want to spread this around, so they can’t.
  2. It’s not just old people for whom this is life-threatening. It’s sick or previously sick people too. One in three Americans has a prior illness or disability. Or healthy people with high volumes of exposure. This can be life-threatening if you spread this around.
  3. You can’t cocoon old people or people in congregate settings. People work there. Those people have families. Those families have school kids. Once there is community spread, it is dangerous.
  4. By the way, who elected you to speak for “old people”? Did people over 70 take a vote: “Please isolate me so you can go to a bar!”

What people who throw around “herd immunity” often don’t understand is “herd” or “immunity.” How many people constitute the herd? How long does immunity last? They don’t know. Because no one does. Or maybe they’re the only ones who know. (It’s part of being the fittest.)

The herd is relative to behavior and mobility, infection rates, super spreaders, immunities, and length of immunity. And clinical advances.

All of this thinking also assumes that if you survive Covid-19, it’s a picnic. But giving somebody lifelong myocardial sequelae isn’t a laughing matter.

All of this isn’t to say we don’t have a set of difficult societal challenges. We do. What happens when one group has to sacrifice, and they’re not the prime beneficiaries of the sacrifice but people they’ve never met are.

It all depends on how we decide to define our relationship with people we’ve never met: strangers or community members? Do I embrace them with indifference, resentment, or love?

Former Medicare, Medicaid & ACA head for Pres. Barack Obama.

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