Don’t End Social Distancing Yet
Theories That We Can End the Coronavirus Pandemic by Reopening Things Now Lack Scientific Support
As the coronavirus pandemic continues in the U.S. and around the world, it is natural that people are becoming increasingly weary and frustrated with stay-at-home and social distancing orders. We are also all fearful about the economic repercussions of the COVID-19 outbreak, which affect the most vulnerable people with the lowest incomes among us. We yearn for the time when we can finally go back to work and to socializing in person with friends and family.
These understandable emotions make some of us prone to believe a theory that everyone but the elderly and chronically ill should return to work and school right away. According to this notion, isolating the elderly and those with chronic underlying medical illnesses, who are the two groups most likely to develop serious complications from coronavirus infection, while allowing everyone else to get infected will ultimately lead to the development of widespread (also called “herd”) immunity to the virus and it will simply peter out.
We noted with alarm, then, a widely circulated article titled “Epidemiologist: Coronavirus could be ‘exterminated’ if lockdowns lifted,” which we first saw in an online publication called WND News, a politically conservative news source. The piece, which was picked up by other online media, was written by Kurt Wittkowski, Ph.D., who is described as “former head of the Department of Biostatistics, Epidemiology and Research Design at the Rockefeller University in New York City.” He asserts that our current efforts to “flatten the curve” of new coronavirus infections actually widen it and that “the only thing that stops respiratory diseases is herd immunity.” Given Wittkowski’s credentials, his ideas may be harder for some to recognize as faulty.
Most urgent is the concern that people will read what he says, believe it, and relax social distancing efforts. The result of prematurely relaxing those efforts, scientists tell us, would be an overwhelmed healthcare system and even more deaths than currently predicted.
We will focus on two questionable aspects of Wittkowski’s proposal: 1.) that we could protect the elderly and medically vulnerable by isolating only them and not the rest of the population and 2.) that herd immunity will develop in a matter of weeks if the virus is allowed to run rampant through the 80% of the population believed to be less vulnerable to serious complications and death.
Isolating Only the Elderly Unlikely to Work
It is true that except for those with underlying chronic illnesses like diabetes and asthma, most children who get infected with the coronavirus experience either no or mild symptoms. But it is not true that only elderly people can get very sick from coronavirus infection. Adults of all ages, especially those with conditions like diabetes, hypertension, and chronic lung diseases and those who are undergoing chemotherapy for cancer or taking steroids on a long-term basis, can get very sick and die from coronavirus infection. Who will get serious complications from the coronavirus depends on multiple factors and is hard to predict. In some cases, although less common, even young and healthy adults have died.
When children go to school, they risk not only passing the virus among themselves but also to teachers, school administrators, school bus drivers, janitorial and kitchen staff, and so forth. These adults can then pass the virus around among themselves and inevitably to elderly people with whom they come into contact. Instead of flattening the curve and reducing the number of new infections and deaths, doing this according to our best mathematical models would prolong the pandemic, cause more people to get infected, and result in more deaths.
Moreover, flattening the curve is essential to preventing our already strained healthcare system from becoming completely overwhelmed. Critica’s Chief Medical Officer, David Scales, reports that the New York City hospital at which he works had to break down walls to create space for additional ICU beds to accommodate very sick COVID-19 patients. And, he tells us, many of those patients are less than 65-years old. Doctors, nurses, and other healthcare professionals are already stretched to the maximum; allowing the virus to run rampant throughout the population as would happen under Wittkowski’s proposal, would only make this already intolerable situation worse.
Herd Immunity Won’t Occur in Just a Few Weeks
What about his suggestion that if we just allow people considered less vulnerable to serious complications from COVID-19 the virus would be exterminated “within weeks?” The problem here is that at present we have very little notion about what kind of immunity people who have recovered from COVID-19 actually develop. Let’s take a look at some basic immunology here for a moment.
One major line of defense against viruses is the development by the immune system of antibodies (aka immunoglobulins) that recognize proteins on the surfaces of a specific virus. These antibodies are produced by a type of immune cell called the B lymphocyte. There are five categories of antibodies, and two classes are particularly important for the fight against a viral invader: IgM and IgG. B cells produce IgM first, but these antibodies tend to be “generalists” and not specific to a particular virus. IgM antibodies typically show up in a person’s blood about ten days after being infected with SARS-CoV-2, the virus that causes COVID-19. A few days later, IgG antibodies, which are more specific than IgM, start to appear and the person usually—but not always--begins to recover.
Antibodies that can neutralize the COVID-19 virus take up to two weeks to develop and are more effective in some patients than others in promoting recovery (source: Shutterstock).
For some viral illnesses, a second exposure to the virus causes a much more rapid antibody response and the virus is neutralized before it has a chance to set in and cause disease. Before the measles vaccine was available, for example, most people who had measles developed lifelong immunity and reinfections were uncommon. For other infections, however, the virus mutates rapidly, and the IgG antibodies produced the first time around are no longer effective. This is the case for viruses that cause the common cold and the flu.
Scientists think that people may develop immunity for a year or more after a first encounter with the coronavirus, but this is not yet certain. It is also possible, we are told, that people who have no or mild symptoms the first time may have such a weak initial immune response that they do not develop any form of immunity to repeat exposures to the virus. That means they could be reinfected and contagious again. Indeed, a troubling report from the South Korean CDC identified cases of coronavirus reinfection in people who had recovered from a first infection.
So Wittkowski’s prediction that allowing the bulk of the population to be exposed to the coronavirus would result in the rapid development of herd immunity is based on no science at all. Right now, the only appropriate public health response to the pandemic is to keep everyone in relative isolation by staying at home, social distancing, and closing of schools and other public spaces. There are already data that this approach, rather than allowing unchecked infection, is working. Once the new infection rate has dropped substantially, we can then ease up on those measures and institute a policy of widespread testing for the virus and for antibodies against it and quarantine only those with active infection. A cogent plan for national surveillance and testing has been advanced. But we are not at that point yet and probably won’t be until this summer at the earliest.
Social distancing appears to be working to reduce the number of new cases of and deaths from COVID-19 (source: Shutterstock).
Anti-viral drugs will hopefully be developed soon that will lessen the burden of severe complications and death from coronavirus infection. Ultimately, we should have a vaccine against it that will cause protective antibodies to be produced without itself inducing illness. Ordinarily it takes many years to develop a safe and effective vaccine and, in some cases, like HIV infection, even years of research do not produce one. With the focused international effort now underway, and the fact that this coronavirus mutates slowly, it is hoped that a vaccine might be available a year from now, although that is probably a bit optimistic.
We all want to see our families and friends in person again, to be able to shop and go to the movies, and to go back to school and work. As the pandemic drags on, it is understandable that we are going to find any theory that would allow those things to happen right away very attractive. These theories are unfortunately now not uncommon across the internet. Our fear with denialist ideas like those of Wittkowski and a handful of other doctors and self-proclaimed experts is that they will weaken our resolve to stay at home and practice social distancing. Those are among the most essential ways we have right now to control the pandemic and maintain a functioning healthcare system. The notion of rapidly developing herd immunity to the coronavirus is unsubstantiated by science and at present dangerous to follow. We all can’t wait to be let outside again. Unfortunately, waiting is exactly what we must do.