Experts Say Herd Immunity Approach to COVID-19 is Flawed, Dangerous in Open Letter

A group of 80 researchers published an open letter in The Lancet that states a herd immunity approach to managing the coronavirus disease 2019 (COVID-19) pandemic is “a dangerous fallacy unsupported by the scientific evidence.”

The authors have expertise in many fields, including public health, epidemiology, medicine, pediatrics, sociology, virology, infectious disease, health systems, psychology, psychiatry, health policy, and mathematical modeling. Although they acknowledged that ongoing restrictions have been challenges for everyone, they said controlling community spread is the best way to protect people during the pandemic.

“It is critical to act decisively and urgently,” the authors wrote. “Effective measures that suppress and control transmission need to be implemented widely, and they must be supported by financial and social programs that encourage community responses and address the inequalities that have been amplified by the pandemic.”

They said continuing restrictions will probably be necessary in the short-term to reduce transmission and prevent future lockdowns. Because these restrictions have led to widespread demoralization and frustration, the authors said there has been renewed public interest in natural herd immunity approaches, which allow a large uncontrolled outbreak in a low-risk population.

Some people have argued that these approaches could lead to the development of infection-acquired population immunity, but the experts wrote that this approach is flawed.

According to the authors, uncontrolled transmission in younger people risks significant illness and death across the entire population. They cited real-world evidence from many countries that demonstrates it is not possible to restrict uncontrolled outbreaks to certain segments of society, noting it is practically impossible and highly unethical to isolate large groups of the population.

The scientists also said there is no evidence for long-lasting immunity to COVID-19 following natural infection and warned that this waning immunity would actually result in repeated waves of transmission over several years. Instead of ending the pandemic, the authors said this would place vulnerable populations at risk for the indefinite future. The best approach, according to the authors, is to suppress transmission of the virus until the population can be vaccinated.

Finally, the authors said herd immunity approaches risk impacting the workforce as a whole and overwhelming the ability of health care systems to provide acute and routine care. They noted that investigators still do not know who is at risk of long-term COVID-19 and said herd immunity places an unacceptable burden on health care workers.

“The evidence is very clear: controlling community spread of COVID-19 is the best way to protect our societies and economies until safe and effective vaccines and therapeutics arrive within the coming months” the authors concluded. “We cannot afford distractions that undermine an effective response; it is essential that we act urgently based on the evidence.”

REFERENCE

Alwan N, Burgess R, Ashworth S, Beale R, et al. Scientific consensus on the COVID-19 pandemic: we need to act now. The Lancet; October 15, 2020. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32153-X/fulltext. Accessed October 21, 2020.