Herd immunity not only would kill thousands of Michiganders and leave millions with lasting health problems, evidence suggests that it might not even work.
GRAND RAPIDS, Mich.—”The situation has changed.”
Those were the words of Spectrum Health’s chief medical officer, Dr. Josh Kooistra, when assessing the past two weeks of coronavirus cases statewide.
In Kent County, the seven-day average for new positive cases has drastically changed in the past month. What was, in mid-September, 48 new cases skyrocketed to nearly triple by mid-October. Kent County, where Grand Rapids and Spectrum Health are located, surpassed Wayne and Oakland counties in rate of case growth Oct. 14.
And it isn’t just Kent County. The day after Kent had the most new cases in the state, Genesee County also posted the highest new infection rate since April. Genesee health officials said the spike was related to large gatherings of people, particularly in schools and houses of worship.
Genesee Health Officer John McKellar noted that a less robust response to mask-wearing and social distancing from Michiganders has contributed to the spread in his community, which includes Flint.
Michigan as a whole has seen a dramatic uptick in coronavirus cases over the past month, but especially in the past several weeks as the Michigan Supreme Court’s defeat of Gov. Gretchen Whitmer’s coronavirus protections has inflamed the pandemic fatigue already weighing on Michiganders.
The Dangerous Solutions Prompted by Pandemic Fatigue
Pandemic fatigue is the exhaustion people are feeling with the changes to daily life prompted by the novel coronavirus, which remains highly communicable, effectively untreatable and for which there is no proven vaccine. All the same, people want life as it was last year to return.
And that urge to go back to life as usual, the New York Times reports, is linked clearly to the increase in coronavirus in recent weeks. But it also drives the understandable desires behind an approach to the pandemic Michigan health officials call dangerous: herd immunity.
Herd immunity is how many communicable diseases are contained. Smallpox was eliminated in large part because of a massive immunization campaign where those who could, for health reasons, not be vaccinated were protected by the vast majority of those who were immune. This is employed annually as Americans go to get their flu shots.
“Usually, when we talk about herd immunity, you’re talking about [it] because of a vaccine,” Dr. Joneigh Khaldun, Michigan’s medical director, testified to Congress Monday. “That is because you need to have a very large segment of the population who is immune to a disease before you start seeing a decrease in the spread.”
For herd immunity to be effective, she explained, 80% of the population needs to be immune, which means in the best case scenario 80% of Michiganders get infected with the expensive and painful coronavirus, survive with potentially lasting damage to their lungs and heart and are immune to reinfection. And no matter how lucky that strategy could be, people will die.
“As I’ve said, that would be inhumane,” Khaldun continued. “We cannot have six million additional Michiganders infected by the disease. We cannot have 30,000 die as a strategy towards herd immunity.”
But without a vaccine available, some in Michigan and across the nation, have advocated for herd immunity obtained through the natural spread of the coronavirus, accelerated by entirely abandoning pandemic precautions. To this way of thinking, the sharp rise in infections and hospitalizations across Michigan is a good thing, as it means more people are contracting the virus and developing immunity.
Except that isn’t necessarily how the coronavirus works.
A Dutch woman became the first person to die from a reinfection of the coronavirus recently, according to CNN. The two versions of the virus in the blood had different genetic makeup, meaning she was infected once and infected a second time. Not only does this mean that surviving the virus doesn’t necessarily make someone immune to the virus, when taken with other research about reinfections it seems to suggest a second infection of the disease is typically far more severe.
The attempt to achieve herd immunity, therefore, could not only fail to combat the virus, but dramatically worsen the situation of reinfection.
Despite this, the strategy has been championed by people like Michigan Senate Majority Leader Mike Shirkey (R-Clark Lake). Shirkey said he was a “big believer” in herd immunity being part of Michigan’s strategy. At the national level, some in the White House have suggested the approach and President Donald Trump seemed amenable to it in his town hall last week.
“I think for the most part it’s about fatigue,” Kooistra said. “People are tired of wearing masks, of the social distancing just because it’s a way of life that we were not used to. And as the pandemic has kind of continued now for months and months, people are fatigued, regardless of whether the executive order is in place or its the Michigan Department of Health and Human Services orders.”
But if not herd immunity, what strategy should Michigan employ to combat the coronavirus? Experts say, use the approach that worked once before.
Fighting the Pandemic and Pandemic Fatigue
Over the spring and summer, Michigan was extraordinarily effective at slowing and containing the spread of the coronavirus with a few simple strategies. Both Khaldun and Kooistra advocate for a return to those strategies.
Khaldun called those strategies “strong mitigation measures” and included things like maintaining social distance, wearing masks, staying home when sick and washing hands thoroughly and frequently.
“I’m very concerned about what we’re seeing now,” she said. “The surge of cases we are seeing could be worse than what we saw in the spring if people are not very careful.”
But that adds another problem for health officials to mitigate alongside the coronavirus: coronavirus fatigue. The tactics health officials call for proved effective when in widespread use, but Michiganders now resist the prevention measures. Writing for Johns Hopkins, psychologist Carisa Parrish explained that the everyday nature of the pandemic precautions slowly grates on people.
“Trying to adhere to anything extra is always a challenge,” says Parrish. “You can add extra steps to your routine for a few days, but sustained behavior change is hard. Especially when no one around you is sick, and you just don’t feel like wearing a mask or saying no to things you like to do. But the fact is, the precautions work.”
Parrish recommends making a commitment to fighting the spread of the virus, staying adaptable as the science evolves, keeping supplies handy and getting kids involved in the process. She also advises practicing all of these as well as the mitigation strategies until they’re second nature.
“The key is repeating that new step until it becomes a habit,” Parrish says. “When you first start flossing or putting your child in a safety seat, it might seem like a chore, even though you know it’s the right thing to do. So when it comes to COVID-19 protection, you just commit to it, and then over time, you find you’re putting your mask on or washing your hands without thinking.”
Parrish acknowledges that adapting to the pandemic is a difficult and highly emotional task, but also a necessary one to keep families and neighbors safe from the virus.
“Accepting this new reality and staying committed to good habits can prevent COVID-19.”