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Herd immunity - Can man overpower the coronavirus? - (5/5/2020)

By Dr. Ron Gasbarro

Ms. Simpson was waiting for the pharmacist to fill her prescriptions when she said, “What’s this I hear about herd immunity and the coronavirus? Does this mean some people will not need to get a vaccine when it is developed?” Since the start of coronavirus pandemic in 2019, scientists have batted around the term "herd immunity" as one solution to the overwhelming virus ravaging almost every country on Earth. The phrase explains the situation in which a high percentage of people in a given geographical area are immune to a disease. This immunity can be accomplished through vaccination.  Or protection may be naturally conferred as the population becomes exposed to the virus and develops antibodies to fight further infections.
Polio, mumps, measles, smallpox, and chickenpox are examples of infectious diseases that were once widespread but are now uncommon in the US because vaccines helped to establish herd immunity. Occasionally, outbreaks of vaccine-preventable diseases are seen in communities with lower vaccine coverage because they never attained herd protection. 

The problem with herd immunity and the COVID-19 coronavirus is that the planet is nowhere close to having widespread resistance to this ominously unknown virus. And science is still a long way from developing such resistance. Epidemiologists estimate that 60% to 90% of any given population must have immunity to a disease for it to stop spreading. Most countries affected by COVID-19 have not surpassed the 1% mark, including the US, which currently has the highest number of cases in the world. 

When European explorers ventured to America, they brought with them Old World diseases that were not indigenous to Native Americans, who consequently had no immunity to them. In terms of death count, the most pernicious European pathogen was smallpox followed by measles, introduced to North America in 1520 and 1531, respectively. Also, bubonic plague and influenza severely reduced tribal populations. 

The impact of European explorers on Native American disease was insidious rather than sudden. Even though European contact started during the 16th century, infections did not significantly impact the Native population until the period between 1620 and 1680, when 87% of the Native population tribes in the American Southwest succumbed. Similarly, the path to COVID-19 immunity may be a long row to hoe, vaccine, or not. We have many questions. Will immunity be life-long, as with the smallpox vaccine? Or short-lived whereby we need a flu shot each year? Will a medication emerge to mitigate the symptoms? Or will humanity have to take its blows in the name of Darwin's survival of the fittest?

Ms. Simpson asked the pharmacist, “How can we get closer to herd immunity?” The virus has already harvested more American lives than the Revolutionary, the Korean, and the Vietnam Wars. Projections warn that by midsummer, more people may die due to COVID-19 than Americans killed in World War 1. Therefore, we have to start with the basics: Social distancing, impeccable hygiene, testing, and respect for the data and the science. The politics and economy are secondary to human life. Yes, it is an inconvenience to be going without a haircut or finding one's restaurant closed. Yet, the real tragedy is that children may be going without parents, and parents may be losing their children. Nature is attempting to thin the herd. Until herd immunity develops, the virus has us corralled. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com.


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