Sweden has finally seen coronavirus cases and deaths dwindle to almost nothing without any mandatory lockdowns or school closures. Though the fact that the Swedish economy still took a bigger hit during Q2 than its neighbors is, if anything, a sign of how much Swedes did pull back on activities like socializing, shopping and dining out - and how people can still make "rational" decisions in the name of safety without being explicitly required to do so.
Despite this, Sweden's leading coronavirus expert Anders Tegnell has said the country has yet to achieve 'herd immunity' - a level of infection where the virus practically stops spreading since it can no longer find new hosts. Given that SARS-CoV-2 has proven surprisingly persistent, even in countries like South Korea that responded swiftly and strongly enough to prevent the type of untrammeled outbreaks seen in the US, herd immunity is really the only option - whether that immunity comes via infections, or via a vaccine.
While Dr. Fauci continues to move forward his expectations for a vaccine (which he now says could be confirmed by the FDA by the end of October), the administration is apparently tweaking its approach to try and find some middle ground that might be more sustainable.
Last week, FDA head Dr. Stephen Hahn apologized for hyping up convalescent plasma as a "game-changing" therapeutic as President Trump worked to allegedly 'oversell' the treatment's efficacy. That said, the results so far are promising, and plasma could still well prove to be a good idea.
Now, one of President Trump’s top pandemic advisers is urging the White House to embrace a controversial “herd immunity” strategy to combat the pandemic, which would entail allowing the coronavirus to spread through most of the population to quickly build resistance to the virus, while taking steps to protect those in nursing homes and other vulnerable populations, according to a handful of unnamed WaPo sources.
A neuroradiologist from Stanford’s conservative Hoover Institution, Atlas joined the White House earlier this month as a pandemic adviser. Since then, detractors have labeled him "the anti-Fauci" for his pro-business slant.
Dr. Atlas has been far less cautious about the dangers of reopening local economies, and has reportedly expressed his belief that NYC, and possibly other cities like Chicago, may have already reached herd immunity, a notion that Dr. Fauci and Dr. Birx reportedly dispute.
WaPo points out that Atlas, who is a medical doctor, doesn't have a background in epidemiology. Amusingly, one of the "outside experts" WaPo cited as somebody who was "concerned" about the shift toward "herd immunity" was none other than economist Paul Romer, whose father was a former Democratic governor of Colorado.
That this approach is even being discussed inside the White House is drawing concern from experts inside and outside the government who note that a herd immunity strategy could lead to the country suffering hundreds of thousands, if not millions, of lost lives.
"The administration faces some pretty serious hurdles in making this argument. One is a lot of people will die, even if you can protect people in nursing homes,” said Paul Romer, a professor at New York University who won the Nobel Prize in economics in 2018.
"Once it’s out in the community, we’ve seen over and over again, it ends up spreading everywhere."
The White House comms team insisted that official policy isn't changing.
Atlas declined several interview requests in recent days. After the publication of this story, he released a statement through the White House: “There is no policy of the President or this administration of achieving herd immunity. There never has been any such policy recommended to the President or to anyone else from me.”
White House communications director Alyssa Farah said there is no change in the White House’s approach toward combatting the pandemic.
The problem, as Dr. Birx points out, is that there's "not enough data" to determine how close - or far - the US is from reaching herd immunity.
Atlas had a hand in trying to bolster supplies of COVID-19 tests and PPE to nursing homes and other 'high risk' institutions.
But one unique problem that the US faces is the higher number of vulnerable people of all ages, since Americans are among the least healthy populations among developed nations. High rates of heart and lung disease and obesity are particularly problematic. But the fact remains that young health people rarely suffer more than a bad cold from the virus, though it has also exhibited a chilling randomness as it occasionally been known to fell seemingly healthy, young people.
"When younger, healthier people get the disease, they don’t have a problem with the disease. I’m not sure why that’s so difficult for everyone to acknowledge,” Atlas said in an interview with Fox News’s Brian Kilmeade in July. "These people getting the infection is not really a problem and in fact, as we said months ago, when you isolate everyone, including all the healthy people, you’re prolonging the problem because you’re preventing population immunity. Low-risk groups getting the infection is not a problem."
What's more, Atlas - who caught Trump's attention thanks to series of Fox News appearances, has said that lockdowns and social distancing restrictions during the pandemic have taken their toll on people's health.
However, Atlas has supporters who argue he brings a fresh perspective as the White House looks to forge a "sustainable" strategy for combating COVID-19 until a vaccine becomes widely available.
“Epidemiology is not the only discipline that matters for public policy here. That is a fundamentally wrong way to think about this whole situation,” said Avik Roy, president of the Foundation for Research on Equal Opportunity, a think tank that researches market-based solutions to help low-income Americans. “You have to think about what are the costs of lockdowns, what are the trade-offs, and those are fundamentally subjective judgments policymakers have to make."
Though he wasn't mentioned in the WaPo story, former FDA director Dr. Scott Gottlieb published an editorial in the Wall Street Journal on Monday claiming that herd immunity is too risky. His reasoning is that embracing the "Swedish model" is based on assumptions that sidestep some of these facts. One such assumption is that there's a large swath of Americans who are already immune.
The science is too preliminary at this point, Gottlieb said, and while surveillance antibody testing in some areas in NYC has turned up staggering levels of infection, it's simply too early to know for certain. The fact that as many as 50% of people have T-cells that develop in response to other seasonal coronaviruses, and which have been shown to counter COVID-19 in a petri dish, is certainly promising.
In terms of what it takes to achieve herd immunity, estimates range from 20% of the population to 70%. Somya Swaminathan, the World Health Organization’s chief scientist has said the 70% figure is likely considering the virus's ability to spread so easily.
WaPo pointed out in a separate article about herd immunity that the WHO recently declared it a "dangerous" strategy.
"If we think about herd immunity in a natural sense of just letting a virus run, it’s very dangerous,” said Maria Van Kerkhove, the WHO’s technical lead on the pandemic. “A lot of people would die." But "just letting it run" isn't what Trump and Dr. Atlas are advocating. Not that nuances like this matter anymore.