Herd immunity is 'a dangerous fallacy'
21.10.2020 16:34
Almost 5,000 scientists and healthcare professionals have now co-signed the so-called “John Snow Memorandum” on Covid-19, which was published in the journal “The Lancet” on October 10, 2020, but can also be found on the online portal of the memorandum of the same name . In this exciting statement, the authors call for “clear communication about the risks posed by Covid-19 and effective strategies to combat them,” but strongly warn against “infection-acquired population immunity,” which would result in a low-risk population. According to the authors of the memorandum, this is “a dangerous fallacy that is not supported by scientific evidence.” Two important objections from Germany support this international initiative: On the one hand, this is a statement from the Society for Virology (GfV), and on the other hand, the group of authors around Prof. Dr. med. Matthias Schrappe, who added an “urgent ad hoc statement” to her four theses papers published in “Monitor Healthcare Research” on the occasion of the Federal Chancellor’s conference with the state prime ministers on October 14, 2020.
>> “Any pandemic management strategy that relies on immunity to natural infections for Covid-19 is flawed.” This is what the authors of the John Snow Memorandum postulate. They justify this harsh statement with an editorial published in Nature and two scientific articles by Chen, Tong, Li et al. and Parry, who would describe that “uncontrolled transmission in younger people carries the risk of significant morbidity” and that the infection would lead “to persistent disease, even in young, previously healthy people” (1). In addition, it is “unclear how long the protective immunity lasts” (2). Likewise, SARS-CoV-2, like other seasonal coronaviruses, is “capable of reinfecting people who have already had the disease, but the frequency of reinfection is unknown (3)”.
In conclusion, the Johns Snow authors warn that prolonged isolation of large parts of the population is practically impossible and highly unethical. Empirical findings from many countries also show “that it is not feasible to limit uncontrolled outbreaks to certain parts of society.” According to the authors, such an approach also carries the risk of increasing the socio-economic inequalities and structural discrimination that result The pandemic, which has already been revealed, will be further exacerbated. Special efforts to protect the most vulnerable are essential, but must be accompanied by “multi-pronged strategies at the population level”.
Statement from the Society for Virology (GfV)
A current statement from the Society for Virology (GfV) responds specifically to this statement, recommending “a scientifically based approach to the Covid-19 pandemic”. The signatories* “note with concern that voices are once again gaining strength that rely on the natural infection of large parts of the population with the aim of herd immunity as a strategy to combat pandemics”. The GfV refers to the “Great Barrington Declaration” (4), which calls for the immediate lifting of all restrictions on public and private life, including all distance rules and the requirement to wear masks. In order to mitigate morbidity and mortality in the vulnerable groups (elderly, those with previous illnesses), the declaration's provisions propose special protective measures for these people, including quasi-isolation ("Retired people who live at home should stock up on food and... have other important things delivered to your home).
The board of directors of the GfV and their co-signatories, however, “decisively reject this strategy”, although they certainly recognize the enormous burden on the population caused by drastic containment measures. Nevertheless, the GfV authors are convinced that the damage that threatens directly and indirectly in the event of an uncontrolled infection “might exceed the burden many times over and can result in a humanitarian and economic catastrophe”. We should therefore strongly advise against pursuing the strategy of uncontrolled infection propagated in the “Great Barrington Declaration”. An uncontrolled infection would lead to an escalating increase in fatalities, since even with strict isolation of retirees there are still other risk groups that are far too numerous, too heterogeneous and in some cases unrecognized to be able to be actively shielded.
Furthermore, according to the GfV, it is not yet known reliably how long immunity acquired through an infection lasts. It is becoming increasingly clear that infections with few symptoms, such as those that predominate in younger people, do not provide stable immunity. The GfV board therefore expressly supports the position of the signatories of the “John Snow Memorandum” and considers the pursuit of herd immunity without vaccination to be “unethical as well as medically, socially and therefore also economically highly risky”.
Statement by the thesis paper author group Schrappe et al.
“The bottom line is that the only thing that remains is that in Germany a concept is being used which, by limiting it to general prevention measures including the threat of a lockdown and by largely foregoing specific prevention approaches, has paradoxically developed into exactly the concept that should actually be avoided , namely the concept of herd immunity”. This is what the thesis paper author group Schrappe et al. in an “urgent ad hoc statement” (5), which primarily refers to the results of the conference between the Chancellor and the state prime ministers on October 14, 2020. Their fear: The concept of herd immunity is “a concept that only accompanies the progress of the epidemic, but without focusing on the urgently needed protection of vulnerable population groups.” The group of authors has always criticized such an approach, and such an approach is to continue to criticize sharply in the future.
However, the minutes of the results of the conference between the Chancellor and the Prime Minister on October 14, 2020 also lead the group of authors to point out further “worrying undesirable developments” that would affect all three subject areas on which the group of authors has so far commented in their four previous theses papers: Epidemiology, Prevention concept and socio-political implications.
In the previous thesis papers published in “Monitor Supply Research” it was worked out strictly analytically that
• the SARS-CoV-2/Covid-19 epidemic is spread by asymptomatic carriers and cannot be captured by linear concepts,
• For this reason, the epidemic cannot be eradicated, but instead spreads homogeneously in the population in the absence of vaccination and therapy (sporadic spread), with focal outbreaks also occurring,
• Frequency information based on random samples must be used with extreme caution and the primary task must be to obtain reliable, representative data through cohort studies and to use clinical data for assessment,
• Test procedures must be validated, especially with regard to infectivity,
• General prevention measures and tracking of infections play an important role, but ultimately the success of prevention can only be achieved through target group-oriented measures, which primarily aim to protect vulnerable groups of people (numerous concrete examples have been suggested, more will follow next). thesis paper),
• the preventive measures must not come at the expense of humanity and dignity of the person,
• the principles of risk communication must be observed,
• Restrictions on fundamental rights must be justified at all times in terms of their proportionality, and
• a mixture of health protection and interventions that can give the appearance of governmental action (e.g. location determination using the Corona app, intervention in the private area to control “visitation regulations”) is not permitted under any circumstances. <<
literature
https://www.johnsnowmemo.com/
to Lancet: https://bit.ly/3dLJHm7
(1) “A comprehensive, longitudinal analysis of humoral responses specific to four recombinant antigens of SARS-CoV-2 in severe and non-severe COVID-19 patients”. PLoS Pathog 2020; 16:e1008796. https://doi.org/10.1371/journal.ppat.1008796
(2) https://www.nature.com/articles/d41586-020-02796-2
(3) “A Parry J. COVID-19: Hong Kong scientists report first confirmed case of reinfection. BMJ 2020; 370: m3340 https://doi.org/10.1136/bmj.m3340
(4) https://gbdeclaration.org/die-great-barrington-declaration/
Thesenpapier 1: https://www.monitor-versorgungsforschung.de/Abstracts/Abstract2020/MVF-03-20/Schrappe_etal_Thesenpapier%201-0_Corona-Pandemie
Thesenpapier 2: https://www.monitor-versorgungsforschung.de/Abstracts/Abstract2020/MVF-03-20/Schrappe_etal_Thesenpapier%202-0_Corona-Pandemie
Thesenpapier 3: https://www.monitor-versorgungsforschung.de/Abstracts/Abstract2020/mvf0420/Schrappe_etal_Thesenpapier%203-0_Corona-Pandemie
Theses paper 4.0: https://www.monitor-bedarfsforschung.de/Abstracts/Abstract2020/MVF-05-20/Schrappe_etal_Thesenpapier_4-0_Corona-Pandemic
Thesis paper 4.1: https://www.monitor-bedarfsforschung.de/Abstracts/Abstract2020/MVF-05-20/Schrappe_etal_Thesenpapier_4-1_Corona-Pandemic
Adhoc statement (5): https://www.monitor-sorgesforschung.de/Abstracts/Abstract2020/MVF-05-20/pdf_0520/Adhoc-Stellungnahme-Covid-19