The idea promoted by some of lifting the quarantine measures and allowing COVID-19 to spread all but unchecked — thereby in theory causing a rapid spread and a rapid development of population immunity — in hopes of leading to herd immunity has been condemned by notable health experts.
Prominent public health expert and advisor to the Odisha state government on health, Professor K. Srinath Reddy has made comments to The Hindu warning of the potential death toll resulting from herd immunity strategies. “The herd immunity idea might prove to be dangerous as it carries the risk of high fatality. It is better to focus on herd protection by emphasising more on disease containment and protection of vulnerable groups,” said Professor Reddy during a video conference with Odisha’s Chief Minister Naveen Patnaik, other Ministers and top bureaucrats on May 7th.
The numbers behind the potential death toll of herd immunity were previously calculated by Health Issues India
“Reducing the concept down to numbers, the predicted mortality rate of coronavirus was originally two percent — a number then revised to 3.4 percent in early March by the World Health Organization (WHO). Figures for the development of herd immunity vary, though typically range from sixty to seventy percent. The Hindustan Times gives the figure as 65 percent.
Therefore, of India’s population of 1.377 billion, a total of 895,050,000 would need to be infected. The mortality rate of 3.4 applied to the infected population would therefore translate to 30,431,700 deaths from the virus (not inclusive of any further deaths after herd immunity is achieved, or a higher death rate in India due to health systems likely being overwhelmed).
India’s current death rate is around 7.5 per 1,000 population — or roughly 10,327,500 per year. The total toll of coronavirus before herd immunity is even achieved is therefore the cumulative deaths of every single potential cause of mortality — heart disease, cancer, infectious diseases, pollution — for three years in a row. All of this for the achievement of a concept which could leave 35 percent of the population still prone to infection.”
The potential for a death toll in excess of thirty million — the equivalent of three years of cumulative deaths from every other cause of death within India — means easing restrictions is not a decision to be taken lightly. Should quarantine measures be lifted too early and cases of the coronavirus skyrocket, this decision cannot be revoked. Any secondary quarantine after this point will be rendered far less effective and deaths will number far in excess of what was originally expected under the quarantine.
“Social distancing must continue to be the focus of all our efforts as there is currently no effective medicine or vaccine available for the disease. Community support and partnership can be immensely helpful,” said Professor Reddy. “…The young are more susceptible to the infection due to larger social contact. But their morbidity is lower. Elderly persons, especially persons with co-morbidities, are at a higher risk. The infection can be quite serious for them and can lead to death.”
Some have argued that India is in a unique position to implement herd immunity due to its far younger demographic. 65 percent of the Indian population is under the age of 35 and only six percent is above the age of 65. In comparison, 22 percent of Italy’s population and ten percent of China’s population is in the older, higher-risk age group. This would mean that the potential mortality rate in India could be lower, as fewer old people would succumb to the coronavirus.
However, even with a younger demographic among the country, the death toll would still likely surge into the millions if the entire country contracted the disease. If coronavirus is allowed to spread unchecked then the already strained Indian health system is likely to be overwhelmed. This would result in far more individuals dying due to lack of access to ventilation and intensive care units. Potentially, this could even see the mortality rate among the young become higher than in other nations.
Professor Reddy notes that the countries that had the most successful outcomes in containing the disease typically began isolation and quarantine measures early. “While countries like Britain, the United States and Sweden suffered heavily due to a delay in imposing lockdowns,” he said, “small nations like Vietnam controlled the disease with social distancing, large-scale testing and contact tracing.”
Currently the global case count is approaching four million. The current number of coronavirus cases across the globe is 4,355,456, with 293,090 deaths resulting from the disease. 1,610,421 have recovered, leaving 2,451,945 active cases. India has seen cases increase rapidly over the last few weeks, with a current total of 56,516 cases and 1,895 resultant deaths. Both case count and the number of deaths could be expected to surge should herd immunity become the guiding strategy. Until treatments or a vaccine are developed, social distancing is among the only tools we have against the virus.