Herd Immunity Covid 19 High Death Toll 5084920

4/3/22, 10:09 PM https://www.verywellhealth.com/herd-immunity-covid-19-high-death-toll-5084920?
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NEWS
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Herd Immunity Through COVID-19

Infection Is Unethical, Experts Say
By
Jennifer Chesak
Updated on October 30, 2020

Fact checked
by
James Lacy
Key Takeaways
More than 60% of Americans would have to contract COVID-19 to reach a herd immunity
threshold.
Experts say that letting COVID spread unchecked through the population as a strategy is
neither ethical nor realistic.
Herd immunity through infection would lead to a high death toll and an overburdened
healthcare system.
The COVID-19 pandemic has brought infectious disease terminology into the mainstream. One
term is herd immunity—or community protection.
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Herd immunity is achieved when a population becomes largely immune to infectious disease
through vaccination or through infection.
As it pertains to the COVID-19 pandemic, experts say that achieving herd immunity by letting the
virus spread unchecked through the population is neither ethical nor realistic.
“I think it is absolutely indefensible to just allow the disease to spread without any sort of
intervention in order to reach herd immunity,” Johan Bester, PhD, director of bioethics and
assistant professor of family medicine at University of Nevada Las Vegas School of Medicine,
tells Verywell. “That is an unethical approach given that there are other ways that are more
effective and protect the well-being of people.”
Related:
What Is Herd Immunity?
Infection-Induced Herd Immunity

The United States has more than 330 million people. To achieve the herd immunity threshold of
60% necessary to curb outbreaks, that means that 198 million people would have to contract
SARS-CoV-2 (the infection that causes COVID-19), according to a Yale University study
published in JAMA.
“ I think it is absolutely indefensible to just allow the disease to spread without any sort of
intervention in order to reach herd immunity.”
— JOHAN BESTER,
According to the Johns Hopkins Coronavirus Resource Center, as of the end of October 2020,
approximately 9 million Americans have had confirmed cases of COVID-19—about 3% of the
U.S. population.
“Imagine that 60% of the American population has to get sick, or in any given state 60% of the
population has to get sick,” Bester says. “We're talking about astronomical figures of death and
disease and long-term complications and all those bad outcomes we don't want in order to
establish herd immunity.”
“As a physician, I could never endorse that,” Mark Schleiss, MD, an infectious disease expert,
molecular virologist, and a professor in the Department of Pediatrics at the University of
Minnesota, tells Verywell. “To me, that is completely unthinkable.”
An Unrealistic Concept
According to the Yale study, while herd immunity is considered a successful strategy for
immunization programs, we don’t have an example of a successful wide-scale strategy that has
purposely used infection to achieve community protection.
We currently don’t know how long people who are infected with SARS-CoV-2 have immunity
from the virus.
“There have been some studies that have come out that showed that people's measurable
antibodies drop month by month after they've recovered from COVID,” says Bester. “And there
have been some reports of potential reinfections. And we have the example of other coronavirus
diseases besides COVID that keep coming back and that people can get more than once.”
Related:
Will COVID-19 Be Around Forever?
The Death Toll

Although it does not provide exact numbers, the Yale study points to the substantial mortality
that would result from intentionally trying to achieve herd immunity through infection of a virus
that does not yet have a safe and effective vaccine.
COVID-19 Vaccines: Stay up to date on which vaccines are available, who can get them, and
how safe they are.
A death toll is hard to predict if the virus were to spread unchecked in the United States. “All I
can do is look at the history of infections that behave similarly with similar death rates," Schleiss
says. The 1918 influenza pandemic, for example, killed about 675,000 Americans, according to
estimates from the Centers for Disease Control and Prevention (CDC).
“It might be dangerous to compare it to the total number of deaths in the United States from
influenza in 1918,” Schleiss says. “We've mitigated this more, and yet we have so, so many
deaths already.” As of the end of October 2020, more than 229,000 Americans have died from
COVID-19.
That is the death toll when just 3% of the nation has had a confirmed infection—a long way from
the herd immunity threshold.
Herd Immunity Threshold
Herd immunity threshold is the percentage of immune individuals that would be required to hal
current outbreaks and interrupt community transmission.
The threshold varies by disease and is based on how many people get infected when one
person has the infection.
Estimates place the SARS-CoV-2 herd immunity threshold at about 60%, but it could be higher.
“We're not sure what that number is,” says Bester. “But at least 60% to 70% will need to be
immune to have any sort of herd immunity response. The point is you still need a whole lot of
people to get [the] disease to get herd immunity.”
The CDC says that older adults and people with certain medical conditions are at a higher risk
for severe illness from COVID-19. Severe illness also puts people at a higher risk of death. The
Kaiser Family Foundation estimates that 92.6 million people fall into this high-risk category.
“You can see that we are talking about an astronomical death toll,” Bester says. “And that
should be unacceptable by any measure.”
Related:
The Facts About COVID-19 and Pre-Existing Conditions
Post-Virus Complications
Loss of life is not the only consequence of a pandemic—and it’s not the only impact of COVID-
19. “Death is one problem,” Bester says. "But the other is that people who don't die might have
serious outcomes that they live with for the rest of their life.”
Letting the virus run unchecked could lead to more complications. Individuals who have
developed long-term complications or lasting symptoms from COVID-19 have been dubbed
“long-haulers.” “We don't know how big that group is going to be,” Schleiss says, “but I think the
long-term, sequela of that is going to be a big, big burden on society.”
Related:
COVID-19 'Long-Haulers' Search for Answers About Chronic Cases
Sequelae are conditions or injuries that develop after someone has had a disease. Researchers
are still learning about the complications that can arise from COVID-19, but some trends are
emerging. “Permanent damage to the brain, the heart, the kidneys—these are all really, really
worrisome issues,” Schleiss says.
Healthcare System Burden
Acute illness from COVID-19 as well as the long-term complications in those who have
recovered can overburden community healthcare systems quickly. “Our healthcare system is
built with a specific capacity in mind,” Bester says. “And it’s hard to just ramp up capacity.”
“ Somebody would have to decide who we let go in terms of palliative care, and that's probab
going to have to be the politicians because that’s just not compatible with what we do as
doctors.”
— MARK SCHLEISS
Other health issues and emergencies don’t fall to the wayside just because society is in the
midst of a pandemic. The other patients that we usually see—people in car accidents, people
with heart attacks, people with cancer, and so on—have to compete with COVID patients for the
same resources," Bester says.
Chasing the goal of achieving herd immunity through infection would also make healthcare
resources scarce, making it more likely that difficult decisions would have to be made regarding
treatment. “Somebody would have to decide who we let go in terms of palliative care,” Schleiss
says as an example. “And that's probably going to have to be the politicians because that’s just
not compatible with what we do as doctors.”
Other Country’s Strategies

In the early weeks of the COVID-19 pandemic, Sweden did not mandate lockdowns. The country
has since made headlines for being a nation attempting to achieve herd immunity through
infection.
The Yale study found that while the country has taken some measures to mitigate virus spread,
Sweden is far from achieving herd immunity through infection. In fact, it's experiencing fallout
from lax strategies.
“I think the Swedish COVID-19 response has quite frankly been unsuccessful,” Schleiss says.
“And it should not be held up as a model for the rest of the world. The per capita death rate in
Sweden from COVID-19 is in the top 10 of all global death rates.”
Bester and Schleiss suggest looking to New Zealand as a nation that is doing an exemplary job
of controlling COVID-19. “New Zealand very early on came together as a society with leadership
from the government saying, ‘We are in this together and we are going to stand together,’”
Bester says.
New Zealand has mostly stopped the spread of COVID-19, with the exception of a few small
outbreaks. The nation has worked to get outbreaks under control through rigorous testing and
localized quarantines when needed.
“I would love to see us be able to do something like that in the USA,” Bester says. “Where we
pull together and say, ‘We’re going to beat this thing for each other and do what needs to be
done.’”
What This Means For You
You may have heard about the concept of achieving herd immunity by means of widespread
COVID-19 infection. However, experts say that this strategy is unethical and unrealistic.
While we wait or vaccines to help mitigate virus spread, the best ways to protect yourself and
others from infection are wearing a face mask, practicing proper hand hygiene, and socially
distancing.
The information in this article is current as of the date listed, which means newer information
may be available when you read this. For the most recent updates on COVID-19, visit our
coronavirus news page.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts
within our articles. Read our editorial process to learn more about how we fact-check and keep our
content accurate, reliable, and trustworthy.
1. Omer SB, Yildirim I, Forman HP. Herd immunity and implications for SARS-CoV-2 control. JAMA.
2020;324(20):2095-2096. doi:10.1001/jama.2020.20892
2. Johns Hopkins University & Medicine. Coronavirus resource center.
3. Centers for Disease Control and Prevention (CDC). History of 1918 flu pandemic.
4. Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019 (COVID-19): People
at increased risk for severe illness.
5. Koma W, Neuman T, Claxton G. How many adults are at-risk of serious illness if infected with
coronavirus?.

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4/3/22, 10:09 PM https://www.verywellhealth.com/herd-immunity-covid-19-high-death-toll-5084920?

Herd Immunity Through COVID-19

Infection-Induced Herd Immunity

The Death Toll

Herd Immunity Threshold

people to get [the] disease to get herd immunity.”

Other Country’s Strategies

What This Means For You

2. Johns Hopkins University & Medicine. Coronavirus resource center.

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