Have you Heard about the Herd

What concerns me a little is that even now the populations of most countries do not appreciate that the strategy of governments around the world has got to be one of allowing the majority of their populations to catch the virus but to try to manage how many people catch it at given times.

As has been shown time and again, the graph that demonstrates how the infection will spread in the community of left unchecked is rapid but relatively short lived. Unfortunately allowing such a devastating spike in cases would result in considerably higher rates of death simply because there would be no system in place to deal with the majority of cases requiring high dependency care. Effectively, those people would be left in their homes to die and then collected for mass burial until such time as the crematoria could cope with the deceased.

So the governments are each trying to manage the spread in their own ways but the aim will be to achieve the so called 'herd immunity'. Once there is herd immunity it means there will still be people who have never had the virus but there are insufficient people in the vicinity to pass the virus on to them such that they will stay safe until they come into contact with somebody who has caught the virus and is infectious at the point in time they meet. That simply means the odds of catching the virus reduces considerably as the number of conditions for catching it reduce further and further.

Plus, after herd immunity is reached, the individuals catching the virus and having severe reactions will be able to be treated in the critical care wards which will have freed up once the peak has passed.

It will be an interesting experiment to watch, well it would be if one was not part of the grand experiment. In some regards I would quite like to catch a mild dose of the virus as early as possible. Firstly, there is evidence the amount of virus infecting an individual has an impact upon the outcome. It makes sense logically.

If a small amount of virus infects the body then the immune system first says 'what's this, I've not seen this before!' creates a defence then attacks and repels. But if amount of virus is greater, the immune system has trouble creating the defence before the viral attack overwhelms it. In addition the fight back of the defensive systems have a negative impact on the body over and above what the virus is doing itself. That is in itself evidenced by the observed two stage illness.

First the viral attack and defence but then the immune system over reaction causing severe lung damage amongst other things. That is why an anti-viral would only work in the early stage of an attack and not once the immune system is causing more damage than the virus itself.

But as far as the grand experiment, well, I guess we will have to see what those countries currently in lock down do first. Because once the lock-down is released then, if the virus still exists in society, there will be pockets appearing again. So there needs to be a plan to rapidly identify and deal with each of these pockets as and when they appear so as not to start a nationwide issue all over again. It's a little like dealing with a bush fire and these pockets are like embers of hot ash landing away from the main fire and starting small fires again.

Such strategies will require the long term on-going support of the population. Once again, that will probably be until there is herd immunity if only because the nature of the virus is so stealthy. Once a case is identified in the community it will likely have already spread to quite a large number of people and they will need to be isolated as is already happening.

That being the case, why would I state so boldly that countries are planning to allow a managed approach to achieving herd immunity. Surely by locking down the population for a period of 14-21 days will allow the virus to die out. Well, I guess it could if the population were fully insulated from the world. So that only works if all the borders are fully shut. That said, it might still be possible to control the virus this way and maybe all those entering the country post lock-down will be required to have a test to prove they either have the virus anti-bodies or they do not have the virus at all. That kind of approach might work and maybe that could be achieved across Europe to allow the internal borders to re-open.

Apart from that, well, it has been stated as government policy in the UK and a few other countries. As I said, it is going to be interesting to watch. One way or another, there are probably three outcomes. First, the uncontrolled epidemic which burns fast and has a high mortality rate, maybe 3-4% but after which it is pretty much over and done with in the space of 3-6 months. Second, the controlled burn towards herd immunity which achieves the same thing as the first but allows more time to treat the very sick and last 12-18 months but with a reduced, c.1%, mortality rate. Third, the extinguish approach being sought in most European and Asian countries where the population is locked down for a month and then each and every small break out is flooded with resources to catch and control.

Much as I like the third option, it will last until such time as a vaccine is available to inoculate the population giving the same herd-immunity as the natural progression. That means that those societies opting for that approach will likely need to accept there will be a slight restriction on free movement with occasional lock-downs in specific areas and a restriction to entry into the country without delays and checks at the borders. That would reduce mortality to <1% but last 12-24 months or until such time as a vaccine exists.

Once all countries in the EU have achieved the same approach then the bloc could open up again internally.

One little caveat, just like an influenza virus, this corona virus is and will continue to mutate so a yearly vaccine will be required just as there is a yearly influenza vaccine produced. Buy shares in the big pharma companies as they will be the ones producing these vaccines moving forward. Until a system is in place to release a proven vaccine and have the infrastructure to identify and combat the on-going mutations, then things will continue to remain a little less 'normal'. But in two years time, there might be normality resumed.