Hiltzik: The COVID strategy that proved lethal in practice

They’ve held credentials from some of the world’s most elite universities — Harvard, Stanford, Johns Hopkins, Oxford. They’ve been welcomed into the highest government policy councils. They became fixtures on television news shows and were quoted incessantly by some of the nation’s leading newspapers.

They’re a cadre of academics and scientists who pushed a discredited solution to the COVID pandemic, shunning masks, school closings, even vaccines, all in the name of reaching the elusive goal of “herd immunity,” resulting in what may have been hundreds of thousands of unnecessary American deaths.

That’s the contention of “We Want Them Infected,” a painstakingly documented new book by Jonathan Howard, a neurologist at New York University and a veteran debunker of the pseudoscience contaminating our efforts to fight the pandemic.

In 2019 you would have been considered a quack if you suggested that the best way to get rid of a virus is to spread the virus. But that became mainstream and influenced politicians at the highest levels.

— Jonathan Howard, M.D.

Howard takes his title from Paul Alexander, an epidemiologist in the Health and Human Services Department during the Trump administration.

In July 2020, Alexander offered his view of how to exploit the relative risks of COVID to discrete populations to reach herd immunity. The idea was that so many people would eventually become naturally infected with the virus, and therefore immune, from further infection that the virus would be unable to spread further.

“Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk,” he told top HHS officials. “So we use them to develop herd … we want them infected.”

Alexander’s proposal was essentially a screed against lockdowns. That suited the Trump White House, which was searching for ways around the economic dislocations caused by the virus. But he was wrong about the toll of sickness and death that would result, allowing the virus to rage among these ostensibly low-risk groups, and wrong about the prospects of reaching herd immunity naturally.

“We Want Them Infected” may be the most appalling and infuriating book you’ll read about America’s response to the pandemic. It’s also essential reading.

The book is populated by quacks, mountebanks and charlatans — and not a few scholars with distinguished academic records — many of whom appear to have been seduced by the embrace of the right-wing echo chamber into promoting unproven and disproved policies.

“It’s unbelievable that while doctors like myself were working to treat sick COVID patients, begging people to stay at home and be safe,” Howard told me, “there was another group of doctors working at cross-currents to us — prominent doctors wanting to purposely infect unvaccinated young people with the promise that herd immunity would arrive in a couple of months.”

They consistently minimized the gravity of the pandemic, but rarely if ever acknowledged that their optimistic forecasts of illness and deaths were consistently proven wrong.

There are a number of problems with the herd immunity theory. One is that immunity from COVID infection tends to wane over time rather than become permanent. Also, infection with one variant of the virus doesn’t necessarily confer immunity from other variants, of which there have been many.

Another problem is that COVID can be a devastating disease for victims of any age. Allowing anyone to become infected can expose them to serious health problems.

Moreover, the prospect that COVID could be defeated by the natural expansion of herd immunity persuaded many people not to bother with proven countermeasures, including social distancing, masking, or vaccination.

Today, more than three years after COVID first appeared, the U.S. still has not achieved herd immunity although it is nearing the goal, in the view of Robert Wachter, chair of the department of medicine at UC San Francisco. The disease’s trajectory has been cataclysmic—the U.S. death toll stands at 1.13 million, hundreds of children have died, and an estimated 245,000 children have lost one or both parents to COVID. The U.S. leads the world in COVID deaths; its death rate of 3,478 per million population is worse than that of Britain, Spain, France, the Nordic countries, Canada and Israel.

Some herd immunity advocates offered their blithe forecasts in a misguided, if not dishonest, attempt to provide comfort to the American public. Scott Atlas, a senior fellow at the Hoover Institution of Stanford University, urged HHS officials in March 2020 to advocate against lockdowns on grounds they were “inciting irrational fear” of the virus, which he estimated would cause about 10,000 deaths. “The panic needs to be stopped,” Atlas wrote.

Atlas soon became a top advisor to Trump, promoting the herd immunity theory in the White House despite the objections of more experienced advisors such as Dr. Deborah Birx.

Howard is especially disturbed at how politicizing the pandemic has allowed fringe ideas to infiltrate public health policies.

“In 2019 you would have been considered a quack if you suggested that the best way to get rid of a virus is to spread the virus,” he says. “But that became mainstream and influenced politicians at the highest levels.”

In his book, Howard reserves his deepest scorn for the promoters of the “Great Barrington Declaration,” a manifesto for herd immunity published in October 2020 and signed initially by epidemiologists Jay Bhattacharya of Stanford; Martin Kulldorff, then of Harvard; and Sunetra Gupta of Oxford. (Thousands of other academics and scientists would later add their signatures).

The core of the declaration was opposition to lockdowns. Its solution was what its drafters called “focused protection,” which meant allowing “those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk” — chiefly seniors.

Older people living at home, the declaration said, should be kept apart from other family members except by meeting them outside, and “should have groceries and other essentials delivered to their home.”

Focused protection, the promoters wrote, would allow society to achieve herd immunity and return to normalcy in three to six months.

As Howard documents, the declaration was little more than a libertarian fantasy. That may not have been surprising, because one of its organizers was an arch-libertarian named Jeffrey Tucker.

For a taste of Tucker’s worldview, consider a 2016 article entitled “Let the kids work.” There he ridiculed the Washington Post for publishing a photo gallery of child laborers from 100 years ago, including miners and sweatshop workers as young as 10.

Tucker’s response was that those children were “working in the adult world, surrounded by cool bustling things and new technology. They are on the streets, in the factories, in the mines, with adults and with peers, learning and doing. They are being valued for what they do, which is to say being valued as people…. Whatever else you want to say about this, it’s an exciting life.”

A better life, at least, than “pushed by compulsion into government holding tanks for a full decade” — that is, going to school.

The declaration’s promoters, Howard writes, never specified how to achieve their goals. Delivering food and supplies to millions of housebound seniors? In a Hoover Institution interview, Bhattacharya said, “We could have offered free DoorDash to older people.”

As Howard observes, Bhattacharya was remarkably sanguine about “creating a program overnight to deliver fresh food to tens of millions of seniors for months on end throughout the entire country.”

Similar hand-waving addressed the problems of multigenerational households, in which millions of vulnerable elders live. Older family members, the declaration authors wrote, “might temporarily be able to live with an older friend or sibling, with whom they can self-isolate together during the height of community transmission. As a last resort, empty hotel rooms could be used for temporary housing.”

Of course, hermetically sealing off tens of millions of “nonvulnerable” people from tens of millions of vulnerable people in a few weeks would be “the single greatest logistical challenge humanity had ever undertaken,” Howard observes. “Nowhere in the world used focused protection to achieve herd immunity in three to six months, as the Great Barrington Declaration promised.”

What the declaration really promoted was complacency. Its drafters, Howard says, were “people with no real-world responsibility for much of anything who made impossible things sound very easy. The task of actually getting food into the houses of elderly people was left up to public health authorities who were understaffed, overwhelmed and underfunded.”

What may be the most inexcusable element of the herd immunity movement was its implication that children could be used as shields for the rest of the population. Its advocates counseled against vaccinating young children on the grounds that their susceptibility to the virus was minimal or even nonexistent, so they could safely acquire immunity naturally — and perhaps, as Vinay Prasad of UC San Francisco implied, provide an immunity boost to adults in their families.

Yet although children tended to suffer less from symptoms when they were infected, they were anything but immune. According to the Centers for Disease Control and Prevention, more than 1,600 American children under the age of 18 have died from COVID during the pandemic.

In any case, death is not the only serious outcome from COVID. The CDC says more than 14,000 children were hospitalized for COVID during the pandemic. An untold number of children may suffer from long COVID or other lifelong manifestations of the disease. For doctors to counsel deliberately exposing children to COVID when a vaccine is available, especially if the purpose is to protect adults, is “a moral abomination,” Howard says. He’s right.

In a world guided by science, the promoters of an unsuccessful herd immunity theory would long ago have lost their credibility and their public soapboxes.

The opposite has happened. Bhattacharya and Kulldorff still have their platforms (Kulldorff is now associated with the right-wing Hillsdale College). Both were appointed in December by Florida’s anti-vaccine governor, Ron DeSantis, to a “Public Health Integrity Committee” charged with questioning federal public health policies.

Scott Atlas, meanwhile, was tapped to deliver the commencement address at New College of Florida, a once-renowned liberal arts institution that DeSantis has turned into a haven for right-wing pedagogy. He was greeted with boos from the audience of graduating seniors, however, indicating that the youth of America perhaps can’t be gulled as easily as their parents.

At this moment, anti-science ideology on the right appears to be in the ascendance. Agitation against the COVID vaccine is metastasizing into an opposition movement against all childhood vaccinations, a trend that threatens to produce a surge in other vaccine-preventable diseases such as measles and polio.

“The anti-vaccine movement has spotted an opportunity to sow doubt,” Howard told me. “Getting rid of all school vaccine mandates has always been the Holy Grail for them.”

Howard’s book is a warning. We may be on the verge of a public health disaster, because the promoters of a failed theory that COVID could be fought through “natural immunity” without vaccines have been able to wrap themselves in the mantle of truth-tellers. But they’re not.

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