I guess I have a hard time understanding this strategy outside of an expectation of a viable, long-term vaccine. Aren’t you simply just trying to wait it out? It’s not like the virus is going to give up after a few years.

A slowly building immunity among the lowest risk group seems like a better long term strategy, and put the old and at risk people into something like New Zealand.

Do we have any evidence indicating the likelihood of that working?

Well, perhaps this could be the first communicable disease of its kind that doesn't produce immunity in the survivors... Perhaps we should craft our response based on that assumption?

Oh, wait. We are...

How long does immunity last? How robust is it? How will we know what the cost would be, so we can make an informed decision on the tradeoffs? Do we have a robust model of the broad immunity response that can help make sound policy decisions?

(These are all honest questions, I’m not leading. I don’t know where to find this information summarized.)

Last I heard, antibodies have been lasting around 3 months, but T-Cell immunity is indefinite (so far none have stopped reacting to the virus).

Your 'of its kind' phrasing does all the work, and it's not justified. Plenty of viruses don't create useful immunity, from flu to AIDS to the other seasonal coronaviruses, where immunity length is in the order of a few months...

Don't we have evidence of reinfection?

We have anecdotes of reinfection. But on the whole, it is very, very uncommon. This suggests that there is some degree of lasting protection in most people.

There are a couple of such claims.

Planet-wide.

Can you name another communicable disease where "herd immunity through natural propagation" is the recommended treatment?

Even relatively less dangerous viruses, like influenza, have strong vaccination programs, and relatively more dangerous viruses (measles, mumps, smallpox, etc.) are only words I know because of the vaccines I got as a child. I can't think of a disease with a nontrivial mortality rate that we don't aggressively vaccinate and have public health measures to prevent. Can you?

> Can you name another communicable disease where "herd immunity through natural propagation" is the recommended treatment?

This was the standard of care for chickenpox (herpes zoster, aka shingles) until 10 or 20 years ago, for example. Sure, the mortality rate is lower, especially among healthy children.

> until 10 or 20 years ago

You're off by a decade and possibly two. I'm older than 20, I was vaccinated for Chickenpox. The vaccine has been commercially available for 35 years.

So I'd reiterate the question.

I'm less than a decade older than you (younger than 35!) and was intentionally exposed to chickenpox as a child at the advice of my pediatrician in the Seattle area. And I've had shingles in my 20s as well, so I'm certainly pro-vaccine.

There may have been a vaccine 35 years ago (I'll take your word for it), but it was not the standard of care even ~25 years ago.

(And to be clear, I'm not advocating for exposing people to COVID, at all. You asked a very broad question upthread with an easy counter-example — chickenpox — and I provided the counterexample.)

That’s complicated though. Getting it as an adult is REALLY nasty, hence the previous history to try and get it done as a kid. Now we immunise instead...

The govt offers chickenpox vaccines here in NZ for kids now. I think it has been a fairly recent addition to the vaccination schedule but it was definitely there 3 years ago when sprog number one arrived.

Sure, it’s been standard of care in the US for a while as well. I’m glad! That change happened sometime after my childhood.

~20 years ago, naturally getting it was the go-to in our area. The idea was "let's just get it over with", because the vaccine isn't 100% effective.

Well, back in the day if one kid got chicken pox other parents would bring their own children around so they could get the infection done and dusted. The younger the child the better.

It’s the default treatment.

Destroying civilization in the off chance that it might help is the approach that’s worrisome.

Can I get clarification on your second sentence? Are you saying that approaches like New Zealand's are destroying civilization?

A few weeks of lockdown destroyed civilisation? With the exception of international travel, life is more or less as per normal in NZ right now. What are you even talking about.

Months of lockdown have destroyed somewhere between a quarter and half of all small businesses in Canada.

The resultant unwinding of commercial real-estate debt hasn’t even begun. The deflationary spike and follow-on “riding the dragon” of inflationary response by central banks hasn’t even begun.

When we finish consuming our personal reserves, and begin in earnest to try to supply food and lodging to the, what, 50% of the population not “employed” by government, what do you guess is going to happen.

It will be illuminating, at least, to those who think they understand how civilization works...

How would antibody therapeutics be a thing if it didn’t produce a certain immunity in the survivors?

The problem is, the vast majority of Americans are at high risk because of being overweight or obese. We can't send them all away.

Source: https://www.nytimes.com/2020/10/10/health/coronavirus-obesit...

We're close behind the US in that regard: https://en.wikipedia.org/wiki/Obesity_in_New_Zealand

Not sure why you are getting downvoted so hard (perhaps due to your 2nd paragraph).

I very much want to read discussion on your first paragraph.

Why would the strategy be difficult to understand when the results so obviously speak for themselves?

Sure, NZ's approach cannot be replicated everywhere else, but the fact is they have this under control and their people can (now) go about their lives.

I think the approach and results have been great. But I'm not clear on what the long term plan will be. Will NZ keep its policies this way indefinitely? Same question for China and other areas that have it under control.

Assuming a vaccine doesn't come, why shouldn't NZ keep their policy up indefinitely? Testing and quarantining visitors doesn't seem that onerous to me. Certainly beats just letting it run wild in the population.

You wait till there's a good vaccine, then get everyone vaccinated and reopen.

At what point do you throw in the towel if a viable vaccine doesn’t come along?

New Zealander here: Why would we need to give up? We can come and go from New Zealand (with an isolation period) and life is normal once you are inside. Non-residents can’t come without some big hurdles though.

"229,566 people were directly employed in tourism (8.4 percent of the total number of people employed in New Zealand)"

That's a lot of people who need rejobbed

You suggest this mode for forever?

If that’s needed. Keep in mind that until relatively recently it took a lot longer to get to New Zealand as it was common to come here by ship. My parents and grandparents got here that way and it worked ok.

What is the “mode” you are talking about?

Seems like life is back to normal and the lockdown is over in NZ

Exactly the mode described in the post I was answering to. I could cite the whole comment, but I don't see a point.

This seems like a long bet. What if we never find a proper vaccine?

Exactly! What happens then?

We carry on as normal, like we are. We have to quarantine for 2 weeks when coming into the country, that is the price. Are you under the impression that something more onerous is happening?

I guess the question is... for how long?

For two weeks!

This is normal for your country which is self-sustainable, other countries cannot follow the same strategy for multiple reasons. I wish we were NZ, but we aren't. We rely on tourism, our whole economy has been build around that, closed borders and 14 days isolation will bury everything. Anyone can suggest a lockdown, but some countries cannot work that way and have to find a compromise, not bet on a vaccine somewhere in the near future (when?).

Maybe you could cater to NZ tourists or if covid safety can’t be guaranteed then go for herd immunity

Either way as a country that depends on tourism you can’t be infecting tourists

The biggest industry in New Zealand was tourism. We rely heavily on open borders until this year.

It seems very unlikely that there can be vaccine that is effective long term. Just as there is no long term Flu vaccine.

We have many vaccines that aren't long-term effective, and we have strategies for those.

It's a great strategy! The internal economy is open because people aren't afraid to be out and about, shopping and going to sporting events, etc. Even in US states with absolutely no restrictions on indoor dining etc. there was a huge drop in activity from, well, people having normal self-preservation instincts.

A strong vaccine candidate within the next 6 months is a strong likelihood, along with antibody-based therapeutics. So the plan is to hold out, keep the internal domestic economy moving forward - the tourism hit was going to happen anyway, so might as well have everything else as operational as possible.

Herd immunity is not a strategy, it's just what used to happen before we understood that we could actually reduce the impact of disease on our lives.

I agree with the first part of your statement, but we really don’t know what vaccination will look like or when it will be here.

NZ may be isolated for a long time. But given the alternatives, that’s the approach I’d take too.

> A strong vaccine candidate within the next 6 months is a strong likelihood

There's zero evidence to support this assertion. First there's zero evidence that it's "strong", whatever that means. Second there's zero evidence that we'll have it in the next 6 months. Remember, it also has to be safe, not just "strong". Ensuring that takes a lot of time.

The Netherlands (where I'm from) aimed for herd immunity in the beginning of the pandemic. So no strict measures just enough to make sure our health care isn't overrun. This was perfectly fine in the first few months, now they are still doing the same measurements (no real lockdown or any strict measures) while our health care is being overrun because of a 2nd wave. This time herd immunity is nowhere to be found.

I can only imagine that NZ is indeed sitting this out till a vaccine is available, because if countries that had herd immunity as a goal in the first place to not have that goal anymore, it probably means it isn't feasible.

That being said, I don't see how _any_ country is able to do anything other than sit this out. Everyone in the US, NL, even DE (which is doing okay in Europe) or NZ and TH (with no local infections) cannot do anything else than to wait for a vaccine to be available or before we just accept this as a reasonable risk.

Personally I think accepting the risk is the most likely situation. I do not have much confidence in a good vaccine being available in 2021, personally I'll get back on the plane in 2021 and just accept the risk. I als know that this is something a lot of people will not accept, but we cannot lock up the world economy for a few years for a virus where the fatality rate for healthy people is so low.

> personally I'll get back on the plane in 2021 and just make everyone else accept the risk.

FTFY

Yeah typically when you fly on a plane the rest of the passengers were forced onto the plane by proud boys.

You have to get off the plane at some point, and then you're around people who did not get on the plane

Why do you say that now in 2nd wave health care is being overrun? Amount of cases is much higher, but amount of deaths and hospitalizations is much lower.

Number of deaths and hospitalizations is much lower because they arranged for the elderly and weak to die first, same way Cuomo send confirmed Covid cases back to nursing homes https://eu.democratandchronicle.com/story/news/politics/alba...

> That being said, I don't see how _any_ country is able to do anything other than sit this out. Everyone in the US, NL, even DE (which is doing okay in Europe) or NZ and TH (with no local infections) cannot do anything else than to wait for a vaccine to be available or before we just accept this as a reasonable risk.

Tactical lockdowns with a strategic approach of maintaining rapidly escalating procedures on a hair trigger is the approach NZ's been taking, and thus far, it's afforded them a much better quality of life compared to the rest of the world.

It's whack-a-mole, but shit, it's cheaper and more effective than whatever it is we're doing in the US.

I spent several months in the Netherlands during the pandemic. It was great. Walking around without a mask is underrated now I suppose.

Why do it slowly? If you're planning to infect everyone anyway might as well get it over with quick.

Unless of course you're worried about the side effect of making a large number of people seriously ill, but if you don't see a way of doing it without causing a ridiculous number of people to fall ill then perhaps it isn't the best choice?

Wasn’t this what all of the “flatten the curve” messaging was about in March? Yes. The reason to slow things down is to avoid overwhelming the health care system.

Okay I may have phrased it a bit too bluntly.

But if you're talking about infecting a large part of the population deliberately then it seems to me you should try to do it as quickly as possible because isolating the vulnerable part of society from the rest is not a sustainable situation.

And well, if we're talking about infecting a large part of society anyway then health and human lives are apparently already expendable to some extent.

I guess if herd immunity is your best option you want to do it as quickly as you can without overwhelming things.

Which is why the “Lock down hard to flatten the curve” thing never really made sense to me. If you prevent all transmission you’ll just drag out the pain. I thought cases are just going to shoot back up when you open so what’s the point?

(Turns out I was wrong though. Delaying cases was very valuable. People getting sick now are much more likely to survive.)

One reason to drag it out is so that you don't overwhelm the healthcare system.