Debunking Herd Immunity: A Review of We Want Them Infected

The unprecedented advocacy for herd immunity as part of the COVID-19 policy has been both controversial and dangerous. This review delves into the flawed assumptions and real-world consequences of the Great Barrington Declaration, which advocated for achieving herd immunity through natural infection. By exploring the misinformation surrounding this approach, we uncover its risks to public health and the far-reaching impact of such misguided strategies.

About the Author: Jonathan Howard, MD

Dr. Howard is an Associate Professor of Neurology and Psychiatry at NYU Grossman School of Medicine and Director of the Neurology Service at Belleview Hospital in New York City. In addition to the book, We Want Them Infected, he is the author of several clinical textbooks in neurology. He hosts the podcast, “We Want Them Infected,” which covers a range of disinformation in the health field. He worked throughout the COVID-19 pandemic at Bellevue Hospital, where he observed firsthand the devastating effects of the pandemic.

An Overview of We Want Them Infected

We Want Them Infected discusses the flaws and damaging effects of the policy promoted by the authors of the Great Barrington Declaration and others of allowing SARS-CoV-2 to spread through the so-called “healthy” population. This would bring about “herd immunity” and thereby bring the pandemic to a relatively rapid end with minimal social and economic disruption.

The Great Barrington Declaration: Background

Great Barrington, Massachusetts, is the home of the American Institute for Economic Research (AIER), a libertarian think tank. AIER sponsored a gathering of public health academics at the Institute that met in October 2020.

The result of that conference was the issuance of the Great Barrington Declaration, a proposed plan for the management of the COVID-19 pandemic, advocating for discarding COVID-19 control measures such as lockdowns, school closings, masks and social distancing (so-called non-pharmaceutical interventions).

Instead, it advocated allowing the development of so-called herd immunity through natural infection with SARS-CoV-2. This document was signed by Sunetra Gupta (Oxford), Jay Bhattacharya (Stanford), and Martin Kuldorff (Harvard). The declaration is short and omits any detailed recommendations.

It does not include any scientific analysis or modeling and was not peer-reviewed.

The three signatories are foremost among the many advocates of this approach, which Dr. Jonathan Howard critiques in his book We Want Them Infected. Howard persuasively argues that it is unscientific, impracticable, and dangerous.

Herd Immunity: Theory vs. SARS-CoV-2

The theory behind herd immunity is that an infection by a novel virus will rapidly spread through a population, all of whom would be susceptible to infection. After a certain percentage of the population recovers and has acquired immunity to the virus, the spread of infection will halt due to the absence of sufficient susceptible individuals to continue the propagation of the infection. Because of the risk of unacceptable morbidity and mortality through this process, the Great Barrington Declaration made three assumptions that, if true, would avoid such outcomes for COVID-19:

1) Infection by SARS-CoV-2 of non-elderly people without underlying medical conditions has a negligible risk of death or serious disease;

2) infection by SARS-CoV-2 provides strong and long-lasting immunity from re-infection;

3) elderly and other vulnerable populations can be effectively isolated from the remainder of the population until herd immunity is achieved through natural infection.

Most public health experts and epidemiologists disagreed with the Great Barrington Declaration. Dr. Howard notes that there is no precedent in history for advocating for the uncontrolled spread of an infectious disease to control an epidemic.

None of the declaration’s three assumptions proved to be correct.

Although the healthy non-elderly did have a much lower risk for serious disease and death than others, it was not negligible, and it led to thousands of deaths in that population. Secondly, infection by SARS-CoV-2 did not produce sufficient immunity to prevent reinfection, especially with the viral variants that later appeared, such as Delta and Omicron. And finally, it proved impossible to effectively segregate the various populations of the vulnerable to prevent the spread of infection to them.

The Impact of Proselytizing for Herd Immunity

Although never fully implemented, the GBD influenced many jurisdictions (such as Florida) to dispense with many non-pharmaceutical interventions and to recommend against boosters or vaccinations in some age groups. In addition, the high level of exposure that the advocates of this policy enjoyed (particularly on Fox News) convinced many people not to vaccinate or employ protective measures. Fortunately, most of the country chose to adhere to recommendations for avoiding exposure and a large percentage of the American populace was vaccinated (the GBD authors wanted their plan implemented even before vaccines were available).

To date, approximately 1.2 million Americans have died from COVID-19, with millions more hospitalized and a large but growing number suffering from complications of COVID-19 infections, including Long COVID. These numbers would be much higher if the recommendations of the Great Barrington Declaration had been widely implemented.

Misleading Narratives and Public Figures

Dr. Howard is frustrated, as is the reader, by the casual disregard for the suffering caused by COVID-19 on the part of COVID-19 minimizers. Only one of the three declaration authors is a physician, and it is unclear whether he ever cared for patients after completing medical school. The same is true for many of the other physicians purveying COVID-19 vaccine misinformation. For example, Dr. Marty Makary, a well-respected professor of surgery at Johns Hopkins, has minimized the seriousness of COVID-19 infections, especially in children. As Dr. Howard observes:

“Dr. Marty Makary has a history of understating pediatric COVID hospitalizations when communicating with the public. In an article for the Wall Street Journal titled “Should You Vaccinate Your 5-Year-Old?” he reported that only 562 children ages 5-11 had been hospitalized with COVID-19. This number came from COVID-NET, a CDC surveillance system that covers approximately 10% of the U.S. population. In fact, the CDC reported that over 8,300 children ages 5-11 had been hospitalized with COVID-19, and this was just before the Omicron wave caused pediatric hospitalizations to spike to their highest levels.”

Another academic physician with commendable credentials, Dr. Vinay Prasad, minimizes childhood COVID risk as well. For example, he noted that fewer children die of COVID-19 than from drowning, bicycle accidents, or cardiovascular disease, which he says we accept as a matter of course. Dr. Howard:

“The CDC’s COVID data tracker added 1,000 deaths to its grim tally in the year before that article was published, which is about the same as the number of children who drown annually and larger than the number of children who die from cardiovascular disease.”

He goes on to point out that we do not regard the death of children from drowning or accidents as “a matter of course,” and nobody has suggested ending the American Academy of Pediatrics initiative to reduce the number of childhood drowning deaths because of their small numbers.

Dr. Howard singles out for particularly harsh criticism statements by many of these individuals that are completely divorced from the reality of clinical care or public health. For example, the signers of the GBD gave no serious thought to the logistical complexities of “protecting the vulnerable.” Suggestions for protecting this diverse group of nursing home residents, the elderly living at home, individuals with pre-existing conditions, and vulnerable people living in multigenerational homes included such thoughtless suggestions as minimizing nursing home staff turnover, putting the elderly up in hotel rooms and feeding the vulnerable sheltering at home through door dash deliveries.

Worse were their criticisms of the heroic people providing clinical care to patients, which were not only ignorant but insulting, such as suggesting that death certificates were filled out incorrectly, that critical care doctors were causing death by intubating people inappropriately, and suggesting that doctors were over-diagnosing COVID to benefit financially.

COVID-19 Misinformation and Vaccine Disinformation

Because there is an increasingly close association between the COVID-19 contrarians and the anti-vaccination movement, Dr. Howard devotes portions of his book covering vaccine disinformation in general. These groups share many of the same disinformation tactics, such as misrepresenting study results, trashing the methodology of studies supporting vaccine safety while lauding small, poorly done studies that support their own viewpoint, and outright lying. For more detailed information on the anti-vaccine movement, read Dr. Paul Offit’s “Deadly Choices. How the Anti-Vaccine Movement Threatens All of US” and Dr. Peter Hotez’s “The Deadly Rise of Anti-Science.”

Final Thoughts

I read this book and wrote the review in the aftermath of the 2024 presidential elections. It is disconcerting and even frightening to watch many of the individuals exposed in Dr. Howard’s book being nominated for important health posts in the incoming administration. I hope dedicated opponents of untruth like Dr. Howard are up for the challenge.

Sources

1. Source

   1. Howard, J. (2023). We want them infected: How the failed quest for herd immunity led doctors to embrace the anti-vaccine movement and blinded Americans to the threat of Covid. Redhawk Publications.