Don’t Blame Great Barrington

By SAM URETSKY

In 2012, when Smithsonian magazine made a list of the 20 best small towns in America, first place went to Great Barrington, Mass. a town of about 7,000 residents that looks and feels like a cross between a Norman Rockwell exhibit and a Hummel Christmas display, all fed with local organic produce. Sadly, this wonderful town has been embarrassed by the Great Barrington Declaration, a document which begins: “As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.”

Their answer to the challenge of COVID-19 is to let the population develop herd immunity – let the people at low risk, the young and healthy, get infected and develop immunity, while protecting the elderly and those with medical conditions which might predispose to serious infections or death.

“Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick, should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sports and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.”

The signatories are Dr. Martin Kulldorff, professor of medicine at Harvard University, Dr. Sunetra Gupta, professor at Oxford University, and Dr. Jay Bhattacharya, professor at Stanford University Medical School. The concept has been endorsed by Dr. Scott Atlas, a neuroradiologist, professor, commentator and health care policy advisor to President Trump.

There have been a number of responses to the herd immunity concept, but perhaps the best appeared in the British Medical Journal Oct. 19 under the heading “The more certain someone is about COVID-19, the less you should trust them.” After discussing the complete whack jobs the authors write “… we are thinking of the many rational people with scientific credentials making assertive public pronouncements on COVID-19 who seem to suggest there can be no legitimate grounds for disagreeing with them. If you do, they might imply, it’s probably because you’re funded by dark forces or vested interests, you’re not evidence based, you’re morally blind to the harm you would do, you’re ideologically driven ... your ideas are a dangerous fantasy …”

Herd immunity exists, sort of, particularly if you have a safe and effective vaccine – but the closest thing to herd immunity on record would be the Black Plague which arrived in Europe in 1347. Five years later, some 25 to 50 million people were dead, but the survivors probably had some level of resistance. For the most highly contagious diseases, like measles, about 94% of the population needs to be immunized to attain Focused Protection. For COVID-19, estimates run between 50% and 70%. But, in one well designed study, “Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study” (Lancet 10/24/20), even in New York, fewer than 25% of the population had antibodies to COVID-19.

The Economist (10/31) noted that in a section of Italy that had been particularly hard hit during the first wave, the survivors have shown a reduction of almost 66% compared to nearby regions that were not as badly effected – but the reviewers concluded, “These data do not prove the case for seeking herd immunity. Without a vaccine, the cost of gaining even mild resistance is grim.”

The death rate during the first wave was simply too high to justify this approach.

The best review of the literature so far was conducted by the Cochrane Library and reached what appears to be a realistic conclusion: “The current evidence is limited because most studies on COVID-19 are mathematical modeling studies that make different assumptions on important model parameters. Findings consistently indicate that quarantine is important in reducing incidence and mortality during the COVID-19 pandemic, although there is uncertainty over the magnitude of the effect. Early implementation of quarantine and combining quarantine with other public health measures is important to ensure effectiveness.”

Also, on Oct. 30, the New York Times published a presentation “Masks Work. Really. We’ll Show You How.” It concludes that masks, even imperfect ones, reduce the risk of disease spread for both the wearer and those in contact with the wearer.

Great Barrington is a wonderful town, with charm, diverse activities, culture, and excellent food. But not everything that comes from Great Barrington should be taken too seriously. Just follow the hiking trails and the science.

Sam Uretsky is a writer and pharmacist living in Louisville, Ky. Email sdu01@outlook.com.

From The Progressive Populist, December 1, 2020

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