Open or close? Open the schools and close the pubs? Open bowling alleys but not skating rinks? Allow open restaurants but not wedding receptions? Britain is playing musical chairs with different services and businesses, but the whole game is misguided and without any scientific epidemiological basis. To open society gradually is certainly wise, but how do we pick one over another?
Covid-19 is a terrible disease, and the primary goal should be to minimise deaths. How is this done? The key is age. The risk of Covid-19 mortality varies more than a thousandfold between the oldest and youngest members of society.
The pandemic will not be over until we reach herd immunity, either through a vaccine or through natural infections. Herd immunity is not a strategy but a proven scientific phenomenon, and to deny that is as silly as denying gravity. With the right strategy, we can even use it to save lives.
Under the vaccine scenario, the right strategy is to protect the elderly and other high-risk groups until they are protected by herd immunity, while the younger generations keep society afloat. Under the second scenario of natural immunity, the right strategy is to protect the elderly and other high-risk groups until they are protected by herd immunity, while the younger generations keep society afloat. If these two strategies sound about the same, they are.
How does herd immunity work? As more people obtain immunity, it gets harder for the virus to find new people to infect, and the epidemic will eventually die out before everyone is infected. It is not known how big the group of infected people must be for herd immunity to kick in, but it is some percentage of the population. If there are many older people in this group, mortality will be high.
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