Wednesday, September 02, 2020

One Advantage to High Infection Rates

The obvious disadvantage is the risk of overwhelming the hospitals, but it occurred to me that there may also be one advantage. 

The latest evidence suggests that immunity after infection probably lasts at least four months. We don't know how much longer it lasts. Suppose that over four months everyone who can get infected does. At that point everyone is immune, so the virus has nobody to infect and vanishes away.

That is an extreme case, but four months is also an estimate of the current lower bound for how long immunity lasts. More plausibly, assume that the infection rate is high enough to push the population to herd immunity before the immunity of a significant number of those infected first wears off. At that point the number of infections starts to go down, since each infected person passes the disease on to fewer than one other. If it goes down far enough before the number of no longer immune people gets high enough to push the population back below herd immunity, it may reach the point where further transmission can be controlled by test and trace.

Suppose, on the other hand, that we hold the initial infection rate low enough so we eventually that reach a point at which people are losing immunity as fast as people are getting it, while the number immune is still below the herd immunity level. In that case the disease goes on forever, or at least until a vaccine becomes available. 

Obviously the argument does not hold if a vaccine is going to show up shortly, which at this point seems likely. It also does not hold if immunity is permanent, as might be the case. But it does imply that under some circumstances a higher infection rate is better, in the long run, than a lower.



Unknown said...

I think the main practical argument about the short term disadvantage of the high infection rate is the ability of the health care system to effectively handle the increased rate of hospitalization. Therefore until you manage to increase the capacity, or manage which groups are exposed to the virus, the idea of heard immunization is imposible politically.

Anonymous said...

Everyone in America at once, or everyone in the world?

One seems almost impossible to organize, and the other seems even more impossible.

But unless the USA closes its borders more firmly than it has now, I don't see how the first one can snuff out the virus.


Prudentius said...

Even in the event of a very deadly disease, a higher rate of infection would be better in the sense that the disease may be completely eradicated sooner rather than later, which would increment the total number of victims. Obviously, I do not want people to die, neither from very virulent disease or the very minor killer which is COVID.

How many people are we willing to put in greater risk caused by the suppression or mitigation strategies than they would be if nothing was done about it, in order to save the lives of very few people or a large number of people? My uneducated opinion is that we could take greater risks in exchange for a greater reward to our efforts, but the big prize (saving many, many lives) must be possible and not a pie in the sky

I conclude that everything that has been done has caused much more harm than good, and that probably no life was saved. Which hurts the pride of many people. That's the problem with pride: it hurts like a bitch.

Also, there is the problem of totalitarianism, which, if it is allowed to live longer, will take hold and cause many more deaths, perhaps preventable epidemics (TB, typhus, poliomyelitis) will now resurface because of the implantation of the "New Normal", plus we might see, if we are alive, worse things than just people dying from disease. Was that possibility taken into account when the Gods of This World made their cost-benefit analysis? I doubt it, as that would have been pessimistic, and we know that one cannot make good public policy with a pessimistic bias. Otherwise, it would have been a conspiracy, but that is impossible anyway.

To end this comment: perhaps there are in this world some people who don't care much about loss of civil liberties, psychological abuse, people dying of hunger and lack of shelter (that is the destiny of the Worst of us, the Smokers, those damn Obese people, the drug Addicts, the Mentally ill, the Deadbeats who never saved any money, most school dropouts and those who never believed in evolution). But they do care very much about works of art: paintings, sculptures, cathedrals, Giant Buddha statues. I inform those particular individuals that such objects are also in grave danger right now, because totalitarians are a threat to everything under the Sun.

So, yeah, it is much better to leave respiratory diseases alone and move along, like always. Which sounds very conservative, but it is actually an extremely progressive strategy. Turns out that some traditions are good to achieve sustainable progress. Who would've thunk.

John Schilling said...

"But unless the USA closes its borders more firmly than it has now, I don't see how the first one can snuff out the virus."

Once the United States has brought the virus under effective control - by whatever means - it will pretty much have to maintain severe travel restrictions on nations which haven't brought the virus under effective control. We can still open the borders to nations which have their version of the pandemic under control - again, by whatever means. There will still be occasional "leakers" coming in from those nations, but they can be handled by the same test-and-trace methods we will necessarily be using to deal with purely domestic outbreaks.

This is true whether we use Dr. Friedman's proposed strategy or some other plan. Unless our plan is so abysmally bad that we're the last nation to bring the pandemic under control, there will be a period where no nation has 100.00% eradicated the virus, some nations have brought the pandemic under effective control, other nations have not, and yet "close our borders with the entire world" would be an economically ruinous strategy.

Joshua Kronengold said...

This basically assumes we will never have a vaccine.

It also assumes that absorbing a very high death rate now is much better than having a very low death rate that continues indefinitely.

That last one is interesting, but I'm not sure it's sustainable when examined. Presuming the current estimates of death rates around 5x the normal mortality if most infected people cannot be helped by hospitals (because hospitals are overloaded)...well, first, it would take five generations to even begin to reap an reward for the big starting death toll (you've already lost 5x the amount of the population you expected to lose if the virus spread more naturally). But even aside from that, that assumes the infection rate remains at close to 100% of the population once the virus hits an equilibrium state. That seems incredibly unlikely. We've had highly infectious viruses before in equilibrium states (chicken pox is the obvious one), and while most people got them eventually, not all people did.

But in some ways more importantly, it also assumes that the fatality of the virus remains constant over time rather than there being better treatments developed over time. That in particular seems incredibly pessimistic, given that doctors have been improving their techniques and their understanding of how the virus functions throughout the pandemic. If that treatment improvement can be expected to continue (to some degree) as long as the virus remains in the population, then a country that accepts an abnormally high infection rate for early immunity will see their death investment paid out even more slowly, as the death rate drops significantly over time.

Mr Bitcoin said...

The virus is dissipating.

Look at hospitalizations in California:

scroll down to middle of page

Mr Bitcoin said...

This has a table comparing 1957 Flu to 2020 Covid

Anonymous said...

Please speak on UK media about this. The narrowness of thought permitted on the subject is shocking. Rational minds must prevail and would be welcomed by a nation starved of them.


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