Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A perspective on herd immunity for COVID-19

Betty Rabinowitz, MD
Conditions
March 10, 2021
Share
Tweet
Share

On February 18, Dr. Marty Makary published an opinion piece in the Wall Street Journal which struck an unusually optimistic note as to the stage of the American COVID-19 pandemic.  Dr. Makary predicts that based on the current trajectory, COVID-19 will be mostly gone by April, allowing Americans to return to a post-COVID-19 normal life. He notes that in the last few weeks, we have seen a dramatic drop in cases (77 percent drop in six weeks) which has been difficult to explain based on a single factor such as vaccinations or drastically improved adherence to social distancing and masking.

Dr. Makary asserts that we have underestimated the numbers of Americans who have natural immunity as a result of under testing and undercounting the number of people who have already had COVID-19. There have been 28 million confirmed COVID-19 cases, based on under testing and counting, this potentially represents from 10 to 25 percent of actual infections. Dr. Makary applied a time-weighted average to determine that there are 6.5 cases for every case confirmed by laboratory testing. This brings the likely number of individuals who have had COVID-19 to about 165 million patients, representing about 55 percent of the American population. If you add to this the 15 percent of Americans who have already been vaccinated, with an anticipated total of 150 million Americans being vaccinated by the end of March, one can only conclude that by the end of April, the U.S. will be experiencing herd immunity, with very low infection rates.

According to a recent Lancet article, the term herd immunity first appeared in the work of American livestock veterinarians concerned about “contagious abortion,” an epidemic of spontaneous miscarriage in cattle and sheep. By the 1910s, it had become the leading contagious threat to cattle in the U.S. Farmers destroyed or sold affected cows.  An astute veterinarian named George Potter was the first to suggest that this was the wrong approach and that the cattle that had already been ill provided a shield against the infection and that these animals should be kept rather than removed. He likened it to suppressing a fire by eliminating its available fuel. In 1919, bacteriologist W.W.C. Topley described experimental epidemics in mice that would resolve unless healthy mice were continuously added to the experiment population. He was the first to describe this phenomenon as herd immunity.  By 1924, herd immunity was used to describe the behavior of an epidemic of Diphtheria among students at the Royal Naval Medical School. Herd immunity thus became part of the vocabulary of human medicine.

During the COVID-19 pandemic, the term herd immunity has become a household term, engendering intense hope and anticipation. It remains to be seen whether the assumptions that have led to Dr. Makary’s optimism are correct, and time will tell how the pandemic will evolve and what role new COVID-19 variants will play. This uncertainty means that we cannot let down our guard, and for now, we should continue adhering to strict social distancing and masking. Nonetheless, Dr. Makary’s article was encouraging as it introduces the hope for a near-term end to this awful pandemic.

Betty Rabinowitz is chief medical officer, NextGen Healthcare. She can be reached on Twitter @DrBettyR.

Image credit: Shutterstock.com

Prev

Using technology for behavioral health integration [PODCAST]

March 10, 2021 Kevin 0
…
Next

The pandemic plight of CHF: one center's response

March 10, 2021 Kevin 0
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
Using technology for behavioral health integration [PODCAST]
Next Post >
The pandemic plight of CHF: one center's response

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Betty Rabinowitz, MD

  • The whole person care model is seeing its day in the sun

    Betty Rabinowitz, MD
  • The future of general internal medicine is bright

    Betty Rabinowitz, MD
  • Men’s mental health: We treat just the tip of the iceberg

    Betty Rabinowitz, MD

Related Posts

  • How to get patients vaccinated against COVID-19 [PODCAST]

    The Podcast by KevinMD
  • COVID-19 divides and conquers

    Michele Luckenbaugh
  • State sanctioned executions in the age of COVID-19

    Kasey Johnson, DO
  • A patient’s COVID-19 reflections

    Michele Luckenbaugh
  • Starting medical school in the midst of COVID-19

    Horacio Romero Castillo
  • COVID-19 shows why we need health insurance

    Jingyi Liu, MD

More in Conditions

  • Why gambling addiction is America’s next health crisis

    Safina Adatia, MD
  • How robotics are reshaping the future of vascular procedures

    David Fischel
  • How the shingles vaccine could help prevent dementia

    Marc Arginteanu, MD
  • Why removing fluoride from water is a public health disaster

    Steven J. Katz, DDS
  • What the research really says about infrared saunas

    Khushali Jhaveri, MD
  • How the cycle of rage is affecting physicians—and how to break free

    Alexandra M.P. Brito, MD and Jennifer L. Hartwell, MD
  • Most Popular

  • Past Week

    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Why gambling addiction is America’s next health crisis

      Safina Adatia, MD | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • How robotics are reshaping the future of vascular procedures

      David Fischel | Conditions
    • Medicalizing burnout misses the real problem

      Jessie Mahoney, MD | Physician
    • How the shingles vaccine could help prevent dementia

      Marc Arginteanu, MD | Conditions
    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
    • When the diagnosis is personal: What my mother’s Alzheimer’s taught me about healing

      Pearl Jones, MD | Conditions
    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Key strategies for smooth EHR transitions in health care

      Sandra Johnson | Tech
    • Reassessing the impact of CDC’s opioid guidelines on chronic pain care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
  • Recent Posts

    • Why gambling addiction is America’s next health crisis

      Safina Adatia, MD | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • How robotics are reshaping the future of vascular procedures

      David Fischel | Conditions
    • Medicalizing burnout misses the real problem

      Jessie Mahoney, MD | Physician
    • How the shingles vaccine could help prevent dementia

      Marc Arginteanu, MD | Conditions
    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...