While India has been in a pandemic-induced lockdown for a little over two months, the inflating numbers of coronavirus cases make us all have multiple questions. We are uncertain about the answers to existential questions like when will all this end or what is the cure to this pandemic.
Amidst the growing uncertainty came up the mention of ‘herd immunity’ as a proposed strategy to successfully fight off the pandemic in India.
What is herd immunity though?
Herd immunity is a strategy where a majority of the population becomes immune to an infectious disease either through vaccination or by getting infected and recovering from it.
While we’re all aware of the vaccine as a solution, the possibility of infected people saving others from getting infected sounds counterintuitive, doesn’t it?
Well, according to experts, it can actually work. An information scientist, Urmila Kulkarni Kale stated that the immune individuals help “break the chain of transmission”. This shall lead to a decrease in the probability of a non-immune individual getting infected and, in turn, controlling the spread of the virus.
While herd immunity has been successful in controlling infectious viruses like measles and smallpox, it’s effectiveness in controlling COVID-19 is still under question.
Why is India considered as an apt choice for using herd immunity as a strategy?
Princeton University and Center for Disease Dynamics, Economics and Policy found that 82% of the Indian demographic is under the age of 50. This creates the most desirable demographic for a smooth functioning herd immunity since even those who get infected will likely have mild symptoms with crude case fatality (fatality if infected) being less than 0.2%. This hands the baton of fighting off COVID-19 to our youth population.
How can herd immunity help India?
While our country has been on lockdown for the purpose of flattening of the curve, a study by the International Institute for Population Sciences(IIPS) found that even though India’s situation could have been much worse if the lockdown wasn’t administered, it is not a solution.
Although the proposed number without lockdown could have been 1.71 crores, the staggering increase in cases and the sinking economy has shifted our country into Unlock 1.0. The weakening economy is why some experts believe we must consider herd immunity.
A prominent epidemiologist, Jayaprakash Miliyil stated, “No country can afford a prolonged period of lockdowns and least of all a country like India.”
To create an intersection of re-starting the economy and building antibodies against the virus, herd immunity is being proposed. Experts believe that we can use our young population to our advantage by creating looser restrictions around the country and letting the majority be exposed to enable the development of herd immunity. If executed effectively, it could help 60% of the population immunity by November and thus, halt the spread of COVID-19.
Lockdown has been effective in slowing down the spread but has lead to huge costs for the government. The consideration of herd immunity, according to a Princeton researcher, shall create a “ trade-off against starvation.” Essentially, it shall lead to an increase in short-term statistics followed by a successful decline.
Some experts believe herd immunity proposes “too large a risk for India”
Although in theory, it sounds like a smooth sailing strategy, it proposes great risks for our densely populated country. It is possible for most of our young population to have mild or moderate symptoms and gain ‘immunity’ to the virus, our youth isn’t fully immune to complications that may arise from it. Even after recovery, there isn’t much research backing the fact that a person won’t get reinfected.
The assumption that the younger adults may not have a severe reaction is problematic since a major statistic of young Indians have dangerous underlying health conditions:
i) About 22% of individuals aged between 20 to 44 have hypertension
ii) 4% of citizens aged between 15 to 44 have Type 2 diabetes
iii) Out of 2.1 million HIV patients, 83% lie between 15 to 45 years
iv) The percentage of youth suffering from chronic pulmonary disease and asthma are 4.2 and 3%
v) third of our population consumes tobacco
With a staggering percentage of our youth falling under the high-risk factors of COVID-19, the consideration of herd immunity being effective begins to seem problematic.
Another significant reason why relying on herd immunity solely is an issue is that it shall lower the risk perception among younger populations. This shall lead to complacency which may make them want to defy the necessary social distancing measure.
An increase in the youth population getting infection also proposes a risk to the elderly and the existing high-risk population. Why? Well, our dense population lives in a joint family structure, especially in rural areas. This makes the isolation of the elderly and the high-risk family members a challenge in itself.
Another reason why it seems problematic as the ‘sole-solution’ is the fact that the voluntary growing cases shall put immense pressure on our healthcare system. According to research, presently in a population of 1.3 billion people, the medical resources available are 0.55 hospital beds per 1000 people with only 48,000 ventilators available. With the increase in cases, the already stifling healthcare system could be in a state of crisis.
Should herd immunity be actually implemented?
Although it proposes great risks, its consideration can’t be completely denied since it could help us find a solution to fighting off the virus and reworking the economy rather than a lockdown which only limits the spread but not eliminate it.
With a vaccine still 12-18 months away, herd immunity being considered as a sole solution seems problematic. According to WHO, herd immunity shall lead to ‘too much illness or deaths’, making us all think if it truly is worth it.