- Current lockdown policies are producing devastating effects on short and long-term public health.
- Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.
- We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young.
- COVID-19 is less dangerous for children than many other harms, including influenza.
- All populations will eventually reach herd immunity.
- Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.
- Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19.
- 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.
- Young low-risk adults should work normally, rather than from home.
- Restaurants and other businesses should open.
- Arts, music, sport and other cultural activities should resume.
The choice we face is stark. One option is to maintain a general lockdown for an unknown amount of time until herd immunity is reached through a future vaccine or until there is a safe and effective treatment. This must be weighed against the detrimental effects that lockdowns have on other health outcomes. The second option is to minimise the number of deaths until herd immunity is achieved through natural infection. Most places are neither preparing for the former nor considering the latter.
The question is not whether to aim for herd immunity as a strategy, because we will all eventually get there. The question is how to minimise casualties until we get there. Since Covid-19 mortality varies greatly by age, this can only be accomplished through age-specific countermeasures. We need to shield older people and other high-risk groups until they are protected by herd immunity.
Among the individuals exposed to Covid-19, people aged in their 70s have roughly twice the mortality of those in their 60s, 10 times the mortality of those in their 50s, 40 times that of those in their 40s, 100 times that of those in their 30s, and 300 times that of those in their 20s. The over-70s have a mortality that is more than 3,000 times higher than children have. For young people, the risk of death is so low that any reduced levels of mortality during the lockdown might not be due to fewer Covid-19 deaths, but due to fewer traffic accidents.