Will herd immunity save us?

What is herd immunity and why is it important in our understanding of the coronavirus pandemic? NCSE Executive Director Ann Reid explains.

A herd of elephants

Photo by Josh Muller on Unsplash

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Approximately 400 years ago, on March 27, 2020, I wrote an article entitled “Is Social Distancing Working?” Here it is three months later and we have a pretty good answer to that question: Yes. In places that imposed restrictions on travel, shopping, and large gatherings, the spread of coronavirus was dramatically slowed.

True, those restrictions also imposed huge financial and psychological burdens and couldn’t be sustained forever. And they didn’t eliminate the virus—though to be fair, that was never the intention—they just slowed it down. So now, as those restrictions are being lifted, case numbers are rising in 27 states, and hospitalizations are either already rising or projected to begin rising soon. As Lin Andrews wrote in considering whether we will see a second wave of coronavirus, we are far from done with this virus—or it’s far from done with us. We can expect ongoing outbreaks of infections that could become overwhelming (see: India, Brazil), quickly subdued (see: New Zealand), or anywhere in between (see: everywhere else).

When will this end? How do we get back to normal life?

The best answer to the latter question is herd immunity. But herd immunity, unfortunately, is a long way off, if it’s even possible at all. There are three big hurdles between us and herd immunity: lots and lots of people haven’t been infected yet, we have no vaccine, and there is evidence that people who have been infected might not stay immune for long.

But first, what is herd immunity? Here’s a list of short videos that illustrate the concept (I prefer video #5, above, because who doesn’t love gummy bears?). If you want to start planning for a herd immunity classroom activity with your students in the fall, consider using this good one from the Centers for Disease Control.

In short, the idea behind herd immunity is that when enough people in a community are immune to an infectious disease, the disease can’t spread. If there are very few susceptible people, an infected person is unlikely to come into contact with one, so the virus will spread slowly, or even disappear. The term “herd immunity” is used because even if a small percentage of people remain susceptible, they will still be protected, just as a baby elephant can be protected from a lion attack by the adults in the herd. (Warning: the video is kind of scary. At least to me.)

Just what percentage of the population needs to be immune to provide herd immunity (also known as the herd immunity threshold, or HIT) depends on the virus. Measles and pertussis (whooping cough) are so infectious that the threshold for herd immunity is over 90%. The threshold for Ebola, by contrast, is less than 60%. (Bonus question: why might thresholds be different? Think about how the virus spreads and how contagious it is.) We don’t yet know what the herd immunity threshold is for the virus that causes COVID-19, SARS-CoV-2— most estimates, which are based on what we know about the virus’s transmission rate, are around 70%.

Unfortunately, some simple math shows the human cost of reaching that percentage of immune people. The U.S. population is about 328 million, and 70% of 328 million is 230 million, so we would need to have 230 million Americans recovered from COVID-19 to approach the herd immunity threshold, assuming one can only contract the disease once. As of June 23, 2020, we’ve had about 2.3 million confirmed cases in the U.S. That case count is probably a huge underestimate, since many, many infected people, especially in the early days of the pandemic, never received tests and so aren’t included in that total count. But even if the number of cases is 10 times higher than the official count—say 20 million Americans—that’s still a long, long way from 230 million. And remember that there have been 119,000 deaths so far, which suggests that there would be over a million deaths on our way to the herd immunity threshold.

A quicker way to reach the herd immunity threshold is through vaccination. But there is no vaccine yet. So that’s off the table for now.

A final complication is that herd immunity requires that people who become immune—either by contracting the disease or through vaccination—stay immune permanently, or at least for enough time for the virus to burn itself out. It is worrisome that we are so far unsure whether being infected by SARS-CoV-2 provides lasting immunity. There are anecdotal reports of people being infected more than once within just a few months (although those infected a second time seem to be asymptomatic and possibly not contagious). There are some indications that people who have experienced mild or asymptomatic infections do not develop protective immunity. Resolving this question will be a major focus of research in the coming months. It appears likely, though, that achieving herd immunity, in the end, will require an effective vaccine, administered to at least 70% of the population.

That’s all pretty sobering. But I’d like to end on a more positive—and empowering—note. Achieving the herd immunity threshold is a very lofty goal. At that level, life really could go back to normal, including open schools with no restrictions, large gatherings both indoors and out, and all the other activities we used to take for granted. But, as we’ve been saying from the beginning, individual behavior can vastly slow the spread of the virus even in a mostly susceptible population. Social distancing, wearing masks, and spending our social contact budget wisely will all slow the transmission of the disease and minimize the number of cases and deaths until a vaccine or a treatment becomes available.

NCSE Executive Director Ann Reid
Short Bio

Ann Reid is the Executive Director of NCSE.

reid@ncse.ngo

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