"Herd immunity" is likely a fantasy, But here's a way we could beat COVID faster, more efficiently, and at a far lower cost.

"Herd immunity" is a term we've heard a great deal of lately. It's the percentage of a population that hs recovered from and is immune to a virus necessary for the virus to "burn out." "Herd immunity" is generally understood to have been achieved when between 60% and 70% of a population have achieved immunity to a virus.

If we assume- not unrealistically- that the actual COVID death rate in the United States is somewhere around one percent (these things are never clear until long after the fact), that would mean that in the absence of an effective vaccine the price of reaching herd immunity would likely be the lives of a number of Americans roughly equivalent to the entire population of Chicago or Houston. 

But wait! Let's not be hasty here. Some estimate that the actual mortality rate for COVID-19 might be half that.

Fine. In that case, we're "only" talking something more than one million dead Americans, more than twice the number of Americans who died in World War II.  Historians currently believe is that 750,000 Americans died in the Civil War, a figure twenty percent higher than the official and traditional figure of 618,222. Since the best estimates put the actual mortality rate for COVID-19 somewhere between  0.4 and one percent, so the only question is at what point between one and two and a half million deaths the final number would fall.  The only real issue is the magnitude of a tragedy unparalleled in American history.

We as a society could never accept that kind of carnage. Only a psychopath would be willing to pay such a price for a return to prosperity even if the alternative were reliving the Great Depression (in reality, the purely economic result of that sort of holocaust would almost certainly be far worse than the Great Depression and in fact might obliterate our economy for a generation).  "Herd immunity" is not only a barbaric strategy for fighting this virus but an impractical one. Only with the development and administration of a safe and effective vaccine could it be achievable.

There have been several promising candidates, and Dr. Anthony Fauci is optimistic that we could have an effective vaccine before the end of the year. May it be so! But if that happens, we don't know how much immunity it will confer, and it will take time to manufacture and administer it to enough people to put the pandemic behind us. But the previous record for developing a truly effective vaccine against a virus was the four years it took to develop the mumps vaccine. There are no guarantees that even the best efforts of the world's scientific community will be able to do better in the case of COVID-19.

But there is another way- one which not only would minimize our casualties but get us through this crisis faster and in better economic shape. There is only one great obstacle to adopting it: our will to put aside our petty politics and stupid individualism and resolve, as a society, to do it.

A new British study suggests that universal wearing of facemasks in public could greatly reduce the spread of COVID-19, enable "reduced" lockdowns during outbreaks, and along with common-sense social distancing could prevent a second wave of infections and perhaps bring the pandemic to a halt within a relatively short time.

There are two significant variables, however: the effectiveness of the type of mask worn, and the percentage of the population consistently wearing them. It's obviously impossible for the 100%-effective barriers worn by medical professionals to be worn by everyone, and unlikely that most of us would wear them for any length of time in any event. But the study predicted that consistent public use even of homemade facemasks that are only 50% effective could cut the average number of others infected by each person who contracts the virus- the base reproduction factor, or "R-" from 2.2 to less than one. Reducing the R to less than one would not only mean an end to the exponential growth of the number of infections but that the virus would be losing ground since fewer people would be infected with each successive generation of the virus as people recover. It probably wouldn't actually disappear, but universal mask-wearing might well bring the crisis to an end and hold the virus well in check until a vaccine could be developed to administer the coup de grace.

Masks that are 70% effective could cut a current infection rate of four to less than one. But this assumes that everyone wears masks.

Three different models, examining the effectiveness of various types of face coverings under differing conditions, all pointed to the universal use of facemasks (or close to it) at least in public as a factor that might drastically shorten the pandemic. All of this, of course, assumes long-term immunity after recovery, and it's still unclear how much immunity recovering from the virus confers and for how long. And the findings are controversial, given the assumptions and variables involved. But the study does seem to show that the universal wearing of masks by enough people for a long enough period, coupled with continued social distancing and relatively short-term lockdowns during local outbreaks, could deal the virus a devastating blow.

A Reuters story interprets the findings as suggesting that the number of people to whom each individual might spread the virus could be cut to less than one if only half the population wore masks. But this overly simplistic analysis ignores the relative effectiveness of different types of masks as well as the initial infection rate in any one place at any one time. And some experts feel that the study overestimates the likely effectiveness of even universal mask-wearing. Like all modeling studies, this one makes a great many assumptions and deals with conditions involving a great many variables.  But there seems to be a consensus that universal mask-wearing at least in public would have a major positive impact.

A recent Chinese study claimed that the spread of the virus could be reduced by as much as 70 to 80% by the universal wearing of masks in the home. The overwhelming majority of infections in China seemed to be cases in which a person caught the virus from a family member. The benefits evaporated, however, if the family waited until a member contracted the virus before started wearing masks; they seem to be effective only as a preventative measure.

It's hard to imagine a significant percentage of the American or Canadian or British population wearing masks at home, and it might not be necessary; a greater percentage of the population in developed Western countries lives alone, our society is far less communal, living conditions are far less crowded even in major urban centers.

The problem, of course, is obvious to anyone going outdoors anywhere in America these days: getting people to comply. Comparatively few people wear facemasks when it's left to a matter of individual choice; locations which have made them mandatory have experienced massive push-backs, and a president heavily invested minimizing the pandemic and its consequences and in a hurry to get things "back to normal" as fast as possible is making the seriousness of a pandemic that has already killed more Americans than the Vietnam, Korea, and Afghanistan wars combined a matter of partisan political controversy. A kind of half-baked libertarianism questions the propriety and even the constitutionality of restricting individual freedom even in a pandemic, as a public health measure, despite the overwhelming legal precedent affirming it and the evidence that the Founding Fathers would have approved of the restriction of individual rights in a public health emergency. But in any case,  to a significant minority of Americans, not wearing a mask is a political statement (just as wearing one has become for others).

The biggest problem- cited even by some of the British scientists responsible for the study, and repeated over and over by American epidemiologists- is that most people fundamentally misunderstand the reasoning behind wearing a mask. Most see it as a matter of individual liberty because they are operating on the false assumption that the wearing of a mask is a matter of self-protection. In fact, the purpose of the mask is not to protect the wearer from others, but rather others from the wearer.  A person with the virus who sneezes or coughs or even breathes too close to someone else is much less likely to spread the virus to somebody else if he or she is wearing a mask, and the aerosol droplets that are the primary means of infection can spread a surprisingly long distance. One scientist has suggested a slogan that might well be the basis of an advertising campaign: "I wear my mask for you; you wear your mask for me."

This is not a matter of individual freedom. It's a matter of social ethics- and responsible behavior.

Richard Stutt of Cambridge University, who led the study, summed up its findings this way:

Our analyses support the immediate and universal adoption of face masks by the public.

If widespread face mask use by the public is combined with physical distancing and some lockdown, it may offer an acceptable way of managing the pandemic and re-opening economic activity long before there is a working vaccine.

The legitimate question of whether the requirement might be relaxed where the risk of infection is minimal aside, it's an indictment of our society that, on one hand, the universal and mandatory wearing of masks in public combined with localized periodic lockdowns and common-sense social distancing seems to be the surest, quickest, and most efficient route toward putting the pandemic behind us, end the recession, rescue the economy, get back to normal, and save the maximum number of lives all at the same time, we almost certainly aren't going to even try to do it.

ADDENDUM:  And the hell of it is that there is no reasonable doubt about the effect of a universal mask mandate either in controlling the virus or in mitigating the effects of the pandemic on the economy. Goldman Sachs did a study recently that estimated that the universal wearing of masks in public would cause a 15% reduction in new cases and save a full five percent of the GNP by preventing widespread lockdowns and other economic disruptions.

There is simply no rational argument against a universal mask mandate and absolutely no reasonable grounds for doubting its efficacy.  The entire argument against it boils down to partisan politics.

Lethal and very expensive partisan politics.