How Herd Immunity Works

And uh, I ate some of that spicy beef ramen in this hot room. Yeah, that's a dangerous combo. I didn't think to open the door, So I'm just like sitting here pouring sweat out everywhere. Well here's the thing. You could go totally dong out like Spartacus if you wanted to, because you're the only one there. People have been talking about dong out lately. To the movie crush page. Yeah,

well it's a pretty hilarious term. But just please put down, like some newspaper or something on the chair before you sit on the bare bottomed Okay. Oh, and by the way, speaking of movie crush, you. I think this is going to come out the day after your movie Crush Mini Crush appearance next week. Yeah, I'm excited about it. Man, I'm a little nervous. So No, it's gonna be great. People are gonna love it. So if you don't listen to the show, maybe listen to this one episode and

then forget about the show again. If you want always stick around, maybe boost the numbers a tad. But it was a lot of fun, and I think I think people would want to hear your appearances. What I really appreciated you having me on it was it was a lot of fun. It was fun professional at hosting. Hey, we turns out we know what we're doing here, don't we don't? Uh? Speaking of which, I think we should frontload this episode with a little bit of a c

o A Um. If you are a pretty hard line anti vaxer, or if you believe in things like planned demmi or that Bill Gates created the coronavirus for population control, you may not want to listen to this because we're gonna bring you hard and leaned facts, lean and mean, depending on your point of view. I think that's a good It's a good c O a. I think that maybe you got rid of two of the hate mail we're gonna get, so thank you for that. Yeah, we'll see.

I mean I think, uh, it just bears saying, just why, why, why rile yourself all up? Just let's listen to your echo chamber podcasts that validate what you think maybe or or or or or calm down and just hear us out and see what you think. Well, that's always a you know, it's always an option. You know. So we're not even talking necessarily just about vaccines or anti vaccines. Um, it's almost like a side thing to this whole thing,

but it's definitely still, um, very much intertwined with it. Um, we're talking about her can't or you can't not talk about vaccines if you're going to talk about her immunity right now, because with with her immunity, especially in the twenty one century, there's basically two ways of getting there, and one of them is a robust vaccination program. That's right. And if you don't know what her immunity is, then um,

then you're probably just fine. You've been living under a rock and you're not near any other humans or the internet. You're still protected though that's right. Herd immunity those the principle uh, sort of in its simplest form of safety and numbers and if you have a lot of people or enough people, because there's actual math involved to figuring that out. It's not just a guess. If you have

enough people that are immune to a virus. Uh. And it can be like you said, through vaccination or through having lived through the disease and then having antibodies, then the population is protected from that disease even if they are an immune. That's that's the idea that so many a certain threshold of people are immune that even people that choose not to vaccinate can hop on that wagon, right. Um. And it's not even like you hop on the wagon, like you are on the wagon just by vulture being

alive in the society or culture. Right. So that's a good point. Um. There's a really easy way of understanding it that Molly Edmonds used in Um the House Stuff Works episode Unheard Immunity that if you pretend you're at a bowling alley and each person has their own lane, and this is basically that bowling alley lane is like there their bubble that they live in, their work their home and everything, and they don't encounter anybody else. That's

kind of like Wally, But with bowling. If the first person on lane one comes down with say the flu um, he can very easily pass it on to the woman in lane two. If she's not immune to the flu, she will contract it and pass it on to the person in lane three, and so on and so forth, and it'll just keep going and eventually people will develop anybodies. Some of those people will die, most will survive, uh, and the flu will have a hard time getting through

that population a second time around. But if the woman in lane two is already immunized to that flu strain, say through like a vaccine or something, then it's not going to transmit from the first guy in lane one to her, or it's certainly not going to transmit beyond her. So she's protected everybody in lanes three through ten just by virtue of having been immune to that flu virus. It's stopped with her, and that's the point of her immunity.

That's the whole that's the basis of the whole thing. Yeah, And if we want to stick with bowling parlance, then that means that that lady is bowling strikes. She's throwing strikes strikes, not even seven ten splits, which she could if she wanted to. That's how she is. Yeah, the perfect game, right. I remember that dumb joke when I was a little about You know, you learn the stupidest jokes when you're a kid because they have to be so dumb. A kid can understand him, I think, I

think so. But about the the guy who bowled a three hundred and one and you're like, you can't bowl a three d and one, Well, you can't bowl a three hundred and lose, man. I know. That's how bad it was, and that's how much it stuck with me. Did you get that from highlights? I don't know where I got that. It's pretty bad. It sounds like a playground joke. I think so. But I think you beat up in the playground even with that one. Yeah. So

let's talk about her community some more. We talked about the two ways natural exposure and vaccinations, and if we're going back pre vaccination and talking about human history. Um, the hurt there was hert immunity, and it was I guess the way to describe it as herd immunity. The hard way. Um, people being exposed to the virus or the bacteria developing that immune response and enough, you know, they reached that tipping point where enough people have it

to where everyone's immune. But they lost a lot of people along the way. Yeah, that's part of the problem is is if you look at it on an individual level, if you are exposed to a virus or a bacterium and it runs rampant and infects you when you come down with an illness from it, you there's basically two outcomes. You can put it up, put up an immune response and win, or you can lose and die. But if

you survive and win, you've become immunized. And that's just the natural course of viruses or bacteria when they encounter humans. It's at least contagious ones infectious ones, right, um. And and we didn't have any recourse other than that. So it's actually kind of good that we do have this natural immune response to I mean, we just wouldn't be

around anymore if we didn't have. Its. Part and parcel with human survival or any biological survival is to be able to mount in immune response, build antibodies so that if you do encounter this thing again. You don't have to go through the illness all over again for the

most part. But like, we didn't have any other tools besides that until the nineteen forties when we were able to mass manufacture vaccines, and now all of a sudden, we could say, create herd immunity without anybody ever having to get sick or almost anybody, um, just through vaccination vaccination programs. Yeah, and here's the deal to uh. In you know, pre vaccination, they could build up an immunity, lose a lot of people on the way, and it

wasn't like, all right, now we're fully set forever. Uh. Sometimes there would be like another swell of exposure, whether or not it's like a bunch of people moving into the country or a bunch of people being born, but basically non immune people kind of flooding the system. And then that percentage point that we're going to talk about dips below that number, and then you kind of you don't have to restart the whole process, but it kind of that hamster wheel gets going again until that herd

immunity is then reached again. Yeah. That's I think that's um what's called an endemic disease where it's still they're just hanging in the background. But for the most part, people are immune to it. And then when you have like an influx of births or an influx of immigrants, that can flare up again. But then those people get um kind of taken into the immunized herd, become part

of the immunized herd as well. And and the deal is is that natural herd immunity is all we had until we developed kind of the ability to make massive quantities of vaccines, right I think of the starting in the nineteen forties. Yeah, I mean there were a few researchers along the way who really brought this along. There was a couple of people, name a couple of dudes named W. W. C. Topley and G. S. Wilson who actually coined the term um herd immunity. But in ninety three.

That was an UH epidemiologist named A. W. Hydrick who studied measles between ninety one and he's the one that actually kind of quantified this and said, I've done the math. If sixty percent of kids fifteen or younger were immune to measles, then we're not going to have a big outbreak, and he wrote a very famous paper about it, and that's where the term really took off. Yeah, and so, um,

herd immunity is basically an epidemiological concept. It gets um sometimes, I think in the in the popular press especially, it gets kind of leaned on as if it's like a natural universal law or something like that. It's basically an observation, but one that has seems to be consistently held up by the success of vaccination programs that we've cre aided

to generate artificial herd immunity. And that's the point. That's the point of vaccine programs is to say, okay, for for basically all of human history, all we had was that natural herd immunity, whether we liked it or not. But now that we have vaccines, we can create vaccine programs where if we vaccinate enough people, we can force

this herd immunity without almost anybody getting sick. Like you might have a slight reaction to the vaccine for a small number of people, usually somewhere around like say three to ten percent, the vaccine is not going to protect you. But if enough people out there get this vaccine, they're going to be vaccinated. Immunized against the disease without ever

having gotten it. And if enough people are vaccinated, we will have this herd immunity without having to undergo some disastrous epidemic that kills off some ungodly number of people and makes an even larger number of people sick. That's the basis of vaccines in the vaccination program. And I mean countless tens of millions of lives have been saved just from the fact that they have existed since the

nineteen forties. Yeah, I mean that's when they came into mass production in se is, when we first started as humans. To kind of understand this concept, there was a man named Edward Jenner who inoculated a little kid, a little boy,

against smallpox. And this is kind of gross sounding, but he infected him with the plus from a blister of cow cow pox, which is less deadly, and he was like, Hey, I think I'm onto something here, and in uh, two hundred and or I guess a hundred and forty something years, we're really going to be on the ball with this stuff, right. And there were others like vaccines along the way, but um, and I think they were all just kind of small batch.

You know, like artisan vaccines that were created, um, but the uh, the it was like the forties where this on this mass industrial scale that that they were produced. And only under those circumstances can you actually get to herd immunity for like a large population like a state or a nation or a world. Basically, Yeah, and you know, I think we've said this will kind of keep beating this drum and repeating this, but the whole concept is

to protect people who haven't even been vaccinated. Just sometimes you're too young to get vaccinated, Sometimes you have a condition as a child where you literally can't be vaccinated,

or maybe you're elderly and you had been vaccinated. But you know, they always talk about, especially with COVID nineteen and and the flu, the elderly population is at risk because they're way more likely to develop complications like uh, pneumonia as a big one for what's going around now, but as far as even something like chicken pox, encephalitis

or hepatitis. And we don't really know the deal with children and adults their immune system and exactly how they work and what the differences are, but it looks like kids are either more robust and against something like chicken pox, like when you have it as a kid is usually not such a big deal. When you have it as an adult, it is a big deal because it may be your adult system just going into overdrive saying you should have had this when you were six, Right, what

is wrong with you? Didn't you have any friends? Did you have chicken pox? Probably didn't you? I did? I did here. Yeah, my sister always had. She had a pox scar like on her temple that I always admired, so I made sure to like pick one on my temple. I don't think Emily got it for some reason. I'm that is in my brain. Oh my is she? Does

she have the vaccine against it? I think so? Okay, because since the mid nineties they came out with a vaccine against ari selah, which is the virus that causes chicken pox, And now it's like you don't have to get it as a kid any anymore. I'm pretty sure somebody I know didn't get it and did get the vaccine, and I'm pretty sure it's right, so pretty well so um so with chicken pox, that's a good example of how like you know, if you haven't when you're a kid,

it's I mean, it's still life threatening. You can get all those same things like encephalitis or pneumonia, but you're just way likelier to get it as an adult. Same thing with the flu, Like the flu can be very deadly depending on how old you are. UM, I think something like it says ninety percent of flu related deaths and fifty to seventy percent of hospitalizations for the flu

are for people over age sixty five. I mean, so for the same exact strain of a bug that, like you know, has a kid at home watching prices right for one day, maybe two, UM, it lands an older person over age sixty five in the hospital on the brink of death. You know, it's just different. And so because that there is that difference, it makes sense to immunize the young, inoculate the young, to protect the elderly.

And let's not forget, even if you couldn't care less about the elderly, you hate the elderly because some old man yelled at you once when you threw a football in his yard, and you've hated all old people ever since. Then do you hate babies because there are there are babies who are too young to be inoculated? And then there's also those people, like you said, who don't have um healthy enough immune systems to get a vaccine, and so they rely on the everybody else the herd to

be vaccinated to provide this immunity for them. So there are really good reasons to be vaccinated in addition to you yourself being immunized against these things. Yeah, and you know, these things work better in a homogeneous population. And every time I see that word, I want to say homogeneous for some reason, that's the British way of saying. Do they say that way? They probably do, probably just to

be contrarian or contrary Indian. Uh, they work better and homogeneous populations, which there are not a lot of those uh still these days, um, thanks to you know, people integrating with one another. So when they do these calculations that we're about to talk about, they take all of that into account, races, ethnicities, mixed races, stuff like that. And so you know, we've been talking about the modeling

and the math involved. It can get complicated, but it's really kind of simple that it's base form, don't you think, yes, especially if you're a mathematical genius in a statistical whiz, which I am not okay, But in the broad strokes, yeah, you you can make a pretty good case that it's understandable for sure that it's it's all based on the reproduction number in relation to the size of the population. Basically, yeah, and that reproduction number they in the in the biz,

it's pronounced are not. It's are with a. I guess that's a zero. Huh, yeah, I'd to say our zero any day. Are not though, for an infection, is a number of people expected to contract that illness after coming into contact with an infected person under the right conditions that they can contract it. So a less confusing way of saying that is the are not number is the expected number of people that a contagious person is going

to infect. Right, So if you understand this about a disease, if you know um, for example, with the MOMPS that's extremely contagious, which means that it has a high are not because the average person walking around infected with the MOMPS and contagious with the MOMPS is going to get something between ten and twelve other people infected with the MOMPS and then they themselves will be contagious. So that means that the MOMPS has a relatively high are not

or reproduction number. So if you understand that about the moms, you can calculate how many people in a population have to be immunized against the momps to to prevent it from transmitting within that population. And, like we said, there's a lot more math to it than that, but ultimately, for the months in today's modern heterogeneous populations, is that the right way of saying. I don't know. Nobody says heterogeneous,

do they. That sounds way too close to erotic. It sounds like something I would say, so um uh, in today's modern society, We'll just put it like that, you need to have about of any given population immunized against momps to reach what's called the herd immunity threshold. That herd immunity threshold is basically what I just said. It's the percentage of the population that has to be immunized

for her immunity to kick in to cover everybody else. Yeah, and I know that everyone's going, what about COVID, What about COVID? What about COVID? Oh? Do you want to not even say yet? You want to wait? Okay, I mean that's fine, that's fine. We'll how about this let's take a break. Oh my god, this is just and then right after the break, we'll we'll dive into this stuff later, but right after the break, we'll give you sort of what they're thinking as of today when we

record right after this shosh and shock. All right, So that was an unfair cliffhanger, uh, And keep in mind, like we kind of learned and we knew this was going to happen with our COVID nineteen podcast, it was out of date like days later, and this will be out of date because there's just so much we don't know yet and we're learning so much every day and

every week. But I've seen the range from six is what they think the immunity threshold needs to be for UH to have a pretty successful herd immunity, Right, that's the current thinking that I saw as well, that they think the reproduction number is somewhere between two and three. I think that's a two point eight is like the

most widely touted for COVID nineteen, thankfully. I mean, can you imagine if it was like a month's level, right, Yeah, No, that's especially with the fact that there's such a thing as asymptomatic carriers who can walk around in fating people. If that was that much more contagious, it would be, Yeah, it would be pretty rotten. Like it as bad as

it is, it could conceivably be worse epidemiologically speaking. Yeah, And here's where we should also point out that, just like we're talking about her immunity, but if we reach her immunity, that doesn't mean like everything is solved. Um, if we come up with a vaccine, which we will, vaccines aren't effective against every single human, so things can still happen. Um, And then sometimes you get an immunization that's effective for a short time, for a few years. Maybe. Yeah,

there's an outbreak of diphtheria in Russia. I mean, like tens of thousands of people fell ill with diphtheria, and they were almost all adults. And they went back and figured out the reason why this happened was because, um, those adults hadn't been given a booster shot for their diphtheria um inoculation and so so they're they're immune response.

They're antibodies that they built up when they were children having been given this diphtheria vaccine had waned, and they it waned enough that diphtheria was able to kind of take over and and cause this outbreak. And so when you look at it like that, that's almost a really good analogy to herd immunity. It's like over time, the the the that threshold can be can be can decline so that the virus or the bacteria can get in the same thing. The individual level, if you don't get

a booster shot if you need it. For some vaccines, you don't need it. I think measles, moms, and rubella are all considered UM to confer lifetime immunity if it does work on you, and I think those are nine seven percent effective. So for nine seven out of a hundred people, when you get an mm ARE vaccine as a kid, you don't need any kind of booster and you're gonna be immune to it for life, right, which

is great. It is UM. That's the point of accedence. Yeah, and this is where we need to dip our toe into something UM. That's called vaccine hesitancy. That's that's what the official name for it is UH. And this is a situation we have UM. I'm not sure about other countries because I didn't do a lot of research into that. But here in the United States, especially certain parts of the United States, there are vaccinine vaccine exemptions in place,

granted for philosophical purposes, religious purposes, personal reasons. UM. It is important to point out here that personal reasons get all the press. UM, like when you see articles about anti vaxxer's as people that choose not to get their child vaccinated for certain reasons. But the the largest percentage of people who don't get vaccinated very sadly. UM. It

has to do with UH finances and poverty, right. I mean, like it's it's if you want to vaccinate your kid, but you can't because you don't have the money or they're not available to you. I think kids in rural areas have much lower vaccine rates than kids in urban areas. UM. That is really sad, and I think that's something that because it's such a public health success, UM, it should be something that's much more widely available than anybody who

wants it. Yeah, here's some numbers on that. There was a study by the CDC in that noted the percentage of children without any vaccines had risen to about one point three percent. And these are kids that were born in the year two thousand fifteen, and then they compared that with the two thousand one survey. They found it was just point three percent of children between the ages

of nineteen to thirty five months. So basically they looked at the numbers and they found that the children who are uninsured or who live in rural areas like you said, or maybe had Medicaid insurance. Seventeen point two percent of the unvaccinated kids were uninsured compared to two point eight percent of overall kids. There's a big deaf It is

a huge diff for sure, UM. And then there are, like you said, there's parents who forego vaccinations, uh, for personal reasons or religious reasons, UM, or philosophical reasons, although I don't understand what the differences between philosophical and personal. Yeah, I agree, UM, and I'd be interested to find that out. But the people who don't vaccinate their kids for whatever reason, who make a conscious decision not to are UM tend

to be viewed as freeloaders. And that's not just us like throw in shade, that's like the term that that is used as freeloaders. They're freeloading on the larger herd. To UM, prevent from being exposed to this disease or these diseases or viruses or bacteria, UM, because they're depending on other people to immunize their kids through vaccinations instead.

That's right. Uh. And there's another weird phenomenon that's happened here in the US that where a vaccine program is so successful that generations will go by without any of this disease. So you're not even familiar with it. So it's sort of absurd in this way that it's been flipped. But one of the reasons sometimes you will hear uh to to not vaccinate. It's like, well, that old disease that haven't you know that, we haven't seen that in two hundred years, And I'm gonna put that vaccine in

Mike Kid and a cycle. Yeah, because the vaccine worked, right, It's a victim of its own success. The vast vaccination program is. And I think from what I can tell, that's how UM public health officials typically explain uh anti vaccine or declines in vaccine rates among people who consciously choose not to that basically, they just haven't seen how bad a disease is, Like you haven't seen what polio can do. To somebody because you were born into a

world war. For all intents and purposes, polio just didn't exist, right, And so you lose that incentive that somebody who is aware of what polio can do, um the incentive that that person has to vaccinate their kid. And then when you couple that with um questions about a vaccine or fears that there are some um negative side effects from a vaccine, that disincentive or that lack of incentive becomes

a disincentive to get that. And so there's this ironic circle that develops where those vaccination rates go down, we dip below the herd immunity level, there's an outbreak of that disease, and then the very people who lead to that decline in vaccination levels point to that outbreak as evidence that vaccines don't work or herd immunity doesn't work, and it's it's um. It's hard to wrap your head around.

It is very hard to wrap your head around, especially if you are fully on board the vaccine and UM herd immunity through vaccine trains. It can be fairly galling, I believe. Yeah. And there's a couple of things, A couple of big challenges to herd immunity and whether or not it can work today. And one of them is that we can get on an airplane with our family and we can fly great, great distances and get places

really fast and then come home again really fast. And this happened in two thousand eight with the outbreak in San Diego. That was a family that went to Switzerland in um the this little boy picked up the virus of the measles while he was in Switzerland. Such a bad little boy he was. He was he he was unvaccinated, He got sick. When he got home, he infected eleven other people, including one who was an infant that was too young to be vaccinated. Just if you were like

ambivalent about this through that that little detailing. Yeah, And at first they were like, what is going on here with this weird outbreak because we have a minimum threshold here in San Diego against the measles for her community, and in two thousand it was declared eliminated basically all

over the country. And so they started to kind of poke around this case and they said, all right, San Diego is doing great, but this kid actually goes to a school and his localized social group is about seventeen of them uh at this school don't vaccinate. So while the city was doing fine, his little localized community had a pretty high percentage of unvaccinated kids, and so that allowed it to spread, right, It allowed it to spread.

Those kids became immunized, they became ill, but then they became immunized to the measles naturally from being exposed to it and having fallen ill um. But the big problem is, in addition to the fact that it just kind of ravaged this hyperlocal social group, there are other pockets within the herd that probably bear a striking resemblance to that

social group. And those social groups come in contact with the other social group that's been infected, you can have an epidemic within the larger immunized herd, which you don't want.

You want those people to be protected. But the decline in vaccine rates and the fact that we can travel, like you were saying so easily, not only does it mean that like a virus or bacteria can travel just as fast on on board a human who's on a plane, um, it also means that there's constant fluctuations to the percentage that herd immunity threshold because of the influx and outflux

of people who are vaccinated or not vaccinated. Right, And this is why those vaccination vaccination rates being high is really important, um, because it's it's protecting everybody. Yes, you want a large public buy in to the concept of vaccinations, and when there is not a large public buying, then your herd immunity is under threat and everybody who is

bought in is is um at risk. Because again you might say, well, who cares if you if you've inoculated your kids, if they're immunized against measles, what do you care if somebody else's kid isn't because they have personal reasons against it. Um, your kids find they're inoculated, don't

forget that. With the measles vaccine, I think it's like pcent effective and that that means that if there's a hundred hundred kids in a room and one of them has full on contagious measles, which again is very contagious like the mumps in its contagiousness, three of those kids who have been vaccinated are possibly going to get the measles from that kid even though they were vaccinated, because their body just didn't form the right immune response or

enough of an immune response that they be protected if they were exposed to that kid. So it is a problem for even people who have been vaccinated against diseases to have a decline and herd immunity. And then also, don't forget the people who don't have uh an immune system that can allow for them to be inoculated or vaccinated, and the elderly who are just by virtue of being older, more susceptible to a really hard about with whatever disease

it is they're being exposed to. Yeah, I've been running up against that, that frustrating sort of circular um non logic about COVID Night Team. I'm a member of a Facebook page of a an area and more rural Georgia. That's all I'll say. You could have just stopped at a Facebook page. And there's been a lot of that same sort of um circular logic of well, all these models are turning out to be wrong. They weigh overstated

everything because look at the numbers falling. It's like that's because we social distance and because we did all this stuff and like it worked, that's how modeling works. Like the initial numbers were really high because that was just sort of the starting point, that was the input data was here we are at the beginning, and this can happen this way, and Americans got together by and large at first at least and did the right thing, and

so those numbers went way down and it worked. And then they're using that as proof of like we'll see the modelings just off. They're just guessing. Yeah that a mile away of course. Just yeah, yeah, everything is political, huh yeah, And I'm just you know, I've tried to I've tried to avoid it, but I have also commented at times like modeling is not guessing. It is there. There's real research and math that goes into it, and and that math changes based on the input data. Like

in a month, there will probably be different numbers. And it's not because they're just guessing and they're wrong, right right, Yeah, it's um it's that distrust and expertise that has really

kind of wrecked things quite a bit. Yeah, all right, let's talk about what's going on right now and how this applies to our situation today with the novel coronavirus COVID nineteen call it whatever you want, Well, wait a minute, I think we should institute a tradition in this episode where every time we're about to talk about COVID, we make it a cliffhanger and take a break. Okay, all right, we'll take a break and we'll talk about all that

right after this a shosh and shock. Alright, Chuck, thanks for playing along with me. We're gonna have like fifty ad breaks in here because we're gonna stop every time right before we talk about COVID. Yeah. So, what we're dealing with now in the most recent days, in a couple of weeks, is a new sort of divide has emerged. Um. Everyone got together at first, it seemed like and there was a lot of unity for five minutes, and then

a dividing line has now formed. Um in the United States and kind of in the world, depending on what your view is on how to best handle this, and the two sort of route are and we'll talk about specific example examples of different countries and what they're doing. But there's elimination and then there's herd immunity and vaccinations and not by not pooping, you don't mean pooping. By elimination, I mean getting rid of it, of the of the virus. But not by pooping, no, not by pooping. But we're

talking about a few countries in particular. Everyone's talking about Sweden right now because Sweden, compared to the rest of the Nordic countries, the rest of Europe and most of the rest of the world, was one country that was like, you know what we are gonna say, if you feel sick, stay at home. If you're at risk, maybe stay at home, try and uh keep a safe distance from people. But bars are open, restaurants are open. Um, no big concerts or anything like that, and let's try and get that

herd immunity going instead of shutting everything down. Right. So they're they're pursuing mixture of like social distancing guidelines, but nothing that's being super enforced aside from you know, those gatherings, like you said. But ultimately they're pursuing basically a strategy of herd immunity while trying their best to keep the curve flattened, right, And I think we're pushing this one out sooner, So this will just be out like four or five days from now, and all these numbers are

going to be changing. But the jury is kind of still out on whether or not that's working in Sweden. UM, as of a couple of days ago, they have a far higher infection rate than their Nordic neighbors. UM not, I mean it's a little lower than some other countries to the south. So we just don't really know yet because the jury is still out. We don't know what our our percentage needs to be right now. Like I said, it could be as high as eight percent, So we

just don't know. As these numbers come in over the next month or two, it's gonna be really telling. UM. I think kind of either way you slice it, it's not right to say, all right, we'll look at Sweden and if if it works there, that means it's gonna work everywhere, because that's just not the case. No be in Sweden has like consistently beat this drum. They're like, look, we're not even sure this is gonna work for us,

but we're willing to try it. But we're far likelier to be successful at something like this because our UM population maybe is a little more collectivists than some other populations. They're healthier, They are healthier, they have a big deal a much stronger um and more responsive health care system. They have a more homogeneous population don't forget, which may mean that they could reach HERD immunity more quickly than some other countries that have less homogeneous populations. Sweden is

more homogeneous. They also get this. They also they don't have like huge mega grocery stores where there's a thousand or undred people milling around all at the same time. They have like smaller shops and markets serve like a particular like corner in the neighborhood, and they have them like every few corners, so there's not tons of people in the market at every given at any given moment. There's just a lot of differences between Swedish culture and

say American culture. That's that is giving the Swedes the confidence to try this. But even still, there are people in Sweden that are like, this is indefensibly reckless. We can't do this, we can't try this is a stupid and like you said, there are some early signs that it is not going so well because compared to um Norway, Denmark, and Finland, their death rate adjusted for um UH population size is between three and six times the death rate

of those nations, and those nations tried elimination. Yeah, and I saw that the UM. I don't. I don't think it was like the I think it might have been the head of whatever their CDC is said that they were surprised by the death toll. Yeah, yeah, and not in a way like they seem like really good people, so it's not like, oh, we never thought of this, but I think they were surprised. It is as high as it's been right UM. And so Sweden is not the only one trying this. India is trying it as well,

and they're doing something very similar to Sweden. They have a lot of social distancing guidelines, but are also kind of hoping for natural herd immunity to kick in UM. And they don't have much of a choice there. They have like point five five hospital beds, so a little over half of a hospital bed per one thousand people

in the country, and forty four thousand ventilators UM. But that both Sweden and India are taking a strategy of saying, if you're older, if you're elderly, if you are in this high risk group for suffering complications from COVID nineteen, you stay home too, and we'll let the younger population go out and get sick because they can handle it better and maybe less of a strain on the health care system. Um, and they'll be the immunized herd for

the rest of the population. I don't know if those strategies are going to work or not, um, but that's kind of like the mentality behind them. Yeah. And there are other countries. I think in England they originally we're going to kind of follow that model, and then everyone said no way, bollocks to that, and so they have, um got some stricter measures going. Belarus is the one

place that's really that. The president there, who's been in office i think since, has called the stricter responses around the world mass psychosis, and he's basically like, I mean they're having a full on military parade this weekend and saying, screw all this. Uh. And Belarus has one of Europe's highest per capita infection rates. Yeah, it's like, have any of you even seen there ownavirus and yourself I haven't. Yeah, jeez.

There was a guy on one of this that same Facebook page that said I don't even know a single person who's had it l O L. And I was like, well, you're you're lucky, sir. You should be thankful for that, and he's like, hmm, it's not luck could be something else dot dot dot, and it's just like, I'm stepping out of this immediately. Man, I don't know if I I say hats off to you for being on that Facebook group or just deeply pity you for being on that Facebook group. Well I sort of have to be

because I have to keep up with some things. Uh. This is a another part of Georgia where on a little little tract of land. Oh gotch, So you need to like nobody's squatting on it. Yeah, I'm the only squatter. So. Um So, this whole herd immunity thing, there's herd immunity itself has been controversial, uh since before the COVID nineteen pandemic. Right, those same but who questioned vaccines also questioned the concept

of reaching herd immunity through vaccinations. There's like suspicion that, um, you're artificially suppressing the vaccine and you're actually weakening the immune system, and that it's going to set us up for this horrible problem down the road. None of that

bears scrutiny under logic. Um, but today herd immunity has kind of reached this controversial inflection point for a totally different reason, and that the people who are saying, well, we're going to opt for to try for her immunity now rather than later so that we can get our economy going again, what they're talking about is her community

without a vaccine. Big, big, big difference, huge difference, because what they're talking about is basically reverting back to the pre vaccine thing where it was just like, Okay, I hope we get to herd immunity sooner than later, and a lot of people are going to die along the way. And that's one of the big flaws of this argument of going for her immunity right now, which is there's going to be a lot of people who die as a result before we get to her immunity because we

don't have a vaccine there. We're going to have to reach her community through just exposure to this virus, just like in the old timey days. Yeah, I was about to say, it's as if we were living in ancient times and just sort of crossing our fingers. So lots of death is a big flaw against it. Um If if the reproduction number for stars Cove two is three,

that's confusing. But if it has, If if COVID nineteen has a reproduction number of three, let's say um, and that that means that the herd immunity threshold is about se That's about the high end that anybody's saying is seventy should stop the virus from spreading anymore. Right, So if that's the case, then that means seventy of a population would be sick. And I think a half to one percent of a fatality rate would mean that of the larger population, point three five to point seven percent

of the population will die. So if you know that, and you can take just the populations of some of these countries that are trying this and say, well, before you reach her community, um Sweden, out of your population of ten point to five million people, about thirty six thousand to seventy two thousand are going to die along the way. Statistically speaking, that's the number that you can bet on, Yeah, between one point to five and about

two and a half a million in the US. And if you're going to look at the world population, we're talking numbers higher than the Spanish flu twenty seven to about fifty four million people dead. And that's if you know, we're not saying like that's gonna happen. We're saying that's if the whole world took the approach of just all right, let's just see how we do, you know, right, And and I mean like this, that's we're a virgin population humanity, not just the US, not just Canada, not just the UK,

not just Sweden. The world is a virgin population to this virus because it's a novel coronavirus. We've never no one on Earth has ever been exposed to this particular virus before, so there isn't any pre built in immunity like there would be if it makes another round a year from now, right, So it just burns. Viruses and bacteria burn their way through populations like that. So you

can imagine it would spread, uh, pretty effectively. And if the fatality rate really is a half to one percent, those numbers could be pretty real depending on what what measures we take to mitigate those, Like you were saying, so death that's a big, big problem, um. And also along the way, we would be doing the opposite of flattening the curve by just letting people go out and

getting sick to get things over with. Yeah. I mean, we we've worked so hard to flatten the curve and it worked in most of the most of the United States, except you know, these weird outbreaks in in smaller towns that didn't have enough beds and then laters and that's all been really really sad to see happen. But by and large, we did the right thing for a while and it flattened the curve pretty well. But this would

fatten that curve right back up. Uh, and we'd be in that same like in a worse situation than we were going in, right. So, um, that's another big one. And then also took reinfection is another huge flaw in this. We don't know if stars cove two, which causes COVID nineteen, um,

how fast it's mutating. If it's like other coronaviruses or other flu viruses, it probably has a lot of what's called antigenic drift, where it mutates really rapidly and creates new strains that the antibodies that have built up this immune defense against one variety are useless to fight this new variety. Right. Yeah, some diseases don't do that, like polio. The reason our polio vaccine has been so successful is because it doesn't mutate very much, it doesn't call it,

it doesn't create new strains. With coronavirus is they tend to do that a lot, so there's a real chance for reinfection. So this herd immunity will just be like this ongoing thing until we can come up with the viable vaccine that can that can protect us from basically any mutated variety of this coronavirus. That's right, an antigenic drift. Do I need to say it? No? You don't, great? Great? Oh yeah, Chuck, I think he's for sure that that

muted trumpet thing that they got going on. What's that thing called on the trumpet that they make that sound with. Oh yeah, the plunger plunger head muffler, the thing. I don't know. Yeah, you're on the trolley. So. Uh. The other thing that we need to consider, and that is the other sort of way that you can go about

this is elimination. Elimination that we were talking about, and not pooping, and that is the opposite tactic, and that's what most of the world has done, including the u S, which is self quarantining, isolating, trying to contain the virus, closing borders, mass gloves, all that stuff. Um, we have flattened the curve for the most part. Other countries have

come close to elimination. New Zealand is getting a lot of press because they and you know, they got a lot of Again, you can't say, like, well, the same thing could happen here in the US because New Zealand is a very isolated place and it's a smaller population and they have super smart elected officials and smart people who listen to those elected officials. Good to get no, man, someone come at me news. England's Prime minister is amazing. She's she's like one of the best. Yeah. I remember

when we were there. Um, we got a cabra, do you me? And I did to the airport and this this guy, I think it was an immigrant from Sri Lanka and he just could not stop boasting about how great the New Zealand government was, about how taking care of their population was, how like how much of a sense of community the whole country had, and it was just really refreshing to experience. Yeah it is, Uh, maybe

we should move there anyway. So the thing about New Zealand, Yeah, I'm sure there's some people listening like yeah, why don't you move there if you love it so much? And there's there's also Kiwis that are going come on over, We'd love to have you. And then there's also probably some there like please don't. We've had enough of you too.

So why it worked there though, was because, like I said, they have you have to have everyone on board, and it seemed like most everyone on board or got on board in New Zealand, and that's just not happened here. So yeah, and I mean, it really has worked for New Zealand, but they've taken serious restrictions, like you you can't fly if you want to domestically, they shut down their reports. If you want to fly to New Zealand, t s for you, you're not gonna get anywhere near

the country. But in addition that, if you're a New Zealand citizen, you can't fly from one place to another if you want to just for the heck of it. Right, There's so they've really insted instituted some draconian measures, but it seems to have worked. Like there was a report that came out two days ago on May fourth, that says that the models originally used to project how many cases. New Zealand was going to have said that they were going to get something like a thousand cases a day

if they did nothing like no lockdown measures. All they've had since March is fourteen hundred and eighty seven cases, not a thousand a day, seven cases total, and they've only had twenty deaths. So it seems like elimination can work. And for that reason, and a lot of people are a lot of countries have said this is what we're gonna try, and elimination just amounts to hiding out from

the virus until a vaccine can be developed. The problem is there are serious flaws to that too, depending on what kind of what kind of government and culture that you have. But even without that, depending on that, it requires that everybody act basically perfectly and avoid everybody else and give up your job, give up your economy and wait until somebody comes up with a vaccine. And that

can be a really pricey, costly measure. Yeah, which is why a lot of people are like this, this we got to find some other way, Yeah, And they've looked at um there are like ways you can look at the countries and decide whether or not people are going to comply or not. Um, there was uh some cultural data.

There was a company called half Steata Insights, and they look it things like individualism of a population, basically like whether or not people are gonna all go along or if people are like heck no, man, I want my freedoms. I'm an individual, I'm an American and you can't tell me what to do, right. And you might not be surprised to learn that in Sweden, Uh they have a rank of seventy one out of one hundred as on individualism.

Uh the U scores ninety one out of a hundred, so basically out of a hundred would be uh difficult to maintain. You know, these kind of restrictions for too long. I mean, if you look at it like that, it's remarkable, how it's remarkable, in heartening, how much people have given up individual liberties for the greater good in this pandemic in the United States. Then, like I hadn't looked at it that way. I just kind of saw like one and thought, okay, you know that's that's that's a that's

a high score. There's a lot of individualism in the United States. We gotta into visual streak like nobody's business, right, But if you look at it almost like it's a it's a percentage of the population that will listen in situations like this, then it really does kind of go to show you how how much of a sacrifice people have made, not just Americans. I don't want to just say it like that, Like if you're in a collective

of society, you're still sacrificing for the greater good. It's just possibly a little more culturally ingrained in you that this is the thing to do. But either way, the idea of people people sacrificing for others is is it's heartening. The problem is is people can only sacrifice for so long until you have just massive economic drawbacks. And and that's the thing. So if you follow the forced herd immunity natural herd immunity strategy towards COVID nineteen, you will

it will result in a lot of deaths. If you follow the elimination strategy, it results in a trem in this amount of economic hardship. And it's easy to say, chuck like, well, lives lost tops economic hardship any day of the week, And ultimately, yes it does. But it's you really should not um understate the toll in human misery of economic hardships and how bad this has gotten

for some people and how quickly. Yeah, And the other thing I'll say too, is one of the arguments I've heard is that, you know, there are going to be so many deaths from people who are who are depressed because they can't go out, and people dying by suicide and stuff like that, which you know, I don't want to minimize that because that that for sure has an

impact on people. But I saw a tweet from a guy that was talking about can we just stop pretending that our former world of like working fifty hours a week and commuting in a stressful environment and hectic crowds and mask consu umerism and pollution and everything else was like a mental health utopia. So it's you know, you've got to kind of look at the big picture and not just pick and choose what you're going to highlight

because it fits your narrative. You know. Yeah, I think one of the like the few good outcomes so far of this has been like a huge down shift in that um manic productivity that drives most Americans, you know. Yeah, And you know, here's The thing is, we don't know. Everything is so new. We're not gonna sit here and pretend like there is only one right way, like, we

don't know. So there's so much that we don't know about this is we don't know the exact right path forward yet as a population, and the medical community doesn't know the exact right path forward. We're all trying to figure this out in real time and build the road as we're driving on it or whatever that expression is. And you know, I have my money on uh, staying at home, slowing this thing down and elimination. Other people might feel a different way, But it seems like that

way is working better. Yeah it is. But again, if you it's still early and the data is still coming in. There was a report this week of a hundred New York hospitals. They found that six or six percent of new cases where among people who had stayed at home and mostly followed the elimination strategy. So this one guy, this doctor who wrote an article that I read, Dr

Stephen Phillips. He said, look, man, like, in addition to all the stuff that we need to be doing to handle this pandemic, let's also create like a really robust data sharing um arrangement, so that we can look back a year or a few years from now and study this and say, oh, actually, these countries followed elimination mixed with the social distancing guidelines, or they followed herd uh immunity pursuit um and they actually came out on top. So that we will know the next time which one

actually does work. Taking everything into account the cost in lives, the economic cost, the cost and personal liberty, and find the best way forward. And it probably won't be a panacea where everything works like one thing works for every country, but we'll have a pretty good model hopefully that can be adjusted to suit the individual country that's adopting it. Hopefully. That's if we can get past all of the arguing

over whether this is even real or not. Yeah, and I know it's hard right now, but I think that the most dangerous thing right now is to have the mindset of, well, you know what, I'm pretty kg and the weather is nice, and I don't know anyone personally who's gotten it, so I'm just sort of going to ease back into normality here. I think that's that's when the second wave comes and things get worse and it's tough, uh, and everyone is anti and KG myself include did you

know I find myself wanting to do things. Um, and it's tough on on kids especially, But I think it's more important now than ever to keep up what's what we're doing. Yeah, we haven't just magically wished the pandemic away. It didn't work. No, and lovely weather. Um, you know to take your walks, get outside, do it safely, but that it is not a reason to be like, well that's old news. Now we can just go back to normal, right right. I saw a post to button it up.

I'm sorry we keep going back back and forth on this, but I saw a post that said, um, easing of lockdown doesn't mean that the pandemic has gone away. It means that they have a hospital bed for you now, right exactly? You got anything else? I got nothing else? Man? All right, Well that's it for her community. Hopefully you guys learned something I definitely did from researching all this, and we hope everyone out there is staying safe, insane

and uh, hanging in there. That's right. Uh. Since I said hanging in there, it's time chuck for listener mail. I'm gonna call this thanks from England and a little shout out. Hey, guys, I wanted to say thank you, thank you for your ongoing efforts with Stuff you Should Know. It's been a welcome distraction at work. I, along with so many feel like we know you guys so well with Stuff you Should Know and Chuck's movie Crush and

Josh's Into the World podcasts. I hope your families remain safe and from my son Dexter and I we wish you all the best for yourselves in the future of the podcast. Sorry to ramble on, which, by the way, Ben, that was not rambling on. That was concise and beautiful. But you're from England, so you're very kind. Uh. Sorry to ramble On, but I was wondering if you would be kind enough to shout out all the UK NHS

staff that are helping us over here. I have friends and family that work for the NHS services and this is the only way I know how to say thank you, So for sure, Ben, thank you to not only them, but to medical providers all over the world who are working hard risking their own lives UM, often with UM equipment that's being reused when it shouldn't be and uh,

I'm not going to wade into those waters. But you don't have all that you need to do your job right now and that's terrible and we should not be in this position. But we are so thank you. Uh. He also says ps Torquay. We heard from a bunch of people on this uh you mentioned the other week and I think that Agatha Christie segment we would pronounce it tour as in tour bus and key Torquay. It's always fun to hear how everyone pronounces these bloody silly

towns over here. Kind regards. That is from Ben Cleaver and Harrowgates, England. Hirogaty Ben. That was such a good email that we are now friends. That's right, thank you for that. That was much needed man Um, thanks a lot for that, and we will very happily shout out the entire NHS, especially all of the people who are out there on the front lines working to save people's lives against COVID nineteen or anything that happens to it

befallen them. That's right, Um, Thanks again, Ben, And if you want to be like Ben and get in touch with us, whether you want to tell us to stop being so political, or you want to tell us that you think we're great. It doesn't matter. We want to hear from you. Either way, You can email us by sending one to Stuff podcast at iHeart radio dot com. Stuff you Should Know is a production of iHeart Radio's

How Stuff Works. For more podcasts for my heart Radio, visit the iHeart Radio app, Apple Podcasts, or wherever you listen to your favorite shows.