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Countering the Second Wave with Facts, not Misconceptions

by Udi Qimron, Uri Gavish, Eyal Shahar, Michael Levitt

On March of this year, the UK government seriously considered avoiding a lockdown, but changed its mind abruptly after mathematical models, presented by Prof. Neil Ferguson, predicted baseless doomsday scenarios. The same type of models predicted that in Sweden, the number of deaths from COVID-19 would reach about 100,000 by June, if
the Swedish government continues to refuse toimpose lockdown measures.
Sweden rejected these models and bravely adopted, although withcertain initial failures, a democratic policy that broadly enabled normal life to continue. Despite the large nursing homes in Sweden, insufficient early protection measures for them, and instark contrast to apocalyptic forecasts – the number of deaths turned out to be 6% of
the onepredicted, about 6,000 people, at an average age of 81. Half of the victims were nursing homeresidents who, in Sweden, have a median life expectancy of 9 months after admission. If a similarpolicy were to be adopted in Israel, for example, this figure of 6,000 places an upper limit of 3,000 deaths, because the size of the Swedish elderly
population is more than double that of Israel. Forcomparison, more than 4,000 people who contract pneumonia die in Israel every year – that is, anaverage of more than 10 people per day. The spread of the COVID-19 epidemic in Sweden has reached its saturation point without fulfillingthe well-known, but erroneous, threshold of infecting 60% of the total population – the presumedrequired level for herd immunity. How did this happen?Contrary to a popular belief, theSwedish policy did not set the goal of causing as many people aspossible to become infected. Its goal was, and still is, to enable a sustainable degree of normal life,while recommending that vulnerable people take
precautions and allowing others to be exposed tothe virus and develop immunity. The latter, who made up less than 20 percent of the population,complemented the natural immunity to the virus that already existed in the population, thus arrestingits spread.Israel and other countries that facea second wave can adopt a policy similar to Sweden,
or evenbetter. Such a policy may provide a fast exit from the crisis and reduce the number of victims. We firstlist counter-arguments. Three arguments against exposing low-risk population to the virus

  1. Acquired immunity following infection is short-lasting, and therefore should not be relied on.
  2. In order to reach the saturation point of the spread of the infection, 60% of the populationmust be infected – an intolerable percentage.
  3. The death toll of such a policy will be higher than the death toll of the alternative – namely, cyclic imposition and easing of restrictions, according to observed rates of infection.We unequivocally reject these arguments because scientific evidence indicates that the exactopposite is true.

All three are based on misconceptions, and those who have conceived these fallacies continue to hold on to them, leading many countries to human-made catastrophe. We refuteeach argument next. Infection with COVID-19
results in long-termimmunityThe first argument – infection does not result in long-term immunity – stems from incorrect reports about re-infection in people who have recovered from a first one. Dozens of cases of re-infection were discovered in South Korea several months ago and caused a great deal of panic. All of theserecurrent infections
turned out to be testing errors (falsely positive) due to inability of the standard PCR test to distinguish between a live virus and its residual genetic material. Of more than 20 million people infected, only few cases of re-infection have been reported and the possibility of a testingerror has never been properly excluded. That almost no re-infections have yet been established aftermillions of infections overwhelmingly indicates that immunity is effective for at least 8 months afterinfection (the time since viral emergence). We see no reason to assume that immunity to COVID-19
will fade away quickly, since immunity typically lasts for years.
There is nothing to suggest it will beany different in this particular case. Widespread infection is not required for stopping the epidemic. The argument that 60% of the population must be infected and becomes immune before the infectionspread is halted is based on an incorrect mathematical calculation. That calculation relies on twomain
assumptions:

1. The contact rate with others is the same for each person in a population

2. COVID-19 is a completely new virus, and therefore, there is no prior immunity. Any exposure to thevirus will
lead to an infection. Recently, Science, one of the leading scientific journals, published an article that highlighted theabsurdity underlying the calculation of the 60 percent threshold. The authors state an obvious fact: Asfar as contact rates are concerned, people do not interact identically with other people; some havemore contacts than others. For example, a cashier at a supermarket and a taxi driver meet manymore people than the average retiree. Since people with many social contacts are key factors intransmitting the virus, their immunity will contribute to stopping the spread of the virus more thanpeople who have little contact with others. The former get infected sooner and become immunefaster than people with low contact rate, so the spread of the virus reaches saturation at a level that is significantly lower than 60%. Again, the latter is founded on the false assumption of uniform socialcontacts for all members of a population. The most significant evidence – decidedly refuting the need for 60% infection rate – is pre-immunity.For example, COVID-19 has several relatives (other coronaviruses) to which the population had
beenexposed, and such prior exposure can provide immunity to a significant segment of the population.Back in April, two of us wrote an article about the postulated nature of this immunity and the statisticalevidence that pointed to its existence. We noted that in several closed communities that underwenttesting, the infection rate was always capped at 20%, which statistically aligns with maximal infectionrate in these communities rather than recurring coincidences.
About a month later, a group ofresearchers published corroborating evidence in Cell, one of the most prestigious journals in the life sciences. About 60% of people in California who had never been exposed to COVID-19, had immunememory cells that recognized the virus and are therefore likely to provide immunity. Moreover, a study in
Germany showed that such immunity could reach a level as high as 81% of the population.We assume that the situation in Israel is even better – for example, due to the age distribution (younger) and the number of children per household (higher). The above figure implies that less than20% of the Israeli population is susceptible to an
infection with the virus, while the vast majority isimmune. A survey of cellular immunity is urgently needed to estimate the level of this type ofimmunity in Israel and in other countries.This rate of pre-immunity to COVID-19 is also evident in the global rates of infection. The virus beganinfecting humans more than eight months ago, and the epidemic has already spread to most of theworld. Yet in all countries, the infection rate remains below 20 percent of the general population. This limited rate of infection has remained unchanged regardless of social distancing measures (if any),such as quarantines, local or country-wide lockdown, mask-wearing, and so on. In Sweden, for example, the infection rate did not exceed 20% and the percentage of people who survived the epidemic exceeds 99.9% (!) of the population. Such is the case in Belgium as well, the country with the highest population mortality rate, where less than 20% were infected, and more than 99.9% of the population has survived the epidemic. Assuming that approximately 80% of the Israeli population have some sort of cellular immunity –whether due to previous exposure to coronaviruses or for genetic or other reasons – we estimate that the epidemic will naturally fade away when 5 to 15 percent of the population is infected. The implications of these findings are of utmost importance.

(https://www.dropbox.com/s/72hi9jfcqfct1n9/Haaretz-20Jul20_ENGLISH%2012082020%20v3.pdf?dl=0

Haaretz-20Jul20_ENGLISH 12082020 v3.pdf)

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