Trump is pursuing a herd immunity strategy — whether intentionally or not

The coronavirus pandemic is still raging in the United States. Daily new confirmed cases have been over 20,000 since March 28, and daily new deaths have been over 1,000 (and often over 2,000) since March 30, with no sign of sustained decline. And yet many states, encouraged by President Trump and his administration, are rolling back their lockdown measures.

In many of these same states, new cases are still surging, especially Texas. Mississippi retreated on its rollback when it experienced an influx of cases. Trump is driving America directly into a coronavirus sandpit, and it's hard to see any way it can be avoided.

A background condition of Trump's position here is the small minority of people who have been protesting furiously about coronavirus containment measures for weeks. The implicit logic of these protests is extremely strange. They are acting as though the lockdowns are something liberals are doing basically for fun, and therefore an intolerable infringement on their personal liberty. In reality, everyone hates the lockdowns. Everyone desperately wants to be able to see their families, catch a movie, or go to a restaurant as soon as possible. They just — and it may be necessary to remind people of this point — don't want to get severely ill or die, or infect others with the virus.

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Several other countries have already demonstrated the way to accomplish this.

What you need is severe lockdown to contain the spread of the virus (and to prevent your health care system from being swamped), and in the meantime you build up a "test, track, and isolate" apparatus that can squelch any subsequent outbreak before it gets out of hand. Anyone with symptoms must be tested, as well as a regular random sample of the population. Positive cases must be moved to an isolated quarantine facility so they don't infect their families, as well as anyone they came in contact with when they were contagious. If you catch a high enough proportion of new cases, then the virus can be throttled.

The basic idea is to go from flattening to "crushing" the infection curve — not just spreading out cases to protect health care capacity but drastically reducing their number. The faster and more aggressively the government moves, the faster things can return to something like normal. Indeed, Taiwan and New Zealand have both virtually eliminated their outbreaks using these measures. Then you just remain cautious until a vaccine is (hopefully) developed, and fully normal life can return.

The conservative anti-lockdown complaints are thus a self-defeating fit of childish foot-stamping. We were already seeing increased case numbers in several of the states that are relaxing lockdown orders, because the virus is still spreading in the wild (and many people are only halfheartedly following the recommendations, which aren't nearly rigorous enough anyways). That means numbers are likely to only get worse and state economies will remain effectively in partial lockdown no matter what governments do, because most people will not go about normal activities with a pandemic on the loose. We can't just will the virus away.

Protests aside, American officials at all levels of government seem completely oblivious to the situation in civilized countries or the arguments about test, track, and isolate. They reacted in blind panic to the pandemic, and then when it became costly to keep containment measures going, they are blindly relaxing them long before the virus has been controlled. Only a few states like Oregon are even talking about contact-tracing measures, let alone isolated quarantine, but realistically for this to work it would have to be the federal government doing it, given the expense and the fact that people can move across state lines at will. That sort of coordination is nowhere in sight.

However, there is a darker possibility. Officials could be pursuing a different strategy to defeat the virus: herd immunity. If roughly two-thirds of the population contracts the virus (and if the resulting antibodies are both universal and long-lasting, which is not at all clear), then statistically the virus will not find enough new victims to perpetuate itself, and will eventually die out. The New York Times reports that even as Trump urges states to re-open, his own analysts behind the scenes are predicting 200,000 daily new cases and 3,000 deaths per day by the end of June — which is what someone pursuing a herd immunity strategy would do. The problem is that, as scientists Carl T. Bergstrom and Natalie Dean explain in the Times, it will take months for the statistics to shake out, and the eventual infection rate will rise well past two-thirds — likely about 80-90 percent. With a U.S. population of about 330 million and the most recent estimates of infection fatality rate of about 1 percent, that means something like 2.6 to 3 million Americans dying.

That rate is not well established so far, but even half or a quarter of that number would be cataclysmic. Yet it is hard to avoid the conclusion that is where the United States is headed, unless a vaccine is developed and moved into mass production at unprecedented speed. (Trump has boasted about supporting vaccine development, but he has done nothing serious to make that happen. The only concrete proposal reported so far is immunizing pharmaceutical companies from legal liability in case their test vaccines cause death or injury.) Even if Trump is not actively aiming at herd immunity, there is no indication that he is even considering the test, track, and isolate option, let alone starting to construct the elaborate and efficient bureaucracy that would be needed. Neither is there any sign that he would be capable of doing such a thing even if he wanted to. Absent major developments, it seems highly likely we are going to keep bumping along with moderate levels of new infection for months or even years.

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