"Herd Immunity" is Epidemiological Neoliberalism

Update: Meanwhile the Netherlands has also officially distanced itself from this approach. However, the point of this article is to unravel the underlying paradigm of this strategy, not to make an argument about its effectiveness.

While most European countries are preparing for lock-downs to stop the spread of the coronavirus, a few countries are opting for a different strategy: herd immunity. Instead of testing as many people as possible and implementing measures to increase social distancing, they want to purposefully let the virus spread among people who are at low risk, so that a large part of the population becomes immune. This approach was first proposed by UK’s prime minister Boris Johnson, who refused to implement social distancing measures until a few days ago. While the UK has officially distanced itself from this strategy, the Netherlands and Sweden continue to hold on to this approach, despite harsh criticism by the WHO.

These countries argue that building herd immunity is the only long-term strategy for dealing with the virus, since the epidemic can no longer be contained and could always resurge again. Instead of putting the entire country under lockdown, only at-risk populations should be put into quarantine while the epidemic keeps spreading. However, countless epidemiologists and virologists have criticized the strategy for being risky, unscientific and likely to result in a high death toll. A recently published report by the Imperial College London, which led to the change in UK government policy, estimated the strategy to result in 250,000 deaths in the UK. Since it is not possible to effectively isolate at-risk populations, especially when the virus keeps spreading, the health care system is likely to become overwhelmed and at risk of completely collapsing.

Epidemiological Neoliberalism

Why would a country like the UK even consider such a risky strategy, and why are other countries still following this approach? The reason is neoliberalism. Since the 1980s, we have been governed by the political paradigm of neoliberalism, which has replaced state-led social policy with privatization and deregulation of the market. Its belief in the inherent justice of the market has led to a political rationale, which literally puts profit before people. And it has colonized peoples’ minds by making them believe it is their fault if they are poor, precarious or unemployed.

The irony of neoliberalism is that it creates the illusion of social mobility, while reinforcing and even deepening social inequality. It assumes that if anyone can “make it” in a free market, it must be peoples’ own fault if they are poor. But this belief is not only wrong, it is also violent. Neoliberalism has resulted in the rich getting richer, and the poor suffering more from disenfranchisement, precariousness and dependency. What might seem like laissez-faire policy, is a refined and complex system of automated structural violence against the weak, which also shatters any possibilities of resistance.

Herd immunity is epidemiological neoliberalism. Much like the unconditional belief in the free market, herd immunity relies on the assumption that an epidemic is best overcome by leaving it unregulated. But just like neoliberalism, it results in violence against the weak and the poor: elderly and disabled people, homeless people, refugees and people with severe health conditions – many of whom are likely to also have a lower socio-economic status because of the correlation between poverty and illness. These are the people, who are at the highest risk of dying from COVID-19 – especially if the healthcare system is overwhelmed and doctors have to perform triage.

Crumbling Welfare States

It is no coincidence that it was the UK and the Netherlands, two of the most neoliberal countries in Europe, which advocated for this approach. These countries have spent the past decades implementing policies that privilege economic over social interests, and systematically defunded healthcare, education and housing. Opting against economically-harmful lockdown measures fits perfectly into their political rationale. Sweden, however, is a more puzzling case: it is a country which is internationally acclaimed for its good social policy and generous welfare state. But even an archetypical social democracy like Sweden has not been immune to neoliberal policy. Like most European countries, its welfare state has systematically been dismantled in the past decades.

The biggest challenge of the corona-epidemic is “flattening the curve”, so that the capacities for critical and intensive care are not overwhelmed. But these three countries already have such low capacities for critical care, that they wouldn’t suffice even with strict lockdown measures. The UK and the Netherlands only have about half the capacity of Italy of critical care beds per capita. And Sweden, the supposedly best welfare state in Europe, has even less than half.

Numbers of critical care beds corrected for size of population (per 100,000 inhabitants) for European countries  
https://www.researchgate.net/figure/Numbers-of-critical-care-beds-corrected-for-size-of-population-per-100-000-inhabitants_fig1_229013572

If these countries wanted to prevent their capacities from being overwhelmed, they would have had to act a long time ago. But that ship has already sailed. Enforcing strict lockdown measures would not only put the economy under strain, but would also expose the crumbling health system from decades of neoliberal policy. Opting for herd immunity allows governments to blame the failure of the health system on the virus, rather than on bad governance. Just like individual poor people can be blamed for not trying hard enough, individual sick people can be blamed for not following quarantine measures. It doesn’t matter whether its nature, fate, or one’s own fault – as long as it’s not the government which is held accountable for peoples’ deaths.

Herd immunity is not just bad science or bad policy. It is biological warfare. Many people will die because of it, and governments won’t take responsibility for it. But this strategy did not appear from nowhere. It is a logical continuation of the political rationale that has governed the world for the past decades, taken to an extreme as a laissez-faire social darwinism. Because people who trust in an unregulated market will also trust in an unregulated epidemic – even if it kills.

This article has been translated to German, Dutch and Turkish.

61 thoughts on “"Herd Immunity" is Epidemiological Neoliberalism

  1. Steven Bebee

    Hard to argue with Sweden’s numbers compared to any other country implementing the policies you are biased towards.

    No one has experience with a situation like this, of this scale. Deriding a country for not trying your preferred best-guess approach is hubris. The reliance on social distancing policies implemented in the dumpster fire that is Italy should have people considering what other approaches may be worth attempting. Clearly they are neither compatible with society nor sustainable economically.

    Liked by 2 people

    1. I can go forever into details but since

      Which “hard numbers”? They stopped testing long time ago! And obviously not counting any corona related deaths (‏ARDS, heart attacks, lung failure etc.). I can go forever into details but since I have 4 doctors in my family you will just have to trust me on this one.

      In addition, Sweden have a long record of hiding data that is not suitable for their agenda. It’s a Top to Bottom country which means that you don’t question the government decisions…you just follow.

      Wishing everybody well from Copenhagen, Denmark.

      Liked by 1 person

      1. Frank

        “Trust me, I have 4 doctors in my family (and therefore know pandemic related things)” is a very cheap way of avoiding other (potentially valid) opinions to stay affirmed in your own beliefs. If anything, it reduces the credibility of your statement and shows that you are not willing to discuss based on factual knowledge. What if Steven also has 4 doctors in the family, but didn’t mention this?

        Liked by 4 people

      2. Jon

        That Sweden has “a long record of hiding data” is an outrageous claim. As far as I know Sweden ranks among the absolute best as far as government transparency, corruption and dependability goes. It frequently ranks top 3 for business because of this dependability and trustworthiness.

        Sweden’s corona-deaths are comparatively very good and the country is effectively containing the disease.

        If you have sources that prove otherwise please post them. From what I read, Denmarks top epidemiologists agreed with Swedish experts that, for example, closing schools is not very effective.

        The difference is that politicians in Sweden don’t usually interfere with the opinion of their experts.

        We shall soon see. But Swedens policy so far rely on the public taking responsibility and practicing social distance themselves, rather that laws forcing them. So far it is proving very effective.

        Liked by 4 people

  2. Is it hard to argue with Sweden’s numbers? Numbers of what? They have about half the European average number of critical care beds.
    The fact is that a number of states have deliberately reduced spare capacity in their healthcare systems, gambling that something like an epidemic or equivalent event, would not take place in the forseeable future.
    Simultaneously, publicly-provided healthcare has been progressively privatised, so that it’s priorites move from maintaining personal quality of life (this being the ultimate purpose of any sane society) and, to that end, keeping people healthy (which, incidentally, contributes to the wellbeing of the economy as a whole).
    Market-led ‘reform’ of the National Health Service, in the UK, has led to a wasteful internal market, which generates duplication and bureaucracy. It has also spawned fragmentstion of the service, and a geographic lottery in standards of care. Contracting out of services has lined the pockets of private investors with public money, whilst privately-operated public facilities have been allowed to go bust (then get bailed out by the taxpayer again).
    While it isn’t guaranteed that an adequately-funded, fully-publicly-operated NHS would have conquesred something like COVID-19 in a few weeks, we would have been fa better placed than we find ourselves now, after 40 years of policy that puts the accumulation of surpluses in the hands of the few ahead of the needs of the majority.

    You can wake up now: the rant is over, while I draw breath…

    Liked by 3 people

    1. Steven Bebee

      Numbers of infected and dead. I would have thought that would have been obvious. Then again someone just launched in to a self-admitted rant about healthcare reform (maybe? hard to make out the point), so apparently not.

      Sweden’s risk-group targeted mitigation efforts have produced quantifiably better results than countries relying exclusively on indiscriminate social distancing and economic self mutilation. The numbers are publicly available. Review them yourself.

      Even China, whose numbers are either believed or dismissed based on the strongly held opinions people are typically looking to validate, only locked down Wuhan.

      Sweden or China. Give me those policies. Give me something that works, and keep a global economic depression of a degree never seen in history at bay.

      Liked by 3 people

      1. Jacopo Fiorancio

        I, like arguably everyone including you, just don’t have enough data to draw conclusions. We know that the health system in Northern Italy is near to collapse when the real total cases are in the highest projections approx 1% of the population, so nowhere near 60%. We know little to nothing more than that, and comparing completely different systems in what are likely to be delayed timeframes is just laughable. Every speculation so far as has been proven wrong, from the early optimism in the effectivenes of mitigation attempts in Italy (I’m from there, and the lockdown was not a hasted early measure. It was put in place when the numbers were already unsustainable in many provinces, with a lot of exceptions to preserve the productive capacity) to the arrogant trust in the superior civic sense in the NL (where I live. The “light” lockdown was predicated on people’s capacity to social distance themselves effectively without an imposition. It didn’t happen). All in all now we can just take note of a long series of mistakes and of the very few positive indications (South Korea?). You can celebrate Sweden’s success as much as you want – I hope you are right and the situation remains in check there – but that says nothing of what would have worked elsewhere, especially when the first sound articles by epidemiologists are starting to prove how hard to contain this epidemics is (check Science). What you wrote just shows your own analytical liberties, wishful thinking and tactless vocabulary (calling Italy a “dumpster fire” today is disgusting).

        Liked by 3 people

      2. Steven Bebee

        @Jacopo

        The analytical liberty being taken here is claiming that a known result (social distancing and crippling economies has not achieved the desired outcome) would be different based on an unknown (but they would have worked great had they only been implemented sooner).

        People around the globe, those who truly care about the well being of humanity, should be begging leadership to change course. Find a middle ground. Find a solution that is sustainable and as effective as possible. This is not a choice between harm and no harm. This is a choice between immediate harm, and an increasingly greater harm that will last for generations.

        Those who continue to clamor for staying the course or for even expanding the failed policies that are being pursued are complicit in and culpable for destroying the futures of coming generations. Look back five years from now. The families living on the street, the legacies of suicides, the crushing poverty that will directly lead to increased mortality – the outcome of fear based decision making and those who cheered it on.

        Liked by 2 people

      3. Jacopo Fiorancio

        Steven, it was obvious you wouldn’t budge even in the light of completely ungrounded claims: how do you know mitigation will work a month from here? What evidence do you have besides the Swedish experience (and the Chinese story reformulated to support your thesis?)? How are you planning to quantify the ethical and political scar millions of death the policy solution you support would leave behind across Europe? Because, you like or not, it is indeed known that a blander mitigation strategy would have already brought Northern Italy’s health system (second in the world after France if we are to believe to these ratings) to collapse. And I state it again: none of the governments that have already imposed lockdowns would have done it if there was the slightest chance to continue going on as before. One liberal after the other had to concede that the health systems could not take the hit. I hope the bubble you live in will stand up long enough to allow you to be the last one illustrating everyone else how to cut losses. No one here wants the demise of the economical system, and no one needs teaching about what the consequences will be. Enjoy your certainties until they last.

        Liked by 1 person

      4. Stefan

        What exactly is that Swedish success you are talking about? The virus was recently brought in here and we haven’t mitigated shit yet. Rather people have been told to continue hanging out in bars and take public transportation to work. Our hospitals are preparing for the big hit one week away. No success has been achieved at all.

        Liked by 1 person

      5. China locked down the whole country not just Wuhan. Why are you spreading false information? People have been in their home even in provinces with < 100 cases.

        Like

      6. China locked down the whole country not just Wuhan. Why are you spreading false information? People have been in their home even in provinces with < 100 cases.

        Also, the claim you are making about people on street is nonsensical. House are not being destroyed. There won't be less need for work. These things you fear can only happen in absence of a clever redistribution of resources – which are not disappearing all of a sudden.

        Liked by 1 person

      7. Ryan K

        Steven, Sweden’s risk-based strategy has produced results that put it in the top-10 for mortality rates (close to Canada). The Netherlands, who pursued a similar strategy as Sweden, has the 9th highest number of cases/1 M population and the 5th highest mortality rate at 4.5%.

        As others have also pointed out, Sweden are very, very early in the disease’s life cycle and they could very well end up looking like the Netherlands. Sure, their economy hasn’t been crippled, but if the Swedish strategy ends up panning out like the Netherlands, I’d say that’s an awful trade-off.

        PS> We will not be able to have complete confidence in Sweden’s numbers because they are only testing (and thus attributing deaths to COVID-19) if you have severe symptoms.

        Like

  3. Stal

    So, judging from that graphic and your logic, I guess the most left-wing country in Europe is also the most neoliberal of them all. Loved the post’s title, though. Yet another chapter for the next edition of the “Everything I Don’t Like Is Neoliberalism” handbook.

    Liked by 1 person

  4. Paul

    China was successful in containing the virus in Wuhan. This is shown by numbers. China’s government took drastic measures locking down everything, all movements and all productive activity, not just social gatherings. Wuhan is a area of 60 millions of people, almost an European nation. The problem I see with building herd immunity is that it makes it impossible to succeed in containment and isolation policies. If you have an area where the virus spreads freely, from there, until the herd immunity has not been achieved, the infection can at any moment spread. This means that either all countries choose achieving herd immunity or those countries choosing it have to be completely isolated. The consequences on the economy of the isolated country shall also be negative.

    Like

    1. GrowBagUK

      Herd immunity is not going to happen without vaccines. We didn’t all just get immunity to polio, or flu through exposure. Virsues mutate quite fast; already many strains of Covid-19. This is not just going to go away in a year or two.

      Like

  5. Andrea Paz

    Yeah every global health expert is crying over the lack of testing testing testing everyone.
    If we don’t know, we know this system is prepare to save few, if any at all.

    Like

  6. Horrible article. All judgment and no solutions. Herd immunity is a cruel proposal, I completely agree, but people are scared of going into poverty and we need to know that the remedy won’t be worst than the disease. Questions must be asked, even stupid, unethical sounding questions, and they must be answered by experts not by some with a passion for “Yiddish revolutionary music” more ready to judge and chastise than to offer a solution. There are 11 million illegal immigrants in this country, many of them (most of them) don’t have access to a bank account, credit cards, etc. How are they going to survive? What are people going to do in Latin America, India, Africa? How are they going to survive if they cannot work and they will not receive government assistance like most of us will? We ned a true assessment of all the risks, not only the sanitary risk. This question is not going to be solved by ordinary people arguing on the internet, it requires an interdisciplinary approach. Yes, health authorities, yes, experts on ethics, but also economists and psychologists (and I mean honest economists not the crooks working for Trump). We need a cold assessment of the risk of driving the world economy to collapse due to a prolonged quarantine and compare it to the risk of driving the health care system to collapse. It must be a compassionate but well reasoned decision, and probably not an “either or” solution but a compromise. Hungry and desperate people are not going to cooperate in the long run. I’m not saying, let’s break the quarantine, what I am saying is that we need to ask difficult questions: what will be the lesser evil? What would be a good compromise? Doctors are already choosing who to give a respirator. We may be condemning a generation of healthy young people to levels poverty not seen since the Great Depression. To a surge in crime. Then again, maybe not, maybe this won’t last too long. Let’s stop judging people for being more scared of losing their homes and ending up in the street than of getting sick and offer them an alternative. We need certainty, not judgment. This article only shames and guilts and offers no comfort to those scared about the economy, and when you live paycheck to paycheck, you are fucking scared and have no room for compassion. Altruism follows from a cost-benefit analysis of helping the other. If the cost is too high, you cannot help. Rich people can afford altruism (even if they not always show it). Poor people not always can. When we shame people for asking difficult, uncomfortable questions, they stop asking asking those questions. However, their minds don’t change.

    Liked by 5 people

    1. Andrei

      What if the world economy is just a convention that we don’t actually need. We have 7.8 billion people on the planet. We have food and shelter for more than that. Why keep it in the hands of some of them in the name of some stupid recent inventions in the history of human kind.

      Liked by 1 person

    2. Berthe

      Hello. I think you are missing the point of the article slightly here. The finger is not pointed at those struggling to stay afloat during a lockdown (the poor, undocumented migrants etc.), but at the system. The system that wants changing is “neoliberalism”, whose two relevant characteristics here are: 1. the self-regulating free market (where everyone strives for his/her own profit, with the hope that the social good – medical and ethical – will be taken care of automatically); 2. everyone fends for him/herself (therefore it’s your own fault if you don’t do well or survive). This system encourages selfish rather than communal behaviour and thinking. An unregulated market in which rich people get to hoard wealth leaves the poor to suffer, just as an unregulated epidemic leaves the weak to suffer and die. Resisting neoliberalism means working as a community to redistribute resources and safeguard human welfare.

      I think the author would agree with you here – that we need “Yes, health authorities, yes, experts on ethics, but also economists and psychologists (and I mean honest economists not the crooks working for Trump).” We can’t change the world overnight, but there are short-term and long-term efforts to think about. For example, in the short-term, we can nationalise private resources (such as private hospitals/beds/medical resources etc.); set in place quarantine measures (not herd immunity! which will kill the weak); ensure those precariously employed have paid sick leave/given minimum income to tie them over this phase; perhaps even suspend rent for those who would be unable to pay during this pandemic etc. Some of these measures are in fact being taken in some countries. But, as you point out, without a holistic approach many will still suffer. For example, shutting down small businesses can aggravate poverty. This is the very reason why we need to move away from the neoliberal model. It doesn’t make sense that we have billionaires and poor – even starving – people side by side on the same planet. It doesn’t make sense to expose the weak/old/poor/undocumented to be killed off by this virus.

      Liked by 3 people

    3. Boris Stankovic

      You want solutions? Here is one:

      Test. Test. Trace. Isolate.

      This requires a large Task-Force to implement and follow through = EMPLOYMENT, meaning services and revenues running.
      Initially it seems a must to lock-down everything, until this Task-Force is up and running – after that the country can continue to operate at something like 80% of normal levels (keep some healthy social distancing), keeping on eye on any new cases, or corona strain mutations.

      Like

  7. jochemspek

    “herd immunity relies on the assumption that an epidemic is best overcome by leaving it unregulated” That is utter nonsense wrt the current situation. First, herd immunity is an effect of the phase-transition that occurs in network connectivity when enough links are made (or broken) (NB by Erdős, see https://en.wikipedia.org/wiki/Evolution_of_a_random_network), any assumptions about regulation of the spreading for this to occur are political at best. Second, nobody except the most disingenuous in the Netherlands suggests to let the virus spread unregulated.

    Liked by 1 person

  8. Pingback: Die Strategie der Herdenimmunität ist die neoliberale Antwort auf Corona

  9. Emm

    No clue about what neoliberalism is…no idea about policies implented the last 40 years but blame it all in neoliberalism. You know policies around the world the last 30 years were mostly in the sphere of socialism…Check what neoliberalism is, what its fundamental principles are and i am pretty sure you would consider rewritting this blog post.

    Like

  10. josephAnderson

    The act of opting for herd immunity is the act of saving smaller and medium sized mom and pop businesses. That’s the opposite of neoliberalism. Throughout full lockdown measures we’re watching lifelines sent the largest corporations while more everyday citizens slip through the crack in larger numbers than 2008. That’s Neoliberalism. It’s worth looking into WHO director Tedros Adhanom. He’s a corrupt technocrat with blood on his hands. Perfect Neoliberal play thing.

    Liked by 1 person

  11. Alejandro

    Guys, this ISN’T something “entirely unprecedented”. In Mexico, ground zero for H1N1 a decade ago, we had lockdown and IT WORKED. The economy certainly suffered, but it wasn’t “crippled” (it’s been hobbling along just as usual, before and after.)

    Stop this herd immunity bullshit. You’re going to get everyone killed. What good is a “great economy” if it is devoid of people?!

    Liked by 2 people

  12. In the words of Boris Johnson’s Chief Chief Adviser, Dominic Cummings:
    “Herd immunity, protect the economy and if that means some pensioners die, too bad.”
    You can fault the Tories for many things but not for a lack of transparency about their true nature. They are almost pathologically bad at keeping up pretence, it’s like they are so damn’ proud about their horrible deeds that the truth just keeps bursting out of them…

    Liked by 2 people

  13. Daniel Fornies Soria

    Neo-liberalisms aside, my perception here in the NL is that the culture is all about budget-optimizing everything, resulting in a system with no leverage at all, and being more reactive than proactive, since being proactive in a precautionary level is often seen as “panicking” or “worrying”, which are socially seen as weaknesses here.

    Liked by 2 people

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  15. B. Schuurman

    This article is not providing full and correct information. For the 10000000th time: the Netherlands are explicitly not using herd immunity as a strategy, the Dutch government has merely spoken about how a certain extent of herd immunity – hopefully – might! be a result of over a year of infections with the corononavirus, and the possible introduction of vaccinations. Until then, the Netherlands try to protect the most vulnerable with restrictive measures and have restricted social contact, group gatherings, promote social distancing, closed schools, restaurants, pubs etc. and restricted unneccesary travel. Exactly the same measures as many other countries are taking. I have no idea why so much foreign news outlets are spreading the message that the Netherlands are using herd immunity as a strategy against the coronavirus. It is simply not true.

    Liked by 4 people

  16. Willem

    The relation between neoliberalism and the virus is poor at best in the Dutch case. The Dutch education, housing and healthcare is among the world’s best!

    Blaming social security in countries that belong in the top of the world sounds more like polarisation to me .. E.g. in the Netherlands there is no Intensive Care healthcare for private care, like in most countries (most of Asia, Africa and America’s) – what could support this story

    Eventually all countries aim for herd immunity, it’s just the path to that point is different for all communities. Many variables.

    Note that the death toll of a severe financials crisis, over time, is arguably much higher!

    Like

  17. Pieter van Kampen

    This article is a lie from start to end. In the Netherlands we have basically the same measures as in other European countries but a bit more relaxed. Everyone should stay at 1,5m, events are forbidden, schools are closed and people are urged to stay at home. The difference with other countries is that we are allowed to go for a walk, a bike ride or anything, at long as we keep a distance, preferably alone. The cities can close shops and parks if they are too busy.
    In any case there is no intend to have as much people infected as possible. The goal is to reduce infections as much as needed to enable the hospitals to keep functioning.

    Like

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  19. Mario

    What is the explanatory value of calling something neoliberal? The UK and the Netherlands are neoliberals, therefore, herd immunity approach. Then, Sweden, if they also endorse herd immunity…they must also be crypto-neoliberals! Is Finland also a neoliberal country that has dismantled its welfare state because it has less critical care beds per capita than the Netherlands?

    Article argumentative strategy: you start from your conclusion and you proceed by reiterating your conclusion, then you conclude: neoliberalism everywhere. This article explains nothing. On the contrary, it is another example of how people think they are “critical” because they use buzzwords and repeat talking points.

    In front of a clear case of bad policy, looking for political metanarrative adds nothing to the discussion. This sentence, by itself, disqualifies an already misleading and poorly argued piece: “Herd immunity is not just bad science or bad policy. It is biological warfare.”

    Like

    1. Pieter van Kampen

      You are so full of shit. The Netherlands never distanced itself from the herd immunity approach because it never had the approach you describe in the first place.

      Neo-liberal? Trump’s right wing supporters may be neoliberal, if that means destroy the government and let the industry grab the money. But that is not the case anywhere else.

      Like

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  21. Great article! It might be more precise to say that using a herd-immunity-only strategy is neoliberal, because it seems even strategies based on solidarity distancing, lock-downs, etc. that are designed to slow spread of the disease so that it does not overwhelm public health systems or kill people unnecessarily, have herd immunity as a longterm goal. This quote from the following article seems to make this clear: “By acting now, we can buy time to amass resources, devise strategies to rebuild our health system and our economy, and develop treatments, vaccines and, ultimately, population herd immunity.” https://www.nytimes.com/2020/03/24/opinion/social-distancing-coronavirus.html?action=click&module=Opinion&pgtype=Homepage

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