Hospital workers process COVID-19 specimens in the lab at UMass Memorial Hospital in Worcester, Massachusetts on November 11, 2020. Erin Clark/The Boston Globe via Getty Images

The US’s horrifying winter coronavirus surge offers a peek at the consequences of a no-lockdown, mass-infection approach.

Some public figures — including Elon Musk and Scott Atlas — have advocated for protecting vulnerable people while encouraging everyone else to resume life as normal.

Now they’re either silent, deny they ever supported a “herd immunity” strategy, or claim the US is still in lockdown.

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Earlier in the pandemic, a handful of public figures and government officials pushed an approach that became known as “herd immunity.” According to that line of thought, letting the virus spread relatively unchecked through the majority of a population should build enough immunity to slow transmission, without disrupting normal life or hurting businesses.

But most experts cautioned against it.

“Herd immunity is not a strategy or a solution. It is surrender to a preventable virus,” Marc Lipsitch, an epidemiologist at the Harvard TH Chan School of Public Health, said on Twitter in August.

Yet the US, due to the patchwork nature of its coronavirus response and a lack of government regulation to slow the virus’ spread, seems to have pursued a version of this strategy by default. Even though the cold-weather coronavirus surge has been far more severe than the one that prompted lockdowns in the spring, most states have been allowing residents to dine indoors, go to a gym or salon, and gather at places of worship throughout fall and winter.

California and North Carolina are the only states with stay-at-home orders, according to a New York Times tracker. There are no mask requirements in 10 states, and another six only require masks in some businesses or counties. Amid these lax policies, air travel for the Thanksgiving, Christmas, and New Year holidays reached levels not seen since the pandemic began.

Travelers crowd Miami International Airport on December 24, 2020. DANIEL SLIM/AFP via Getty Images

And now we are seeing the consequences.

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The US has reached its worst pandemic peak yet. More than 411,000 people have died. Los Angeles County had to suspend air-quality regulations that limit the number of cremations each month because so many people are dying. Hospitals are filling to capacity in Utah, Arizona, South Carolina, Texas, and Georgia, leaving crowded ER waiting rooms.

Those who advocated for a no-lockdown, mass-infection strategy have now either fallen silent, denied that they ever supported herd immunity, or distanced themselves from the country’s recent approach to the pandemic. That includes Sweden’s lead epidemiologist, the authors of the controversial Great Barrington Declaration, and Elon Musk.

2 champions of mass infection: Elon Musk and Scott Atlas

“Herd immunity” is a a misnomer, since herd immunity is everyone’s eventual goal. The question is the way to get there: by mass vaccination or mass infection.

Elon Musk was one of the most prominent advocates for the latter route.

“Essentially, the right thing to do would be to not have done a lockdown for the whole country but to have, I think, anyone who’s at risk should be quarantined until the storm passes,” Musk said in a September interview on the podcast “Sway.”

Elon Musk on the red carpet for the Axel Springer awards in Berlin, Germany, December 1, 2020. Hannibal Hanschke/Reuters

When interviewer Kara Swisher pointed out that many people would perish in that approach, Musk responded: “Everybody dies.”

Musk did not respond to a request for comment on his previous statements, and he hasn’t made any public statements about the coronavirus since he tested positive for it (and called rapid testing “extremely bogus”) in November. But last week, The Boston Globe reported that Musk had donated $5 million to two coronavirus researchers through his foundation.

Scott Atlas, a neuroradiologist who served as a White House coronavirus advisor for about four months, has also argued that the best approach to the pandemic would be to isolate vulnerable populations – the elderly and immunocompromised – and let everybody else go about their business.

He laid out this strategy in an October interview with UnHerd, at which point he said population immunity might be a “secondary gain” of his ideal approach. But before he took the White House job, he talked about herd immunity through mass infection as a goal in itself.

“In the absence of immunization, society needs circulation of the virus, assuming high-risk people can be isolated,” Atlas wrote in an op-ed for The Hill in April. “It is very possible that whole-population isolation prevented natural herd immunity from developing.”

White House coronavirus advisor Dr. Scott Atlas speaks about COVID-19 testing in Washington, DC on September 28, 2020. MANDEL NGAN/AFP via Getty Images

After Atlas joined the White House coronavirus task force in August, The Washington Post reported that he was pushing behind the scenes for the US to embrace herd immunity – a charge he says is untrue.

“I firmly deny the false accusations that, as a special advisor to the President, I advocated at any time for ‘herd immunity’ via letting the infection spread as a scientific approach to the pandemic,” Atlas told Insider. “All policy considerations I recommended to the President were designed to reduce both the spread of the virus to the vulnerable and the structural harms to those impacted the most – the poor and working class of America.”

The anti-lockdown manifesto

However, Atlas praised the Great Barrington Declaration, a document that argued for “focused protection” – isolating and sheltering vulnerable populations, like the elderly, while letting everyone else go about their normal lives.

“For people who are under, let’s say, 60 or 50, the lockdown harms are mentally and physically worse than COVID,” Jay Bhattacharya, a professor of medicine at Stanford University and one of the three authors of the declaration, said in a debate with Lipsitch in November.

Though the declaration’s website claims that more than 13,000 medical and public-health scientists have signed it, its publication in October drew widespread criticism from many other public-health experts. In an open letter and the John Snow Memorandum, experts argued that there is no evidence that herd immunity can be reached through natural infection. What’s more, they said, “focused protection” isn’t realistic, since it’s unclear how governments would single out vulnerable people and separate them from the rest of society.

Plus, young and healthy people can still have severe, long-lasting coronavirus symptoms, and the long-term effects of such widespread sickness can’t be known.

Left to right: Martin Kulldorff, Sunetra Gupta, and Jay Bhattacharya at the American Institute for Economic Research, Great Barrington, MA. Taleed Brown/Wikimedia Commons

The authors of the Great Barrington Declaration, however, stand by it and do not think the US pursued their recommended strategy, intentionally or accidentally.

“With the exception of a small handful of states, the US has followed a lockdown policy,” Bhattacharya told Insider in late December. “The primary class of people that does not believe we are in lockdown are the rich, who can afford to stay at home, work remotely without threat of losing their job, and pay to not experience the harms of the lockdowns.”

The Sweden strategy

In November, Bhattacharya pointed to Sweden as a good example of herd immunity done right. The approach there, he said, was not simply “let it rip,” since the country aimed to protect the vulnerable while avoiding lockdowns.

Indeed, Swedish state epidemiologist Anders Tegnell directed a response to the virus that did not mandate lockdowns, masks, or social distancing. He claimed that this no-lockdown approach would produce high rates of immunity, which would later protect the Swedish population from new COVID-19 surges.

Tegnell denied that herd immunity was the strategic goal, but whatever the terminology, his theory has proven wrong.

Anders Tegnell at a news conference on the COVID-19 situation in Stockholm, Sweden, on October 29, 2020. ANDERS WIKLUND/TT News Agency/AFP via Getty Images

Sweden did not escape a winter surge of coronavirus cases, as Tegnell predicted. On January 8, the Swedish parliament passed a new law allowing the government to institute nationwide lockdown measures. The country’s death toll stands at nearly 10,800 – several times higher than in neighboring Norway and Finland, where 543 and 633 people have died, according to the World Health Organization.

In December, Tegnell told Insider that he holds the same position that he repeated regularly when Sweden remained open: “The agency or me never supported the herd immunity approach as a strategy.”

Susie Neilson contributed reporting.

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