By Dr Sheri Fanaroff  MBBCh FCFP MFamMed, a Family Physician, practicing in Melrose, Johannesburg. Fanaroff is a member of GGPC (Gauteng General Practitioners Collaboration) which has created a platform for doctors to share resources during Covid-19. Look for  #voicesthatcare on the GGPC Facebook page. 

“If most of us are going to get COVID-19 anyway, why not just get it now and get it over with?” People have gone to the extent of wanting to host Coronavirus Parties. This is a party which encourages people to get infected, assuming they will be immunised thereafter.  Is this really true?

Why Coronavirus Parties are a terrible idea

History of Viral Parties

Chickenpox parties were common in the USA before a vaccine was developed. These are still sometimes organised today by “anti-vaxers”. They are those who falsely believe that vaccination is more dangerous than contracting the disease. During the 2009 influenza pandemic, “swine flu parties” also took place in some countries. The theory of the “viral party” is that exposing yourself or your child to the disease means:

  •  you will “get it over with”,
  • be immune and
  • be able to continue normal life without worrying about getting sick again.

Coronavirus parties have recently been documented in Germany, the US and the UK. They have been explicitly banned in the Netherlands.

Immunity – Can you catch COVID-19 twice?

The main problem here is that we still don’t know whether all infected patients are immune. Can they catch COVID-19 twice?  Further, if they do develop immunity, how long this will last? The UN published a scientific brief stating that the idea that one-time infection leads to immunity is unproven (April 2020).  The WHO statement also says “There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection”.

In some countries, like Korea and China, there is a growing number of recovered patients who have suffered a relapse or possibly a second bout of the disease. So if you can potentially get it a second time, why would you want to go through the risk of having it at all? Added to this, we still don’t have reliable antibody tests. A person who gets an asymptomatic infection, may not even know that they have had it.

Risks

In my opinion, no-one should actively go out and get infected. There is no way of predicting exactly who will get a severe infection and be at risk of dying. Yes, we know that elderly people with comorbidities like obesity, diabetes and COPD (Chronic obstructive pulmonary disease) are more likely to suffer severe illness and have a higher mortality rate. But, there are also cases of younger, previously healthy adults who have gotten very ill and died.

Also, many children infected are asymptomatic. But, there are sporadic cases of children in the US and Europe who have developed multi-inflammatory syndromes and been severely affected. While these cases are exceedingly rare, it is not something that any parent should willingly put their child at risk for. There is also a risk of long term damage (lungs, kidneys, brain hypoxia) in people who have recovered from COVID.

Flattening the Curve

The main reason for the harsh South African lockdown and attempt to slow down the spread of infection was to slow down the exponential growth. Consequently, this would not overwhelm health services and give our hospitals time to prepare. If everyone in the country is sick at the same time (which coronavirus parties would contribute to), we will soon run out of ICU beds and ventilators.

Practically, slowing down the rate of infection has been supported because:

  • it buys our hospitals time to cope with expected surges.
  • also buys us time to do medical research and
  • identify treatments.

There is a lot more knowledge worldwide about which treatment protocols are more effective, than there was three months ago. And the later on in the pandemic you get COVID-19, the more likely it is that there will be an effective treatment. Of course the ultimate prize is that there will ultimately (hopefully) be a vaccine. Which might mean that you may not ever need to get it!

Herd Immunity

Those in favour of everybody getting infected now, are hoping that once we reach “herd immunity”, the threshold will be crossed. This means enough people are immune and so the number of new cases begins to decline. The problem is that herd immunity is complex and may occur only once more than 80% of a population are infected. This is especially true in areas where there are high population densities, like informal settlements. Flattening the curve does not only DELAY the number of infections, but it also REDUCES the ultimate number of infections.

Also, most countries are nowhere near achieving herd immunity, (even if one assumes that herd immunity is achieved at only 60%). Recent surveys showed that only 4.4% France and 0.27% of England have been infected. So, despite what sounds like large numbers of infections in these countries, they are still a very long way away from herd immunity. The country that might be closest to achieving herd immunity is Sweden. However, their strategies have been widely questioned as they have a death rate far higher than surrounding countries.

Ethics

Supposing we assume that the total mortality rate from COVID is the same whether or not we delay infections. With the parties, all the deaths will be crammed into a shorter period of time. This still means that some people will be cheated of life.(NB: this is not the prediction given that flattening the curve allows more people to access medical care as well as reduces the total number of infections)

Doctors are trained with the principle of “Primum non nocere” – “First do no harm”. They would never actively encourage anybody to expose themselves to an unpredictable illness. And they also adhere to the principle of fighting to keep people alive and healthy, living a good quality life for as long as possible.

It is also unethical for young healthy people to willingly infect themselves. Remember, the more vulnerable and elderly people they pass it on to, may not be so lucky as to have mild or asymptomatic infection.

Debunking the Coronavirus Parties Myth

Coronavirus parties:

  • put participants as well as their unwilling contacts ( friends, family and colleagues) at risk of hospitalisation and death.
  • the surge in infections may end up causing schools and part of the economy to close again, as hospitals become overwhelmed.
  • While there is still no official statement from any of the major health authorities on corona parties, the CDC statement on chickenpox parties could well be applied. It reads as follows :

“CDC strongly recommends against hosting or participating in these events. Chickenpox can be serious and can lead to severe complications and death, even in healthy children. There is no way to tell in advance how severe your child’s symptoms will be. So it is not worth taking the chance of exposing your child to someone with the disease. The best way to protect infants and children against chickenpox is to get them vaccinated”. Hopefully soon, we will have the option of vaccination for Coronavirus too.

So by all means, let’s have a Corona Party.

Crack open a Corona beer, and have A ZOOM PARTY with your family and friends while physical distancing, washing hands and keeping safe. But please don’t intentionally get infected!

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