I agree with Daniel Goldman. Social distancing can be too effective. The ultimate goal must be herd immunity. That can be achieved by mass vaccination, which will take, give or take, two years if we’re aggressive, or it can be achieved by mass exposure, which can be achieved much more quickly.

If we had the collective smarts, we would use social distancing to protect the vulnerable only. We would send the kids who live with healthy parents to school, let them blow on each other’s birthday cake, let them get “sick” and then render them useless to the virus as vectors. Young, healthy people would be tested, and those who prove positive and then negative will be allowed to interact with vulnerable populations. Way before a vaccine could provide immunity, circulation would provide it.

Thing is, we apparently aren’t smart enough as a species, or as a country, to use this method. Time was, parents hoped their kids would get chicken pox or mumps so that they would be immune for life and not spread the disease. Now, we think “vaccine.” I have no problem with vaccines; I and my kids get the ones offered. But waiting for a vaccine simply does not seem like a good strategy.

The limiting factor here seems to be hospital capacity. We want to “flatten the curve” so as to not overwhelm the treatment facilities. That’s a bit odd, since there is no treatment, but let’s suppose that overwhelming hospitals would cost lives. Analogies to Katrina come to mind; the levies are being over-run. If we had more hospitals, would we relax social distancing so that the curve rises to meet the higher limit? I doubt it. Still, it would be nice if we had more hospitals.

And how do the economic effects of social distancing affect death from all causes? We don’t have universal healthcare, and, even if we adopted it tomorrow, one may expect that the economic dislocations of businesses shutting down will cause an increase in homelessness and death by other causes. A lot of misery might be prevented if we could isolate only those who need to be isolated and let everyone else get on with their lives. I would love to see some assumptions on that dynamic written into the computer code.

My guess is that history will record that we over-reacted to this bug, not in the sense that we worried too much about it, but in that our response was insufficiently nuanced. The social distancing will last much longer than necessary because herd immunity will not be achieved until nearly everyone’s been vaccinated (as with smallpox in its day). We will look back and realize that we could have done better…