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Published on: Apr 20, 2020
3 minute read
By: Dr Rajan Choudhary

Is Herd Immunity A Valid Strategy For COVID 19?

Yesterday we explained you what Herd Immunity means and how it works, today we will take the discussion further to determine whether it is effective and can be recommended in the current context.

COVID-19 currently does not have a cure or a vaccine. Lockdown is the only strategy that appears to be working. Could implementing policies that encourages herd immunity be used to accelerate immunity in the population without the need for a vaccine?

INFECTIVITY

For the strategy to work we need to know a few things about the virus. How infective is it? In one of our earliest blogs we discussed infectivity at length and determined that the R0 (infectivity) may be between 2 and 3. This means each person with the virus can infect around 2-3 people at a time. Whilst this is not as high as Mumps (10-12) it is much higher than the common flu. The higher the R0 the more people that need to be immunised before herd immunity is achieved. For COVID it is estimated that 70% of the population need to be infected.

This is based off our current testing. Due to shortages in testing kits, only testing those that have a high likelihood of being infected and poorly organised testing infrastructure in some countries, we are likely underestimating. The number of people infected may be much higher as we are missing those that are asymptomatic but still have the disease and are still passing the disease on.

MORTALITY

Secondly, we need to know the mortality from COVID-19. Early estimates of mortality were as high as 10%, as we had little data on how many people were truly infected, but as the number of infected cases rose, and testing amongst the infected and symptomatic population rose, a more accurate mortality has been found to be around 1%. There is a risk we may still be underestimating the true mortality, as some cities have noted a spike in cardiac deaths, and some evidence supports possible cardiac damage due to COVID. But from the data we have, we know its mortality is lower than MERS (34%) and SARS (10%) but more than influenza (0.1%).

estimates of the COVID-19 case fatality rate

Whilst we have some data on who is likely to suffer from severe COVID symptoms (elderly, immunocompromised, people with heart or lung problems) we still cannot accurately determine who will get severe COVID in the “low risk” population. Simply because someone is young and healthy does not mean they will not die from COVID.

LENGTH OF IMMUNITY

Third we need to know how long this immunity will last. Similar coronaviruses responsible for the common cold usually create immunity that lasts for a few months, which is why we often get the cold repeatedly. A virus is also very prone to mutations that can change the structure and functions of its proteins, proteins responsible for tagging, latching on to and entering cells. If the structure of these proteins changes enough, then our antibodies will not be able to bind on, and new types of antibodies will have to be made with a slightly different structure. This effectively means our bodies have to start from step 1 again to create immunity, and we have to make new vaccines. This mutation rate is why we have to make new vaccines every season for the flu.

LONG TERM COMPLICATIONS

Finally, we need to know if there are any long-term implications from a viral infection. Again, this is something we do not know yet, as the virus has only been around for a few months. There may be implications for the cardiovascular system, long term breathing problems or more. And even if the complication rate appears relatively low (say, 1%), if millions of people are allowed to get infected, by definitions thousands or tens of thousands of people will have these complications, complications that can lead to issues later in life or an early death.

CONCLUSION

So, is herd immunity a viable strategy for COVID? Without a safe vaccine the general consensus appears to be no.

We don’t know how infective the virus really is or how many people it has infected

A 1% death rate is still very high. This means for every 100 people to be infected; one will die. This would mean hundreds of thousands of people dead in a country with a population over 10 million. It is unacceptably high.

If the death rate is 1%, then hospitalisation rate is likely higher. Almost all countries do not have capacity to have 1% of the population in hospital. Overwhelming the healthcare system will lead to poorer care, and worse care for those who do not have COVID. Leading to more people coming to serious harm or dying as a result of poor healthcare, not because of COVID.

We don’t know the long-term effects of COVID. By purposefully infecting people instead of waiting for a vaccine we may be causing unnecessary damage to a person’s health that only becomes apparent later in life. But this is speculation as we do not currently know if COVID has long term effects,

We don’t know if all of the risks above will amount to anything. The immunity may not last long enough, leading to another spike in infections and mortality.

Mass vaccination appears to be the safest strategy. And though human clinical trials have started on a number of vaccines, we are still months away from deployment. Until then we should not come out of lockdown prematurely, not until we have received an unbiased assessment from public health officials that states it is safe.

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Diabetes Symptoms in Men: Early Warning Signs You Should Not Ignore

Diabetes is one of the fastest-growing health challenges worldwide, and men are particularly vulnerable to its long-term complications. In India, the burden of diabetes has increased sharply over the past two decades, driven by lifestyle changes, sedentary habits and dietary patterns. Despite this, many men remain unaware of early diabetes symptoms or delay medical consultation until complications develop.

Understanding diabetes symptoms in men is essential for early diagnosis, effective management and prevention of serious health consequences.

What Is Diabetes?

Diabetes is a chronic metabolic disorder characterised by high blood sugar levels due to:

insufficient insulin production
ineffective insulin action
or both

The most common form affecting men is type 2 diabetes, which is strongly linked to lifestyle factors.

Why Men Are at Higher Risk

Several factors increase diabetes risk in men:

higher abdominal fat accumulation
smoking and alcohol consumption
irregular eating patterns
work-related stress
lower healthcare-seeking behaviour

According to Indian Council of Medical Research data, a significant proportion of men remain undiagnosed until advanced stages.

Early Diabetes Symptoms in Men

Frequent Urination

Excess sugar in the blood causes kidneys to work harder, leading to increased urination, especially at night.

Excessive Thirst

Frequent urination leads to dehydration, causing constant thirst.

Fatigue and Weakness

Cells cannot utilise glucose efficiently, resulting in low energy levels and persistent tiredness.

Unexplained Weight Changes

Men may experience unexplained weight loss despite normal or increased appetite.

Increased Hunger

Insulin resistance prevents glucose from entering cells, triggering frequent hunger.

Diabetes Symptoms Unique or Commonly Seen in Men

Erectile Dysfunction

Diabetes damages blood vessels and nerves, leading to erectile dysfunction.

Studies show a strong association between diabetes and male sexual health problems.

Reduced Testosterone Levels

Men with diabetes often have lower testosterone, affecting libido, muscle mass and mood.

Decreased Muscle Strength

Poor glucose utilisation affects muscle health and physical stamina.

Skin and Infection-Related Symptoms

Slow-Healing Wounds

High blood sugar impairs wound healing, increasing infection risk.

Frequent Infections

Men with diabetes are more prone to:

skin infections
urinary tract infections
fungal infections

Vision and Nerve Symptoms

Blurred Vision

Fluctuating blood sugar affects eye lenses, causing blurred vision.

Tingling or Numbness

Nerve damage, known as diabetic neuropathy, causes tingling or numbness in hands and feet.

Why Diabetes Symptoms Are Often Ignored by Men

Many men dismiss symptoms as:

work-related fatigue
ageing
stress

This delay increases the risk of complications.

Long-Term Complications of Untreated Diabetes

If untreated, diabetes can lead to:

heart disease
kidney failure
nerve damage
vision loss
sexual dysfunction

According to WHO and Lancet studies, early detection significantly reduces complication risk.

Importance of Early Diagnosis

Early diagnosis allows:

better blood sugar control
lifestyle modification
prevention of organ damage

Routine screening is crucial, even in the absence of symptoms.

When Should Men Get Tested?

Men should consider testing if they:

are over 30 years old
have a family history of diabetes
are overweight
have a sedentary lifestyle
experience any warning signs

Annual screening is recommended for at-risk individuals.

Managing Diabetes After Diagnosis

Effective management includes:

healthy diet
regular physical activity
weight control
stress management
medical treatment as advised

Early management improves quality of life.

Role of Preventive Healthcare

Preventive healthcare focuses on:

early screening
lifestyle intervention
regular follow-up

According to NITI Aayog, preventive strategies are essential to control India’s diabetes burden.

Mental Health and Diabetes in Men

Diabetes can affect mental wellbeing, leading to:

stress
anxiety
depression

Addressing emotional health improves diabetes outcomes.

Breaking the Stigma Around Men’s Health

Men often avoid seeking help due to stigma.

Promoting awareness helps:

normalise health conversations
encourage timely medical care
reduce preventable complications

Conclusion

Diabetes symptoms in men often develop gradually and may go unnoticed for years. Frequent urination, fatigue, unexplained weight changes and sexual health issues should never be ignored. Early diagnosis and timely management significantly reduce the risk of serious complications and improve long-term health outcomes. Awareness, routine screening and proactive healthcare are essential steps for men to protect their health and wellbeing in an era of rising lifestyle diseases.

References

Indian Council of Medical Research (ICMR) – Diabetes Epidemiology and Risk Studies
World Health Organization (WHO) – Diabetes Prevention and Management Guidelines
National Family Health Survey (NFHS-5) – Diabetes Prevalence in Men
Lancet Diabetes & Endocrinology – Male-Specific Diabetes Outcomes
NITI Aayog – Non-Communicable Disease Prevention Reports
Statista – Global Diabetes Trends and Gender Differences

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