Raj Bhopal: Herd or Human Immunity?

Zugzwang is a German word for “a position in chess where every move is disadvantageous where we must examine every plan, however unpalatable.”

Raj Bhopal, CBE DSc, BSc MD, MPH, MBChB, FRCP, FFPHM, is professor emeritus of public health at the University of Edinburgh, Scotland. He held the chair of Public Health in the university until his retirement in 2018.

Bhopal is also the author of Concepts of Epidemiology: Integrating the Ideas, Theories, Principles, and Methods of Epidemiology.

Bhopal’s recent article, COVID-19 zugzwang: Potential public health moves towards population immunity, was published in Public Health in Practice. Public Health in Practice is an official journal of the Royal Society for Public Health and a sister journal of Public Health.

The article offers that scientific inquiry around various SARS-CoV-2 interventions has been frustrated by an unappealing mix of competing ethical priorities societies face, alongside political battles and terms like “herd immunity.”

The term is reminiscent of domesticated animals rather than human individuals, according to Bhopal, and distracts from the fact that even temporarily acquired population immunity could be part of a multi-faceted and vigorous COVID-19 social mobilization.

In addition, Bhopal uses his background in public health to point toward ways supportive measures could accomplish more than punitive ones. While fringe violence and extremism for any reason is completely unacceptable, miscommunicated or disruptive measures may exacerbate existing social tensions in endemic communities in ways surprisingly parallel to attacks on aid workers during recent Ebola responses.