1. Background and Basis of Herd Immunity
2. Herd, Population, Collective, or Group Immunity
3. Person-to-Person Transmission Dynamics Inducing Specific Immunity
4. Applied Immunoepidemiology for Epidemic Control Strategy Development
5. Herd Immunity Applications in the Current COVID-19 Pandemic
6. Herd Immunity Limitations in the Current COVID-19 Pandemic
6.1. Laissez-Faire Attitudes or Natural Herd Immunity
6.2. Possible Consequences of Obtaining Herd Immunity by Natural Pathways
6.3. Epidemiological Limitations
6.4. Immunological Limitations
7. Herd Immunity Effectiveness
8. Herd Immunity and Vaccines
Conflicts of Interest
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|Country||Rapid Tests Based on Antigens and Antibodies||RT-PCR Screening Tests||Citizen Information Measures||Geo-Position and Tracking Applications||Quarantine Measures||Use of Masks and Other Safety Measures|
|Canada||Yes. To date (12 April, 2020), Health Canada has approved this measure (shipping only in Canada, not worldwide).|
Several biomedical private entities received approval for the production of rapid kits.
|Government has a guide for public and private institutions.|
Performed with a rapid test.
|Large governmental web page with answer and questions (FAQ).|
COVID-CANADA App provides a central resource for accessing personalized, trusted, and evidence-based information.
|Authorities are still discussing this. |
No official information available.
|16th of March, borders were quarantined|
Since the 7th of April, the population has been under lockdown
|Suggested mask implementation.|
Thermal scanning. Plexiglass barriers to ensure social distancing.
GPS–Bluetooth technology to determine whether citizens have had contact with a COVID-19 positive subject.
diagnoses and rapid/point-of-care serological tests, especially in Wuhan province, the focus of the onset of COVID-19.
|The results of PCR tests are returned the same day in mainland China|
and performed on even suspected patients.
|No information was obtained.||Yes. Using 4g and 5g connections.||Border health quarantine; infectious diseases on 20 January 2020 in Wuhan and other key areas of Hubei.||Strict entry control in buildings (a green health QR code used to grant access) connected to a governmental database that is informed on the health status and movements of the citizens.|
Strict disinfection protocols that are shared on social media to engender feelings of security and comfort among the population.
|Colombia||Yes. With limitations in the ability to obtain rapid detection kits.||Yes. With the participation of University laboratories and state epidemiological surveillance. There are problems with the analysis of samples and the reporting of sample results.||Yes. Limited due to the low diffusion of the government.|
The use of a WHO WhatsApp bot that delivers real-time information to phones.
|No.||Yes. From 24 March till 27 April.||Compulsory use of masks on public transport systems and in public areas, such as stores, outdoor marketplaces, and banks.|
|European Union||Yes. Antigen and antibody-based rapid tests are widely used in the countries of the European Union and the United Kingdom. Their application is recommended to support laboratories that perform RT-PCR tests. The use of commercial tests with a "Conformité Européenne" (CE) seal is recommended. Tests based on direct SARS-CoV-2 antigen detection and indirect antibody detection tests are used.||RT-PCR is the current test methodology applied in EU member states. The ECDC recommends nucleic acid amplification-based tests, such as RT-PCR, as diagnostic tests.||Yes. The use of the WHO WhatsApp bot delivers real-time information to phones.||Europe’s telecom companies are sharing location data with health authorities in Italy, Germany, and Austria to check whether people are remaining at home. The data are aggregated and anonymous, mapping concentrations rather than individuals to respect Europe’s privacy laws.||The authorities of the European Union recommend home isolation for people who have mild symptomatology and quarantine for people who have been potentially exposed.||In the European continent, Bulgaria, Georgia, Luxembourg, Poland, the Czech Republic, and Ukraine have mandatory mask-wearing.|
Masks are only necessary in enclosed public places, public transport, and shops in Austria, Lithuania, Romania, and Slovenia.
From 11 May in France, masks will be mandatory on public transport and recommended for shopping and small areas.
In Germany, Spain, and Italy, donning a face mask is also compulsory, including public transport and shops.
|Russia||No information available.||Yes, since 27 March, AmpliTest SARS-Cov-2 is used to test for the virus in just 2 h and 30 min.||No information available.||Yes. Only patients who have tested positive and have been hospitalized.||18 March: restrictions on the entry of foreigners.||No information available.|
|Japan||Yes, but rapid tests are applied to a lesser extent than in other countries. Confirmatory tests of PCR RT are preferred.||86,800 PCR tests have been conducted through to 17 April. Private laboratories can be authorized to perform PCR tests.||Yes. The use of the WHO WhatsApp bot delivers real-time information to phones.||No data available.||Maintained social and economic functions.|
No cities blockaded as in other countries;
only partial quarantine.
|Among other countries such as Hong Kong, South Korea, Thailand, and Taiwan with similar cultures, the broad assumption is that anyone could carry the virus; thus, masks are encouraged to be worn at all times and in all places.|
|United Kingdom||Yes. Since 15 March, rapid tests are available for use in community pharmacies or at home.|
Two million tests have been bought from China as of the 1st April.
|National Health Service (NHS) is providing guidance and standard operational procedures for public and private institutions.||Yes. The use of the WHO WhatsApp bot delivers real-time information to phones.||Yes. A governmental App|
is used to track the progression of medical conditions by citizens self-reporting their symptoms
No information on geo-tracking.
|Since 23 March.||The use of a mask is not mandatory. Instead, the government urges the public not to wear them in order to ensure sufficient supplies and personal protective equipment (PPE) for healthcare workers.|
|United States of America||Yes. On 2 April, the FDA approved antibody tests. Since then, they have been widely applied among the population.|
Commercially manufactured serologic tests that check for SARS-CoV-2 antibodies in individuals are becoming increasingly available for use through healthcare providers.
|Despite its large population and density, it ranks sixth in performing the most RT-PCR tests, behind South Korea, Canada, Germany, and Italy.||Live information on the government’s web page.|
The Federal Communications Commission (FCC) supports and encourages citizen information.
|$500 million for the Centre for Disease Control (CDC) to launch a new surveillance and data-collection system to monitor the spread of COVID-19.||Depending on the State, the beginning of the quarantine may fluctuate from 19March to 3 April.||Does not specifically advocate the use of surgical masks but does advise the use of “simple cloth face coverings” to slow the spread of the virus and prevent asymptomatic people from transmitting it to others.|
Mandatory use of masks depends on the state.
|Venezuela||Yes. With limitations in acquiring rapid detection kits.||Yes; limited due to the excessive centralization of the RT-PCR sample processing in a single government laboratory. There is a mobile laboratory established on the border with Colombia. There is no periodical publication of epidemiological data.||Yes. Highly limited due to low diffusion and information control of government.|
The use of the WHO WhatsApp bot delivers real-time information to phones.
|No||First country in Latin America to establish a lockdown (from 24 March to 27 April). Due to shortages of fuel and food, it was very difficult for the population to respect this order.||Mandatory use of masks. |
Random temperature check among citizens.
China’s measures are being slowly replicated, according to Nicolas Maduro. (e.g., the use of “Carnet Patria”, which is similar to Quick Response (QR) codes but has a digital wallet where the government distributes economic bonds).
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