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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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Only Health-Based Rewards: Why Wellness-Focused Incentives Drive Healthier Workplaces

Corporate rewards have traditionally focused on monetary incentives, gift cards or generic perks. However, organisations are increasingly realising that such rewards offer only short-lived motivation. Only health-based rewards, such as massages, gym bags and fitness trackers, represent a more effective approach to corporate wellness by reinforcing healthy behaviours that deliver long-term benefits.

In India, where lifestyle diseases are rising rapidly among working professionals, aligning rewards with health outcomes is no longer optional.

What Are Health-Based Rewards?

Health-based rewards are incentives designed specifically to improve or support employee wellbeing.

They focus on:

physical health
mental wellbeing
preventive care
recovery and stress relief

Unlike cash incentives, they encourage repeated healthy actions.

Why Traditional Rewards Fall Short

Cash rewards and generic gifts:

provide temporary satisfaction
do not influence daily habits
fail to support long-term wellbeing

Behavioural studies show that incentives disconnected from health goals have limited preventive impact.

The Case for Only Health-Based Rewards

Health-based rewards directly reinforce behaviours such as:

regular physical activity
stress management
recovery and self-care
preventive health participation

WHO workplace health guidelines emphasise incentives that promote sustained behaviour change.

Types of Effective Health-Based Rewards

Massages and Recovery Therapies

Massage therapy:

reduces muscle tension
lowers stress hormones
improves circulation

Monthly or quarterly massage rewards support physical and mental recovery.

Gym Bags and Fitness Gear

Practical fitness accessories:

encourage regular workouts
reduce barriers to exercise
promote active lifestyles

Visible gear reinforces identity as a health-conscious individual.

Fitness Trackers

Fitness trackers:

track steps, activity and sleep
create accountability
encourage daily movement

Data-driven feedback increases participation and motivation.

Psychological Impact of Health-Based Rewards

Health rewards create:

intrinsic motivation
positive habit reinforcement
long-term lifestyle shifts

Unlike cash, they associate rewards with self-care rather than consumption.

Impact on Employee Health Outcomes

Regular participation in wellness incentives leads to:

improved physical activity levels
reduced stress
better sleep patterns

ICMR data links activity-based interventions with lower lifestyle disease risk.

Benefits for Employers

Reduced Healthcare Costs

Preventive health rewards reduce chronic disease burden over time.

Improved Productivity

Healthy employees demonstrate:

better focus
fewer sick days
higher energy levels

Stronger Wellness Culture

Health-first rewards signal genuine organisational commitment.

EY-FICCI reports show preventive wellness programs deliver measurable ROI within 12–18 months.

Why Health-Based Rewards Work Better in India

Indian workplaces face:

long working hours
sedentary routines
high stress levels

Health rewards directly address these risks rather than ignoring them.

Aligning Rewards With Preventive Healthcare

Health-based rewards complement:

health screenings
fitness challenges
mental wellbeing programs

This integrated approach strengthens outcomes.

Avoiding Pitfalls in Reward Design

Effective programs:

avoid one-size-fits-all rewards
offer choice within health categories
ensure inclusivity

Poorly designed incentives reduce engagement.

Measuring Success of Health-Based Rewards

Success indicators include:

participation rates
health screening uptake
employee feedback
reduced absenteeism

Data-driven evaluation improves program effectiveness.

Long-Term Behaviour Change

Sustained wellness improvement requires:

consistency
reinforcement
meaningful incentives

Health-based rewards support gradual but lasting change.

Role of Leadership Support

Leadership participation:

increases credibility
boosts engagement
normalises wellness culture

When leaders embrace health rewards, employees follow.

Health-Based Rewards and Mental Wellbeing

Rewards such as massages and fitness trackers:

reduce burnout
improve mood
enhance resilience

Creating a Preventive Wellness Ecosystem

Only health-based rewards work best when combined with:

education
screenings
access to care

WHO emphasises integrated wellness ecosystems for maximum impact.

Conclusion

Only health-based rewards represent a strategic shift from short-term perks to long-term wellbeing investments. Incentives such as massages, gym bags and fitness trackers actively promote healthy habits, reduce lifestyle disease risk and strengthen workplace wellness culture. By aligning rewards with preventive health goals, organisations create meaningful engagement, healthier employees and sustainable productivity gains. Health-focused incentives are not just rewards—they are tools for lasting wellbeing.

References

Indian Council of Medical Research (ICMR) – Lifestyle Disease and Workplace Health Reports
World Health Organization (WHO) – Workplace Health Promotion and Incentives
National Family Health Survey (NFHS-5) – Adult Lifestyle Risk Factors
Lancet – Behavioural Incentives and Preventive Health Studies
NITI Aayog – Preventive Healthcare and Workforce Wellbeing
EY-FICCI – Corporate Wellness and Productivity Reports
Statista – Employee Wellness Incentive Trends

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