Anti-lockdown memo is unrealistic and irresponsible
Nobody cheers for shuttered shops, closing restaurants, boarded-up bars. Nobody is cheering for the economy to crater, for schools to close, for hospitals to be overwhelmed, to be shut in. And people, not even a year into this decade-like pandemic, are tired.
But nobody has offered a more reasonable solution, either, when your epidemic response strategy fails. If you take care of public health, the economy can recover. It’s a shared, and sequential, approach.
Yet, enter the Great Barrington Declaration.
The document was created by Oxford epidemiologist Dr. Sunetra Gupta, and medical professors Dr. Martin Kulldorff of Harvard and Dr. Jay Bhattacharya of Stanford. It is backed by the right-wing libertarian American Institute for Economic Research, which is backed by rightwing billionaire Charles Koch. It holds that lockdowns are more damaging than the alternative.
“Those who are not vulnerable should immediately be allowed to resume life as normal,” it states.
“Simple hygiene measures, such as hand washing and staying home when sick should be practised by everyone to reduce the herd immunity threshold. Schools and universities should be open for inperson teaching. Extracurricular activities, such as sports, should be resumed.
“Young low-risk adults should work normally, rather than from home,” the document says.
“Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.”
Is there good science associated with this? No. Are there citations or references? No. Can any prankster sign it? Yes. Was it recently pushed by the Toronto Sun, which called it “a worthwhile document,” and in a strangely unbylined piece in the National Post, and in some conservative talk radio circles? Yes. Is the Trump administration interested? Yes.
Is it unscientific libertarian hooey, at the expense of our shared humanity? Oh, yes. Absolutely.
“My personal view was I was mortified by that,” says Dr. Gerald Evans, the chair of the division of infectious diseases at Queen’s University, and a volunteer member of the province’s science table. “My thought at the time was this was an ideologically bent statement, and had nothing to do as much with the science, and what we’re facing.”
“Quite frankly, it’s a dangerous philosophy,” says Dr. Isaac Bogoch, an infectious diseases specialist at the University of Toronto. “And there’s some significant, fundamental epidemiological, infectious-diseases and public health flaws in this.”
“This is a hallucinatory document,” says Dr. Amir Attaran, a professor of law and epidemiology at the University of Ottawa.
First, protecting vulnerable people is impossible. As Bogoch notes, up to 40 to 50 per cent of Canadians either fall into a vulnerable category, or are closely connected with someone who does.
“It really promotes this concept of cocooning, where you can somehow shield vulnerable populations from getting COVID-19,” Bogoch says. “That concept doesn’t pan out in reality … Vulnerable populations do not live in hermetically sealed bags, and they’re going to be exposed, despite our best efforts. So we have to keep community rates as low as possible to keep people from getting this infection.”
But even if we could, nobody knows what COVID immunity looks like, or how long it might last. Britain started to execute a plan based on herd immunity this year, and then realized it’d gotten the maths wrong.
“There has never been a virus that we’ve gotten under control with herd immunity except through immunization,” Evans says.
“It’s an extension of the British government early on in the spring: ‘oh, let’s let everyone get infected, sure people will die, but who the heck cares? We’ll have immunity.’ You can’t achieve herd immunity this way.”
Oh, and the economy doesn’t get saved if you let the disease run wild. That, in theory, is the point of this.
“Excluding oil-dependent provinces, whose problems go beyond COVID, the provinces which seem least economically damaged in 2020 are those which fought COVID aggressively, to the point of virtual elimination,” Attaran says. “Nova Scotia, New Brunswick, Prince Edward Island, Manitoba. The most economically damaged are those which dithered most on controlling it: Ontario, and Quebec.
“If a fundamental premise of the Barrington bull---t is that an embrace of further infection will help us regain normal, it’s wrong in both public health and economics.”
Yes, death rates are low for this disease, though there is more than death to COVID, too. Everyone understands that the pandemic, and restrictions, have adverse consequences. That’s why people encourage government support to people who need it, until any vaccines arrive. And to be aggressive and robust in controlling the virus in the first place.
Because the alternative is overwhelming hospitals, sacrificing people, and losing the economy anyway. That’s all this is.
“Because we can’t shield the most vulnerable populations as well as this declaration portrays, the path to quote unquote herd immunity … is paved with dead bodies,” Bogoch says. “It is. You can argue what the infection fatality ratio is. It might be 0.5. It might be 0.7. It’s irrelevant. It’s something. And when you factor that across the population, knowing that you can’t shield your vulnerable populations, that is an unacceptable number of deaths, no matter how you calculate it.”
Bogoch notes that 0.5 per cent of 38 million Canadians would be 190,000 dead.
Ordinarily, this would be the part where I might interview the local (non-infectiousdisease-trained) doctors who signed the petition. But that would be rewarding asymmetric credibility, which as we have seen — on climate change, for instance — is less journalistic objectivity than false equivalence masquerading as objectivity.
Meanwhile, I could have called more or less every respectable infectious diseases doctor or epidemiologist in Canada, but they are putting markers down anyway. The John Snow Memorandum simply lays out the science and stands for a humane approach, and as with climate change, the science is on one side of the argument. Snow’s far more reputable signatures are piling up.
So what have we learned? People who push herd immunity are not following the science, and are not actually looking out for you. They’re looking for an easy alternative to the hard work of communal sacrifice and investing in public health.
Nobody wants lockdowns. But nobody should want to burn down the village to save it, either.
“If a fundamental premise of the Barrington bull---t is that an embrace of further infection will help us regain normal, it’s wrong in both public health and economics.” DR. AMIR ATTARAN UNIVERSITY OF OTTAWA PROFESSOR