12/10/2020

Research / Other publications

Learning the Lessons of the Pandemic

In the last few days the World Health Organization has announced that it does not recommend lockdowns as the “primary means of control” of the coronavirus. Dr. David Nabarro, who is the WHO’s “special envoy” on the coronavirus epidemic and presumably knows something about the costs and benefits involved, went on to suggest that there was only a limited role for lockdowns in combatting the virus:

“The only time we believe a lockdown is justified is to buy you time to re-organize, regroup, rebalance your resources, protect your health workers who are exhausted, but by and large, we'd rather not do it," he told the media.

Other methods of controlling the virus are as good or better than lockdowns—there’s a long list of them on the WHO’s website—and they don’t have the catastrophic impact of lockdowns. As Nabarro explained with some feeling:

Look what's happened to smallholder farmers all over the world. … Look what's happening to poverty levels. It seems that we may well have a doubling of world poverty by next year. We may well have at least a doubling of child malnutrition.

On most occasions when we hear appeals like that, they come accompanied with a bill for the rest of us in the form of higher redistributive taxation. We sigh “well, it’s a good cause” and pay up, even if it means cutting down on some little luxuries (or, if we’re among the poor ourselves, giving up some portion of necessities too).

On this occasion, however, industries, social services, charities, and ordinary taxpayer-citizens, rich and poor alike, would all benefit economically if the lockdowns were to end. Dr. Nabarro might have said with equal force and relevance: “Look at what’s happening to steelworkers, coal-miners, secretaries, para-legals, physiotherapists, plumbers, carpenters, Anglican vicars, waiters, travel-agents, and strip-tease dancers.”

It might not have had the same emotional impact as his appeal to prevent child poverty, but it would be pointing to severe everyday economic damages experienced by the whole community. Almost everyone in the private sector is hit by lockdowns, and they will by paying the accumulated bill for their own enforced idleness for a very long time to come. And that should count for something.

Of course, Nabarro was announcing a U-turn by the WHO. That’s usually felt to be a political disgrace and a cause for great embarrassment. Maybe sometimes it is exactly that. But it surely makes sense to change policy, however drastically, when the evidence suggests that the existing policy is producing negative or perverse results. And that seems to be the case with lockdowns.

Almost simultaneously with Dr. Nabarro’s statement, three distinguished medical experts-- Sunetra Gupta of the University of Oxford, Jay Bhattacharya of Stanford University, and Martin Kulldorff of Harvard University—wrote what amounted to a statement of skepticism about lockdowns which were, they said, inflicting irreparable damage on health.

That statement, known optimistically as the Great Barrington Declaration, became a petition that’s already been signed by 1200 health professionals. It is unsparing in its critique of the policies of many, even most, governments worldwide:

As infectious disease epidemiologists and public health scientists, we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.

Coming from both the left and right, and around the world, we have devoted our careers to protecting people. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice.

Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.

The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.

Even or especially if governments agree with the professors, however, they must be horrified  by the idea that lockdowns are a mistake, an overreaction, and a net disadvantage in cost-benefit terms. That conclusion is politically disastrous for them. They have spent much of the last year telling their voters that lockdowns were essential to prevent the spread of the virus and protect lives.

In the countries of the Anglosphere that usually pride themselves on their dedication to liberty, they have been exceptionally heavy-handed in their enforcement of lockdowns on the citizenry, imposing heavy fines on citizens for breaches of it and insisting on closing down cities with curfews and prohibitions of church services, drinking, and even singing. And they have made lockdowns a key item in a coronavirus “orthodoxy” that dismissed other policies—Dr. Gupta’s “focused protection” (focused that is on the elderly and especially vulnerable), or Sweden’s alternative policy mix that included a much more limited lockdown.

Nor are governments alone in the dock. Scientists too have to share in the blame. Did the Imperial College and SAGE scientists in the UK, for instance, make a mistake when they recommended abandoning HMG’s original strategy ( tested and approved by the WHO only the previous year) and moving to a lockdown one? Not at the time, perhaps, when UK policy was dominated by a need to avoid the National Health Service being overwhelmed by the avalanche of cases that had overwhelmed Italy’s health services.

That decision was in line with Dr. Nabarro’s argument that a lockdown was “justified to buy you time to re-organize, regroup, rebalance your resources, protect your health workers who are exhausted, etc. Long after that threat passed, however, the scientists continued to press the politicians to tighten the lockdowns ever more firmly. And the politicians are afraid to disagree with the scientists.

Britain’s current policy is now a kind of paralysis: almost everyone, including ministers, realizes the lockdown was a mistake and is increasingly a catastrophe for the country’s economic future but the government has been so successful in inculcating a fear of the virus that far outstrips the real risks to the entire population that it carries that the public now supports tightening the lockdown rather than lifting it.

For that outcome—which is worse in Australia and the U.S. than in Britain—the media must accept a heavy share of the blame. Their coverage has often been more driven by political considerations than by medical ones. Mainstream reports of the pandemic in the U.S. has been more concerned to damage Donald Trump than to provide a cool and fair-minded examination of how best to treat the virus—“Orange Man Bad” being its main diagnosis of any of the cures proposed.

And social coverage is worse. At the time of writing, Twitter had ruled against coverage of the Great Barrington Declaration on the grounds that it was misleading (i.e., Twitter disliked its political implications.)

The lessons of the Covid-19 pandemic will be relevant long after the virus has reached herd immunity and become one of the many illnesses dormant in the population that springs into life every Fall. They tell us that whether the threat is a global pandemic or a rise in global temperature, we must preserve a free and skeptical public debate. That means asking the experts to give us their opinions but also to tell us where they differ and why.

Some of the most prescient criticisms of the lockdown policy came from other experts like Dr. Gupta and some from intelligent non-experts like (Lord) Jonathan Sumption, a distinguished lawyer, who saw in official  policy the logical likelihood that a lockdown could do little more than redistribute Covid-19 infections and deaths over time—but at huge loss in our economic prospects and our political liberties too.

In short, the biggest global threat today is the ever-present danger of an establishment consensus that won’t allow other views to be expressed and debated. And that threat hasn’t faded even if the lockdown does.

 

Original article here.