How many times in 2020 throughout this COVID-19 crisis have you heard our politicians tell you they will listen to the experts, our leading scientists? Which experts are they referring to though?
What would you think if over the last seven months we didn’t need to endure lockdowns, curfews, travel restrictions, gone to the footy, had our kids attend school, gone to a pub, restaurant and cafe when the mood took us and then hit the gym the next day to work off the extra kilos? In effect, just lived life as we normally have with a few precautions.
Well that’s exactly the position of four of the world’s leading epidemiologists.
Why do we never hear this position at least aired by our politicians and health bureaucrats even though they continually lecture us about being guided by the experts and the science? Well these preeminent experts and these scientists say our government is getting it wrong and alarming so.
In any scientific field, there is a variety of opinion, in fact, that is the essence of scientific endeavour. Identify problems, conceive solutions conduct trial and error experiments and engage in debate and discussion until a viable outcome is discovered. Even then, there will continue to be scientific development to arrive at better alternatives or alternative solutions.
Our politicians try to make it seem as though science has all the answers in a compact box of hard and definitive answers when nothing could be further from the truth. One of the more sickening optics of the overreach of government throughout this pandemic has been to witness politicians and bureaucrats evading accountability for some of their most deplorable decisions by hiding behind what they claim is the best public health advice.
The important word in that sentence being “public which means a government employee locked away in a bureaucratic department relying on the public purse.
There are two things that should concern us with that. Firstly, the best scientific minds don’t reside in public government departments; they are predominately either in private industry or institutes of advanced learning where successful research is handsomely rewarded. Second, any person employed as a public servant in a government bureaucracy, despite denials, will always be pressured by the government of the day to toe the line on any policy direction implemented by that government.
So my interest was piqued when I read about a declaration from four of the world’s leading epidemiologists speaking out against the lockdown policies of governments across the globe. Not surprisingly having lived in Melbourne for the last seven months and enduring one of the harshest if not the harshest lockdown on the planet, I wanted to find out more
These four epidemiologists meet in the living room of the Stone House of the American Institute for Economic Research, on October 3, 2020. Along with them were economists and journalists who were there to discuss the global emergency created by the unprecedented use of state compulsion (i.e. lockdowns) in the management of the Covid-19 pandemic.
From this, The Great Barrington Declaration emerged, which urges a “Focused Protection” strategy. This declaration calls for an URGENT re-evaluation of economic and scientific strategies to protect vulnerable classes from Covid-19.
There was an interview of two hours that involved legitimate and fascinating discussion about all the issues surrounding covid-19 without all of the political stigmatising of opinion that is usually attached to these conversations. Every citizen would take the time to watch this
This interview took place the morning prior to the drafting of the declaration document and its content was so important I decided to record every question and answer. It’s not word for word as I have condensed the questions and answers to streamline the interview, but what I have listed below certainly captures all the subject matter of this interview. While this took me five hours to complete due to a combination of my inadequate typing skills and the required research into words and terms I didn’t understand, by its completion, I had gained a far greater appreciation and understanding of this virus and viruses in general, how they have been managed in the past and most importantly this current covid-19 virus could of and should of been managed
Quoting directing from the YouTube video on this meeting
“During the greatest public policy crisis of our lifetimes, this film chronicles what appears to be a turning point, the moment with the moral courage of a few people broke through the pro-lockdown opinion consensus. With patience and careful explanation, the panel reveals the lockdown agenda as cruel pseudoscience that has had a devastating economic, medical, social, and cultural impact on everyone but especially the poor and struggling.”
The Four world-leading Epidemiologists in this filmed interview are.
Martin Kulldorf, PhD – Professor of medicine at Harvard Medical School, Biostatistician and Epidemiologist in the division of Pharmacoepidemiology and Pharma economics, Brigham and Woman’s Hospital. His current research enters on developing new statistical methods for post-market drug and vaccine safety surveillance.
Sunetra Gupta – Infectious disease epidemiologist and a professor of theoretical epidemiology at the University of Oxford, England. Professor Gupta has performed research on the transmission dynamics of various infectious diseases including malaria, influenza and COVID-19.
Jay Bhattacharya – Professor of Medicine at Stanford University, Research associate at the National Bureau of Economics Research and senior fellow at the Stanford institute for Economic Policy Research. Dr Bhattacharya’s peer-reviewed research has been published in economics, statistics, legal, medical, public health and health policy journals.
Stefan Baral, MD (remotely) – Physician epidemiologist and an Associate Professor in the Department of Epidemiology at the Johns Hopkins School of Public Health (JHSPH)
The event was hosted by Edward Stringham and the American Institute for Economic Research
They are interviewed by
David Zweig an independent journalist who writes for the New York Times, The New Yorker amongst other publications
and
John Tamny, Political Economy editor, Forbes, RealClearMarkets, Financial Times, National review
“They granted full access and freedom to ask anything, and none of the questions were seen in advance. What unfolds here is purely extemporaneous and spontaneous.”
Has the term “Herd Immunity” become a PR problem or there something else at play?
The term “Herd Immunity” for some reason has been maligned, when in reality over history this is how humans have resolved various viruses. A Pathogen (virus) spreads through individuals and as they recover they become immune to that virus, as it spreads through a community that community can then achieve what science refers to as “Herd Immunity”.
This term for whatever reason through the Covid-19 scenario has been largely demonised. We have arrived at this point due to a lack of education and sophistication of thinking.
This is as much a crisis of language, as it is a fundamental understanding of how a pathogen spreads, how we manage risk and what the social contract is to reach equilibrium.
What is it that you are proposing?
An elimination strategy won’t work in this case, so alternatively you can attempt to keep or get the numbers down through lockdown measures. This strategy though causes substantial damage with it not being sustainable in the long term. The third strategy which most governments aren’t implementing is to let herd immunity build up in the population while protecting the vulnerable within society until you reach the point where those with immunity are actually protecting those who are vulnerable to it.
Going into lockdown while waiting for a vaccine causes enormous collateral damage, from things such as mental health issues created by the isolation of children from their schools and friendship groups to house evictions and people missing medical checks for things such as cancer screenings.
This will not be visible in the immediate future but people who could have lived for another 15 years will instead be dying from cancer in the next 3 to 5 years for example.
Is there a way to model data between the two different approaches of lockdowns versus herd immunity?
The evidence coming in now is that lockdowns and the associated economic collapses will be devastating across the globe.
The UN is estimating that 130 million extra people alone are at risk of death of starvation across the globe due to lockdowns by the end of this year. One in four Americans between 18 and 24 seriously considered suicide in June. The UN also estimates that in India 1.4 million are at risk of death as tuberculosis patients aren’t receiving treatment, while GAVI, the vaccination program that helps vaccinate almost half the world’s children against deadly and debilitating infectious diseases, has been suspended. This means we are going to see outbreaks in things like diphtheria, pertussis (whooping cough) and measles.
In focusing on just Covid-19, governments across the globe will ensure more damage and more lives are lost than had a more holistic view had been taken.
Data models should only represent one component of any decision-making process due to the complexities of the domino effect on other health conditions. Modelling, at least in this group’s memory, has not been used previously to drive health policy in real times.
How many academic colleagues would agree with these individuals, “Probably more than you think”.
Herd immunity will ultimately happen whether it’s through a vaccine or through a wide enough spread of the virus through the population. When you try to serve everybody, you effectively serve nobody
A common question amongst many in the public is that this is a novel virus and we don’t know for sure what its effects could be on people. Is there enough data, that as experts, you can say with some degree of confidence what impacts the different strategies could have?
We have learnt who is at risk and who is at less risk, we have learned about comorbidities that can put you at risk and others that put you at less risk. We can use those facts to design strategies more effectively and efficiently than we could have in March, when we were still coming to terms with the virus. There have also been many therapies developed for the disease that didn’t exist in March and you can see that most recently with President Trump for instance where he has been treated with two drugs that experts didn’t know would be effective against Covid-19 back in March. So there has been a lot learned about the disease and how to treat it in the past six months.
The deeper question about risk though is really important, which by the way is not true for this disease but every disease. There is always a RISK. The only adult thing to do is to manage those risks appropriately, to lock ourselves in our houses and to lock down our economies is an illusion which in itself creates enormous risks with the uncertainties involved. There needs to be a more holistic approach to managing ALL the risks in dealing with this virus, not just the virus itself.
The correct approach is to assess all those risks and balance them and then make decisions on the basis of them as a whole. The reality is that there is no safe choice in dealing with this. If people are so paranoid about dying from cardiovascular disease, from cancer, from diabetes, from a car accident or even the annual flu then yes maybe they can add covid-19 to that long list of things to be afraid of before going to get some counselling.
For most people, this is just one more thing that could affect us in our lives but it makes no sense to go around being terrified by it. Instead, for example, when we drive a car, we put on a seatbelt to lower the risk as opposed to eliminating the risk. So with covid-19, we should wash our hands for example, which also lowers the risk but doesn’t eliminate it. So we cannot let covid-19 interrupt life, just realise it is part of a long list of things that could impact us, in being paranoid about it, we are developing problems both currently and in the long term.
It seems the reason behind the lockdowns in March was how quickly this disease spread? However, the first known case was diagnosed in China in November 2019, wasn’t the disease spreading rampantly well before March. Considering the travel to and from China around the globe is it unrealistic to consider that herd immunity was achieved long ago?
A paper was actually produced in March to observe that scenario was exactly what we were seeing but it was roundly condemned as being irresponsible. The important point is that within the scientific community there is a lot of uncertainty in regards to this, which also means there must also be a lot of uncertainty over any perceived benefits from any lockdowns.
So in the absence of certainty on how much herd immunity exists within a society, how do we evaluate a correct path in regards to the risks of a herd immunity strategy?
Achieving herd immunity varies by location, demographic, population behaviour and strategies that are used. So there is uncertainty over what levels of immunity you need within a population to achieve herd immunity. What is known is the factor of risk by age groups as well as background conditions, so we need to develop a strategy that is much better at protecting our vulnerable groups while at the same time letting those at least risk groups such as children and young adults live as close to normal lives as possible.
Taking that into consideration how do you manage the risks in schools for example, where teachers, who can be older adults, mix with children?
When talking about risks, there are two types of risks. Firstly what are the risks for infection? The risk for infection is there for everybody including children and young adults. There is secondary risk through the chance of dying from an infection and the risk for these groups is extremely low. Teachers in their 20’s to 40’s are at a low risk. but teachers in the more at risk age groups (i.e. 60+) aren’t as much at risk from children (as they transmit less) as they are from other teachers. Taking this into consideration, instead of closing schools, to protect the teachers most at risk could teach from home or assist other teachers with things such as grading of students work.
Children are being forced to take an unreasonable burden through this pandemic and they should instead be allowed to get on with living their lives
Taking this into consideration, is there a misconception in the wider community about the risk posed by the opening of schools? Is the idea of a lack of safety at schools reasonable or a mistake?
It’s part reasonable and part mistake. It’s reasonable in that as a society we want to protect the most vulnerable. As a society, we are putting in enormous resources to address this virus, in the educational sphere those resources should be used to restructure a school to allow the most vulnerable to be protected, so that’s reasonable.
What’s unreasonable or a mistake, is that we have shut down the entire education structure for children who are bearing an enormous cost as a result. Importantly, what should be remembered and stressed is that developing a herd immunity within a community is a temporary issue. In a school environment for example once enough immunity is reached, vulnerable teachers and even students could return at that point. Wouldn’t a three month period of developing immunity be preferable to locking down the education system indefinitely as we are now doing through lockdowns?
So what about a 40 year old teacher who is in good health, who still has concerns about going to school to teach kids, what does the data tell us that we could ease their concerns?
Be very careful when driving to work.
Joking aside, the issue is in the public health messaging. The people you describe have a 2 in 1,000 chance of dying if they become infected with the virus with just as minimal chance of any long term effects, which can happen with any virus, including the flu for example. The problem with our messaging is that it has made the people who are vulnerable under-estimate the risks they face, while the people who are least vulnerable vastly over-estimate the risks that they face. It’s this misconception of risk that is causing the problem. The public messaging should accurately reflect the data and it’s not.
Considering that in the field of epidemiology people work in very different field and areas, yet as a society, we seem to focus on one individual as the appointed leader of the field towards dealing with any virus, is there a danger voices from across the spectrum are not being heard?
Infectious diseases are complex and areas of expertise are broad. The media should take a broader approach when looking for expertise.
Scientific consensus, is there a politicisation around the approach to the pandemic that is detrimental? Are you as individuals tainted by perceived political associations and if so how do we get around that?
We can only convey the truth as we see it and what we believe. We cannot control the surrounding noise, but we need to keep the conversation happening. As scientists, we can inform the debate on what should happen, but the decisions we take as a society are ultimately political.
What’s most important is to have a debate, instead, we are finding efforts to de-platform voices that don’t conform and claiming that contrarian decisions are dangerous. That is extremely problematic.
Hypothetically if your view is in the minority, that doesn’t necessarily, mean you’re wrong? Is that dangerous?
You have to say what you think, time will tell in the long run who is right and wrong. Shutting down debate is irresponsible. The tragedy is that some within the sphere aren’t willing to speak out. The general feeling is that within the infectious disease expert community there is strong support for a herd immunity approach; however outside the field, at least amongst those who are vocal in the media, there is more of a group think towards lockdowns and contact tracing type of strategy.
So why has a group think occurred outside your field of expertise, which is a complete distortion from the public perception of what is happening, which is potentially very problematic?
We don’t know the answer to that, maybe we as scientists should ask you journalists that questions as you may have better insights than we do on that.
One form of speculation is that once as a community you form an impression around a subject it is very hard to change it and we formed an impression surrounding covid-19 in March that’s hard to change, which is just a part of human nature. An important part of dealing with any virus is keeping an open mind to the data as it evolves and then to evolve our thinking and approach along with it. In a broader sense, with the messaging to the community that is harder to achieve.
Why are you not wearing masks?
After reading much of the literature, we are not overwhelmed by the evidence that wearing masks mitigates the spread of the virus. Where you can’t social distance there is potential benefit but the science isn’t settled there.
Public health shouldn’t divide us. Mandatory mask-wearing may lead to stigmatising sections of our community. In other words a good person wears a mask and a bad person doesn’t. We need to work against that.
There is also a school of thought that wearing a mask leads to people touching their face more which actually heightens the risk of spread of the virus.
In contracting the disease you are not hurting anybody, in fact, it can be argued strongly that you are helping others by helping to developing herd immunity.
On a more general point, through lockdowns we are protecting the more privileged and wealthy middle and upper-class sections of our community, while we are throwing the poorer, less privileged under the bus. For example, the more privileged can afford to take time off work or work from home, the less privileged can’t afford to take time off work and have less opportunity to work from home. Children from poorer families have fewer opportunities than children who attend private schools, whose parents can afford a tutor or even parents who are more capable with home-schooling responsibilities. Also because cities are more attuned to herd immunity due to population density compared to regional communities, it’s the urban working class bearing the brunt of the disease and the collateral damage.
More broadly, you have to think about how these strategies are impacting on poorer communities globally.
The first case outside china come up in Malaysia? Yet countries in that country and surrounding countries have not been impacted as badly with covid-19 compared to other counties.
The scenarios are that those countries are largely younger demographically. The other scenario is resistance amongst those populations through exposure to previous corona viruses in those countries and a third scenario is that the covid-19 virus spread in that part of the word between November and March and they achieved a degree of herd immunity before the virus had spread to other parts of the globe.
Also in many of those countries, there is much more inter-generational mixing which may have meant through any exposure to previous corona viruses, older communities in those countries may have already built up effective antibodies and T-cells to combat the virus.
Considering that we now know that some of the things we first believed about the AIDS epidemic were totally inaccurate, how can we be confident that some of our current perceptions about Covid-19 are accurate?
Professor Jay Bhattacharya responded, “One of the things that haunts us, is that we may look back on this as one of the biggest public health mistakes in history. I really believe that.” (I quoted this word for word as I found this frightening.)
Some states in the USA such as Florida are more opened up than New York for example? This allows us a real word experiment between how high population density states to discover evidence about the best approaches?
On kids at schools, the data is in unequivocally. Kids are safer at schools. Scientific evidence points to keeping schools open.
Why then is there is such recalcitrance to this for example in New York if the data and evidence is so strong?
If people were educated in the data and it’s evidence then those decisions wouldn’t be being made. (Comment: I think this is a generous observation that dodges the obvious political intentions of that state’s governor and that city’s mayor)
Dr Gupta, you have spoken about the global social contract as it relates to infectious diseases? I have never heard that before and I think it’s so interesting and I wonder whether you could talk about that.
What are we alive for? We live for things such as arts, culture and education. We will try and protect the vulnerable but ultimately any disease will kill people. When a person who is a 45-year-old teacher, for example, refuses to enter into a class to teach their students through fear of the virus, that is extraordinarily individualistic and the social contract is broken between that teacher and his/her students. The same could be argued between the relationship between first and third world countries as well.
Where did this concept of lockdown originate? Was there any engagement within the scientific community? If there wasn’t, where do you think this idea came from and do you think it was realistic conceptually?
The first I had heard of this lockdown idea was after H1N1. The first thought in this instance was to use it to flatten the spread so the hospitals didn’t get overwhelmed. That idea was originally right in some places and made some sense because a lockdown delays the onset of a disease, it doesn’t prevent it or eliminate it, it just puts it off into the future, so at the point in time the thinking surrounding lockdowns made sense in that setting.
What has stunned me is that in places where there was very little risk of hospitals and health systems being overrun, lockdowns were put in place one after another. What stunned me even more, was that after those lockdowns were introduced was that it was difficult to generate a discussion and even a debate about those lockdowns as they continued. That debate just didn’t happen and instead, by assumption, lockdowns stayed in place.
For example in a proper environment what we would like to see is a discussion about the endpoint of this disease and at the moment all the discussion is about a vaccine, but there is a risk associated with that. One thing that is problematic is that as cases start to decline it becomes more difficult to run a vaccine trial due to declining sample sizes being available.
So there really hasn’t been a full debate, we have sort of landed at this policy by default from this thesis of let’s flatten the curve.
Are you concerned that through the silencing of voices within your scientific community, that its credibility may be affected amongst the general public?
It’s important to understand that there isn’t consensus in a scientific debate or discussion. If the public is ignorant to a particular side due to the media not publishing those views, then that can damage the public’s confidence in the science and have repercussions in people accepting vaccines for examples. However, if people come to realise that science isn’t an exercise in consensus, that could be a healthy thing.
This film which you can see at https://youtu.be/jtiInz1DWuA , will help everyone rethink what has happened to the world over the last 7 months. The document is now open for signing by medical professionals, practitioners and the general public.
You can sign the document by visiting: http://www.gbdeclaration.org
