The herd must choose between immunity or poverty

by Matthew Eason

Yesterday, over 4,000 doctors and medical experts signed a letter expressing their “grave concerns” over the attitude and response to the Covid-19 pandemic from nations across the world. The primary problem that these scientists, including top epidemiologists at Oxford, Harvard and Stanford, had with the popular lockdown approach is that it can and will cause “irreparable damage” to health in other ways. This “Barrington Declaration” will only exacerbate growing concerns in the UK and across the world that lockdown has been a fundamentally flawed approach to the virus.

Instead of lockdown, they call for governments to adopt a process they have called “focused prevention”. In essence, it is a system that combines shielding of the most vulnerable and a common sense approach to hygiene. The vulnerable would fall under the categories you would expect; those in care homes, the elderly, those with pre-existing conditions to name a few. One clear example of this is that “vulnerability to death from Covid-19 is more than a thousandfold higher in the old and infirm than the young” and that “for children, Covid-19 is less dangerous than many other harms, including influenza.”

Those who are not vulnerable would be expected to immediately to resume life as normal with basic hygiene measures – such as handwashing – being able to reduce the risks of transmission and the threshold for “herd immunity”. Does this all sound familiar? It does seem remarkably like the UK government’s original approach to the pandemic does it not.

Despite herd immunity becoming a seemingly unpopular term and theory in the UK, this letter is remarkably clear on this issue; herd immunity is possible and it is not viable to close down society to wait for a vaccine – indeed herd immunity, the point at which the rate of new infections is stable, is supported by vaccinations but not dependent on it.

Given that shielding can reduce the vast majority of the risk for those vulnerable groups and common sense precautions can mitigate the risks for those who are not at-risk, it is right that we look at the harms that the lockdown itself causes – as a comparison. In this, the 4,000 scientists all agree that lockdowns are devastating both short- and long-term public health outcomes. Some of the clear examples that are coming out are that there are “lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come”.

It has become increasingly obvious that economically and for public health reasons, countries cannot and must not stay locked down. Measures that promote shielding and opening the country are the only answer to mitigate both health and economic damage. The “Barrington Declaration” was clear, we will face irreparable damage from perpetual lockdown.

Pushing towards herd immunity is the only viable way forward. Of course, this relies on maintaining high standards of hygiene from the public and from major public service organisations like TfL – as an aside I cannot be the only person who is concerned that regular thorough cleaning of train and tube carriages is deemed “special”.

Ultimately, the government needs to trust that ordinary citizens – especially those with the least risk – will behave responsibly. Perhaps they will understand that much of the “misbehaviour” is due to citizens pushing back against the restrictions to test boundaries that they know they can ignore – partially due to miscommunicated, garbled policy and partially due to many of them being completely unenforceable in the long term.

If the government was right before – as it seems they were – perhaps they should have stayed true to their initial decision. Perhaps their decision to lock down was based on what we now know was wildly inaccurate data from Public Health England and then deemed too risky to change course when the truth came out. Maybe the abrupt change in policy is just another example of one of this government’s failings, that rather than making a decision or sticking to a policy position it would rather jump in fright at every negative media headline and change direction.

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