Sunetra Gupta, Jay Bhattacharya and Martin Kulldorff
UnHerdSun, 04 Oct 2020 01:00 UTC
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.
Fortunately, our understanding of the virus is growing. We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.
As immunity builds in the population, the risk of infection to all - including the vulnerable - falls. We know that all populations will eventually reach herd immunity - i.e. the point at which the rate of new infections is stable - and that this can be assisted by (but is not dependent upon) a vaccine.
Our goal should therefore be to minimize mortality and social harm until we reach herd immunity. 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.Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.
Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. 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. Great Barrington, Massachusetts, 4th October 2020To sign the declaration, follow this link (will be live later today):
www.GBdeclaration.org
Comment: What a pleasure it is to listen to informed rational scientists talk about the virus with some healthy doses of sanity.
But, of course, there have already been some
detractors of these ideas:
Last month, two scientific groups in the UK offered conflicting advice. In one open letter, Prof Gupta and her colleagues argued that suppressing the virus was "unfeasible", while the other, headed by Prof Trish Greenhalgh, also at Oxford, said it was not practical to cut off an entire cohort of vulnerable people from open society.
William Hanage, a professor of epidemiology at Harvard, said the declaration seemed to be attacking the idea of mass, ongoing lockdowns, a proposal that nobody was suggesting. "After pointing out, correctly, the indirect damage caused by the pandemic, they respond that the answer is to increase the direct damage caused by it," he said.
Work by Hanage and others suggests Covid becomes more lethal than flu for people in their mid-30s and climbs exponentially from there, meaning that swathes of the population would need protecting. "Stating that you can keep the virus out of places by testing at a time when the White House has an apparently ongoing outbreak should illustrate how likely that is," he said.
Another concern, he added, was that an uncontrolled outbreak among young and healthy people could leave many with long-term medical issues, including the "long Covid" disorders that have already affected young people.
In a Twitter thread responding to the declaration, Gregg Gonsalves, an epidemiologist at Yale University, said shutdowns and other interventions were necessary to reduce rates of infection. With nearly half of the population having some underlying health risk for Covid-19, he said herd immunity strategies were about "culling the herd of the sick and disabled. It's grotesque."
www.GBdeclaration.org