Frankfurt shoe store closed

A closed Frankfurt shoe store during lockdown.
Whether or not lockdowns are justifiable on public-health grounds, they certainly represent the greatest infringement on civil liberties in modern history. In the UK, lockdowns have contributed to the largest economic contraction in more than 300 years, as well as countless bankruptcies, and a dramatic rise in public borrowing.

This does not mean that lockdowns were the wrong policy, since they might have been necessary to prevent the National Health Service from being overwhelmed with COVID-19 critical-care patients. (And such measures are justified, proponents argue, on the grounds that they prevent infected individuals from harming others by inadvertently transmitting a deadly disease.) But as I will argue below, there's plenty of evidence that supports those on the other side of this issue, notwithstanding the efforts of politicians, experts, and social-media companies to paint such dissent as marginal or even dangerous.

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Throughout the pandemic, the British government has assured the public that it is being "led by the science." However, a number of scientists and other commentators have disputed this claim. These "lockdown sceptics" (for want of a better term) have argued that indiscriminate, heavy-handed lockdowns are not grounded in science, and that a more focussed protection strategy is preferable. On October 4th, 2020, three scientists — epidemiologist Sunetra Gupta, medical professor Jay Bhattacharya, and biostatistician Martin Kulldorff — gave a forceful endorsement of this alternative view when they signed the Great Barrington Declaration. This is a statement by infectious-disease experts and public-health scientists who have "grave concerns" about the impacts of "prevailing COVID-19 policies." Since then, many other scientists, healthcare workers, and members of the public have added their signatures.

The Declaration is based on the idea that all populations will eventually reach "herd immunity," which is when enough people are immune to a pathogen that the rate of new infections tapers off, thereby affording a degree of protection to those who lack immunity. The Declaration states that achieving herd immunity for COVID-19 can be assisted by vaccines, "but is not dependent" on their use. (The authors have since confirmed that they are "firmly in favour of voluntary vaccination.") Our goal, according to the Declaration, should be "to minimize mortality and social harm until we reach herd immunity."

As to the protection of vulnerable sub-populations — especially elderly people and those with serious pre-existing conditions — the Declaration suggests that "nursing homes should use staff with acquired immunity, and perform frequent testing of other staff and all visitors," and that elderly people "should have groceries and other essentials delivered to their home." The Declaration also notes that "staying home when sick should be practiced by everyone to reduce the herd-immunity threshold." These measures are obviously distinct from the stricter ones associated with the "lockdown" label. (More detailed proposals can be found on the Declaration's website.)

So far, the focussed-protection strategy put forward in the Declaration has not been explicitly adopted anywhere in Europe. British Health Secretary Matt Hancock strongly criticized the Declaration in Parliament, stating that both of its central claims are "emphatically false." When the UK's Chief Medical Officer, Chris Whitty, was asked about the Declaration during an interview with the BMJ, he likewise opined that it was "wrong scientifically, practically, and probably ethically as well." He also claimed that it's "really a pretty minority view."

Social-media content moderators have frequently treated the Declaration, and lockdown scepticism more generally, as fringe viewpoints bordering on "misinformation." And there have been several recorded instances of lockdown sceptics losing access to social-media audiences, at least temporarily. In May 2020, YouTube removed a video in which Freddie Sayers of the media outlet UnHerd interviewed oncologist Karol Sikora, a lockdown sceptic (and former World Health Organization director) — though YouTube subsequently reinstated the video, admitting it had been removed "in error."

Then in January, YouTube deleted the account of talkRadio, a British radio station that has featured many lockdown sceptics. According to YouTube, it has a policy of removing items that "explicitly contradict expert consensus from local health authorities or the World Health Organization." (The account was reinstated "upon further review.")

In some cases, academics who've expressed scepticism about lockdowns have even been sanctioned by their academic peers. Last October, radiologist Scott Atlas — a lockdown sceptic and former advisor to Donald Trump — became the subject of an open letter signed by 98 of his Stanford University colleagues, which accused him of spreading "falsehoods and misrepresentations of science." (Atlas arguably has overstated the case against social distancing.) Later that month, Nobel Prize winner Michael Levitt — a biophysicist and early critic of lockdowns — was disinvited from giving the keynote speech at a biosystems conference. He was told there were "too many calls by other speakers threatening to quit if you were there. They all complained about your COVID claims." In early February, ethicist Christoph Lütge — an outspoken critic of Germany's lockdown measures (which he has called "medieval") — was removed from the Bavarian Ethics Council after other members distanced themselves from his remarks.

According to Bhattacharya, there are "an enormous number of scientists, epidemiologists, and other people" who disagree with the policy of lockdowns, but they are "very uncomfortable of saying so for fear of being smeared." Swedish epidemiologist Jonas Ludvigsson was lead author of a study published in the prestigious New England Journal of Medicine, which reported that only 15 children in Sweden were treated in an intensive care unit for COVID-19 or multi-inflammatory syndrome in the period up to June 15th. He subsequently received "an onslaught of intimidating comments from people who disagreed or disliked his research findings." The experience took its toll on Ludvigsson, who decided to quit researching COVID-19 altogether. In response, the Swedish government has promised to strengthen laws around academic freedom. (It should be noted that pro-lockdown academics have also been subjected to abuse via email and social media.)

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The key question is whether lockdowns are indisputably backed by "the science," as many proponents argue. If the answer to this question is no, then it's wrong to characterize the alternative focussed-protection strategy as a fringe viewpoint. I argued in a previous Quillette article that lockdowns have been effective in geographically peripheral countries that imposed strict border controls at the start of the pandemic (notably Australia and New Zealand). However, I suggested that any beneficial effect of lockdowns in countries such as the UK, France, and Italy must have been relatively small. Of course, others may disagree with my assessment of the evidence, believing instead that death rates would have been much higher in the absence of measures such as mandatory stay-at-home orders and forced business closures.

Yet there is evidence that lockdowns represent a departure from conventional forms of pandemic management. And when assessing novel public-policy instruments, the burden of proof generally lies with those who seek to impose them. Lockdown advocates, such as Conservative MP Neil O'Brien, have made much of the fact that prominent lockdown sceptics at various points underestimated the infection fatality rate and overestimated the level of population immunity. And of course, it is absolutely right that such errors should be pointed out and corrected. But lockdown advocates have made errors, too. And since they've had more influence on government policy, all else being equal, their errors will have been more consequential.

In April, researchers at Uppsala University in Sweden analysed projections from an epidemiological model that its creators said was "based on work by" Neil Ferguson's team at Imperial College. This model predicted that "with the current mitigation approach" there would be 96,000 deaths in Sweden by July 1st. In fact, there were only 5,370 deaths by that date. Imperial College has since clarified that Neil Ferguson's team was not responsible for these predictions. Yet as historian Phil Magness points out, "the Uppsala team's projections closely matched Imperial's own UK and US predictions when scaled to reflect their population sizes," which suggests the two models are based on quite similar assumptions.

In November, American researchers compared the predictive performance of eight international COVID-19-mortality forecasting models. They found that the "Imperial model had larger errors, about 5-fold higher than other models by six weeks," and that this was "largely driven by the aforementioned tendency to overestimate mortality." The comparative inaccuracy of the Imperial model is noteworthy, given that a report by Ferguson's team published on March 16th has been described as the "catalyst for policy reversal" in the UK. More recently, it emerged that a model developed by the Imperial team assumes there is no seasonality to COVID-19, which puts the model at odds with a large body of scientific evidence.

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As many sceptics have noted, up until the lockdown of Hubei province in January 2020, the consensus among epidemiologists (at least in the West) was that lockdowns were not an effective way to deal with influenza pandemics. In October 2019, just three months before Hubei went into lockdown, the WHO published a report evaluating the effectiveness of various measures designed to mitigate the impact of pandemic influenza. The report recommended things such as ventilation of indoor spaces, prevention of mass gatherings, and isolation of symptomatic individuals. However, it classified "quarantine of exposed individuals" as "not recommended in any circumstances," and noted that "there is no obvious rationale for this measure."

Ten years ago, the British government published a report titled "UK Influenza Pandemic Preparedness Strategy 2011," which took a similarly dismissive view of lockdowns. At one point, the report noted that it will "not be possible to halt the spread of a new pandemic influenza virus, and it would be a waste of public health resources and capacity to attempt to do so." One might object that this is irrelevant, since COVID-19 is much deadlier than the kind of influenza envisaged in the report. But that is not so. The report stated that local planners should "aim to cope with a population mortality rate of up to 210,000 — 315,000 additional deaths, possibly over as little as a 15-week period." (The UK's official COVID-19 death toll, since the pandemic began a year ago, is slightly more than 122,000.)

Another objection one might raise is that, although the influenza virus and SARS-CoV-2 are both respiratory pathogens, they are in fact different viruses, and so must be governed by slightly different dynamics. However, the reproduction number for SARS-CoV-2 (which quantifies its transmissibility) is actually greater than the corresponding number for pandemic influenza. This matters because, all else being equal, the more transmissible a respiratory pathogen, the less effective quarantine measures will be (although it should be noted that SARS-CoV-2 has a longer incubation period, which would tend to make such measures more effective). In any case, the UK government's scientific advisers agreed at a meeting on February 4th, 2020, that officials "should continue to plan using current influenza pandemic assumptions."

One month later, on March 5th, Whitty, the Chief Medical Officer, took questions from British MPs regarding the epidemiology of COVID-19. The discussion, available on YouTube, is quite revealing. At 25:50, Whitty states that "we will get 50 percent of all the cases over a three-week period and 95 percent of the cases over a nine-week period." At 30:20, he states, "what we're very keen to do is not intervene until the point we absolutely have to, so as to minimise economic and social disruption." At 34:15, he states, "one of the bits of advice we will give when this starts to run is for people who are older or have pre-existing health conditions to have some degree of isolation." At 41:50, he states that we should try to make sure such people "are protected from the virus over the period of this peak." And at 1:06:00, he reiterates that "one of the best things we can do" is to "isolate older people from the virus." This all sounds rather similar to the Great Barrington Declaration.

One might object that Whitty was not yet aware of the high transmissibility of SARS-CoV-2 and the relatively high lethality of COVID-19. But again, that is not so. At 19:15, he states, "we are all convinced that the upper end of the mortality rate overall, in terms of people infected, is one percent." And at 23:00, referring to the fraction of people who could end up becoming infected, he states that "we would always put 80 percent as our starting point." Since the British population is about 66 million, assuming an infection rate of 80 percent and a mortality rate of one percent yields an upper bound of more than 500,000 deaths — a number that, thankfully, the country is unlikely to ever reach. Why the UK abandoned the approach laid out in its Pandemic Preparedness Strategy is not entirely clear, but the decision appears to have been influenced by the aforementioned report from Neil Ferguson's team published on March 16th.

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Without a large representative survey, it's impossible to know exactly how many experts support the Great Barrington Declaration's focussed protection strategy. (There is also the issue of exactly how to define "expert" in this context. For example, although Ferguson is a professor of mathematical biology, and leads a major epidemiology modelling group, his bachelor's and doctoral degrees are both in physics.) To my knowledge, the only attempt to gauge expert opinion on focussed-protection was undertaken by Daniele Fanelli, a Quantitative Methodology researcher at the London School of Economics.

Using the Web of Science database, he identified 1,841 authors who'd published at least one paper that included certain keywords relating to COVID-19 mitigation. He then emailed each of these authors with the question, "In light of current evidence, to what extent do you support a 'focused protection' policy against COVID-19, like that proposed in the Great Barrington Declaration?" There were six response categories: "none," "little," "partially," "mostly," "fully," and "don't know." Of the 122 experts who've responded so far, only 25 percent said "none," while 28 percent said "mostly" or "fully." (The remainder said either "little" or "partially.") Fanelli's survey is obviously limited by its low response rate. And supporters on both sides can argue about self-selection bias. But the results do suggest that a sizeable number of experts support focussed protection.

The debate over lockdowns versus focussed protection is by no means settled. And as I've previously noted, it may be more sensible to ask when each policy is most likely to be effective, rather than to assume one or other is preferable in all circumstances. What is clear, however, is that the strategy outlined in the Great Barrington Declaration cannot simply be dismissed as an ill-informed viewpoint with little or no basis in science. When the next pandemic hits, we must make sure that scientists can put forward arguments without threats of professional deplatforming, so that those who depart from the public consensus may assist in the common enterprise of safeguarding public health.

Noah Carl is an independent researcher based in the UK. Follow him on Twitter@NoahCarl90.