Consider the Great Barrington Debate and its critics

Interview with Supervisor Jim Desmond and Martin Kulldorff of Harvard University

https://podcasts.apple.com/us/podcast/around-the-county-with-supervisor-jim-desmond/id1456405094#episodeGuid=96aa6d0b-d90c-4b54-87e2-538898d0b3e6

"Three of the world's top epidemiologists published a short treatise advocating opening up societies across the globe immediately. Over 510,263 people including about 28,113 medical and public health scientists and 10,290 medical practitioners have signed on this week."

Early this week, three of the world's top epidemiologists published the Great Barrington Declaration, a short treatise that advocates a controversial approach to managing the coronavirus pandemic. Professors Jay Bhattacharya of Stanford University, Sunetra Gupta of Oxford University and Martin Kulldorff of Harvard University argued that societies across the globe should reopen immediately and completely. 

Instead of observing measures designed to slow the spread of the virus, the young and healthy should resume normal activity to incur herd immunity and thereby protect those vulnerable to severe illness. The authors urged the adoption of this strategy, which they call "Focused Protection," in light of increasing evidence that "current lockdown policies are producing devastating effects on short and long-term public health... Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed." 

While these scientists are not the first to express such views, given the degree to which their stance conflicts with the prevailing wisdom that everyone has a moral obligation to participate in efforts to "stop the spread," it is not surprising that they have already encountered significant opposition. Among their primary detractors is Yale epidemiologist Gregg Gonsalves, who considers their proposal akin to a suggestion that society "cull... the herd of the sick and disabled. It's grotesque."

It is hard to see where Gonsalves reads into the declaration, which seeks to balance the interests of all demographics, a call to "cull... the sick and disabled."

Gonsalves's more measured, and conceivably legitimate, argument is that, since around 50% of the United States population is vulnerable, those most likely to experience severe illness cannot simply be separated out from the rest of society. Some version of this notion – that the strategy is logistically unfeasible and therefore must be discarded – is the most prevalent critique of the document. Gonsalves and others, for instance Dr. Michael Head at University of Southampton, also contend that the declaration's premise is false, because no one in the scientific community is calling for either extended or extensive lockdowns.

But this latter claim is simply untrue. Many prominent scientists have called for extreme lockdowns in the United States, as recently as September. While they claim this action would eradicate the coronavirus entirely, it is becoming increasingly evident that such suppressive measures last only as long as they are in place.

Once lifted, the virus simply resurges, as has been demonstrated by countries such as Peru, which initially implemented one of the world's most extreme lockdowns and now has one of the worst outbreaks. Melbourne, Australia, has been under a severe lockdown for over a month, despite having declared early victory against the virus. The United Kingdom has been enacting various forms of shutdown for several weeks after having been more or less open for the summer, and the mayor of New York City and governor of New York State have been threatening to impose localized lockdowns in Brooklyn and Queens neighborhoods in which cases are rising. Thus, whether endorsed by the scientific community or politicians, forced closures of schools and businesses are the default mechanism for managing rising cases in many parts of the world.

Lockdowns are no strawman, contrary to the claims of Gonsalves and colleagues.

As for Gonsalves's more compelling concern, it is true that protecting vulnerable members of society who do not reside in nursing homes, while allowing the rest to go about their lives, is not a simple feat. But the many scientists who conclude that, therefore, "Focused Protection" is not viable are woefully misguided. Initially, some portion of the vast resources that societies are expending to lock down could be diverted to this project. But more importantly, the critics' position drastically underestimates the harm lockdowns inflict on a society.

Oxfam recently published a report concluding that 130 million more people will probably die of starvation due to supply chain disruptions resulting from lockdowns around the world. As Time magazine explained, that is exponentially more people than will succumb to the coronavirus itself. The Centers for Disease Control and Protection has estimated the probable occurrence of more than 93,000 "non-COVID-19 'excess deaths' this year, including 42,427 from cardiovascular conditions, 10,686 from diabetes and 3,646 from cancer. Many are due to government shutdowns of nonessential medical care." Those numbers are for this country alone.

Likewise, mental health is deteriorating; substance, child and domestic abuse are increasing and children, especially those who come from families without means, are falling behind in school. Countless businesses have closed, many for good, spelling financial disaster for their owners and hardship for employees. All due to lockdowns, despite the common misattributions in headlines to the "coronavirus" itself.

While Gonsalves and the other critics are quick to argue that "Focused Protection" is "grotesque," at no point do they address the crux of the matter, which is that the harms of locking down and social distancing, especially to the young, outweigh the benefits. Their opposition stems from the myopic worldview that led to lockdown and social distancing strategies in the first place: that the pandemic is a uniquely horrible problem that justifies sidelining all others in the quest to solve it.

Instead, as society has seen over the past seven or eight months, the coronavirus is just one among countless difficulties that the world faces; when contemplated dispassionately, it does not stand out the way that, for instance, nuclear war or a truly apocalyptic pandemic would. At 1.05 million deaths over the past nine or 10 months, the coronavirus appears to be a problem along the lines of, for example, traffic accidents, which cause 1.35 million deaths per year, or tuberculosis, which results in 1.5 million deaths annually.

Most people understand and accept that preventing these deaths must be balanced against other interests. If, for instance, the nation banned vehicular travel to avoid deaths resulting from traffic accidents, but doing so caused 130 million deaths from supply chain disruptions, people would immediately recognize it as a failing proposition. Clearly, the same logic ought to apply in this case.

Critics of the Great Barrington Declaration correctly observe that the health care system will not be able to prevent every death from coronavirus among the vulnerable. But their argument rests on the false assumption that preventing coronavirus deaths is more important than anything else, and while efforts can be made to mitigate collateral damage, in the end all must give way to this overarching goal.

Rather, like all else in life, mitigation efforts must be balanced against the injury those measures cause. Since lockdowns will probably cause more deaths by starvation alone than the coronavirus, never mind the myriad other harms, the critics' position simply does not withstand any scrutiny. By contrast, the writers of the Great Barrington Declaration expressly recognize both sides of the equation and seek to minimize coronavirus deaths among the vulnerable and suffering inflicted upon the nonvulnerable.

To read the short Barrington Debate treatise, visit https://gbdeclaration.org/.

The three doctors who signed the declaration include:

Dr. Martin Kulldorff, professor of medicine at Harvard University, a biostatistician, and epidemiologist with expertise in detecting and monitoring infectious disease outbreaks and vaccine safety evaluations.

Dr. Sunetra Gupta, professor at Oxford University, an epidemiologist with expertise in immunology, vaccine development, and mathematical modeling of infectious diseases.

Dr. Jay Bhattacharya, professor at Stanford University Medical School, a physician, epidemiologist, health economist, and public health policy expert focusing on infectious diseases and vulnerable populations.

Copyright 2020 American Institute for Economic Research. Reprinted with permission.

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