Is the cure more deadly than the virus?

Opinions are largely divided when it comes to the nature of preventive measures necessary to stem the further spread of Covid-19.

Decision-makers depend on the guidance and recommendations of medical experts in adopting health safety protocols the public should adhere to.

Interestingly, a prominent group of global medical experts recently initiated a process to specifically focus on the negative impacts on the public health in general as a result of coronavirus related shutdowns and curfews in a country.

Titled ‘The Great Barrington Declaration’, the group of infectious disease epidemiologists and public health scientists raised grave concerns over the damaging physical and mental health impacts of the prevailing Covid-19 policies, and recommended an approach they called ‘Focused Protection’.

The experts claimed that the ongoing lockdown policies in many countries are producing devastating effects on short and long-term public health. The results 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, they claimed.

Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed. The normal time-line for releasing a vaccine to the public is between 8 – 12 years, they opined.

“The vulnerability to death from Covid-19 is more than a thousand-fold higher among the old and infirm than the young. Indeed, for children, the virus is less dangerous than many other viral strains, including influenza”, the medical experts declared.

As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. It’s a known fact that all populations will eventually reach herd immunity – i.e. the point at which the rate of new infections is stable. The goal should therefore be to minimize mortality and social harm until herd immunity settles in, the experts recommended.

The most compassionate approach that balances the risks and benefits of reaching herd immunity is to allow those at minimal risk of death to live their lives normally and to build up immunity to the virus through natural infection, while better protecting those at the highest risk. This is what medical experts call “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 homes.

When possible, they should meet their 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, they further said.

The medical experts are of the view that 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 remain 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, they said.

On October 4, 2020, ‘The Great Barrington Declaration’ was authored and signed in Great Barrington, United States, by 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, Dr. Rajiv Bhatia, Physician, Epidemiologist and public policy expert at the Veterans Administration, USA

The other eminent medical professionals who endorsed the declaration were: Dr. Stephen Bremner, Professor of Medical Statistics, University of Sussex, England, Dr. Anthony J Brookes, Professor of Genetics, University of Leicester, England, Dr. Helen Colhoun, Professor of Medical Informatics and Epidemiology, and Public Health Physician, University of Edinburgh, Scotland, Dr. Angus Dalgleish, Oncologist, Infectious Disease Expert and Professor, St. George’s Hospital Medical School, University of London, England, Dr. Sylvia Fogel, Autism Expert and Psychiatrist at Massachusetts General Hospital and Instructor at Harvard Medical School, USA.

Dr. Eitan Friedman, Professor of medicine, Tel-Aviv University, Israel, Dr. Uri Gavish, Biomedical consultant, Israel, Dr. Motti Gerlic, Professor of Clinical Microbiology and Immunology, Tel Aviv University, Israel, Dr. Gabriela Gomes, Mathematician studying infectious disease epidemiology, Professor, University of Strathclyde, Scotland, Dr. Mike Hulme, Professor of Human Geography, University of Cambridge, England, Dr. Michael Jackson, Research Fellow, School of Biological Sciences, University of Canterbury, New Zealand, Dr. Annie Janvier, Professor of Pediatrics and Clinical Ethics, Université de Montréal and Sainte-Justine University Medical Centre, Canada, Dr. David Katz, physician and president, True Health Initiative, and founder of the Yale University Prevention Research Center, USA, Dr. Andrius Kavaliunas, Epidemiologist and Assistant professor at Karolinska Institute, Sweden, Dr. Laura Lazzeroni, Professor of Psychiatry and Behavioral Sciences and of Biomedical Data Science, Stanford University Medical School, USA, Dr. Michael Levitt, Biophysicist and Professor of Structural biology, Stanford University, USA were also among the signatories.

They were joined by the recipient of the 2013 Nobel Prize in Chemistry, Dr. David Livermore, Microbiologist, Infectious Disease Epidemiologist and Professor, University of East Anglia, England, Dr. Jonas Ludvigsson, Pediatrician, Epidemiologist and Professor at Karolinska Institute and Senior Physician at Örebro University Hospital, Sweden, Dr. Paul McKeigue, Physician, Disease modeler and Professor of Epidemiology and Public Health, University of Edinburgh, Scotland, Dr. Cody Meissner, Professor of Pediatrics, Expert on Vaccine Development, Efficacy, and Safety. Tufts University School of Medicine, USA, Dr. Ariel Munitz, Professor of Clinical Microbiology and Immunology, Tel Aviv University, Israel, Dr. Yaz Gulnur Muradoglu, Professor of Finance, Director of the Behavioural Finance Working Group, Queen Mary University of London, England, Dr. Partha P. Majumder, Professor and Founder of the National Institute of Biomedical Genomics, Kalyani, India, Dr. Udi Qimron, Professor of Clinical Microbiology and Immunology, Tel Aviv University, Israel, Dr. Matthew Ratcliffe, Professor of Philosophy, Specializing in Philosophy of Mental Health, University of York, England, Dr. Mario Recker, Malaria Researcher and Associate Professor, University of Exeter, EnglandDr. Eyal Shahar, Physician, Epidemiologist and Professor (emeritus) of Public Health, University of Arizona, USA, Dr. Karol Sikora, Physician, Oncologist, and Professor of Medicine at the University of Buckingham, England, Dr. Matthew Strauss, Critical Care Physician and Assistant professor of Medicine, Queen’s University, Canada, Dr. Rodney Sturdivant, Infectious Disease Scientist and Associate Professor of Biostatistics, Baylor University, USA, Dr. Simon Thornley, Epidemiologist and Biostatistician, University of Auckland, New Zealand, Dr. Ellen Townsend, Professor of Psychology, Head of the Self-Harm Research Group, University of Nottingham, England, Dr. Lisa White, Professor of Modelling and Epidemiology, Oxford University, England and Dr. Simon Wood, Biostatistician and Professor, University of Edinburgh, Scotland.

– Dr. Dietmar Doering

(The writer is a Social Scientist and Head of AGSEP Research)