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To Friends and relations

I have always been a sceptic about lockdowns. Am I still – in the face of rising rates of infection and news of hospitals being overwhelmed?

The answer is yes, I still am. But is it worth thinking about now? The vaccines are being rolled out – hooray! We’ll soon be let out of jail anyway. And there’s no likelihood of the lockdown restrictions being lifted here or anywhere else any time soon, whatever anyone says or thinks.

I keep talking to my sister Amanda (a distinguished pathologist) about it and she thinks we should keep up the scepticism. She reckons that we should go further and when people go on about the risks and how we’ve got to have more restrictions, we should say what we think. Though maybe not on Twitter!

So, let’s tackle the big question. Do lockdowns work? There have been, to my knowledge, at least three studies done: one published in the Lancet in July 2020; one in October 2020 by Tel Aviv University; the third one by an organization called Frontiers in Public Health (a publisher of scientific journals based in Lausanne).

The Lancet study was based on information from 60 countries up to May 2020 (when the first wave of the pandemic was already declining). It tried to discover whether there were “correlations” between Covid deaths (and, I think, critical care cases) and the severity or otherwise of lockdown rules. They found – I have to say, surprisingly (as to which, see below) – no correlation at all. They found other correlations – in particular levels of obesity – but none for lockdowns. Of course, correlation doesn’t equal causation. Had they found a correlation for lockdowns, it wouldn’t have proved that lockdowns work. But the lack of any correlation does get pretty close to proof that they don’t.

The other two studies reached similar conclusions. The Tel Aviv one said that there was no “statistical link” between lockdown severity and Covid deaths.

The November one was done on a more extensive basis (presumably with more information available) on as many as 160 countries. They found that the stringency of lockdown measures did not “appear to be linked to the death rate”.

Let’s face it. These conclusions are counter-intuitive. At the most extreme level, obviously lockdown must work. If everyone really does stay at home in isolation, surviving on baked beans stored in the basement, they may go mad but they won’t die of Covid.

But why, in the real world, don’t lockdowns work? Amanda and I thought about it and came up with some reasons.

The first is that we in the west were (mostly) locking the stable door after the Covid-infected horse had well and truly bolted. This may explain the experience down under. The Australians and the New Zealanders apparently were able to impose their rules before the virus had taken hold. As soon as we Europeans started imposing ours, the virus was already at work. Indeed the death rate was (I believe) already declining – for other necessarily non-lockdown related reasons. According to some scientists (who I won’t name as they get vilified for expressing these views!), lockdowns only have any chance of working if the disease hasn’t become endemic.

The second reason is that those most likely to die of Covid, or even get it seriously, tend to look after themselves anyway, quite irrespective of the rules. We certainly know many friends in the vulnerable category who have been isolating themselves much more strictly than the most severe rules require ever since the alarms started. Speaking personally, I regard myself as perhaps semi-vulnerable and haven’t been on any public transport since March, even though I’ve been allowed to. (I lie – I went, wearing my mask, on an almost empty bus some weeks ago. I survived.) The obvious conclusion is that lockdown rules mainly affect the behaviour of those who aren’t going to die anyway. Hence the lack of the “correlations” that the learned doctors and researchers were looking for.

Expanding on this, slightly more than 99% of the total population are not at risk of death from Covid. It follows that lockdown doesn’t affect them to the extent of saving their lives. Even today, 81,000 deaths since the pandemic began represent 0.12% of the total population of 67 million. The effect lockdown has (including all the voluntary isolation that has been happening) on 99% of people is (i) obviously, preventing some of them getting the disease and being seriously ill, (ii) some being mildly ill (and worried) but getting better without treatment and (iii) more seriously for the population at large, preventing the virus getting around and causing natural immunity. On this basis it’s probable that lockdown has made the second wave worse.

The final reason is that, increasingly, people don’t obey the rules. I hesitate to regard this as terribly important. It’s obviously true (look at the traffic on the Wandsworth Bridge Road!), but it must relate in part to people’s native common sense. People realise that taking more walks than allowed (or recommended) in an open park, sitting alone on a park bench (I was moved on when doing that many months ago), whatever, won’t actually increase any risks. Will asking the police to do more to enforce rules of this kind reduce the death rates? Presumably not.

Perhaps we are left with the point I referred to at the start: how do we prevent the hospitals being overwhelmed? Frankly, I have no answers. I simply doubt that lockdowns are the answer.

The problem is that the NHS seems not to have been well prepared to cope with the pandemic. Even this needs qualifying. We were told that the hospitals were in danger of being overwhelmed during phase one. It turned out that they weren’t. Maybe this time some will be. Who knows?

No, the problem at the level of the NHS and its alleged lack of preparedness plainly requires urgent action. Our politicians have been trying to grapple with NHS reform for as long as I can remember. My only point is that imposing yet more lockdowns ain’t the answer.

I feel I can’t leave all this without trying to answer the obvious final question – the question that is probably in the mind of anyone who has been brave enough to read this far. Why do the politicians of almost every country in the world seem to disagree and to go on relentlessly in imposing lockdown rules?

Many people have come up with highly imaginative conspiracy theories: it’s all a devilish plot to “reset” the capitalist world; it’s all about persuading people to buy the vaccines that Bill Gates has invested so much money in developing; the Chinese are laughing all the way to the bank; etc, etc.

I hesitate to go down these roads. I am quite a believer in what I think is referred to as Hanlon’s Razor: “never attribute to malice that which is adequately explained by stupidity” (attributed, as with many things, to Goethe).

My best guess is that it’s all down to the pressures of political reality – and not much to do with medical science or, indeed, to stupidity. Poor Prof Chris Whitty, who is presumably well aware of all the points I’ve made!

Back in March, which seems like ancient history, our government was (in my view - now) rightly hesitant about going the lockdown route – as I seem to remember was Chris Whitty. They are now widely criticised for being too slow in locking down. But we can, I think, forgive them for doing the first of, sadly, many U-turns. They were faced with horrifying pictures in the media of hospitals being overwhelmed; with the public braying for “action”; and crucially the forecasts of thousands of deaths by Prof Ferguson (only later much revised downwards). What politician in the world could do other than reach for the only apparently available weapon?

Having gone down this road, they were stuck. To make it work, they thought they needed to frighten us all. They succeeded beyond (probably) their wildest dreams. Ever since, the public has been massively in favour of continued, and indeed strengthened, lockdown restrictions. (Or at least they say they are, when asked by the pollsters.)

So, to follow the science (forgive the phrase) as described above, and to follow the advice of the scientists behind the (much reviled) Great Barrington Declaration, and to take note of Lord Sumption’s views, would be brave indeed. It would mean admitting that the lockdown thus far has been largely useless. It would mean facing down opposition politicians of all stripes and persuasions, including many on their own side. It would mean going against the continued policies of our neighbours in Europe. And it would mean trying to persuade the public that the inevitable rise in infections, which are entirely normal in the winter months, are nothing to do with government policy and that the government is actually largely powerless to prevent them. Wow! You don’t have to be a highly-paid spin doctor or media consultant to spot that that course of action isn’t a winner.

No, much best to stick it out and put all bets on the vaccine. Which itself will involve a bit of spin. Note that all mention of natural immunity (rudely described as herd immunity) is much discouraged. We must all be vaccinated. The focus is on numbers vaccinated. And the hope (including mine) is that this will reduce the mortality numbers (and even the numbers infected, the so-called “cases”) and, eventually, allow us to keep calm and carry on. Hasten the day, say I.

I should add a final point, relevant to where we are now. Obviously, as implied already, isolation by an individual will reduce that person’s risk of getting the disease. It’s just that the rules, as applied to the population at large, don’t seem to work, although they may delay the impact of the problem. If this latter point is right, we have successfully postponed the problem to a time of year when we are least able to cope with it. However now, with the vaccine available, it does presumably make sense as individuals to isolate ourselves (and to go along with the lockdown) until we get the vaccine. So, I hear you say, do we need to stay sceptical about lockdowns? Can’t we shut up about it?

I say that we do need at least to think about it, because there can’t be any guarantee that the vaccine will be so effective as to get people away from their fears. People are still very fearful. What will happen when the next strain arises? Viruses are cunning little beasts. We must arm ourselves with the best of the scientific opinions, uncluttered with the fears that have been disseminated, so that we can avoid the catastrophe of yet more lockdowns.

Tony Herbert

January 2021

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