This article first appeared on The Critic: https://thecritic.co.uk/in-defence-of-lockdown-sceptics/
I was disappointed to read The Spectator article by Alistair Haimes about his sudden conversion to the lockdown cause. The brilliant data analyst has been a valuable ally, having written several pieces laying out the case against lockdowns for The Critic and contributed to Lockdown Sceptics, the daily blog I edit. I hope he will return to the fold in due course.
His argument boils down to this: “When the facts change, I change my mind.” But what facts have changed? He cites three. First, the health service is under severe stress and unless we can reduce virus transmission over the next few weeks it’s at serious risk of being overwhelmed. That wasn’t true when the second national lockdown was imposed in November, he says, but it is today. Second, we now have three approved Covid vaccines, with more to follow, so any new restrictions will be short-lived. Third, there is a new variant of SARS-CoV-2 which is around 50 per cent more transmissible than the pre-existing variants.
I’ll take each of these in turn.
First, I’m sceptical of the claim that we have X number of days to save the NHS – a familiar trope that I thought the Labour Party had flogged to death. Let’s not forget that a winter bed crisis in the NHS is an annual event, as you can see from this collection of Guardian headlines. According to PHE, there was no statistically significant excess all-cause mortality in England in the final week of 2020 and while excess winter deaths this season are above the five-year average, they are currently below the peaks reached in 2016/17 and 2017/18.
I published a piece on Wednesday in Lockdown Sceptics by Dr Clare Craig on Emergency Department Syndromic Indicators that looked at various indexes of ill-health, such as hospital admissions for Acute Respiratory Infection, Influenza-like illness and Pneumonia, and those are all below the baseline for an English winter – or were until a week ago. These data suggest that some of the people currently in English hospitals with Covid-19 have either been misdiagnosed or would have been hospitalised with something else if they hadn’t been laid low with Covid. In some NHS regions, critical care bed occupancy numbers are currently above what they were in December 2019 – an unusually mild flu season – but there was still some headroom on 27 December, as you can see from this bar chart.
But let’s allow that things have got worse by an order of magnitude in the past week or so and some NHS trusts really are on the cusp of being overwhelmed, which they may well be. (See this report in Lockdown Sceptics by a senior doctor.) Will the lockdown Boris announced last week do anything to avert this catastrophe, as Alistair seems to think? The only difference between the new national lockdown and the Tier 4 restrictions that were already in place in 80 per cent of England on 1 January is that restaurants and pubs can no longer serve alcohol to take away and schools will be closed. But schools had already closed when London went into Tier 4 on 20 December and there isn’t much evidence that those restrictions reduced the R number in the capital. As SAGE member Professor Andrew Hayward pointed out on Tuesday, nearly 10 million key workers are still travelling to and from work. In addition, people are still going to supermarkets, chemists and corner shops. The statistician William M. Briggs, co-author of The Price of Panic, argues that it is misleading to think of lockdowns as quarantines. Rather, they just create a number of “concentration points”; herding people into a limited number of spaces, and in that way increase the rate of transmission. If masks worked this mobility might not matter, but the recent mask study in Denmark suggests they don’t.
Some lockdown enthusiasts pick out a handful of examples where lockdowns have coincided with a fall in Covid deaths but that’s not a scientific approach. Numerous research studies, published in reputable, peer-reviewed journals, have concluded that there is no association between Covid mortality and the standard suite of non-pharmaceutical interventions, such as mandating masks in indoor settings, closing schools and universities, shutting non-essential shops, imposing curfews and banning domestic travel. You can adjust the lockdown variables all you like – timing, severity, etc. – but there’s no signal in the noise. The American Institute for Economic Research has collected some of the best of these studies here and we’ve created a compendium of the evidence that non-pharmaceutical interventions don’t work at Lockdown Sceptics. The epidemiological models that SAGE uses to persuade the Government to ratchet up the restrictions rely on counterfactuals – if you don’t do y, x number of people will die – that cannot be falsified because the Government always end up doing SAGE’s bidding, as Alistair Haimes has pointed out.
On the other hand, it is incontestable that lockdowns cause harm. Lockdown sceptics are sometimes accused of putting profit before people, but I’m not just talking about economic harm – increased borrowing, businesses going bankrupt, growing unemployment. The negative impact of school closures on children has been flagged up by numerous educational organisations, including Ofsted, with the most disadvantaged paying the highest price. The Centre for Mental Health estimated in October that that up to 10 million people will need either new or additional mental health support, thanks to the trauma of enforced isolation, and reports of domestic abuse to the Metropolitan Police increased by 11 per cent during the first lockdown compared to the same period last year. Drug overdoses in San Francisco killed more than three times the number of people last year than Covid-19.
It’s also nonsense to imagine the economic damage caused by the lockdowns won’t have ruinous public health consequences – anything that hurts profits, hurts people. Professor Sunetra Gupta estimates that the global economic recession caused by the lockdowns will result in 130 million people starving to death and the United Nations predicts it will plunge as many as 420 million residents of the developing world into extreme poverty, with low-income countries seeing average incomes falling for the first time in 60 years.
Even in the absence of the detailed cost-benefit analysis the Covid Recovery Group of MPs has repeatedly asked for, it seems overwhelmingly likely that the harms caused by lockdowns in the UK alone are greater than the harms they prevent. According to one study out of Bristol University, the ongoing restrictions will cause 560,000 deaths; 310,000 more than Professor Neil Ferguson and his team predicted would die absent a lockdown but with voluntary “mitigation” measures in place.
As the now disgraced President of the United States said, the cure is worse than the disease. That essential point hasn’t changed, so I see no reason why sceptics should change their minds about lockdowns now. Yes, the NHS may be in genuine peril, but that doesn’t mean we should set aside our well-founded doubts about the effectiveness of heavy-handed interventions. On the contrary, trying to quarantine people for a third time, given that the policy clearly hasn’t worked, seems like Einstein’s definition of insanity: doing the same thing over and over and expecting different results.
What about the vaccines? True, some sceptics did argue that shutting people in their homes until a vaccine became available was impractical because it might take years to develop one. But that was never the central plank of our case (see above). On the contrary, our preferred alternative to locking down is “focused protection”, as set out in the Great Barrington Declaration, and vaccines make that strategy more attractive, not less.
Our starting point is that the number of people who died from Covid-19 in English hospitals in 2020 who were under 60 with no underlying health conditions was 388 and the virus is less deadly than seasonal flu for healthy people under 70. Note, we’re not claiming that SARS-CoV-2 is less deadly than the average bout of seasonal flu for the entire population – although that’s true of some flu seasons – only that it’s likely to kill fewer healthy people under-70, including children. Whenever we cite that 388 statistic, critics accuse us of being callous, as though we’re saying older people and those with chronic conditions don’t matter. Far from it. We think the Government should pull out all the stops to protect those who are vulnerable to this disease, including care home residents, who made up about 40 per cent of those who died from Covid-19 in the first wave (and 50 per cent of those who died in Scotland). Shielding for people in these groups should not be compulsory – we believe in trusting people to make their own risk assessments and adjust their behaviour accordingly. But it should be a viable option, with all the necessary support. Meanwhile, the rest of us should be permitted to go about our lives, taking the same precautions we would in a normal flu season.
The arguments for and against “focused protection” have been well-rehearsed, but the vaccines deal with one of the best objections – that it would be inhumane to expect the vulnerable to shut themselves away until the rest of the population develops natural herd immunity. That would create a two-tier society. But now that we have a vaccine, those groups only need shield until they’ve been immunised, at which point they can re-enter society (something they can’t do at present, even after they’ve had the jab, because there’s no “society” to re-enter). The Government is planning to vaccinate 13.9 million people by mid-February – although that number includes everyone who works in health and social care settings – and there are about 16 million who fall into the above vulnerable categories.
So, yes, the vaccines do make a difference – they strengthen the sceptics’ case by making “focused protection” more palatable.
What about the new variant? I’m reserving judgment on whether it’s more transmissible. As Mike Hearn pointed out recently, ONS infection survey data released on 23 December show that the percentage of the UK population testing positive for the new variant began to fall in November before taking off again, and in some areas it has already started to dip, as was clear from the plot presented by Chris Whitty on Tuesday. If it’s 50 per cent more transmissible than pre-existing variants, why isn’t the percentage just constantly rising in all parts of England?
But suppose the new variant is more infectious. What evidence is there that the new lockdown measures will interrupt transmission? If the first two lockdowns didn’t stop the original virus in its tracks, why will a third stop a turbo-charged version?
I sympathise with Alistair Haimes. He believes the NHS is at risk of falling over and wants us to do something – anything – to protect it. Lockdown sceptics also don’t want to see the NHS fall over, but where I part company with Alistair is in believing that a third national lockdown is the right mitigation strategy. Wouldn’t it be better to offer robust protection to the vulnerable and make vaccinating them an absolute priority? Not only would that be more likely to “save the NHS”, but it would also save the rest of us from the harms caused by yet another lockdown. “Focused protection” is sometimes dismissed as not scientifically credible, but the 700,000+ signatories of the Great Barrington Declaration include over 13,000 medical and public health scientists and nearly 40,000 medical practitioners.
Alistair thinks this lockdown is more palatable than the others because there’s light at the end of the tunnel, thanks to the vaccine. Within 100 days, he estimates, it can be dismantled, hopefully never to be seen again. I wish I shared his optimism. At Tuesday’s Downing Street briefing, Chris Whitty said restrictions might well be back next winter and some people have called for masks to remain mandatory indefinitely.
The problem with allowing the state to suspend your civil liberties is that you may never get them back. I treat the Government’s claims that it will relinquish the powers it has arrogated to itself when the crisis is over with extreme scepticism, just as I do every official announcement about the virus.
One final point. Over the past week or so, some of the most prominent lockdown sceptics have been vilified in the media, accused of encouraging members of the public to ignore social distancing guidelines and thereby causing people to die. These attacks may ratchet up over the next few days as the NHS comes under more and more pressure, although it’s hard to imagine them becoming even more hysterical. Paul Mason wrote a column in New Statesman on Wednesday saying that Allison Pearson, Laurence Fox, Julia Hartley-Brewer, Peter Hitchens and me should be consigned to the seventh circle of hell.
But the assumption underlying these criticisms is that lockdowns work, which is precisely the point under dispute. Is it reasonable to expect us to just take that on faith and keep any doubts we have to ourselves? After all, we don’t ask the Paul Masons of this world to take it on faith that lockdowns cause more harm than good and accuse them of killing people by advocating for tougher restrictions. We think history will prove us right, but we’re not so full of righteous certitude that we want to silence our opponents.
One of the most unpleasant aspects of this crisis is that it has brought out an ugly, authoritarian streak in so many people, particularly those in positions of authority. Before March of last year, I believed that totalitarianism could never take root in British soil because we are such a Rabelaisian, freedom-loving people, fiercely proud of our independence. Now, I’m not so sure.
This article first appeared on The Critic: https://thecritic.co.uk/in-defence-of-lockdown-sceptics/