NEWS AND OPINION
Even if you could understand why lockdown was imposed, it very rapidly became apparent that it had not been thought through. Not in terms of the wider effects on society (which have yet to be counted) and not even in terms of the ways that the virus itself might behave. But at the start, there was hardly any evidence. Everyone was guessing. Now we have a world of evidence, from around the globe, and the case for starting to reverse lockdown is compelling. Here are 10 reasons why I believe that it is wrong to continue with lockdown and why we should start to reverse it immediately and rapidly.
1. You cannot understand the significance of this virus simply by looking at the raw death figures
Lockdown was enacted on a prediction of 500,000 deaths in the UK, rapidly reduced to 250,000 and then to 20,000. As I write the UK death toll is 30,150. Broadcast media has relentlessly focused on the number of deaths and emotional stories surrounding victims. While every death is sad, the significance of a death toll can only be understood by looking at the big picture. This pandemic is unique in the way it has been observed and measured. This means that we are testing and counting a far greater proportion of COVID cases than have ever previously been counted for other respiratory infections such as influenza. This is true even though many COVID cases in care homes were not initially included in the numbers. We don’t really know how many people die of flu each year, because the surveillance relies mainly on surrogate measures rather than actual testing, but the estimated number for 2014/15, the highest of recent years, was 28,330. So yes, COVID is a nasty new disease. But even if you assume 40,000 COVID deaths, its death toll is in the same ballpark as diseases we live with, not something so extraordinary as to justify the lockdown reaction.
And because it is new, this is likely to be as bad as it gets (see 9 below). The majority of cases are asymptomatic. The most common symptoms are not fever, cough, headache and respiratory symptoms; they are no symptoms at all. The typical case does not suffer respiratory fibrosis; the disease leaves no mark. Somewhere around 99.9 percent of those who catch the disease recover. Of those unlucky enough to die, over 90 percent have pre-existing conditions and were anyway approaching the end of their lives. To say this is not being uncaring: it is simply a fact of life that older people are more likely to die in any event, and especially more likely to die from new types of infection.
2. The policy response to the virus has been driven by modeling of COVID — not other factors
Not only has such modeling been extravagantly wrong before in predicting the course of viral epidemics, but it says nothing about anything else. In this case, it has been bedeviled from the start by poor data and flawed assumptions. The data on virulence was hugely biased in favor of severe cases. There was an assumption that 80 percent of the population would rapidly catch the disease, when in fact 15 percent seems nearer the mark. Even the much-discussed transmissibility of the virus, the R number, is not something that is known accurately because there has been so little testing; it remains an assumption or an output of the models. Modeling can be very helpful in terms of pointing out the weaknesses in our data, which is why it is incredible that after six weeks of lockdown we have still done so little community testing. But, in complex situations, models are rarely comprehensive or accurate enough to be a sufficient basis for public policy. The very models that put us into lockdown — on the basis of predictions no longer believed accurate — are keeping us here despite their known flaws.
3. We don’t know if lockdown is working
You may be forgiven for thinking that we do. But the fact is that direct evidence for the effectiveness of lockdown in this situation is minimal, and the approach is mainly based on modeling. Many counties with very different approaches to lockdown seem to have similar curves, in so far as their different testing and recording of the virus allows meaningful comparison. Are the curves a result of our actions or are they just a manifestation of the way this virus is coming into equilibrium with its new human hosts? The curves on ships affected by the virus seem similar to the population curves too. It’s easy to make plausible-sounding arguments that what we are doing ‘must’ be slowing the spread. But Sweden’s model of voluntary social distancing seems equally effective, but with much lower costs.
4. We should ease the lockdown to save lives
The economic and direct health costs of lockdown are enormous. Lockdown has caused huge disruption to healthcare of conditions other than COVID, which is having significant immediate effects and will also have significant delayed effects. But apart from this, economic downturns are a direct cause of ill health. One way to try and measure health interventions is by using ‘quality of life years’, or QALYs. One QALY equates to one year in perfect health. In the UK, the average age of someone who dies of COVID is 80. Most of those dying have a relatively small number of QALYs left. But the direct health effects of lockdown and economic downturn have a disproportionate effect on younger people with many more QALYs left, so comparing deaths between COVID and other causes such a suicide does not do justice to the scale of the health effects attributable to lockdown. Also, we should not forget that there is more to life than death. One year with depression (for example) is not one QALY. When you factor in all the lockdown-attributable mental and physical health effects short of death, as well as the deaths, it is clear that lockdown is having a huge impact on QALYs across the population that far outweighs those caused by COVID.
5. Lockdown is not sustainable
Unless we are to live this way forever, lockdown will have to be eased. Then what? Pandora’s box is open. No one thinks this virus will be eradicated. It will be present within the population and will spread in its own way. To understand the overall effects of a virus we cannot just look at now or the next few weeks. The impact of this pathogen will be measured, like flu, over years. Some years will be worse than others. There is no guarantee or even probability that this lockdown will have made any impact on the overall numbers of deaths in say five years time. Lives ‘saved’ now may well be claimed later. Our own immune systems have been honed by hundreds of millions of years of evolution to cope with viral threats. They are the only way we survive in a world full of viral pathogens, many of which we have all already had without ever knowing. Countries that are now pleased to have a low incidence of the virus will have to face it later unless they are to enter a North Korea-like state of isolation. Even then the virus may enter on the wind, or domestic cats, or some other way we haven’t yet thought of. No country has ever improved the health of its population by making itself poorer. Lockdown is impairing our ability to live with the effects of this virus, while not changing the long game.
The all-out war on COVID-19 was a full-fledged frontal attack. Close down the economy, something that has never in history been done before. The result: a Stress Pandemic. While the so-called curve of COVID-19 is flattening, which our leading care experts assured us was essential, there has been no flattening in the curve of the shutdown-created stress.
Little was known about this new coronavirus when it began its worldwide blitzkrieg. It was quickly thought to be serious. Quickly labelled a pandemic. The early projection of its potential damage; i.e., 2 million American deaths, a fatality rate of 4% to 5%, never materialized. Was it dramatically overstated? Or did our apocalyptic defensive blunt the attack? It is easy to criticize an overreaction, but little was known about this pathogen. To err on the side of caution was, obviously, far better than to err on the side of recklessness.
There was no choice. Expert projections had to be taken seriously, although it does cause one to rethink the term “expert.” War was declared on COVID-19. A team of medical experts was assembled. Decades of their lives dedicated to public health. Fine public servants. Health care lifers. These men and women predicted that we were headed for a health disaster, a pandemic, the likes of which this nation hadn’t seen since 1918. The cure? Isolate. Educate. Communicate. It was decided to bring to this virus war something never deliberately attempted in history, I suspect. Scuttle our own economy. Shutting down the economy does far more than isolate, educate, and communicate. It dictates. It dictates how every citizen should live every hour, every day.
When the shut-down-the-economy decision was made, no close-down-the-economy expert was consulted. There are none. No Ph.D. candidate ever wrote a thesis on what would happen to a country, to a culture, to a government that inflicted this kind of wound on itself. It was then beyond one’s wildest imagination.
It’s not only civil war that produces such linguistic deformations. Any crisis will do.
Our part of Connecticut was badly damaged by Hurricane (or, for the weather pedants among you, “Superstorm”) Sandy in 2012. Like many families, we had to move out of our house for months and were subjected to seemingly endless meetings with various local and FEMA officials who eagerly seized the chance to tell us huddled masses what we could and couldn’t do with our property. Just as every public official and talking head now is an amateur epidemiologist, so back in 2012 they were all expert meteorologists.
I remember one meeting in particular when it was explained to us that storms like Hurricane Sandy were “the new normal.”
“The new normal.” Is there a more nauseating flake of smug linguistic presumption? I think that the imperative “stay safe,” born of our coronavirus panic, comes close. But “the new normal” is worse because it pretends to knowledge not just solicitude. That wretched town official who was telling us serfs what we could and could not do with our homes did so on the hollow authority of knowing, or pretending to know, what the future would bring.
So it is now. At one of President Trump’s near-daily coronavirus press rallies last month, a media mouth began a question by noting the “new normal in which, you know, there’s [sic] smaller crowds in restaurants and bars and—” The president cut him off.
That’s a pretty serious omission. The state’s bars and restaurants employed upward of 500,000 people at the time of the shutdown. To her credit, Mayor Lori Lightfoot has set up working groups with representatives of various sectors, including the food and beverage business, to provide recommendations. But even her slow reopening plan for the city of Chicago could end up strangling a once-thriving food and dining scene.
At some point, Pritzker and Lightfoot are going to need to trust the business community and the public to take baby steps on their own.
During Alice's adventures in Wonderland, she found herself in the presence of the King of Hearts. He wanted her to go, so he cited Rule 42: "All persons more than a mile high to leave the court." Heads turned to Alice. "I'm not a mile high," she objected. "You are," said the King. The queen testified that Alice is nearly two miles tall. "Well, I shan't go, at any rate," Alice said, "besides, that's not a regular rule: you invented it just now."
Nearly seven weeks into our otherworldly adventures in COVID-related confinement—a home-prison sentence with occasional trips to the Save Mart—more of us are bristling at the irrational restrictions that our elected officials are placing on us. Americans gave them the benefit of the doubt for several weeks, acknowledging the unusual circumstances of a novel coronavirus that experts originally claimed could take millions of lives.
But now we're left stuck in the King of Hearts' court, amazed by the illogical and arbitrary nature of the newly imposed rules. In Michigan, you can go boating, but may get arrested if you use a motor. In California, selling marijuana is essential, but not giving a haircut. We can't know what the exact rules are because they change so quickly and without the usual vetting. Who knows if we'll be the next person handcuffed for playing in a park?
Our democratic system of sausage-making is odd enough and results in a crazy array of sometimes-oppressive laws. But there's a process for making them, a system of checks and balances, and court systems that keep it all in check. It's not perfect, but it's not arbitrary and capricious. In a world of executive orders, though, truth is whatever the king—or the governor or president—says it is.
Rules don't have to be logical, but we must obey. There's no room for local decision-making or thoughtful disagreement. It's all about power. As author Ayn Rand wrote, "The only power any government has is the power to crack down on criminals. Well, when there aren't enough criminals, one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws."
And that's where we are now. The government, under the auspices of addressing an admittedly serious health crisis, can criminalize virtually everything—from leaving your home for a stroll, to operating your business. Some states have begun loosening the restrictions, creating a path for the reopening of society so people can take care of themselves again. Have you noticed that Gov. Gavin Newsom keeps moving the goalposts?
As scientists scramble to find COVID-19 treatments among existing approved drugs, researchers in Hong Kong may have found a winning combination. Early data shows that a triple antiviral therapy may be safe and effective in treating patients with mild to moderate cases of COVID-19, according to a study published Friday in Lancet.
All three drugs used in the study are already approved to treat other illnesses. Interferon beta 1b is a drug commonly used to treat multiple sclerosis, lopinavir-ritonavir is an anti-retroviral medication used to treat HIV and ribavirin is commonly used to treat hepatitis C.
Researchers from six different hospitals in Hong Kong assigned over 120 patients to one of two treatment groups. They gave one group of patients suffering mild to moderate COVID-19 symptoms a cocktail of all three drugs, and gave the other group only lopinavir-ritonavir.
The Los Alamos National Laboratory has posted a new study, as reported this week by the Washington Post and the Los Angeles Times, that finds that the strain of the novel coronavirus that emerged in Europe and has spread to much of the world is different than the strain of the virus at its origin in China. Those findings are consistent with our research which we posted (in Russian) on April 15, 2020. Although we are not epidemiologists, we are posting our slightly updated analysis below in English in the interest of sharing what may be significant findings with a wider audience. We welcome the scrutiny and consideration of the epidemiology community and hope that our analysis and any corrections or critiques to the below will help advance our knowledge.
From a microbiological point of view, there are several varieties of the SARS-CoV-2 coronavirus. But from the epidemiological point of view, the world is dealing with two distinctly different supertypes of the coronavirus – the so called “East Asian” and “European” ones.
