Thread by @drraghibali

Why I haven't signed the Great Barrington Declaration (GBD) or John Snow memorandum (JSM):

Having consistently highlighted the health harms of lockdown, I did of course welcome the GBD’s emphasis on the many harms of lockdown – particularly in countries without welfare states

– where lockdowns are even more likely to cause overall health harm. However, a declaration is not a policy and there are still too many unanswered questions. Although I fully agree on the need to focus protection on care homes & hospitals, I am not convinced that it is

feasible to shield the very large numbers of vulnerable people in the community when COVID transmission is high (esp. for those who live in multigenerational households). Also, the number of ‘non-vulnerable’ who would be symptomatic and hospitalised in the coming 3 to 6 months

(about 50 per cent of COVID admissions are currently aged 18-64) would make it very difficult to maintain all NHS services – there is not enough capacity (particularly of staff) leading to increased non-COVID health harm. And no country has successfully followed the GBD strategy

It also does not currently have public support (more than 2:1 oppose it) which would be essential in maintaining compliance with shielding for the vulnerable; and in persuading the less-vulnerable to be exposed by returning to normal life.

Finally, advocates of the GBD have not shown that it will cause less overall harm which is, of course, the key overall metric it should be judged by.

And so to the JSM. I understand the rationale of those who advocate a second lockdown & say it is better to have a shorter lockdown now than a longer one later – which may be true – but this is not the key question, which should be: is it less harmful than not having one at all?

The limitations and harms of lockdowns have been well documented by me and others and I will only add a few points:

There is insufficient evidence that a two week lockdown will achieve its aims and it may not be possible to lift it after two weeks if cases are still rising.

And this strategy may just lead to an unsustainable cycle of lockdowns. Lockdowns are only effective if they are complied with and there is no guarantee compliance it will be high enough to be effective.

The models presented have only shown that a lockdown may reduce COVID deaths, but they have not modelled the number of non-COVID lives that will be lost or adverse health effects from other causes - which are equally important.

Although the intention of the 'circuit breaker' lockdown is to buy time to get Test &Trace (T&T) back on track and ensure the NHS is prepared, it is hard to see how two weeks would make much difference when the NHS has had months to prepare.

T&T is of course an essential part of the solution but, again, there is insufficient evidence that we will ever be able to control the virus through T&T – we tried this over the summer when virus levels were almost zero and it hasn’t worked here – or in most countries in Europe.

It is also not true to say that ‘the only thing that works is lockdowns’ – social distancing and self-isolation before lockdown here was bringing R down, and Sweden has showed it is possible to overcome a first wave without one – which I will return to in a later thread.

Finally, although public support for a two week lockdown is currently high, this would change if it was made clear that it could be 4 or 6 weeks or that it may well cause more long term health harm than benefit.

I know and respect many of the scientists supporting both positions and know they believe their strategy will cause the least overall harm, but neither adequately acknowledges their limitations or uncertainties – and are overly confident in their assessment of their effectiveness

Both strategies are likely to cause significant mental health harm to the elderly/vulnerable and neither adequately present the costs. They both also assume very high levels of compliance – which of course is not guaranteed – and without which neither strategy will be effective.

Is there a potential 'middle-way' between GBD and JSM which could improve compliance; keep all NHS services running & schools open; protects lives and livelihoods & cause the least overall harm?

We urgently need to find out as outlined below:

conservativehome.com/platform/2020/…

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