After reading a paywalled article from The Spectator written by a recently-retired Professor of Pathology and NHS consultant pathologist Dr John Lee, I cannot help but feel that we are not quite on the right track with our coverage of the virus and lockdown.
In announcing the most far-reaching restrictions on personal freedom in the history of our nation, Boris Johnson resolutely followed the scientific advice that he had been given. The advisers to the government seem calm and collected, with a solid consensus among them. In the face of a new viral threat, with numbers of cases surging daily, I’m not sure that any prime minister would have acted very differently.
Boris Johnson appeared to be reluctant to impose martial law in the UK and to place the nation under house arrest, but he did so upon scientific advice. Jacinda Ardern seemed much less reluctant. That she is now looking to pay and set people’s wages, fix prices in supermarkets and switch New Zealand to a command economy aligns with her outlook and goes further than she could dream of taking us in ‘peacetime’.
The global lockdown is the most significant event in recent world history. It is the most significant cultural and social event in New Zealand’s history. It is probably also the most significant constitutional event in our history. The Anglosphere has (willingly) given up 800 years of hard-won freedoms, its parliamentary democracy and rule of law to become a police state, albeit a ‘kind’ one, to use Ardern’s terminology. To turn New Zealand into a police state by promulgating middle-class fear is an extremely regressive and regrettable move as people will inevitably be encouraged to nark on their neighbours.
The simplest way to judge whether we have an exceptionally lethal disease is to look at the death rates. Are more people dying than we would expect to die anyway in a given week or month? Statistically, we would expect about 51,000 to die in Britain this month. At the time of writing, 422 deaths are linked to Covid-19 — so 0.8 per cent of that expected total. On a global basis, we’d expect 14 million to die over the first three months of the year. The world’s 18,944 coronavirus deaths represent 0.14 per cent of that total. These figures might shoot up but they are, right now, lower than other infectious diseases that we live with (such as flu). Not figures that would, in and of themselves, cause drastic global reactions.
I am no scientist, but what if the scientific ‘evidence’ upon which the lockdown were based is false? Dr John Lee says that “rushed science is bad science”, and calls into question many of the assumptions which led to lockdown. We recently witnessed similar scenes over Brexit, which for three years was stymied by ‘expert’ evidence as part of Project Fear. Without the EU, Britain would starve, run out of medicines, people would die, the economy would collapse. None of these things turned out to be true.
If we take drastic measures to reduce the incidence of Covid-19, it follows that the deaths will also go down. We risk being convinced that we have averted something that was never really going to be as severe as we feared. This unusual way of reporting Covid-19 deaths explains the clear finding that most of its victims have underlying conditions — and would normally be susceptible to other seasonal viruses, which are virtually never recorded as a specific cause of death.
What Dr Lee is saying is that many people die from flu complications but we typically don’t hear about it (500 per year in New Zealand, 17,000 in the UK, and as many as 70,000 in the US). We need to be very careful in how we measure coronavirus-related deaths, because often people die ‘with’ it and not ‘of’ it – meaning that they have an underlying condition and would have died anyway. The lady who sadly died in New Zealand over the weekend was already hospitalised and died in this manner ‘with’ the virus according to RNZ. However, that’s not how her death is being generally commented upon. Dr Lee says that we ought to be measuring the effect of the virus on the death rate, not deaths per cases of infection.
Let us also consider the Covid-19 graphs, showing an exponential rise in cases — and deaths. They can look alarming. But if we tracked flu or other seasonal viruses in the same way, we would also see an exponential increase. We would also see some countries behind others, and striking fatality rates. The United States Centers for Disease Control, for example, publishes weekly estimates of flu cases. The latest figures show that since September, flu has infected 38 million Americans, hospitalised 390,000 and killed 23,000. This does not cause public alarm because flu is familiar.
Sweden hasn’t shut up shop and is in no worse position than the rest of Europe. Is what we are doing worth it?
As an aside, I lived through SARS in South-East Asia – a very similar threat. That was mainly controlled at the borders, with all arrivals and departures being screened with heat sensors. Some provision was made for the elderly and frail, but everyone else was able to get on with their lives – even in countries which are considered to be less than democratic. Singapore has its borders firmly closed now though life carries on inside the country. Offices and restaurants are open but entertainment venues are closed.
Our borders remain open and 800 or so people arrived in the country two days ago which is somewhat ridiculous given that our borders are easy to control. I suspect that the virus has been here since January and that it flooded in on the back of the government’s dairy-bad / tourism-good narrative, by which it’s considered beneficial for high volume, low-value tourists to defecate in our wilderness, but not cows.
This, however, is secondary. We are dealing with a flu-like illness and what we have given up may not be worth it. The fear-driven response is that lives can’t be valued with money, which is, of course true, but as Dr Lee says this isn’t a case of lives versus money – it’s lives versus lives, by which he means the effect that the lockdown is having on people’s lives (the full cost of which isn’t currently known) versus the effect of the virus on the death rate.
Clearly, the various lockdowns will slow the spread of Covid-19 so there will be fewer cases. When we relax the measures, there will be more cases again. But this need not be a reason to keep the lockdown: the spread of cases is only something to fear if we are dealing with an unusually lethal virus. That’s why the way we record data will be hugely important. Unless we tighten criteria for recording death due only to the virus (as opposed to it being present in those who died from other conditions), the official figures may show a lot more deaths apparently caused by the virus than is actually the case. What then? How do we measure the health consequences of taking people’s lives, jobs, leisure and purpose away from them to protect them from an anticipated threat? Which causes least harm?
The moral debate is not lives vs money. It is lives vs lives. It will take months, perhaps years, if ever, before we can assess the wider implications of what we are doing. The damage to children’s education, the excess suicides, the increase in mental health problems, the taking away of resources from other health problems that we were dealing with effectively. Those who need medical help now but won’t seek it, or might not be offered it. And what about the effects on food production and global commerce, that will have unquantifiable consequences for people of all ages, perhaps especially in developing economies?
Governments everywhere say they are responding to the science. The policies in the UK are not the government’s fault. They are trying to act responsibly based on the scientific advice given. But governments must remember that rushed science is almost always bad science. We have decided on policies of extraordinary magnitude without concrete evidence of excess harm already occurring, and without proper scrutiny of the science used to justify them.
In the next few days and weeks, we must continue to look critically and dispassionately at the Covid-19 evidence as it comes in. Above all else, we must keep an open mind — and look for what is, not for what we fear might be.
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