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Source: United Kingdom – Executive Government & Departments

An open letter has been published, arguing against lockdown policies and for ‘Focused Protection’.

Prof James Naismith FRS FRSE FMedSci, Director of the Rosalind Franklin Institute, and University of Oxford, said:

“The main signatories include many accomplished scientists and I read it with interest.  I will not be signing it however.

“At one level this declaration is a statement of a series of scientific truths and as such is non-controversial.  The declaration identifies the elderly and vulnerable to be at far far greater risk from covid-19 than the bulk of the population, an established fact.  I do not think anyone disagrees that the disruption to education, social life and the economy have been very hard to bear and that they particularly disadvantage the young, the group least likely to suffer serious ill effects from covid-19.

“The declaration is correct, that once herd immunity is reached in the non-elderly population this will protect the elderly by greatly reducing the general viral spread.  A vaccine would be a short cut.

“The authors have neglected to point out that our ability to treat covid19 is greatly improving due to scientific and medical breakthroughs, a point that strengthens arguments for their policy by reducing the toll of the virus.

“That said, the declaration omits some rather critical scientific information that would help better inform policy makers.  It would help to consider the following points:

“We do not know yet how long immunity will last, so achieving herd immunity may not be simple.  We do not have herd immunity to the common cold despite many of us having one or more each year.  It would have helped had the leading scientists who signed this declaration estimated achievability of herd immunity with different immune response decays.

“The desired range for herd immunity is not stated nor how far away we are from it, thus no estimate of the number of deaths or the life changing complications that will result in the lower vulnerability group is made.  Whilst these numbers are much lower than in the elderly, they are not zero.  I suspect the public would like to know this.

“A working description of vulnerability is not given, the Goldacre paper in Nature assigned probabilities, what is the personal score threshold being advocated?

“From a public health point of view, it would have been useful to estimate the gains with different assumptions of the timing of the arrival of the vaccine.

“With respect to the UK, there are a limited number of critical care beds.  Is there an estimate of the risk of overwhelming the NHS and ending up with triage (thus rising fatalities)?

“I agree wholeheartedly that protecting the most vulnerable will reduce deaths.  We knew this by April and to my knowledge everyone advocates this.  However, the continuing number of deaths in the USA and the rise in infections in the UK amongst this very group seen in ONS surveys would indicate this is hard to achieve.  The declaration thus risks the same error we have seen with the UK’s track trace and isolate scheme – one can promise a scheme that is very easy to describe but is hard to deliver.  Whilst actual implementation maybe beyond the expertise of the signatories, when scientists offer advice in a public forum it would help if they could be clear with the public about the risks of failure or error.  The declaration is silent about what happens if we resume normal life (the easy bit) and fail, for whatever reason, to protect the vulnerable (the hard part).  Further, the declaration is silent as to what success in shielding looks like?  100 % protection is impossible to achieve.  How many deaths and how many life changing events will result if we are 80% or 60% successful?  A more cautious policy might be government demonstrating that it can shield the old and vulnerable under current restrictions, as measured by the infection prevalence in this age group.  These data would give a best case estimate of the toll of the policy.  With this information we could move to resume normal life in stages fully aware of the consequences whilst continuing to monitor viral spread in the elderly.

“It is absolutely proper that scientists offer their best advice to government, especially perhaps, when that advice differs from the mainstream, as this does.  In this pandemic, which has been such a disaster, it is clear that there have been many mistakes by medics, scientists and politicians.  Humility and willingness to consider alternatives are hallmarks of good science.

“I would support the signatories giving their full consideration to all the scientific issues surrounding their prescription so that they might give more actionable policy advice.”

Prof Jeremy Rossman, Honorary Senior Lecturer in Virology, University of Kent, said:

“The actions taken to control COVID-19 have clearly had significant physical and mental health impacts across the population, often with the most disadvantaged suffering these consequences most acutely.  The Great Barrington Declaration attempts to alleviate these impacts by promoting herd immunity and the protection of vulnerable populations.  Unfortunately, this declaration ignores three critical aspects that could result in significant impacts to health and lives.  First, we still do not know if herd immunity is possible to achieve.  Herd immunity relies on lasting immunological protection from coronavirus re-infection; however, we have heard many recent cases of re-infection occurring and some research suggests protective antibody responses may decay rapidly.  Second, the declaration focuses only on the risk of death from COVID-19 but ignores the growing awareness of long-COVID, that many healthy young adults with ‘mild’ COVID-19 infections are experiencing protracted symptoms and long-term disability.  Third, countries that have forgone lockdown restrictions in favour of personal responsibility and focused protection of the elderly, such as Sweden, were not able to successfully protect the vulnerable population.  While there is clearly a need to support and ease the physical and mental health burdens many are suffering under, the proposed declaration is both unlikely to succeed and puts the long-term health of many at risk.”

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MIL OSI United Kingdom