Truths, Untruths And Scientists

It seems fairly obvious, I’m sure you will agree, that politics is confrontational. That to be on one side of an argument is to be opposed to the other side. Quite often, as we all experience on social media, the evidence for particular arguments is, to put it mildly, tendentious. But, when arguing about  the pandemic we can always turn to science, can’t we? Whilst trust in politicians remains understandably low a recent poll carried out by Survation for the Open Knowledge Network found that 64% of those surveyed were more likely to trust scientists since the pandemic began.

In some ways the trust in scientists is to be expected. Most people, perhaps all people, want the pandemic to end. We are looking to science to step in where politicians (with the possible exception of Jacinda in New Zealand) have shown themselves to be hapless and out of touch. So, when a group of scientists tell us that they have the answer to the pandemic we are bound to listen and to take them seriously. But, trust in science is not quite the same thing as trust in scientists. Science has done a remarkably good job of presenting itself as above politics and most people’s view of scientists is a positive one.

Science And Scientists

Here’s a little thought experiment. In your mind conjure an image of a scientist. What do you see? Did a white coat, a test tube, a laboratory play any part? For many people it is likely to be a picture of Einstein or some other famous scientist from our past. Science is about people conducting experiments in a search for the truth and in so doing helping to take society forward. It is not characterised by, for example, Josef Mengele who carried out appalling experimentation in concentration camps. Neither is it characterised by thalidomide which destroyed so many lives during the 1960’s. Or, by the many scientists employed to create weapons of destruction, or whose life work is supporting the so-called ‘beauty’ industry.

Science has been responsible for some of the most amazing advances our society has made. It has eradicated smallpox, for example. It has made possible open heart surgery which I was recently a beneficiary of. So, in no way, am I suggesting that science is a bad thing. But, it also makes mistakes and my main point is this: scientists are not modern day gods, nor paragons of virtue. They are, like the rest of us, prone to egoism, narcissism, and, my main point, political views. Of course, they are entitled to have political views. Everybody is. But, the idea that politics follows the science and that science is above reproach is a fairly dangerous one, for it places scientists (not science) on a pedestal and allows their opinions a weight not always deserved.

According to The Spectator (the Johnson family house blog), there is a conspiracy to prevent people from hearing about the Great Barrington Declaration. Toby Young claims that if you google it you get pages rubbishing it before a link to the declaration itself. Far be it from me to call Toby Young a snivelling, self-important, lying weasel but this is a screenshot of my Google search, and as you can see the link to the declaration is at the top. 

There are certainly plenty of conspiracies around the pandemic an attempt to silence those promoting the ‘herd immunity’ thesis is not one of them. Young gives the illusion that the declaration should be taken seriously by stating that these “experts” propose a “tried and tested way of managing the risk posed by a new infectious disease, dating back thousands of years”.

Young, like many in the anti-lockdown camp, are keen to spread unscientific opinion as fact masked behind the fact that those expressing the opinion are “scientists”. The closest the declaration  gets to admitting it is not a scientific paper but a political declaration is in its opening passage which says that those signing it are “from both the left and right”. What they do not tell you is that the declaration is sponsored by the American Institute for Economic Research (AIER). This might not be that important, after all if they are genuine why should it matter where they chose to get together. But the AIER is owned by a company called American Investment Services Inc. AIER was founded in 1933 and, according to its website, “educates Americans on the value of personal freedom, free enterprise, property rights, limited government and sound money”, all of which are decidedly right-wing concerns connected to a philosophy known as libertarianism. In and of itself, of course, this does not invalidate the claims of people connected with them.

Focused Protection

The declaration makes a number of claims, some of which are undoubtedly true, but uses them to produce a conclusion that what is needed is the abandonment of lockdowns and a policy of herd immunity together with what they call ‘Focused Protection’. Nobody is denying that the national lockdown in the UK resulted in “lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health”, but whether these amount to a strong case for abandoning lockdown altogether is a matter of opinion not science. As Professor James Naismith, Director of the Rosalind Franklin Institute has said:

“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.” But, as he continues:  “One can promise a scheme that is very easy to describe but is hard to deliver.  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). ”

I don’t want to be accused here of what-ifery, but vaccination rates amongst children are also disrupted by poverty and war. For example the World Health Organisation and UNICEF whilst voicing concern about the effects of Covid on childhood vaccination rates note that: “Progress on immunization coverage was stalling before COVID-19 hit, at 85 per cent for DTP3 and measles vaccines.” In Syria, or Gaza vaccination rates, and mental health issues are being exacerbated by Covid-19, but political decisions which none of the signatories to the GBD seem overly concerned with are the root cause. A point made by Stephen Griffin, Associate Professor in the School of Medicine at the University of Leeds: “Sadly, focusing on the pandemic rather than the cultures and environments in which it arose ignores long-standing issues in society that existed prior to, and likely long after the pandemic has passed.”

The authors of the declaration ignore any evidence which might contradict them. For example, they argue that “Keeping students out of school is a grave injustice,” and advocate “Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed.” There is very little doubt that the re-opening of schools helped to fuel the latest spikes in Covid leading to further lockdowns. At the last count, according to the excellent @ToryFibs Twitter account, some 3,000 schools had children in isolation. There does not appear to be any attempt by the four governments of the UK to log all the cases. But the BBC reports that in Liverpool there are currently 500 staff and 8,000 pupils who are self-isolating. Meanwhile, according to the Manchester Evening News, more than 500 schools in the Greater Manchester area now have pupils or staff who are self-isolating.

Education is important, and I am not in any way suggesting that it should be a secondary issue when dealing with an unprecedented pandemic situation. Nonetheless, again if we look on a global scale, Nature reported prior to the pandemic that on current predictions only 61% of young adults (aged 25-29) will have finished secondary education. That most of these are in the poorest countries of the World, is one reason why those of us in the relatively wealthy parts of the World (Europe, America, Australia etc) spend so little time worrying about it. The point is that no matter how disruptive lockdowns are to education, for some children the free market (which the AIER promote) is hardly doing any better.

Age and Covid

However, whilst the UK is in the grip of a second wave of Covid, the authors repeat the half-truth that the ‘vulnerable’ are from a particular age-related cohort. They claim that “vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.” It would help here if the authors were to define what they mean by ‘old’ and ‘young’. It is certainly the case that older people are the vast majority of deaths. Taking just hospital deaths in the UK, 53% of Covid deaths have been in the over 80’s. For those aged up to 19 years the percentage is 0.07%. However, as a matter of maths that is less than one thousand times, actually around 780 times. If we are supposed to accept that these are scientists without a political agenda then it would help if they at least got the basic maths correct.

As for flu, according to the latest figures for England and Wales released by Public Health England. The proportion of young people under 19 dying from flu was 0.86%. As a matter of maths that is 13 times the proportion of young people dying from Covid. In terms of numbers 13 under 19’s died from flu in 2018, whilst 21 have so far died from Covid this year.

Whilst it is true as the Declaration says that older people have a greater chance of dying from Covid than younger ones, the rates of infection according to the World Health Organisation are greatest in the 25-64 age group who accounted for 64% of infections from January to July. But, even if we just concentrate on fatal cases, we should not forget that in England alone, 2,599 people aged under 60 have already died from Covid. The authors are pursuing a libertarian agenda which is roughly one of ‘survival of the fittest’. As Michael Head, Senior Research Fellow in Global Health, University of Southampton, commented: “There are countries who are managing the pandemic relatively well, including South Korea and New Zealand, and their strategies do not include simply letting the virus run wild whilst hoping that the asthmatic community and the elderly can find somewhere to hide for 12 months.”

According to the Declaration: “As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. We know that all populations will eventually reach herd immunity – i.e.  the point at which the rate of new infections is stable – and that this can be assisted by (but is not dependent upon) a vaccine.” It would be true that if immunity was building the risk of infection would, by definition, fall. However, there is not a scrap of evidence to support either the assertion that immunity is falling or that populations will reach ‘herd immunity’ without the aid of a vaccine. As Professor Jeremy Rossman, Honorary Senior Lecturer in Virology, University of Kent says: “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.”

Herd Immunity

There is no recorded instance in history of herd immunity being achieved without a vaccine. People often cite the Spanish Flu of 1918 as an instance. As Euronews reported earlier in the current pandemic, the Spanish Flu (it didn’t originate in Spain by the way) was dealt with by extensive lockdowns and in America you could be fined $100 for not wearing a mask in public. Nobody knows for certain how the pandemic ended, although better sanitation and the use of anti-viral drugs seems to have played some part and some measure of immunity building up. 

As Dr Julian Tang, Honorary Associate Professor in Respiratory Sciences, University of Leicester points out flu has not been eradicated, but its effects can be managed with a range of interventions: “each year during our annual influenza season, we vaccinate the vulnerable – elderly and those with comorbidities – including pregnancy and even primary school children who have contact with such vulnerable groups in an effort to further protect the vulnerable. And if this fails to prevent influenza infection of the vulnerable groups, we have antivirals like oseltamivir and zanamivir that we can give to anyone who has influenza or in whom we even just suspect influenza to reduce the severity of their illness. But we don’t yet have these additional ‘tools’ (the vaccine and antivirals) for COVID-19, to assist with this ‘Focused Protection’ approach.”

The approach proposed by the GBD is one of prioritising the economy over the lives of the ‘vulnerable’. According to the declaration: “nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors.”  A herd immunity approach will inevitably increase the burden on the entire health care system. We know that health care workers are extremely vulnerable to death from Covid. The Health Services Journal did a survey between February and April when Covid was first developing in the UK. They  identified 109 health care workers who had died in that period. Of those, 89 had verifiably been working, mostly in patient facing roles. Of the others, there was no evidence that they had not been working.

Just under a third of those who died were under 50, with 8% under 30. The median age was 54. The majority of deaths were among nurses and midwives who accounted for one-third of deaths. It is not just age it appears, but viral load. The more contact with Covid 19 the more likely you are to contract the disease and the more likely, therefore, you are to suffer severe symptoms including death. Age is clearly only one, if an important one, of a range of variables. Around 18% were doctors. What is most shocking in the statistics is the over-representation of BAME individuals. 71% of nurses who died were identified as BAME (compared to their 20% of the NHS workforce), 56% of healthcare support workers who died were BAME (compared to their 17% of the workforce), whilst 94% of doctors were BAME (compared to their 44% of the workforce). 

The inability to define the ‘vulnerable’ is a major flaw in the declaration. It is assumed that the only bad outcome of covid is death, of course we now know that many people are suffering long-term fatigue and other ill effects, and that these lingering affects are just as prevalent amongst the younger cohorts as the older. But, even leaving ‘long Covid’ aside for a moment, the excess deaths are disproportionately to be found in poorer communities. A study in the journal Frontiers in Sociology found that in the USA “the number of deaths confirmed to be caused by Covid-19 demonstrated a pattern whereby the number of deaths was greater in areas of relatively greater poverty”. Meanwhile, J Patel writing in Public Health journal in June concluded that “a combination of factors leaves the most economically disadvantaged particularly vulnerable to COVID-19”. Patel argues that in describing “the vulnerable” governments should be clear who they mean and not just consider it as “the elderly”. That advice was sound then and remains sound in the face of so-called ‘experts’ calling on a return to normality for those not vulnerable. As Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton noted in relation to the focused protection plan: “It is a very bad idea.  We saw that even with intensive lockdowns in place, there was a huge excess death toll, with the elderly bearing the brunt of that, and 20-30% of the UK population would be classed as vulnerable to a severe COVID-19 infection.”

The way forward

There is certainly a debate to be had about the way in which governments of the right (UK, USA, Brazil etc) are dealing with the pandemic. Surely I am not alone in thinking that they either should adopt this herd immunity approach (with the resultant high number of deaths among elderly, poor and/or BAME communities) or they need to stop bringing in half-measures. For what its worth, and I accept that my opinion is actually worth very little, it does seem that politicians and scientists are being far more led by what they perceive as public opinion than by science.  Covid-19 is a virus. It is passed from person to person. It therefore does not need a ‘scientist’ to work out that the more people you come into contact with the greater your risk of contracting the virus. To stop a virus spreading you need to reduce the contact between people. Keeping schools open because young people don’t die at the same rate as older people is ludicrous. Schools and universities do not just contain young people. Teachers, lecturers, cleaners, administrators etc. are generally of the older generation. The number of deaths in the 40-59 age group in England (and this is only deaths in hospital) is 2,358. Although that is under 8% of the total, it still represents a 1 in 32 chance of dying if you become infected.

The signatories to the Great Barrington Declaration should be honest. They are not signing as scientists following the science, but as individuals with a right-wing libertarian agenda, who believe that the free market can solve all our problems. They are not concerned particularly with the education of young people, but rather with the activities of economically active individuals, whose ability to maintain the economy is being disrupted by what the authors see as the protection of a small minority. They are not insensitive enough to say ‘let the old die’ but have no idea how their proposals would work in practice. As Dr Rupert Beale, Group Leader, Cell Biology of Infection Laboratory, Francis Crick Institute noted: “This is wishful thinking. It is not possible to fully identify vulnerable individuals, and it is not possible to fully isolate them.”

The Declaration came at a perfect juncture for the right-wing libertarians who regard any curtailment of their ‘freedom’ as an imposition. It has given succour to the anti-lockdown, anti-mask and anti-vaccination movement by proposing a laissez fair, survival of the fittest strategy wrapped in an illusory jacket of care for the elderly. As Wired Magazine’s Matt Reynold’s noted in an opinion piece: “What is more interesting about the Great Barrington Declaration is what is missing. There is nothing about test and trace or mask-wearing – two interventions that we know are effective at stopping the spread of Covid-19 and don’t require any curtailing of our individual behaviour.”

People, whether scientists, politicians or just members of particular communities, are entitled to hold contradictory and sometimes unpopular opinions. People’s opinions don’t necessarily have to be evidence-based. But, scientists, especially when talking as members of the scientific community, have a duty to be careful what they claim, especially when the evidence does not exist. Scientists can make political statements, but they should make it clear when they do so that these statements are their personal opinions not based necessarily on scientific rigour. I object to the Great Barrington Declaration because it is based on unfounded allegations of the possibility of herd immunity, and because it provides a platform for those who care little for other members of their community and simply want to whinge about how their personal freedom is being affected. News alert people: we are all having our personal freedom curtailed because it is the only way we can protect the most vulnerable in our society. I object most strongly though because people citing this declaration almost always preface it with the fact that the main signatories are “respected scientists” and are from Harvard, Stanford and Oxford as if these two facts alone mean that they have a knowledge that is above politics and greater than anybody else. Although I would not call them frauds because that would not be true I do believe that the fact that the declaration emerged from a right-wing libertarian think-tank is significant, and that people should not be taken in by those promoting a society where the vulnerable will, in all probability, far from being protected be thrown to the wolves.