Circuit-breaker Lockdown?

As infection rates in Europe and the US increase the debate around solutions seems to be becoming increasingly polarised.

Some say we need another lockdown. 41% strongly support, according to a YouGov poll, compared to 11% who strongly oppose. Others say we need strong measures. A fringe but growing group of scientists and medical professionals are arguing for ‘focused protection’ and a rejection of the lockdown model.

The problem, as I see it, is that no-one’s arguing for a return to the lockdowns of Spring. Everyone agrees on the damaging effect they had. When WHO professor David Nabarro told Andrew Neil that ‘We in the World Health Organisation do not advocate lockdowns as the primary means of control of this virus’, it seems that that’s what he meant.

But surely something must be done to avoid thousands of unnecessary deaths?

The Lockdown Sceptics and Barrington signatories argue that the lives saved by a lockdown are out-measured by the lives lost from the economic fallout. Most, including SAGE, don’t agree with this. The lives of people suffering right now should also be weighed more heavily than those of the future.

The central problem, though, is hospital overcrowding.

Those who reject lockdowns often argue, for example, that ICUs are ‘half-empty’, as the Telegraph and others have reported. As David Oliver has written in the BMJ, though, for people working in ICU’s this is upsetting stuff to read. Hospitals might seem emptier because visitors are restricted. He writes:

‘ Lobby shops and cafes aren’t running as usual. Car parks have spaces. Physical appointments, tests, and procedures are organised differently, to avoid crowded waiting areas or patient-to-patient transmission. But hospitals are not “literally half empty,” however much this is repeated.’

It seems that the best approach aims to keep the virus at levels which are ‘manageable’ within the current capacity of public health services. Anything north of this warrants some kind of limited and ideally (if the messaging and organisation is successful) local restriction. Unfortunately, this might be the course of things across the winter, until a vaccine is made available. Of course, the solution in the meantime is an effective track, trace, and isolate system.

Oliver writes that:

‘ The NHS entered the pandemic with one of the lowest numbers of acute beds per capita among developed nations4 and was already struggling to meet waiting time standards for emergency departments, surgery, or outpatients. Overcrowding will be disastrous for infection control, but modelling from Edge Health, reported in the Guardian, suggested that over 100 hospital trusts in England would be overwhelmed, at 10% over usual capacity, if a second pandemic surge compounded the usual rise in seasonal admission this winter.’

In the meantime, The Spectator publishes conspiracy theories that the Barrington Declaration is being suppressed by Google, Reddit, and the BBC. The reason it won’t initially be on the first page of Google when articles referring to it are is that it’s a new website; Google automatically ranks older more trusted sites higher in the rankings until a new site attracts more attention. The BBC is also unlikely to want to give the Declaration much air-time if it gives the impression there is a 50-50 divide amongst scientists and the medical community. There’s not. Barrington is a fringe position, whether its signed by Oxbridge and Ivy League professors or not, and while it should obviously be discussed (many are, free speech warriors) it leaves serious questions unanswered:

How is ‘focused protection’ achieved?
How will public services not be overwhelmed?
What projections are herd immunity based on?

I’m not blanket against it; I’m against it unless more evidence is produced and suspicious of the usual suspect free-market pundits that have lined up to tout it. I wonder if, just maybe, they’re guided by their ideology rather than the evidence?

https://www.bmj.com/content/371/bmj.m3924

https://www.spectator.co.uk/article/why-cant-we-talk-about-the-great-barrington-declaration