In recent online conversations about coronavirus I am finding increasing numbers of people who are moving towards a more sceptical position on the lockdown but unaware of the sceptics’ arguments and evidence as it has evolved since the virus reached our shores. I got the feeling they would appreciate a primer or at least a refresher.
Here then for them is my resumé of the sceptical case to date.
At its heart is the observation that while lockdowns are not needed to prevent a catastrophic loss of life, and hence they cannot be justified on those grounds, they are themselves extremely harmful and highly costly (in human life terms as well as economic terms) while what they achieve is of little to no benefit.
Both lockdown proponents and those who have reluctantly accepted them as a necessary evil appear to forget that lockdowns are both an extreme and an unprecedented intervention that require extraordinary justification. Yet I am somehow made to feel by lockdown advocates that the default position is to lock down and the sceptic must justify not doing so. This is wrong. The default position is always not to lock down. Lockdowns (a term previously used only in conjunction with prisons – the emergency lockdown when inmates are rioting) are not only economically devastating, they infringe almost every human right we hold dear.
It is the lockdown proponent on whom the burden of proof falls, and who must demonstrate that the threat faced is so great that only a lockdown will be adequate to address it.
The primary proof that lockdown was unnecessary is that the level of threat predicted has failed to materialise – quite simply, the virus has not killed as many as was feared, it has not infected as many and it has not proved anywhere nearly so deadly for those it has infected. That this would be the case was evident to some scientists whom the government chose not to call on for advice such as epidemiologist John Ioannidis, virologist Sucharit Bhakdi and biologist Michael Levitt. Their findings and analyses should have been enough to make clear to everyone by the time UK deaths plateaued in early April that this ‘flattening of the curve’ had come too early to be the result of lockdown.
Locking down deflected from a real need to meet increased demand for specialist health care, a need to work out its optimum management during the epidemic, plus the problems of practical implementation of effective protective isolation rings for the elderly and vulnerable. Policy-makers appeared to hope it would buy them time, but then the lockdown took on a logic of its own as government talked about waiting for a vaccine and the endpoint receded ever further into the future.
Without doubt many people are still under the impression that the death toll in the UK would have been much higher had we not locked down, that is, locking down earlier would have saved many more lives and finally that there are far more deaths to come as lockdown is lifted and the virus resurges in a still largely vulnerable population – the ‘second wave’ fear.
There is strong evidence that all these ideas are mistaken. It is much more likely that the population has already, despite lockdown conditions, developed a high measure of collective immunity to the virus, with up to 80 per cent of those exposed to the virus fighting it off without developing any or only very mild symptoms. This itself suggests there will be no deadly second wave, though there may be small local outbreaks.
There remains the question of how, under lockdown, did the virus continue spreading, apparently reaching this collective immunity threshold? Although it might appear counterintuitive, researchers have keyed into evidence that shows the virus spreading mainly in places of close indoor interaction such as hospitals, care homes and private homes, none of which which were isolated or protected by the general lockdown and which, given the intensity of staff and patient interaction, travel and close family member interaction, ironically became the most risky environments, rather than out on the streets, or elsewhere in the community.
A consequence of lockdown – in confining people to close contact indoor spaces – may have been to make things worse rather than better. In any case, worldwide evidence demonstrates that the best way to avoid a high death toll in an infectious disease scenario is not to lock down but rather to install high levels of protection and control, especially at borders, and make use of special ‘fever’ hospitals to avoid infecting other patients.
Screening at borders – as instituted in Taiwan where they have suffered precisely seven deaths – and border closure would without doubt have helped to limit the spread by restricting the number of independent introductions of the virus into different communities in the country.
Regardless, the evidence is that the collective immunity threshold has been reached in the UK and many other countries. There are three dimensions to the proof.
Exhibit A in the case for the prosecution is the fact that the infection growth rate slowed down in London weeks before lockdown began, and even before public transport use began to drop. This can be seen clearly on the following graph.
Examination of the graphs shows that the slowdown from exponential to linear growth in the daily number of deaths in London hospitals occurs on March 24. That’s the day lockdown began. Infections have been estimated to occur an average of two to three weeks before deaths, meaning this corresponds to a slowdown in infections in London on March 10 at the latest, likely earlier. This is at least two weeks before lockdown, and as the graph below of London public transport use shows, is also before there is any drop in public transport use. This is strong evidence that the infection rate is slowing down because it is approaching a natural limit, the collective immunity threshold, rather than due to any government intervention or change in public behaviour.
Exhibit B is the London antibody survey from May that found 17 per cent of the population of the city were carrying antibodies. That is similar to the 20 per cent found in New York City and the 14.2 per cent in Spain’s worst affected region. It suggests that around 20 per cent may be the natural limit of antibodies in a large, densely populated city.
Lockdown advocates will ask, What about the other four fifths of the population? Well, it appears that many of them, up to 60 per cent, may already have resistance to the virus through cross immunity from other coronaviruses. As this study in Cell ‘Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals’ concludes: ‘We detected SARS-CoV-2-reactive CD4+ T cells in 40%–60% of unexposed individuals, suggesting crossreactive T cell recognition between circulating “common cold” coronaviruses and SARS-CoV-2.’
Lastly for exhibit C, we can point to the absence of new deadly surges in countries which have lifted restrictions, including many in Europe, such as Denmark which reopened its schools as early as April 15. While there have been some reports of surges in cases (rather than deaths) these are always local in nature and mostly explicable by the ramp-up in testing as lockdown is lifted. Israel, for example, has just reimposed restrictions after a surge in cases since early June. However, there has been no surge in deaths, which remain down at just two per day. There is also the example of Sweden, where most schools, bars and restaurants remained open throughout the epidemic and there was no confinement to homes or bans on visiting others, yet there was no greater loss of life than in the UK. This is further evidence that populations do not remain vulnerable after this epidemic, lockdown or no lockdown, and that the collective immunity threshold has been reached.
Add to this the fact that the death rate from the virus is estimated by the United States Centers for Disease Control to be around 0.26 per cent (dropping to 0.05 per cent for those under 50), much lower than originally feared, and a picture emerges of a virus for which it is hard to see how lockdown could be justified.
In conclusion, there should be a fundamental presumption against deploying a measure as harmful, costly and illiberal as a general lockdown of the healthy population. It is very difficult to see how such a high bar has been reached in the case of this virus. This is particularly the case as lockdowns appear to have very little effect on the spread of the virus, and may well make things worse – not least in terms of collateral damage to health services as well as being catastrophic for the economy. Lockdowns should therefore be ended as soon as populations can be persuaded they are safe (and active effort should be made to convince them of this, including replacing over-cautious government scientists with more evidentially-grounded ones), and the experiment not repeated again.