Dear Prime Minister, Chancellor, CMOs and Chief Scientific Adviser
We are writing with the intention of providing constructive input into the choices with respect to the Covid-19 policy response. We also have several concerns regarding aspects of the existing policy choices that we wish to draw attention to.
In summary, our view is that the existing policy path is inconsistent with the known risk-profile of Covid-19 and should be reconsidered. The unstated objective currently appears to be one of suppression of the virus, until such a time that a vaccine can be deployed. This objective is increasingly unfeasible (notwithstanding our more specific concerns regarding existing policies) and is leading to significant harm across all age groups, which likely offsets any benefits.
Instead, more targeted measures that protect the most vulnerable from Covid, whilst not adversely impacting those not at risk, are more supportable. Given the high proportion of Covid deaths in care homes, these should be a priority. Such targeted measures should be explored as a matter of urgency, as the logical cornerstone of our future strategy.
In addition to this overarching point, we append a set of concerns regarding the existing policy choices, which we hope will be received in the spirit in which they are intended. We are mindful that the current circumstances are challenging, and that all policy decisions are difficult ones. Moreover, many people have sadly lost loved ones to Covid-19 throughout the UK. Nonetheless, the current debate appears unhelpfully polarised around views that Covid is extremely deadly to all (and that large-scale policy interventions are effective); and on the other hand, those who believe Covid poses no risk at all. In light of this, and in order to make choices that increase our prospects of achieving better outcomes in future, we think now is the right time to ‘step back’ and fundamentally reconsider the path forward.
Professor Sunetra Gupta; Professor of theoretical epidemiology, the University of Oxford
Professor Carl Heneghan; Director, Centre for Evidence Based Medicine, the University of Oxford
Professor Karol Sikora; Consultant oncologist and Professor of medicine, University of Buckingham
Sam Williams; Director and co-founder of Economic Insight
Gupta, who is a professor of theoretical epidemiology at Oxford, told The Londoner that alongside huge social and educational benefits, the “evidence is mounting that early exposure to these various coronaviruses is what enables people to survive them”.
But with no sign of a second summer wave nor an autumn eruption reminiscent of 1918, the commentariat has amended the definition. Suddenly, a “second wave” meant Covid’s seasonal return, in winter, a year on. Widespread adoption of a new phrase in the Covid lexicology – “winter wave” – has academically formalised the idea.
But instead of looking us square in the eye, the Tories have chosen Big Brother’s panopticon; No 10’s new Joint Biosecurity Centre, which will drive “whack-a-mole” local lockdowns, is slickness posing as strategy – and, as it happens, reporting into track-and-trace app failure Dido Harding. When the public twigs that the infection is unlikely to be controlled in this way, the sheer panic could send us back into national lockdown. Three scenarios might help avoid the latter: a vaccine comes along; the Government gets its act together with a plan to protect the vulnerable; or we put in place safety valves against mass hysteria.
Imperial College’s research needs to be particularly scrutinised, as its international influence grows. Dr Seth Flaxman – the first author in the paper that notoriously claimed lockdowns may have prevented over 3 million deaths in Europe – this week won fresh funding to model the pandemic across several countries.
Revelations that disrupt the narrative also need to find a stronger voice: within 24 hours, the scandal of PHE’s inflated daily death figures was running out of mileage. This week’s London School of Hygiene and Tropical Medicine modelling on the impact of the pandemic on cancer deaths never gathered steam. So too a paper by Oxford’s Prof Sunetra Gupta, which elegantly combined those uneasy epidemiological bedfellows – theory and evidence – to find some parts of the UK may already have reached herd immunity.
- We have already developed herd immunity to COVID-19 and will continue to manage it through herd immunity.
- Flu is much more dangerous than COVID-19.
- COVID-19 will settle into an endemic state just like flu.
- Hopefully vaccines will be important in protecting the vulnerable.
- Another way to protect the vulnerable sector is to allow the population to develop natural immunity.
- There’s no reason to think the virus will mutate into a lower level of virulence.
- During the 1918 flu because of a large number of ‘immunologically naive’ individuals but this is not the case with COVID-19.
- Most of us have some degree of coronavirus immunity and therefore some protection to COVID-19.
- The current H1 influenza strain is antigenically identical to the 1918 flu. H1 flu doesn’t kill as many people as the 1918 flu because most people already have cross immunity.
Prolonged periods of lockdown cocooning the public from germs could leave people dangerously vulnerable to new viruses, a leading epidemiologist has warned.
Sunetra Gupta, professor of theoretical epidemiology at the University of Oxford, fears intense social distancing could actually weaken immune systems because people are not exposed to germs and so do not develop defences that could protect them against future pandemics.
“It’s becoming clear that a lot of people have been exposed to the virus and that the death rate in people under 65 is not something you would lock down the economy for,” she says. “We can’t just think about those who are vulnerable to the disease. We have to think about those who are vulnerable to lockdown too. The costs of lockdown are too high at this point.”
We spoke to Sunetra Gupta, Professor of Theoretical Epidemiology at the University of Oxford and head of the team that released a study in March which speculated that as much as 50% of the population may already have been infected and the true Infection Fatality Rate could be as low as 0.1%.
In her first major interview since the Oxford study was published, she goes further by arguing that Covid-19 has already passed through the population and is now on its way out. She said:
• Many of the antibody tests are “extremely unreliable”
• They do not indicate the true level of exposure or level of immunity • “Different countries have had different lockdown policies, and yet what we’ve observed is almost a uniform pattern of behaviour”
• “Much of the driving force was due to the build-up of immunity”
• “Infection Fatality Rate is less than 1 in 1000 and probably closer to 1 in 10,000.”
• That would be somewhere between 0.1% and 0.01%
On lockdown policy:
• Referring to the Imperial model: “Should we act on a possible worst case scenario, given the costs of lockdown? It seems to me that given that the costs of lockdown are mounting that case is becoming more and more fragile”
• Recommends “a more rapid exit from lockdown based more on certain heuristics, like who is dying and what is happening to the death rates”
On the UK Government response:
• “We might have done better by doing nothing at all, or at least by doing something different, which would have been to pay attention to protecting the vulnerable”
On the R rate:
• It is “principally dependent on how many people are immune” and we don’t have that information.
• Deaths are the only reliable measure.
On New York:
• “When you have pockets of vulnerable people it might rip through those pockets in a way that it wouldn’t if the vulnerable people were more scattered within the general population.”
On social distancing:
• “Remaining in a state of lockdown is extremely dangerous”
• “We used to live in a state approximating lockdown 100 years ago, and that was what created the conditions for the Spanish Flu to come in and kill 50m people.”
On next steps:
• “It is very dangerous to talk about lockdown without recognising the enormous costs that it has on other vulnerable sectors in the population”
• It is a “strong possibility” that if we return to full normal tomorrow — pubs, nightclubs, festivals — we would be fine.
On the politics of Covid:
• “There is a sort of libertarian argument for the release of lockdown, and I think it is unfortunate that those of us who feel we should think differently about lockdown”
• “The truth is that lockdown is a luxury, and it’s a luxury that the middle classes are enjoying and higher income countries are enjoying at the expense of the poor, the vulnerable and less developed countries.”