By Robert Verbruggen
Tuesday, October 20, 2020
The Great Barrington Declaration is an eight-paragraph
statement from many leading skeptics of the First World’s aggressive reaction
to COVID-19. It was organized by the American Institute for Economic Research,
a free-market think tank, and signed by lockdown skeptics including Jay
Bhattacharya of Stanford, Sunetra Gupta of Oxford, and plenty of others. Scott
Atlas, the Stanford health-care expert who’s drawn fire for the role he’s
playing in the White House’s approach to the pandemic, has endorsed it as well.
There’s good and bad in the declaration itself. More than
anything, though, it makes me wonder if the kind of big-picture thinking it
presents even matters, at least in the U.S. Truth be told, we’ve never had a
coherent national strategy for fighting this thing, and we’re not going to
start now.
The concept at the declaration’s heart is “focused
protection.” We’ve known from the very beginning of the pandemic that COVID-19
is incredibly dangerous to seniors while posing much less of a threat to the
young and healthy. Now that the strictest lockdown phase is in the rearview
mirror, it makes a ton of sense to focus our remaining efforts largely on the
old and sick. As the authors write,
adopting measures to protect the
vulnerable should be the central aim of public health responses to COVID-19. By
way of example, nursing homes should use staff with acquired immunity and
perform frequent PCR testing of other staff and all visitors. Staff rotation
should be minimized. Retired people living at home should have groceries and
other essentials delivered to their home. When possible, they should meet
family members outside rather than inside. A comprehensive and detailed list of
measures, including approaches to multi-generational households, can be
implemented, and is well within the scope and capability of public health
professionals.
That’s great. But for the Great Barrington posse, the
flip side of protecting seniors is doing almost nothing to protect anyone else.
In their own words:
The most compassionate approach
that balances the risks and benefits of reaching herd immunity, is to allow
those who are at minimal risk of death to live their lives normally to build up
immunity to the virus through natural infection, while better protecting those
who are at highest risk. . . .
Those who are not vulnerable should
immediately be allowed to resume life as normal. Simple hygiene measures, such
as hand washing and staying home when sick should be practiced by everyone to
reduce the herd immunity threshold. Schools and universities should be open for
in-person teaching. Extracurricular activities, such as sports, should be
resumed. Young low-risk adults should work normally, rather than from home. Restaurants
and other businesses should open. Arts, music, sport and other cultural
activities should resume. People who are more at risk may participate if they
wish, while society as a whole enjoys the protection conferred upon the
vulnerable by those who have built up herd immunity.
That’s where I depart from the declaration. We absolutely
do need fewer restrictions on the young than we have on the old, and the
declaration is right to harp on the harms of “lockdown policies,” though such
policies are basically over anyway. But it’s crazy to believe that anything
beyond “simple hygiene measures” for younger people — even having them work
from home when possible, or restricting major spectator gatherings that could
easily turn into super-spreader events — is never worthwhile.
Getting infected with COVID-19 can be bad, even for the
young. Younger age groups are at low risk of death, but these folks do
sometimes wind up hospitalized. We’re still not sure how badly the disease
damages lungs and hearts after the infection has passed. We’re also not sure
how long immunity lasts, or how many more people need to get infected before we
reach herd immunity. And it’s hard to let the virus run wild among most of the
population while isolating seniors: Nursing homes are staffed by younger adults
and visited by family members; about a quarter of Americans 85 and older live
in multigenerational households. On top of all that, treatments improve, and a
vaccine likely gets closer with each passing day.
There’s value in delaying infections. There isn’t infinite
value, not by any stretch, but there’s value. The idea shouldn’t be focused
protection for the elderly while everyone else packs into crowded bars and
spits in each other’s mouths; the idea should be focused protection for the
elderly and mild, reasonable, sustainable precautions for the general
population. Work from home if your job can be done that way, wear masks, keep
six feet apart, avoid densely crowded gatherings, meet friends outdoors when
possible, and take a test and quarantine if you get sick — but don’t isolate
yourself from the things that make life worth living, don’t shut down
businesses that can operate safely, and definitely don’t severely undermine
important activities such as school.
Frankly, though, does any of this high-level discussion
even matter in this country? We have a federalist system, and every state is
doing its own thing, making decisions based on the immediate political and
epidemiological realities on the ground, not on any greater theory of how to
minimize the total pain. The Great Barrington Declaration won’t get my local
politicians to reopen the schools; at most it’ll provide cover to politicians
who already wanted a laxer approach anyway.
In fact, confusion about what we’re trying to achieve has
reigned from the beginning. When the lockdowns started, people talked about
“flattening the curve” or taking “14 days to slow the spread,” but hardly
anyone admitted that mere curve-flattening or spread-slowing would just ease us
into herd immunity. (Say what you will about the Imperial College people and
their doomsday scenarios, but they didn’t sugarcoat anything: They were the
ones saying you needed to suppress the disease, possibly with repeated
lockdowns over many months, to avoid mass casualties.) Some of us hoped a brief
lockdown could buy us time to massively ramp up testing and tracing, but these
efforts achieved less than one might hope. When the time came, the lockdowns
were extended, but eventually they gave way to other ad hoc restrictions. In
the end, we did squelch the first wave — but then we went through a second and
now seem to be getting a third, because we never figured out a way to control
the spread in a sustainable manner.
Fortunately, each wave seems less severe than the last
because treatments have improved and we’ve gotten better at protecting the
elderly. But more than 200,000 people are dead, and no one should pretend that
American COVID policy has a coherent vision behind it that we can debate and
change.
Right now, on the whole, our measures roughly approximate
a rational approach — with more effort dedicated to protecting seniors and a
basic recognition of the fact you can’t keep people locked down forever over a
disease that poses relatively little threat to most of the population — but
there are infuriating exceptions. Here in Fairfax County, Va., my family can
dine at restaurants indoors, but I can’t send my kindergartener to public
school. That’s just American democracy for you, though, and if we’re going to
fix it, it will have to be at a local level.
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