A Proposal for a Prudent Response to Covid, from Harvard and Stanford

(Courtesy of a source, slightly modified for publication🙂
There was an interview on September 23rd, of Harvard and Standford Professors of medicine, Martin Kulldorff, Jay Battacharya, and Michael Levitt — providing a clear and sane appraisal of the Covid-19 situation.
It is 2 hours in length ( a great watch for a Friday night movie). View it before Youtube pulls it for going against the WHO’s party line.
But there is a summary courtesy of Nick Hudson |  https://twitter.com/NickHudsonCT/status/1309471981792886784
A couple highlights…
The purported reason for lockdown was to prevent overburdening of healthcare resources. Massive overprediction of demand happened nearly everywhere. Instead, the real problem was that hospital utilization fell so low that the sustainability of hospitals was jeopardized.
Non-Covid deaths at home have skyrocketed. Elective procedures, cancer screening & doctor visits that didn’t happen have caused or will cause death and health impacts. It is likely excess deaths coincidental to the epidemic arose because treatment wasn’t sought or provided.
Initial Chinese case fatality rates were obvious overestimates of the infection fatality rate. Using cases is complicated. Countries define them differently. Cases should be defined by a positive test AND presence of symptoms. Recording cases on a test only is unsound.
Covid mortality is sharply age-differentiated, with a 1,000-fold risk difference between the old & the young, for whom it’s less severe than flu. Every yr there are flu deaths among kids. Not with Covid. Among 1.8m Swedish children who stayed at school there were 0 deaths.
“Second waves” of cases in countries are not generally accompanied by second waves of deaths. Where they are, they are instances of “filling in” places that weren’t impacted initially. They don’t seem to occur in the same location.
Calling Covid a “novel” coronavirus was a mistake. Coronaviruses are far from new and this one is closely related to ones that have circulated among humans for ages.
The scientific evidence for t-cell mediated immunity is very strong. It is very clear that there is long-lasting protection from prior infection. This is no surprise. It happens with many diseases.
Herd immunity is not a “strategy”. It is the inevitable outcome, whether through natural infections, vaccines or, most likely, a combination of both. The longer you drag that out, the harder it is to protect the vulnerable.
The goal of a vaccine is herd immunity. Covid is never going to be eradicated. It will be endemic. The reason there are few cases in New York is mostly because of immunity, not guidelines.
Seroprevalence is an unreliable guide to assessing whether herd immunity has been attained. Antibody production declines over time, yet immune memory persists much longer & is very effective at protecting recovered people from contracting the disease when exposed again.
Structuring society simply to limit the number of covid cases is a mistake. A holistic approach is the only one that is fair. Age-targeted strategies are crucial.
Mandates to wear masks: The evidence doesn’t suggest they’re effective in slowing spread, yet they cause social strife. There aren’t sufficient benefits to require them. In general, it’s better to provide advice than issue mandates. Instead of sowing panic, provide info.
General lockdowns, closing schools, businesses & beaches, cause serious public health problems, increasing total deaths. Lockdowns should be off the table. Another would be disastrous. It’s healthy for the young to go to bars & restaurants. The elderly should avoid crowds.
The benefits of lockdown are small and the costs are enormous and catastrophic. We know this as a matter of certainty. Lockdowns have never in history eradicated a disease. Countries that are continuing with lockdowns are harming their populations.
Efficacy of coercive non-pharmaceutical intervention mandates in general is not evident in the data, with the exception of hand-washing. For example, mask mandates are uncorrelated with disease spread. Mask-wearing by kids at school does not make sense.
A frequent mistake is to interpret continuing decline in the disease as evidence that an intervention is effective. Continuing decline in the change in daily deaths is the natural pattern of the disease.
A policy that asks the young to isolate or distance is a mistake. It was a mistake to close schools. This exposed huge numbers of children to risks that their schools normally protect them from. The focus should be on protecting the elderly.
It’s not right to expel students for going to parties. Such policies to quarantine the young are unnatural & cause psychological harm. 1 in 4 young adults seriously considered suicide in June. Universities have an obligation to respect that and not harm their students.
Children transmit to adults at much lower rates than for other respiratory diseases, posing little risk to teachers, whose risk is no worse than other professions. Sick kids should be sent home as is normal. There’s no point in schools taking any other measures.
Testing asymptomatic youngsters at schools and universities makes no sense. “There are certain people who think testing is the solution to everything. I’m not one of them.” (Levitt)
Deploying PCR test with cycle thresholds of 40 isn’t sensible for general purposes, especially when attached to an environment of contact tracing & quarantine. This results in quarantining huge numbers of people who aren’t even contagious, imposing enormous costs on them.
These are functional and epidemiological false positives. These costs make people less willing to co-operate with contact tracers. As many as 60% consequently lie when asked to disclose contacts.
Oxford University opines you’re only likely to be dealing with live virus for cycle thresholds of 25-26. Higher than that and you’ll be picking up viral fragments. It only really makes sense to up sensitivity in nursing home contexts.
There has been a tear in the fabric of society. The media has been irresponsible and partisan.
The Imperial College group declined engagement with top scientists who were critical of their work, including some who were pointing out that their numbers were out by an order of magnitude.
Top academics producing results that contradict the prevailing narrative have struggled to get their work published. You solve hard problems by having discussions, and many academics have been unwilling to engage in them.
“As a public health scientist who has been working with infectious diseases outbreaks for many years, I am absolutely stunned by the reaction of the scientific community as well as the media to this…” (Kulldorff)
There have even been open calls by academics to establish in effect a censorship board over open science. Stanford Professor John Ioannidis’ videos were suppressed. Dissenting scientists have been attacked.
“Dr Sunetra Gupta is the pre-eminent infectious disease expert in the world and until very recently has had a very hard time getting people to even listen to what she is saying.” (Kulldorff)
“Dr Heneghan, also at Oxford …& my colleagues, Baral, Chandler, Livingstone, Yih & some who are afraid to speak out … favour an age-targeted approach. Most of the high-profile scientists [you hear the opposite from] have not actually been experts in infectious diseases.”
When this is over we are going to have to work hard to re-establish the public’s acceptance of science.