Dr Piers Robinson is our Chair. Off-Guardian is your host. The proposition to be debated is:
SARS-COV-2 merits suppression measures in order to combat the virus rather than the herd/community immunity approach
Dr Anderson delivers his opening statement in support of the proposition:
I ask readers to reflect a little on health systems and the ideas behind them, and not just react to particular measures. To simply react to the crisis as ‘lockdown vs no lockdown’, and complain how it affects individual liberties, misses that.
The 2020 pandemic has shown us massive failures in western neoliberal health systems – privatised, heavily commercialised, lacking in preventive capacity – and this deserve analysis.
I suggest we learn from the experience of independent countries, those well organised on principles of humanism and social solidarity, e.g. China, Vietnam, Cuba, Venezuela and Syria. Their actions during the pandemic have some important lessons.
It is important to go beyond the fantasies that the current epidemics were not serious public health threats, which demand a social response. Cynical responses which cry ‘the data is all wrong, scientists should not be believed, public health systems want to poison us all’ both miss the neoliberal failures and prevent us from engaging in social responses.
1. On the broad debate:
I have read some of the material that my colleague Denis Rancourt has written on this subject. I disagree strongly with his idea that all viruses are part of a regular winter cocktail, with little difference between them.
Demonstrable, collective medical science is important, and differs in character from political debate, which is mostly constructivist and argumentative.
Differences between diseases are important. Some affect the young and others the old. Many epidemiologists say, “if you’ve seen one pandemic, you’ve seen … one pandemic” (Osterholm; Horton).
That is, “COVID-19 doesn’t behave like flu, which doesn’t behave like Ebola” (Spinney). We know now that COVID19 is not only linked to respiratory illness but also vascular and neurological illness.
It simply entrenches ignorance to say: ‘we can ignore all contemporary public health data’ (because of the chronic uncertainties), and ‘we can ignore medical science consensus’ (in favour of our chosen dissidents). We should engage with the best available evidence.
The consequences of denying the pandemic, as do a western liberal minority, are that people assist the neoliberal privatising project and self-exclude from meaningful engagement in many real issues: how to manage particular quarantine regimes, social security, medical regimes, etc.
Pandemic deniers run parallel slogans to those of neoliberals like Boris Johnson and Donald Trump: ‘no worse than a flu’, ‘natural herd immunity’, ‘the cure is worse than the disease’.
This denialism is not really a ‘left’ position because it begins by rejecting preventive health measures (e.g. quarantine and vaccines, at the centre of all public health systems) and its justifications generally capitulate to individualism (‘my liberties above all’).
2. On the proposition:
Does SARS-CoV-2 merit suppression measures in order to combat the virus rather than the herd/community immunity approach?
I say yes, the 2020 pandemic was a serious health crisis which required prompt protective measures to contain the spread and mitigate the illness and death. This should be understood in principle, first, before moving to criticise the various quarantine and hygiene measures taken by particular governments. It is always important to not conflate principles with particular political actions.
Protection of populations could not be achieved by simply allowing the disease to run its course and hope that some sort of natural immunity might result. That would have allowed many millions to die.
I will briefly address the science on the danger of the virus and why ‘herd immunity’ is only really viable with the help of a vaccine. We can debate the science on excess mortality, vaccines, face masks, lockdown casualties, and so on, later.
Epidemiologists calculated a range of Infection Fatality Rate (IFR) estimates, a few months into the pandemic. They suggested IFRs between 0.2% and 1.3%, but the consensual area is between 0.5% to 1% (Verity et al; Basu; CDC; Bhattacharya; Mallapaty). That is, about 5 to 10 times the seasonal flu, not inconsistent with the more than one million COVID19 deaths reported from 200+ countries and territories in seven to eight months of epidemic, compared to an average of 400,000 annual deaths from flu globally, in recent years (Paget). No responsible health official can afford to just cherry pick the most optimistic estimates.
On acquired immunity, measurements of antibodies to COVID19 in some of the hardest hit European cities and New York show 10% or less, plus some higher levels T-cell reactivity (Jones and Helmreich; Pitt; Woodley). That is far too low for any sort of ‘natural’ herd immunity which, given COVID19’s highly contagious nature, has been suggested to require 85%. Observed natural levels of antibodies or T-cell reactivity do not yet come close to that (Pitt; Doshi). This is where the 300+ vaccine candidates try to do better. Let’s see how good they are.
3. Neoliberal failures and independent responses
This is my characterisation of the approach taken by neoliberal countries (UK, USA, Sweden, Brazil):- they stripped their public health capacity, decades before this crisis;- they developed societies of privilege and exclusion, fuelling distrust and resentment;- they delayed for many weeks state responses to the epidemics, allowing contagion to spread;- they imposed quarantine controls very late, using police and not health officials;- they generated both contagion and prolonged ‘lockdowns’ – the worst of all worlds.
What did the more independent countries (China, Vietnam, Cuba, Venezuela, Syria) do?- they built and extended public health systems;- they extended universal guarantees and made more inclusive systems;- they promptly imposed protective quarantine measures, led by health personnel;- they generated shorter ‘lockdowns’ which, with testing and tracing, could be more focused.
Why should we not reflect on why Cuba and Syria (e.g.) imposed quarantine measures before they had a single infection, while the UK and the USA waited 7-8 weeks? The first two contained their epidemics, the latter two did not.
Find out more about our two eminent debaters here
Read Dr Rancourt’s opposing opening statement here
Basu, Anirban (2020) ‘Estimating The Infection Fatality Rate Among Symptomatic COVID19 Cases In The United States’, Health Affairs, 7 May, online.
Bhattacharya, Jay (2020) ‘We Must Question The COVID-19 Status Quo (w/Dr. Jay Bhattacharya)’, ZDoggMD, YouTube, 14 September, online:
CDC (2020) ‘COVID-19 Pandemic Planning Scenarios’, US Centre for Disease Control and Prevention, 20 May, online.
Doshi, Peter (2020) ‘Covid-19: Do many people have pre-existing immunity?’, BMJ, 17 September, online.
Horton, Richard (2020) The COVID-19 Catastrophe, Polity, Cambridge MA Jones, David and Stefan Helmreich (2020) ‘A history of herd immunity’, The Lancet, 19 September, online.
Mallapaty, Smriti (2020) ‘How deadly is the coronavirus? Scientists are close to an answer’, Nature, 16 June, online.
Paget, James et al (2019) ‘Global mortality associated with seasonal influenza epidemics: New burden estimates and predictors from the GLaMOR Project’, J Glob Health. 2019 Dec; 9(2): 020421., online.
Osterholm, MT (2012) ‘Final column: pandemic preparedness after H1N1: remember if you’ve seen one pandemic, you’ve seen one pandemic’, in Gigi Kwik Gronvall (2012) Preparing for Bioterrorism, Center for Biosecurity of UPMC, Maryland, online:
Pitt, Sarah (2020) ‘What will happen if we can’t produce a coronavirus vaccine? And is herd immunity the answer?’, The Conversation, 15 August, online.
Spinney, Laura (2020) ‘The Rules of Contagion by Adam Kucharski review – outbreaks of all kinds’, The Guardian, 25 March, online.
Verity, Robert et al (2020) ‘Estimates of the severity of coronavirus disease 2019: a model-based analysis’, Lancet, 30 March, online.
Woodley, Matt (2020) ‘More evidence suggests no long-term COVID-19 immunity’, News GP, 13 July.