‘There’s no direct evidence that the lockdowns are working’
Dr John A Lee on why we need to keep questioning the response to Covid-19.
The UK government has extended its lockdown for another three weeks. But could the shutdown of society be doing more harm than good? In fact, is there any evidence it is doing any good at all? Dr John A Lee, a recently retired professor of pathology and NHS consultant pathologist, has repeatedly called for a critical and dispassionate examination of the evidence in relation to Covid-19, raising questions about the government and its advisers’ interpretation of the data. spiked caught up with him to find out more.
spiked: You have been a relatively lone voice in questioning mainstream assumptions about coronavirus. Why have you found it important to speak out?
Dr John A Lee: As a doctor and a scientist my entire career, I believe that medicine and science have improved life immeasurably over the past 200 years, and especially over the last 50 years. But in the particular mix of science, medicine and politics that we are seeing now, I am not absolutely sure that is the case. I think it is more important than ever to try and look at this issue in a clear way in order to make sure that we are really doing the right thing on the basis of the right ideas. And it isn’t clear to me at the moment that we are.
spiked: What problems do you see in the way figures are currently being recorded and reported?
Lee: The figures are just so unreliable. It’s very difficult to understand when you are looking at figures from different countries, and figures in isolation about things like death, what they really mean. And obviously, if we can’t understand what the figures mean, it is quite difficult to then know what we should do about them.
These figures are then fed into models of the disease and the epidemic which are being used to influence and inform public policy. But those models are only as good as their input data and the assumptions they make. And there are so many unknowns which means the models’ outputs are really quite questionable. And given that we have now got ourselves into this situation, for a variety of reasons, getting ourselves out of it using the same models and predictions is even more questionable. So we are in a very difficult situation.
For example, we are currently in lockdown for two reasons. One is that the initial figures suggested that we were dealing with a very highly virulent disease. The World Health Organisation initially suggested that the case-fatality rate – the proportion of people diagnosed with the disease who die – would be 3.4 per cent. This is a very high number which would have caused a huge number of deaths. But as we have had gradually more and more data coming in, those percentages have been falling. In many examples, more complete data are now suggesting case-fatality rates of 0.4 per cent. My guess is that it will end up between 0.5 and 0.1 per cent, and probably nearer to the lower end of that. So if the disease isn’t as virulent as was originally thought, the number of deaths will be correspondingly lower.
The second reason that we were then put into lockdown is that it was assumed that this new virus was going to rip through the population, and a very high percentage of people were going to be infected quickly. This would cause a big surge or peak of cases which healthcare systems wouldn’t be able to deal with. The lockdown is supposed to reduce that peak, to enable health systems to cope with it. We had various pictures from Italy, Spain, New York and other places showing that health systems weren’t able to cope. But of course, in lots of other places, health systems have been able to cope with it.
The real point is that there isn’t any direct evidence that what we are doing is actually affecting the peak. It is possible to make arguments that sound reasonable that a lockdown should affect the peak. And yet other places which are doing different things seem to have similarly shaped graphs. It is only an assumption that the lockdown is having a big effect on the virus spread, but this is not a known scientific fact.
As far as I can see, Sweden, despite not having anywhere near as severe a lockdown as we have had, actually has a very similar curve to ours. And Sweden’s death rate per hundred thousand people is roughly half of ours at the moment. So it is not a given that what we are doing is either working or is having all the right effects.
spiked: Has the media given us an accurate picture of what might be going on?
Lee: I suppose that depends on what media you are looking at. It seems to me that there are two types of media: there is the investigative-journalism type media that tries to find out whether the facts and the interpretations of stories are really true. And then there is the less critical type of media which essentially illustrates a story that it thinks it already knows. And I think in the case of Covid-19, because of what originally came out of China and the pictures that were beamed around the world, people felt that they already knew that this was a highly virulent and dangerous disease. So pretty much the entire media coverage has illustrated this as a very dangerous disease.
Don’t get me wrong, it is clearly a nasty disease, but it is not as nasty as it was originally thought. Unfortunately, the media have tended to reinforce the initial ideas about what this disease was like which have not necessarily been borne out by the numbers since then.
I think that there has not been enough questioning of the story that has been placed out there by governments. Governments were placed in a difficult position. Because of the amount of fear and panic and apparent severity of this disease, they felt they had to do something. But of course, having done something, they are now in a position of having to justify their actions.
We can reasonably question the assumptions of the models, for example. The accuracy of the models, and their predictions of how many people will be infected and die, depend on things like the transmissibility of the virus. But that isn’t something we know very accurately at the moment. It also depends on population susceptibility. The UK models, as I understand it, said that 60 to 80 per cent of the population would be infected by the virus in a short period of time. Whereas in fact some of the evidence from enclosed populations, such as the Diamond Princess cruise ship, suggests that only 15 per cent of the population may be susceptible. Maybe that is because the virus spreads in a different way than we thought. Maybe some people actually have immunity based on other coronaviruses that are already out there in the population.
If you change those numbers, it makes a huge difference in the number of cases you would expect in a given time. Really, the case for lockdown depends on the number of cases coming through, which is very important for people to distinguish from the number of people who are going to die of this virus. The fact is, Pandora’s Box is now open. This virus is spreading in the population. There is no evidence whatsoever that we are going to be able to put it back in its box. So it is going to spread through the population at a certain speed. And after a year or two, the number of people who are going to have died from it is probably going to be similar either way – it is just a question of the speed at which those people are dying.
The real question, therefore, is what are the downsides of the treatment that we have chosen for this virus? Do lockdowns actually have side effects that could be even more severe than the virus we are trying to suppress? And I think there is clearly a serious worry that they could have.
spiked: Is the lockdown sustainable?
Lee: If you still believe that this virus is incredibly virulent and therefore is killing a high percentage of people that it infects, it might be reasonable to stay locked down. For example, in the plague that spread through Europe in the 14th century, it is reckoned that maybe one in three people died. Obviously, if we were facing something like that, it would be reasonable to take very extreme measures. But this is a disease that is maybe going to kill 0.3, 0.2 or 0.1 per cent of people that it infects. And it may only infect a relatively small proportion of the population. We just don’t know.
So we do have to ask what are the side effects of this treatment. And the fact is, they are clearly huge, but they have been largely unassessed. It seems incredible to me that we are not equally as interested in the effects of the lockdown on lives and livelihoods as we are in the actual virus itself. I think we are guilty at the moment of being a bit monomaniacal and focusing only on one thing, and really not focusing enough on the consequences that are coming out of what we have done to face this one thing.
spiked: Will governments find viable exit strategies?
Lee: I think it’s difficult because governments, having gone down this route, are stuck between two rather difficult places. One is the worry that any relaxation of the lockdown which causes an increase in the scorecard number of deaths will be criticised.
But also, the very fact that the lockdown was put in place, despite the huge set of side effects, means that the government has to justify having done it. In a way, that actually makes it harder to come out of a lockdown. If it subsequently becomes apparent that the lockdown – or at least the severity of the lockdown (I do agree with temporary, limited social distancing for vulnerable groups) – was overdone, then the government is going to come in for criticism from that angle, too.
I think personally that we should aim to relax the lockdown faster than some commentators are suggesting. The government’s reticence to talk about this is based on modelling assumptions of numbers which we know are fraught with uncertainty. It is equally possible to make a case that relaxing the lockdown more quickly than is currently being suggested will have beneficial effects overall, even if the number of viral deaths ticks up again. Time will tell, but they are going to have to try to do the right thing soon, which means not prolonging this unnecessarily.
Dr John A Lee was talking to Fraser Myers.
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