Doctors at Stanford University are at the forefront of a global movement of health experts who are criticizing lockdowns to control COVID-19 and say schools and businesses should reopen, but with a focus on protecting the elderly and infirm who are most vulnerable to the virus.
Called the Great Barrington Declaration after the western Massachusetts town where it was hatched this month at an economic policy think tank, their statement of purpose is the handiwork of three principal drafters who include Stanford medical professor Dr. Jay Bhattacharya.
“As infectious disease epidemiologists and public health scientists, we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies,” the declaration states. “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.”
Though the arguments are not new, with more than 18,000 medical, science and public health practitioners among its more than 191,000 worldwide online signatories, it represents the largest public break among health experts from their peers’ prevailing support for lockdowns since the pandemic began early this year.
But the declaration has drawn fire from other doctors and public health officials who say lifting lockdowns will only invite a new wave of COVID-19 infections and fatalities from the deadly virus. More than 7.6 million people in the United States have contracted the virus, and 213,000 people have died.
“Whose grandmother and grandfather and family members are you willing to sacrifice for this stupid idea?” asked Santa Clara County Executive Jeff Smith, whose administration in March led the Bay Area in imposing the first U.S. lockdown in the pandemic and has since been criticized since for its slow pace of reopening.
The declaration’s signers are clearly frustrated with the dominant public health orthodoxy that indefinite and costly shutdowns are needed to keep the virus in check.
“A number of scientists and non-scientists alike tried to raise questions about both the effectiveness and the potential harms of the lockdowns as long ago as March,” said Laura Lazzeroni, a Stanford professor of psychiatry and behavioral sciences specializing in biomedical data science, who also signed the declaration. “But honest and investigative scientific discussion has been difficult to achieve this year.”
Why? Dr. Rajiv Bhatia, a practicing physician, affiliated assistant professor of medicine at Stanford and former deputy health officer for San Francisco, who also signed the declaration, blames politics.
President Donald Trump, who has seen his administration’s economic gains and his re-election prospects upended by lockdowns, has urged reopening and questioned the evolving science around the virus, which he recently contracted and is recovering from.
“If you raise a critical perspective, people associate you with Trump,” Bhatia said. “It’s hard for even me to speak to colleagues about this.”
Bhattacharya, who drafted the declaration with doctors Martin Kulldorff, a Harvard University medical professor, and Sunetra Gupta, an epidemiologist at Oxford University, has been at the center of the lockdown controversy from the start.
In March, he co-authored a Wall Street Journal opinion column suggesting the new coronavirus may not be as deadly as many believe. The following month, he co-authored a Stanford study that indicated the virus was far more prevalent than presumed and as a result, the death rate far lower.
That pre-peer-review study – which was later revised – drew withering criticism and even prompted Stanford to review the team’s work, which Bhattacharya said he was confident would be vindicated.
Bhattacharya, who was not available for comment, and the co-signers argue lockdowns haven’t been properly weighed against the ensuing harm. Not only has there been lost livelihoods and learning for workers and students, but the lockdowns have caused harm to their mental and physical health from prolonged isolation, lack of exercise and avoidance of routine vaccinations, medical checkups and other procedures, they say.
Paulette Altmaier, a former Cisco Systems vice president and philanthropist who criticized Santa Clara County’s slow reopening in a full-page newspaper ad in May, found it refreshing.
“Science is about learning from new data and vigorous debate,” Altmaier said. “Instead, for the first time, we have had people claiming to be ‘following the science and the data’ who are in fact merely imposing their opinions on us by fiat, with catastrophic consequences for children’s education and people’s livelihoods.”
But Smith, who has a medical degree, and other health experts say the approach called for in the declaration hasn’t worked so well in countries that have taken it, such as Brazil and Sweden.
Brazil has the world’s fifth-highest per-capita COVID-19 fatality rate, according to Johns Hopkins University, though it is lower than that of Peru, which has the second-highest rate despite having had one of the world’s longest and strictest lockdowns. Sweden’s fatality rate is much higher than neighboring Norway, Finland, Denmark and Germany, though lower than that in the U.S., United Kingdom and Italy.
“There are a lot of communities around the world that have tried to take the approach of ‘let it spread and we’ll do minimal separation and social distancing’ and have seen bad outcomes,” Smith said. He argues that the restrictions are needed to protect the vulnerable because the virus can be spread by people who don’t know they’re infectious.
Experts like Dr. George Rutherford at UC San Francisco say the country is nowhere near reaching “herd immunity,” and loosening restrictions will only mean many more will have to get infected and die to reach that point.
“It hinges on how many deaths we are going to tolerate before we get to a level of herd immunity where we stop transmission,” Rutherford said. “I have to come down on the side of preventing mortality.”