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The BFD. Source: Southwestern Public Health

Since we went into lockdown doctors have started coming out of the woodwork. After all, it’s not often that medical doctors write opinion pieces in national newspapers. Pathologist Dr John Lee has written a second article for The Spectator in which he is at great pains to point out why the figures for Covid-19 infections are a vast under-estimate, and why Covid-19 deaths are a substantial over-estimate. He explains the difficulty of testing for this flu-like illness: “At the moment, we have to take it on trust that the tests in use are measuring what we think they are.”

“So far in this pandemic, test kits have mainly been reserved for hospitalised patients with significant symptoms. Few tests have been carried out in patients with mild symptoms. This means that the number of positive tests will be far lower than the number of people who have had the disease.”

Lee points out that Sir Patrick Vallance, the UK government’s chief scientific adviser, “suggested that the real figure for the number of cases could be 10 to 20 times higher than the official figure.”

“If he’s right, the headline death rate due to this virus (all derived from lab tests) will be 10 to 20 times lower than it appears to be from the published figures. The more the number of untested cases goes up, the lower the true death rate.”

Professor Neil Fergusson of Imperial College, who was instrumental in spooking Boris Johnson into a full national lockdown, now expects

“fewer than 20,000 Covid-19 deaths in the UK but, importantly, [that] two-thirds of these people would have died anyway. In other words, he suggests that the crude figure for ‘Covid deaths’ is three times higher than the number who have actually been killed by Covid-19.”

The distinction between dying ‘with’ Covid-19 and dying ‘from’ Covid-19 is significant, according to Lee. He gives examples:

“… an 87-year-old woman with dementia in a nursing home; a 79-year-old man with metastatic bladder cancer; a 29-year-old man with leukaemia treated with chemotherapy; a 46-year-old woman with motor neurone disease for 2 years. All develop chest infections and die. All test positive for Covid-19. Yet all were vulnerable to death by chest infection from any infective cause (including the flu). Covid-19 might have been the final straw, but it has not caused their deaths. Consider two more cases: a 75-year-old man with mild heart failure and bronchitis; a 35-year-old woman who was previously fit and well with no known medical conditions. Both contract a chest infection and die, and both test positive for Covid-19. In the first case it is not entirely clear what weight to place on the pre-existing conditions versus the viral infection – to make this judgement would require an expert clinician to examine the case notes. The final case would reasonably be attributed to death caused by Covid-19, assuming it was true that there were no underlying conditions.”

Lee concludes that the death rate due to Covid-19 is likely to be around 0.1 percent, which is similar to seasonal flu.

In an article for The Telegraph consultant cardiac surgeon, Jullien Gaer argues that herd immunity is the only way out of the present situation.

“This is a tried and tested method for managing outbreaks of infectious disease: once a sufficiently large proportion of the population has some form of immunity, acquired either through vaccination or surviving a disease, it becomes impossible for it to spread.”

The issue with herd immunity, as we know, is that it requires a significant number of vulnerable people (typically the elderly) to contract the illness and face the risk of death before immunity across the community is established. It’s for this reason that herd immunity isn’t promoted and we don’t hear very much about it.

The alternative is an authoritarian lockdown. Gaer asserts that two states have been particularly successful at this: Israel and the People’s Republic of China.

The social and political atmosphere within the People’s Republic of China is truly unpleasant, as anyone who has spent time there will attest. The Chinese state tracks its citizens on their mobile phones, snoops on their private lives and issues reprimands even for minor misdemeanours. For more major misdemeanours, people disappear. Freedom of speech is absent and censorship laws are rigorously enforced. Footage of the Wuhan lockdown, which from time to time surfaces ‘illegally’ on the internet, shows the draconian state regime at its most disturbing.

History has shown repeatedly,” Gaer says, “that liberties surrendered, however noble the cause, may be a long time returning. So there is both a medical and a philosophical reason why the authoritarian approach is not necessarily the answer.”

“Medically, fighting an epidemic by suppressing it through draconian restrictions of liberty achieves the opposite of herd immunity. It ensures that the majority of survivors have no immunity and so are at just as much risk next time around. Of course, the advocates of this approach are banking on the development of vaccines and other therapies for the management of the next epidemic. But a usable vaccine will almost certainly not be available by the time this disease comes back for an encore. Novel treatments based on anti-malarial drugs and antibiotics will also need to be evaluated in proper clinical trials.”

Having gone into lockdown for this disease – and, surprisingly, all too willingly – we will be forced to do the same thing again every time this disease or another disease recurs. And as we are seeing – less than one week in – we are fast becoming a country which is not worth living in, and certainly, one which our grandparents wouldn’t recognise.

“For centuries,” says Gaer, “we have found no difficulty in asking young men and women to put their lives at risk in defence of our democracy,” for example during the World Wars. “The difference this time is that it would be those of us in the last third of our lives being asked to bear the greatest risk as opposed to those who should still have decades of life ahead of them.”

Gaer hopes that the idea of herd immunity has not gone away and may play a part surreptitiously, either by accident or by design.

“I certainly hope that is the case because, when our children and grandchildren emerge blinking into the post-apocalyptic dawn I, for one, hope that the society into which they emerge is broadly-speaking the same as the one in which I have lived my life – not one that resembles the People’s Republic of China.”

Meanwhile in The Telegraph, Norman Tebbitt, an ex-Conservative cabinet minister who served under Margaret Thatcher, and who survived the Brighton bombings, believes that the risk has been inflated:

“I may be 89 and under self-imposed house arrest, but I fear coronavirus has been overhyped.”

A growing number of people, even those within the most vulnerable age group, are wondering not just whether the lockdown is necessary, but whether it is worth it.

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