The case against lockdowns – the cure is worse than the disease

 A group of Irish Doctors presents the tradeoffs of lockdowns and finds them wanting.  They are a bad idea.  Here is a link to the paper.

Trust Government to make problems worse.

Some excerpts follow.

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Firstly, let’s briefly take stock of the current situation, with the benefit of 8 months of experience:

 • Mortality impacts from COVID-19 are now known to be within the envelope of previous recent significant respiratory seasons (e.g. 2000, 2015, 2018).2

 • Current pressure on hospital and ICU beds is comparable to previous winters.

 • Lockdown has not previously been employed as a strategy in pandemic management, in fact, it was ruled out in 2019 WHO and Irish pandemic guidelines,3 and as expected, it has proven a poor mitigator of morbidity and mortality (fig.1).

 • “Test and trace” becomes overwhelmed and loses effectiveness after a virus has substantially entered a population (up until 2019 it was not recommended by the WHO for this very reason).3 Tactical testing may still have a role e.g. for workers and residents in key environments such as nursing homes etc, ideally using dependable antigen testing rather than PCR. We believe that the virus is on its way to being endemic, and recommend that testing be reorganised and focussed in conjunction with clinical case evaluation, as per pre-existing WHO and Irish pandemic guidelines.

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The original purpose of lockdown was to "flatten the curve", protect hospital capacity for the provision of ongoing non COVID-19 care and reduce morbidity and mortality from COVID-19. Confidence in this strategy was based on reasonable assumptions, modelling and forecasts derived from the available data in the spring of 2020. We now have the benefit of experience and multiple published analyses reflecting real-world data and outcomes. A recent paper in The Lancet showed no correlation between lockdown measures and mortality outcomes: “Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people”. 4 Notably, a large number of published preprint analyses converge on lockdowns having a minimal beneficial effect on mortality outcomes.5 6 7 8 9 10 

There is a dearth of published evidence indicating that lockdowns reduce overall mortality; a significant concern in itself, given the enormous negative impacts of lockdown. Sweden is particularly notable as a “control” country which largely followed the 2019 WHO Pandemic Guidelines, rather than pursuing the very new lockdown approach. With this strategy, they experienced a similar mortality impact to other European countries, when various key factors are accounted for. Below we see that Sweden had a relatively tiny impact compared to the Spanish Flu of 1918, and one which hardly stands out from more recent years (fig. 2). On current data, Sweden will essentially have a “normal” excess mortality in 2020 – with no real signal emerging versus prior years. Regardless of lockdown intervention, Ireland also exhibits no excess mortality versus prior years, even when zoning in on the first five months of the year (fig. 3).

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It is difficult to estimate the burden of non-Covid morbidity and mortality during 2020 and to predict the effects in the years to come. An April report from the UK ONS indicated that it will far exceed the number of deaths observed with, or due to COVID-19 (in the region of 50,000 for the UK so far): “Various evidence supports the estimate that 75% of elective care has been postponed…If this activity were cancelled entirely it would result in an estimated 185,000 additional deaths. This scenario does not account for other cuts to services that are known to have taken place already in many out-of-hospital services partially or fully, including NHS health checks, non-urgent primary care (dental and GP), de-prioritised community services, and some screening and vaccination programmes”. 15 It is crucial to note that COVID-19 deaths sadly occur in people close to or above life expectancy age. In contrast, lockdown-induced deaths will occur in people well below the life expectancy age. Therefore the “life years lost” as a result of lockdown could far exceed the number of those saved. Given that many publications demonstrate that lockdown has no significant impact on mortality – the life years lost due to lockdown will likely outweigh those saved by a huge factor.

Striking data from Public Health England, detailed excess mortality trends for the months leading up to November 2020.16 No excess mortality was observed in the hospital or care home setting. In contrast, all of the excess mortality occurred in the “home” or “other places” (fig. 6). In other words, the excess death for many months now, cannot be due to COVID-19, as the latter would dominate deaths in the hospital and care home settings. Rather, the inference is that excess death is now driven by the negative effects of lockdown itself.

In further support of this, it is clear that the excess death is dominated by the 14-44 and 45-64 age groups, and largely absent from the more aged groups (fig. 7). This is not the pattern of COVID-19 impact. We believe this pattern is consistent with lockdown-induced morbidity and mortality.

Cardiovascular disease is the world’s biggest killer, and fatal events are strikingly affected by speed of access to proper care. Lockdown interventions have seriously impacted this care. There are many published analyses now summarizing the impacts. For instance, a recent UK study “…recorded a 56% increase in the incidence of OHCA (out of hospital cardiac arrest) from 1stFeb to 14thMay, versus 2019” 17. Another study had similarly striking conclusions: “A retrospective analysis of 9 UK hospitals showed a decrease in admissions of 58% and a decrease in emergency department presentations of 53% after 23rdMarch 2020, when compared to the same period in 2019”18.

 Another study concluded: “Deaths in the home included a 35% excess cardiovascular deaths”, while another stated the COVID-19 pandemic resulted “in an excess of acute cardiovascular deaths, nearly half of which occurred in the community” 19. These impacts of lockdown, for cardiovascular deaths alone – could potentially exceed the COVID-19 mortality impacts over the longer term.

Cancer screening and treatment are additional crucial health pillars negatively impacted by the lockdown strategy. A recent UK paper captured the stark reality: “Results of COVID-19 disruption on cancer mortality range from 1,412 deaths for one month of assumed disruption to 9,280 deaths for six months of disruption” 20. Cancer screening has also been badly impacted: “the number of performed CT scans dropped by 28% in April, May and June 2020 compared to the same time last year, with the additional challenge that CT scanning has been used to diagnose COVID-19. MRI scanning has also decreased by 53%.” 21Just one cancer type e.g. colorectal, could have very significant numbers of life years lost: “Delays of 2/4/6 months across all 11,266 patients with colorectal cancer diagnosed per typical year via the 2 week wait pathway were estimated to result in 653/1,419/2,250 attributable deaths and loss of 9,214/20,315/32,799 life years respectively”. 22Another report calls out the major impacts and future loss of life years in the balance: “the weekly number of cancers detected decreased by 58%. The proportion of missing cancers ranged from 19% (pancreaticobiliary) to 72% (colorectal)”. 23The Irish Cancer Society published a submission to the Oireachtas on 17thJuly, which laid out the grim impacts that lockdown would have on increased cancer death rates into the future.24As with cardiovascular disease, the impacts of lockdown, for cancer deaths alone - may exceed the COVID-19 mortality impacts over the longer term.