“We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.” Excerpt from The Great Barrington Declaration, authored and signed October 4, 2020 by Dr. Martin Kulldorff, professor of medicine at Harvard University; Dr. Sunetra Gupta, professor of epidemiology at Oxford University; and Dr. Jay Bhattacharya, a professor, physician, epidemiologist, and health economist at Stanford University’s Medical School.
What should we do? As commonplace activities like going to work, going shopping, gathering to worship, and going to school have become fraught with the fear of contracting and spreading COVID-19, this question has weighed heavily upon us. Because our sense of security has been shaken, because we feel vulnerable where we once felt safe, we want reassurance.
Where can we find the certainty and normalcy we crave when so much of life has become strange, uncertain, and full of loss? Science, facts, and medically-sound evidence do offer the prospect of clarity. They can provide insight into where we have been, where we are now, and what may happen in the future depending upon how we act. Here is a vivid example.
Widespread diagnostic testing is providing us with a clear picture of how well countries have controlled the spread of COVID-19. To visualize these data, I have graphed–using an application available on Canada’s CTV television network website–the number of COVID-19 cases reported weekly on a per capita basis in the United States and in two European countries: Belgium, the political center of the European Union; located in western Europe; and the Czech Republic located some 500 miles to the east.
As shown, three to five months into the pandemic (days 96 through 168 on the graph), public health measures implemented in Belgium and in the Czech Republic helped control the rate of infection to a much better degree than what we experienced here in the U.S.
But this state of affairs has dramatically reversed. By the last week in October, Belgium’s weekly rate of new infections skyrocketed to about 100 cases per 100,000 residents. This is 5 times higher than the rate in America.
The situation in the Czech Republic is even worse. Their infection rate per 100,000 residents has surged to 110 cases per week. This explosion of COVID-19 cases has occurred despite a second nationwide lockdown that severely restricts travel, closes shops and restaurants, limits gatherings to two people except for weddings and funerals, and forces schools to teach their students via distance-learning only.
Sadly, these two countries are the rule, not the exception. Since the outbreak of this pandemic, reported rates of transmission of COVID-19 across Europe now are higher than they have ever been. Armenia, Austria, Bosnia, Croatia; France, Great Britain, Italy, Ireland, Liechtenstein, Luxembourg, Macedonia, Poland, Portugal, the Netherlands, Romania, Slovakia, Slovenia, Spain, and Switzerland all are at record highs. And in each and every one of these countries, rates of transmission are higher than they have ever been in the U.S. Despite this tsunami of new infections flooding over the European continent, several northern European countries, notably Germany, Denmark, Sweden, and Norway, have kept their rates of infection relatively low over the course of this pandemic.
Here’s what these alarming COVID-19 infection rate data imply. Successful strategies for addressing this pandemic must resemble plans for running a cross-country marathon more than they resemble a hundred-yard dash.
The original lockdowns and social distancing restrictions were like runners sprinting out to an early lead. But sprinting cannot be sustained over the duration of a marathon. An athlete’s finite resources will be expended too quickly. Similarly, governments cannot sustain extended, repetitive nationwide lockdowns over the long haul. In Aesop’s Fable “The Tortoise and The Hare,” the Hare hops out to an early lead. But it is the steady plodding of the Tortoise that wins the race.
These musings lead me to quote again from the Great Barrington Declaration, which, in less than a month’s time, has been signed on-line by more than half a million concerned citizens and endorsed by tens of thousands of public health scientists and medical practitioners from around the world.
“Current lockdown policies are producing devastating effects on short and long-term public health … with the working class and younger members of society carrying the heaviest burden.
Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume.”
However you or I feel about this proposed public health policy, we all must bear in mind that we do not have the luxury of risk-free choices. Whatever policies we choose will be accompanied by tragic consequences.
More broadly, this COVID-19 pandemic has revealed a very striking absence and a glaringly obvious need. It’s a need I sought to begin to address when I developed the Floriescence paradigm and then launched the non-partisan, non-profit Floriescence Institute in 2014. Here’s what I mean.
Various federal agencies such as the NIH, CDC, FDA, and Homeland Security can provide accurate and timely information regarding the medical and public health aspects of this disease. They can help develop, approve, and deliver personal protective equipment, diagnostic tests, and life-saving therapies and vaccines. But what they cannot do is develop comprehensive public policy. No single governmental agency can synthesize a coherent policy for a health crisis as complex as we are confronted with today.
Nor should we ever expect this. Why? For two reasons. The scope of what we value and what gives meaning to our lives is much greater than the combined mission of these agencies. And second, science and the technology it spawns will never, indeed can never, tell us what we ought to do. As I have written in our book Floriescence: “We must seek additional guidance elsewhere, outside of the fields of science. We must take what science has to offer and enter into the axiological realms of ethics and aesthetics to more fully elucidate paths toward well-being in the 21st century.”
Crafting good public policy toward combating COVID-19 must reflect what we cherish, what we are willing to risk, and at the deepest level, what gives meaning and purpose to our lives. In this regard, I am pleased that The Great Barrington Declaration acknowledges the role played by “arts, music, sport, and other cultural activities” in coping with this pandemic. And I applaud the humility of these eminent physicians for recognizing the limits of their disciplines.