The (Not So) Great Barrington Declaration

It is all too easy for some to take an idea — in this case, for example, personal freedom — and turn it into an ideology, creating a prism through which they judge everything.—Pope Francis, New York Times 11/26

A long-time reader of my column wrote to me recently asking my opinion of The Great Barrington Declaration that was discussed in last month’s Crozet Gazette column, Science to Live By. I hadn’t really heard too much about it, so I went online and read it. A shudder of dread went through me as I read it.
My short answer to the reader was, “This declaration is indeed dangerous nonsense as Dr Fauci has said.

Not for nothing, but it is from a Libertarian think tank funded by the Koch family.
The coming vaccines are game changers, we just have to stay alive till they are deployed widely.

The next few months are going to be apocalyptic in the U.S. Stay safe!”

But a longer explanation is in order because it is an important topic, and a deeper understanding of it may just save your life.

The Great Barrington Declaration (GBD) is a single-page document written by three prominent academics, sponsored by a Libertarian organization which advocates for a new strategy to address the COVID pandemic. The strategy is to allow all schools, bars, restaurants, sports, churches, gyms, everything to open back up fully and with no restrictions. Hmm. More than half a million people have signed the document online, indicating approval. It has circulated widely on the internet and influenced many people.

The authors of the document reason that a substantial proportion of the population is at low risk for mortality from COVID and they should go back to work, go back to normal life, get the virus and gain immunity. Meanwhile the “vulnerable” should be protected by remaining isolated as much as possible unless they also wish to also go back to unrestricted living. Everyone could make their own choices about which public health measures to follow based on their own perception of their risk.

Simple, right?

The problem with this logic is that the CDC has estimated that close to half of the population has an underlying condition that puts them at risk for severe COVID-19 consequences. It is not so simple to isolate half of the population from the other half and the declaration makes no mention of how this would be done.

The other problem with this proposition is that some of those at low risk do get very sick and die. Five percent of all people hospitalized with COVID are adults aged 18-34 years old. Of those young adults, 21 percent required intensive care, 10 percent required mechanical ventilation, and 2.7 percent died.

By the authors’ estimates, in three to six months enough healthy people will have been infected and recovered that the USA will have achieved herd immunity and we can all go back to living without any restrictions or worries. That sounds pretty good.

The WHO estimates that at least 65% of the population would need to be infected in order to achieve herd immunity. That is 213 million people in the US. The CDC sets the mortality of COVID at 0.65% (6.5 deaths per 1000 infections). If 213 million people in the U.S. got infected to achieve herd immunity, that would leave 1.4 million Americans dead. Not so good.

The country’s death toll since the pandemic’s start is now more than 264,000. And nearly another 60,000 people could lose their lives over the next three weeks, according to a forecast published by the US Centers for Disease Control and Prevention this week. That is 4,000 deaths per day coming up. This is why I said the next few months are going to be apocalyptic. But it doesn’t have to be.

More than 120,000 lives could be saved by February if mask wearing became mandatory for all Americans, according to projections from the University of Washington’s Institute for Health Metrics and Evaluation. In a bonus, Goldman Sachs calculates that one trillion dollars would be saved by universal masking, money that would otherwise be lost to business closures and medical costs. 

The GBD makes no mention of masks, social distancing, avoiding crowds and washing your hands, which is why I think it is dangerous nonsense. It also poses a false dichotomy of “Lockdown” versus total personal freedom. No one is advocating a lockdown, where everything is closed, but rather some sensible restrictions on high-risk activities like hanging out it a crowded bar or singing in a choir.

The GBD is not just dangerous nonsense, it is also selfish nonsense. It elevates personal freedom over the common good. In the words of Oliver Wendell Holmes, “Your right to swing your fist ends where my nose begins.” No one’s freedoms should endanger another. Or in the words of Pope Francis in his recent editorial in the NYT on the human response to the pandemic, “Looking to the common good is much more than the sum of what is good for individuals. It means having a regard for all citizens and seeking to respond effectively to the needs of the least fortunate.” 

I am optimistic for the coming vaccines. But we have to increase our vigilance now, with the pandemic surging harder than ever. It is going to be tough this holiday season to not gather with family and friends, but we cannot. Already, over one million people ignored public health authorities’ advice and flew home for Thanksgiving. Many more drove. The wages of that breach will undoubtedly come due in the coming weeks as new cases, while hospitals are at or over capacity in large segments of the country.

We are back to needing to flatten the curve to avoid overwhelming our healthcare systems and providers. Stay home and stay safe this year. Wear a mask. Practice social distancing. Avoid crowds. Wash your hands. 

We have a lot to be thankful for this holiday season. Mostly it’s that 2020 is ending. 2021 will bring vaccines and the winding down of the pandemic. Happy New Year!