Revisiting the Great Barrington Declaration

Events have vindicated the GBD — and now Jay Bhattacharya, one of its three co-authors, has been nominated by Trump as the new director of the National Institutes of Health (NIH)

Politically speaking, these are bleak days in almost every respect. But now and then some good news filter through. Trump’s nomination of Jay Bhattacharya, professor of medicine at Stanford University, as the new director of the National Institutes of Health (NIH), the primary agency of the United States government responsible for biomedical and public health research, is one such example. Throughout the dark days of the pandemic, Bhattacharya was a rare source of light and inspiration, standing up for truth and science in the face of pseudo-scientific authoritarianism and corporate corruption. As is well-known, he was one of the three co-authors, alongside Sunetra Gupta and Martin Kulldorff, of the Great Barrington Declaration — a hugely influential document that criticised the lockdown policies, presciently predicting their devastating effects. For the occasion, I’m publishing the section of the book written by Toby Green and myself, The Covid Consensus: The Global Assault on Democracy and the Poor—A Critique from the Left, dedicated to the Great Barrington Declaration. This is followed by an article of our published in early 2022.

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What might an alternative strategy of pandemic management have looked like?

As we’ve described already in this book, the alternative was to protect those who were most at risk from the virus — which, it soon became clear in the case of Covid-19, were the vulnerable, the elderly, and those in public-facing roles, a disproportionate number of whom were from minority communities. A “focused protection” strategy of this kind, as an alternative to lockdown, was put forward in an open letter published on 5 October 2020 called the Great Barrington Declaration (GBD), authored by three world-leading scientists: Sunetra Gupta of the University of Oxford, Jay Bhattacharya of Stanford University and Martin Kulldorff of Harvard University. It revolved around a simple but powerful idea: “The most compassionate approach that balances the risks and benefits of reaching 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”.

The authors would later state that their intention was simply to kickstart an open debate about potential alternatives to lockdowns — especially as their mounting social and economic costs were becoming increasingly apparent. Instead, what they got was the opposite: concerted aggression against the declaration and its authors orchestrated at the highest levels of the political, health, and media establishment, and aimed precisely at shutting down any debate about lockdowns. Interestingly, the people behind the attack were the same ones who had previously tried to shut down the debate about all the previous aspects of the pandemic — from the origin of the virus onwards. The opponents of the GBD were the proponents of the “single narrative” view of the pandemic and of its science [discussed previously in the book].

In the days immediately following the GBD’s publication, the declaration quickly started gathering a lot of attention in the press. Thousands of scientists from around the world rushed to sign it. The public health officials who had enforced the pro- lockdown consensus weren’t happy about it. Thanks to emails obtained via a Freedom of Information Act request, we now know that Francis Collins, the then-Director of the National Institutes of Health, sent an email on 8 October — just three days after the publication of the GBD — to Anthony Fauci. “This proposal from the three fringe epidemiologists [...] seems to be getting a lot of attention — and even a co-signature from Nobel Prize winner Mike Leavitt at Stanford. There needs to be a quick and devastating published take down of its premises”, Collins wrote. Fauci replied to Collins that the takedown was indeed underway, and a week after his initial email Collins himself spoke to the Washington Post about the GBD. “This is a fringe component of epidemiology”, he said. “This is not mainstream science. It’s dangerous”.

His message spread and the alternative strategy was dismissed in most precincts. An article in Wired denied that there was any scientific divide and argued that lockdowns were a strawman and weren’t coming back (the following month restrictions were reinstated). As the Wall Street Journal wrote:

Dr. Fauci also emailed an article from the Nation, a left-wing magazine, and his staff sent him several more. The emails suggest a feedback loop: the media cited Dr. Fauci as an unquestionable authority, and Dr. Fauci got his talking points from the media. Facebook censored mentions of the Great Barrington Declaration. This is how groupthink works.

As on other occasions during the pandemic, the strategy was successful. As Kulldorff recalled:

Some colleagues threw epithets at us like “crazy”, “exorcist”, “mass murderer” or “Trumpian”. Some accused us of taking a stand for money, though nobody paid us a penny. Why such a vicious response? The declaration was in line with the many pandemic preparedness plans produced years earlier, but that was the crux. With no good public-health arguments against focused protection, they had to resort to mischaracterisation and slander, or else admit they had made a terrible, deadly mistake in their support of lockdowns.

Within a few weeks, the concerted attack on the GBD and its authors had succeeded in demonising them in the eyes of the world’s public opinion. Yet another crucial debate that citizens were denied — and yet another example of the violence and authoritarianism with which the Covid consensus has been enforced over the past years. In hindsight, however, there is no doubt that the Great Barrington Declaration has been vindicated.

Some heavily criticised the recommendation made by the GBD scientists of allowing normal life to continue in the main while shielding the most vulnerable, pointing to the ethical enormity of requiring a major sector of the population to isolate from the rest of society; however, the ethical dimensions of enforcing lifetimes of penury on people from a wide range of occupations and on large sections of the young, of removing all possibility of social mobility among many children from poorer backgrounds whose educations have been savaged, of policies leading to a huge increase in domestic violence, and of bringing starvation and wasting diseases to millions of children in the Global South were hardly less severe.

But looking back, the most outrageous accusation against the GBD was that it advocated a “let it rip” strategy — that it essentially ignored the fate of the most vulnerable people in society. In fact, as Kulldorff notes, the focused protection approach is the exact opposite. “Ironically, lockdowns are a dragged-out form of a let-it-rip strategy, in which each age group is infected in the same proportion as a let-it-rip strategy”, he says. Indeed, the recommendations of the GBD scientists for focused protection had clear and practical elements aimed precisely at protecting the elderly and the weakest, including free accommodation for younger members of multi-generational households and measures to reduce the spread of Covid-19 in care homes. In view of the massive number of deaths registered in care homes that we noted at the start of this chapter, there seems to be little doubt that focused protection was the right course of action. It would have avoided inflicting needless pain on workers, women, and children through repeated lockdowns, while arguably saving countless lives by focusing first and foremost on the elderly and especially on nursing homes.

At the same time, one of the key aspects of the document was, as Sunetra Gupta put it later, that it was a strategic document: “People criticize us on the finer points; ask why didn’t we lay out exactly how it was to be enacted. But a fundamental point that people fail to appreciate was that it was a strategic statement. The way that it would be implemented in different locations had to be worked out specifically within those settings”. The best strategies for focused protection would not have been the same in Germany as they were in India. But certainly, had the whole of society turned its attention to developing clear and focused protection of vulnerable populations in the way in which it turned its attention to lockdowns, there can be little doubt that innovative solutions would have emerged. […]

The politicisation of the debate followed the political polarisation of the previous decade — and was heightened by the fact that 2020 was a US presidential election year. Yet the irony was that the GBD authors acknowledged that they came from different political perspectives, both left and right. Sunetra Gupta, for one, was an internationalist who saw herself as “on the left of the left”. The GBD proposals were seen by their advocates as driven by science, not politics. But science had been captured by politics, and other interests. The GBD was publicly trashed in an orchestrated media blitz coordinated by figures such as Dr. Anthony Fauci. The consequences will be felt for years, if not decades, to come.

For further reading, consider buying our book.

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This is an article that Toby Green and I published in UnHerd in January 2022, titled “Has the Great Barrington Declaration been vindicated?”:

Has the left finally woken up to the devastating costs of implementing lockdowns? In its first edition of 2022, the Observer carried a surprisingly balanced interview with Professor Mark Woolhouse, a member of Sage whose new book — The Year the World Went Mad — argues that long lockdowns promoted more harm than good and failed to protect the vulnerable. Its favourable reception appears to herald a new direction in the critique of Covid measures and policies on the left; for the first time, the question of what really represented the collective good in the Covid debate has been put on the table by a mainstream left-liberal publication.

This is certainly a new departure. As we have previously noted on UnHerd, the left has strongly supported restrictive measures in the fight against the pandemic.

It argued that these restrictions, which clearly infringe on individual freedoms and rights, were nonetheless justified in the name of “the collective good” and “the collective right to life”. This allowed them to pre-empt any criticism of the new Covid consensus: if you’re against any of these measures, you’re against the collective interest. And so thinkers like us, who have always criticised neoliberal individualism and argued in favour of progressive state intervention, suddenly found ourselves accused of being libertarians or outright “right-wingers”, just for taking a critical stance of governments’ response to the pandemic.

Indeed, it would appear that for many on the left today, anything can be justified in the name of the “collective good”. It’s easy to see why right-wing critics view this uncritical invoking of collective benefits as proof of the left’s inclination towards authoritarian or “Stalinist” control. While such caricatural definitions are easy to laugh off, as leftists we can’t deny that there is something disturbing about the lack of critical commentary from the left on how to reconcile the need for collective action with the importance of individual rights and freedoms in the response to Covid.

After all, the left has historically championed civil rights and freedoms in society which are associated with individual liberties: the right to protest, the right to work, the right to sexual independence and freedom. Expanding the freedoms of men and women — while emphasising that this can only be achieved through collective action — has always been a central tenet of leftist, even socialist-democratic, ideology. So clearly something more complex than “default authoritarianism” is at work in the juxtaposition of the current Covid crisis and the left’s broad response towards civil and individual liberties.

Part of it has to do, we believe, with the left’s criticism of the rise of desocialised individualism. The growing emphasis in economic and political thought on personal autonomy and the individual’s responsibility for their own fate, which has accompanied the rolling back of welfarism, has radicalised the ideological construction of the individual. We can see this in the renewed popularity of a figure such as Ayn Rand, with her message of enlightened egoism as the basis of civilised life. However, criticising modern individualism is one thing; laughing off the very idea that individual rights and freedoms matter is another, as is arguing that anything goes in the pursuit of “saving lives” and the “collective good”.

All of which has meant that, until the Observer’s interview with Mark Woolhouse, there has been painfully little critical analysis from the mainstream left as to whether the raft of restrictive Covid measures we have seen over the past two years have indeed served the collective good — or saved lives for that matter. By definition, for something to be considered in the collective interest of a society, it has to be in the interest of at least a significant majority of its members. However, it’s hard to see how lockdowns (and other subsequent measures) meet this criterion.

Their psychological, social and economic impact might have been justified from a collective-interest and life-saving standpoint if Covid represented an equal threat to all citizens. Yet soon into the pandemic, it became clear that Covid-19 was almost exclusively a threat to the elderly (60+): in the last quarter of 2020, the mean age of those dying both with and of Covid-19 in the UK was 82.4, while by early 2020 the Infection Fatality Rate (IFR) — the risk of actually dying if you catch Covid — in people under 60 was already known to be exceptionally low: 0.5 per cent or less. A paper written late in 2020 for the WHO by professor John Ioannidis of Stanford University, one of the world’s foremost epidemiologists, then estimated that the IFR for those under 70 was even lower: 0.05%. As Woolhouse points out in his interview “people over 75 are an astonishing 10,000 times more at risk than those who are under 15”.

Moreover, given the impacts on other aspects of medical care, the preservation (or prolonging) of life of the elderly was certainly being achieved at the expense of the life expectancies of younger sectors of the population — to say nothing of the catastrophic impacts in the Global South. This has indeed been confirmed by evidence which shows that excess deaths in younger age groups rose sharply in 2021, with very little of this attributable to Covid mortality.

If anything, Covid restrictions should have been framed in terms of solidarity: as measures which implied the overwhelming majority of the collective, which risked little or nothing from Covid, paying a price, and a heavy one at that, in order to protect, in theory at least, a minority (in Western countries people aged 60 or older represent on average around 25% of the population). Acknowledging this from the start would have avoided much loss of trust in public institutions down the road, and would have allowed for a rational discussion around important questions of intergenerational equity, proportionality and the balancing of rights and interests.

A possible counter-argument is that avoiding healthcare systems being overrun with Covid patients, regardless of their age, was in the interests of everyone. This might be true from a purely theoretical standpoint. However, both arguments hinge on the assumption that lockdowns were actually useful in reducing hospitalisations and deaths. But there’s hardly any evidence that this has been the case.

In early 2021, John Ioannidis published a paper claiming that there was no practical difference in epidemiological terms between countries that had locked down and those that hadn’t. Several other studies have appeared since then that confirm Ioannidis’s initial findings: see, for example, here, here and here. Indeed, some of the countries that locked down the hardest are also those with the highest mortality figures and excess death rate. Peru is an obvious example, while Sweden’s excess mortality is below the European average for 2020.

Meanwhile in the US, the end of 2021 confirmed the reality that lockdown strategies had little or no impact on Covid mortality. The two neighbouring states of Michigan and Wisconsin followed very different Covid policies, with Michigan favouring severe restrictions while Wisconsin lifted them much earlier; yet at the start of this month, Michigan’s Covid mortality rate was far higher than Wisconsin’s, at 2,906 deaths per million compared to 1,919 per million in Wisconsin. Another stark example comes from comparing two other neighbouring states: North and South Dakota. South Dakota infamously imposed no Covid restrictions, while there were mask mandates in North Dakota during the second wave in Winter 2020/2021: yet as of January 1st 2022, the two states’ death rates are very similar, at 2,810 per million (South Dakota) and 2,640 (North Dakota).

Another case that is less talked about is that of Italy. Over the course of the past two years, Italy has implemented some of the strictest and longest lockdowns in the world (indeed, it is the country that “invented” the concept of national lockdown), topping every other Western country in terms of average stringency of anti-Covid measures. Yet Italy is also one of the countries with the highest mortality rate per capita — well above the United Kingdom, Spain, France, Germany, Sweden and several other countries that adopted much less restrictive measures. And there’s evidence that this isn’t despite the lockdowns but, most likely, because of them.

As Piero Stanig and Gianmarco Daniele, two professors at Bocconi University, explain in their book Fallimento lockdown (“Lockdown Failure”), the worst possible thing you can do when dealing with a highly infectious disease that spreads almost exclusively indoors and targets the elderly is to lock old people up inside their homes with other family members, and ban citizens from spending time in arguably the safest place of all: outdoors. In other words, even from the narrow perspective of saving lives, not only were lockdowns not in the collective interest of society, they weren’t even in the interest of those whose lives were actually at risk.

Such an outcome was easily predictable. Indeed, the WHO’s 2019 report on pandemic preparedness states that the quarantine of exposed individuals — let alone of the entire population — “is not recommended because there is no obvious rationale for this measure”.

The grotesquery of the global responses becomes even more apparent when we take into account the fact that while governments went out of their way to keep healthy people locked in, chasing runners down solitary beaches or checking shopping trolleys to make sure people were only buying essentials, they all but abandoned those most vulnerable: nursing home residents. According to a recent Collateral Global study, Covid deaths in nursing homes amount on average to a staggering 40% of all Covid deaths in Western countries, despite representing less than 1% of the population. In some countries (Belgium, France, the Netherlands, Slovenia, Spain, Sweden, the UK and the US), more than 5% of all care home residents were killed.

In view of this, it seems obvious that the focused protection approach championed by the Great Barrington Declaration (GBD) — based on “allow[ing] 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” — was the right course of action. It would have avoided inflicting needless pain on workers, women and children through repeated lockdowns, while arguably saving countless lives, by focusing first and foremost on the elderly and especially on nursing homes.

Naturally, the way in which this worked would have been very different in different settings. While in richer countries the resources and infrastructure were certainly available to direct policy in this way, in poorer countries with high Covid mortality and weak healthcare systems — such as Latin America, India and South Africa — the capacity of governments to offer focused protection was limited. Nevertheless, funds could have been used for this purpose, rather than to fund schemes such as contact tracing, which the WHO had specifically disbarred in all circumstances as a pandemic response in its aforementioned 2019 report.

Instead, countries such as Argentina, Colombia, Peru and South Africa have faced the catastrophe of both severe Covid restrictions and high Covid mortality. What has followed is the destruction of the livelihoods and access to food of tens of millions of citizens; a recent report showed that after almost two years, Covid restrictions have completely shattered the world’s informal economies, with 40% of domestic workers, street vendors and waste pickers still earning less than 75% of their pre-Covid earnings.

And yet as we enter 2022, our openness to reassessing the paths not taken remains constrained. Not only has there been no acknowledgment of the missed opportunity of focused protection at the institutional level — and no apology to the authors of the statement, victims of a vicious smearing campaign — but even now the GBD is dismissed by academics and epidemiologists such as Woolhouse, even though the focused protection policy he advocates is drawn from it.

Meanwhile, throughout the past year, governments have actually upped the ante, coming up with even more invasive, oppressive and discriminatory measures — all in the name of public health and the collective interest. Yet surely the past two years have revealed the dangers of assuming that a “collective response” to the pandemic requires lockdown measures. Many other “collective responses” — such as focused protection and the GBD’s suggestions of free deliveries of groceries to the elderly and vulnerable, and frequent rapid testing of care home staff and visitors — would likely have been more effective.

It is time for the left to look reality in the face and take stock of the fact that the prevailing Covid response of most Western governments has been an abysmal failure on all fronts —not least that of “saving lives”. An alternative approach is desperately needed. Fortunately, and tragically, it’s been hiding in plain sight all this time.

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Thomas Fazi

Website: thomasfazi.net

Twitter: @battleforeurope

Latest book: The Covid Consensus: The Global Assault on Democracy and the Poor—A Critique from the Left (co-authored with Toby Green)