Copy-paste from The New Statesman.
The hyper-polarisation of discussions about how to handle the coronavirus pandemic risks stifling nuance and undermining scientific inquiry. By Laurie Clarke.
On one side of the Covid-19 debate are the anti-maskers, self-styled freedom fighters versed in the ideals of free market libertarianism and the defence of personal liberties. On the other, are the militant pro-lockdowners – curtain-twitching vigilantes obsessed with rising case numbers to the exclusion of every other metric.
These caricatures have dogged popular culture since the coronavirus crisis began. Six months since the first peak in April, the debate is still highly politicised.
A number of scientists say a climate of fear has taken hold where academics are afraid to speak out for fear of being vilified. The replacement of nuanced debate with hyper-polarisation and insult-trading has prompted many to despair over the erosion of healthy scientific discussion and a potential breakdown of public trust.
The politicisation of the coronavirus debate surprised Stefan Baral, associate professor in epidemiology at Johns Hopkins University. At the start of the pandemic, he was caught offguard by the swiftness with which comments that could be interpreted as undermining the severity of the problem were labelled “Trumpian”.
In early March, he conducted a BBC World interview in which he mentioned the seasonality of coronavirus (suggesting that while cases would diminish over summer, they would likely surge again in autumn). “After that, I got a series of warnings from professional contacts and others, asking me if I had aligned with Donald Trump,” says Baral. “Even the BBC producer asked me if I had aligned with Donald Trump, because I guess he had also talked about seasonality.”
“I felt like it was the very definition of toxic, where there was no opportunity to discuss real empiric measures,” says Baral. “Instead, it’s been replaced with people yelling at each other and often personalising what are different perspectives on an infectious disease.” It’s now clear that coronavirus cases dipped over summer in the Northern Hemisphere – although scientists say it’s still too early to say conclusively whether SARS-CoV-2 will become a seasonal virus.
Although he feels he shouldn’t have to, Baral tells me that politically he is left wing. In fact, it’s his sense of injustice which has prompted him to constructively criticise the concept of lockdowns on an empirical basis. Because of this critical stance, in addition to being portrayed as right wing he has been accused of not valuing life – an absurd claim to make about a health practitioner, he points out.
Baral’s experiences aren’t unique, in fact such experiences intensify the further one drifts from the accepted orthodoxy on Covid-19. At present, this orthodoxy leans towards advocating for “zero Covid” (the total eradication of the infectious disease), with the immediate aim of suppressing case numbers by adopting a series of partial or full lockdowns until a vaccine is available.
Chief of the outriders, and possibly one of the most divisive figures in the coronavirus debate, is Sunetra Gupta, a professor of theoretical epidemiology at Oxford University. From the start of the pandemic, Gupta has advocated against lockdowns for the entire population, as well as suggesting that some measure of latent population immunity to the novel coronavirus might be conferred from previous contact with other coronaviruses. (It’s still a fledgling area of research, but there are some hopeful results that common coronaviruses that cause mild symptoms like those of the common cold might have this effect.)
Gupta co-authored the Great Barrington Declaration (GBD) with Jay Bhattacharya, professor of medicine at Stanford University, and Martin Kulldorff, professor of medicine at Harvard Medical School. The document advocates “focused protection” in response to the pandemic, rather than lockdowns for the entire population. It’s premised on the idea that the sooner younger and healthier people acquire “herd immunity”, the quicker that vulnerable people will be able to re-enter normal life.
Population immunity – whether achieved through natural or vaccine-induced immunity, or a mixture of the two – has long been an element of infectious disease management. However, a number of scientists came out in strong opposition to the GBD – disputing some of its claims about coronavirus, and saying that shielding the elderly and vulnerable wasn’t feasible. Most public health organisations, including the World Health Organisation (WHO), and governments including the UK’s, decided not to adopt the recommendations of the GBD.
For swimming against the tide, Gupta and others who share her perspective have encountered substantial criticism. Gupta says that she has been on the receiving end of abuse and smears, including that she is funded or affiliated with right-wing groups or that her work is pseudoscience. She’s also seen people publicly trying to undermine her credentials by saying that she has authored no peer-reviewed studies on coronavirus, which is untrue.
A publication called the Byline Times has published a number of articles attempting to link academics aligned with Gupta’s position on coronavirus with right-wing groups. A September article headlined “Right-Wing Lobbying Groups Reviving ‘Herd Immunity’ in the UK” ran in the publication naming Gupta, and the scientists Carl Heneghan and Karol Sikora. In fact, the article provided no evidence that any of the three were working with right-wing lobbying groups in order to “revive herd immunity”. The same themes were echoed, however, in a recent Guardian op-ed co-authored by Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine and an Independent Sage member.
Francois Balloux, director of the UCL Genetics Institute, who has aimed to stay fact-driven and critical of the prevailing Covid-19 orthodoxies throughout the pandemic, describes the Byline Times piece as “McCarthyite”.
The libertarian think tank the American Institute for Economic Research (AIER) provided the venue in the Massachusetts town for the signing of the GBD but did not have a hand in designing the content, according to its authors. Gupta denies she has ever received funding from any organisation apart from Oxford University. Similarly, Bhattacharya denies he or Kulldorff have ever received funding from “Koch-linked networks” (networks linked to the billionaire businessman Charles Koch).
Like Baral, Gupta claims to be left wing in her political standpoint, saying that her criticism of lockdowns stems from concerns about the lack of safety nets and the wider social and mental health implications. She says she couldn’t countenance supporting school closures for example, given that many children eat their only meal of the day at school.
However, the backlash that Gupta and some of her compatriots have caused, and the rapidity with which they’ve been tarred as right wing or “unscientific”, hasn’t gone unnoticed by other academics. Baral describes a “tremendous amount of fear in the scientific community” about positing ideas that challenge the positions espoused by Western governments, the UK government advisory panel Sage and health bodies such as the WHO.
He and like-minded scientists have formed a support network to discuss the situation in private. “We have a WhatsApp group, where we share concerns about talking publicly about these things,” he says. “There are these big names out in the space right now that have a lot of influence, and I think that one doesn’t want to be seen as going up against them.”
Some epidemiologists I approached for this article said they couldn’t speak to me for this reason. One said by email that for someone who, like them, is at an early stage in their career, “putting your head above the parapet is a dangerous thing to do at the moment”. They said growing frustration “means there is a lot of anger, and a lot of the scientific discourse has become very acrimonious and even personal… It’s beginning to feel like open discussion is being stifled.”
As part of a Reddit Ask Me Anything, GBD author Bhattacharya said: “I’ve been at Stanford for over 30 years, both as student and professor, and I have never felt a more oppressive environment regarding open discussion of key issues than I do now.”
The scientists I spoke to (excluding Gupta) didn’t sign the Great Barrington Declaration and are not necessarily advocates of what has become known as the herd immunity strategy. However, they are more vocal about pointing out that lockdowns are deeply harmful in themselves, or willing to critique the scientific basis for interventions such as removing children from schools.
Balloux and Gupta both said that despite some of the backlash they’ve experienced (“I’ve lost friends,” says Balloux), they have both received a number of emails from colleagues and members of the public thanking them for speaking out on a topic that many feel too scared to broach.
What are the potential consequences? Primarily, loss of a career. Balloux puts this down to the precarious position of academics, many of whom are on temporary contracts until well into their research careers. Fear of being seen to challenge the diktats of powerful institutions could mean missing out on promotion or a permanent position. Gupta and Balloux both say they are lucky to have the security of being able to share their views without fear of consequences down the line.
The rigidity of coronavirus debate is even impacting what scientific research is published in journals. Gupta says that she has had trouble getting peer-reviewed a theoretical paper that contradicts some of the accepted doctrine on coronavirus, on the grounds that it is not of “general interest”. Critics will say that the probable true reason is that the study has flaws, but Gupta’s experience appears to be part of a trend. Gabriela Gomes, a maths and statistics professor at Strathclyde University who specialises in the mathematical modelling of infectious disease dynamics and epidemiology, has encountered similar difficulties.
In early August, she wrote on Twitter that her team’s paper estimating relatively low herd immunity thresholds was rejected by a number of journals. The main reason given, she says, was that: “Given the implications for public health, it is appropriate to hold claims around the herd immunity threshold to a very high evidence bar, as these would be interpreted to justify relaxation of interventions, potentially placing people at risk.” Gomes wrote at the time: “This is the very sad reason for the absence of more optimistic projections on the development of this pandemic in the scientific literature.”
At present, scientists are struggling to publish a randomised control study in Denmark that examined the population effects of wearing masks. While there is some evidence that masks could work, this is mostly based on laboratory or observational studies. Thomas Benfield, a clinical researcher at the University of Copenhagen and one of the lead investigators on the mask study, has refused to share the results, but has said that it will be published “as soon as a journal is brave enough”. This has led many to conclude that the results demonstrate a lack of evidence for mask wearing and that is why the team is encountering difficulty in getting the study published.
The effect of politicisation can happen in reverse too. In June, The Lancet was forced to retract a flawed study suggesting hydroxychloroquine was dangerous. Critics believe one of the reasons the material was rushed out was because they appeared to rebuke the position of Donald Trump, who spoke in support of hydroxychloroquine as a possible treatment for Covid.
A conservative attitude towards which scientific studies are permitted to inform the debate might be led by a risk-averse approach to causing Covid-19 deaths, but neglects the harms caused by a cycle of lockdowns. Data analysed by the New Statesman found that since the beginning of the pandemic, 31,165 more people in Britain have died in their homes than forecast. Only 9 per cent of these excess deaths had Covid-19 mentioned on the death certificate.
The impact of lockdown on people’s incomes and mental health, and the fact that many older or at-risk people have been in self-imposed isolation for the best part of the year, are somewhat neglected by the position that lockdowns are the best strategy for overall public health.
This is compounded by the wretched inequality of lockdowns. Most of the academics I interviewed refuted the idea that supporting lockdowns is in any way progressive, despite the fact that this position has been portrayed as a counterpoint to that of right-wing libertarians. Baral says that lockdowns are “absolutely an intervention only benefiting the rich”. He points out that they are only comfortable for people who can work at home, and that have spacious houses and the means to order in food and entertainment. “That the people who advocate for very strong suppression measures – that actually only benefit people who are financially well off – think of themselves as progressive is quite amusing,” comments Balloux.
Baral calls lockdowns “unbelievably unjust”, citing the fact that in some states in the US private schools have remained open while public schools are closed. That using various stages of lockdown has become the de facto way of tackling coronavirus in the UK and western Europe could speak to the way that class interests direct the prevailing narrative.
And while people decry herd immunity as junk science, those on the other side of the divide say the evidence for lockdowns is patchy too. The major European countries with the highest mortality rate per 100,000 people so far are Belgium, Spain, the UK, and Italy. All instituted harsh lockdowns, yet still recorded the highest death rates in Europe. Lockdown advocates will point out that Sweden, which had no mandatory lockdown, came in fifth for population fatality rate among major European countries. But other countries such as Japan and Belarus that didn’t implement mandatory lockdowns have recorded significantly lower fatality rates. A study published in the Lancet’s EClinical Medicine found no relationship between full lockdowns and lower Covid-19 mortality. Put simply, the argument that lockdowns are an effective protective measure is not based on irrefutable empiricism either.
This is why a letter published recently in the British Medical Journal (BMJ) advised that the more certain someone is about Covid-19 and the interventions to address it, the less you should trust them. Penned by George Davey Smith, professor in clinical epidemiology at the University of Bristol, and two others, the letter takes aim at the “many rational people with scientific credentials making assertive public pronouncements on Covid-19 who seem to suggest there can be no legitimate grounds for disagreeing with them”. It continues: “If you do, they might imply, it’s probably because you’re funded by dark forces or vested interests, you’re not evidence-based, you’re morally blind to the harm you would do, you’re ideologically driven (but I’m objective), you think money matters more than lives, [or] your ideas are a dangerous fantasy.”
The debate has degenerated, with various factions doubling down on their view about how the virus should be managed. “It is polarised, and that I think there’s quite a lot of anger about it, and I’m angry about it,” says Christina Pagel, professor of operational research at UCL and member of Independent Sage. “I find some of those academics deeply unscientific and irresponsible; that makes me angry.” She singles out those that only pay attention to results that bolster their position, and who attempt to rationalise away any “unwelcome” science.
“There is a tremendous amount of fear, and fear turns to anger very quickly,” says Baral.
But much of the divide is also down to the basis of each argument. “It’s not necessarily to do with the science,” says Muge Cevik, an infectious diseases and virology clinician and researcher at the University of St Andrews, who worked in an Edinburgh hospital during the first wave of Covid-19. “This conflict seems to be more about the values and risk tolerance.”
Take the schools debate, she says. One side started from the assumption that schools should remain shut to stymie Covid-19, unless evidence suggested they would be safe. The other side assumed that in-person education should continue, unless there was evidence to suggest it was risky.
Some of the divide is also due to the limits of what epidemiological and scientific input can offer in answering questions that affect entire societies, and that go beyond the health impact of Covid-19 and into the functionality of the health system, the economy, and mental health. “In the end, the answer is not scientific – it’s ethical or moral,” says Balloux. “It’s, ‘what do we value’? What value do we give to the life of someone who’s 80 years old in a care home vs the education of a child?” (A recent Oxford University study found that the average age of coronavirus fatalities is 82.)
The scientists I spoke to were concerned about the effect Covid-19 might have on the scientific discipline as a whole, as well as public trust in science. “This time in history will not age well. It will not be regarded well in the future on any side of the equation,” says Baral.
He particularly rejects the sloganeering that has defined the debate, often pushed by self-appointed Covid experts. He recalls the first time he saw a buzz phrase transmit from appearing on television and social media to rapidly mutating into accepted fact (the strategy of the “Hammer and the Dance” coined by businessman Tomás Pueyo). “It felt like the death of my profession,” he laments.
“What I really worry about is… that we might lose further this notion that there is factual truth,” says Balloux. “And also, to some extent, that there is a common good.”