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Sun 25 October 2020
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Epidemiologist Deepti Gurdasani and neuroscientist Hisham Ziauddeen warn against the false narrative of the ‘two views’ on how to tackle a second Coronavirus wave, which undermines the almost unanimous consensus that does exist on the most serious pandemic in living memory

As the UK enters its second wave of the COVID-19 pandemic, it has become evident that a clear public health strategy is required in response.

At this crucial point, when clarity is urgently needed, a troubling narrative has emerged: that there is a ‘schism’ within the scientific community, with two very divergent scientific views about how the second wave should be handled. 

On 21 September, a group of scientists, led by Professor Trisha Greenhalgh of Oxford University, published an open letter to the UK’s four regional Chief Medical Officers and the Chief Scientific Advisor, in the British Medical Journal (BMJ). 

The letter advocated for a strategy of continued suppression of the Coronavirus, through multiple interventions. The group warned against pursuing ‘herd immunity’, given that there is no evidence of long-term immunity with COVID-19. The letter also argued that it was practically impossible to separate a group of ‘vulnerable’ people from the ‘non-vulnerable’ and that such a strategy had not worked in any country so far.

It seems unusual that a group of scientists should argue against taking measures that would save lives during the most serious global pandemic in living memory.

Professor Greenhalgh is well known for her extensive work on synthesising current evidence on face coverings and COVID-19 transmission and has co-authored 14 papers on the disease this year. The letter was co-signed by 23 experts in this area, including 15 in public health or epidemiology, three in social and behavioural sciences, and several members of the Independent SAGE group. 

On the same day, another group of scientists led by Professor Sunetra Gupta and Professor Carl Heneghan, both of Oxford University; Professor Karol Sikora, of the University of Buckingham; and Sam Williams, of the consultancy Economic Insight also wrote to the four UK Chief Medical Officers, the Prime Minister and the Chancellor suggesting that the Government’s current strategy of suppression of the Coronavirus was “infeasible” and was “leading to significant harm across all age groups, which likely offsets any benefits”.

In the letter, which was published in the Spectator magazine, the authors essentially argued against general restrictions, suggesting that these be limited to older and vulnerable members of society, to minimise the impact on society. In the footnotes, they appeared to deny that lockdown had any impact on reducing cases or deaths and suggested that deaths from COVID-19 would have decreased anyway, meaning that the restrictions had been unnecessary.

Of the letter’s 32 co-signatories, only six appear to be epidemiologists or public health scientists, with one sociologist and several economists. None of the four lead authors of the letter have any peer-reviewed publications on COVID-19.   


False ‘Balance’

The narrative that these two views reflect a rift within the scientific community provides a false sense of legitimacy to what is a fringe view among scientists, espoused largely by individuals who do not work in this area. 

In the public health community, there is an almost unanimous consensus: that COVID-19 is a serious illness with high infectivity and mortality. Certain groups are more at risk from it (such as older people) but none are spared by it. A significant subset of people develop chronic complications of the infection and it is still unclear if it confers long-term immunity in most people. Managing this pandemic requires either a suppression strategy, with restrictions and mitigatory measures, or an elimination strategy. Every country is implementing at least one of these strategies in some measure. 

Any strategy involving infection of vast swathes of the population in the hope that this will confer immunity and bring an end to the pandemic – ‘herd immunity’ – is deemed unacceptable given the high mortality rate, the poorly understood long-term effects of the disease, and the lack of evidence for long-term immunity with COVID-19.

The fringe view is that COVID-19 is not as serious as we have been made to believe, that ‘herd immunity’ is possible without huge costs, and that only the elderly and vulnerable get seriously ill. Such arguments appear to rely on discredited narratives about increases in cases being false positives, or due to increased testing, and that deaths due to COVID-19 are low relative to other causes.

Sweden is repeatedly held up as an example of a country that controlled COVID-19 without the need for major restrictions, despite this being demonstrably untrue. Sweden has the highest mortality rate among the Nordic countries, with cases now rising again.

The proponents of this fringe view argue that the Coronavirus cannot be suppressed or eliminated, despite clear evidence from the successes of several south-east Asian countries that have started to return to near-normal life. 

They also treat controlling COVID-19 and its economic impact as dichotomous, when the evidence broadly suggests that countries that controlled the virus are doing better economically, even when restrictions are imposed.

They point to long NHS waiting lists and patients being unable to access care, ignoring the fact that the best way to normalise health service capacity is to control the virus so that it is not overwhelmed (and reverse over a decade of underfunding that has contributed to this).

It seems unusual that a group of scientists should argue against taking measures that would save lives during the most serious global pandemic in living memory that has resulted in almost a million deaths to date. 

There has clearly been a concerted effort to promulgate this view and bring it into the media spotlight and it is now appears to being considered seriously by the Government, with Professors Heneghan and Gupta recently invited to brief Boris Johnson personally ahead of the press briefing on the UK response to the second wave. It has also recently emerged that some of the major proponents of this view in the UK may have ties with Government contractors, the ‘Nudge Unit’ and funding links to organisations with ties to the inner circle of US President Donald Trump.

The risk that COVID-19 poses is not a matter of opinion or perspective. It is a reality grounded in overwhelmingly clear evidence.

The presentation of these as opposing views by the media feels increasingly reminiscent of ‘balance’ in the climate change ‘debate’. Indeed, like climate change deniers, the proponents of the fringe view do not provide alternative models or explanations for the real world data. Instead, they selectively misinterpret the data to support their view and dismiss, criticise and question the legitimacy of any data that contradicts their position. 

Including these views in the mainstream media without critical analysis risks making them mainstream and polarising the public at a point where we need collective action to control infection.

The inconsistent messaging by the Government and the lack of evidence-driven policy has created a ripe environment for such fringe views to thrive and gain traction in the UK. Unsurprisingly, we are now seeing vocal factions in the UK, and other countries, protesting against the very measures that have been demonstrated to be necessary to control the pandemic.

We are now in grave danger of repeating history and making the same mistakes that led to one of the highest mortality rates in Europe during the first wave. Our Government, the mainstream media and the scientific community must act responsibly to avert this. Divisive rhetoric may attract public attention but can also cost lives. 

Deepti Gurdasani is an epidemiologist and Senior lecturer at Queen Mary University of London. Her research focuses on epidemiological and genetic factors that influence global health. Hisham Ziauddeen is a psychiatrist and neuroscientist at the University of Cambridge


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