The White House-backed 'Great Barrington Declaration' calling for herd immunity wouldn't just fail — it could lead to 640,000 deaths
*The White House has propped up a document from a libertarian think tank called "The Great Barrington Declaration" this week.
*白宫本周撑起了一份来自自由意志主义智库的文件，名为《大巴灵顿宣言》(The Great Barrington宣言)。
*The declaration proposes an end to COVID-19 restrictions: allowing "those who are at minimal risk of death" to "live their lives normally" and get infected, in the hopes that the US and UK might develop herd immunity against the coronavirus.
*But that argument creates a false dichotomy between lockdowns and letting the virus spread unchecked.
*One projection suggests attempting herd immunity could lead to 640,000 additional deaths by February 2023.
*Thousands of other experts have also spoken out against the declaration, and on Wednesday they drafted their own counter-memo.
The White House is applauding a new document drawn up earlier this month at a libertarian think tank in small-town Massachusetts, which falls neatly in line with the Trump Administration's own coronavirus plan: reopen, reopen, reopen.
The letter,called the Great Barrington Declaration (named after the 7,000 person Massachusetts town where it was drafted) was written by three scientists from Oxford, Stanford, and Harvard Universities, who lament the effect of the pandemic — and strategies to mitigate it — on society.
The declaration's bottom line: Most people should go out and live life as if the virus does not exist, while at the same time "better protecting those who are at highest risk" of dying or getting sick from the virus. (The document does not explicitly say how, exactly, they would go about protecting high-risk people from the virus.
The Barrington group calls this idea "focused protection," and it's one the White House has long touted.
Many of the concerns in the declaration about the fallout from COVID-19 lockdowns are real, including "lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health."
But most public health experts around the world agree that the scientists' stated plan is both shortsighted and deadly.
The Infectious Diseases Society of America, an association of more than 12,000 disease scientists and doctors across the country, released a statement on Wednesday calling the Barrington plan "inappropriate, irresponsible and ill-informed."
周三，由全国1.2万多名疾病科学家和医生组成的协会-美国传染病协会(Infecous Disease Society Of America)发布了一份声明，称巴灵顿的计划“不合适、不负责任和消息灵通”。
There is no safe way to completely reopen every school and every business while properly shielding people from death and disease until you get the number of cases down in a population to very low levels, as South Korea has done, by testing, tracing, and distancing. Trying to circumvent that critical public health work — by instead letting people rush out and get infected — is an unprecedented public health strategy, and one that for this particular virus, would not work anyway.
The resulting "death toll would be enormous and totally unacceptable," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases,told actor Matthew McConaugheyin August.
美国国家过敏症和传染病研究所所长安东尼·福奇(Anthony Fuci)在8月份告诉演员马修·麦康纳(Matthew McConoke)，由此造成的“死亡人数将是巨大的，完全不可接受的”。
Even with that reality on the table, nearly half a million names have signed onto the declaration, which has been translated into 22 languages.
Herd immunity isn't what the declaration says it is
Pursuing herd immunity to the coronavirus through natural infections is, in a word, impractical.
About 0.5% of the world's population has been exposed to the virus so far. We have a long way to go to hit even some of the lowest posited herd immunity thresholds, which would require 50% (or more) of the population to be exposed.
But the Barrington declaration instead states that "the most compassionate approach that balances the risks and benefits of reaching herd 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."
Public health experts largely agree that's not what herd immunity actually is.
"Herd immunity is achieved by protecting people from a virus, not by exposing them to it," World Health Organization director general Tedros Adhanom Ghebreyesus said on Monday. "Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic. It's scientifically and ethically problematic."
世界卫生组织总干事Tedros Adhanom Ghebreyesus周一表示：“牛群免疫是通过保护人们免受病毒感染而实现的，而不是让他们暴露在病毒之下。”“在公共卫生史上，羊群免疫从未被用作应对疫情的策略，更不用说大流行了。这在科学和伦理上都是有问题的。”
"Achieving herd immunity without a vaccine is a recipe for carnage," Gregg Gonsalves, anepidemiologist at Yale School of Public Health, tweeted Wednesday.
耶鲁大学公共卫生学院(Yale School Of Public Health)首席流行病学家格雷格·贡萨尔维斯(Gregg Gonsalves)周三在推特上写道：“在没有疫苗的情况下实现群体免疫是大屠杀的秘诀。”
It's something that health experts have stressed as being deadly and unethical: people are not herds of cattle to be culled in order to boost our collective immunity. Herd immunity is, instead, most often achieved by vaccinating a population.
"I think we need to be really careful when we use terms in this way around natural infections in humans, because it can lead to a very brutal arithmetic which does not put people, and life, and suffering at the center of that equation," the WHO's Mike Ryan said in May.
A growing number of reinfection cases also suggest coronavirus immunity is not iron-clad. If we let the pandemic rage through unvaccinated populations like a wildfire, we could be staring down another five or six years like 2020 peppered with peaks, dips, and waves of deadly infections.
"Most people who are infected with the virus that causes COVID-19 develop an immune response within the first few weeks, but we don't know how strong or lasting that immune response is, or how it differs for different people," Tedros said.
The plan touted by the Great Barrington Declaration could result in 155 million new COVID-19 infections in the US
So far, more than 216,000 Americans have died from COVID-19, and 7.8 million — less than 3% of the country's population — have been infected. In order to reach some semblance of herd immunity through natural infections, the US could be staring down another 155 million cases, give or take. One projection suggests attempting herd immunity in the country would result in 640,000 deaths by February 2023.
"That's the reason why we're against saying, 'Let it fly. Let everybody get infected and we'll be fine.' That's a bad idea," Fauci said inAugust.
What's more, the very nature of the coronavirus — which often spreads via silent, asymptomatic carriers and takes between two and 14 days to incubate, during which time people can unknowingly expose others to their infection — makes "shielding the vulnerable," as these declaration authors suggest, impossible.
Young people who return to their pre-pandemic lives can't guarantee they won't bring the virus home to their parents, especially since some rapid COVID tests may only pick up about 70% to 80% of infections, and can produce false negatives.
Letting the virus run rampant, even amid younger populations who are, broadly speaking, at lower risk for severe cases, risks overwhelming our healthcare system. Lots of young Americans also have comorbidities like obesity and diabetes that put them athigher risk of developing severe cases.
"We don't have a COVID-19 vaccine yet, nor a more general use antiviral treatment," virologist Julian Tang from the University of Leicester said in a criticism of the Barrington plan. "Without these anti-COVID-19 'tools', I cannot see how they will achieve this 'Focused Protection' for these vulnerable groups in any practical, reliable or safe way."
One June study suggested the US's coronavirus restrictions prevented about 60 million infections from March 3 to April 6 alone.
We already have evidence already that letting the virus run amok in a society doesn't result in herd immunity.
At a recent Senate hearing, Kentucky Senator Rand Paul claimed New York City, which got gobsmacked by the US's first wave, controlled its outbreak by pursuing this strategy.
But Dr. Fauci was quick to correct Paul in the hearing: "If you believe 22% is herd immunity, I believe you're alone in that."
There are non-herd immunity strategies that would help the world get back to normal
In the US, testing efforts have been slow, and even now, the rapid testing being rolled out in nursing homes across the country is so riddled with errors that some states are pushing to halt it altogether.
The country hasn't yet pursued the tried and true virus-fighting strategies that many other countries have used successfully: widespread testing, contact tracing, and universal mask-wearing.
The Barrington authors have embraced a false dichotomy that lets our public health system off the hook. Controlling the pandemic isn't a choice between "lockdowns" and letting the virus rage to achieve herd immunity.
Countries that crushed the virus, like South Korea and New Zealand, didn't pursue either of those strategies. They tested, contact traced, and shared information with their citizens that helped those citizens minimize the outbreak.
"We've got to get a testing regime and a contact tracing regime in place, we've got to get the PPE available, and widespread, and we did none of that — and that's the problem," public health expert Ezekiel Emanuel told Insider, after he published a research letter in the medical journal JAMA earlier this week showing how inferior the public health response to the virus was in the US compared to many other rich countries.
本周早些时候，公共卫生专家伊齐基尔·伊曼纽尔(Ezekiel Emanuel)在医学杂志“美国医学会杂志”(JAMA)上发表了一封研究信，显示与其他许多富裕国家相比，美国对埃博拉病毒的公共卫生反应是多么糟糕。之后，公共卫生专家伊齐基尔·伊曼纽尔(Ezekiel Emanuel)告诉Insider：“我们必须建立一个检测制度和接触者追踪制度，我们必须让个人防护设备(PPE)可用，而且要广泛使用，但我们没有做到这一点--这就是问题所在。”
"Schools can open, and lots of other things can happen when the transmission rate is very, very low," he said. "And that's what we failed to do."
The scientists who wrote the declaration haven't published any peer-reviewed studies about COVID-19
The Barrington writers met at the libertarian-minded American Institute for Economic Research think tank in early October to draft the document, which has since amassed hundreds of thousands of signatures (including some dubious signers, such as Dr. I.P. Freely, Dr. Person Fakename, and Dr. Johnny Bananas, as Sky News reported.)
10月初，巴灵顿的作者们在具有自由意志主义思想的智库美国经济研究所(American Institute For Economic Research)会面，起草了这份文件。自那以后，文件已经积累了数十万个签名(据天空新闻(Sky News)报道，其中包括一些可疑的签名者，比如I.P.Frely博士、Person Fakename博士和约翰尼·巴纳纳斯博士(Dr.Johnny Bananas)。)。
The three writers all hail from prestigious universities. Even so, none of these health policy experts — Martin Kulldorff (Harvard University), Sunetra Gupta (University of Oxford), and Jay Bhattacharya (Stanford University) — have published any peer-reviewed studies about the coronavirus.
Bhattacharya did, however, co-author a pre-print (preliminary research that has not been vetted by other scientists), study in April that used antibody testing to conclude a majority of California COVID-19 cases had gone unreported. Bhattacharya's wife recruited participants for that study via an email that falsely claimed an "FDA approved" test would tell them if they were immune and could "return to work without fear," BuzzFeed Newsreported.
Perhaps the greatest testament to how strongly public health experts condemn The Great Barrington Declaration is that they have taken the time to write a whole separate document, The John Snow Memorandum, published in leading medical journal The Lancet on Wednesday. Already, nearly 600 top-tier scientists, virologists, vaccine experts, medics, researchers, disease modelers, and public health professors have added their names to that memo.
或许，公共卫生专家对大巴灵顿宣言的强烈谴责最好的证明是，他们花了时间写了一份完整的文件-约翰·斯诺备忘录(John Snow Memory)，周三发表在领先的医学杂志《柳叶刀》(The Lancet)上。已经有近600名顶级科学家、病毒学家、疫苗专家、医务人员、研究人员、疾病模型师和公共卫生教授在备忘录中加入了他们的名字。
"The evidence is very clear," the memo says. "Controlling community spread of COVID-19 is the best way to protect our societies and economies until safe and effective vaccines and therapeutics arrive within the coming months."