Many are doubtlessly bored with protracted and pedantic discussions on the rights and wrongs of lockdown as a tool to mitigate Covid19 deaths. No one is dispassionate; we are either for and resistant to opening up or against and demanding our economy and our grannies back. As England moves to lessen restrictions there are concerns from SAGE advisers that now is too early accompanied by a whiff there might be protest resignations from our academic boffins if their views are not respected. To most European governments it was clear; to do nothing would have been criminal and the more they did the more lives they would save.
Ivor Cummings, better known as the Fat Emperor for his promotion of low carb diets to reduce heart deaths, has an opposing view which is, he claims, dispassionately based on only the data and logic.
Image below is from Ivor Cummins
Ivor’s conclusion is that this novel coronavirus once spreading in the population runs its course. Data from a number of sources confirms his view that lockdown after the virus is moving in the population has had little, if any, additional impact on death compared to basic distancing and good handwashing. Excess deaths in Europe in 2018 when Covid-19 did not exist were 140,000 and this year 2020 are 161,000 and it’s not finished yet. So Covid-19 is a killer there is no dispute. Covid-19 has given us a pointy painful peak of deaths in the last two months mostly in groups vulnerable to the infection. Ivor argues that the milder winter of 2019, with fewer than normal excess deaths, provided a cohort more vulnerable to Covid-19 once it appeared. If we look away from the toxic infectious environments of nursing homes and hospitals, we find that lockdown has not had much impact compared to social distancing as is happening in Sweden.
The grocery trade, for example, had few if any workers off sick because of Covid-19 and these are people on the front-line 8-10 hours a day mixing with each other and bumping into us getting a pint of milk, a packet of sausages or a dozen cans of larger.
Ivor notes countries that have reversed their lockdowns for example Denmark and to a greater degree Israel suggesting that the death curves for those countries just continues to do their thing that is fall without the dreaded second spike in infection rates followed by deaths which UK scientists are so worried about. If Ivor is right, and he has a number of high profiles experts on his side including Nobel Prizewinning Stanford Professor Michael Levitt, then lockdown has only provided about 5% more to the reduction in deaths compared to sensible social distancing. Professor Levitt claims the excess burden of death from coronavirus COVID-19 is closer to a month than to a year. I cannot fault his logic but really hope that he is missing something because we all put some considerable effort into this lockdown and we would like to think it was worth it.
In an article a few weeks ago in the Spectator Lionel Shriver makes a similar point that Covid-19 is surprisingly nosocomial meaning it is spread in healthcare setting of care homes and hospitals. Infection from this virus results from the close-up sustained exposure that we never get from strangers in supermarkets. Both Ivor and Lionel are concerned about the collateral deaths that will occur because or health service and or economy have been locked down. They predict excess deaths from heart disease, cancers and mental health in coming years will swamp the Covid-19 death spike.
I suppose we need to look back and see why we locked down in the first place and the main reason was to stop the health system being swamped. We have now got the necessary ICU capacity and the empty Nightingale hospitals that were required by the statistical models so opening up society and the economy can happen.
One thing that government and the media did exceedingly well in lockdown was keeping people on board. The message was about saving lives and we never seemed to stray into discussions that saving lives only meant postponing deaths. As one of my critics in another blog stated it was a no brainer; if you had a choice to die today or in six months which would you choose. This is certainly a good point but at what cost we must ask and then we get into the ethics. If a new drug or surgical intervention is found and it costs more than £30,000 for a quality adjusted life year (QALY) the NHS is unlikely to pay for it as it is not deemed to be value for money. I’m sure that someone is already working out the costs per QALY of lockdown and when we take into account the hit to the economy it will make £30K seem like spare change.
I am a pharmacist in Belfast.