Ten reasons to end the lockdown now

By Dr John Lee. He is a former professor of pathology and NHS consultant pathologist. Excerpts:

"1. You cannot understand the significance of this virus simply by looking at the raw death figures

Lockdown was enacted on a prediction of 500,000 deaths in the UK, rapidly reduced to 250,000 and then to 20,000. As I write the UK death toll is 30,150. Broadcast media has relentlessly focussed on the number of deaths and emotional stories surrounding victims. While every death is sad, the significance of a death toll can only be understood by looking at the big picture. This pandemic is unique in the way it has been observed and measured. This means that we are testing and counting a far greater proportion of Covid cases than have ever previously been counted for other respiratory infections such as influenza. This is true even though many Covid cases in care homes were not initially included in the numbers. We don’t really know how many people die of flu each year, because the surveillance relies mainly on surrogate measures rather than actual testing, but the estimated number for 2014/15, the highest of recent years, was 28,330. So yes, Covid is a nasty new disease. But even if you assume 40,000 Covid deaths, its death toll is in the same ballpark as diseases we live with, not something so extraordinary as to justify the lockdown reaction. 

And because it is new, this is likely to be as bad as it gets (see 9 below). The majority of cases are asymptomatic. The most common symptoms are not fever, cough, headache and respiratory symptoms; they are no symptoms at all. The typical case does not suffer respiratory fibrosis; the disease leaves no mark. Somewhere around 99.9 per cent of those who catch the disease recover. Of those unlucky enough to die, over 90 per cent have pre-existing conditions and were anyway approaching the end of their lives. To say this is not being uncaring: it is simply a fact of life that older people are more likely to die in any event, and especially more likely to die from new types of infection.

2. The policy response to the virus has been driven by modelling of Covid – not other factors 

Not only has such modelling been extravagantly wrong before in predicting the course of viral epidemics, but it says nothing about anything else. In this case, it has been bedevilled from the start by poor data and flawed assumptions. The data on virulence was hugely biased in favour of severe cases. There was an assumption that 80 per cent of the population would rapidly catch the disease, when in fact 15 per cent seems nearer the mark. Even the much-discussed transmissibility of the virus, the R number, is not something that is known accurately because there has been so little testing; it remains an assumption or an output of the models. Modelling can be very helpful in terms of pointing out the weaknesses in our data, which is why it is incredible that after six weeks of lockdown we have still done so little community testing. But, in complex situations, models are rarely comprehensive or accurate enough to be a sufficient basis for public policy. The very models that put us into lockdown – on the basis of predictions no longer believed accurate – are keeping us here despite their known flaws."

"8. The health service has not been overwhelmed nor likely to be 

The epidemiological models had nothing to say about how quickly our health service could adapt to a new disease. As it turned out, it adapted quickly. It has not been overwhelmed nor been close to it. That fear can no longer be a justification for continuing the lockdown. In fact, lockdown has merely harmed our ability to adapt more quickly. Unfortunately, the episode has also revealed less palatable things about the NHS. The gusto with which managers followed the Covid refrain meant that many vital treatments and investigations for conditions that we can and were dealing with were summarily put on hold. What is the moral equation that shows why a patient with one particular disease takes priority over all others? Is it right that health care staff can simply be ordered who to treat by managers? Who takes responsibility for patient care? I know many who are deeply unhappy to be working in an NHS where the command and control culture is so embedded that doctors can be told to stop, for example, cancer chemotherapy halfway through a course and feel they have no option but to comply.

9. The virus is almost certainly not a constant threat 

As I explained in my last magazine piece, an evolutionary view suggests that the virus is likely to change quickly, with less virulent forms becoming dominant. Lockdown could potentially slow this beneficial tendency. On this view, asymptomatic people spreading the virus is a good thing because it means that the disease becomes milder more quickly. This could already be contributing to the flattening of the deaths curves that we are seeing. In this case, the sooner we lift lockdown, the better. It also implies that the peak in illnesses we have seen this time is likely to be as bad as it gets. In future, the virus will come into equilibrium with the population as wider immunity combines with predominantly milder forms of the virus to cause a lower overall death rate that nevertheless fluctuates from year to year, much like flu."