Dr. Ari Joffe is a specialist in pediatric infectious diseases at the Stollery Children’s Hospital in Edmonton and a Clinical Professor in the Department of Pediatrics at University of Alberta and has written a paper titled COVID-19: Rethinking the Lock-down Group think that finds the harms of lock downs are 10 times greater than their benefits.
Initially Joffe was a strong proponent of lock downs but has since changed his mind. There are a few reasons why he supported lock downs at first.
First, initial data falsely suggested that the infection fatality rate was up to 2-3%, that over 80% of the population would be infected, and modelling suggested repeated lock downs would be necessary.
But emerging data showed that the median infection fatality rate is 0.23%, that the median infection fatality rate in people under 70 years old is 0.05%, and that the high-risk group is older people especially those with severe co-morbidities.
In addition, it is likely that in most situations only 20-40% of the population would be infected before ongoing transmission is limited.
Second, doctor Joffe is an infectious diseases and critical care physician, and he was not trained to make public policy decisions. He was only considering the direct effects of COVID-19 and my knowledge of how to prevent these direct effects.
He was not considering the immense effects of the response to COVID-19 (that is, lock downs) on public health and well being.
Emerging data has shown a staggering amount of so-called ‘collateral damage’ due to the lock downs. This can be predicted to adversely affect many millions of people globally with food insecurity [82-132 million more people] and severe poverty [70 million more people].
But also maternal and under age-5 mortality from interrupted healthcare [1.7 million more people], infectious diseases deaths from interrupted services [millions of people with Tuberculosis, Malaria, and HIV], school closures for children [affecting children’s future earning potential and lifespan].
Followed by interrupted vaccination campaigns for millions of children, and intimate partner violence for millions of women.
In high-income countries adverse effects also occur from delayed and interrupted healthcare, unemployment, loneliness, deteriorating mental health, increased opioid crisis deaths, and much more.
Third, a formal cost-benefit analysis of different responses to the pandemic was not done by government or public health experts. Initially, I simply assumed that lock downs to suppress the pandemic were the best approach.
But policy decisions on public health should require a cost-benefit analysis. Since lock downs are a public health intervention, aiming to improve the population well being, we must consider both benefits of lock downs, and costs of lock downs on the population well being.
Once he became more informed, the more he realized that lock downs cause far more harm than they actually prevent.
The initial modelling and forecasting were inaccurate. This led to a contagion of fear and policies across the world. Popular media focused on absolute numbers of COVID-19 cases and deaths independent of context.
Fear and anxiety spread, and we elevated COVID-19 above everything else that could possibly matter. Our cognitive biases prevented us from making optimal policy.
We ignored hidden ‘statistical deaths’ reported at the population level, we preferred immediate benefits to even larger benefits in the future, we disregarded evidence that disproved our favorite theory, and escalated our commitment in the set course of action.
We need to take an “effortful pause” and reconsider the information available to us. We need to calibrate our response to the true risk, make rational cost-benefit analyses of the trade-offs, and end the lock down group think.
We need to better educate ourselves on the risks and trade-offs involved, and alleviate unreasonable fear with accurate information. We need to focus on cost-benefit analysis – repeated or prolonged lock downs cannot be based on COVID-19 numbers alone.
We need to keep schools open because children have very low morbidity and mortality from COVID-19, and (especially those 10 years and younger) are less likely to be infected by, and have a low likelihood to be the source of transmission of, SARS-CoV-2.
We should increase healthcare surge capacity if forecasting, accurately calibrated repeatedly to real-time data (up to now, forecasting, even short-term, has repeatedly failed), suggests it is needed.
With universal masking in hospitals, asymptomatic health care workers should be allowed to continue to work, even if infected, thus preserving the healthcare workforce.
Toronto Sun / ABC Flash Point Health News 2021.