corona dilemma

Corona-dilemmaet, som beskrevet af økonom Paul Frijters, The London School of Economics
Skaden forårsaget af nedlukninger er meget værre end sygdommen fra COVID-19. Det er argumentet fra adskillige folkesundhedsembedsmænd og økonomer rundt om i verden, herunder en Alberta-ekspert inden for smitsomme sygdomme og kritisk behandling, Dr. Ari Joffe fra Stollery Children's Hospital og University of Alberta.

'Jeg er virkelig bekymret for, at (lockdown) tilgangen vil ødelægge økonomier og fremtiden for vores børn og vores børnebørn,' siger Joffe, der har praktiseret på Stollery i 25 år og nu har skrevet et review paper om virkningerne af nedlukningen.

Omkostningerne ved nedlukningerne i Canada er mindst 10 gange højere end fordelen med hensyn til befolkningens sundhed og trivsel, anslår han, i det mindste hvis du tager højde for adskillige variabler som økonomisk recession, social isolation og indvirkning på forventet levealder, uddannelse og det fulde spektrum af sundhedsmæssige prioriteter.

Hvis du ser på problemet over hele verden, vil lockdowns forårsage mindst fem gange og mere sandsynligt så meget som 50 gange mere skade end fordel.

Mange folkesundhedseksperter fortsætter med at gennemføre obligatoriske nedlukninger, som det for nylig blev set i Ontario og Quebec. Men Joffe støtter ikke længere de fleste af disse foranstaltninger, hvilket er helt modsat hans holdning i marts.

In the early days of the pandemic, Joffe joined with 14 other leading Canadians with medical expertise in infectious disease and critical care to co-sign a National Post column pushing hard for public health measures, including stringent lockdowns of school, non-essential business and restaurants.

"Canada and the rest of the world are now in the early phases of what will likely be the worst pandemic of acute respiratory infections in 100 years," they wrote.

Canada was ramping up health-care capacity, but the physicians warned our hospitals could soon be overwhelmed, as had been seen in China, Italy and Spain: "It is time for the provinces and federal government to use their authority to mandate an Italy/Spain-type shutdown."

Joffe says he supported lockdowns because at first it was feared that the highly-infectious disease would hit everyone hard, killing two or three of every 100 people infected.

Joffe worried he might well be exposed to the disease at work and bring it home to his family.

But the expected surge of child and young adult COVID-19 patients at the Stollery never came, he says, nor was there any major wave of ICU cases in Alberta.

Medical experts, such as Stanford's John Ioannidis, started to come out with information in the early summer showing that COVID-19 infection fatality rates were much lower than the numbers that had been used to justify the lockdowns. Instead of being as high as 3.0 per cent, it was likely around 0.25 per cent.

Economists were largely silent on lockdowns at first, but some of them also started to speak out. Joffe dug into the work of Paul Frijters of the London School of Economics.

Economists like Frijters attempted to quantify the harm that will be caused not just by COVID-19 infections, but by the isolation, unemployment, malnutrition and negative health outcomes brought on by worldwide lockdown.

Joffe hopes for a vaccine but also realizes an effective one might not materialize. He worries we might have waves of damaging lockdowns for years. His preference to avoid aggressive lockdowns is also being pushed hard by numerous prominent scientists who have signed the anti-lockdown Great Barrington Declaration.

In response, more pro-lockdown public health experts have put out the John Snow Memorandum.

The scientific dispute isn't easy for laymen to navigate. Joffe himself has signed the Great Barrington Declaration and says we should keep open schools, universities, stores and restaurants, but he's not sure it's right to open things up to extent of allowing large public crowds indoors. His focus is on spelling out in plain language the real risks to people.

The risk to children from influenza each year is greater than the risk of COVID-19, he says. If an individual is less than 65 and has no co-morbidities their COVID risk is also low. The focus should be on protecting people over the age of 65, he says, while also respecting their right to live as they choose.

In speaking out, Joffe will no doubt get some anxious and angry blowback, but he's making a significant contribution.

More facts, and less fear, will assist us in this debate. More focus on all the impacts of public health policies, not a myopic obsession with one single factor such as case counts, is also well advised. Joffe and others are leading us in that direction, which is the sanest way out of the COVID-19 crises.