To lockdown or not to lockdown: how about we actually follow the science for a change?

With a few notable exceptions, the level of scientific discourse within the political and journalistic classes is abysmal. And for those with a sense of humour, I’m going to prove this by anecdote. A well-known journalist recently referred publicly to the spread of Covid-19 as being “only mildly exponential”. This is about as meaningless a statement as could possibly be.  And as for the politicians… well, don’t get me started.  Professor Sunetra Gupta’s emphatic take-down of the Health Secretary’s recent mansplaining about the undesirability of herd immunity was far too polite.

It is worth reminding ourselves of how the scientific method is supposed to work. First, you put up a hypothesis.  Second, you try and disprove it. If you successfully do this, you have a definitive answer (your hypothesis was wrong).  If you fail to disprove your theory, then your hypothesis stands.  But the corollary is not true: you can’t prove a non time-limited hypothesis.

A hypothesis that does stands the test of time – by dint of not being disproved – becomes universally accepted as a “good” hypothesis.  Borrowing cinematic language, it becomes canon.  However, long-lasting hypotheses can have spectacular falls from grace because a good hypothesis has to explain all observed facts – a single proven discrepancy is enough to consign it to the bin.

Still, a scientific theory that works well for us most of the time may still be useful, even if it is found to have a big hole in it – such as classical electromagnetism finding it rather difficult to explain point charges (the problem literally being a hole – singularity – in the theory). Thus, the scientific method – the incremental ruling out of hypotheses by experiment and review by peers – has served mankind well in recent centuries.

The concept of some theories standing the test of time better than others was beautifully captured by Sir Arthur Eddington: “If someone points out to you that your pet theory of the universe is in disagreement with Maxwell’s equations – then so much the worse for Maxwell’s equations. If it is found to be contradicted by observation – well, these experimentalists do bungle things sometimes. But if your theory is found to be against the Second Law of Thermodynamics I can give you no hope; there is nothing for it (but) to collapse in deepest humiliation”.

A dystopian vision of science in 2020

Reluctantly, though, we need to move on from sharing nuggets of wisdom from long-departed rational luminaries and consider the problems of the day. A new type of science has emerged during the coronavirus pandemic, one more palatable to those who wish to consume information in very small corpuscles. It involves capturing the imagination with nightmarish visions of Armageddon, and “evidencing” these doomsday scenarios with “proof” from a computer modeller.  The soufflé of fear is then leavened with a barrage of carefully selected facts and a smattering of non-representative samples.

Rinse, repeat, and – in the blink of an eye – we find ourselves in a totally new world. The concept of mass hysteria is not new to the human race, but perhaps naïvely we all thought that our society might have developed some (herd?) immunity to such phenomena.

The scientific method in its true sense seems to have been abandoned by too many in this crisis. In the face of fast-moving events in early 2020, various scientists rushed to put forward competing theories in an attempt to diagnose the problem. Despite very nasty outbreaks of Covid-19 in certain concentrated geographies, which was itself due to the very rapid (and exponential) spread of the novel SARS-CoV-2 virus, these fizzled out relatively quickly.  In the cases of Wuhan in China and Bergamo in Italy, this correlated with the imposition of aggressive policies of restrictions of movement. But as many at the time point out, this did not mean that the now ubiquitous “lockdowns” were the cause of this fizzling.

Scientists that postulated alternative hypotheses for this rapid drop-off in cases – based on the observation that this behaviour was akin to the spread of a virus that was struggling to find susceptible people to infect – were given short shrift. Or, to be more accurate, they were absolutely monstered. For instance, John Ioannidis, a Professor of Medicine, Epidemiology, and Population Health from Stanford University, was essentially ostracised for presenting early data that put the infection fatality rate lower than the merchants of doom were using to sell their wares.

Instead, we listened carefully to the panicked demands of those urging our government to shut down the economy to “save lives”.

As a thesis, “lockdowns save lives” is unproven.  A good thesis needs to explain all observed facts, or it is disproved by inspection. Brutal lockdowns have had high death rates and still not suppressed the virus; areas of relatively low restrictions have had fewer excess deaths.

And now? The World Health Organisation has just published a peer-reviewed paper by Professor Ioannidis that states: “the inferred infection fatality rates tended to be much lower than estimates made earlier in the pandemic” and “most locations probably have an infection fatality rate less than 0.20% and with appropriate, precise non-pharmacological measures that selectively try to protect high-risk vulnerable populations and settings, the infection fatality rate may be brought even lower”.

Perhaps we would have been better off following the science in the first place.

We owe it to the most vulnerable, the sick, those less fortunate in life to give everyone the best possible deal.  Lockdowns, circuit breakers, “increased measures”, higher risk tiers are just about tolerable for those “haves” who can afford it. But the “have nots” – and the “have not much time left” – might well question whether these are in any way proportional measures. This is especially so for a virus – SARS-CoV-2 – that seems to have reached a state of  what is called “endemic equilibrium” in many parts of the world (and quite likely in the UK).

Science reminds us that correlation does not imply causation. The blanket, draconian separation of us social beings with a great lockdown didn’t work last time, and therefore we cannot say it will work this time. A more credible hypothesis – as proposed by various scientists back in the early days of this crisis – is that Covid-19 is not the killer the misguided and the doomsday cultists made it out to be. Clearly, my heart goes out to all those affected by the tragedies that befall us mortal beings, but some of the terrible consequences of our lockdown strategies for cancer sufferers are horrific. In these straitened times, we need to consider very carefully where the areas of greatest risk are.

So, let me put up a hypothesis.  If (1) the rise in respiratory disease and hospitalisations caused by SARS-CoV-2 – perhaps adjusted for regional differences – approximates a linear uptick in line with the usual rise we see every year, and (2) we are chasing asymptomatic people round the country with a non-specific testing regime, then any rise in cases of coronavirus are actually a sign that the virus is in endemic equilibrium. In this case, we would be decreasing the likelihood of a devastating outbreak during the winter, by letting it spread naturally – linearly – through the healthy population now.

This hypothesis is consistent with observed facts. Prove me wrong.

If only we had Sir Arthur with us today.  He might have helped us to be guided by the scientific method rather than this terrible politicisation of “the science” we are currently experiencing.

Dr Alex Starling is an advisor to and non-executive director of various early-stage technology companies.