It is day 577 of “three weeks to flatten the curve”. The “saviour” vaccine has been offered – not just to those at risk as planned – but to everyone over the age of 12. And we’ve cried freedom. Yet we do not seem to have hit the sunlit uplands.  Fear stalks the room. The Coronavirus Act 2020 extension is in the bag, and the usual suspects are talking up winter restrictions. The government’s “Plan B” envisages all sorts of costly and potentially counter-productive measures, such as vaccine passports (deeply unethical) and further restrictions (pointless and damaging).  

This is irrational. In September 2020, I described the path we were on as one that would destroy the life chances of the living. I suggested we should instead “First, Do No Harm”, because interventions – however well-intentioned – have unquantified harms which can end up having devastating consequences, especially if they do not yield the hoped-for benefits.  

Yet here we are again, and it is extraordinary that something I wrote thirteen months ago could be equally applicable to the coming winter, the only fundamental difference being that the nation’s finances have since been crippled.  
So where do we go from here? Surely not down the same road? 

The narrative of fear is shakily supported by four spindly constructs, each of which should be dispensed with. Let’s call them the Four Horsemen of the Coronapocalypse:

  1. Lockdowns and draconian restrictions, such as test & trace, mask mandates and enforced isolation. Let’s face it, they don’t work.  Just compare relatively free England to highly vaccinated yet restricted Scotland – excess mortality has been excessively high this last summer.  Across the world, waves of epidemic have come and gone regardless of their severity (and in fact were usually waning prior to their imposition). Masks do not stop aerosol spread – breathe deeply within miles of a farm: when conditions are right, that bovine smell of country air will not have reached your nostrils telepathically. But the known harms of all restrictions are huge, and are amplified if these ‘one-size-fits-none’ non-pharmaceutical interventions are viciously enforced. Such over-bearing state control is known to cause serious supply-chain problems – empty supermarket shelves were commonplace behind the iron curtain.  
  2. Mass screening/testing. There is a very large body of literature that discusses the ethics of mass screening campaigns – contrary to popular belief, they are not a harmless intervention. Both false negatives and false positives can have repercussions. It is therefore crucial to take into account the opportunity cost – i.e. what that money could be spent on instead – when constructing such a programme.  £1 billion on a few weeks of lateral flow testing, or a shiny new hospital?  Why were the experts – the UK National Screening Committee – totally excluded from the planning for Operation Moonshot?  Additionally, the use of a diagnostic test to determine the health of a person is anathema to pre-2020 medicine: it is for a doctor to diagnose illness.  Diagnostic tests are useful tools to confirm, or assist, this process of medical diagnosis – but they are just tools, and should not be used for primary diagnosis. Testing obsessively for SARS-CoV-2 means we don’t see the woods for the trees: roughly 10,000 people die every week in England & Wales, of which a small proportion involve Covid – if every life really mattered equally, would we not proportionally look at root causes? 
  3. Vaccine mandates/passports. Coercing someone to undergo a medical procedure is grievous bodily harm.  Doing this by threatening penury because they lose their current employment is abhorrent. If it is possible to stoop any lower, some fear that vaccinated people are more likely to be super-spreaders (c.f. Marek’s disease).And if it is possible to compound such a terrible matter even further, it is particularly sick (sic) that naturally immune frontline healthcare workers (heroes in 2020) are the ones being turfed out of their jobs due the vaccine mandate imposed by the government, thus further undermining the NHS. Not only does coercion make a mockery of everything the West stands for, surely it has the potential to undermine confidence in medical authorities? And given popular messaging in the 80s and 90s, is it that unexpected that some will “just say no” to a drug pusher?  Especially when the government’s own data shows that Covid-19 rates are higher among the fully vaccinated in all age cohorts over 30 years old.
  4. Censorship, bad science and the stifling of rigorous debate. This one is probably the most corrosive of the paper tigers, but it should be tamed nonetheless. Western society has had an incredible run of success based on individual freedoms and appropriate checks and balances to avoid state overreach. Each of the G7 industrialised nations is currently subject to a form of totalitarian rule: power has been exceptionally concentrated in the hands of very few individuals. For some reason the doomsday modelling is trotted out again and again, despite being consistently wrong. The press has been neutered or brought to heel with both stick (OFCOM’s iron control of media output) and carrot (taxpayer dollars spent on advertising). This is precisely the kind of lop-sided polity that the West has patronisingly criticised in developing countries in recent decades.

If it wasn’t for the news blackout, it would be common knowledge that: 

  • The Nordics have essentially completely rescinded all Coronavirus restrictions, and are practically getting on with life. The Nordics are seeing ‘normal’ mortality rates;
  • The USA decision to proceed with boosters led to the resignation of the two highly respected FDA senior vaccine team members, who then published a paper in the Lancet questioning this decision.  Instead, yesterday we were hectored by the Health Secretary to “get your booster jab or risk your freedoms”;
  • We would know more about safe off-label treatments, for example Ivermectin, a very cheap and Nobel prize-winning antiviral drug.  After a history of veterinary use, it was approved by the FDA for human use in 1996, has been on the WHO’s list of essential medicines since at least 2015 and was described in the Journal of Antibiotics in 2020 as an antiviral “wonder drug”. The Nebraska Attorney General has issued a recent detailed opinion explicitly permitting the prescription of off-label Ivermectin for Covid-19.  So why do news outlets like the BBC publish hit pieces entitled “why people are using a horse drug”? We would also know more about Indian regions such as Uttar Pradesh that have very successfully utilised treatments – including Ivermectin – to cost-effectively limit the impact of Covid-19, despite very low vaccination rates.

If these Four Horsemen of the Coronapocalypse are taken out of the equation, SARS-CoV-2 and Covid-19 become an entirely manageable problem.  Endemic viruses cannot be suppressed or eradicated with leaky vaccines.  We can’t unspend the outpourings from the treasury since March 2020, but we most certainly should cut our losses.

The Royal College of Paediatrics and Child Health has demanded a complete stop to testing of children. The vaccines should be made available to those who are at risk, not squeezed into every arm.  We don’t need to hobble the economy – or infringe liberties – with vaccine passports. We should rescind vaccine mandates to avoid health services being hit by staff losses.  

Most importantly, we must restore democracy by returning to “business as normal” in the House of Commons, which should include reforming legislation in the Public Health Act 1984 so that HM Government – or any petty tyrant for that matter – can never again unleash the Four Horsemen of the Coronapocalypse.

Dr Alex Starling (@alexstarling77) is an advisor to and non-executive director of various early-stage technology companies.