India Needs Its Own Great Barrington Declaration On Covid-19 – Here’s Why

India Needs Its Own Great Barrington Declaration On Covid-19 – Here’s Why

by Anand Lakshman - Monday, October 19, 2020 09:03 PM IST
India Needs Its Own Great Barrington Declaration On Covid-19 – Here’s WhyThe authors of the Great Barrington Declaration, Dr Martin Kulldorff, Dr Sunetra Gupta, and Dr Jay Bhattacharya
  • The Great Barrington Declaration has triggered a debate in the scientific community

    What path should India take? One rooted in science and the local reality

The “Great Barrington Declaration” has cleaved the global Covid-19 scientific community recently.

Three eminent professors from the universities of Harvard, Oxford, and Stanford – Dr Martin Kulldorff, Dr Sunetra Gupta, and Dr Jay Bhattacharya – met at a libertarian think tank called the American Institute for Economic Research, located in a small sleepy ski town in Massachusetts, on 4 October, igniting a storm in the Western scientific world, largely political in nature.

The declaration calls for those who are not vulnerable to be allowed to resume life as normal – not the ‘new normal’ as has become fashionable to say these days but back to in-person teaching in schools, young people back at workplaces rather than working from home, the opening of restaurants and other businesses, and the resumption of sports, music, and cultural activities.

The declaration recommends an approach called “Focused Protection”, which says that the central aim of public-health responses to Covid-19 should be protecting the vulnerable – the elderly and those with co-morbid conditions.

The declaration has been highly politicised, with the authors meeting the Trump administration’s secretary for Health & Human Services, Alex Azar, and Dr Scott Atlas, an influential advisor, soon after.

Critics have pounced on the declaration, calling it "dangerously wrong", “Not so Great Barrington Declaration”, and “a dangerous libertarian strategy for Herd Immunity". Some have labelled the scientists as mavericks and said they have got their projections on herd immunity wrong in the past.

The American Institute for Economic Research, where the three researchers met, lists oil billionaire Charles Koch as a key donor, and the think tank's stated position on climate change is that it is a minor and manageable risk.

Herein lies the irony of the world we live in and the schisms that affect the greatest crisis the world has faced at scale since the Second World War.

The declaration should be reviewed for what it says, not for who says it and at whose expense.

Insinuations and coloured remarks make any objective review of the declaration and its contents near-impossible. The authors have even stated at the beginning of the declaration that they come from both the left and the right, in their political and social views, and have dedicated their careers to protecting people.

It is also important for us in India to review the declaration from our own context and the prism of lessons learnt from the pandemic. For instance, the declaration's nursing-home example is irrelevant to India and it misses a mention of masks in the list of preventive measures.

The uniqueness of India, in terms of its large population, density, age structure, and the prevalence of pre-existing immunity to the coronaviridae family, should inform our debates. Unfortunately, our public-health think tanks lack the muscle, trust, or intellectual prowess to offer an India-specific strategy and way forward.

Interestingly, two of the three authors of the Great Barrington Declaration have Bengali origins. Kolkata-born Dr Sunetra Gupta, an infectious diseases epidemiologist, is a novelist. Her debut novel, Memories of Rain, was awarded the Sahitya Akademi Award in 1996. Dr Jay Bhattacharya, a physician and health economist, is a second-generation American from California, the United States.

Science is all about observation, data, and inference. It tells us that the pandemic affects the old disproportionately. The mortality rate among the aged and infirm is 1000 times that of the young.

Data from seven countries show that more children have died of influenza during the early days of Covid-19 (March–May 2020) than due to the coronavirus disease – 107 influenza deaths versus 44 Covid-19 deaths.

Science also tells us that there is a lot yet to be learned about this novel virus and its effects on the human body. Long Covid, for example, is seen as a combination of four different syndromes, which includes multi-organ damage, prolonged post-viral fatigue, fluctuating symptoms, and post-intensive-care complications, and it may be affecting 10 per cent of Covid-positive patients currently.

Coming to technology, the natural corollary of our understanding of the science of Covid, our primitive knowledge on the dynamics of transmission was applied to effect large-scale lockdowns. Masking, another technological application, has the potential to influence the course of Covid significantly.

However, lockdowns, social distancing, and masking are all human behaviours with varying degrees of adoption, blunting the efficacy of the technology at play.

We now need predictable technology that can be applied at an industrial scale. Vaccines fit the bill perfectly, as their benefits aren’t subject to the vagaries of repeated human behaviour. Once you get vaccinated, your future actions have no bearing on you contracting Covid.

Objective science has no chance to survive in the polarised narrative of Fox News and ABC. Politics will dominate the debate and we will always get to hear one-sided stories. We, in India, should not allow the Western narrative or debate on Covid-19, coloured by its politics and imperatives of their population structures and socio-cultural needs, to bloom here.

Last heard, the competing scientific worldview has come up with a more refined opposing line, called the 'John Snow Memorandum', on 14 October with more than 4,000 scientists, researchers, and healthcare professionals endorsing it.

Unsurprisingly, an associate professor of Indian origin, Nahid Bhadelia, is one of the voices leading this brigade.

The time has come for a 'Dhanvantari Declaration' or a 'Charaka Consensus' – an Indian strategy rooted in science and the local reality. It should be one that recognises our strengths and weaknesses, in demography, health systems, economics, and the competing canvas of infectious diseases.

Whatever it may be, it deserves scientific debate and dissection, not Arnab Goswami's prime-time, on-the-rack torture.

Note: The author is a public-health specialist and entrepreneur who has read and signed the Great Barrington Declaration. He has read the John Snow Memorandum as well and is not in complete agreement with either.

Anand Lakshman is a medical doctor and public health entrepreneur. He is founder & CEO, AddressHealth.
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