“If They Wish”

My Signing of the Great Barrington Declaration

“If They Wish”

My Signing of The Great Barrington Declaration

If anything is clear since the beginning of this pandemic, it is the extraordinary predilection the virus has for the aged and infirm. This was known pre lockdown in the lesson from the Diamond Princess and been a robust finding to this day, so much so that governments the world over are without excuse in failing to frame responses accordingly. It ought not to be lost on the reader that this is in contrast to historical pandemics of influenza, pandemics that targeted a more diffuse age strata and about which we have never ever substantially locked down. 

Thus enter Professors Sunetra Gupta, Martin Kulldorff and Jay Bhattacharya of Oxford, Harvard and Stanford respectively. Meeting at Great Barrington Massachusetts they were the key cosignatories of the Great Barrington Declaration (GBD), since signed by many tens of thousands of scientists and clinicians, including yours truly. It must be noted that the GBD was released October 2020, and as such applies to life before the vaccine that was hoped first to arrive (as it did), and then hoped in vain to prevent transmission (as it didn’t). It is also to be noted that had the recommendations of the GBD been followed, herd immunity would have obviated all talk of the vaccine altogether. In that sense it is alive today in August 2022 as it was almost 2 years ago.

Great Barrington Declaration (gbdeclaration.org)

The proposal was a simple one drawing upon the facts at hand and the first principles of the science of how respiratory viral pandemics come to an end as they always do. That is by the getting of herd immunity, humanity licking its wounds and moving on. The authors proposed a minimally restrictive path by way of the strong members of the population admixing, inevitably contracting and developing immunity whilst keeping the vulnerable safe.

“The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.” 

Now it might seem hardly sporting and even masochistic to criticise fellow lockdown critics, most especially at a time we found ourselves very much in the minority against the interminable avalanche of fear mongering hysteria. But I find I must gently take issue with the authors of the GBD with almost falling into the orbit of technocracy and utilitarianism. For against this picture in which what one is “allowed” to do is framed in terms of sterile risk benefit analysis, only in the closing sentence do they redeem the concept of autonomy as a virtue in itself

“People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.”

In so doing the authors redeem themselves in turn, whilst our collective governments damn themselves as the authoritarian monsters that they are. For I ask the reader to elaborate on the case of one “at risk”, who at one stage or another of this pandemic either had wishes utterly denied or cleverly crafted by censorious propaganda engineering their ill informed consent to self-imprisonment.

Just what if an “at risk” individual, likely elderly, decided to exercise their wishes? No one knows the hour which will be their last and the cloaked figure with the scythe comes a knocking. And so the subject person of our moral argument might have the temerity to venture out into the sun, to cross a postcode, to see the sea or hear the wind through the trees of the forest, and not just in state sanctioned “essential exercise”. They may well wish drive cross country to attend that big wedding or to catch a plane which will carry them to a country that will receive them, to hug their grandchild or partake in the worship of their God under an unmasked choir, all of this come what may the day after. This is the body that is their private property and the life that is their own is it not?

Now one might ask “but what of infecting others”? What a feeble and slippery non sequitur! What others? Are they forcing themselves into the home of one who would rather isolate? Are they grabbing them by the arm and forcing them into the world outside? Are they failing maintain the etiquette of distance? Are they not mixing in social contract with others like themselves, others who share in the same risk, mirrors of selves with as much community interest as self interest, for communities can only be in the hearts, minds and praxis of individuals with love of togetherness.

There is no wiggle room for our governments to escape the conclusion they have declared themselves owners of the body. And for what? To the salvation of bare biological life cruelly oblivious of the very idea of autonomy and a life well lived? Or do our leaders share in the vanity to be Churchill to a virus that is Hitler, only succeeding to drop bombs on freedom and expecting praise in return? Or perhaps it is cowardice in wishing to avoid being that government who failed to join with the herd of a different kind. From the land of Mao to belt and road northern Italy and beyond the chain of falling dominoes exported lockdown and other restrictions around the globe as the holy writ of “the science”. Only Sweden did not bow to intimidation and peer pressure.

Or perhaps it is to political exchange representation from the persons in community to protecting the abstract “public” that is the institutional hospital and health sector. This is despite front line health workers sharing in a dirty little secret. Almost all hospitals the world over, even at the height of the pandemic, were hollowed out and half empty waiting for the deluge that never arrived. Besides, what if there had have been a surge eventually, as was portended in the idea of “just a few weeks flattening the curve”? In the unlikely event our elderly subject did end up sick in hospital they would have joined the ranks of other lifestyle influenced injuries and illnesses. So what? From obesity to motorcycle injury to chronic airways disease, truly I ask what makes this one choice so heinous to be singled out for judgment.

I have heard it argued that what if the elderly subject of our thought experiment wants to go out into the world and bring his equally libertarian virus back home with him to a vulnerable, reluctant and fearful spouse. We cannot allow him to do this they say. Is this the triumphant argument from which to make health policy writ large? Seriously! A potential domestic dispute is to be the yardstick to lock down the world, when couples ought to figure it out on their own. Such things are possible.      

But still something gnaws away at me when I read the GBD and it is this. There is the sense in which the participation in freedom one might wish is permitted as grant from the public health authority rather than acknowledged as natural right. The word “allow*” is used twice, without clear explication from what ethical tree does this allowance grow and have its being. And hovering around the GBD and outside the declaration itself was the controversial charge against its authors that they rightly denied, i.e. that the GBD suggested “to just let it rip”. Here once again we see the siren song of tyranny almost capturing the GBD. The denial of “just letting it rip” is couched in terms of how and where the virus will be controlled by preventing its access to the vulnerable. In a sense the GBD really is a matter of letting it rip, with the qualifier to let it rip for some but not for all. and fair enough for this was the best advice then as it is now. Notwithstanding this, there is an assumption that seems to go unchallenged by the authors, i.e. that public health has the authority to “let” anything. Given the dyadic relationship between virus and mankind (or womankind) we might ask each member of the relationship their thoughts on the matter. If we are to give voice to the virus, it might say in virtue of its power that mankind has no choice in the matter to let it do or do not. It will spread, multiply and sometimes kill before its season is over and it mutates into something else or disappears altogether. And mankind can do nothing but record the facts of its power latter in the annals of the history of medicine. On the other hand the libertarian might enquire who has the power over allowing the individual go forth in the world creating the conditions of letting them rip. Once again, an acknowledgment of natural rights was in order. For the human being might well turn their attention, and their anger, at the public health technocrat. They might say “you don’t let me do anything”. The jewel of a lesson in the GBD is the (possibly) unintended dramatic tension between the temptation towards public health as a vehicle of technocratic tyranny on one hand, versus public health as a potential voice for health nested within liberty on the other. Still, bravo to the authors that the liberty of our potential wishes won out in the end of the GBD, but only just? Let us keep a steady hand on the reins of public health lest next time we not be so fortunate.