Professor Gupta: Lockdowners Should Hang their Heads in Shame

AIER is pleased to offer the full transcript of this important interview with Professor Sunetra Gupta of Oxford University.

Hur mår Sverige:

Hello, everybody, and welcome to How Are You, Sweden? My channel here on YouTube. And normally I do my shows in Swedish, but today I have a very special guest, all the way from the United Kingdom, Dr. Sunetra Gupta. Welcome to the show.

Dr. Sunetra Gupta:

Very pleased to be here.

Hur mår Sverige:

And I have so many, maybe too many questions to ask you. I’m calling you from Sweden, a country that last year dealt with the pandemic in a different way than did most of the world, avoiding hard lockdowns and mandatory masks. And you are a professor, of course, of epidemiology, researcher in the field of viral and bacterial infections, and one of the three main signers of the Great Barrington Declaration, which we will come to in a second. First, please tell our listeners a little bit more about yourself and your research.

Dr. Sunetra Gupta:

Well, I work on infectious diseases, of course, but I started off essentially as someone who is interested in applying mathematical ideas to the study of biology. So I came from, my original interest in the sciences was kind of triggered by how useful mathematics can be in understanding physical systems, and while I was an undergraduate, I realized you could actually apply mathematics not just to physics and chemistry, but also to biology. That’s where I started. So that’s what I’ve been doing all along, is trying to use mathematics to shed light on biological problems. And very quickly became interested in infectious disease systems, where you can use these methods very nicely.

And most of my work has been on how pathogens evolve, and the various kind of population structures that emerge. Some pathogens like measles have no variation, whereas others like influenza are variable. And in developing these ideas, apart from the epidemiological insights one gains, one of the things that’s been very satisfying is that our models for flu have actually been translated into a blueprint for a new type of universal flu vaccine, which we’ve patented and licensed, and are now in the process of developing.

So while my expertise is as a theoretician, we have at the moment, in our research group, a thriving laboratory, which works mainly on flu, but of course last year, Craig Thompson, who runs that, and our research group enterprise, has also been working on COVID. So we have expertise. This is almost as an apology, but one ought to contextualize when people say, “Oh, she’s a theoretician.” I work on the theory, but we have a lot of expertise in the immunology and the laboratory work that goes into this, and we’ve taken ideas all the way to a translational level where we hopefully will be able to develop a new type of flu vaccine. So there is a broad range of expertise, not to mention, of course, general public health strategy, which I’ve always been interested in.

Hur mår Sverige:

Yeah. I have nothing but admiration for your work. And I forgot to mention I am also a physician, currently training to be a psychiatrist. I last year got my PhD in clinical microbiology, but since I’ve changed routes. But anyway, let’s talk a little bit about the Great Barrington Declaration. What is that, and why did you choose to take a public stance on this issue during the pandemic?

Dr. Sunetra Gupta:

So it was almost exactly a year ago that the awful realization occurred to me that many European countries were going to go into lockdown. And I was very worried, just at a sort of very visceral level, about how this would impact poorer communities in these countries. And more broadly, I was worried about how other countries, such as India, where I come from, who absolutely could not afford to go into lockdown, might think this was the only way to control this or respond to this crisis. And I knew that it would immediately cause a loss of lives. And that’s what happened in India, and South Africa, and other places that chose to go into lockdown.

Now, when China and Italy went into lockdown, or parts of it, that was motivated, I feel, by slightly different sentiment, which was to prevent the virus from escaping. And while that’s maybe not practical, it is noble in its intent. But to lock down a country to stop it getting in, and then also further to that, locking it down to stop it spreading within the country, seemed to me to be not a very sensible strategy, and where the costs of that strategy would be felt immediately among the underprivileged. So that was a year ago now.

Hur mår Sverige:

Yeah.

Dr. Sunetra Gupta:

But I thought the best way to try and get a dialogue, which is the most important thing, that was my feeling, that doesn’t translate immediately into recommendation, but I felt there needed to be a dialogue surrounding this which was grounded in a broader understanding of the population dynamics of this disease. So a lot of the recommendations were centered on a particular realization of a model with a certain set of parameters, and I felt at that point, the best way I could intervene was to show that actually a whole range of other model … I mean, the same model, but with different parameters, could fit the scenario. And it remains the case that we can explain everything that’s happened so far simply on the basis of herd immunity, or we could explain it or attempt to explain it, I think that would be more difficult, as a result of interventions. But the truth is that models can only tell you how, what the possibilities are. They can’t, unless you have the data, you can’t really tell what is causing what. And I felt that that was something-

Hur mår Sverige:

Are you talking about the model coming out, I think in early spring, was it February, March, from Ferguson? And is that the models that way-

Dr. Sunetra Gupta:

Yes. So that’s a fundamental kind of model that one would use in these pandemics. So there’s no actual difference between the model they used, or there was a large computer simulation, and the very simple deterministic model that we then put in the public domain last year, to say that actually there are a variety of scenarios that fit what is currently happening. Whereas what the Imperial College Group had done is pick a certain scenario, because when you make a complex model, what you do is you say, “Well, which is the best fit to the data?” And at the time, the only data they had was the Diamond Princess data, and whatever was coming out of Oregon. So, and this has always been the case, there’s no real disagreement between us in the fundamental way in which this is spreading. It’s just that they chose a particular scenario, and what I was saying is there are a number of scenarios that fit this.

So that’s where I started in March. That was last … I can’t believe it was a year ago. And then as time wore on, it seemed to me that this sort of fascination with lockdowns was reaching a different dimension. And therefore I realized that I could not just put out scientific ideas, that I needed to come out and say, on the basis of these scientific ideas, and on the basis of what we might at that point imagine the costs of lockdown already felt in many parts of the world, that we needed to think of a different strategy. And quite independently, myself, Jay Bhattacharya, Martin Kulldorff, and many other people, of course, had this idea that maybe the best solution would be to focus-

The best solution would be to focus protection on those who are vulnerable to death and disease from COVID, and allow the natural course of the disease to occur so that we then… That would be we’re using population level immunity, exploiting our knowledge about how these pathogens, the epidemic behavior of these pathogens in order to reduce the risk again to the vulnerable. The focus is always how do we reduce the risk to the vulnerable population? Because otherwise, public health problems are about people who are vulnerable, so that’s always the focus. But what people have failed to realize is that the buildup of herd immunity is something that protects the vulnerable population. The sooner we can establish that the closer we are to the situation we enjoy with the other seasonal coronaviruses.

Hur mår Sverige:

As a Swedish person, I am on the one hand sad and frustrated about how we in parallel to so many other countries fail to protect the vulnerable older and sick population. The median age of those who died was around 84 years old. But at the same time I’m grateful that we didn’t have a hard lockdown and that we weren’t forced to wear masks on the streets, or we were able to live our lives pretty normally during all of 2020. I think now as Sweden is using more and more restrictions and politicians are calling out for harder measures, a Swedish lockdown. I think there is a naivety among the Swedish population that they don’t really know what that means. Can you please tell us what is life under lockdown? What are the harms of this system?

Dr. Sunetra Gupta:

Well, first of all, there is this fantasy that lockdowns protect the vulnerable and that’s not true. Lockdowns have harmed the vulnerable people, lockdowns expose vulnerable people. Because what we have enjoyed as lockdown in not just developed but developing countries, is a protection of the wealthy or at least people who have enough resources to be able, maybe not wealthy, but just generally the middle classes to different degrees. Obviously, if you’re very wealthy, then none of it matters. What do you do? You just sit in your beautiful estate and it’s kind of fun actually. If you are in just… Or an academic like myself, I live in a nice house in Oxford, my daughters came back during lockdown and worked at home, which was really quite a privilege. It was wonderful to have them back. We have a nice garden, we have a dog we’ve been walking, it’s fine.

Lockdown is not a problem for the people who have the privilege, are fortunate enough to have nice enough accommodation. Other than the fact that we can’t go to art galleries and concerts, oh well there’s always recordings. It’s not a problem. When you think about that, when you contrast that to what’s actually happening, obviously I mean we could start with the developing world. The image that returns to me is of there was a report of a 90-year old woman walking home. This is last year this time. From Delhi, where she sells toys on the pavement, 90 years old. What do you make from toys on the pavement? Just maybe enough to eat on that day. Some days she probably doesn’t eat or didn’t eat. She was walking back to her village because she could no longer do that. This is the reality in most of the rest of the world.

In this country, the idea that lockdowns protected vulnerable people is a real fallacy. Because what happened and they keep saying, “Oh, look at all these poor people who died.” Well that’s funny, because those poor people are the people who were obliged during lockdown to go out to earn a living, and classed as essential workers. They drove buses, they cleaned the hospitals. Not surprisingly, some of them shouldn’t have been doing that. Obviously most people don’t actually die from this disease, but some of them had comorbidities, have diabetes, were overweight or obese or whatever it is, had asthma and should not have been out there. Instead of protecting those people, we protected the middle classes who are now saying “Oh, okay, do we really need to lift lockdown?” Maybe, okay we do want our kids to go to school.

But the idea that lockdowns protect the vulnerable is a fantasy. Also, with the elderly here, I mean okay maybe we protected some of them, not very well from dying of COVID, but then we sentenced them to live their rest of their lives in isolation, without the one thing that would matter I imagine when I’m old, I would just like to touch my children to be holding my hand. That’s the one thing we’ve deprived them of. Lockdowns do not protect the vulnerable in any sense. The only way they might protect the vulnerable is by reducing infection. But that too is called into serious question, thankfully, by examples such as Sweden, which didn’t go into that kind of lockdown and achieved not very dissimilar results to places that did.

Hur mår Sverige:

You mentioned the protection of the vulnerable and how you feel the situation is for children who as a group are also vulnerable. Of course children coming from households where they are already not protected very well. How have they suffered through this year in Great Britain do you feel?

Dr. Sunetra Gupta:

I think we should hang our heads in shame. Absolutely hang our heads in shame. In terms of as I said the thoughts, the horrible images that crowded in my head last March, I’ve talked about India and slums around the world where this would have a devastating impact. But also I thought of the child for whom in this country even going to school is the only relief from a household that’s dysfunctional, the only place where they get a proper meal. We have just abandoned those children it seems to me, not to mention of course, other children who maybe don’t live in such terrible circumstances, but to not go to school has been an extraordinary imposition on that age group. Where if we all are equipped to give them what they need at home, that would be fine.

Maybe some of them have benefited from having their parents teach them rather than their teachers, but this is no way to live. But what actually really breaks my heart is watching them go to school and then be told you can’t sit with your friend, and you have to wear a face mask and you have to swab yourself. All of this could have been avoided if we had protected those who are vulnerable to death from infection. I think we have totally failed on our duties to children. I don’t understand how people can tolerate that kind of harm to children.

Hur mår Sverige:

I agree. Sweden kept schools open from one year that’s kindergarten to 16 years, all schools all the time open every day. We have seen very few serious cases, very few even deaths. I don’t know if there are any real deaths from COVID-19 among children [inaudible 00:19:27] but very, very few, we’re talking about millions of children who-

Dr. Sunetra Gupta:

It’s negligible.

Hur mår Sverige:

It’s not a disease for children it’s a disease for the old mainly, and for those who have precondition diseases. But still, how though would you recommend and how do you do in practice to protect the vulnerable while young and healthy can keep living their lives? Do you have any concrete suggestions? How would you manage the situation where you live for example?

Dr. Sunetra Gupta:

So, yes, absolutely. Now, so I never got to where The Great Barrington Declaration came in, but it was obviously a bunch of us getting together and saying, “Okay, let’s make this a concrete proposal that people can consider and open up a debate.” And on that website, you will find some suggestions for how we think this might be effective. But the truth is that these… And I can mention some of them too. So first of all, what we are doing during lockdown in this country is making everyone stay at home. So it seems rather illogical to say that… Or we can’t make people over a certain age or those who are over a certain age and are in a bad health, why can’t we oblige them to stay at home? We’re obliging everyone to stay at home at this point.

So it seems that a big part of protecting the vulnerable would require them to stay at home just like everyone is doing right now in this country, or to take socially distance walks. Well, I hardly need to tell you in Sweden, you laid out those recommendations. But that seems to me to be the largest part of how you wouldn’t protect the vulnerable. And since it is a subset of lockdown, it seems rather bizarre that it should be dismissed as not being possible.

Furthermore, that would only have to occur over the period where the epidemic was raging. And as soon as, which should be over by three, maybe six months, right now we’ve locked everyone up for much longer than in many parts of the world and stopped children from going to school. So that would be the biggest part of it, and most developed countries, that’s completely feasible, because most elderly people live on their own or people over the age of 65 don’t live with young people. So that’s possible, and then there are families where that’s not the case. Some of those families, you can still isolate the grandparents for awhile for that period of time.

And in families who live in very small cramped quarters, which shouldn’t be happening anyway, we would have to put special measures in. So maybe evacuate, and I like using that word because that is what we do in situations of crisis. You could evacuate the elderly or the vulnerable to somewhere and give them a very nice, I think [Amuga Cevik 00:22:56] called it luxury evacuation. Create a luxury experience out of evacuation. And we certainly had the money to do that, which we threw away on test, track and trace and all sorts of activities that were, I think, due to fail.

So I think that a very large part of it is you just pay the people who are vulnerable. So you do the opposite of lockdown, you tell the bus driver who has diabetes and is obese, you say, “You are going to stay at home and we are going to deliver a lot of food and give you lots of money to stay at home, because that overall protects you.” And overall, is a lower expenditure than what we tried to do by suppressing infection in the community.

Hur mår Sverige:

Yeah. Yeah, and I like also how you mentioned on your website, how, for example, in schools, if they are kept open or reopen, then teachers, of course, who are over the age of 60 or have comorbidities, they can be at home teaching or helping other teachers in administrative work or something like that. So they [crosstalk 00:24:16]-

Dr. Sunetra Gupta:

Exactly, I’m sure you can find solutions to that problem. It seems to be a smaller magnitude of problem, and what we need, of course, are experts on the ground to tell us exactly how you would do it. And at the end of the day, I’m not an expert in that area. If people assessed this suggestion and said, “Look, actually it’s not going to work.” Then I would of course accept that. But what happened instead was that people dismissed it outright. I was just watching Anthony Fauci saying, “This is nonsense, that’s nonsense.” He said. I mean, is that a reasonable way for anyone to react to a suggestion that should at least be debated and discussed?

Hur mår Sverige:

Yeah, Anthony Fauci, of course being the leader of the pandemic restrictions and politics in the US. And I mean, the Great Barrington Declaration, was founded by you and a very prominent researcher in Harvard and in Stanford, and also signed by Nobel Laureate, Michael Levitt, among other very high profile researchers in infectious diseases and many other fields. Are you surprised that you didn’t get to come to the government, get your proposition out there and have a serious debate about different ways to handle the pandemic? Are you surprised that there was such a hard drive to the other way, to go to lock down and these policies that now are so disastrous for many countries?

Dr. Sunetra Gupta:

Yes, it’s mystifying. I mean, of course, myself and then another researcher at Oxford, Carl Heneghan, who has been very, very active in showing the data, showing evidence-based medicine. Well, he is the head of evidence-based medicine here in Oxford, and he has taken a very data-driven approach to this whole process. And we were both asked to, it’s no secret now, to present our ideas at a cabinet meeting, but they were then immediately dismissed and did not get to be debated at all. There was no debate, debate was actively shut down, so that’s mystifying to me. In fact, what happened instead was a series of ad hominem attacks and campaigns were launched against us.

Hur mår Sverige:

We don’t have very much more time, but I would like to ask you just a few more questions. And one argument that proponents of a Swedish lockdown used is that the new variants, we have the British one, the Brazilian one, the South African one, I think even we have a Swedish one, are so dangerous and pose such an imminent threat to our health, that we need to now to shut down, just for a few weeks and then open up again. And what is the scientific basis for the threat that these variants pose? I mean, are they more lethal, are they scarier?

Dr. Sunetra Gupta:

I think the scientific basis for panic on that front is very flimsy. So this is an area that I particularly work on, which is how do pathogens evolve under selection pressure from obviously our immune systems, and also other things that we do. So again, there is the whole range of possibilities here. Why did this pathogen almost uniformly around the world develop certain, or the ones that succeeded, had certain mutations like the Nelly and the Eek mutations. Some of which may increase transmissibility and some of which clearly allow them to evade certain antibody responses.

Now we know that under selection pathogens will evolve, but the likelihood that they would evolve to be something hugely monstrous is very low. The likelihood is that some of these mutations might have conferred a small transmission advantage, which in a competitive landscape always causes that variant to take over. So it’s sort of part of the natural dynamic of pathogen populations is that you do get… If you have something that has a slightly higher transmission or has a slight transmission advantage, it will come to dominate, it’s called competitive exclusion. It doesn’t have to have a very high transmission advantage, and that’s broadly what we are seeing. We are watching certain variants come to dominate, sort of take over, but not because they are far more aggressive.  It’s because they’re just a little bit better at transmitting. 

With regard to virulence, there’s very little evidence that there’s any increase in virulence. And then immune evasion is of course an issue, but aslo the pathogens will evolve to evade immunity if they can. It seems to me that there has been some degree of immune evasion particular in the E2K mutation. But that does not cause us to lose immunity to severe disease and death. In any case, we know from coronaviruses that immunity to reinfection is incomplete, so we are constantly reinfected by these viruses, but they don’t cause any harm. So all of this conforms … completely fits very nicely into a general model for how coronaviruses circulate at equilibrium. We have four coronaviruses which are doing that, so I don’t see any cause for this level of alarm.

Hur mår Sverige:

No.

Dr. Sunetra Gupta:

Surrounding these variants. I mean, when they were first detected, maybe there could have been a little bit of caution exercised. Now we are two, three months down the road and in any case the most plausible explanation was always that they weren’t going to be terribly more frightening. It’s very unlikely we’ll suddenly release this sort of monstrous new variant.

Hur mår Sverige:

Okay, that’s reassuring. And I mean another question about this that I would like to ask you is, what is happening to science right now? You mentioned ad hominem attacks from other scientists being mounted against the Great Barrington Declaration, against yourself, I have also experienced some of these attacks. Right now in Sweden, there is a professor that is being almost persecuted on social media for having written an article about COVID-19, with some results that some persons didn’t like. He has also gotten threats to his person, and has now decided to quit doing science about COVID-19. There are also exclusion and censorship on the social media platforms from scientists who are well-recognized around the world, and they have been unable to speak and get their ideas out there. So, what is happening right now to science? Do you have any ideas about that?

Dr. Sunetra Gupta:

I think it’s disgraceful. I’m glad at least that Karolinska took a stand against it, and I think it’s very important. It’s not happening, that universities take a very serious stand against this kind of behavior. I have not met with much success in asking for a concerted effort to lay down some guidelines for what … I mean, against what is frank defamation, frank defamation, and as you say threats from other … Well, threats I don’t know. But defamation from other academic colleagues should not be acceptable. Obviously, you can’t do much about social media, as the general public can issue threats of all kinds.

Obviously, I wouldn’t go so far as to say that there have been threats in academia, but the language of dismissal has been absolutely of the lowest level. Ad hominem attacks and just general kind of statements as to, “This won’t work,” or, “This is pseudoscience or disinformation.” It’s staggering that people have come out like that. When I look at some of the accusations leveled against me, and they’re really quite ridiculous. I mean for example, apparently I said that the epidemic was over last May, and then just yesterday someone forwarded me an article where I’d said I strongly expect there to be a resurgence in winter.

Why would I have gone to the trouble of signing and producing the Great Barrington Declaration if I thought the epidemic was over? I mean, they are based on the most fallacious sort of assumptions, and they seek to promote them. I’ve never seen this kind of behavior. I do think universities and academic institutions need to stand up strongly and rebuke those people who have actively engaged in these tactics.

Hur mår Sverige:

Mm-hmm (affirmative). And just finally, I know you are pressed on time. What is the way forward now? Is this, for the U.K. I mean, for the United Kingdom, and you have … I know Boris Johnson has some sort of exit plan out to reopen the schools gradually, and opening up the society. But is this the new normal? Will politicians, based on supposed threats from viruses or bacteria or fungi, be able to close down our society, break down democratic progression that has taken centuries to evolve?

Dr. Sunetra Gupta:

Well, I certainly think that right now because … There’s two parts to this question, I guess. One is, what should we do now? We have vaccines that protect against disease and death, so they offer a focused protection. You asked me a question earlier about, how can we do this? Well, that’s something we can argue about. I don’t think we can argue about whether vaccines can offer focused protection or not. They absolutely do, so I think this is the time to vaccinate the vulnerable, or indeed even before that, protect them until they get vaccinated, and open up immediately, everywhere.

In terms of the damage that’s been done by some of these mitigation strategies, I think that what’s very important is to analyze that damage. We have set up an enterprise called Collateral Global, to look at both the harms and also the benefits if you … There may be some. There may be lessons at least to be learned from the impositions, so we’ve set up this project that will be looking at these. We hope that in the future, at least the costs of these mitigation strategies will be on the table. The other dimensions which have to do with how we want to live our lives in the first place are also a critical consideration. I hope that we will next time think about those as well, and mostly I hope we will remember how precious children are, and how our obligations towards children, how they override almost everything, in my opinion.

Hur mår Sverige:

Yeah. Dr. Gupta, thank you so much for coming and for your very wise comments. Hope to maybe see you someday again.

Dr. Sunetra Gupta:

My pleasure. Thank you very much.

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