Great Barrington Declaration

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Great Barrington Declaration
That's [other critics of the Declaration] being polite... What everyone really thinks is, 'this is all fucking stupid'.
—Rupert Beale, group leader of the cell biology of infection laboratory at the Francis Crick InstituteWikipedia[1]
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The Great Barrington Declaration is a pseudo-scientific tract authored by a number of academics during the COVID-19 pandemic. The declaration advocates for the complete cessation of mandatory non-pharmaceutical interventions in the pandemic for most individuals, while shielding members of the population who are particularly likely to die from the disease from it through various means. The stated aim is to protect the latter group and allow for the development of herd immunity to the virus in the unprotected sector of the population, while avoiding social and economic issues that come with lockdowns or other interventions.[2] The approach it suggests is described as Focused Protection,[2][3] while SAGEWikipedia refers to it as segmentation.[4]

The problem is that the Declaration is, despite the pedigree of its writers, not an academic or scientific work or based on any kind of study, but a statement of political intent — it is the length of a single side of paper and does not contain any citations, or even footnotes, and is expected to be carried on the weight of the credentials of its authors. In reality, what the declaration provides for would — if allowed to take place — inevitably have led to widespread sickness and death, while condemning the vulnerable to the same social and economic perils that it claims to wish to avoid for everyone else, and even then without properly shielding them from COVID-19. It completely ignores the mechanics of how SARS-CoV-2 spreads, and its consequences for those who catch it, while glossing over the actual effects of the disease, and as such is essentially denialist in its approach. The UK government, along with many academics, has specifically rejected the Great Barrington approach as infeasible and unethical.[4][5]

The most serious argument against the Declaration is that it would have crossed the line into genocide, on the grounds that it had "intent to destroy, in whole or in part, a national… group."[6][7]

Oh, and also the Declaration was sponsored by an American hard-right free market think tank, the American Institute for Economic Research, that also engages in climate denial. Surprise!!!

Who's behind it[edit]

It claims to be the creation of "infectious disease epidemiologists and public health scientists".[2] It was unveiled by a trio of prestigious scientists: Sunetra Gupta of the University of Oxford, Jay Bhattacharya of Stanford University, and Martin Kulldorff of Harvard University. Gupta is an epidemiologist who has consistently tried to argue that the virus is less serious than we believe: she began her work on COVID with the Oxford model, a best-case scenario for COVID in the UK that predicted few deaths (it was presented as a possibility and subsequently has been proven to not match the facts, but seems to have been scientifically legitimate); since then she has argued for lifting the lockdown, citing the economic consequences.[8] Bhattacharya is a professor of medicine who also works for economic think-tank National Bureau of Economics Research, which claims to be non-partisan and has a focus on inequality.[9] Kulldorff is a professor of medicine and a biostatistician and epidemiologist; he has been criticised for appearing on the Richie Allan show, a radio program with links to the far right that has featured holocaust deniers and antisemites, although Kulldorff claims he didn't know its reputation and he doesn't seem to be obviously far-right himself.[10]

The declaration was launched at the Great Barrington, Massachusetts offices of the American Institute for Economic Research (AIER).[note 1] This is a libertarian think tank, part of the Atlas network, with links to and funding from various unsavory far-rightists like the Koch brothers and notorious climate change denying oil company ExxonMobil.[12][13]

Who supported it[edit]

Its creators claim the declaration has been signed by 15,000 health practitioners, but an investigation by Sky News in the UK found that many of the signatories were using fake names, including posing as serial killers and Dominic Cummings, as well as Dr. I.P. Freely, Dr. Person Fakename and Dr. Johnny Bananas.[14]

The Declaration is, or at least was, a firm favourite of denialists who were opposed to lockdowns for various reasons, ranging between questioning their efficacy or simply objecting to them on an ideological or political level. Lockdown sceptics who were supportive of the Declaration continue to argue that it would have produced better results than the approach actually taken by governments, although even they seem to grant that a total release of restrictions and encouraging of spread as advocated by the Declaration would have been going too far, and that some restrictions, for example on gathering size and isolation of symptomatic individuals, should have remained.[3]

Other assorted figures who have endorsed the Declaration include:

  • The White House of Donald Trump, who after meeting the Declaration's authors displayed yet again his tendency to agree with the last person who told him something[15] (Whether this counts as him "trying" the approach is dubious, since it mainly just coincided with what he wanted to do anyway i.e. reopen everything no matter what.)
  • Nigel Farage, who no longer having Brexit as rallying cry immediately pivoted to being anti-lockdown as part of his next grift crusade and renamed the Brexit Party to the "Reform Party" accordingly
  • Rishi Sunak, British Chancellor of the Exchequer, who brought Sunetra Gupta into Downing Street along with another pair of cranks to extol the virtues of not locking down
  • Karol SikoraWikipedia, continuing his trend of being thoroughly wrong about the pandemic
  • The editorial board of the Wall Street Journal

Who didn't support it[edit]

Pretty much anyone whose opinion counts for anything, from public health officials to academics to politicians. We'd just be restating the Wikipedia article here so please go and look at the "Critical commentaries" section of its Great Barrington DeclarationWikipedia article for all the critical commentary you could ever wish for, and then some.

The "competing" "John Snow Memorandum" summarises the academic criticisms of the Declaration, most of which are largely reflected in this article. Unlike the Great Barrington Declaration however, it cites its sources. Or rather, it has some sources to cite.

Did anyone actually try it?[edit]

The United Kingdom's government under Boris Johnson briefly flirted, early on in the pandemic, with the idea of reaching herd immunity through mass infection. This rather heterodox approach lasted less than a week before it collided with both public outrage and academic reports that this would make a lot of people very dead indeed, and shortly afterwards the country entered national lockdown for the first time.[16] Johnson now steadfastly denies that herd immunity through infection was ever the plan (despite direct evidence to the contrary), and indeed if it ever was then it was abandoned very quickly. The UK government, as well as its scientific advisors, is now on record as specifically repudiating Great Barrington as a strategy for dealing with the virus[5], although chancellor Rishi Sunak is apparently a fan of it, and actually brought Sunetra Gupta into Downing Street to tell Boris Johnson not to have another lockdown and try the "herd immunity" approach instead.[note 2]

Sweden is sometimes cited by lockdown sceptics as a country that achieved success by deliberately not locking down and instead gently encouraging people to voluntarily avoid crowded areas. However, this was not because of a desire to reach herd immunity through mass infection, but due to Sweden's constitutional setup prohibiting the institution of national lockdown, with herd immunity being seen as something of a side benefit. The net result of this strategy has been Sweden suffering a greater human cost than its Scandinavian neighbours, while still suffering from an economic contraction almost equally bad and ending up no closer to herd immunity than anyone else.[17]

Arch-fuckwit Donald Trump had a meeting with the Declaration's three authors, following which his administration suddenly became very enthusiastic (at least privately) about the concept of herd immunity through infection. It's debatable whether this would count as the USA "trying" Focused Protection however, largely because Trump never appeared to make any particular effort to protect anyone, let alone focus that protection in any meaningful sense, and because there was no discernible difference between Trump doing nothing of consequence about the pandemic before this meeting and doing nothing of consequence after it. We'll be charitable here and say that the US having the second-highest COVID deaths per capita in the G7, and the single highest absolute COVID death toll in the world, had nothing to do with any deliberate effort to make people catch the virus.

Various countries such as the United States, Brazil, the United Kingdom and India have suffered from more-or-less uncontrolled viral outbreaks due to a mixture of ideological fuckery, poor or non-universal healthcare systems and government incompetence. Even allowing for these outbreaks not (officially) being part of a deliberate effort to get the population to develop antibodies to SARS-CoV-2, the results have been human death and suffering on an immense scale, and all of these countries are now engaged in mass vaccination programmes since - surprise! - immunity through infection isn't sufficient to achieve herd immunity without killing even more people.

Besides the few examples above, one of which is very debatable, no country appears to have seriously considered using herd immunity through infection as a deliberate means of controlling or escaping the pandemic. Great Barrington suffers from many of the same issues as libertarianism — reasonable-sounding calls to "just give it a try" ignore that you don't need to try things which you know won't work and which have foreseeable negative consequences that are impossible (or at the very least, extremely difficult) to reverse.

Why it wouldn't have worked[edit]

The short answer is that the Declaration, despite being authored and endorsed by people who frankly should have known better, was simply scientifically illiterate and wilfully blind to both the consequences of infection with SARS-CoV-2, the nature of viral spread and the basic mechanics of how society works:

  • You can't tell who's going to die from COVID before they get it — a key flaw in the Declaration's approach is that it assumes that perfect information exists about who is going to die or get sick from COVID, and is thus deemed "vulnerable" and subject to the shielding measures it calls for. Even people themselves do not necessarily know if they possess one of the risk factors that makes them more likely to die or suffer serious illness from contracting COVID-19, which further complicates matters.[4]
  • You'll end up locking down most of the country anyway or else lots of people will die needlessly — the result of the above is that either you would shield too many people, and you're thus replicating the issues with the lockdowns that you sought to avoid, or you don't shield enough people and therefore lots of people will die who otherwise wouldn't have, or whose deaths would have been prevented if the spread of the disease was reduced or halted. 2.2 million adults in the UK are designated as "clinically extremely vulnerable" and so were directed to shield in mid-2020,[18] roughly 3% of the entire population, however 24.4% of the population possesses an underlying condition considered to give a person a greater risk of severe COVID-19.[19] Given that one of the risk factors for COVID-19 is obesity, a condition possessed by somewhere upwards of 25% of the population of many Western countries,[20] you'd either be condemning a great number of these people to death or locking down that many people in addition to people with other more serious health conditions.[note 3][note 4]
  • You don't just need to only shield "the vulnerable" to protect them — even assuming that you know exactly who "the vulnerable" are, you need to close off every route of the virus reaching them. This means that if a non-vulnerable person lives with a vulnerable one, they need to shield too. If a vulnerable person is cared for, the people who care for them also need to shield to avoid contracting the virus to pass it on, as will anyone who lives with those people, and so on and so forth (the Declaration mentions that only people with acquired immunity should be allowed to care for the vulnerable, but ignores the possibility of both asymptomatic transmission occurring and of acquired immunity not actually turning out to exist). Eventually, you'd wind up either shielding such a ridiculously large proportion of the population that all you've achieved is a mass lockdown anyway... or you don't properly lock down and the "vulnerable" aren't properly protected.[4]
  • Shielding is difficult to follow — coupled with the above, shielding advice (as implemented for vulnerable people in the UK in addition to a general lockdown)[21] is far more restrictive and harder to follow than normal lockdown advice, essentially mandating that the shielded individual does not leave their house at all, not even for essentials, unless they absolutely 100% have to. Aside from this being nakedly discriminatory, and inflicting upon a certain segment of the population hardships that the Declaration apparently considers beyond the pale while letting everyone else do whatever, this would be extremely challenging to follow and would probably need to continue indefinitely, essentially until herd immunity is generated through some means - and if this is through infection, you'd need to consider that a significant proportion of people would take steps to actively avoid the virus as much as possible, rather than contracting it and gaining immunity to it. Absolutely no country has managed to completely shield their vulnerable population from the virus[4] and the United Kingdom's health secretary has directly stated that it's not possible to do so.[5] All of this adds up to mean...
  • Shielding is not 100% effective and so a lot of vulnerable people would die anyway - no country (outside of certain police states) has managed to fully enforce the lockdown regulations that it has instituted, let alone 100% protect their vulnerable populations from COVID-19. Any shielding measures will undoubtedly either not be followed by some portion of the public, be followed imperfectly or simply not be effective enough to stop the spread of the virus in the context of a society where everyone outside the shielded group is expected - indeed, desired - to have contracted it. The end result of this is that a lot of these vulnerable individuals will still undoubtedly catch COVID, get sick and die, no matter what a particular government does, short of literally locking people into their homes.
  • COVID is not risk-free even for those who are statistically at less risk — although you're less likely to die or have severe symptoms if you're otherwise healthy and under the age of 65, this could still happen and cannot be predicted.[note 5] The Declaration, aside from glossing over this reality entirely, also completely ignores the existence of "long COVID", where symptoms and health issues persist for months following symptomatic COVID infection, a phenomenon experienced in around 10% of people who have tested positive for COVID according to the UK's Office of National Statistics. Given that the Great Barrington prescription is for (generously) somewhere between 50% and 75% of the population to be infected with the virus, on purpose, this means 5-7% of the population experiencing long-term sickness in a way that is not yet fully understood and may not be effectively treatable. This, suffice it to say, would not be a good thing.
  • Lots and lots of people would get sick and die - Given that the fatality rate of COVID hovers somewhere around 1%, if you were to let the virus run rampant in (for example) the UK, this would be somewhere around 700,000 deaths, and three to four times that figure being hospitalised, completely overwhelming the country's healthcare capacity (and likely resulting in additional collateral deaths in the process).[note 6][4]
  • It's not clear that long-lasting immunity results from COVID infection — a lot of Great Barrington's prescriptions rely on infection with COVID conferring long-lasting immunity, as opposed to e.g. vaccination. While it appears that this is indeed the case based on scientific research,[22] at the time of the declaration (October 2020) this wasn't known for certain, so pursuing herd immunity via infection would have been an incredibly reckless gamble and a deeply unethical mass uncontrolled experiment upon an entire country. If it had worked the way the study's authors stated, it would only (only!) have resulted in the aforementioned 700,000 deaths and associated mass hospitalisations and long term sickness as would be expected from deliberately exposing 75%+ of the population to a novel infectious disease. If it hadn't, and herd immunity did not result through natural infection, it would have resulted in all that for no benefit whatsoever. Very ethical! Such morality! Wow!
  • Viruses mutate with greater transmission — More spread of a virus is more of an opportunity for it to mutate into a more virulent form that may potentially evade existing immunity. This has already happened, with numerous variants of the virus originating in areas where spread has been rampant (e.g. the so-called "Kent" variant). Luckily for all of us, the variants that exist haven't noticeably increased the fatality rate of the virus, but there's no particular reason to think that a 1% IFR would have held forever if the virus was given free rein to mutate throughout an entire population, or that any immunity acquired through infection would also have held against any new variants that came into being.
  • At some point you have to stop shielding people — the idea of the shielding approach is that you shield people who can't be exposed to live virus or they'll likely get sick and die. However the Great Barrington Declaration neglects to provide an exit plan for these people. Anyone released from the shielding without being vaccinated first would be immediately exposed to the cocktail of viral variants that would be floating around, and therefore be at a huge amount of risk. Additionally, upwards of 90% of the population would need to have antibodies for herd immunity to come into play, and so a lot of the people who are shielding would need to have these antibodies too — and because they can't get them through infection, they'd need to get them from a vaccine. Which then raises the question — if you wind up needing to vaccinate the vulnerable anyway before you can let them loose, why not just wait until you can vaccinate everyone rather than letting hundreds of thousands of people die needlessly to reach the same end result?
  • If the virus was let free, then people and the economy would suffer anyway — The stated aim of the declaration is for people at lower risk to carry out work and leisure activities as normal. The problem is that it's exceedingly difficult to imagine a scenario in which a deadly plague roams the land, healthcare systems get overwhelmed by people asphyxiating and people are dying in their tens of thousands per day, but the economy is roaring and people are happily going out to work and socialising in bars and restaurants. In reality, a significant proportion of people would be taking active steps to avoid the virus, since (as noted) getting it is not risk-free even if you are at a lower risk, and the unfolding horrors of an uncontrolled COVID-19 outbreak would rapidly lead to people staying inside out of fear for their lives. Even aside from that, sociologists have noted that people frequently find their relatives dying to be "very sad", and it's hard to overstate what the psychological effects would be of millions of people losing family members in a very short space of time to a disease that is very unpleasant to die from indeed, amidst widespread economic and social chaos. Most people would (if given the opportunity) likely prefer to stay inside for a few months rather than never see mee-maw ever again because she fucking died alone choking on her own lung fluid.
  • Residents of any country that tried it would have been trapped there — It's also very difficult to imagine a scenario where a country that actively pursued this hare-brained scheme would not be shunned by the rest of the world as a basket case and its residents barred from entry to other countries indefinitely.[note 7]
  • It's grossly unethical — as noted above, any country pursuing this would have essentially be subjecting its residents to a vast uncontrolled experiment on whether you can develop herd immunity to a SARS-type virus via mass infection - an approach that has never been deliberately tried ever in the context of an outbreak of a disease, let alone a pandemic. There would be no informed consent on this, and no real way of opting out other than leaving the country — you'd be taking part in it whether you liked it or not. The government would, in this scenario, be knowingly allowing hundreds of thousands of its own citizens to die, tens of millions to become ill and its own healthcare system to collapse, with uncontrollable generational knock-on consequences — a horrendously unethical act no matter how you spin it, distinguished only from certain war crimes by its gross scale.[note 8] And that's taking things in aggregate — there are various social factors that are shown to make people more likely to get sick or die from COVID than the average, including poverty, while those of comparatively greater means would have more ways in which to avoid the virus, such as by moving to less populous areas or simply leaving the country through any means they had available. The net result would be lots and lots of poor people dying while the middle and upper classes were able to take whatever routes out they could get. Great!
  • It's politically untenable - The economic meltdown, global isolation and mass bereavement that would inevitably follow any attempt to let the virus rip, combined with the express disregard for the health and wellbeing of the population inherent within such a plan, would at the very least cause severe political difficulties for whichever figure or party tried to implement it, if not lead to actual civil unrest. It's instructive to remember that, as noted, it took a little over a week for the government of the United Kingdom to walk back its initial idea of herd immunity via mass infection and pretend that it had never even considered such an idea (Boris Johnson's statement that amounted to "your nan's going to croak, deal with it"[23] likely didn't help). In the real world, while critics of behavioural restrictions are noisy, they are very much out of step with the rest of the population, and government-instituted restrictions to deal with the virus are overwhelmingly popular to an extent that dwarfs support for most other policies of any kind, with 85% of Brits supporting new lockdown measures in January 2021 and only 11% opposing them. [24]

"But what about how bad lockdowns are!"[edit]

Even granting that lockdowns and behavioural restrictions have economic and social costs of their own, including increases in mental health problems, reduced access to routine healthcare and a marked reduction in economic activity, many of these things can and have been ameliorated with government intervention (e.g. grants to businesses that have been forced to close and individuals that have been laid off, and extra funding for remote healthcare and psychotherapy services), while early predictions from lockdown sceptics of things like a wave of suicides resulting from the stresses of lockdown do not appear to have been borne out in reality.[25]

In every conceivable way, compared to what actually happened in the real world in countries that took early and decisive action to limit the spread of the virus in advance of workable vaccines becoming available, the "focused protection" approach would have led to many more deaths, much more sickness (both acute and chronic), longer-term economic disruption, worse health outcomes, worse mental health outcomes and greater overall uncertainty due to the lack of a reasoned - or even apparent - exit strategy.

Of course, one can make a reasoned and somewhat legitimate argument that the imposition of government constraints on what a given person can or cannot do are illegitimate and morally wrong, and that people should be free to make decisions based on their own perceived risk. Great Barrington appears to be an attempt to square the circle between this moral viewpoint and the fact that people (who are, broadly, not very good at understanding risk or at voluntarily making individual short-term sacrifices in exchange for the long-term welfare of other people who they may not even knowWikipedia) doing whatever they feel like in the midst of an epidemic of an asymptomatically-spread airborne disease would cause a foreseeable and preventable public health disaster... by pretending that this disaster would actually be a good thing.

Conclusion[edit]

The Great Barrington Declaration was a stupid idea thought up by some cranks who were being paid by a libertarian think-tank to give some seemingly-scientific backing to the sociopathic idea of letting lots of people get sick with and die from a novel disease for the sake of short-term economic interests and leisure. It would not have achieved any of its stated aims if implemented, and would in fact have made the situation in any country that attempted to follow it rigorously much, much worse. It would have inevitably led to profound human suffering and death, amounted to a grossly unethical experiment conducted upon the citizens of a country by its government, and likely would have had no long-term benefit whatsoever. Any country pursuing it would have been seen as an irresponsible, idiotic basket case and found itself even more isolated from the rest of the world than most countries already were.

Luckily for all of us, the Great Barrington Declaration never got much traction outside of a few wingnuts and Internet blowhards, although frankly that's more gravitas than it deserved. Where governments did happen to follow its commandments it was usually accidentally through idiocy, ideology or incompetence rather than any kind of enlightened effort (e.g. Donald Trump advocating against masks and lockdown restrictions out of economic concern and vulgar libertarianism, and Boris Johnson and Rishi SunakWikipedia resisting lockdowns until it was precisely too late for the same reasons); the results of this were, predictably, a mass surge in hospitalisations and deaths, not herd immunity.

What support there was for "focused protection" has been almost completely obliterated by the fact that vaccines now exist against SARS-CoV-2, and one no longer hears about it all that much from people who were apparently otherwise totally convinced. The reality is that the Great Barrington Declaration existed solely as a nominally-scientific fig-leaf for those who were against mandatory restrictions on behaviour (either for economic reasons or purely ideological ones) to claim that there was an alternative means of dealing with the pandemic, in the face of the overwhelming scientific consensus of reducing transmission via social contact until a vaccine is available. It can, and should, be seen in the same context as climate change denialists attempting to muddy the waters with "alternative" explanations for global warming, whose prescriptions conveniently align with the idea that everyone should continue to do whatever they were already doing without intervention.

See also[edit]

  • Jair Bolsonaro of Brazil — He opposed lockdowns, face masks, and even vaccinations, relying on a herd immunity strategy.[26]

External links[edit]

Notes[edit]

  1. One might be forgiven for thinking that AIER was duplicitously trying to convey that the Great Barrington Declaration itself was 'great', rather than that it was originating out of its own office in Great Barrington. Sadly, not even Great Barrington is 'great', with population 7104 in the year 2010.[11]
  2. Johnson listened, but eventually had to lock down again anyway because - surprise - the virus kept on surging and people kept on dying. Who could have known?
  3. Only "morbid" obesity — defined as a BMI of 40 or over — is considered to constitute an "underlying condition" for the purposes of e.g. vaccination segmentation in the United Kingdom, however a BMI of over 35 has been shown to increase the risk of hospitalisation and death from COVID-19.
  4. A common "rebuttal" to this from advocates of focused protection is that many of the people susceptible to COVID because of age or an underlying condition are likely to die soon anyway. Leaving aside that people only get one life[citation NOT needed] and that life being arbitrarily and knowingly shortened in the name of "herd immunity" is not really a very nice thing to do even if they otherwise didn't have much of it left, there are many people who are at greater risk of death from COVID through e.g. obesity, asthma, sickle cell anemia, or some other form of chronic illness yet are also unlikely to die soon in the absence of some external stimulus. The idea that a thirty-year old person with asthma is somehow knocking at death's door is patently idiotic, and the idea that they should be condemned to death monstrous, but must be accepted if the logic of this rebuttal is to make any sense at all.
  5. Funnily enough, a lot of the people most enthusiastically for Focused Protection happen to be in that "less at risk" group. Just fancy!
  6. This would, incidentally, negate another of Great Barrington's claimed issues with lockdown, that they dissuade people from seeking medical attention — good luck getting medical attention when a good portion of the country is occupying every hospital bed choking on their own lung fluids!
  7. Of course, many countries have barred non-citizens from entry anyway, despite lockdowns and other interventions — but citizens of those countries whose epidemics of COVID have been more controlled have found borders to be more open to them than those of countries where COVID runs rampant, and there is no reason to think that a country allowing it to happen deliberately would be treated any better.
  8. On the flipside, of course, people could still go for pints, so who can say whether it's more or less ethical than lockdowns???

References[edit]

  1. ‘I’ve had emails calling me evil’... Meet the Covid scientists at war, The Evening Standard
  2. 2.0 2.1 2.2 Great Barrington Declaration, accessed Jun 11, 2021
  3. 3.0 3.1 What Would a Focused Protection Strategy Have Looked Like?, Noah Carl, LockdownSceptics.org
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Summary of SAGE advice on segmentation, 15th October 2020
  5. 5.0 5.1 5.2 Health Secretary Matt Hancock in the House of Commons, 13th October 2020: "The Great Barrington Declaration is underpinned by two claims, and both are emphatically false. First, it says that if enough people get COVID, we will reach herd immunity. This is not true. Many infectious diseases never reach herd immunity, like measles and malaria and AIDS and flu. And with increasing evidence of re-infection, we should have no confidence of herd immunity to COVID, even if everyone caught it. […] The second central claim is that we can segregate the old and vulnerable on our way to herd immunity. This is simply not possible."
  6. Why The "Heard Mentality" Approach Only Increases Suffering by Craig Klugman (October 23, 2020 at 3:09 AM) Bioethics Today.
  7. Convention on the Prevention and Punishment of the Crime of Genocide Approved and proposed for signature and ratification or accession by General Assembly resolution 260 A (III) of 9 December 1948 Entry into force: 12 January 1951, in accordance with article XIII
  8. One-to-One: Covid Response Controversy, The Biomedical Scientist, 3 September 2020
  9. See the Wikipedia article on National Bureau of Economic Research.
  10. Anti-lockdown advocate appears on radio show that has featured Holocaust deniers, The Guardian, 19 Oct, 2020
  11. See the Wikipedia article on Great Barrington, Massachusetts.
  12. The pursuit of herd immunity is a folly – so who's funding this bad science?, Trish Greenhalgh, Martin McKee and Michelle Kelly-Irving, The Guardian, 18 Oct 2020
  13. Koch-Funded PR Agency Aided Great Barrington Declaration Sponsor by Nafeez Ahmed (13 October 2020) Byline Times.
  14. Coronavirus: 'Dr Johnny Bananas' and 'Dr Person Fakename' among medical signatories on herd immunity open letter, Sky News, 9 Oct 2020
  15. https://www.newsweek.com/white-house-embraces-herd-immunity-latest-push-end-covid-19-lockdowns-1538430
  16. Britain Drops Its Go-It-Alone Approach to Coronavirus, 17th March 2020, Foreign Policy
  17. Swedish official Anders Tegnell says 'herd immunity' in Sweden might be a few weeks away by Kim Hjelmgaard (Published 6:42 a.m. ET Apr. 28, 2020; Updated 9:58 a.m. ET Apr. 28, 2020) USA Today.
  18. "Coronavirus and shielding of clinically extremely vulnerable people in England: 28 May to 3 June 2020", Office for National Statistics
  19. UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records
  20. Obesity as a predictor for a poor prognosis of COVID-19: A systematic review
  21. Original shielding guidance from the first lockdown in 2020
  22. Lasting immunity found after recovery from COVID-19, NIH, 26th January 2021
  23. "I must level with the British public: many more families are going to lose loved ones before their time." - Boris Johnson, 12th March 2020. On the 23rd March he went on TV to announce a stay at home order, having announced the closure of various venues on the 20th.
  24. https://yougov.co.uk/topics/politics/articles-reports/2021/01/05/brits-support-national-lockdown-jan-2021
  25. Suicides in the UK increased from an average of 84 a month in the three months before national lockdown to 85.4 a month in the three months immediately after, a 1.6% rise - compare and contrast with the hundreds of thousands of deaths that would inevitably form a part of a "focused protection" strategy
  26. Bolsonaro's rule is 'worse threat than coronavirus,' say Brazilians as nation passes 500,000 deaths by Rodrigo Pedroso & Juliana Koch (6:38 PM ET, June 19, 2021) CNN.