Editorials

A Betrayal of the Precautionary Principle

Making difficult decisions in the face of uncertainty is a common feature of all crises. The pandemic was no exception but, sadly, much of the decision-making was conducted under a misapprehension (and, occasionally, wilful distortion) of the uncertainties involved.

The biggest uncertainty was the extent to which non-pharmaceutical interventions would curb the spread of infection. Instead, it was presented as fact that lockdowns and mask mandates would help achieve this; we now know that to be very much a matter of debate (to put it kindly) and yet faith in these measures persists, to the extent that those who dare to question their efficacy are treated as heretics.

None of this would matter if these interventions did not cause significant collateral damage. Yet given the conditions under which the majority of the world’s population lives, if there was one thing we could be certain of it was that people would die—of hunger, malnutrition, disease and malaise—as a result of them. In more affluent nations, the impact can be felt in postponed operations and disruption to education.

The justification for all of this has to be that many more people would have died without such interventions, which were predicated (as Ball’s article demonstrates) on the uncertainties surrounding the nature of the virus.

And yet, SARS-CoV-2 has actually been behaving almost exactly as any standard epidemiology textbook and a passing acquaintance with the characteristics of other seasonal coronaviruses would lead you to expect. It is headed towards endemicity (rather than eradication); its dynamics are determined by the waxing and waning of natural immunity against a background of seasonality in transmission; it was never any more virulent than the other seasonal coronaviruses (people were not specifically immune to it, so the vulnerable were especially at risk); and it evolved to evade natural immunity or to marginally improve transmissibility (which is all it needed to outcompete the prevailing variant).

The real long shadow of Covid-19 falls on those who were affected by the mitigations we imposed, not on the lucky few who sat at home on their laptops sipping Chablis and hoping that it would all go away if we diligently wore masks and lampooned anybody who dared to disagree. Much of this could have been prevented if life had gone back to normal as soon as we were able to protect the vulnerable, whether by shielding or through vaccines.

Sunetra Gupta is Professor of Theoretical Epidemiology in the Department of Zoology, University of Oxford and a member of Collateral Global’s Scientific Advisory Board.