David Livermore: What led me to Collateral Global

I worked for Public Health England from 1997 until 2018, directing its antibiotic resistance laboratory from 1998 until 2011. Planning for respiratory viruses wasn’t my role, but I worked alongside those responsible. They thought us overdue for a pandemic.

As in 1889-94, 1918-19, 1957-58 and 1968-69, it would cause many deaths. But, as then, there was a limited amount we could do. Even after swine flu in 2009, or Operation Cygnus in 2016, there was no suggestion that the world should be turned upside down in response. The 2011 Pandemic Influenza Plan, still current in 2020, stressed the desirability of keeping life as normal as possible. In March 2020, the government began by following that plan.

Then – and blame whom you will – policy veered into the uncharted realm of lockdowns.  I doubted they’d do more than delay the inevitable, but maybe they were worth a try. Three weeks to flatten the curve would give time to procure PPE.

“What was done had an honourable intention (‘saving lives’) but has led to over-reach, suffused with hubris. There is a vast dislocation of society, unlike anything from the equally (or more) lethal pandemics of 1889-94 or 1918-19.”

As three weeks dragged into four months, my doubts hardened. The human and economic cost was daily clearer, whilst death trajectories remained similar in Sweden, with no lockdown; the UK, with a moderate lockdown and France, with 1-hour exercise paroles. Damage to civil liberties troubled me, watching police in riot gear lined up against innocuous protesters.

Worse, autumn revealed failure.  Cases, hospitalisations, and deaths rose despite Track and trace, masks, and more draconian enforcement. A second lockdown was justified by bogus modelling. It achieved only the selection of the Kentish variant, which spread more efficiently. 

Observing these failures led me to co-sign the Great Barrington Declaration and become an active critic in the media.

The advent of vaccines, earlier than I expected, did give me pause. Might these halt the pandemic?  If so, maybe the damage wasn’t in vain? Now, though, we’re learning that vaccines, whilst useful in preventing severe disease, are imperfect. Immunity wanes. Vaccinees catch and transmit COVID. Delta kiboshed the notion that the ‘R’ number could be reduced sufficiently to send COVID-19 the way of measles, polio, or smallpox. COVID-19 is now endemic across Europe, the Americas, South and SE Asia, with remaining ‘Zero-COVID’ jurisdictions wobbling.

Most of us will face a few rounds with the virus. Children and adolescents will build a deep immunity as to other circulating respiratory viruses. Those of us longer in the tooth are given a useful shove in the right direction by vaccines.  Over time it’ll become one more common cold. This is the messy reality of ‘Living with COVID’. Politicians mouth the phrase but are nervous of the actuality.  

That old 2011 plan was brutal but it did have the merits of being in touch with biology and experience. Instead, what was done had an honourable intention (‘saving lives’) but has led to over-reach, suffused with hubris. There is a vast dislocation of society, unlike anything from the equally (or more) lethal pandemics of 1889-94 or 1918-19.

It is this world view – a deep scepticism of utopian policies adopted ‘on the hoof’ and enforced with a mixture of panic and zeal – that leads me to CG. The resulting damage is plain in daily life, let alone in data I review professionally. My 99-year old aunt’s dementia snubbed out the last flickers of recognition whilst she was ‘protected’ from the virus. My cousin, a teacher, tells of weaker students who ‘disappeared’ from online teaching. The pub at the end of the road remains closed. The man who guided me across the Solway Firth, over-sands and through deep channels, has seen his pub go to foreclosure. Two trains in the past fortnight were cancelled owing to ‘persons hit by trains’, usually a euphemism for suicides. Prices are everywhere higher.

I could go on, but you can build your own list.

What matters is that CG objectively catalogues the damage done for it will hit us everywhere: in other healthcare, in our balance with other respiratory viruses, in education, in mental health, in the economy and in the nature of simple day-to-day interactions for years to come.  Only if we unequivocally establish the price paid will we immunise ourselves against fighting a respiratory virus in this vastly harmful and profligate way ever again.

David Livermore is a Professor in Medical Microbiology at Norwich Medical School, University of East Anglia.

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