No matter what Twitter says about loosening restrictions, I know the reality on the NHS frontline

On Boxing Day, TalkRadio presenter Julia Hartley-Brewer pinged off two tweets that subsequently gained a lot of traction. She noted that “just 377 healthy people under 60 have died of Covid” in the UK. She told us that “the Great Barrington Declaration was and is correct” and that we should “help the millions of old and sick to shield while allowing the young and healthy (and our economy) to carry on living”. The Declaration calls this strategy “focussed protection”.

I’ll be honest – the urge to reply with something flippant was fairly intense. But all polemicists want you to react in this way so they can claim the moral high ground of being a “superior debater”. So instead I chose to write this piece, doing my best to explain why this strategy is fundamentally flawed.

I’m glad I held my tongue because I’ve since worked a shift at my local hospital where all 21 Covid-19 patients that I was responsible for reviewing were under the age of 60, some with no underlying health conditions. For those that we discharged, another patient waiting in A&E replaced them almost immediately.

This serves to illustrate my first point. That simply measuring the mortality of a disease is a terrible way of assessing the impact of that disease. Allowing the “young and healthy” to carry on as normal would invariably lead to a not insignificant proportion of that group requiring hospital admissions. The inevitable strain on the NHS would impair its ability to provide routine care for the “millions of old and sick”, a phenomenon that has occurred even in full lockdown.

Furthermore, we know that younger populations are not immune to the long-term consequences of Covid-19 infection. There is every reason to believe that the health and economic impacts of a swathe of acute infections and “Long Covid” cases amongst younger populations could be catastrophic in the short and long term.

Hartley-Brewer has relentlessly extolled the virtue of the Great Barrington Declaration, despite it making little effort to explain how “focused protection” would work in practice. Dr Rupert Beale of the Francis Crick Institute puts it simply: “it is not possible to fully identify vulnerable individuals, and it is not possible to fully isolate them.”

Around one-third of the UK population would be classed as “vulnerable”, not accounting for people who have a risk factor but don’t know about it, like those with undiagnosed high blood pressure and diabetes. The authors of the Declaration don’t dare countenance what the impact of an inevitably incomplete “focused protection” strategy on the “old and sick” would be.

But what astounded me most about Hartley-Brewer’s comments was that they appeared alongside her retweets of the good news that we are on the verge of being able to vaccinate two million vulnerable people in a fortnight. It would be an act of unforgivable foolhardiness to open the floodgates now when the prospect of acquiring widespread immunity via a safe route is so imminent. Not least because we don’t even know if allowing mass infections amongst younger populations would even confer the much-heralded herd immunity state.

No one denies that Covid-19 restrictions have had a significant impact on the nation’s health and economy. That is why lockdowns should always be a last resort and, as demonstrated in other countries, can be avoided with a robust community test and trace system. But there is a reason why thousands of scientists and doctors signed up to the "John Snow Memorandum”, which calls “focussed protection”, by the Great Barrington Declaration’s proposal, “a dangerous fallacy unsupported by scientific evidence”.

To use her own words, Julia Hartley-Brewer was and is incorrect. We should help the millions of old and sick by minimising community infections and vaccinating people quickly, allowing everybody (and the economy) to carry on living.