Martin Kulldorff: Lessons from Sweden for the next pandemic
Hello, and welcome, everybody. Thank you for coming in real life, those of you who have. I know there's been train strikes, and it's been hard. Those of you who are joining online, I think the camera is over there, welcome to you too. Thanks for joining the live stream. In a sense – there's some seats over here – in a sense, this already feels like fighting yesterday's war.
And partly, I'm over the moon about that, because you walk around the streets of London and people have mainly forgotten about COVID. It feels like we live in a post-COVID world. There are still posters on all of the tube stations asking people to wear face masks and it's amazing how few people are. It really feels like the public has even moved beyond the bureaucracy on this point and it does feel over. And yet, it does feel important to try to understand what did happen, not only for the historical record, but actually because it might suddenly become quite relevant once again, quite quickly, if we're faced with another pandemic or another threat that is interpreted like that.
The title of this talk is 'Lessons from Sweden for the next pandemic', and we will try to end up there, so we will try to be future-facing. I found out that Martin Kulldorff, the famous co-author of The Great Barrington Declaration – in fact, another of the co-authors, I'm afraid I'm going to out you here, Jay Bhattacharya is also present in the back of the room. Seems like a friendly crowd at this stage. This time, exactly. I thought we had to grab him and have a sort of in-person, a 3D event.
He was just telling me before now that this is actually the first interview in front of a live audience that he has done, so strict have the pandemic policies been in Harvard and and subsequently. When we first spoke, it was on the day of your declaration. We did a YouTube interview, and the three of you were sitting there in the house in Great Barrington. And this was, I think, what month was it in 2020, October? October.
This felt very fraught. It felt momentous and I think it was momentous. The atmosphere, even then in October 2020, was very, very tense. One remembers previous great moments of dissent in history, that almost felt equivalent. I was going to say Martin Luther posting his, whatever they were, treatises on the door of the church.
It felt quite momentous. And predictably, the reaction was very, very strong. Now, I would say, the atmosphere has changed.
And in some senses, the arguments have, some of them have been won, some of them have been softened, and you're no longer crucified in the public square for having a range of views on the topic of the pandemic, which is good news. But what I wanted to start with, and really the reason for this conversation, is that on the topic of Sweden – and I confess a bias here, I am half-Swedish, in fact, my Swedish mother is even in the audience – if you go around asking people about the Swedish experiment, or what happened during the COVID pandemic in Sweden, most people – you should try it – most people will tell you, "Oh, that didn't that didn't end well did it? That was a bit of a disaster. Shame. That didn't end well." And it feels like the history of of that period was written at a certain point during the experience of the last two years, which was before we had all the information. A chart that I want to put up here, and we're going to keep up there, is the deaths per 1000 of all of the countries in Europe, from COVID since the beginning, and as you can see, Sweden is very much towards the bottom of the list.
It's 20th out of 28 countries. And whatever your view on the details, and I know people like to get geeky about them and hopefully we will, that is a hard number to talk away at the end of this conversation. So Martin, welcome. Thank you very much. It's a great pleasure to be here.
Let me just start with with with an open question, then. Was the Swedish approach to COVID a success or a disaster? I think Sweden took the right approach. They follow the basic principles of public health, that are long-standing. Sweden did not go into panic. So in the overall way of things Sweden did, I think, great. It managed to keep the deaths from COVID down at the same time by protecting older people, at the same time, as they didn't have other collateral damage on other public health, on cancer, cardiovascular disease, mental health, and so on.
So I think Sweden took the right approach and the right or principles of this. There were some issues that they could have done better, and we can talk about that later. But I think it did good. I think, though, that we shouldn't really talk only about Sweden, because, if you look at the neighbours of Sweden, Finland, Denmark and Norway, they took a very similar approach to Sweden. They were not in the news media to the same extent.
But at some points, Sweden had less restrictions than the neighbours, but at other points during the pandemic, the neighbours actually had less restrictions than Sweden. So all those four countries, I think, took a much lighter approach to doing general lockdowns, general restrictions, focusing more on on protecting those who really needed protection, the older people. So you would have us remember a Scandinavian approach? Yeah. And they sort of influence – that is the point with Scandinavian countries are very close to each other. So they influenced each other in how they dealt with the pandemic.
I'm going to dive straight into a potential and controversial one, which is, you talked there about Denmark and Norway. Usually, if you go into any conversation, saying that Sweden did well or had a better result than many European countries, the very first pushback you will get, is that, yes, true if you compare to other countries, but compared to the Scandinavian countries, they had a very bad result. At some points it was ten times the deaths per 1000 of Denmark and Norway, that has since become tighter, but what is your explanation for that? Why did Denmark and Norway have so much better final numbers than Sweden? So in terms of the countermeasures and the amount of lockdowns, they were very similar.
But also if you look at different regions within these countries, they're actually quite big differences. I didn't look at the numbers recently, but sometime in 2021, I looked at comparing Stockholm, the capital of Sweden, with my home province, which is up in the north Vasterbotten. And Stockholm had three times as much mortality than my home province. And the national policy was the same.
So there are regional differences that happen because it can start earlier in one place, for example. But what about Denmark, for example, they famously shut international travel down straightaway, when Sweden was keeping it open for months afterwards. They would probably argue, or most people would say, that helped their pandemic response and maybe if Sweden had done that, they would have done better.
What's the response to that? I think it was too late for Sweden to do it. In the winters, we'll have winter vacation, where people go skiing. And in the north, we go skiing up in Lapland.
In Stockholm and south, they go often skiing in the Alps (some go to the north also). But those areas which had the winter vacation first in Sweden, they had less COVID early on. Stockholm had it among the latest.
So they had a lot of people who went to Italy and got infected there. There was also others who travelled to London. So tere was a lot of travel during this winter vacation, and especially from Stockholm. So if Sweden had closed before that winter vacation, then I think there would have been less COVID early on in Sweden. So you said there are things that Sweden could have done better. Just to make sure that we're not accused here of just kind of whitewashing the Swedes – what are they? What should Sweden have done that it didn't do? So a few – I also want to say what Sweden did specifically rather well, but we'll do the negatives first.
So one thing is in Stockholm, they did a terrible job protecting the older people in nursing homes, during the first wave of the pandemic. There was too much staff rotation and they should have done better isolation of the nursing homes, during the early time period. For example, they should have had young staff members who could live more permanently in the nursing home during the first wave. And then once the testing came to do daily testing of nursing home staff, and then do less staff rotation so that there's less people who actually go from one nursing home to another nursing home and so on. They should also have less rotation in terms of – Sweden has a very good system where older people can get home service, somebody comes to help them with the cooking and cleaning so they can still live at home – and there should have been less staff rotation on that side also.
So that's one thing that Sweden did not do so well, I think. Another one is I think that Sweden never closed the schools and daycare for ages 1 to 15 during the first wave which was very good. And I think it was the only major Western country who did not close schools. I think Iceland also kept them opened as the smaller country.
But I think Sweden should have kept the high schools and universities open also during the first wave. For example, if we kept the universities open, there would have been less multi-generational mixing because the students went home but if they had been at the university they would have mixed with younger people instead of older family members. So you think that actually was counter-effective? It was counterproductive to do it, yeah. A third thing is there were older people who were working in very exposed industries, like cab drivers for example, or bus drivers. They should have been given a sabbatical during the height of the pandemic, not in the summer where there was very little transmission, but during the peak of 2020, and then the next year, the peak there.
So they could have been given a few months of temporary early retirement so they didn't have to work in these exposed settings, until the vaccine came and then they would be fine again. So I think Sweden could have done a better job with people who are still in the workforce, but at the upper ages of 60 plus. So the answer then, in terms of differences – because that's usually the argument that comes first, differences between the Nordic countries – you don't feel that had Sweden adopted an approach more like Denmark, where they had been severer on things like international travel, they could have got a result closer to Denmark's? Was that possible? I don't think so because it hit Stockholm sooner and earlier than it hit Copenhagen or Helsinki and Oslo. I promised that you could give us your top three good points from what Sweden has done. So I'm going to fulfil that. What comes to mind first? So I think the most important thing is to keep the schools open and the daycares open.
I think if you look at the US where I live, to me, that's the biggest mistake of the pandemic, the close of schools. It had no positive effect on the pandemic and the collateral damage on children has been enormous. You can't just keep kids away a school year and think that nothing is going to happen.
So while kids do get COVID, there's more than a thousand-fold difference in mortality between the youngest and the oldest. So they are at very minimal risk. They are at less risk from COVID death than from influenza death during a typical influenza year.
So to me, that's the biggest mistake that the US did and the best thing that Sweden did, to make sure that the schools were open. Sweden also did other things that was good. One thing they did very early on was to make sure that if somebody was sick, they could stay home without losing pay. So if they had symptoms, they could just stay home and they didn't lose any income. So that was a change that was done very early on.
And I think that was very effective because again in the United States, you have poor people, they feel a little bit sick, but they can't afford to stay home because they have to have income. So then they go to work. So I think that was a very smart thing that the Swedish government did. A third thing was the vaccine rollout.
Again in the United States you could see on on Facebook or Twitter, young people in their 20s or 30s were bragging very early on that they got the vaccine, even though they were very low risk for mortality or severe disease. Sweden was very, very strict to do an age-based approach. So at the beginning, the health care workers was an exception, so healthcare workers, then by age. And it was very, very strict, and actually some people got fired, because they took the vaccine out of order. And I think that really helped Sweden.
If you look at the first wave in the spring of 2020, there is a peak of cases and a peak of deaths. And then in the second wave that peaked in December of 2020, there's a peak of cases and the peak of deaths. And then the third wave kicked in April of 2021, and there's a peak of cases, but there's no peak or deaths. And that's because the oldest people had been vaccinated. So they were protected by the vaccine.
So you put that all down to the vaccine? That difference in that I believe is because of the vaccine, yeah, that they protected. And we know that even if you have the vaccine, you will eventually get COVID. But it does protect older people from severe disease and mortality.
So I attribute that to the... We'll probably come back to the vaccine. I just want to put another chart up, if I could, which is the history over time of this story. And I'm going to ask us to take a moment of time travel and just revisit certain key periods because these were huge, huge arguments. And intellectually I'm not sure that we are quite clear what exactly did happen and what we should be thinking? When the pandemic first hit, and we were doing interviews and we were talking to people, we knew that Sweden had had, more than Nordic countries but less as we see from the red line, less than the UK.
And then there was that magical summer of 2020. And I remember going to Stockholm in July. And suddenly, it was like, here everything was shut down and there was masks everywhere and it was everywhere, and then you went to Sweden, and it was just like normal life. No one seemed to be very worried about it. The charts weren't going up.
And the hope that we had in that summer – I'm speaking personally but I'm sure that many people shared it – was that somehow the magical herd immunity had been achieved. And I know because I interviewed Anders Tegnell that summer in July, and he definitely thought that immunity was part of the reason why those charts had flattened. And I asked him, "Do you think in the case of a forthcoming second wave, Sweden will be better protected because of that than other countries?" And he said, yes, he did expect that. Did you also think, during that first summer of 2020, that some form of herd immunity had been achieved in places like Sweden, and that was why those charts had flattened? So the answer's a little bit complex.
So I was pretty sure that there will be another wave next winter. That's what I expected. And that's why we wrote the Great Barrington Declaration in early October of 2020 because we expected there will be another wave and we didn't want schools to close etc.
And we wanted to protect the older people. I also wrote an op-ed in Aftonbladet, which is one of the big newspapers in Sweden, urging Sweden to do more to protect the older, high risk people as we were approaching a second wave. So in that sense, we hadn't reached herd immunity, because there was going to be a second wave. On the other hand, we know now that this is a seasonal virus.
So it's more common in the winter than in the summer in the Northern Hemisphere. And that's because the herd immunity threshold varies by season. So when we went into 2020, there's less transmission, therefore, the amount of immunity that existed was enough to keep it down.
So the herd immunity threshold was lower in the summer. And then as the winter come, the herd immmunity threshold goes up. And now we'll have another spike. So the herd immunity threshold is not a constant. It's something that varies over time, through the seasons.
So in that sense, it was correct that we had sort of a temporary herd immunity in the summer of 2020. But then when the herd immunity threshold goes up again, we no longer have herd immunity. Were you disappointed, were you surprised or disappointed when there was such a big second wave in Sweden in winter? I expected a second wave. I did not know how big it was going to be.
I also think that you can see that when the second wave came, it came sooner in those places where there had been less before, and it came later in places where they had more before like Sweden. And that's also because you already have some immunity. So that means that with some immunity it takes longer until you reach that level where you don't have the seasonal herd immunity anymore. So one thing that happened, for example, is that some of the countries in Eastern Europe, like Czech Republic for example and I forget exactly which others, they were praised in early 2020 for all their lockdown measures that kept it at bay, but then, of course, they were hammered in the second winter. So I sort of expected the same thing as Anders Tegnell, that if Sweden had had it more early on, they would have it less later on. And that's sort of what happened, that other countries catched up with Sweden, and then sort of passed.
I remember it very clearly because I had also hoped that, and then when that winter did come, Sweden had an even bigger surge than the neighbouring Nordic countries again. The catch up has happened much later. And I just wondered what your thoughts are on this, that that phrase herd immunity that everybody was arguing about for pretty much two years, it was this concept. It feels like it's now been retrospectively redefined by both sides in some way. And if it's just a constantly moving number, it's not really a useful concept is it? The idea was enough people were going to get immunity that suddenly infections would fall off a cliff, and it was this natural phenomenon that was on our side.
And I think of all the arguments on the anti-lockdown or light side of this, herd immunity is the hardest one for for that side because it was never reached. Either those countries that had got it worse first time around then got it, continued to get it worse, and then there were new variants and it feels like the magic moment that we had hoped for didn't come. Am I being overly negative on that? Well, I don't know if herd immunity is a magic moment, but the fact that you have different levels of herd immunity, or in a seasonal pattern, is not a surprise, I think. Early in the spring of 2020, we didn't really know if COVID was seasonal or not. Now we know it is.
And the seasonality comes from having this herd immunity threshold that sort of changes. And because it's just that during the summer, you transmit it to fewer people, and in the winter you transmit to more people. And that's what creates the different herd immunity threshold over time. But I think what also happened, which I think was sort of tragic, is that we're always going to have new variants. That's a given, there's going to be new variants because of mutations. And the new variants that are going to take over are the ones that are easier to transmit.
So new variants are always going to be more transmittable. But what happened because of the lockdown, you get a pandemic curve that sort of stretched out over time, which means that any mutation has a lot of opportunity to spread worldwide. If you have less lockdown, things happen more quickly and more at the same time. So any mutation that happens then is not really going to affect the whole world in the same way. So what happened is that the earlier variants, they were less transmittable.
So that means that with the earlier variants, you have a lower herd immunity threshold, which means that you can sort of stop it before, while still having a big chunk of people who were not infected. On the other hand, because of lockdown, we get variants that were more transmittable and the Omicron variant is very highly transmittable. So that means that the herd immunity threshold is much higher.
Almost everybody now is going to get COVID sooner or later. So is the logic of what you just said that the whole world made COVID-19 longer and worse through these lockdowns? Is that your opinion? Yeah. And of course that's just one aspect of lockdown because the the major catastrophe from the lockdowns is all the collateral damage on public health in terms of people not getting their cancer screening or cancer treatments. And therefore maybe they'll die three years from now instead of fifty years from now. Cardiovascular disease outcomes, mental health has been deteriorated in many, many countries.
Diabetes care not as good, childhood vaccination rate was plummeting in the US – in Sweden, they held steady – but in the US they were plummeting. And those reduction of vaccination efforts for common childhood diseases, that has consequences. So theoretical question, what would have happened if the world had done nothing at all in response to COVID-19? I know that's not what you were suggesting in the Great Barrington Declaration, you had this concept of focused protection for the elderly or for vulnerable people, but it remains controversial how practical that was and we can talk about that.
But what do you think would have happened if there was no public policy response? Then a lot of older people would have died, and of course a lot of old people did die. But do you think more older people would have died? We're looking back two years after right now... In some countries more older people would have died.
For example in Sweden, if Sweden had done nothing, more older people would have died. But overall, and this is where it starts being interesting for future pandemics, you still think faced with pathogens or threats equivalent to COVID-19, there needs to be a major public health intervention. You don't think that minimal intervention is better? There should have been more intervention that there was in terms of protecting the older people. I think that's one of the tragedies of how we dealt with this pandemic, that we didn't properly protect older people. Did anyone manage that? Is there any country or state or part of the world that you would point to that did manage to protect the vulnerable? So not 100%, because that's impossible.
So there was never an opportunity to eliminate all death among older people. That would be an unrealistic goal. But if we compare, for example, after the first wave. So they did antibody surveys in the summer of 2020. They did a very good survey in Spain, I think they surveyed 60,000 random people of different ages. And we can see in Spain that the percent of people who were working-age adults like 20 to 65 – I forgot the exact age range – the percent with antibodies in that age range was about the same as the percent of people in 65-plus, in the retired population.
So they didn't do any focused protection because the proportion exposed was the same in those two groups. I think it was about 5/6% in both of those groups at the time. Sweden also did a survey and Sweden also had about 5/% among the working-age adults, but only 3% with antibodies in the older, retired people. So Sweden did – that's hard evidence that Sweden did manage to protect the older people in the way that Spain did not do. So can I ask about – I don't have those numbers for the UK.
So I don't know exactly where UK falls in there but.. So COVID-23, or monkey pox two, or whatever the new big fear is – and I think we can be confident there will be future pandemics and that people are certainly more sensitive to them than they were previously – so I think it's reasonable to expect that there will be future fears probably quite soon. When that happens, what should a responsible government do? Is the answer then, that you think your Great Barrington plan remains the responsible one? So there should be a dramatic intervention. Suddenly, groups in society that might be old and vulnerable should be tucked away, hidden at home protected? And then everyone else carries on as normal if they feel confident doing that? Is that the plan for COVID-23? I don't think it will be in 23. But there will be another pandemic.
We have had pandemics throughout history for hundreds and thousands of years. So yes, there will be another pandemic. It might not be a coronavirus, it might be influenza or, or who knows what. But they will for sure be a pandemic. The key thing is not to copy the Great Barrington Declaration for COVID because that was COVID-specific.
Because in a sense we lucked out with COVID because it didn't affect children very much. To me, when I first read about the outbreak in Wuhan, I was nervous and afraid for about 20 minutes. Because I'm a parent of three kids. So as every parent, I'm much more concerned about their health than my health. So I looked at the numbers from Wuhan, it was very clear that the deaths were among the older people and at that time, you would expect about equal exposure because there weren't really any measures at that early on.
So it was very clear that this was a disease of older people, that older people were at very high risk, worse than influenza, but my kids will be safe. So that was very reassuring to me. But the next pandemic might not be like that. The next pandemic could be where the disease affects children more than adults, for example, the 1918 pandemic, the influenza pandemic, hit younger people more than older people. So what we have to do is follow the principles of public health, which is, one is you can't only look at the pandemic, in this case COVID. You have to look at other health outcomes as well.
You can't just shut down cancer treatment, cardiovascular, diabetes treatment, ignore mental health. You can't just keep people inside so that they can't exercise; exercise is good for your health. So you have to look at it as all diseases and not just COVID. And that was one of the huge mistakes that we did. Everything was focused on COVID, and we ignored all other aspects of health.
So that's the principle that we have to follow in the next pandemic also. Proportionality. And I think we can bank that as a lesson from Sweden because that's something Anders Tegnell talked about a lot. I'm Minister for Health, not Minister for COVID, that was his line that he kept repeating. He did very good on that. And he mentioned that many times during his press conferences, and I think the Swedish public understood that because he made it very, very clear.
So proportionality is our lesson number one. Lesson two. Another one is that we have to look at it long term, not short term.
In the beginning here, if we looked at here you would think, "Okay, UK and Sweden is doing terrible, but the rest of Europe is doing great, so they're doing the right approach." Well, if you just push the pandemic forward, that doesn't really help. And it can actually harm because then people will get sick when they are older, at which they have more risk.
People were just looking at the current data instead of looking at the projection for the future. And there's also something that Anders Tegnell was very, very vocal about. I know, during one of the interviews, he said, "Come back in the year, and we'll see." So he very much thought of it long term.
And that's another principle that we have to do whatever the next pandemic is. And then the third one is, we have to focus on those who are vulnerable, who are at high risk, and everybody's not going to be at the same risk. So if the next pandemic is mostly dangerous to children, well, then we have to protect the children. If the next pandemic is mostly dangerous to old people, we have to protect the old people. If it's mostly dangerous to people with some underlying health condition like diabetes, that's the people who we have to protect. So that focused protection, I think, is always the key thing to protect those who are at highest risk.
But who that group is, for the next pandemic, we have no idea. In this case, it was the older people, but next time it might be a different group. So this is the hardest one, isn't it? I think the first two principles there, which is keep things in proportion, keep a longer term view, I think a lot of people would now sign up to and in retrospect feel that weren't necessarily adhered to. This third one of focused protection, remains very unproven in a sense, because the argument was, you can't isolate one group in society, because everyone moves around all the time.
And we don't have mechanisms to do that. And actually, this whole atmosphere of solidarity that everyone was so keen on, it was all about everybody trying to keep levels low, so that it didn't reach the older people, and I haven't yet got an example of a country where they did manage it. So that's the one I struggle with most, that in a future pandemic – for example, children. We can't really take children out of society because they need to be fed and clothed and looked after by adults who are mixing.
So are you sure that we should be trying in the next pandemic to have these lockdowns for certain groups in society, even if they're voluntary withdrawals from society? We actually did focused protection and we did successfully. But for the wrong group. If you look, for example, at Toronto. You look at the different neighbourhoods, the wealthy neighbourhood, versus the working-class neighbourhoods. At the very beginning of the pandemic, they're about the same level of COVID. Lockdowns go in.
COVID plateaus in the rich neighbourhoods, continues to rise in the working class neighbourhoods. We see the same thing in Los Angeles. So in a sense, we did focused protection for young, wealthy professionals, like lawyers, or bankers, or journalists or scientists, and successfuly so because there was a differential in Covid mortailty in these groups. And we can never separate it completely. So we can never protect a group 100%. But if you take all the cab drivers, and let them – who cannot work from home, because cab drivers cannot work from home – but if you let them take a sabbatical for a few months, during the height of the pandemic, they are less likely to be exposed.
Some of them will still be exposed and some of them will still die, but you reduce the numbers there. And I think also, the numbers I mentioned from Sweden versus Spain, shows that you can actually make a difference and reduce the exposure to the older people like they did in Sweden, not perfectly. But as compared to Spain they did it. And I think the difference between these curves of, for example, Sweden and Spain, is that Sweden was more successful in protecting the older people. If you look at Norway, I think it was even more successful. I think Norway has a different nursing home system than Sweden, which is much better in terms of infectious disease prevention.
They tend to have smaller homes, for example, and less commercial homes. So what about the vaccines? I feel like I've got to ask, is your view that the vaccines have been a success? It sounds like you think they have. Many people will be more disappointed in the performance of the vaccines.
When they first were announced, it was going to be 95% efficacy, which meant 95% of people wouldn't get it as it was defined at the time. That didn't happen. And now we're on booster number four, for many people. Do you feel the vaccines have have worked? It has both been a success and an enormous failure. So first of all, in general, I'm very much pro-vaccines. I've been working with vaccines for over 20 years.
And I think vaccines are one of the greatest inventions that we have as humankind, and has saved – like the smallpox vaccine by itself for example has saved millions of lives. But the way that the vaccines were launched and utilised, I think, was a scandal. You mentioned that there was 95% efficacy. And the clinical trials for the Pfizer-Moderna vaccines show 95% efficacy for symptomatic disease during the few months, maybe three or four months, after getting the second dose. Now, symptomatic disease is not what we really care about.
What we really care about is deaths and hospitalizations. So the clinical trials that came out for Pfizer-Moderna did not show a reduction in mortality for these vaccines. Neither did it show a long term reduction, this was only a very short term. So what it turns out was that the immunity wanes very quickly.
So you will still get COVID. The protection against death stays a little bit longer. Because it when we spoke earlier, just now, you talked about the third wave in Sweden and how there was a wave of cases, but there wasn't a wave of deaths. And you did put that down to the vaccine.
So you do think – So that was a huge success, because the third wave in Sweden came a few months after the oldest people had been vaccinated. So by vaccinating the older people first, they managed to push that wave down. If they had done vaccinations equal among old and young, there would still have been a peak, because the old people would not have been protected as much.
So what's the scandal? You use the word scandal, what's the scandal? Well, it was over-promised, it was over promised. But the other scandal is that there has been a denial of natural immunity. So if you have had COVID, you have excellent immunity. You might still get COVID at some point in the future, but it will be much milder, just like it is if you get infected by one of the other coronaviruses which you had been exposed to probably since you were a child.
So this denial of natural immunity by many public health authorities, including the current head of the Centre for Disease Control in the United States, is very bad, because why would you vaccinate people who already have immunity when there are a lot of people around the world who don't have it, and who need the vaccines? So you're wasting vaccines on people who don't need it, when it should go to the people, old people, both in the US and in Europe, and India and Brazil, and so on, who have not had a vaccine and who need it to protect themselves. So I think that's one scandal. Also just denial of natural immunity. People know about this, we've known about natural immunity since 430 BC during the Athenian plague. So this is not a new concept. It would have been shocking if the immunity from the vaccine was better than the immunity from having recovered from COVID.
So by pushing these vaccines on those who already had COVID, was both unnecessary and unethical, but it's also diminishes the trust in public health authorities and diminishes the trust in vaccines. For example, the polio vaccine and influenza vaccines are incredibly important vaccines. So there's now a growing amount of vaccine scepticism and vaccine hesitancy that has spilled over on other vaccines.
So it's very natural and I very much understand, but these vaccine fanatics who insisted that everybody should be vaccinated, including those who already have immunity from having recovered from COVID, I think they have destroyed the confidence in vaccines in general, to an extent that a small group of pre-COVID, so-called anti-vaxxers had never succeeded. So I find that very, very disappointing and disturbing that they play around with the scientific knowledge that we've had for so long. And thereby destroying the confidence in vaccines, other vaccines that are critically important. So you think they should have remained voluntary across the board and no mandates or what's your view? I don't think there should be any mandates for vaccines, for any age group. Also I work on vaccine safety, itakes time to to know to what extent there are adverse reactions and we still don't know the full picture of that. So for that reason alone, there shouldn't be any mandates.
But I don't think for example, children should get the COVID vaccine. They are at miniscule risk from serious complications from COVID. And we know that there are some adverse reactions like myocarditis, for example, but we don't know the full extent of it. And by this point, more than 75% of kids in the US have had COVID, there's probably a similar number in Europe. So those 75%, they already have excellent immunity. Are you worried about this? There's these studies coming out showing adverse reactions to mRNA vaccines.
The data is still being gathered. We're not sure exactly what it shows. But do you think that they are causing harms? We know that there are certain harms because we proved that myocarditis is an adverse reaction to the mRNA vaccines. We know that there are blood clots from the AstraZeneca and J&J vaccines. We know about anaphylaxis.
But we don't have the full picture yet. And I think eventually, we will know more about it. But it's always a risk-benefit.
So for all the people who haven't had COVID, the risk of COVID is quite high for mortality, maybe up to 5% risk of dying. So even if there's a small risk from the vaccine, the benefit outweighed that small risk. But for a child who has miniscule risk of dying or of serious complication of COVID, even if it's a tiny risk of adverse reactions, that will overweight the benefits. So you have to always balance the risks and benefits. And because the risks vary so greatly with age, you have to take that into account when you decide who should get vaccinated or shouldn't. So what what would the age be, knowing what you know now, what in your view is the age at which it's no longer sensible risk-reward wise to take the COVID vaccine? So it's hard to say a specific age.
But if you were 83 years old, or 77 years old, and you haven't had COVID then I would certainly recommend you to take the vaccine if you haven't already done so. Especially in the fall when the next wave is approaching, that seems to be the best time. If you're 50? On the other hand, if you are five or fifteen, I would not suggest that you should be vaccinated. But what that cutoff is, is we don't know.
It's impossible to say what the correct cutoff is. And that's one reason for not doing the mandate. In a moment, I'm going to come to some questions from the audience and also from our online audience. But I just wanted to ask a bit more of a personal or reflective question, which is that leaving aside the technical arguments over lockdowns and vaccines and all of that, how has your personal experience been of this? You've been attacked a great deal. You're no longer a professor at Harvard.
You have parted company with that university, and you are now focusing on these other organisations, which are Brownstone, and – – the Academy of Science and Freedom. The Academy of Science and Freedom. What reflections do you have about the atmosphere, the politics, how the debate became so unbelievably hostile? And I suppose I should say is there anything we can learn from Sweden in that respect? Do you think there's a cooler temperament up there that we should try to remember in future controversies? So I think there's a lesson to learn from Sweden because, since I read Swedish I've been following the debate in the Swedish news media. And the people in Sweden who opposed Anders Tegnell and his strategy, and wanted to do that more lockdowns, like the UK and other European countries, they were heard in the Swedish media.
So there was a discussion on both sides. And I think that was very healthy, very, very, very good. And then people can read the different arguments. I think in the US, it was very one-sided. People assumed that there was scientific consensus for the lockdowns. There were several of us among my own colleagues, infectious disease and other colleagues that I know personally, the majority were against the lockdowns.
But there was this perception that there was a consensus for lockdowns and if somebody spoke out, they were thrown away as that's one person or they're not an epidemiologist, they're something else. So I think that's where the Great Barrington Declaration made a difference. Because when that came – there was nothing new in it. Of all the things I've ever published, it probably had the least novel scientific ideas in it. It was already there in the pandemic plans that countries had for years before and a lot of people had said it before including the three of us.
But the difference was that it came from three people other than one person. All of the three of us have worked on infectious disease technology. It included the person who, in my mind, is the preeminent infectious disease epidemiologist in the world, Professor Sentra Gupta at Oxford University. And all of us came from reasonably respectable universities, Oxford, Harvard and Stanford. So it was impossible to ignore.
So I think – we were attacked, including by the NIH Director Collins and Anthony Fauci and Jeremy Farrar at the Wellcome Trust here and Christian Drosten in Germany who called us pseudo-scientists. But I think the key thing was to show the public that there was not scientific consensus for lockdowns, that there were many scientists, and we had thousands and thousands of other scientists and public health practitioners who signed it, as well as hundreds of thousands in the public. So it was proof that there was not consensus, it sort of popped the bubble, proving that there was no consensus for lockdowns and that's why it was attacked, I think. How was it for you though? You're there at Harvard, do you feel that you were defended by the university properly? No, I didn't get much defence from the university, no.
Any defence? No. I got private emails from many of the faculty members, many of whom I'd never heard of before. So there was such support, yes, from individuals. But we got to that incredibly scary place where at one of the world's preeminent educational establishments, a professor is getting secret, furtive emails from colleagues supporting them, but nothing in public and being attacked in the media and by members of the government. The university doesn't defend them, even though they're trying to delegitimize your professional work.
We got to quite a scary place, didn't we? I think that's a huge problem for science as we move forward, because science can only thrive with discussions. It's a process. And if we don't have open discourse about science, science is going to die.
So as we go forward, I never doubted that we would be right, that Sweden would come out and proven to have been right about the pandemic, I never doubted that, I knew that was going to happen. But I think we have a big problem in science that we have to fix how the science operates. I think it's very centralised. It's what Dr. Gupta says, it's a real cartel system.
So within different branches of science, you have a cartel system who is controlling the research funding, publications, and so on. And, for example, Anthony Fauci sits on the biggest pile of infectious disease research money in the world, and he has for 40 years. So it's very hard for any scientist to object to what he's saying, because that has consequences.
It can have consequences down the road. So we have to decentralise how science operates so we don't have this cartel system. Okay, I'm going to come to some questions, first of all in the room. I have Toby here, but I'm going to go to a guy at the back first, and then Toby in the front row. Thank you for this lesson. If you just say your name and then ask your question.
My name is George Tricush. I'm an advertising professional. I have a degree in political philosophy. But I'm actually about to study decision-making as a PhD student, it's related to risks. So I would like to ask three questions. I'll aim to be very short.
Can we just choose one? Two! Right. So the first question. You said in some future pandemics, the initial response, my worry given that we don't know which particular group is the vulnerable one. Would you say that initial lockdowns might be actually a good response if we don't know? So, some academics and analysts argued in favour of initial lockdowns, until we find out what actually what should be the the outcome.
The second question is related to collateral damage that you're actually very into. Would you say that there is not only collateral damage related to what we know is the risks from previous pandemics and pandemics we know, like mental health, physical health, a lot of these, but there are also those unknown unknowns like we don't know when we impose lockdowns indiscriminately, top-bottom, we can cause many problems we are not aware of. That's why I'm surprised that like authors like Nassim Taleb, who is very well-known for unknown unknown concept, actually argued in favour of lockdowns, but somehow failed to realise that unknown unknowns are also relevant for these collateral damage side. So this is the two questions, sorry for being too long.
So on the second question, I agree with you, 100%. I think it was more of a comment than a question. So I agree with you. On the first one, I think whenever there's a new pandemic, we will know pretty quickly who are at risk, because we will find out who is dying. So I'm not concerned about that. I think that will be clear very early on.
So I think the one argument for an early lockdown is to flatten the curve so that everybody does not get sick at the same time. That just means to push some of the cases a little bit in the future so that we can take care of people when they get sick. So I think that is an argument for lockdown, but I think that lockdown should also have been for older people because they were the ones who went to the hospitals, they were the ones who were potentially overwhelming the system.
So in my view, that early lockdown should also have been focused on the older people to make sure we spread those cases out. So no universal lockdowns? Not for COVID. Toby.
Do I need a mic or shall I just speak loudly? Thank you. Toby Young. I'm the editor of the Daily Sceptic, the editor in chief of the Daily Sceptic.
When it was lockdown sceptic, I think you contributed. I just wanted to begin by saluting your moral courage, your commitment to public health and scientific rigour. You paid a heavy price, though you may not have realised you would have been paying that price when you signed the Great Barrington Declaration. But nonetheless, I think it took a great deal of moral courage.
So thank you. But my question is, you referred earlier to the efforts by Francis Collins, Jeremy Ferrar, Anthony Fauci, Christian Dorsten and of course many others, over here the signatories of the John Snow Memorandum to discredit the signatories, particularly the three principal signatories, of the Great Barrington Declaration. And to delegitimize you, to cast you as beyond the pale in order to preserve the illusion of scientific consensus behind the lockdown policy. And my question is about their motives. And within the lockdown sceptic community, there is this great schism between the conspiracy theorists, and the cockup theorists, and I'm a cockup guy. But I find it difficult when arguing with the conspiracists.
They say, "Well, look, how do you explain the coordinated effort of these scientific gatekeepers, these controllers of vast budgets, these people with the ears of political leaders, huge influence over public policy, how do you explain this coordinated effort on their part to discredit you and Sunetra Gupta and Jay Bhattacharya?" You can't quite explain it for self-interested reasons. In a way they made themselves look foolish, and it's all come out now that it was coordinated – Jeremy Farrarr revealed it in his memoir – and if their faith is in the scientific method, why did they do something so antithetical to the scientific method as to try and demonise and smear people who are merely challenging scientific orthodoxy? Why did they in a way betray their faith? What they've done has undermined, as you yourself assert, public trust in science, which – that's their lodestar. So they've made themselves look foolish, they've betrayed their faith, there's no obvious self-interested reason for them to have done it. So what's the explanation if it wasn't that they were enlisted in some diabolical conspiracy? Martin.
Well, I can't read their minds. But I have two comments. One is, they clearly don't have faith in the scientific method, because if you do believe in science, you believe in open discourse. If somebody disagree with me, I want to debate them and discuss with them and use my scientific arguments to try to convince them or if they succeed, to convince me, great, that can also happen.
But that discourse, whatever is the end result, I think is critical and that is when you believe in science. So anybody who tries to shut down scientific discussion does not believe, I think, in science and enlightenment. So therefore, I don't think they do believe that, even though I can't read their brains. I think the other explanation, at least when it comes to Anthony Fauci is that he is a lab scientist. Does virology and immunology. He knows more about immunology than I do.
But he's not a public health scientist. And I think he doesn't understand infectious disease epidemiology, and public health. The principles of looking not only to one disease, but at multiple diseases, looking long term and not short term, looking at all members of society, not only those who are well enough that they can work from home. So those are the basic principles of public health. And I think that someone like Anthony Fauci did not understand because he's a lab scientist. He, for example, said, it's impossible to protect the older people with focused protection.
If you're a public health scientist, I think it's obvious that you can do it, not 100%, but it's obvious they can do a lot more. And I think Christian Drosten is very similar. He's a virologist, a lab scientist, with very little understanding of public health. But they were very well connected because they're sort of leading people in infectious disease in their countries, and Fauci is head of NIADI, Jeremy Farrar is the head of the Wellcome Trust, which is, I think, one of the biggest funding agencies of medical research in the world. They definitely had the Gates Foundation on board because I know that the Gates Foundation was actually calling people who were against lockdowns trying to convince them to tone down their criticism of lockdowns. Was surprising from to hear from a private foundation.
I just want to chip in with a follow-up question there, which is there not a third factor here, which is politics? It was a half scientific, half political controversy, because it's about how you organise society and, at least in the scientists I interviewed, those that seemed more on the political Left, were attracted by the romance of a big project that could unite society and could remake the world and would put their discipline in the centre of things. Neil Ferguson, I'm not saying this for the first time, but when I interviewed him, he said he thought it was an extremely exciting moment, that we were beating back a highly transmissible virus for the first time in history. And you could tell that it was glamorous, and it felt idealistic and progressive and all of those kinds of words.
Do you see yourself politically opposed to those people? Do you think you're politically more attracted to smaller government, to a more libertarian way of running society? I'm from Scandinavia. And if we look at the Scandinavian countries – the four main ones, Sweden, Denmark, Norway, and Finland – at the beginning of the pandemic, they all have socialist governments, social democratic governments. They were the governments in Europe who had the least restrictions. Norway had a Conservative government in the beginning, but through the election they shifted to a social democratic government. So if you look at the various European countries, for sure, I think it's the Scandinavian social democratic countries who took the lighter approach with less lockdowns protecting the working class and children, and so on, while UK had a Conservative government.
Germany had a Conservative government. Excuse my ignorance, because I don't know every – France had a Conservative government – America had Donald Trump. Exactly. And I don't know every country in Europe exactly where they are on the political spectrum but for sure, I think in Europe, it was the Left countries who were less sceptical towards these lockdowns.
And I think one interesting thing in Sweden, the Prime Minister, Stefan Lofven, as well I think Sweden was one of the few countries that actually had a member of the working class as the Prime Minister as the leader of the country, because he's a welder. And I think that could have something to do with it. He knows the concerns of the working class that maybe somebody like Boris Johnson does not understand. Okay, I'm going to take more in the room, but let's take one from online, people who are watching online.
I think Flo has some ready. Yeah, so I've got one here about variants. And it's quite a straightforward one from John Hawksley. And he asked, "Why has the original variant disappeared? Rather than herd immunity does each variant in fact have a limited lifespan because of cumulative failures in its replication?" I think it's because when there's a new variant that's more highly transmissible, that competes out the previous variants. And that can sometimes be a good thing, because if the new variant is less fatal, but more transmittable, that can actually be a good thing.
Okay, let's take a couple in the room. This lady here. Hi, I'm Alexa. So my question is – this talk is about the future – and the lessons learned aside, what do you think the ramifications of this pandemic will be? It makes me nervous – I was at university while the pandemic happened. I wasn't at primary school, I wasn't at secondary school – mental health effects, like all of that. I know it's a bit fortune-telling.
But what do you think the biggest impacts will be? I think there will be an enormous distrust in public health agencies. I think there will be an enormous distrust in science, in the scientific community. I think that will take decades to repair, if it can be repaired, I don't know. I'm sure there will be consequences, political consequences as well. They're obviously enormous public health consequences from the collateral damage, which I mentioned.
I think there's also economic consequences of these lockdowns that we're starting to see now. So I think the consequences are profound. And maybe we are in a tiping balance in terms of whether we sort of accept this as the standard way of doing things, which I think would be terrible, or maybe we go in a different direction, where we say, this was a big, big fiasco (which I think it was), let's make sure it doesn't happen, and let's make sure we repair the damage, and make sure it never happens again. I think in January of this year, the UK had its own ONS figures, the Office for National Statistics made available to the public.
And they spoke about the deaths from comorbidities, and the deaths directly from the virus. And it's no coincidence that the UK has the second highest obesity rate in Europe. And the number of deaths from comorbidities, if I remember correctly, were caused by obesity.
So what extent do you think as individuals, our individual responsibility to our health is also a responsibility to the communities we live in, to our society. And in regards of that, do you not expect that governments at this stage of the game should really be saying to the nation's, talking about the nation's health, how to lead the healthiest lives, and educate us towards that. I think that's always important to do and I think it's especially important during the pandemic. We know that if you're in good physical health, you have a better ability to fight an infection. So for example, you want people to be out exercising, you don't want people to stay at home, inside.
You want them out there running, walking, bicycling, canoeing, whatever, because physical exercise is important. So it's always important, but it's extra important during a pandemic. We're actually going to take three questions on the trot this next time, and then you can answer whichever one – the guy standing up at the back and then we'll go one from online.
Will Jones from Daily Sceptic. You talked about doing a lockdown for the old people in a future pandemic as well possibly. And I was speaking to an adult social care worker this week who said that she saw in her people that she looked after that old people who lived at home who previously could walk, went out for a walk every day, once the lockdowns came in, would not even be able to walk unaided from their bedroom to their lounge. And we know that thousands of old people during the lockdown – because we did lockdown old people, of course, along with everybody else – died as a direct consequence of lockdowns and also suffer, those who didn't die, suffered many misfortunes and harms. Do you think it's ever justifiable, given those harms, to confine old people, for example, to lock them down, given that the immense harmful impact that it has on them, not just talking about a little bit, but but actually many thousands of them dying? Or would it not be better just to let the virus, which is a natural event, just to take its course? Well, I don't think it's an either/or because we shoul