Having addressed the epidemiology of The Great Barrington Declaration, I want to move on to what I believe is its most problematic aspect: assuming that the population would have accepted it. The two big problems with this assumption are 1) young people in particular were not keen on getting or spreading COVID and 2) supporters of the GBD wielded a remarkable amount of political capital in the first year of the pandemic and failed to use it to implement their plan.
First, whenever we discuss the GBD, we need to realize that at its core it was an ask of the young. Young people were supposed to willfully increase their risk of getting COVID unvaccinated (perhaps to 100%) so that this plan could be attempted. Yet I have not often seen them included in the discussion of whether they are okay with that happening.
In my experience–and as a 23 year old, it counts–both my liberal and conservative friends were pretty much all on board to help mitigate COVID. I’ll start with the selfish fact that we’re not exactly a group that’s bought into making sacrifices for the economy (certainly not our health) given our relative sense of disillusionment with it. We are also progressive and racially diverse, with a sense of communitarianism shown in our broad willingness to adopt NPIs despite low risk, and a sense of injustice in our attention to the racial differences in mortality. Not all young people are like this, but disproportionately they are and no one would deny that.
I can say as well that many of us were less concerned with dying, and more with other effects of the virus. In particular, we have to realize that the term long COVID actually came out of a popular, non-medical movement headed by relatively young people who found themselves lastingly ill without prior risk factors. I personally was hearing of young and healthy people in my own life faring poorly, and when I looked back over the evidence surrounding potential harms I was surprised (COVID is by its mechanism of action a vascular disease, which means it can have systemic effects). Because I know my generation has a strong focus on disability, this is something we recognized as very serious and didn’t want to impose on ourselves or others.
As far as I can tell, the authors of The Great Barrington Declaration have not addressed how they would convince young people to go along with their plan. Yet the final paragraph of the GBD makes their behavior the cornerstone: “Those who are not vulnerable should immediately be allowed to resume life as normal…Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume.”
The vast sum of that activity would be young people who had not shown clear interest in conceding to the virus, despite Sunetra Gupta’s claim that “it doesn’t matter if they’re infected.” Even if they did, they may change course as the virus spikes, hospitalizing 1-2 of their friends, classmates, or coworkers, and leaving others disabled potentially for months. Repeat waves which seriously hurt even a small minority of those we care about would be hard to just accept when the risk is modifiable. I wouldn’t do it, and I don’t think most people my age would.
I say that too as someone who found they have a heart and lung condition during the pandemic (still don’t know what triggered my first episode of breathing difficulties, though I’m sure that if I caught COVID in the hospital it would have been much worse). Several of my peers at Harvard pointed out in response to the GBD that many health conditions go undiagnosed in the United States. There would be rare cases like me who wound up seriously ill, in the ICU or even dead, and frankly I don’t know how my friends or fellow students could just go on with life knowing that happened. I have to think they would feel terribly guilty, and doubt if what they were doing was justified. At the least, the GBD would need a high level of confidence and consensus going in. And while I can’t speak for every young person, I will opine that this does not seem like a plan that would fly with Gen Z.
More empirically, I can say it didn’t fly with the United States. We forget that its authors started the pandemic with quite a lot of political capital. That’s because they aligned with what the presidential administration already had in mind.
If you look back to March of 2020, you will find that President Donald Trump was deeply uncomfortable with the very concept of lockdowns along with some other public health measures from the start. His language was often strikingly similar to the rhetoric the authors of the GBD continue to use daily. A mere nine days into the formal lockdown he tweeted: “WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF,” a refrain he would repeat many times thereafter. The spirit of The Great Barrington Declaration is that the public health response to COVID was worse than COVID, and so bad in fact that two of its authors started a charity just to study its harms.
Trump battled Fauci in April with respect to re-opening. He would criticize him heavily as the main obstacle to re-opening, as Drs. Kulldorf and Bhattacharya have done. Trump called Fauci an alarmist in contrast to himself: “I don’t want to create panic.” Dr. Bhattacharya has written multiple times about Fauci stoking panic. Trump claimed that: “If it were up to the doctors, they may say let’s keep it shut down – let’s shut down the entire world…” A feature piece about The Great Barrington Declaration quotes Dr. Bhattacharya talking about COVID monomania, or sole focus on the virus above all else. All three authors talked at length about this perceived problem at the signing of their document.
Trump and his top health officials would later detail their national plan in a way that made it directly analogous to The Great Barrington Declaration. At the Republican National Convention in August he said “We are aggressively sheltering those at highest risk, especially the elderly, while allowing lower-risk Americans to safely return to work and to school.” There is no meaningful difference between this and the GBD.
Scott Atlas–Trump’s COVID advisor–was a proponent of many of the same policies as the authors of the GBD. I’m told he frequently corresponded with at least one of its authors, which if true makes a lot of sense. For instance, he came out and said on national TV: “Low-risk groups getting the infection is not a problem.” The GBD advocates: “allow[ing] those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection.”
More on the nose, Atlas would later tweet an article specifically about the GBD with the caption: “Top scientists all over the world line up with #Covid_19 policy of @realDonaldTrump: Protect the vulnerable and OPEN schools and society. That is the science!”
Alex Azar–Trump’s head of Health and Human Services–met with the authors of the GBD the day after it was published. Naming them specifically, he tweeted: “we heard strong reinforcement of the Trump Administration’s strategy of aggressively protecting the vulnerable while opening schools and the workplace.” This is him telling us that the GBD was the plan of the administration well before its official publication.
This wasn’t the only meeting the authors had with the administration. In fact, there was a far more important one two months earlier with The President of the United States. The day after this meeting, Trump described his strategy as: “sheltering those at highest risk, especially the elderly, while allowing lower risk Americans to safely return to work and to school.”
With repeat and explicit endorsement, the only fair conclusion is that The Great Barrington Declaration was the policy of the Trump White House. This was the administration in power during both pre-vaccine waves.
Yet when the administration pushed this plan, they were met with popular resistance. Trump ended up with a lower approval rating than Fauci, and dissatisfaction with his handling of the pandemic was a major issue in the 2020 election. Frankly if a plan does not work once endorsed by the country’s highest powers then it does not work. Because an epidemiological plan needs to meet people where they’re at, especially The Great Barrington Declaration which requires a high degree of cooperation to protect the vulnerable. We were nothing but divided that year.
My personal view is that the continued pursuit of anti-NPI politics is a factor in why the United States did poorly. And to make clear why, all I have to do is cite its authors. Drs. Kulldorff and Bhattacharya recently criticized my colleagues in vaccine advocacy by claiming that their overbearing push to vaccinate people made many not want to get vaccinated. I disagree. But if this is their premise, doesn’t it stand to reason that a relentless push for a public health plan people didn’t want would have further polarized the country?
The clear answer is yes, which brings me to the conclusion of this essay.