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How to Cope with Surging COVID-19 | Munk Debates

EPISODE #52

How to Cope with Surging COVID-19

Be it resolved, the public health response to COVID-19 should focus on protecting the old and letting the young get on with living normal lives.

Guests
Martin Kulldorff
Stephen Reicher

About this episode

We’re heading into the twelfth month of a global pandemic and in many places the spread of COVID-19 shows no signs of slowing down. As infections continue to surge, countries in the northern hemisphere have started to reimpose lockdowns restricting people's movement and social interactions and closing portions of their economies. Many political leaders and their public health advisors argue that these kinds of restrictions are necessary as a crisis measure when infections spiral out of control, threatening a collapse of hospitals and devastating health consequences. They also advocate a strategy of suppression to keep infections low once the crisis is brought under control. But some politicians and public health experts are criticizing what they believe is an overly draconian approach. They say that it makes no sense to prevent the healthy and young from going about their normal lives when their risk of dying from the virus is less than the flu and they suffer considerable collateral damage from lockdowns. They argue that countries should adopt a focused approach to fighting the pandemic that zeroes in on protecting elderly and vulnerable.

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Guests

Martin Kulldorff

"With COVID-19 there’s a thousand-fold difference in mortality between the oldest and the youngest. That’s something we have to utilize as we fight this enemy."

Martin Kulldorff

"With COVID-19 there’s a thousand-fold difference in mortality between the oldest and the youngest. That’s something we have to utilize as we fight this enemy."

Martin Kulldorff is a biostatistician, an epidemiologist and a Professor of Medicine at Harvard Medical School. His research centers on the development and application of new methods for the early detection and monitoring of infectious disease outbreaks and for post-market drug and vaccine safety surveillance.

Stephen Reicher

"To send out many millions of young people who've made such sacrifices to keep the pandemic under control and expose them to a disease where we don't know the consequences is absolutely unethical, quite apart from ineffective."

Stephen Reicher

"To send out many millions of young people who've made such sacrifices to keep the pandemic under control and expose them to a disease where we don't know the consequences is absolutely unethical, quite apart from ineffective."

Stephen Reicher is Wardlaw Professor of Psychology at the University of St. Andrews. He is a fellow of the British Academy, of the Royal Society of Edinburgh and the Academy of Social Sciences. His work focusses on issues of social identity and group behaviour, including behaviour in crises and emergencies. Stephen sits on the COVID-19 advisory groups to the UK and Scottish Governments and is also a member of the UK group Independent SAGE.
 

Show Notes

During the debate Martin argues that the enormous difference in mortality rates between young and old should serve as a key tool in a COVID-19 public health strategy. The US Centers for Disease Control and Prevention (CDC) has put together a graphic that shows the wide span in hospitalization and death rates for different age groups starting with 0-4 years and going up to 85+ years.

During the debate Stephen makes the point that COVID mortality rates are not the only indicator that should be focused on when making public health policies. He refers to “Long COVID”, a non-medical term that refers to people who experience extreme symptoms of COVID that last much longer than a few weeks. This UK study tracked patients after they left the hospital and found that even after they had recovered “53% reported persistent breathlessness, 34% persistent cough and 69% persistent fatigue.” Other long term effects include heart damage, which you can read about here. Stephen also refers to a study that shows that a significant percentage of COVID-19 patients experience PTSD after being ill.

Both Martin and Stephen discuss the controversial strategy of population immunity (aka herd immunity). Stephen argues that a second wave in Brazil’s largest city in the Amazon, Manaus, which was hard hit earlier in the year, suggests that population immunity is not a strategy that will work.

Martin and Stephen disagree about the effectiveness of population immunity that is not based on a vaccine. Martin argues that the very small number of people who have been infected by COVID-19 a second time suggests that it is a powerful tool that we should harness. This article looks at the evidence to date on reinfections. While it confirms that COVID-19 reinfections appear to be rare, this may partly be due to the difficulty in scientifically determining second reinfections, which have to be genetically sequenced to be confirmed.  There is growing documentation of reinfections which suggests they might be more common than originally thought.

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