Tuesday 29 December 2020

"Underlying health conditions": the Brewer-Hitchens argument

There have been many sceptics, doubters and conspiracy theorists in the face of the Covid pandemic. Some said that the whole thing could be solved through 'herd immunity' without vaccination. That's to say the 'herd' (us) would become immune by virtue of us producing antibodies and/or the virus becoming 'weak', simply by being everywhere. Yes this would kill the 'very old' but - it was implied or stated - this wouldn't matter very much. The argument also turned on ignoring what happened with e.g. the Black Death, myxomatosis, or Dutch Elm Disease). A version of this argument suggested that the 'vulnerable' should be shielded. 

This argument developed into the 'underlying health conditions' argument. This states that as Covid mostly affects those with these conditions, then the precautions we're taking are too severe and risk many other people's lives in the process. This argument comes from e.g. Peter Hitchens and Julia Hartley-Brewer. For the argument to stick, though, we need a good picture of numbers of who has these underlying health conditions. What seems to have happened is that the argument has implied that 

a) very few people are dying from Covid anyway and that 

b) most of this few are people with these conditions.

So the argument rests on statistics. 

And to be fair, they have a remedy: shield these vulnerable people along with the 'very old' (that's Brewer - though as her stats only included the 'under 60s', she may think that the over-60s are therefore 'very old'. Not clear from her statement.)

Let's unpack that.  What are these 'underlying conditions' that correlate with death from Covid? If you go  online you'll find a wide range of these from asthma to high blood pressure, from rheumatoid conditions to obesity. This is important. The Brewer-Hitchens argument and remedy can't be put forward,  if we don't know what range of illnesses are 'netted' by the term 'underlying health conditions'. And once we're sure which conditions probably put us at risk from dying if we contract Covid, we need a sense of what numbers are we talking about. After all, Brewer and Hitchens are advocating a radically different policy from the one(s) that the government is suggesting: namely, shield these people and the 'very old'.

Responses on twitter have ended up with figures from between 20 and 50 million. Perhaps you can do the sums of people of all ages who are obese, asthmatic, suffer from cancer, high blood pressure (more than 140 diastolic), etc... It's a lot. And now add in, let's say, the over 75s as the 'very old'. 

And now let's apply the Brewer-Hitchens remedy: shield them.  I think it's fair to ask, where? how? Or why wouldn't shielding these millions not in effect be the same as some kind of lockdown? Or do they have another plan in mind? At one point in March, Robert Peston seemed to be passing on a government plan to put hundreds of thousands from these categories into army-style camps. No one took up what he claimed was an inside story so perhaps it was quickly dropped. 

In other words, we have to keep asking, what underlying conditions put Covid patients at risk? How many people are there in the population who have these conditions? How would we shield them without also in effect limiting the movement of millions more on top of that total? 

Surely, it's for them to flesh out the details, the stats and the proposals?