The Great Barrington Declaration
As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.
Coming from both the left and right, and around the world, we have devoted our careers to protecting people. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice.
Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.
Fortunately, our understanding of the virus is growing. We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.
As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. We know that all populations will eventually reach herd immunity – i.e. the point at which the rate of new infections is stable – and that this can be assisted by (but is not dependent upon) a vaccine. Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.
The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.
Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.
Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. 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. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.
On October 4, 2020, this declaration was authored and signed in Great Barrington, United States, by:
Dr. Martin Kulldorff, professor of medicine at Harvard University, a biostatistician, and epidemiologist with expertise in detecting and monitoring of infectious disease outbreaks and vaccine safety evaluations.
Dr. Sunetra Gupta, professor at Oxford University, an epidemiologist with expertise in immunology, vaccine development, and mathematical modeling of infectious diseases.
Dr. Jay Bhattacharya, professor at Stanford University Medical School, a physician, epidemiologist, health economist, and public health policy expert focusing on infectious diseases and vulnerable populations.
Co-signers
Medical and Public Health Scientists and Medical Practitioners
Dr. Eyal Shahar, MD professor (emeritus) of public health at the University of Arizona, a physician, epidemiologist, with expertise in causal and statistical inference.
Dr. Eitan Friedman, MD, PhD. Founder and Director, The Susanne Levy Gertner Oncogenetics Unit, The Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center and Professor of Medicine, Department of Internal Medicine and Depertment of Human Genetics and Biochemistry, Tel-Aviv University
Dr. Rajiv Bhatia, MD, MPH a physician with the VA health system with expertise in epidemiology, health equity practice, and health impact assessment of public policy. He formerly served as a Deputy Health Officer for San Francisco for 18 years.
Dr. Michael Levitt, PhD is a biophysicist and a professor of structural biology at Stanford University. Prof. Levitt received the 2013 Nobel Prize in Chemistry for the development of multiscale models for complex chemical systems.
Dr. Rodney Sturdivant, PhD. associate professor of biostatistics at Baylor University and the Director of the Baylor Statistical Consulting Center. He is a Colonel in the US Army (retired) whose research includes a focus on infectious disease spread and diagnosis.
Dr. David Katz, MD, MPH, President, True Health Initiative and the Founder and Former Director of the Yale University Prevention Research Center
Dr. Laura Lazzeroni, PhD., professor of psychiatry and behavioral sciences and of biomedical data science at Stanford University Medical School, a biostatistician and data scientist
Dr. Simon Thornley, PhD is an epidemiologist at the University of Auckland, New Zealand. He has experience in biostatistics and epidemiological analysis, and has applied these to a range of areas including communicable and non-communicable diseases.
Dr. Michael Jackson, PhD is an ecologist and research fellow at the University of Canterbury, New Zealand.
Dr. Jonas Ludvigsson, pediatrician, epidemiologist and professor at Karolinska Institute and senior physician at Örebro University Hospital, Sweden.
Dr. Sylvia Fogel, autism expert and psychiatrist at Massachusetts General Hospital and instructor at Harvard Medical School, USA.
Dr. Andrius Kavaliunas, epidemiologist and assistant professor at Karolinska Institute, Sweden
Prof. Udi Qimron, Chair, Department of Clinical Microbiology and Immunology, Tel Aviv University
Prof. Ariel Munitz, Department of Clinical Microbiology and Immunology, Tel Aviv University
Prof. Motti Gerlic, Department of Clinical Microbiology and Immunology, Tel Aviv University
Dr. Uri Gavish, an expert in algorithm analysis and a biomedical consultant
Dr. Paul McKeigue, professor of epidemiology in the University of Edinburgh and public health physician, with expertise in statistical modelling of disease.
Dr. Helen Colhoun, professor of medical informatics and epidemiology in the University of Edinburgh and public health physician, with expertise in risk prediction.
Prof. Matthew Ratcliffe, Professor of Philosophy specializing in philosophy of mental health, University of York, UK
Prof. Mike Hulme, professor of human geography, University of Cambridge
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