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The covid-19 pandemic took power from the people

BMJ 2021; 373 doi: (Published 03 June 2021) Cite this as: BMJ 2021;373:n1410

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Re: The covid-19 pandemic took power from the people

Dear Editor,

I am not so much concerned about the public having a voice as I am about professionals outside the system having one. Having followed a number of Twitter threads and blog comments it is clear that many of the public are simply not informed enough to make informed decisions; the strange concerns that have been aired over the risks of coronavirus vaccinations are a case in point. However, the "ruling cabals" have successfully stifled any contrarian professional comments or suggestions even when these have been based on facts from research and, indeed, have turned out to be correct. There should be some forum for informed scientific debate.

"The Science" can change - witness the growing, if circumstantial evidence that the original outbreak in Wuhan was due to a laboratory leak, and the realisation that the letter in "The Lancet" last year which refuted the suggestion has been undermined both by scientific analysis and by the realisation that there were undeclared conflicts of interest (the latter alone being grounds to request retraction). Witness also the disagreements within official bodies, with individual SAGE members offering different perspectives in the media (or as one might put it airing internal disagreements over policy in public). What is also bizarre, in my opinion, is that scientific advice continues to be offered (and thereafter followed) by people whose predictions and modelling have been called into question or even discredited.

The government is accused of dithering. If, in a clinical situation with an acutely ill patient, where you haven't a clue what's going on, is it not reasonable to dither? That said, the fact remains that decisions over the acute management of very sick Covid patients appears to have been in the hands of epidemiologists, infectious disease specialists and non-medical scientists rather than acute care physicians who might - just - have seen something like it before and do know what to do. Any inquiry must ask whether the government was getting its advice from the right experts.

But now is not the time. The situation continues to evolve, with conflicting statements on what deaths were actually due to the coronavirus (from, not with); on the true figures for excess mortality; on the issue of whether lockdowns truly coincided with the waning of infection; on whether Test and Trace worked; on whether border controls worked; with no clear picture, as yet, on how vaccination will both halt spread and prevent serious disease that results in hospitalisation and death; with absolutely no idea what effect a release from lockdown may have; on the cost-benefit analysis of medical priority over economic shutdown. So what point is there in an inquiry now? We have enough evidence to make judgements on some specific aspects, such as PPE supply. We have evidence of unnecessary delays in introducing treatment for severe disease. We have insufficient for almost everything else. An inquiry now will distract all from getting the pandemic under control, not least because we need to fully understand inter-national differences.

Competing interests: No competing interests

07 June 2021
Andrew N Bamji
Retired consultant rheumatologist