Intended for healthcare professionals

Views And Reviews Acute Perspective

David Oliver: Dismissing unwell people to argue for pandemic freedoms is abhorrent and unrealistic

BMJ 2021; 375 doi: (Published 24 November 2021) Cite this as: BMJ 2021;375:n2844
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}
    Follow David on Twitter @mancunianmedic

On 12 November the Daily Telegraph headlined with “Six healthy children died of covid in a year, but lockdowns fuel youth health time bomb.” It explained that, of 3100 child deaths in the 12 months since March 2020, only 61 were “with covid,” 24 were “from covid,” and six were in children with no underlying health conditions.1 The Daily Mail ran a similar piece, emphasising that mortality from covid in children had been around one in 500 000.2

Although the stories centred on the serious issue of worsening access to care and worse outcomes in children with serious conditions other than covid, the headlines and graphics were clearly designed to push a message that our focus on covid protection measures had been disproportionate and unjustified for a condition unlikely to harm otherwise healthy children. It didn’t mention the role of children as unwitting spreaders of infection.3

The casual dismissal of people with underlying health conditions repeated a chilling pattern I’ve observed throughout the pandemic, with the following narrative:

  • “Covid largely kills older people, people with underlying conditions, or those with lifestyle related health problems, especially obesity. Even then, many deaths are ‘with’ covid, not ‘from’ covid, so the numbers are exaggerated. So why not just protect those at risk as best we can, get them to take more responsibility for their health, and let the rest of us get on with our lives without behavioural restrictions, masks, vaccine certificates, or measures that will harm jobs, the economy, and care of people with non-covid conditions?”

The reason I find all of this so problematic is the utter disregard for the rights or human value of older people, people with disabilities, or those with underlying conditions—not least in ethnic minority groups or deprived areas, given that inequalities played a huge part in poor covid outcomes.45 In some quarters there seems to be a desire to blame people who are overweight or obese for their own increased risk. I’ve seen people online take it further by boasting that their own fitness regimen and diet will give them natural immunity and that protection measures—including vaccination—are therefore not needed.

Statistical analyses have shown that covid takes, on average, a decade off the life expectancy of the people who die.67 Most people who die from or with respiratory infectious diseases have underlying long term conditions, covid or otherwise. Are we going to write all of them off too, on the altar of individual freedoms?

Besides, the “underlying health conditions”8 in people admitted to hospital or killed by covid are disorders such as hypertension, asthma, diabetes, obesity, or cancer—and many people live, work, and function with these for many years. Indeed, the millions of citizens who live with these conditions or are older than working age encompass half the adult population. People with these conditions or others such as dementia or frailty are someone’s husband, wife, mother, or father. Would you want to see them written off, just so that you could carry on life as if there were no pandemic?

The attitude shown by some sections of the media and society seems deeply selfish, and it casually disregards the human worth of anyone unfortunate enough to be old, unwell, disabled, or poor.


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