Is Lockdown No 2 justified ?

Professor Gordon Wishart, Chief Medical Officer at Check4Cancer gives his thoughts on Lockdown No2 and it's likely effect on cancer services that have already been decimated this year with the sole focus being on halting the pandemic. 

Prof Gordon Wishart Head Shot

Is Lockdown No2 justified? by Professor Gordon Wishart 

As we return to lockdown once more, there is growing concern that the decision was based on inaccurate data. The projected figure of 4,000 deaths per day without further lockdown, as presented by Vallance and Whitty, was based on an outdated model and has now been retracted by both government advisors. There is a good reason why scientific publications are subjected to academic scrutiny by peer-review, much of which has been abandoned in the clamour for data and relevant models during the pandemic. Belatedly, the Office for Statistics Regulation has now advised that, where models are referred to publicly, particularly to inform significant policy decisions, the model outputs, methodologies and key assumptions should be published at the same time. Better late than never but, it is not surprising that when claims of increasing deaths were combined with the NHS about to be overwhelmed, the motion to re-enter lockdown was passed with a large majority but was that the correct decision?

This week a former scientific advisor to Pfizer explained that respiratory virus pandemics do not have a second wave, but they can resurge during winter months. He argues that the use of PCR testing, where tiny molecules are amplified multiple times, is inadequate for population testing as it produces a high number of false positives, partly due to detection of fragments of dead virus as well as common parts of other coronaviruses. Therefore, we cannot rely on the number of ‘cases’ from the current testing system, as it is likely that we are simply observing the tail of the original wave from earlier this year, which is most apparent in the North-West and East Midlands. This conclusion would fit with the fact that the pattern of spread is quite different from the first wave, with a much higher ratio of ‘cases” to deaths. 

The pre-lockdown message was that hospitals and ICU’s were filling up and about to become overwhelmed. What was not acknowledged in the government announcement or media headlines, however, was that hospitals are always close to full at this time of year. In my entire career, surgeons have been frustrated by their elective admissions being cancelled in winter months as medical patients start to fill up surgical beds. In fact, the current bed occupancy of approximately 80% is no different to last year and while it is still impossible to separate those who die from Covid from those who die with Covid, the increase in deaths attributed to Covid appears to mainly affect the North-West and East Midlands and could have been tackled by increased hospital capacity in those areas rather than widespread lockdown.

So, there may be an argument that regional restrictions may well have succeeded, and that widespread lockdown might not provide any additional benefit. That is why Sage should have also reviewed the likely harm to physical and mental health during further lockdown and taken that into account when making their decision. At a time when Macmillan has announced 50,000 undiagnosed cancers this year, and the recent Lancet editorial claims that UK cancer care has been threatened by government incompetence, the decision to take us back into lockdown may well cause more harm than good and, is likely to be the subject of much debate and discussion in the coming months and years.