“During high transmission times, older people should be offered home delivery of groceries and other essentials.”
The protocol for one of the COVID vaccine trials was 414 pages of dense policies and procedures. This is the kind of serious document that serious scientists produce when actually they intend for their plan to be acted on in the real-world.
With this in mind, let’s consider the plan to to “protect the vulnerable”, which was the pillar of the Great Barrington Declaration (GBD). How might we have accomplished this laudable goal? Though many people thought the best way to protect the vulnerable was to limit spread of COVID and vaccinate as many people as possible, the GBD claimed that by spreading the virus among hundreds of millions of unvaccinated, “not vulnerable” Americans, herd immunity would arrive in 3-6 months, and the pandemic would be “naturally over.” While “not vulnerable” people lived in a world of pure COVID, “vulnerable” people would be locked down in a world of zero COVID. The only tasks were identifying “vulnerable” and “not vulnerable” people and creating an impenetrable wall between them.
A section of the GBD titled Protecting the Old and Other High-Risk Groups laid out their “plan”, which they called “focused protection”. You should take 5 minutes and read it. It’s just 880-words long. Their answer to the question “How do we protect older people living at home?” was only four sentences long. It turns out, the GBD wasn’t a serious plan for public health officials, it was just a laundry list of demands of them.
Many of the GBD’s demands were banal and obvious. As Gideon Meyerowitz- Katz wrote:
Of the 19 policies proposed on the GBD website itself, 13 were commonplace, boring recommendations that virtually every developed country in the world implemented in March/April 2020. These are the sort of bland and obvious stuff that public health departments tried to promote at the very start, like “test people who are at high risk” or “meet outside to lower your risk of infection”. That they form the vast majority of suggestions that made up Focused Protection gives us some insight into how useless the policy was and still is.
However, many of their other demands sounded great, but left out a few details- kind of like a coach whose game plan is to “score more points than the other guys.” It’s certainly not the wrong plan, but it’s not a good plan, and his team will lose. To pick just one example, the GBD wrote that “During high transmission times, older people should be offered home delivery of groceries and other essentials.”
That sounds nice, but it’s worth thinking seriously about this part of their “plan” for a moment, something the authors of the GBD clearly did not do. Creating a program overnight to deliver fresh food and other essentials to tens of millions of seniors for months on end while the virus spread uncontrolled would not be an easy task. There are many opportunities for things to go wrong. Who would identify the homebound vulnerable? How would they create their shopping lists? What if seniors weren’t internet savvy? How would the funding structure be arranged? What if the people who were supposed to be delivering food were themselves sick with COVID or caring for a sick relative? What if they turned out to be scammers who left seniors hungry? What if seniors refused the service and went to crowded grocery stores anyway while the virus was raging? What about younger people with underlying medical conditions? Who would determine who qualified for this program?
In an interview from October 2021, a year after the publication of the GBD, Dr. Jay Bhattacharya sought to answer these questions by saying:
We could have offered free DoorDash to older people. I mean, yeah, it would depend on the community and the living circumstances. It would be a local thing, right?
This was obviously something Dr. Bhattacharya just thought of off the top of his head. The idea of millions of homebound seniors surviving off DoorDash for months on end is something a high school student might come up with, and it shows how little thought the authors of the GBD put into their declaration, especially considering delivering groceries and other essentials to homebound seniors was just one of many tasks public health officials were supposed to accomplish as the virus raged.
None of this stopped the authors of the GBD from making very bolds claim about their list of demands, however. Without any evidence, the GBD flatly stated that it was “possible to shift infection risk from high-risk older adults to low-risk younger adults”. It claimed public health professionals could do easily this if they tried. It said:
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.
Of course, the authors of the GBD didn’t have to actually do anything themselves, not even lobby governments for home delivery of groceries and other essentials. Once they wrote the words “During high transmission times, older people should be offered home delivery of groceries and other essentials“, they had just one job, to make endless media appearances congratulating themselves for their “plan” and to convince the public it was all well within the scope and capability of public health professionals.
Meanwhile, it was up to public health officials to convert the GBD’s demands into reality. It was their job to actually get groceries and other essentials into the hands of older people. Though the authors of the GBD boasted, “we have delineated many practical policies” to protect the vulnerable, this wasn’t close to true. Anyone who actually wanted to implement their “plan” wouldn’t have a clue what their first step might actually be. Indeed, two years after the publication of the GBD, Dr. Bhattacharya backtracked and admitted the hollowness at the its core by saying:
I think that was probably the most legitimate criticism of the, of the Great Barrington Declaration is how do you do focused protection? Now, the Great Barrington Declaration was a one page document. It wasn’t aimed at producing a comprehensive strategy for—a detailed tactical strategy for how to do focused protection in every single setting. What it was, was, was a change in principles, how we are managing the pandemic and an invitation to discussion and thinking and creative thinking by local public health. Right? So we gave some suggestions for how this might be accomplished in some settings, right? So for instance, in dense urban settings with lots of multigenerational homes, it might have involved making hotel rooms available for older people who live in multigenerational homes.
So they’ve, if someone is exposed in the house, they can call local public health. Local public health, then offers them hotel room for a few days until they get cleared. Or organizing home deliveries. It would’ve been difficult no matter what, especially in very, very crowded places, very, very poor places, without the vaccine. But it would, I think it would’ve been possible, certainly.
It wasn’t possible actually, which is why the GBD can’t point to anywhere in the world where “focused protection” was a success. Sweden couldn’t avoid the restrictions they opposed, and the Delta variant pummeled Florida immediately after Dr. Bhattacharya falsely told its citizens “we have protected the vulnerable by vaccinating the older population.” Obviously, nowhere achieved herd immunity in 3-6 months through the mass infection of unvaccinated youth as the GBD promised.
“Why didn’t they just protect the vulnerable and get on with life?”
However, the fundamental futility of the GBD was a feature, not a bug. First, it provided a fig leaf to shield against accusations that the GBD was a “let it rip” strategy. After all, they wrote the words, “older people should be offered home delivery of groceries and other essentials“.
Second, it provided a scapegoat. Indeed, when overwhelmed, underfunded, and besieged public health officials invariably failed to meet the GBD’s many demands, the authors of the GBD blamed them. It was as if our coach, the one whose plan was to “score more points than the other guys,” berated his players after their inevitable loss by saying “I told you exactly what to do.”
Dr. Bhattacharya, for example, said their failure to implement his demands “was a failure of imagination on the part of public health“. He scolded them further, saying the reaction of the “public health community was to just to throw up their hands and say, ‘We can’t do it.'” On social media, he asked “why didn’t they just protect the vulnerable and get on with life?“, as if there was no difference between writing the words “older people should be offered home delivery of groceries and other essentials” and actually delivering groceries and other essentials.
This is how the slogan “protect the vulnerable” morphed from a half-baked “plan” into a battering ram to repeatedly attack public health officials and convince the public they were incompetent and indifferent to the suffering of the vulnerable. As measles cases ramp up around the world, the purposeful undermining of public health as a valid concept will be the lasting legacy of the GBD.
Of course, the authors of the GBD advised and influenced many politicians at the highest level. They met with President Trump and his Health and Human Services Secretary, Alex M. Azar. Dr. Scott Atlas brought their ideas to the White House, and Dr. Bhattacharya said it was “an absolute honor” to work with Florida Governor Ron DeSantis. They claim to have delineated many practical policies to protect the vulnerable, and they said it would’ve been possible, certainly. So an obvious question emerges.
Why didn’t they just protect the vulnerable?
Side note: I invite you all to listen to my podcast with science writer Wendy Orent discussing these topics.