From the vantage point of three years into the COVID-19 pandemic, at times October 2020 seems like ancient history, although I do still remember it well. The pandemic was building as the first deadly winter approached, and it was not clear when (or if) there would be safe and effective vaccines against COVID-19. There was hope, of course, because the reports coming out about the clinical trials of the mRNA-based vaccines from Pfizer/BioNTech and Moderna sounded promising, but even the most optimistic wouldn’t have predicted that the vaccine would receive emergency use authorization (EUA) and start rolling out to high risk frontline workers a mere two months later and then to the high risk general public not long after that. The 2020 Presidential election was in full swing, as much as it could be given the pandemic-driven restrictions on large gatherings. It was truly a bizarre election.

As far as that month goes, from a public health standpoint arguably the most pernicious development came early in the month, on October 4, when a document known as the Great Barrington Declaration (GBD) was announced, to great fanfare. We at SBM (particularly Dr. Jonathan Howard and I) have spilled considerable digital ink on the topic of the GBD, starting from the very beginning, when I first noted that its authors had followed a disinformation path laid down long ago by deniers of evolutionary theory, climate science, and that HIV causes AIDS in which a “statement” is proffered and signed by many people in order to give it the appearance of a scientifically respectable “alternative” position to the current scientific consensus on a topic. Never mind that the vast majority of signatories (and often the writers) of such “statements” don’t have the relevant expertise to pontificate so confidently on the scientific topic being addressed. That’s unimportant to the promoters of such “statements,” which are propaganda based on a technique known as “magnified minority,” not scientific statements:

I myself like to refer to it as “scientific astroturfing,” in which “astroturfing” is a term to describe how corporations and ideological propagandists try to produce the illusion of “grass roots” support for their position by producing the appearance of popular support for it behind the scenes, hence the term “astroturf,” which is, of course, fake grass. It was also true then that, when it was published at least, the Great Barrington Declaration was a little different (but only a little different) in that COVID-19 was a new disease and the scientific consensus regarding it wasn’t nearly as solid as the consensus was in the case of evolution, climate science, and vaccines. That didn’t mean that there weren’t wrong answers, though, and the GBD was very, very wrong about a great many things. Recall that its signatories advocated a “let ‘er rip” approach to the pandemic in which the virus should be allowed to spread through the “healthy” population, the better to reach “natural herd immunity” within 3-6 months, all while using “focused protection” to keep safe those at highest risk of severe disease and death, such as the elderly and those with chronic health conditions that predispose to severe disease and death. Notably, how, exactly, to implement “focused protection” was never really well explained, leading to GBD advocates to retrofit strategies that never would have worked anyway because it’s impossible to fully protect those most vulnerable to bad outcomes when a virus is spreading unchecked through the rest of the population. More on that later. Let’s just say that the GBD is a profoundly eugenicist document that basically falsely claims to protect the vulnerable while leaving them at the mercy of a deadly virus.

Unfortunately, as Gavin Yamey and I documented a year and a half ago, the GBD was immensely influential among certain government leaders anxious to end pandemic restrictions and get back to normal life, such as President Donald Trump in the US and Prime Minister Boris Johnson in the UK. Indeed, despite their claims of having been “silenced”, GBD authors had met with President Trump in the summer leading up to publication of the GBD and had been meeting regularly with Trump administration officials.

So why write about the GBD yet again, given that Dr. Howard correctly asked in June if anything about it was even remotely relevant and correctly answered the question with a resounding “No!” The reason is the increasingly desperate and bizarre efforts of the Brownstone Institute to promote a revisionist history in which the GBD was right and everyone else in public health was wrong. It’s an effort that has been ongoing for several months now, but it was crystallized in an article that I saw on the Brownstone Institute website last week by one of its authors (Gabrielle Bauer) titled “Focused Protection: Jay Bhattacharya, Sunetra Gupta, and Martin Kulldorff“. You will recall that these are the now disgraced trio of scientists who originally published the GBD: Jay Bhattacharya, an MD/PhD (the PhD is in economics) and Professor of Health Policy in health economics at Stanford University whose publications tended to be about health economics and policy before the pandemic; Prof. Sunetra Gupta, Professor of Theoretical Epidemiology at Oxford University; and Martin Kulldorff, who at the time was a Professor of Medicine at Harvard University, where his primary work was in biostatistics.

Bauer’s article seems to be the latest in a series of articles based on a recently published book that she edited featuring essays by the usual Brownstone Institute suspects titled, Blindsight is 2020: Reflections on Covid Policies from Dissident Scientists, Philosophers, Artists, and More. Unsurprisingly, it is published by the Brownstone Institute, which was founded by Jeffrey Tucker in 2021 as the “spiritual child of the GBD”. Interestingly, its “About” page no longer describes Brownstone’s as being “in many ways, spiritual child of the GBD,” although the almighty Wayback Machine reveals all.

Here’s the thing, though. Bauer admits in her essay that the GBD “didn’t get every detail right”. That is most assuredly true, but in reality details matter, and the “detail” that the GBD didn’t get right happens to be the core concept behind the entire declaration, namely the claim that the pandemic could be ended by “natural herd immunity.” Let’s dig into that “detail” and some of the other revisionist history about the pandemic and the GBD that Bauer posits.

The Brownstone Institute admits error without admitting error

It’s important to fast-forward to what is the most relevant passage in Bauer’s essay, because to me it represents an admission of the glaring error at the heart of the GBD that its signatories never, ever concede. Of course, Bauer does her best to minimize this admission and make it sound as though it wasn’t really an error but a minor miscalculation that didn’t invalidate the GBD at all, all while leaving it until the second from last paragraph that mentions it almost as an aside. The error? It has to do with reaching herd immunity rapidly by letting the virus rip through the “low risk” population while using “focused protection” to keep “high risk” people safe.

Given this admission late in the essay, it’s important to read and not forget the part near the beginning of her article, where Bauer cites the part of the GBD about “Focused Protection,” which tellingly is capitalized to make it seem as though it is some sort of big deal concept:

This confluence of circumstances made it impossible not to consider the question: Might we give low-risk groups back their freedom while protecting more vulnerable people? That’s exactly what the GBD proposed. I’ve reproduced it here in abbreviated form:

Current lockdown policies are producing devastating effects on short and long-term public health. Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.

We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. We know that all populations will eventually reach herd immunity 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 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. 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. 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.

Also notice that, back then, GBD signatories were not (yet) rabidly antivaccine (that came later), although, as you can see, they did pointedly take pains in the GBD to minimize the importance of developing an effective vaccine to control the pandemic, citing “natural herd immunity” as the most important factor that would end the pandemic, a strategy that was doomed from the start for a number of reasons pointed out by the John Snow Memorandum (JSM), published by public health scientists alarmed at the blithe “let ‘er rip” message of the GBD. First of all, even if “natural herd immunity” were rapidly achievable as outlined in the GBD, it would require massive suffering and death to reach, if it could be reached at all. The JSM signatories labeled the GBD a “dangerous fallacy unsupported by scientific evidence” while pointing out that uncontrolled transmission “in younger people risks significant morbidity and mortality across the whole population” and, in addition to “the human cost, this would impact the workforce as a whole and overwhelm the ability of healthcare systems to provide acute and routine care.” Second, “natural herd immunity” requires that immunity after infection be lifelong, or at least very long-lived. We now know definitively that such is not the case, but even in 2020 the JSM pointed out that there was “no evidence for lasting protective immunity to SARS-CoV-2 following natural infection,” a point that today could be argued that there is considerable evidence that protective immunity to SARS-CoV-2 wanes within several months to a year and that the virus is quite capable of evolving new variants that can largely evade preexisting immunity after prior infection with preceding variants. This is not even a controversial observation any more, although Martin Kulldorff, who has since left Harvard to become the Senior Scientific Director for the Brownstone Institute, has repeatedly echoed an antivax talking point portraying “natural immunity” as far superior to immunity from a vaccine.

This brings me to another passage from Bauer’s article, in which she seems to walk back some of the GBD’s definitiveness in its claims right before her conclusions, almost as an aside:

The GBD didn’t get every detail right, of course. Nobody could have anticipated, back in the fall of 2020, all the surprises the virus had in store for us. While reasonable at the time, the Declaration’s confidence in herd immunity proved overambitious. We now know that neither infection nor vaccination provides durable immunity against Covid, leaving people vulnerable to second (and fifth) infections. And for all their effect on disease severity, the vaccines don’t stop transmission, pushing herd immunity still further from reach.

For the moment. I’ll ignore the exaggerated claims about the vaccines not stopping transmission at all, which is an antivax talking point in which black-and-white thinking is used to transform the much lesser effectiveness of the vaccine at stopping transmission compared to its much greater effectiveness in preventing severe disease and death into a narrative claiming that the vaccine does “not prevent transmission at all.” Citing the lack of durable postinfection immunity after SARS-CoV-2 infection as nothing more than a mere “detail” that the GBD didn’t quite get entirely right takes major cojones, too, given that very concept on which the GBD was based was that allowing the virus to infect those deemed at low risk of complications and death while using “Focused Protection” to keep those at high risk safe would rapidly build up “natural herd immunity” that would protect those at high risk as well as the general population. Oopsy-daisy! Bauer seems to be saying. We got that little part wrong. Oh, well, our trio of GBD authors were still correct because, well, just because!

It’s also not true that “nobody could have anticipated” this outcome either. The JSM anticipated exactly this outcome shortly after the GBD was published. Let me cite the part of the JSM addressing this issue more liberally, taking an version from October 15, 2020, so that no one can claim that I’m citing a more recently updated version:

Any pandemic management strategy relying upon immunity from natural infections for COVID-19 is flawed. Uncontrolled transmission in younger people risks significant morbidity(3) and mortality across the whole population. In addition to the human cost, this would impact the workforce as a whole and overwhelm the ability of healthcare systems to provide acute and routine care.

Furthermore, there is no evidence for lasting protective immunity to SARS-CoV-2 following natural infection(4) and the endemic transmission that would be the consequence of waning immunity would present a risk to vulnerable populations for the indefinite future. Such a strategy would not end the COVID-19 pandemic but result in recurrent epidemics, as was the case with numerous infectious diseases before the advent of vaccination. It would also place an unacceptable burden on the economy and healthcare workers, many of whom have died from COVID-19 or experienced trauma as a result of having to practise disaster medicine. Additionally, we still do not understand who might suffer from long COVID(3). Defining who is vulnerable is complex, but even if we consider those at risk of severe illness, the proportion of vulnerable people constitute as much as 30% of the population in some regions(8). Prolonged isolation of large swathes of the population is practically impossible and highly unethical. Empirical evidence from many countries shows that it is not feasible to restrict uncontrolled outbreaks to particular sections of society. Such an approach also risks further exacerbating the socioeconomic inequities and structural discriminations already laid bare by the pandemic. Special efforts to protect the most vulnerable are essential but must go hand-in-hand with multi-pronged population-level strategies.

Yes, the JSM called it, no matter how much GBD apologists and flacks have tried to claim otherwise. That’s because it didn’t take a heck of a lot of knowledge about virology, immunology, infectious disease, and epidemiology to recognize the twin flaws at the heart of the rationale behind GBD: that it was unlikely that postinfection immunity would be durable and that it’s impossible to keep the virus confined to the “low risk” population, not to mention that it is impractical even to try, meaning that any herd immunity approach would result in many more deaths than necessary.

If we accept for the moment Bauer’s ridiculous view of the GBD signatories as some sort of heroes of freedom, we can for rhetorical purposes cast the GBD as Abraham Lincoln and the JSM as John Wilkes Booth. (Wait for it.) If we then cast Bauer as Mary Todd Lincoln, it’s difficult not to ask her a question about the pandemic, “Other than that, Mrs. Lincoln, how was the play?” Deluded ideologue and hack that she is, her answer appears to continue to be, “Just great!” Of course, in reality it is not the JSM signatories who were the villains and the GBD signatories the heroes. Quite the opposite! I merely use this old chestnut to show how far Bauer goes to spin her revisionist history. Bauer tried to bury this concession in a single brief paragraph added almost as an afterthought near the end of a much longer piece in order to seem “reasonable,” but it upon which the GBD was based was not only anticipated to be probably incorrect back in October 2020 but demonstrated conclusively to be incorrect over the subsequent two and a half years.

Truly, at the Brownstone Institute, the GBD reminds me of a certain fictional character from a 1970s movie meeting reality.

Reality vs. Bauer’s conception of the GBD

I was tempted to end this post here, after having pointed out that Bauer had basically admitted—while trying to minimize the admission as merely “not getting all the details right” and “who could have anticipated what would happen?”—but Bauer’s portrayal of the GBD signatories as some sort of brave soothsayers who suffered for telling the “Truth” is hard to resist at least briefly looking at. This passage stands out to me in particular, in which Bauer portrays the public and public health establishment as “frightened” and not yet “ready” to accept the “Truth” of the GBD. I will cite it at more length than I usually quote because I want you to experience it in all its “glory”:

In the early months of the pandemic, scientists concerned about lockdowns feared “coming out” in public. The GBD partners took one for the B team and did the dirty work. They paid a heavy price for it, including the loss of some personal friendships, but they held their ground. In print, on air, and on social media, Bhattacharya continues to describe lockdowns as “the single worst public health mistake in the last 100 years,” with catastrophic health and psychological harms that will play out for a generation.

It’s no longer unfashionable to agree with them. A National Post article written by four prominent Canadian doctors in late 2022 maintains that the “draconian Covid measures were a mistake.” A retrospective analysis in The Guardian suggests that, instead of going full bore on the lockdown strategy, we “should have put far more effort into protecting the vulnerable.” Even the sober Nature admits that lockdowns “exacerbate inequalities that already exist in society. Those already living in poverty and insecurity are hit hardest”—exactly the key takeaway from the Australian Fault Lines report released in October 2022.

Kulldorff captures this sea change in one of his tweets: “In 2020 I was a lonely voice in the Twitter wilderness, opposing lockdowns with a few scattered friends. [Now] I am preaching to the choir; a choir with a wonderful, beautiful voice.” The landscape has also become more hospitable for Bhattacharya, who in September 2022 received Loyola Marymount University’s Doshi Bridgebuilder Award, awarded annually to individuals or organizations dedicated to fostering understanding between cultures and disciplines.

Perhaps the concept of focused protection simply arrived too early for a frightened public to metabolize it. But the idea never died down completely, and after the paroxysms of moral indignation ran their course, it slowly grew a second skin. By September 2022, the tally of GBD co-signatories had surpassed 932,000, with over 60,000 of them from doctors and medical/public health experts. Not bad for a dangerous document by a trio of fringe epidemiologists. And would it be churlish to point out that the John Snow Memorandum maxed out at around 7,000 expert signatures?1

I note that this is the passage immediately before the bit about the GBD not getting “every detail right”. Note the narrative, in which the GBD signatories “took one for the B team” and were willing to do “the dirty work.” In truth, that last part about “dirty work” is accurate, just not in the way that Drs. Kuldorff, Bhattacharya, and Gupta” conceive it. From my perspective, they were useful idiots who did indeed to the “dirty work,” just dirty work for the American Institute for Economic Research (AIER), a right wing think tank, brought together at its Great Barrington, MA headquarters by its then-Editorial Director, Jeffrey Tucker, along with a number of sympathetic journalists and PR flacks, with Tucker later bragging about how he had been “in the room where it happened” as the GBD was drafted.

If you doubt the far right wing nature of AIER and now the Brownstone Institute, which Tucker later founded and is now rife with other ideologues, COVID-19 pandemic minimizers, antimaskers, anti-lockdowners, and antivaxxers, consider that Tucker is a former Ron Paul acolyte and neo-Confederate. Let’s just say that the GBD signatories did indeed do some seriously “dirty work” for some seriously dirty people who can’t make up their minds whether to label public health fascist or Communist. I guess it’s both, depending on what Tucker and the Brownstone Institute need.

As for Dr. Bhattacharya winning the Doshi Bridgebuilder Award (Navin Doshi, not that Doshi), one has to wonder what Loyola Marymount University was smoking to think that he had in any way “fostered understanding” between cultures. The award happens to be jointly sponsored by Bellarmine College of Liberal Arts, the Department of Theological Studies, and the Navin and Pratima Doshi Professorship of Indic and Comparative Theology; so maybe that explains it. For example, past recipients include luminaries such as Rupert Sheldrake and Deepak Chopra (who was the award’s very first recipient in 2006).

According to the revisionist history of people like Bauer and many other Brownstone Institute flacks and GBD supporters, Kulldorff, Bhattacharya, and Sunetra have all been totally “vindicated”—never mind not getting all the “details” right, such as the central premise of what the GBD proposed—and now everyone’s getting on board, as evidenced by the GBD having so many more signatories than the JSM. It’s just that everyone was too “frightened” and deluded in October 2020 to see how correct the GBD would be proven to be! I have a phrase to describe this characteristics of cranks and propagandists: The fallacy of future vindication.

Perusing the Brownstone Institute’s website, I also found a bit more revisionist history, or at least oddities. For one thing, Martin Kulldorff is no longer listed as the Senior Scientific Director of Brownstone, but rather as this, in addition to a GBD co-author:

Martin Kulldorff is an epidemiologist and biostatistician. He is Professor of Medicine at Harvard University (on leave) and a Fellow at the Academy of Science and Freedom.

“On leave” from Harvard is also new. It’s been well over a year since it was announced that he would be taking on the role of Senior Scientific Director at the Brownstone Institute, and in that announcement there was nothing about him being “on leave” from Harvard, and Bauer’s article states that he had “ended an 18-year run as a Harvard University professor in 2021” and his bio described him as, “Most recently, he was professor at the Harvard Medical School for ten years.” A perusal of his Brownstone Institute entry using the Wayback Machine at reveals that it was sometime between late June of last year and September 8, 2022 when his entry changed from his having been at Harvard for 10 years to his being “on leave.” For some reason the Wayback Machine did not crawl his bio page between June 28 and September 8, 2022. A similar tedious search led me to discover that sometime between March 18, 2022 and April 24, 2022, Kuldorff’s bio changed from describing him as “Senior Scientific Director of Brownstone Institute” to “Senior Scholar of Brownstone Institute.” So who is running the pseudoscience clown car at Brownstone these days? Dr. Kulldorff isn’t even listed any more on the “about” page of Brownstone. (I was too tired to plod through successive crawls to see when his name disappeared.)

Maybe Kulldorff decided to become full time faculty at the Hillsdale College, a conservative college that has become a font of COVID-19 misinformation even after having managed to get its employees vaccinated ahead of schedule by February 2021, before front-line health workers (and senior citizens and K-12 teachers in Hillsdale County). He was, after all, one of the first three fellows named to Hillsdale’s Academy for Science and Freedom, along with Jay Bhattacharya and Scott Atlas. Whatever happened, it’s interesting to me that Brownstone brought Martin Kulldorff on with such fanfare in November 2021, only for him to cease to be listed as Senior Scientific Director less than six months later, and for this all to happen with few, if any, outsiders noticing, even ones who have paid a lot of attention to the Brownstone Institute.

One wonders what sort of behind-the-scenes movement among the various players at Brownstone is occurring and who is in charge of messaging, other than Jeffrey Tucker. The answer, likely, is probably: No one. He is in charge of messaging, because Brownstone Institute is very much an astroturf fake “think tank” designed to promote an ideological message, its scientists being there to provide a patina of seeming scientific respectability.

None of this stops Bauer from concluding:

Be that as it may, the GBD creators wrote a crucial chapter in the pandemic story. They planted seeds of doubt in a locked-in narrative. After all the insults were thrown, the seeds took root in our collective consciousness and may well have shaped policy indirectly. And as research continues to document the dubious benefits and profound harms of the maximum-suppression strategy, yesterday’s shamers and mockers are inching back toward the question: Could we have done it another way? Might focused protection have worked just as well, or better, and with considerably less damage?

Sadly, we already know the answer to Bauer’s question, and it is a resounding “no.” That answer notwithstanding, the Brownstone Institute continues to promote a narrative in which the GBD authors are brave mavericks who spoke “Truth” even though they were supposedly “silenced” (they weren’t), while promoting a counterfactual narrative in which those who tried to promote sound public health interventions somehow “inverted the heroic archetype“, as though it is somehow “heroic” to let oneself catch a disease that can result in severe disease and even death, as well as long term debilitating symptoms for many survivors. It’s not, and the GBD authors are not heroes who were vindicated. They served as useful idiots for ideologues who have done serious harm to public health.



Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.