An interview with David Paton

David Paton is a professor of industrial economics at Nottingham University Business School. He’s also a lockdown sceptic and a member of the Health Advisory & Recovery Team. During the pandemic, he’s written articles about lockdowns, Sweden, the pingdemic and Covid forecasting. He tweets under @CricketWyvern. I interviewed him via email.

On 4th February, you wrote a piece for The Critic titled ‘Seven indicators that show infections were falling before Lockdown 3.0’, which argued that infections probably peaked before England entered full lockdown on 6th January. Could you briefly summarise the evidence you presented?

Working out when infections start to go up or down can be tricky for several reasons: not everyone with an infection will be tested, symptoms typically appear some time after the initial infection, and there will be a longer lag before an infection results in hospitalisation or death. These lags will vary from case to case and in an unknown proportion of cases, there are no symptoms at all.

The interesting thing about January’s lockdown is that every single indicator tells us that infections peaked well before the full lockdown was in place. Since my article in The Critic, two further pieces of evidence have confirmed this.

First, we now have the more formal analysis of mortality data by Professor Simon Wood of Edinburgh University, which concludes that infections were falling before each of the three English lockdowns.

Second, the ONS Official Incidence Estimates were published in mid-March and put the peak of infections between 20^th and 26^th December. By the time of lockdown, the ONS estimate infections had already fallen by 40%. These are estimates, but even the lower bound of the 95% confidence interval for 20^th–26^th December is higher than the upper bound for the week of lockdown.

In my view, saying infections “probably” peaked before the lockdown is no longer a fair reflection of the evidence. Rather, we can be “virtually certain” that they did.

This has important implications. It means that, like the first two lockdowns, the January national lockdown was not necessary for infections in England to start falling. Put another way, hospital admissions would not have continued to rise to unsustainable levels in the absence of lockdown. Of course, this does not answer the secondary question of whether earlier tiered-restrictions had any significant impact on infections. However, it is worth noting that infections were falling pre-lockdown even in regions like Yorkshire which were never put into Tier 4.

Then on 18th March, you wrote an article for Spiked titled ‘The myth of our ‘late’ lockdown’, which argued that locking down earlier wouldn’t have made much difference. In the article, you referred to “the discredited assumption that governments can turn infections on or off like a tap”. What did you mean by that?

For the past two years, Governments around the world have made policy based on the assumptions that: Covid cases continue rising indefinitely unless restrictions are introduced, restrictions and lockdowns inevitably lead to lower infection rates, and lifting restrictions always leads to cases surging. All of these assumptions are wrong.

Time and again, we’ve seen infections go down before lockdowns were introduced or, as in Sweden in spring 2020, Florida a year later and many other cases, without significant additional restrictions. In other cases like Germany and the Czech Republic in early 2021, we’ve seen infections continue to rise during strict lockdowns. Particularly striking for me was England last November when infections in London and the South East actually started to rise in the middle of our national lockdown.

This doesn’t necessarily mean that lockdowns and other restrictions have no effect at all. In some cases, they may lead infections to fall a bit sooner than otherwise, or somewhat faster. But even the evidence for some small, marginal effect is not particularly strong, especially when you take a long term perspective. And for many restrictions like curfews, vaccine passports, table service at pubs and the rule of 6, it is hard to identify any supporting evidence at all. At a minimum, Governments (and often their scientific modellers) overestimate the impact of their interventions, particularly on serious health outcomes.

For many people this is counterintuitive – surely lockdowns reduce human interaction and hence have a very large impact on infections and deaths? In fact, the reality is more complicated. People respond to rising infections and deaths by changing their behaviour voluntarily. And these voluntary changes will be concentrated among the more vulnerable, meaning compulsory restrictions do hit activity (and hence the economy) even more, but because the vulnerable have already limited their interactions, they have less effect on serious outcomes.

In addition, restrictions can have unintended consequences that may outweigh any benefit of the intervention. Who can forget the scenes of packed tube stations when the 10pm curfew caused thousands of people to leave pubs and restaurants at the same time? And if you shut pubs for months on end, it is no surprise that young people simply decide to meet up in unlicensed venues and private homes. I discuss other reasons why lockdowns are less effective than people imagine in this article for Spiked.

Economists are trained in concepts like trade-offs, cost-benefit analysis and unintended consequences. Yet “most either stayed silent or actively promoted lockdown”, to quote Mikko Packalen and Jay Bhattacharya. Why have there been so few critics of lockdown within the economics profession?

In terms of our value judgements and personal stances, economists are probably no less susceptible to fearmongering messages from Government and social pressures to conform than other people. However, you are right that we should expect economists to be more prominent in pointing out the flaw of basing a policy almost entirely on one outcome, i.e., trying to control short run infections.

There has been some excellent work by economists looking more closely at the cost and benefits. An early example is the work of Professor David Miles and colleagues, who estimated that the costs of continuing restrictions were likely far higher than any benefits. A more recent paper by Professor Doug Allen of Simon Fraser University in the International Journal of the Economics of Business concluded that, using mid-point estimates, the costs of lockdowns probably exceeded the benefits by a factor of 141 times. As a result, Professor Allen suggests that “lockdown will go down as one of the greatest peacetime policy failures in modern history.”

The reality may be even worse than that. Recent research by economist Professors Karli and Anthony Glass and colleagues provides evidence that the first English lockdown probably had the net effect of increasing excess mortality. In other words, even if lockdowns averted some deaths due to Covid (and we cannot even be certain about that), these were outweighed by the deaths caused by lockdown.

There are other economists who have spoken out about the damage caused by lockdowns. However, one worrying thing which cannot be ignored is the vilification many academics experience when they do speak out against the mainstream policy response. I have been contacted personally by academics who have been threatened with disciplinary action for discussing evidence against lockdowns in a public forum. Given this, it is perhaps no surprise that many economists prefer to keep their heads under the parapet. It is hard to suppress the truth for ever, and I suspect that as more research comes out on the high costs of our interventions and their limited (at best) effectiveness, history will judge the lockdown sceptics favourably.

Some people argue that vaccine passports are needed to encourage take-up of the vaccines. What do you make of this argument?

It is a fundamental principle of medical ethics that treatment should only be given if there is full and informed consent. To introduce vaccine passports as a way of blackmailing young people to get vaccinated is, in my opinion, reprehensible. Indeed, I find it remarkable that politicians openly admit this is their intention. That in itself reveals a moral vacuum among many of our leaders.

Although such an approach is wrong in principle, there is little evidence to justify it even on public health grounds. A policy of offering vaccination to the elderly and vulnerable has a strong basis in terms of the impact on serious illness and deaths. The public policy benefits on infection rates from broader vaccination programmes of the general population is less clear.

For example, a recent paper in the European Journal of Epidemiology found that increases in infections were not associated with vaccination levels across countries or US counties. This should perhaps not be surprising given the increasing evidence on how fast vaccine effectiveness against infection (not necessarily serious illness) wanes, and the fact that a large proportion of the unvaccinated have immunity from previous infection.

There seems to be little acknowledgement of the possibility that, for some people, the risks of vaccination, even if low, may outweigh any benefits. Take, for example, a healthy 20-year old male who has recently had Covid. Given the immunity from previous infection and the very low risks of Covid for his age group, any benefit (public or private) of vaccination will be vanishingly small. In contrast, he faces a small but non-trivial risk of heart problems, particularly after the second dose. It is disgraceful that public policy is pressurising and (in the case of healthcare workers) coercing people into getting vaccinated when they judge that vaccination is not right for them at this time.

Apart from being unethical, authoritarian vaccination policies are likely to have adverse long-term consequences for public health by increasing vaccine hesitancy and distrust among key groups. Dr Alex de Figueiredo and colleagues at the London School of Hygiene and Tropical Medicine have published some interesting research data on this. Vaccine mandates and passports may well increase take up to some extent, but the danger is they will cause some people to get vaccinated when it is not in their interests, whilst others in vulnerable groups for whom vaccination may be very beneficial will double down on their hesitancy.

The official reason given for offering the vaccine to 12–15 year olds, against the recommendation of the JCVI, is that doing so would “reduce disruption to education”. But that doesn’t stack up, does it?

No it does not. I wrote about this for the Spectator when the rollout was announced. The official modelling suggested that, by reducing the number of infections and subsequent isolation, vaccination would only save an average of 15 minutes of education per child. But even this ignored time lost from vaccination process itself during the school day, as well as time lost due to vaccine side effects.

There are also problems with the modelling which, remarkably, ignored immunity from previous infection and assumed 55% vaccine effectiveness from one dose for a 6 month period. A recent pre-print (which hasn’t yet been peer reviewed) by researchers from the UK Health and Security Agency finds that, for the first 9 days following vaccination, children experience close to 30% negative effectiveness: i.e. for 9 days, vaccinated 12–15 year olds are more likely to test positive than the unvaccinated. Effectiveness rises to 75% by 2 weeks but then wanes very quickly: just 4 weeks later, vaccine effectiveness is already below the 55% used by in the Govt model.

The authors conclude that if the aim is to prevent infection, “regular Covid-19 vaccine boosters will be required” for adolescents. We can wonder what the response of parents would have been if they had been given this information when the vaccination rollout for children started in October.

You’re a Brit. Given what we know now, what should Boris Johnson have done in March of 2020?

We now have copious evidence that Government lockdowns and restrictions have very limited (and in many cases zero) benefit in terms of reducing serious illness and death. But they cause huge economic, social and psychological damage. As we discussed earlier, it is now also clear that infections were already decreasing at the time of the national lockdown. This is important as it means that, in contrast to the messages being put out at the time, there was no prospect of infections rising to such an extent that health services would have been overwhelmed.

So Boris Johnson could and should have avoided mandatory restrictions and lockdown back in March. Apart from investing in health service capacity and capability, the more general policy focus should have been on providing accurate information and advice (especially for the most vulnerable) and voluntary guidance. Instead, the Government did exactly the opposite with messaging designed to create fear, attempts to manipulate behaviour and a very one-sided presentation of statistics.

For example, as early as 13^th April 2020, it was clear from the “deaths by specimen date” which I presented daily in my Twitter feed, that deaths in England had started to decline by 8^th April. Given the lag from infection to death, this was the first evidence we had that infections peaked before the national lockdown on 23^rd March.

Without a doubt Government advisors were aware of this too. Yet for weeks afterward, they continued to talk at the daily press conferences about increasing death numbers, focusing on days when there was a particularly high number of reported deaths, even though many of the deaths had occurred several weeks earlier. Had they presented the data fairly, the case for continuing lockdown would have been fatally weakened. Perhaps Ministers saw their approach as one of political necessity, but it will cause long term lack of trust in Government messaging.

It is sometimes argued that politicians can be excused for going down the lockdown route in the spring of 2020, as they were facing a new virus and there were so many uncertainties. I disagree. In such circumstances it is more important than ever to hold fast to principles and ethics.

We need to remember that the Government took it upon itself to decide who we could invite into our own homes, and even our gardens. They shut down schools for millions of children for months on end. They criminalised public worship. They ordered millions of healthy young people to stay locked up in their houses for most of the day. That they did all this without presenting any strong evidence that such measures have significant public health benefits makes it even worse.

Irrespective of any benefits, for the Government to criminalise normal human activity for months on end is simply wrong. It should never have happened and it should never happen again. The tragedy is that, given recent events in Parliament, I am not sure that any lessons have been learnt.