When it comes to lock-downs and the risks and trade-offs of public health measures to prevent COVID-19, Doctor Ari Joffe is something of a contrarian. Joffe is a specialist in Pediatric Critical Care and Pediatric Infectious Diseases, practicing at the Stollery Children’s Hospital in Edmonton, and is a Clinical Professor in the Department of Pediatrics and with the John Dossetor Health Ethics Centre, University of Alberta. In a commentary written for the McDonald Laurie Institute, Joffe says he was an initial proponent of lockdowns as COVID-19 fears rose in the early stages. But, he says it was his own cognitive biases that made him and others focus on controlling the disease to the exclusion of important broader considerations.
He says, as the pandemic emerged, better information emerged. For example, he says usually 99.95 per cent of people under the age of 70 infected by SARS-CoV-2 survive. Joffe says determining who is at highest risk is important. He says children are 100 to 1000 times at lower risk of death than those over 80. The risk of death is 100 times lower for people under 65 years of age than for those 65 or older.
Joffe says lockdowns, causing interruptions in economic activity and supply chains, are estimated to cause more than 83 million people to become food insecure, and over 70 million to enter severe poverty. He says both of these are likely to cost many more millions of lives in the coming years. Violence against women is also projected to increase by many millions of cases.
Joffe says fear of attending hospitals has resulted in 50 per cent declines in visits for heart attacks and strokes; non-urgent surgery and cancer diagnoses and treatment have been delayed, with backlogs that he says, will take years of catch-up and untold effects on prognoses. He says, in terms of excess mortality during the pandemic, 20 to 50 per cent has not been due to COVID-19 but is likely attributable to these collateral effects.
Joffe has several recommendations on how we should move forward, including keeping schools open because children are at low risk and focusing on protecting people at high risk.
