WHO doctor says lockdowns should not be main coronavirus defence
Recent commentary from the World Health Organization’s (WHO) special envoy on COVID-19 has sparked questions about the legitimacy of lockdowns to stop the spread of coronavirus.
“We in the World Health Organization do not advocate lockdowns as the primary means of control of this virus.”
This statement from Dr David Nabarro has also prompted questions about whether the WHO has backflipped on its advice, months after the pandemic was declared.
So, when should lockdowns be considered, what is the WHO’s advice on them and how does this affect Australia?
WHO doctor calls on world leaders to use other control methods
The latest discussion about strict lockdowns started after the WHO’s special envoy on COVID-19 said they should not be used as the primary method of control.
Dr Nabarro made the statements in an interview with The Spectator.
“The only time we believe a lockdown in justified is to buy you time to reorganise, regroup, rebalance your resources; protect your health workers who are exhausted,” Dr Nabarro said.
“But by and large, we’d rather not do it.”
Dr Nabarro told The Spectator the economic impact on small countries that rely on tourism and increased poverty levels are two major effects of shutting communities down.
“We really do appeal to all world leaders, stop using lockdown as your primary method of control,” he said.
“Lockdowns have just one consequence that you must never ever belittle, and that is making poor people an awful lot poorer.”
While the statements by themselves seem to call for an end to lockdowns, the message is consistent with a piece written by Dr Nabarro days earlier.
Titled, Reflections about the Middle Path, he advocates for governments around the world to find a balance between restrictions and normal life.
“Too many restrictions damage people’s livelihoods and provoke resentment. ‘Virus run wild’ will lead to lots of deaths as well as debilitating long-COVID among younger people,” he wrote.
The message from the article is that health measures which involve strict personal hygiene, effective contact tracing and isolating when ill are the essential measures to be taken.
“Public health services are organised to offer locally-integrated support for interrupting transmission and suppressing clusters,” he wrote.
“This means test-trace-isolate-protect services everywhere, with clearly justified performance metrics.
“It is important there is enough testing capacity to pick up where the virus is, to detect spikes and manage surges.
“Lockdowns just freeze the virus … they do not lead to elimination.”
So when should lockdowns and restrictions be lifted?
The WHO put out a six-step plan for governments to follow to ease restrictions.
To ease restrictions the WHO says governments should:
- Ensure transmission is under control
- Make sure health systems can care for every case — including tracing and isolating
- Minimise risks in health facilities, including nursing homes
- Have preventative measures in workplaces, schools and other essential places
- Manage the risk of the virus being imported in from another place
- Fully educate the community on the new normal, and how they can protect themselves
Does this mean the WHO has backflipped on its advice?
The WHO has been advocating for contact tracing, hygiene and isolation since the beginning of the pandemic.
During a media briefing on April 14, the Director General of the WHO, Tedros Adhanom Ghebreyesus, spoke directly to the issue of lockdowns.
He said while some countries may have been considering lockdowns, contact tracing was an essential measure all governments needed to have in place.
“We know that early case finding, testing, isolating, caring for every case and tracing every contact is essential for stopping transmission,” he said.
“As I have said many times, physically distancing restrictions are only part of the equation, and there are many other basic public health measures that need to be put in place.”
The Director General also spoke about the impracticality of lockdowns in countries with weaker economies, similar to the statements made by Dr Nabarro to The Spectator.
“In countries with large poor populations, the stay-at-home orders and other restrictions used in some high-income countries may not be practical.
“Many poor people, migrants and refugees are already living in overcrowded conditions with few resources and little access to healthcare.
“How do you survive a lockdown when you depend on your daily labour to eat?”
Dr Margaret Harris, a spokesperson for the WHO, was asked on Monday morning if the organisation had backflipped on its own advice.
Appearing on Chanel Nine’s Today show, Dr Harris said claims of a backflip were the result of misreporting of Dr Nabarro’s comments.
“Right from the start we have said what we’d really like to see is a strong tracking, tracing, the community hand-washing [and] mask wearing, so that you don’t have to go into lockdown.
“A lot of countries have had to go to lockdown, but we say do all the other things to avoid going there because the economic and social costs are very high.”
This statement by Dr Harris on Monday is consistent with a statement she gave to Australian media in April.
In an interview with the Sydney Morning Herald and The Age — both owned by Chanel Nine — she said the WHO was advocating for strong contact tracing.
“We have never said go into lockdown — we have said track, trace, isolate, treat,” Dr Harris said.
How has Australia approached lockdowns?
This now leads us to one of the big questions — if the WHO says lockdowns are a last resort, why do parts of Australia still have them?
Lockdowns and restrictions in Australia have been firmly in the spotlight for months.
Victoria’s numbers are very low compared to the peak of its second wave.
Queensland and Western Australia have virtually no community transmission, yet still have varying border restrictions.
Way back in April — less than a month after the first major coronavirus restrictions were put in place — now-Acting Chief Medical Officer (CMO) Paul Kelly said Australia’s coronavirus strategy recognised the possibility of a second wave.
He explained the measures being taken were about putting the second wave off as far into the future as possible to ensure the nation was ready to deal with an increase in cases.
“And that’s why precedents have been set by the Prime Minister before we lift social distancing and socialisation about case finding, keeping the cases low if possible,” he said at a press briefing.
“If cases occur, [it’s about] finding them quickly, finding their contacts, quarantining them and decreasing the size of any outbreaks that we might have by having a very detailed and quick response.”
He added: “That ability to do the laboratory testing rapidly and accurately, to be able to find cases, find their contacts, is another reason to download the app. It will help us to fight a second wave.
“The longer we leave that second wave into the future, the more likely it is we’ll have successful treatments.”
The Acting CMO also said back then that it’d be up to the states and territories to use their own judgment to ease lockdown restrictions as they saw fit, based on the rate of infections.
“That’s not a mixed message. That is a changed message,” he said.
“And we will, as we have always done, undertake to share those differences and share those announcements as soon as they come to be.”