Follow the Politics, Not the Science

5 March 2021  /  Updated 6 March 2021

Introduction

This article contrasts the policies pursued by the UK Government in response to the COVID-19 pandemic with prior national and international preparedness guidelines. It begins with illustrative reference to Popper’s criteria defining the scientific method and to seven foundational ethical principles proposed for use in public health education. It then examines scientific evidence for the value of Non-Pharmaceutical Interventions (NPIs) in the mitigation of respiratory virus outbreaks.

It finds that, until mid-March 2020, the UK Government followed existing national and international guidelines recommending low stringency NPIs – such as hand hygiene, social distancing and isolating when sick – to slow the spread of infections. There was some scientific evidence these measures were beneficial and accompanying harms limited. Government advisers assessed SARS-CoV-2 disease characteristics and risks realistically, incorporating known behaviour of similar respiratory viruses.

However, on March 23rd, 2020, an unprecedented lockdown – involving travel bans, stay at home orders and mandatory business closures – was implemented in the absence of empirical evidence for their utility. As well as contravening the existing pandemic preparedness guidelines, this violated key principles of public health ethics and human rights.

Many scientific studies have since shown lockdowns cause considerable harm for minimal benefit and the error has been compounded by a failure to abandon these policies as confounding evidence has accumulated.

These harms could have been avoided if the UK Government had respected the pandemic preparedness guidelines and the scientific and ethical principles underpinning them, and resisted media pressure – or coercion – to behave like ‘many other Governments’. Instead, lockdowns have been extended and repeated, and vindictive suppression of scepticism has increased – including that based on accepted principles of law, ethics and scientific inquiry.

Politics – not the science – caused the UK to become a ‘lockdown autocracy’ with one of the worst pandemic outcomes in the world. An inept but unchallenged administration arose, funded by borrowing and fiscal easing, supported by an acquiescent public highly dependent on Government subsidies, and led by media fear mongering with the manufacturing of ‘heroes’ and ‘villains’, vilification of dissent and condemnation of rational and viable alternatives.

The article concludes that an absence of leadership in the UK allowed human rights law and the ethics and principles of evidence-based public health to be disregarded, precipitating economic and social devastation and excess mortality. If a future such occurrence is to be avoided, new legislation and formal censure of those responsible – whether from politics, media, medicine, science or the judiciary – will be necessary.

Scientific method

Scientific certainty is a rare commodity, even amongst scientists. Experts frequently disagree and they cannot all be right. Many will doggedly hold on to their beliefs, even in the face of a mountain of contradictory evidence. It is the scientific method – not scientists themselves – which is intended as a defence against the fallibility of scientists and the incompleteness of knowledge.

According to the respected philosopher of science Karl Popper, scientific knowledge evolves via a process of postulation, corroboration and falsification (Popper 1963; Shea n.d.).

It is a requirement of scientific understanding that it can be used to explain phenomena and make predictions based on them that may be subject to independent falsification in observed reality – for example via the use of comparative controls, repeated tests and new experiments. Science is inherently sceptical.

Scientific knowledge is always provisional as – in principle – new evidence could be found that contradicts and overturns current understanding.

These principles should apply to NPIs and lockdowns, which should be based on rigorous science and subject to amendment as new empirical evidence emerges.

Public health ethics

Medicine is governed by ethical principles originating from the time of Hippocrates. These include the duty of physicians to benefit and not harm the patient, to acknowledge uncertainty and seek help beyond their area of expertise, to avoid under and over treatment, to respect privacy and personal circumstances and to consider the healthy as well as the sick (Shiel n.d.). Their application to public health is problematic as the focus of care moves from the patient to the population. For illustration, seven principles proposed for public health education (Schröder-Bäck et al. 2014) are as follows:

Non-maleficence

Beneficence

Health maximisation

Efficiency

Respect for autonomy

Justice

Proportionality

Beneficence and non-maleficence refer to the benefits and harms of public health measures. Health maximisation addresses whether the overall benefits outweigh the overall harms. It is not ethical to implement an intervention which leads to a benefit in one area while causing equal or greater harm in others.

The principle of efficiency concerns the optimal use of resources. It is this moral principle that invites an evidence based cost-benefit analysis of how limited resources may be best utilised in the overall public health interest.

The remaining three principles ask how public health interventions impinge on individual liberty, whether they fairly protect the health of all citizens, and whether their benefits outweigh infringements of other moral considerations – including loss of autonomy, privacy, freedom of speech, political activity, financial autonomy, education, the company of family and friends, and so on.

These principles also should apply to NPIs and lockdowns. If there is insufficient evidence for – or evidence contravening – ethical compliance the intervention should not be implemented.

Value of Non-Pharmaceutical Interventions in the mitigation of respiratory virus outbreaks

Pandemic preparedness guidelines available in early 2020 focused heavily on influenza as flu was anticipated to be the cause of a future infectious disease outbreak.

According to recent World Health Organisation (WHO 2019a), US Centers for Disease Control and Prevention (CDC – Qualls et al. 2017a), European Centre for Disease Control (ECDC – ECDC 2017, 2021) and UK Department of Health (DH – DH 2011a) guidelines and the reviews of scientific studies accompanying them (WHO 2019b; Qualls et al. 2017b; ECDC 2017, 2021; DH 2011b), it is clear most of the scientific literature is recent, with much produced following the 2009 H1N1 flu pandemic. As Qualls et al. 2017a noted with regard to the CDC guidelines of 2017…

when the 2007 strategy was being developed, the evidence for the use of NPIs during influenza pandemics was limited, consisting primarily of historical analyses and contemporary observations rather than controlled scientific studies.

Testing the efficacy of NPIs for the mitigation of respiratory disease outbreaks does not, practically or ethically, lend itself to the kind independent repetition and falsification – and use of comparative controls – demanded for scientific understanding. Prior to 2020, assessments of the benefits and harms of NPIs remained rare, and for lockdowns unknown. Nevertheless, NPIs were proposed as a mechanism to reduce the rate of infection as an adjunct to antiviral medicines and vaccines, where they may be of limited effect or unavailable. Within the guidelines, personal measures include 1) social distancing, 2) staying at home if sick and avoiding the sick if healthy, and 3) observing good hand hygiene practices.

The WHO (2019a, b) note the positive risk-benefit balance of measures of this kind, perhaps somewhat mitigating doubts of their scientific reliability. The WHO did not recommend contact tracing, quarantine of exposed individuals, entry and exit screening or border closures. Interventions such as school closures and banning of mass gatherings seem to have been beneficial according to some, but not all studies. Conversely, they carry significant economic and social costs.

None of the guidelines recommended mandatory large scale lockdowns.

Although SARS-CoV-2 was new in 2020, the behaviour of other respiratory viruses, including other coronaviruses, has been the subject of extensive scientific enquiry. However, even after a hundred years of study, there are key aspects of ‘flu transmission that are debated (see Cannell et al 2008, for example) and understanding of each epidemic may involve “looking over one’s shoulder and asking ‘what happened?’” (Kilbourne 1973).

At least nine viruses are believed to cause respiratory disease, including influenza and coronaviruses, which predominate in winter in the northern temperate latitudes, tending to peak between December and March (Moriyama, Hugentobler and Iwasaki 2020; Hendley, Fishburne and Gwaltney 1972, Isaacs et al. 1983, Gaunt et al. 2010, Killerby et al. 2018, Masse et al. 2020, Monto et al. 2020, Nickbakhsh et al. 2020a). Coronaviruses naturally – and adaptively – mutate (Ren et al 2015) and seasonality naturally affects transmission of the virus and the human body has many natural mechanisms of resistance to respiratory viruses, including antibody-mediated immunity and others (see Moriyama, Hugentobler and Iwasaki 2020).

Virus-virus interference seems to affect the prevalence of some respiratory viruses from year to year (Kloepfer and Gern 2020, Nickbakhsh et al. 2020b) and it is interesting to note ‘flu seems to have disappeared with the arrival of SARS-CoV-2 – although respiratory virus surveillance during the pandemic is heavily skewed for COVID-19 detection.

A parsimonious view might be that SARS-CoV-2 followed a predictable pattern of seasonal respiratory virus behaviour. Its lethality – although elevated as a novel pandemic virus – was, again typically, quickly identified as far less than initially believed, as confirmed by early data from China, Italy and the Diamond Princess cruise liner (CEBM 2020a) – where a lack of transmission between some individuals in close proximity suggested a proportion of the population may be less susceptible to infection and disease.

As late as mid-March 2020, the statements of the UK Government’s scientific and medical advisers Sir Patrick Vallance and Professor Chris Whitty (Sky News 2020, Guardian News 2020) – supported by the Scientific Advisory Group for Emergencies (SAGE 2012) – appeared to reflect this view of the disease characteristics of SARS-CoV-2 and the likely immunological responses to it. They emphasised the limited risk to the vast majority of people, and the elevated risk to the elderly and vulnerable to COVID-19 – and the need to specifically protect those at high risk. The advisers also acknowledged the possible overlap in mortality of pandemic deaths with other natural deaths; the tendency of viruses to mutate – predominantly to less virulent strains; that the NHS predictably goes over capacity in some ICU areas every winter; that track and trace is useful at the beginning and end phases of a pandemic, but not when the virus is widespread and the negative impact of interventions on other aspects of health.

In mid-March, the they defended (Sky News 2020, Guardian News 2020) the UK Government’s policy recommending low stringency NPIs intended to slow the spread of infection to prevent the health system from being overwhelmed. This would allow both COVID-19 and non-COVID-19 patients to be treated and reduce ‘overshoot’ of overall infection beyond the proportion sufficient for herd immunity.

The lockdown and its failure in practice

Prior to the emergence of COVID-19, the CDC, ECDC and UK DoH did not advocate hard lockdowns involving mandatory business closures, travel bans and stay at home orders. Nevertheless, precisely such a lockdown was implemented by the UK Government on March 23rd 2020 (GOV 2020), without scientific and epidemiological precedent.

Given the absence of evidence for benefits of lockdown that would outweigh acknowledged harms, it might be anticipated the decision was made at least in the expectation that a positive outcome would arise. However, subsequent empirical evidence has shown a lack of benefit of lockdowns above low stringency NPIs and considerable harm in many areas.

For example, a comparison of 10 countries (Bendavid et al. 2021) showed mandatory stay at home orders and business closures had no further effect on case growth than less restrictive NPIs such as social distancing, discouraging travel and bans on large gatherings as practiced in Sweden or intensive testing, tracing and isolation of cases and close contacts as practised in South Korea. A comparison of 166 countries (De Larochelambert et al. 2020) found “no link between the stringency of measures used to fight the pandemic and mortality from COVID-19”. The scientific literature challenging the efficacy of lockdowns beyond low stringency measures or small effects now extends to over 30 papers (InProportion 2021).

A similar number of studies (Collateral Global 2021) offer empirical evidence confirming anticipated harms to physical, mental and social health, education and the economy arising from lockdown policies. These affect all parts of society, causing unemployment (ONS 2021), debt (ONS 2020a), and falling educational attainment (Blainey, Hiorns and Hannay 2020, Christakis, Van Cleve and Zimmerman 2020) and rising obesity in children (NHS 2020). Among reported adverse health consequences, for example, are increases in abusive head trauma in children (Sidra et al. 2020) and domestic violence severity (ONS 2020b).

Of critical concern are lockdown-caused fatalities – including additional COVID-19 deaths such as those caused by nosocomial infections (SAGE 2020, CEBM 2020b, Discombe 2021) – both immediately and in the long term. The Office for National Statistics (ONS) reported 12,900 non-COVID related excess deaths in England and Wales for the period March 7th to May 1st 2020 compared to the previous five years (ONS 2020c). While it is difficult to distinguish under-counting of COVID-19 fatalities – due to early limited testing – from over-counting due to use of RT-PCR cycle thresholds exceeding the recommended limits in the absence of clinical signs (WHO 2021), one small autopsy study (Pell et al. 2020) showed that deaths attributable to reduced access to health care exceeded undiagnosed COVID-19. Another study (Edler et al. 2020) of 80 RT-PCR related COVID-19 fatalities found four to have been wrongly classified and entirely unrelated to SARS-CoV-2 infection. The authors note: “With the exception of two cases, all the deceased suffered from severe pre-existing conditions, predominantly of the cardiovascular system and the lungs.”

Both short and long term lockdown induced fatalities are anticipated due to decreases in hospital treatment of chronic and acute disease – such as reduced admissions for heart attacks and strokes in adults (Blecker et al. 2021). Similarly, delayed access to paediatric care has been found to most frequently affect children suffering from diabetes, sepsis, abuse, cancer and appendicitis (Lynn et al. 2020).

In contrast, scientific papers claiming reductions in deaths following lockdowns are few in number. They use predictive or simulation modelling approaches (Ferguson et al. 2020, Flaxman et al. 2020a, Dehning et al. 2020, Keeling et al. 2021), including the Imperial College London model (Ferguson et al. 2020, Flaxman et al. 2020b) which is seen to have influenced the UK Government’s radical policy change in late March 2020 (Conn et al. 2020, Whipple 2020) – or focus, for example, only on parts of the UK (Davies et al. 2020) to the exclusion of Scotland.

The scientific reliability of predictive simulation models is questionable. People exist in a complex physical and social environments. They do not behave with the uniformity of particles in a subatomic world. It is not clear to what extent predictions incorporate substantial variables such as virus seasonality, mutation, pre-existing and non-acquired immunity, and nosocomial disease caused by infections acquired in hospitals and care homes referred to above, and the empirical research on NPIs does not offer a particularly reliable foundation on which to build predictive models. Methodologically, these models are – strictly speaking – unfalsifiable: we can never know what would have happened in the UK if lockdowns had not been adopted. We can only try to infer it, as discussed previously. Apart from Sweden, Belarus and some US States – notably Florida and South Dakota – there are few western states where lockdowns were not adopted, but there is no empirical evidence they fared worse than those that were locked down (see OurWorldInData.org).

The few post hoc studies demonstrating lockdown efficacy involve Imperial College and SAGE authors such as Neil Ferguson (Flaxman et al. 2020a), John Edmunds (Davies et al. 2020) and Michael Tildesley (Keeling et al. 2021) who would appear to be judges in their own cause, and when these models have been subject to independent testing – fundamental to the scientific method – they have been found wanting.

For example, Soltesz et al. (2020) found “the public events ban and the lockdown being mutually effective in Sweden and 10 other European countries – was not addressed by Flaxman et al., which is noteworthy as this result undermines the conclusion of lockdown being especially effective” and suggested “the model, and its conclusion that all NPIs apart from lockdown have been of low effectiveness, should be treated with caution with regard to policy-making decisions”.

Chin et al. (2020) also re-examined the Imperial models and were highly critical of them in certain areas. For example, they suggested “results included in the Nature paper seem to suffer from serious selective reporting, providing the most favourable estimates for lockdown benefits” and “the three European countries excluded from the Nature publication had among the least favourable results for lockdown”. They concluded: “Inferences on effects of NPIs are non-robust and highly sensitive to model specification. Claimed benefits of lockdown appear grossly exaggerated.”

Furthermore, a small number of ‘natural experiments’ have allowed empirical comparative analyses, rather than simulation – again suggesting flaws within the latter. A study from Denmark found no difference in infection rates between municipalities under strict lockdown compared to those under low stringency controls (Kepp and Bjornskov 2021). A study of US Marine recruits showed no significant difference in infections between quarantined and non-quarantined participants (Letizia et al. 2020).

The ethical implications of locking down

Irrespective of the reasons for their implementation, there is a strong case to be made that lockdowns are unethical as they deliver neither non-maleficence nor beneficence.

The UK Department of Health and Social Care produced a provisional cost-benefit analysis of life-years lost and saved with and without lockdown (DHSC 2020) on April 8th, 2020, the day COVID-19 deaths peaked. This was based on a ‘mitigated’ scenario of March 28th, by which time SARS-CoV-2 infections had also already peaked. This suggests both health maximisation and efficiency have been afterthoughts in the implementation of lockdown. More recently, some independent studies have used nascent empirical data to offer cost-benefit evaluations as the pandemic has progressed.

Miles et al. (2020), for example, used the Quality Adjusted Life Year (QALY) to balance lives lost due to COVID-19 against those lost as a consequence of the first UK lockdown. They concluded: “we find that having extended the lockdown for as long as three months is likely to have generated costs that are greater than likely benefits”, “a policy of ‘let’s wait until things are clearer’ is not reliably prudent” and “a movement away from blanket restrictions that bring large, lasting and widespread costs, and towards measures targeted specifically at groups most at risk is now prudent”.

Thomas (2020) used the Judgement or J-value to compare the known economic effects of the 2007-9 recession on mortality with the anticipated increase in due to lockdown. He concluded: “The challenge for the UK Government will be to manage its interventions so that the inevitable impending recession is not significantly worse than that induced by the 2007–9 financial crash.”

With deaths – even in the short term – being attributable to delayed diagnoses, the long term implications are substantial. Jenkins et al. (2021), examined cancer outcomes in the UK and remarked “preventing COVID-19 deaths through lockdowns might result in more life-years being lost than saved”. Kampf and Kulldorff (2021) found rates of cancer diagnosis and chemotherapy, and emergency treatment of strokes and coronary disease, had fallen substantially and asked that all aspects of physical and mental health to be jointly considered in planning.

The infringements of lockdown on respect for autonomy are ubiquitous and include those at little or no risk from SARS-CoV-2 as well as the most vulnerable, whether or not they wish to be deprived of their liberty or wish others to be deprived of theirs. Lockdowns impinge on rights to liberty and security, freedom of expression, education, property and a private and family life, as enshrined in the Human Rights Act 1998, although exceptions may apply in the pursuit of health and the prevention of infectious disease (GOV 1998).

Lockdowns disproportionally affect poorer individuals and groups – in education, for example (Andrew et al. 2020) – and millions of people in less developed countries (World Bank 2020). It is difficult to see how they are just.

Whether proportionate in their impact on the liberties of a free and democratic society in part may be a matter of belief, but it remains doubtful that lockdowns have yielded meaningful further benefit against which any harms can be weighed.

As no scientific and epidemiological precedent has been established for the use of lockdowns, their implementation seems to contravene the planning guidelines of the ECDC (ECDC 2017), which requires the benefit-cost, feasibility, legal and ethical, risk mitigation, scientific and socio-political considerations to have been assessed in advance; and also of the UK DH (DH 2011a), which requires interventions to be evidence based or based on established best practice in the absence of evidence, based on ethical principles, and based on established practice and systems, as far as is possible.

The UK Government pandemic flu preparedness strategy refers to its own ethical framework (DH 2011a) noting it has “been reviewed by the Committee on Ethical Aspects of Pandemic Influenza (CEAPI) in the light of the experience of the H1N1 (2009) influenza pandemic and the Committee has concluded that it remains appropriate and fit for purpose in planning for a further pandemic”. The framework is referred to online (GOV 2017). It requires that:

“media and other people responsible for communications will have a role to play in ensuring that people know what the real situation is and what they need to do, without exaggerating or minimising the situation”

“people will have as much chance as possible to express concerns about or disagreement with decisions that affect them”

“plans will be adapted to take into account new information and changing circumstances”.

The supporting 2007 document is available in archived form (DH 2007). A Moral and Ethical Advisory Group (MEAG, MEAG 2020a), which supports SAGE, has adopted this framework. MEAG is primarily mandated with responding to requests (MEAG 2020b), and the available meeting summaries suggest it has not received a request to consider the fundamental ethical principles of the lockdown itself.

Follow the politics?

As late as March 19th, 2020 (Guardian News 2020), UK Government advisers advocated the pursuit of established pandemic guidelines and ethical principles, advancing to the introduction of low-stringency NPIs – including hand hygiene, social distancing, and isolating when sick. They acknowledged the uncertainties, the importance of truthfulness, the need to balance anticipated benefits against anticipated harms and to modify policy as more reliable evidence accumulated.

On March 23rd, this approach was dropped (GOV 2020) in favour of a lockdown with closures of schools – including primary – and non-essential businesses, mandatory stay-at-home orders, travel bans and bans on mixing between households. The scientific and epidemiological precedent for this lockdown policy was fragmentary, poor and arguably non-existent. No meaningful attempt seems to have been made to weigh supposed benefits against certain harms, or to formally consider the overall maximisation of health and use of resources.

The lockdown, as anticipated, has been harmful and appears to have delivered no benefit beyond low stringency measures such as those persisted with in Sweden. The NHS was not overwhelmed in April 2020 and the Nightingale field hospitals were not used. Neither was the NHS overwhelmed in January 2021 – by which time the NHS had had many months to prepare for a winter resurgence. However, the wave of infections followed a rise and fall typical of a seasonal respiratory virus (Merrow and Urban 2020; Audi et al. 2020) – and did so in most northern latitudes. There is no need to invoke lockdown stringency or vaccine roll out to explain it.

It is not clear why scientific understanding, pandemic planning principles and public health ethics were abandoned but, judging by statements of UK Government advisers, lockdowns were favoured by mathematical modellers who – with behavioural psychologists – appear to have been particularly influential: while the UK government advisers appeared to acknowledge the fallibility, inconsistency and predictive nature of simulations, paradoxically, they emphasised the importance of mathematical modelling and the behavioural sciences in formulating their advice (Guardian News 2020, Conn et al. 2020, Whipple 2020).

Seemingly oblivious to wider issues, Professor Ferguson is, for example, quoted – regarding the lockdown in China – as stating: “It’s a communist one party state, we said. We couldn’t get away with it in Europe, we thought… and then Italy did it. And we realised we could.” (Whipple 2020).

There was evident and considerable media pressure on the advisers – who are not politicians – to lockdown like other countries, seemingly irrespective of the consequences. For illustration, questioning Sir Patrick Vallance on March 13th 2020 (Sky News 2020), Stephen Dixon of Sky News UK began:

“The big question here is why the advice that is being given to our Government does seem to be different to the advice being given to many other governments who are taking much more stringent action…”

Regarding the percentage of the population that would need to be infected to reach herd immunity, he continued:

“Sixty percent?… I mean even with that, even looking at the sort of best case scenario… I know we were talking last week, we were saying… you know… half of one percent to one percent fatality in something like this, that’s an awful lot of people dying in this country….” (Sky News 2020, at 5:25 to 5:38 minutes).

An Infection Fatality Rate of 0.5 to 1.0 percent in the UK, with a population of about 68 million, would yield about 200,000 to 400,000 deaths.

This was an understandably frightening number. Perhaps the UK Government yielded to political and media pressure to favour a lockdown like “many other Governments” even though this went against scientific understanding and pandemic guidelines.

It may also explain why Sir Patrick has not subsequently abandoned lockdowns, despite the cost-benefit deficit – and despite the formal expectation that SAGE (2012) may advise on:

“the scientific and/or technical pros and cons of policy options identified by others”

“the degree of consensus (e.g. all, the majority, most, some or few experts agree)”

“differences in opinion (i.e., are there differences in scientific/technical opinion and what are the sources of disagreements?)”

“the degree and cause of uncertainty (e.g. confidence levels, margins of error and the reasons for not being more certain).”

On March 23rd, 2020, the ethical principles too were ignored. Truthful and proportionate communication, critical discussion and a flexible response to the pandemic as it unfolded not only ended, but was replaced with fear mongering, and one-sided shaming and vilification of those who resist or challenge the lockdown, which has become a totem (BBC 2020, Cohen 2021, O’Brien 2021). The concept that the virus is an ‘enemy’ is a scientific absurdity, but the Government and media have managed to construe an enemy within.

While, on the one hand, an eminent author of the Great Barrington Declaration (GBD 2020) – Sunetra Gupta, Oxford University Professor of Theoretical Epidemiology – has been singled out for criticism by a Member of Parliament (O’Brien 2021), on the other the President of the Royal Society of London has been reported as asking for mask refuseniks to be treated like drunk drivers who are a threat to health workers and grandmothers (Rawlinson 2020). This is about politics not science, and it is hard to see who would dare disagree – on legal, ethical or scientific grounds.

If this is the case, the media usurped the scientific role of SAGE, of leaders in public health preparedness and ethics and of the Government, becoming itself the primary arbiter of pandemic policy. In Sweden, by contrast, where the Public Health Agency (Folkhälsomyndigheten 2021) is insulated from political and media interference, Anders Tegnell and colleagues were able to pursue the conventional wisdom of pandemic preparedness relatively unmolested, fairing better than the UK and no worse than many other European countries in COVID-19 fatalities (see OutWorldinData.org). In Florida and South Dakota also, by contrast, more resilient elected leaders appear to have been unwilling to buckle to media pressure to lockdown.

At present, the Johnson administration constitutes a lockdown autocracy, and not one that appears likely to be replaced internally in its current inept state. It is sustained by borrowing and quantitative easing, and has enormous control over the life chances of much of the public. The media support it by seemingly endlessly propagation of fear and division, and the dismissal of comparative examples of relative success – Sweden, Belarus, Florida, South Dakota – where lockdowns were not pursued.

Mr. Johnson has proved how easily authoritarian government can be established in a democracy. The few rule in the name of the many and – it may predictably transpire – have among them profiteers and violators of laws the many are expected to follow (McNeill and Grey 2020, Campbell 2020).

Despite the objections of one of Britain’s most senior former judges (Sumption 2020a, b), it is startling to note the only successful challenge to the lockdown on legal grounds relates just to the awarding of contracts (Dyer 2021). No substantial judicial resistance to the lockdown has emerged despite the infringements of public health ethics and human rights, questionable benefit and the wide-ranging harm lockdown has caused and the abandonment of existing scientifically supported pandemic preparedness guidelines.

Conclusionleadership and accountability

Cnut the Great, King of England and Denmark, is said to have rebuked his sycophantic courtiers by demonstrating to them that he could not, in fact, command the tide.

Perhaps Cnut practiced leadership in a way that contemporary politicians do not – or cannot, where their re-election depends on a public perception of infallibility.

It is tempting though to wonder if Cnut had been advised by the present SAGE whether he would have known not to go to the shore when the tide was coming in, but to wait until the tide was going out before issuing the relevant command.

In Cnut’s day, the public – for common sense reasons – believed the sun circled around the earth. The reality, we now know, is the reverse.

It may seem common sense that lockdowns and cloth masks reduce the spread of seasonal respiratory viruses and save lives, but whether or not they really do is a question of science.

Being himself a biographer of Winston Churchill, Boris Johnson’s view (Johnson 2014) of his political idol is interesting. Regarding Churchill’s determination to continue the war against the Nazis following the fall of France, he has commented:

“They needed somebody of the scale of Churchill to deal with them, they needed somebody with the moral courage to take the decision he did. I’ve talked about the deciding to fight on in May 28th 1940. Well, a year from that date, thirty thousand British men, women and children had died. You cannot imagine any politician today having the courage to take that decision, but it was right. It was the right thing to do.” (Johnson 2014, at 37:26 to 37:55 minutes).

He adds, in comparison: “there are no politicians today who are fit to loose the latches of his sandals. I mean he was a… he was a one-off, and in a way it is a good thing and its thanks to Churchill that our times do not require such people.” (Johnson 2014, at 38:14 to 38:31 minutes).

Within weeks of Mr Johnson’s victory in the 2019 general election the COVID-19 pandemic emerged – and, if Britain needed a Churchill in March 2020, it didn’t get one.

Johnson is no Churchill. If he is a Cnut, he is one who having convinced the people he can control the tide, let them drown in it.

Why and how a ‘deadly embrace’ with media and politics led to the subversion of science in a public health emergency is beyond the scope of this article. However, it is essential that those responsible for legal and ethical breaches be formally censured and legislation introduced to prevent a future occurrence.

The co-authors are a PhD epidemiologist trained at a Russell Group University and a retired former Professor of Forensic Science and Biological Anthropology.

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