Table 9.

Other calls for a change in COVID-19 response priorities.

References	Content of the call for adjusting COVID-19 response priorities
Open letter on July 6, 2020, to the Prime Minister and Premiers of Canada (213)	The current approach “carries significant risks to overall population health and threatens to increase inequalities… Aiming to prevent or contain every case of COVID-19 is simply no longer sustainable… We need to accept that COVID-19 will be with us for some time and to find ways to deal with it.”
	The response risks “significantly harming our children, particularly the very young, by affecting their development, with life-long consequences in terms of education, skills development, income and overall health.”
	Suggest that we need “to focus on preventing deaths and serious illness by protecting the vulnerable while enabling society to function and thrive… While there is hope for a vaccine to be developed soon, we must be realistic about the time… We need to accept that there will be cases and outbreaks of COVID-19.”
	“Canadians have developed a fear of COVID-19. Going forward they have to be supported in understanding their true level of risk… while getting on with their lives – back to work, back to school, back to healthy lives and vibrant, active communities….”
	COVID-19 “is not the only nor the most important challenge to the health of people in Canada… The fundamental determinants of health – education, employment, social connection and medical and dental care – must take priority…”
Open letter to National Cabinet of Australia (214)	“exposure to COVID-19 is only temporarily avoidable”; “to analyze the COVID-19 effect it is necessary to understand it as shortening life. But the lockdowns and the panic have also had a cost in shortening life for others.”
	Some of these costs include that the lockdown: “will decrease national income… and this will have a measurable effect on the length of the average lifespan,” “[has] disrupted normal health services… estimated an increase in cancer deaths over the next 12 months of 20%,” [and will cause] future suicides by the unemployed and others whose lives have been ruined.”
	Urge for “a cost-benefit analysis, including lives saved versus lives lost, both directly and consequentially… [and] weekly or daily non-epidemic death figures should be posted as well as deaths from the epidemic…”
Ioannidis, JPA (95, 215–219)	Called for evidence to guide policy, noting many of the collateral and recession effects discussed above.
	“Shutdowns are an extreme measure. We know very well that they cause tremendous harm.”
	“the excess deaths from the measures taken is likely to be much larger than the COVID-19 deaths… learning to live with COVID-19 and using effective, precise, least disruptive measures is essential to avoid such disasters and to help minimize the adverse impact of the pandemic” (95).
	“When major decisions (e.g., draconian lockdowns) are based on forecasts, the harms (in terms of health, economy, and society at large) and the asymmetry of risks need to be approached in a holistic fashion, considering the totality of the evidence” (219).
Resignation letter by economist in Victorian Treasury (220)	“the pandemic policies being pursued in Australia… are having hugely adverse economic, social and health effects… The need for good policy process does not disappear just because we face a public health crisis… the elderly are many times more vulnerable to a serious outcome than the young. It was necessary, therefore, to work out a targeted age-based strategy… The direct and indirect costs imposed by regulatory approaches may not be… immediately obvious. Risk regulation that is poorly targeted or costly will divert resources from other priorities… needed to commission a cost-benefit analysis of alternative policy options….”
	Governments should have realized “they are hostage to chronic groupthink and actively sought alternative advice… instead of performing its taxpayer-funded duty of providing forthright analysis of alternatives… can (even now) be managed by isolating the elderly and taking a range of voluntary, innovative measures.”
The Great Barrington Declaration (221)	“current lockdown policies are producing devastating effects on short and long-term public health… leading to greater excess mortality in years to come… keeping students out of school is a grave injustice… The most compassionate approach that balances the risks and benefits of reaching herd immunity, 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.”