Sweden's former top state epidemiologist has claimed unless a vaccine is found soon, lockdowns like New Zealand's won't prevent any deaths at all - just push them into the future.
Johan Giesecke's call, published by journal The Lancet, comes the same week a new paper claims lockdowns in hard-hit western Europe haven't saved a single life at all, which has split opinion among experts.
Sweden has taken a different approach to handling the COVID-19 pandemic than most other countries, deciding against a lockdown of any kind, instead relying on people following social distancing guidelines. As of Monday, it had 26,300 confirmed cases and 3225 deaths - far more than its Scandinavian neighbours, but only a fraction of those seen in Spain, Italy and the UK, which have all implemented lockdowns of various kinds.
Sweden's first case of the coronavirus was reported on February 4, just a few days after the UK, Spain and Italy reported theirs. Since then, the latter three have recorded about 90,000 deaths between them.
A new study published online claims the lockdowns have saved no lives at all. Thomas AJ Meunier's paper, which has not been peer-reviewed, claims mathematical modelling shows there was no difference in the spread of the disease before and after lockdowns were implemented in Italy, France, Spain and the UK.
"Extrapolating pre-lockdown growth rate trends, we provide estimates of the death toll in the absence of any lockdown policies, and show that these strategies might not have saved any life in western Europe."
Kiwi epidemiologist Simon Thornley, who as part of the controversial 'Plan B' team has publicly called for an earlier loosening of New Zealand's lockdown restrictions, told Newshub while Meunier was operating "outside of his field", the paper "reads well and is logically laid out". He said it showed the "pre-lockdown trend from the model predicted fewer deaths from COVID-19 than were observed post lockdown", at least in the 17 days after the lockdowns were implemented.
"The unfavourable difference is most marked for France, Italy and Spain, with Great Britain's observed data following more closely the pre-lockdown model predictions... In France, Italy and Spain the lockdown had an unfavourable further effect over the social distancing which was enacted before lockdown."
Dr Thornley said it was consistent with the Plan B group's findings that New Zealand's strict lockdown wasn't any more successful at stopping COVID-19's spread than Australia's looser approach.
"Lockdowns, particularly severe ones, as in New Zealand, force a lot of people into close proximity at supermarkets, for example," he told Newshub. "More relaxed social distancing may be better as it does not lead to large crowds congregating as they are doing in supermarkets in New Zealand."
But epidemiologist Shaun Hendy of the University of Auckland said the paper was a "very poor piece of work and its conclusions shouldn't be taken seriously".
Unlike New Zealand, the virus was spreading widely in the community in the UK, Italy and other hard-hit European nations before their lockdowns were implemented. But that doesn't mean the belated lockdowns haven't helped, said Dr Hendy, who is also director of Te Pūnaha Matatini, a New Zealand Centre of Research.
"You need a good model of the way the disease spreads, but the author here uses a very naive approach by simply extrapolating a fit to early data that doesn't capture any of the underlying disease dynamics or the way that control measures work.
"In reality we expect the effects of control mechanisms such as testing and case isolation, lockdowns, social distancing, et cetera, to each saturate in effectiveness.
"For example, just because social distancing might slow the spread of COVID-19 to an extent does not mean it is going to completely eliminate the disease on its own without other interventions. Unfortunately this is what the author’s model assumes is possible. If the author had chosen to use any accepted model of disease spread, they would not have come to this conclusion."
Te Pūnaha Matatini's modelling in early April suggested unlike most countries, New Zealand had the chance to eliminate the virus - at the time we were recording dozens of new confirmed infections every single day.
Another epidemiologist contacted by Newshub either declined to comment on Meunier's paper as it was written by a sole person and not peer-reviewed, and might suffer "quality control" issues. Others didn't respond.
Were victims going to die anyway?
Dr Thornley also said the average age of death from COVID-19, disproportionately targets the elderly, was "about the same as our average life expectancy", so it is "very hard to claim that COVID-19 is shortening our lives either here or in Sweden".
But a University of Glasgow study found the average victim of COVID-19 would have lived another 10 years. People who make it to the average life expectancy can generally expect a few more years of life, as the average life expectancy at birth includes people who die young.
"Among people dying of COVID-19, the number of years of life lost per person appear similar to diseases such as coronary heart disease," that study concluded. Like much research into COVID-19, that study was also was not peer-reviewed before publication.
'Very little we can to to prevent this spread'
Dr Giesecke said in The Lancet it's "become clear that a hard lockdown does not protect old and frail people living in care homes - a population the lockdown was designed to protect".
He believes around a quarter of everyone living in Stockholm, the Swedish capital, would have been exposed to the virus already - 98 percent of them without even realising it, or experiencing symptoms mild enough to not bother getting tested for the virus, called SARS-CoV-2.
"Everyone will be exposed to [SARS-CoV-2], and most people will become infected," he wrote. "COVID-19 is spreading like wildfire in all countries, but we do not see it - it almost always spreads from younger people with no or weak symptoms to other people who will also have mild symptoms.
"This is the real pandemic, but it goes on beneath the surface, and is probably at its peak now in many European countries. There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear."
This has been the case in South Korea and Germany - both countries successfully controlled the first wave of the coronavirus, but have experienced new outbreaks as restrictions were lifted this week.
"I expect that when we count the number of deaths from COVID-19 in each country in one year from now, the figures will be similar, regardless of measures taken," said Dr Giesecke.
New Zealand, being remote and without land borders, is lucky - we have a chance at eliminating local spread of the virus, like we have with other diseases like measles.
To keep out new cases, we have implemented a 14-day quarantine at the border for returning Kiwis, and blocked entry for most foreigners. Dr Giesecke says this would have to stay in place for as long as it took to find a vaccine - if one's found at all - if we want to avoid having an outbreak in the future.
"Our most important task is not to stop spread, which is all but futile, but to concentrate on giving the unfortunate victims optimal care."
Though it doesn't appear to be mutating as fast as some other viruses, like influenza, it could be years before a vaccine for COVID-19 is found.
"Optimistically if things all go exactly right, you know, we could be in a situation a year, 18 months from now, where the initial vials of a licensed vaccine are given out," Dr Wayne Koff, head of the Human Vaccines Project, told RNZ on Sunday.
But most vaccines take a decade to develop, he said. The fastest on record was mumps - and that took four years.
There are more than 100 different potential vaccines being developed and trialled at the moment. Meanwhile, around 5000 people die every day from the disease - and it hasn't even taken hold in poor, under-resourced parts of the world yet.
