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Letter from concerned Doctors and Scientists to the Irish Government

Dear Taoiseach Martin, Tanaiste Varadkar and Minister Donnelly

We, the undersigned would like to recognise the leadership that has been shown this year by many of our scientific and political leaders, as we faced a very uncertain situation in the face of this new virus. Engagement from all sectors of society allowed us to flatten the curve and buy time in the short term. These efforts enabled us to minimise adverse impacts and learn so much about SARS CoV(2) since April 2020.

As doctors, we must keep our knowledge base up-to-date. Doing so allows us to deliver on one of our most important obligations: to help our patients manage any disease process that might affect them. The current situation is no different. Our understanding of Covid19 has significantly evolved over the last few months, and we have come to learn much more about the SARS CoV(2) virus, which causes it. We now know who it impacts and the extent of that impact. We also know its similarities to, and differences from other common coronaviruses. We also know Its seasonal nature which is no different to most respiratory pathogens. Perhaps most importantly, we have developed more optimal medical strategies for this condition in the subset of patients who unfortunately suffer the most severe impacts.

In light of this, we as front-line doctors feel more confident about managing Covid19, and we want to reassure society that now we can effectively coexist with the virus. Unfortunately, the current unilaterally enforced national strategy has not evolved in step with our improved scientific understanding and insight. We are in effect managing this as a “crisis”, from day to day, level to level - as though it were March 2020 when the actual crisis was present. The situation is entirely different now in so many ways.

Some of the critical evidence that has emerged includes, but is not limited to:

  • Immunity: there is evidence for a significant degree of established community immunity to SARS CoV(2) based on multiple follow-up studies. These studies indicate that greater than 80% of close household and indoor contacts of a positive case, do not exhibit symptoms or test positive for SARS CoV(2). There are many published papers on this phenomenon, including a very recent one in the BMJ.

  • Lockdown: there are now multiple published papers indicating that lockdown measures have little impact on the morbidity and mortality impact of Covid19. These lockdown measures, however, certainly have an enormously detrimental effect on public health. Senior, experienced medical professionals are expressing grave fears that we are creating an enormous burden of more advanced disease states (e.g. cancer) should we not reorient all health services back to their original purpose. Have we forgotten about the crucial economic determinants of health? And that those disproportionately affected are the most vulnerable in our society (including children, women and the less well off). In short, the current strategy seems to be oblivious to this reality. It appears, astonishingly - that no-one is doing a cost versus benefit analysis for this.

  • Testing: current test method for SARS CoV(2), i.e. PCR swabs, can yield results with questionable accuracy. These tests were never intended to be used in this setting, and are unreliable: 1-3 % false-positive rate, i.e. in a real-world scenario of low

prevalence, this false positive rate would mean that more than 50% of the “positives” could be false. Added to this problem is the detection of old and irrelevant viral fragments, and infections so slight that they have no clinical significance. The truth is that only a fraction of daily reported ‘cases’ are clinically significant in terms of transmissibility or impact.

Fatality: the infection fatality rate (IFR) of Covid19 is approximately 0.23-0.27%. The IFR reduces to only 0.05% in the population under 70 years old. This data has been published by the WHO in recent days, based on research done by Prof. John Ioannidis of Stanford University, currently the most cited doctor in epidemiology and medicine. Real-life population fatality rates will be significantly lower than this across all the groups.

Given this massive body of new evidence, we as doctors strongly advise that we open the discussion on COVID 19 to a broader range of medical and scientific expert opinions.
As a matter of urgency, we need to have this discussion for Ireland - openly and transparently. We desperately need to stop lurching from crisis to crisis, with every daily report of new PCR positive “cases”.

To achieve this, we as a society must commit to:

  • opening up the scientific debate, which has been extraordinarily stifled over the

    past six months

  • taking seriously our obligation to change the strategy in response to the new

    evidence

  • leveraging our unique Irish societal characteristics, to enable a more focused and

    intensive protection strategy for those who need it most.

    With the application of all the scientific evidence and with brave political will, we can negotiate a path forward that ensures optimal health, societal and economic outcomes for the Irish people. We propose a “proportionate de-escalation” of the current exclusive focus on Covid19 to the exclusion of all other health and wellbeing needs of our Irish society. We wish to leverage our collective expertise and intellect as front-line physicians and scientists - to help our society to move forward with confidence into the future.

    Finally, we must open up this discussion to include the growing group of Irish and international experts who have been excluded from the conversation so far. We must acknowledge that many of these experts have been at the forefront of furthering our understanding of this virus and its impacts.

    Yours Sincerely

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