This is a working document that will be revised frequently over the next few weeks

The Great Barrington Declaration (GBD) laid out the central tenets of a more reasonable, scientific approach to understanding COVID-19. However, something is still missing from the national conversation: There has yet to be a clear articulation of the path forward to normalcy. Specifically, we need to discuss steps that can be taken to address the reasonable and serious concerns around COVID-19 but are properly balanced against the human rights of the citizenry. Below we offer ten steps to dramatically improve the current situation that we feel both sides of the divide can agree on. This approach is apolitical and can be used to guide the country out of this crisis.

Communicate the age-stratified fatality rates

The CDC’s current best estimates for age-stratified infection fatality rates (IFR) are:

  • 0-19 years: 0.003%
  • 20-49 years: 0.02%
  • 50-69 years: 0.5%
  • 70+ years: 5.4%

The risk to people under the age of 20 is over 1000 times lower than the risk to those over 70.

Polling has shown that the general population has a poor understanding of the mortality rate of the disease, dramatically overestimating their personal risk of dying of COVID-19. Until the public understands the actual risks (preferably in the context of other risks that are taken for granted), common-sense measures will continue to be resisted in favor of a pseudo-religious belief in non-pharmaceutical interventions (NPI) that have not been proven to work anywhere. Personal responsibility, combined with the knowledge of facts and accommodations for those who are vulnerable to poor outcomes, should be the centerpiece of all policy implementations.

Re-think the testing strategy

  • PCR tests are not calibrated to convey the person’s level of contagiousness. It is immoral to quarantine people that are non-contagious and are of no danger to the community. Information about an infection or even prior infection is useful for public health officials, but a one-size-fits-all response to case discovery does not serve the cause of public health.
  • A shift to rapid antigen testing and away from PCR testing may be a valuable adjustment to the current testing regime, as long as we understand the false positive and negative rates of all approved tests.
  • All tests are currently approved under Emergency Use Authorizations, and they should immediately begin the formal approval process that is required for other diagnostic tests.
  • Home tests without mandatory reporting should be made available as soon as possible.
  • Testing of asymptomatic individuals (unless it is part of a randomized surveillance study) should end. Tests should be used primarily in situations where they are needed to protect the vulnerable–for example, in hospitals and nursing homes.

Track and trace is a reasonable approach to limiting the spread of the virus, and efforts should be taken to accomplish this as with any communicable disease. That being said, it must be accepted that unless this effort is limited to identifying contagious people, it is doomed to fail and will not be accomplished successfully. Recent efforts to infer “potential exposure settings” has been exploited to shut down businesses in specific industries with little evidence of outbreak potential.

Children. It has been established that children are not a significant infection vector of COVID-19. The educational, psychological, and sociological damage done to millions of children worldwide due to school closures is incalculable. Schools must be opened for in-person education, everywhere, immediately, without masks or social distancing.

Workers. It must be accepted that any person’s work is essential, and it is not the place of government to pick winners and losers. Businesses must be allowed to operate freely and without interference. If a business is to be closed, it must be done with due process and must be based on transparent and unambiguous data that demonstrate specific problems in that specific business.

Non-Pharmaceutical Interventions. We believe strongly that encouraging positive hygiene habits (healthy eating, exercise, washing hands) is a positive approach that public health officials can rightly influence. Social distancing can be a proper tool to help mitigate spread, but mandating public social distancing has had a dramatic negative effect upon the population and needs to be re-examined. It is established science that masks do not stop the spread of this virus. While COVID-19 is a “novel” pathogen, the virus size and method of spread is the same as similar respiratory viruses. If public health officials are going to make the claim that masks have been shown to work, RCT studies must demonstrate that the science has changed. If these studies exist, they should be widely circulated and explained. 

Hospitalization (general & ICU) usage must be clearly delineated between those who have COVID-19 as a primary diagnosis and those who are hospitalized for another reason and have a positive COVID-19 test.  Moreover, the “primary COVID-19” number should be the primary metric to determine whether any short-term community-wide mitigation efforts need to be undertaken. Furthermore, detailed and accurate dates, demographics, and severity measures should be published along with any hospitalization data.

Deaths. Today, per guidance from the CDC, anyone that has ever had a positive COVID-19 test is counted as a COVID-19 death, even if the final cause of death was unrelated to COVID-19. COVID-19 deaths need to be tallied like other diseases, and COVID-19 (typically pneumonia or ARDS) must be the primary cause of death. Furthermore, detailed and accurate dates and demographics should be published in a uniform manner across all geographic entities.

Government Powers. Emergency declarations and powers are meant to deal with just-in-time events where the legislature does not have time to act. COVID-19 is no longer this type of an emergency and is likely already endemic. As such, it is time for emergency powers to cease and for the legislature to resume their role and pass laws to deal with how governments should deal with these pandemics. Serious sunlight must be shone on the actions to address COVID-19 so that we may learn and address successes and the serious failures.

One size does not fit all. With few (if any) rigorous studies of what has worked to minimize the harm to the population as a whole during a pandemic, resources should be devoted to studying how various regions have approached it and all the variables that could influence the various outcomes. We also need to study the effects of the many government actions that have influenced hospital billing, treatment, testing, and death reporting. Local, state, and federal political influences have badly deteriorated the trust we have in our institutions.

Liability protection is likely needed to allow businesses and institutions to operate without fear of lawsuits.