Coronavirus (169) Lancet Offline: COVID-19 — a reckoning

20 March, 2020

Citation and extracts from Lancet editor-in-chief Richard Horton's latest Offline in The Lancet:

CITATION: Richard Horton. Offline: COVID-19—a reckoning

Comment| volume 395, issue 10228, p935, march 21, 2020

Published: March 21, 2020DOI:

“To be clear we have one strategic aim: save lives.” So stated a UK Government health adviser in an email sent to me last weekend. It was an email filled with frustration... But this emergency is more than a public health catastrophe. It is a full-blown political crisis, one that is afflicting every nation in the world... The world is dangerously unprepared. And this global political crisis isn't over yet. It has barely begun.

The UK should have been a country that was prepared for an emergency of the scale of severe acute respiratory syndrome coronavirus 2. Johnson had said that, “We have a clear plan.” That plan was set out with stark clarity by Graham Medley, one of the UK Government's expert advisers on pandemics... “We are going to have to generate what we call herd immunity... And the only way of developing that, in the absence of a vaccine, is for the majority of the population to become infected.” He advocated “a nice big epidemic” to infect and render immune as many healthy people as possible... With a 0·3–1% mortality, that meant a plan that would accept somewhere between 117 000 and 390 000 deaths. But when the brutal consequences of this strategy became clear, it was quickly ruled impermissible. The goal changed to saving lives...'


Best wishes, Neil

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