《大巴灵顿宣言》
作为传染病流行病学家和公共卫生科学家，我们对现行COVID-19政策对身心健康的破坏性影响感到严重关切，并建议采取一种称为“重点保护”的方法。
我们来自世界各地的左右两派，从事保护人们健康的职业。目前针对新冠疫情的封锁政策正在对公共健康产生短期和长期的破坏性影响。其后果（仅举几种）包括儿童接种率降低，心血管疾病恶化，癌症筛查人数减少和心理健康恶化，并导致未来数年内发生更高的过度死亡率、工人阶级和较年轻的社会成员负担最重、让学生辍学的严重不公平现象。
如果把这种政策坚持到疫苗出现为止，将造成难以弥补的损失，而贫困人口受到的伤害则尤其严重。
幸运的是，我们对病毒的了解正在加深。我们知道，老年人和体弱者感染COVID-19的死亡率比年轻人高一千倍。实际上，对于儿童来说，COVID-19的危险性并不大于其他流行性疾病，包括流感。
随着人们的免疫力增强，所有人（包括高风险群体）的感染风险都会下降。我们知道，所有人群最终都将获得群体免疫，即到达新感染率稳定的时间点，并且这可以通过（但不依赖于）疫苗来帮助到达。因此，我们的目标应该是尽量降低死亡率和减少社会伤害，直到我们获得群体免疫。
最富有同情心的做法是兼顾群体免疫的风险和好处，使死亡风险最小的人过正常生活，使他们通过自然感染增强对病毒的免疫力，同时更好地保护那些风险最大的人。我们把这种政策称之为“重点保护”（Focused
Protection.）。
采取措施保护风险最大的群体应该是应对COVID-19的公共卫生措施的主要目标。举例来说，疗养院应使用具有获得免疫力的员工，并对其他员工和所有来访者进行频繁的PCR测试。人员轮换应尽量减少。对于在家居住的退休人员，应将蔬菜等生活必需品送到家中。在可能的情况下，他们应该在室外而不是室内与家人见面。可以实施全面的措施，包括针对多代人同居家庭的措施，并且这些措施完全应该不超出公共卫生专业人员的能力范围。
应该立即允许那些风险不大的人恢复正常生活。每个人都应采取简单的卫生措施，例如洗手、生病时待在家中，以降低群体免疫的门槛。中小学和大学应该开放进行面对面教学。应该恢复体育运动等课外活动。低风险的年轻人应该正常工作，而不是待在家里。餐馆和其他商家应恢复营业。应该恢复艺术、音乐、体育和其他文化活动。风险更大的人可以根据自己的意愿参加，而全社会将获益于获得群体免疫力者对高风险群体的保护。
2020年10月4日
宣言的领衔签署者：
Martin Kulldorff博士，哈佛大学医学教授，生物统计学家，流行病学家，在检测和监测传染病暴发和疫苗安全性评估方面具有专业知识。
Sunetra Gupta博士，牛津大学教授，流行病学家，在免疫学、疫苗开发和传染病的数学建模方面具有专业知识。
Jay Bhattacharya博士，斯坦福大学医学院教授，流行病学家，卫生经济学家和公共卫生政策专家，专注于传染病和弱势人群。
签名者包括7200多名医学与公共卫生科学家、16000多名医生和近24万名其他人士
The Great Barrington Declaration
The Great
Barrington Declaration – As infectious disease epidemiologists and public
health scientists we have grave concerns about the damaging physical and mental
health impacts of the prevailing COVID-19 policies, and recommend an approach
we call Focused Protection.
Coming from
both the left and right, and around the world, we have devoted our careers to
protecting people. Current lockdown policies are producing devastating effects
on short and long-term public health. The results (to name a few) include lower
childhood vaccination rates, worsening cardiovascular disease outcomes, fewer
cancer screenings and deteriorating mental health – leading to greater excess
mortality in years to come, with the working class and younger members of
society carrying the heaviest burden. Keeping students out of school is a grave
injustice.
Keeping these
measures in place until a vaccine is available will cause irreparable damage,
with the underprivileged disproportionately harmed.
Fortunately,
our understanding of the virus is growing. We know that vulnerability to death
from COVID-19 is more than a thousand-fold higher in the old and infirm than
the young. Indeed, for children, COVID-19 is less dangerous than many other
harms, including influenza.
As immunity
builds in the population, the risk of infection to all – including the
vulnerable – falls. We know that all populations will eventually reach herd
immunity – i.e. the point at which the
rate of new infections is stable – and that this can be assisted by (but is not
dependent upon) a vaccine. Our goal should therefore be to minimize mortality
and social harm until we reach herd immunity.
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. We call this Focused
Protection.
Adopting
measures to protect the vulnerable should be the central aim of public health
responses to COVID-19. By way of example, nursing homes should use staff with
acquired immunity and perform frequent PCR testing of other staff and all
visitors. Staff rotation should be minimized. Retired people living at home
should have groceries and other essentials delivered to their home. When
possible, they should meet family members outside rather than inside. A
comprehensive and detailed list of measures, including approaches to
multi-generational households, can be implemented, and is well within the scope
and capability of public health professionals.
Those who are
not vulnerable should immediately be allowed to resume life as normal. Simple
hygiene measures, such as hand washing and staying home when sick should be
practiced by everyone to reduce the herd immunity threshold. Schools and
universities should be open for in-person teaching. Extracurricular activities,
such as sports, should be resumed. Young low-risk adults should work normally,
rather than from home. Restaurants and other businesses should open. Arts,
music, sport and other cultural activities should resume. People who are more
at risk may participate if they wish, while society as a whole enjoys the
protection conferred upon the vulnerable by those who have built up herd
immunity.
October 4, 2020
