Greece Should Not Impose a Lockdown, Says Stanford’s Ioannidis

Dr. John Ioannidis of Stanford University Medical School. File photo

Dr. John Ioannidis, the renowned medical professor at California’s Stanford University Medical School, warned in an interview with Greek Reporter that Greece should not impose a second lockdown.

“It would be a devastating mistake to do so and it will run the risk of severely damaging and crippling the country,” he said.

The esteemed epidemiologist, who had called earlier in the year for there to be no lockdowns in response to the virus, had some stern words of warning when weighing the risks between protecting the populace from Covid-19 and shutting down the economy once again.

Ioannidis was valedictorian of his class at Athens College, graduating in 1984. Graduating at the top of his class at the University of Athens Medical School, he is now a Professor of Medicine, Health Research and Policy and Biomedical Data Science at Stanford.

File Photo

Greece is now in the grip of the dreaded second wave of the virus and ICU capacity is at 70%, according to recent figures. Lockdowns are now being discussed.

The professor said that “I cannot predict what will happen with the coronavirus in the Autumn but we must understand that the chances of us dying from the virus are extremely small.”

“The mass infections in northern Italy were caused by bad management in hospitals. Patients with no Covid were put together with patients who were positive for Covid,” he explained.

He added that “The vaccine, hopefully, will be found,” but said that it might not be available this year, or even for a longer period of time. He also cautioned as well that there was no guarantee that the vaccine would be effective.

Dr. Ioannidis has also claimed that he had calculated that the economic crisis which hit Greece between 2010-18 cost around three thousand lives per year.

Greek Reporter asked the coronavirus expert if he could explain for our readers exactly how lives are lost in this way.

“Indeed,” the medical professor told Greek Reporter, “we published an analysis of the Greek mortality data in Lancet Public Health that showed that each year of the economic crisis that hit Greece in the last decade resulted in 3,000 excess deaths – every year.

“The bulk of that excess was for common causes of mortality like cardiovascular disease and nervous system problems, but there were also considerable contributions from suicides and mental health deterioration,” Ioannidis explains. “There was also a clear increase of deaths due to medical errors and poor medical care.

“Financial crises devastate both mental and physical health and they severely damage our health systems,” he continued. “The severity of the current crisis due to the pandemic and the imposed lockdown is clearly more severe than what happened in the last decade and reversibility cannot be guaranteed.

“The fact that the Greek health system is so unprepared is not just due to incompetent politicians who have succeeded each other without doing much to remedy the shortages, but also due to the severe cuts imposed by the financial crisis. The most vulnerable people (the aged, those who have serious diseases and those who are poor and disadvantaged) are hit the hardest in such crisis settings.”

Greek Reporter asked the professor if Greece should impose a lockdown now — and if not now, at what point should a lockdown be imposed? Or, perhaps, is this type of draconian action simply not the answer?

Lockdown would be “Devastating Mistake”

“Greece should definitely not impose a lockdown,” the Stanford professor warned. “It would be a devastating mistake to do so and it will run the risk of severely damaging and crippling the country. Such a suicidal strategy can cause tremendous mental and physical harm to Greeks.

“Even the first lockdown was already devastating, and the devastation is likely to cause many excess deaths in the mid- and long-term. A second lockdown for a country on the verge like Greece is a totally unacceptable choice in my mind. Life should continue and schools should remain open.”

Greek Reporter then asked Ioannidis why Greece is experiencing a second wave, after everybody had for so long congratulated the country and its citizens for their first response to the pandemic. What, in the final analysis, went wrong?

“The first wave that hit Greece was of very small magnitude. Barely about 1% of the population was infected (roughly 100,000 people) and the wave had already peaked and mostly subsided even before the lockdown was imposed on March 23,” the professor replied.

“The early peak, estimated to have been around March 10, was missed since hardly any testing was done.

“Apparently people got scared from what they saw happening in Italy and they started using social distancing, limiting their exposures and promoting hygiene measures well before the lockdown was decided. Greece has hardly any visitors from China in January and February and few visitors overall during that period of the year,” he stated.

“Plus,” he added, “there is very little mobility across the country in wintertime. Conversely, despite the sharp decline in tourism volume, there were still several million visitors during the summer months — and unfortunately only roughly 1 in 8 were tested upon arrival.”

“Entirely silly”

The epidemiologist is a noted critic of scientific studies and the misuse of data in public policy, publishing an editorial in the medical journal STAT in March of 2020 slamming the decision-making process in the global response to the COVID-19 pandemic, even calling it a “once-in-a-century evidence fiasco.”

Ioannidis explains to Greek Reporter that “The initial decision’s rules on who to allow to visit and who to test looked at the number of documented cases in a given country, which is entirely silly because the number of documented cases is a tiny portion of all cases and depends largely on how much testing is done.

“As a result,” he states, “many people came from countries in the Balkans and elsewhere where few tests were being done but where there were clearly active epidemic waves. Concurrently, during the summer months there were many mass gatherings with little to no protection.”

He continued his critique, saying “Testing also remained extremely limited for people in the country itself; the numbers of tests done was pretty low if one excludes tourists. One is doomed to have a second wave under these circumstances.”

Greek Reporter then asked Ioannidis what measures – aside from a dreaded lockdown – Greece can take to prevent the further spread of the virus and keep people out of the ICU.

“Hygiene measures (hand washing and respiratory etiquette), proper use of masks where appropriate, avoidance of mass events, and avoidance of congestion are standard measures,” he replies. “It is possible that they may not suffice to fully contain the spread and that some substantial spread will continue.

“In this case,” he cautions, “a lockdown is not the answer. It will not decrease the spread at this point very much, plus it will be devastating, as we discussed. Attention should thus be given to protecting the vulnerable groups and settings with draconian measures so as to avoid having the virus spread to people where it can be highly lethal.

Protecting Vulnerable Groups

“This means,” he said, “repeated universal testing in nursing homes and in hospital staff and health care workers and in any other high risk location (prisons, refugee shelters, some high risk jobs) and extra protection with reduced exposure to risk for highly vulnerable individuals.”

Given the nature of the Greek hospital system, which had only 1,017 ICU beds in May, according to Health Minister Kikilias, with plans to add more during the summer, Greek Reporter asked Ioannidis if the Greek health system could withstand the pressures.

“The best defense is helping the healthcare system,” he says. Asked what form this should take in Greece, he responded “We were lucky in the first wave that was small by itself and could be contained, but this only meant that we gained some valuable time to prepare better for the second wave.

“Preparation means building the health care system, both at the level of ICU care and at the level of primary care (so that one can keep the virus at bay in the community and not have to deal with the epidemic at the hospitals, with the risk of massively infecting the hospital environment).

“Some measures were taken to increase the number of ICU beds and these are most welcome, but probably they were not enough and sadly I hear that these beds and units may not yet be operational,” the professor adds.

“After all this time lost with self-congratulations and celebrations, I hope that a serious, urgent plan can be put in place to buttress the health care resources,” he urges. “In a time of crisis and knowing the limitations of the public health system, it is imperative also for the resources of the private health sector to be mobilized for the public good.

Ioannidis concludes “Greece has superb physicians and health care staff, but we should not desert them without the necessary ammunition to win this war.”