Straight to the point

Written for PANDA by Karen Harradine, edited by Chris Waldburger

In March 2020, the South African government, in lockstep with other countries, and in apparent contradiction with decades of documented pandemic planning, implemented a nationwide lockdown on all its citizens.

At the heart of this radical new policy was Professor Salim S. Abdool Karim.

At the outset of the lockdowns, he would be appointed by the government as chair of the Ministerial Advisory Committee (MAC). The MAC would provide the scientific rationale for the National Coronavirus Command Council, an adjunct to the Cabinet, which would soon implement levels of lockdown. This entailed new regulations, the most memorable of which were mass testing and contact tracing, compulsory mask-wearing, school (and later beach) closures, social distancing, hand-sanitising, and periods in which economic activity was drastically reduced to a set of designated essential services.

It is thus worth understanding the work and life of Karim, a figure who proved to be so influential in all our daily lives in South Africa as we lived through an unprecedented era of global history.

Professor Karim, together with his wife, Professor Quarraisha Abdool Karim, founded the Centre for the AIDS Programme of Research in South Africa (CAPRISA) in 2002. Along with South African institutions such as the University of Cape Town, the University of the Western Cape, the University of KwaZulu-Natal, the National Institute for Communicable Diseases, and the National Research Foundation, CAPRISA collaborates with the United Nations, and was founded under the auspices of the National Institutes of Health in the USA and the Mailman School of Public Health at Columbia University in New York.

The Mailman School and Columbia University are heavily funded by the influential Bill and Melinda Gates Foundation (see here also), which funds multiple scientific institutions and universities and is well-known as a global supporter of Covid-19 regulations and vaccines. Similarly, the Gates Foundation is a major donor to the University of KwaZulu-Natal, the University of the Western Cape, and the University of Cape Town.

Karim also holds professorships at the likes of Harvard and Cornell, and serves on the Science Council of the World Health Organization (WHO), the Africa Task Force for Covid-19, and the Lancet Commission on Covid-19.

But do these positions and connections enhance his credibility, or detract from it? Before the Covid-19 response, very few would have suggested the latter. But now?

Like Gates, CAPRISA has also been known to partner with the Chinese government, the originators of Covid-19 lockdowns.

CAPRISA itself is classed as a non-profit company that generates most of its revenue from grants and is exempt from income tax. In 2021, as a director of CAPRISA, Karim’s total remuneration was more than R3 million. Quarraisha Karim is also a director, having earned over R2.3 million in the same year. Together, the Karims earned a total of R5.4 million from CAPRISA, which  also paid for over R1.6 million of travel expenses in the same year.

This is the background of Karim. This is the global public health ecosystem from which he suddenly emerged into the public eye, just as the country and the world were starting to embrace radical new policies that all had the concept of ‘social distance’ at their heart.

Just as the concept of social distancing contradicted the strategies for dealing with respiratory viruses that had been in place since the Hong Kong and Asian influenza pandemics, so too do Karim’s positions during the lockdown era appear to contain notable inconsistencies.

Karim advocated a ‘zero Covid’ approach, which holds that the spread of the virus could and must be stopped. Whilst New Zealand and Australia would be lauded for the apparent success of this approach in their countries, time would prove the impossibility of eliminating the virus from any society. Both countries would later see a high number of cases per capita, even after vaccination was encouraged and mandated to stop transmission.

Karim’s Covid-19 MAC regularly recommended lockdowns to achieve ‘zero Covid’ in South Africa. Yet, while he was leading the MAC, Karim wrote an article for the New England Journal of Medicine in May 2020 acknowledging the punitive effects of lockdowns on the economy, the poor, and those with chronic diseases like tuberculosis (TB) and HIV. He also noted:

“Poverty and unemployment mean many people live in informal settlements where implementing preventive interventions  such as hand washing and social distancing is difficult.”

If lockdowns cause such damage, and if their intentions are so compromised by our socio-economic circumstances, why were they pushed so hard by the likes of Karim?

Four months after noting lockdown harm and hinting at its impracticality in vast swathes of South Africa, Karim appeared in an interview with Radio 702, where, in attributing excess deaths in 2020 almost entirely to Covid-19, he made no mention of this damage which had been knowingly done to South Africans. Instead, he simply praised the South African effort he had guided.

Where was the honesty about the trade-offs? Where was the admission that, given his criticism of lockdowns for a medical journal, many of the excess deaths could actually have been caused by the draconian measures he championed?

As we shall see in Part Two, Karim’s successor as director of the South African Medical Research Council (SAMRC), Professor Shabhir Mahdi, would tell Sky News in January 2021 that the first lockdown had inadvertently created mass transmission.

Of course, this would then call into question why lockdowns were imposed in the first place. If, as Karim himself suggested, lockdowns are extremely harmful, why impose them if the virus spreads regardless?

This all leads to an inevitable question: were scientists like Karim, who were lauded by media and leaders globally, neutral with regards to political pressures?

Perhaps more importantly, why has a scientist of the stature of Karim not asked or explored this question himself? Healthy scientific scepticism and the questioning of outcomes of non-pharmaceutical interventions with known harms should surely have required a transparent reckoning on the part of the scientists who legitimised such interventions for political leaders in South Africa and around the world.

Karim, along with virtually all government-affiliated scientists, was strongly critical of the many eminent scientists who disagreed with him, including those who created the Great Barrington Declaration (GBD). In one of his weekly CAPRISA updates, and in court papers, Karim reproached the GBD for wanting ‘the virus to spread unchecked’.

But this was never the GBD’s approach. Instead it emphasised ‘focused protection’, a core part of its proposed response to Covid-19, explained comprehensively on its website. Focused protection has as its premise the very truth explicated by Karim – that lockdowns are a major public health risk on their own. Allowing the non-elderly and those uncompromised by severe comorbidities to carry on with daily life, economic activity, and schooling, protects the vulnerable by maintaining health services and economic stability, whilst allowing herd immunity to develop far more quickly. The GBD is also very similar to the UK’s 2011 pandemic plan, which was quickly discarded by the British government in favour of the lockdowns that had first been implemented by the Chinese government in Wuhan.

During a more recent interview, Karim misrepresented the GBD again, stating that the GBD promotes focused protection only for the elderly. Focused protection, however, always referred to all vulnerable people and not just the elderly. More importantly, in the same interview, he claimed that Sweden suffered ‘substantial numbers of deaths’ because it followed the GBD pandemic plan.

Both points are untrue.

Sweden implemented its approach before the GBD was drafted and evidence shows that, despite its comparatively older population, Sweden’s Covid-19 mortality rate is 1,890 per one million, only slightly higher than South Africa’s mortality rate of 1,675 per one million, and this was despite admitted shortcomings in its handling specifically of residents of aged-care facilities. Sweden’s overall mortality rate (a far more reliable measure) is also better than countries like Germany and France, which had implemented lockdowns, with no discernible increase in overall mortality during the Covid-19 outbreak. The only real difference between the two countries is that, unlike South Africa, Sweden did not impose the harsh and damaging societal lockdowns recommended by Karim for South Africa.

What is most worrying is Karim’s apparent lack of curiosity regarding these issues.

As a prominent scientific expert, who is on record as being cognisant of the harms of lockdowns, why has he not acquainted himself better with the scientists who agreed with this assessment and proposed a different course? Dismissing the GBD out of hand is in conflict with the collaborative and self-questioning nature of the scientific method itself.

Like other experts who have displayed this anomalous lack of curiosity, Karim has remained firmly in his place as a government expert, notably as an expert witness in legal proceedings.

On 19 May 2022, Sakeliga, a non-profit South African business group, commenced litigation against the Minister of Health, Dr Joe Phaahla, for his promulgation of amendments to the National Health Act which would make the Covid-19 emergency measures applicable and ready to be re-activated in perpetuity. Sakeliga’s case is that in the absence of a state of disaster such action is contrary to established law.

Again, Karim is on record recognising the damage lockdown regulations cause. He has also recognised that they did not prevent transmission. Why would he support government efforts to make them a permanent part of their public health toolkit?

This lack of scientific self-awareness is worrying to say the least. But it is perhaps emblematic of a whole host of concerns related to Karim’s work as a scientist who has immense power in the sphere of public health.

And perhaps that is the problem. Could it be that it is the world of public health, with its web of funding and its notable connections with the Chinese government, that has so compromised scientific transparency and humility in this age of the war on respiratory viruses?

PANDA has been vilified for criticising these conflicts of interests and this strange new religious mantle which science has claimed for itself. But it was the world of Karim, and the likes of his MAC, which wrought the ravages of lockdowns in South Africa, with seemingly no positive effect on viral transmission or excess deaths.