Recommendations given by the World Health Organization (WHO) carry substantial weight. During the Covid-19 pandemic, the WHO partnered with the world’s largest tech companies to restrict information and scientific debate to billions. YouTube explicitly banned all content contradicting the WHO’s recommendations, whilst the WHO actively vilified those questioning its recommendations. A concerning outcome of this suppression of open discussion in international public health has been an apparent loss of evidence base in subsequent WHO recommendations, particularly in response to pandemics.

When the WHO endorsed the unprecedented measures taken by the Chinese authorities in response to the outbreak of SARS-CoV-2, this was a watershed moment in WHO pandemic policy. Traditionally, these recommendations were relatively cautious, grounded in a recognition of health as not “merely the absence of disease.” WHO recommendations during health emergencies often focused primarily on avoiding harm by unilateral border closures. Although the organisation still upheld its traditional advice against trade and travel restrictions for a few weeks, this also changed after countries imposed restrictions irrespective of the WHO’s caution. With the WHO giving ambiguous advice, governments around the world followed each other unreflectively, imposing lockdowns that turned a respiratory disease into a global socioeconomic crisis, plunging millions into poverty.

The lockdowns and mandates of the Covid-19 era can be regarded as the largest natural experiment in public health. With governments imposing dozens of measures simultaneously, attributing effects to specific measures is tricky, and it is no wonder that the academic debate on what worked and what didn’t is far from being settled. The fact that Sweden had one of the lowest excess mortality rates worldwide despite having some of the least aggressive restrictions certainly calls into question the unprecedented lockdowns, extended school closures, and mask mandates. Or at least in a rational world, it would. Nonetheless, these measures are becoming the new go-to response to future pandemics, now promoted by the WHO itself. This is confirmed by a systematic comparison of the WHO’s pre- and post- Covid pandemic response recommendations.

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