As we approach our third year of this pandemic, I cannot help but shake my head at the decline of discourse and debate when it comes to public health issues. Whether it was masks, vaccines, or school closures, what should have been instances of "science informing public policy" became a nasty mixture of fear and politicization. None was as frustrating for me as watching what happened with the lockdowns, especially given how encompassing and onerous lockdowns are.
I was hoping that voluntary social distancing would have sufficed and that we would not have to implement lockdowns. As early as mid-March 2020, I expressed concern that if implemented, lockdowns would become a major problem. My fears came true on this one. In spite of the fact that most people were voluntarily doing their own social distancing beforehand, lockdowns became a reality. "Stay home, stay safe" became a mantra early in the pandemic. Politicians decided to implement the lockdowns because "we had to do something to stop COVID, and something was better than nothing." The thinking was that if we isolated healthy individuals and minimized in-person contact with other human beings, we would be able to stop or at least significantly slow down COVID transmission. The decision to implement lockdowns went well beyond violating the logical fallacy of the Politician's Syllogism. There are times where doing something is better than nothing, or in this case, that the something you suggest is worse than what you are trying to prevent.
While sitting at home while in lockdown in early May of 2020, I was emphatic about removing lockdowns. My issues with lockdowns went well beyond those of freedom. I expressed concerns ranging from societally overreacting to the disease severity of COVID and the damage it was causing the economy and healthcare system to the fact that there was no precedent for isolating healthy individuals at this scale.
Fortunately, we have moved beyond the lockdowns. We have vaccines that are effective at preventing severe cases of COVID. More people have developed natural immunity against COVID. Our understanding of COVID and our treatment thereof has improved. While I am cautiously optimistic that Omicron is contagious to give enough people natural immunity and help us move beyond the pandemic stage, we are still reeling from the effects of the lockdown. It will take years for us to understand the full effects of the lockdowns. A question we can answer now is whether the lockdowns saved lives.
Last week, the experts at Johns Hopkins University released a meta-analysis of 24 relevant studies (Herby et al., 2022) examining lockdown stringency index studies, shelter-in-place order [SIPO] studies, and specific non-pharmaceutical intervention [NPI] studies. I want to touch upon the NPI aspect before getting into the lockdowns more specifically. The authors found that there was no evidence that "lockdowns, school closures, border closures, and limiting gatherings have had a noticeable effect on COVID-19 mortality. There is some evidence that business closures reduce COVID-19 mortality, but the variation in estimates is large and the effect seems related to closing bars (p. 39)."
In terms of lives saved by the lockdowns, the Johns Hopkins study says it depends on the type of study you use. "Specific NPI studies also find no broad-based evidence of noticeable effects on COVID-19 mortality." If you look at SIPO studies, their results for lockdowns were "only reducing COVID-19 mortality by 2.9% on average." That means the range for the effects on COVID-19 mortality is 0 percent to 2.9 percent. Regardless of which number on the range you select, this comes with the issue of looking at a subset of people instead of looking at the population at large.
When I conducted my literature review of lockdown evidence in June 2021, I came across a most intriguing study from economists at the University of South California and the Rand Corporation (Agrawal et al., 2021). Those economists found that for each week shelter-in-place orders were in place, there was a 2.7 percent increase in excess deaths. Combining the 2022 Johns Hopkins study with the USC/Rand Corporation study, not only was forcing people to stay at home ineffective in saving lives, but it caused a net increase in death. This is the part where I segue into the main takeaway of the 2022 Johns Hopkins study, which is a far cry from what lockdown lovers would like to hear:
While this meta-analysis concludes that lockdowns have had little to no public health effects, they have imposed enormous economic and social costs where they have been adopted. In consequence, lockdown policies are ill-founded and should be rejected as a pandemic policy instrument.
If only someone had told us beforehand, we could have saved ourselves a lot of grief. This is where I find the lockdown debacle especially infuriating: we were told beforehand. In September 2019, experts at Johns Hopkins said that quarantining the healthy would very well be the least effective NPI (p. 57). Weeks before the pandemic began, the World Health Organization [WHO] stated that isolating the healthy is not recommended "because there is no obvious rationale for this measure, and there would be difficulties in implementing it (WHO, p. 16)." Instead of "following the science" or deigning to conduct a cost-benefit analysis in order to justify such a policy, politicians across the world ignored the science and wreaked havoc on millions of people's lives. To quote the Johns Hopkins study (p. 43):
Lockdowns during the initial phase of the COVID-19 pandemic have had devastating effects. They have contributed to reducing economic activity, raising unemployment, reducing schooling, causing political unrest, contributing to domestic violence, and undermining liberal democracy. These costs to society must be compared to the benefits of lockdowns, which our meta-analysis has shown are marginal at best. Such a standard benefit-cost calculation leads to a strong policy conclusion: lockdowns should be rejected out of hand as a pandemic policy instrument.
The difference between the advice that Johns Hopkins experts gave in 2019 and the study they released last week is that we have a strong evidence base of how ineffective and horrid lockdowns are. I am not delving into the specific costs of the lockdowns mentioned above or attempting to monetize said costs today because that is another conversation for another time. What I can say is the following. While there was bound to be some damage done by the pandemic regardless of response, a lockdown was a way to collectively shoot ourselves in the foot and make the problem worse. Whether they were doing it out of the goodness of their hearts or to consolidate their own power, politicians upended the lives of millions and caused unintended consequences that will impact our lives for years to come.
I hope the outcomes of the lockdowns make us question whether an emergency should constitute a "we should do something" response. Like with any policy, we should ask whether the policy in question is an improvement over the situation one is trying to prevent. With the lockdowns, we can definitively say that lockdowns provided next to no benefit while devastating life as we know it. Mark Twain once said that history doesn't repeat itself, but it rhymes. There will be another pandemic. Let's hope that we learned our lesson from this pandemic and the next pandemic doesn't rhyme with this pandemic by stupidly including a lockdown.
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