The Evidence Base Against Lockdowns Grows: Why Lockdowns Are Ineffective and Very Likely Cause Deaths

"Stay home, stay safe." This was the mantra at the beginning of the pandemic that was used to solidify the justification the lockdowns. By shutting down workplaces, schools, and other venues, as well as staying home, the lockdowns were meant to lower the rate of transmission of COVID-19, and by extension, save lives. The so-called conventional wisdom stated that the cost of the lockdowns was worth the lives that we would save during this pandemic. I'm not going to get into the costs of the lockdowns right now. I will save that for another time since it will require much more detail. I simply want to ask whether lockdowns reached their primary goal of saving lives. 

I expressed my concerns about the lockdowns at the beginning of the pandemic. My concerns ranged from overestimation of the fatality of COVID-19 to the costs of the lockdowns and the burden of proof of such a policy prescription. I also bemoaned the lack of an evidence base for lockdowns. Speaking of a lack of an evidence base, there was no evidence base prior to the pandemic. Why? Because there was no instance in human history prior to this pandemic in which we isolated healthy individuals en masse. It was standard epidemiological understanding that it does not make sense. In September 2019, the well-renowned Johns Hopkins University stated that lockdowns would be the least effective manner to control the spread of a pandemic (p. 57). In October 2019, the World Health Organization said that isolating those who were not sick is not recommended because it had no rationale (p. 16). In short, using lockdowns to try to slow down the slow of coronavirus was not "following the science." 

Now that we have a pandemic in which we ignored the science and went through the social experiment of isolating the healthy en masse, we have better an evidence base as to whether lockdowns are good public policy practice. Have lockdowns actually saved lives? 

Earlier this week, economists from the University of South California and RAND Corporation released a paper asking this very question (Agrawal et al., 2021). The authors analyzed data across 43 countries and all 50 states in the United States. What did they find? A one-week increase in shelter-in-place [SIP], also known as lockdowns, was associated with a 2.7 percent increase in excess deaths per 100,000 individuals (p. 13). The big picture takeaway from the authors is that "we fail to find that SIP policies saved lives. To the contrary, we find a positive association between SIP policies and excess deaths (p. 4)." 

Three reasons suggested by the authors for the findings are a) people would have adjusted their behavior, with or without SIPs, b) SIPs increased deaths of despair, and c) reduction in non-COVID-19 healthcare increased excess deaths. If you need more details on the rationale behind such reasons, you can view my analyses last year here and here.

You might be thinking that this is one study, even if it authored by economists from prestigious institutions. The reality is that the aforementioned study is hardly the only study questioning the efficacy of lockdowns. If you are looking for something comprehensive, the American Institute of Economic Research provided a list back in December 2020 of 35 other studies showing that inefficacy of lockdowns. The list I provide below is a good sampling of studies from reputable sources, a majority of which are from 2021, showing why lockdowns are ineffective:

• A study from The Lancet (Chaudhry et al., 2020) concluded that "government actions such as border closures, full lockdowns, and a high rate of COVID-19 testing were not associated with statistically significant reductions in the number of critical cases or overall mortality." To the lockdown's credit, they provided improved patient recovery rates. So if lockdowns did not provide a reduction in critical cases or mortality, what played a major role in mortality or critical cases? Obesity and smoking prevalence negatively affected these factors, whereas nurses per capita and GDP per capita had a positive correlation.
• An economist from the University of Chicago provides further insight (Mulligan, 2021), specifically with regards to transmission rates at home versus work. The conventional wisdom was that the level of confinement at home would provide for lower transmission. However, households were shown to have a higher transmission rate. Why? Because the mitigation efforts in the workplace (e.g., universal mask wearing, screening, social distancing) were effective. These safety protocols used in the workplace were not used in homes. 
• Researchers from Tel Aviv University used mobility data to determine if lockdowns save lives (Loewenthal et al., 2020). These researchers were actually expecting lockdowns to help. What they found was no statistical correlation between lockdown severity and COVID-related fatalities. The authors continued to state that while social distancing matters, strict lockdown policies were not necessary. 
• Professors at the University of Chicago's Harris School of Public Policy found that lockdowns "had no detectable health benefits, only modest effects on behavior, and small but adverse effects on the economy (Berry et al., 2021)." The reason for the ineffectiveness, per the professors, is that people were social distancing before the lockdown measures were in effect. While the lockdowns did not affect social behavior, the authors nevertheless emphasize the importance of social distancing behavior. 
• Stanford researchers concluded that more restrictive non-pharmaceutical interventions [NPI] (e.g., lockdowns) were no more effective than less-restrictive NPIs (Bendavid et al., 2021). The researchers even postulate that increased intra-household density and transmission because lockdowns forced people to stay indoors more frequently. In other words, the lockdowns provided no significant, beneficial effect.
• An economist from the Simon Fraser University in British Columbia conducted a cost-benefit analysis of lockdowns (Allen, 2021). Some valid points are made in this cost-benefit analysis. The first is that the lockdowns were ineffective because the voluntary changes mimicked lockdowns. Second, the lockdowns were not able to prevent non-compliance to the extent required. Third, many of the earlier studies did not disentangle the effects of government restrictions from voluntary behavior (Plus, earlier studies relied more heavily on modeling). Fourth, and most importantly, there is a lack of correlation between lockdown stringency and COVID deaths per capita. Basic statistics teaches that without correlation, there is no causation, i.e., lockdowns did little to nothing to prevent COVID deaths. 
• French researchers used a Pearson correlation test to determine what most greatly caused COVID deaths (De Larochelambert et al., 2020). Regarding lockdowns, the researchers found that "stringency of the measures settled to fight pandemic, including lockdown, did not appear to be linked with death rate." What did appear to be linked with the death rate, according to the study, include high chronic disease levels, countries within the 25°/65° latitudinal strip, lower temperatures combined with lower UV levels, countries with a higher life expectancy and its slowdown, and metabolic risk factors (e.g., inactive/sedentary lifestyle, obesity).
• Although not a study per se, the Center for the Study of Partisanship and Ideology [CSPI] has a lengthy, but very nice piece called The Case Against Lockdowns.

Conclusion: It might seem intuitive to have lockdowns slow down the rate of transmission enough to save lives. What has played out in the data is different, including a lack of correlation between lockdown stringency and COVID deaths. If anything, the lockdowns could have caused more deaths than saved. We have seen multiple factors contribute to the ineffectiveness of lockdowns. People were already social distancing prior to the lockdowns, and would have done so regardless of regulations. Lockdowns increased deaths of despair. Non-COVID health concerns were delayed, thereby creating more health problems than preventing. Lockdowns forced people to spend more time indoors, which increased transmission. Such lifestyle factors as obesity, smoking, and being sedentary played a major role in severe COVID cases and mortality. There is no shortage of explanations of what affected COVID mortality or morbidity more so than the lockdowns.

Given what we all went through during lockdown, it must be shocking or jarring to hear that we endured it for nothing. A lockdown might seem like a nice way to placate the fear or a way to seem to take control over a virus with the real potential to kill you. However, the growing amount of evidence shows that lockdowns do not fulfill its goal of saving more lives than it takes. Since we went through so much pain and sacrifice to so little effect, this should truly make us ponder whether the lockdowns were worth all the costs.