Review and meta-analysis of the effects of lockdowns on Covid-19 mortality [pdf](sites.krieger.jhu.edu)
sites.krieger.jhu.edu
Review and meta-analysis of the effects of lockdowns on Covid-19 mortality [pdf]
https://sites.krieger.jhu.edu/iae/files/2022/01/A-Literature-Review-and-Meta-Analysis-of-the-Effects-of-Lockdowns-on-COVID-19-Mortality.pdf
88 comments
At least based on my experience in the US the "lockdown" orders in practice were not significantly more strict than the government issuing very strong recommendations.
I agree on a social behavior point of view. However, there is nuance. Very strong recommendations don't close public and private schools, day care, public parks and beaches, nor significantly curtail economic activity in restaurants and other non-essential businesses.
Schools here had already been closed for two weeks before a stay-at-home order was issued, but I get your point.
That said, in April 2020 I assure you that economic activity in restaurants and non-essential businesses would have been severely disrupted regardless of government action. Most were already closed or take-out only.
That said, in April 2020 I assure you that economic activity in restaurants and non-essential businesses would have been severely disrupted regardless of government action. Most were already closed or take-out only.
The first few months where everything was closed, including parks and beaches?
I don't recall any point, at least in my region: Bay Area, CA, when people universally complied with these closures. I think OP's point is: regardless of whether things were ordered closed, enough people were out and about horsing around, ignoring the closures, that nothing was effectively closed.
There was no real lockdown in the USA, if you go beyond just looking at the mandates and take into account people's actual behavior. So I'm not sure how they review effects of a lockdown that never happened.
There was no real lockdown in the USA, if you go beyond just looking at the mandates and take into account people's actual behavior. So I'm not sure how they review effects of a lockdown that never happened.
Unless you plan on deploying the U.S. military on every street and beach during the next lockdown, what we saw was what happens when a lockdown is declared. They're measuring the efficacy of an intervention: lockdowns being declared; high/low compliance is irrelevant to the intervention's effectiveness, since compliance isn't within the government's control.
'There was no real lockdown in the USA '
Not really true.
Hawaii closed parks, trails, and beaches. https://www.travelandleisure.com/travel-news/hawaii-coronavi... ' Honolulu, city parks were closed on Aug. 8 along with beaches and state parks and indoor attractions like bowling alleys and arcades. '
Colorado closed all ski areas. https://coloradosun.com/2020/03/14/jared-polis-executive-ord...
Not really true.
Hawaii closed parks, trails, and beaches. https://www.travelandleisure.com/travel-news/hawaii-coronavi... ' Honolulu, city parks were closed on Aug. 8 along with beaches and state parks and indoor attractions like bowling alleys and arcades. '
Colorado closed all ski areas. https://coloradosun.com/2020/03/14/jared-polis-executive-ord...
The problem is that the effectiveness of lockdowns depends on the degree to which you are able to compartmentalize. If some regions have a lockdown and not others, but people are able to freely move from one region to another, then the least strict policy will be the one (roughly speaking) limiting disease transmission.
The stringency index should be aggregated as the minimum of all areas that allow for freedom of movement.
The stringency index should be aggregated as the minimum of all areas that allow for freedom of movement.
Is it possible to stop movement of wild animals which are infected and transmit it back to humans? Impossible goal posts to pursue.
No, and it's not even possible to completely stop human movement. At the end of the day you need trucks to get across, etc. But getting close to perfect isolation is feasible: this is where monitoring and testing becomes most important, as you have to react quickly to contain any outbreak leakage.
Importantly, the key benefit of this approach is that it allows you to open up in a controlled fashion areas that are clear of any outbreaks. So while the measures are most extreme and most costly up front, they ultimately are economically advantageous because they are of shorter duration.
Importantly, the key benefit of this approach is that it allows you to open up in a controlled fashion areas that are clear of any outbreaks. So while the measures are most extreme and most costly up front, they ultimately are economically advantageous because they are of shorter duration.
Closing parks and beaches is definitely something but is it fair to call that a "real lockdown"? Compared to places with curfews and travel restrictions?
It's definitely something, I would call it a crappy ineffective and poorly advised lockdown
I have no idea about your area.
Here in Lincoln, NE, everything was locked down to the point where open air parks had bright orange fencing around the playground equipment.
Grocery stores, Home Depot and Walmart were all that were open.
Walmart had a block long line, socially distanced of people waiting to get in. A Walmart employee was controlling the flow and ensuring masks.
The streets were empty. You couldn't go anywhere even if you wanted to.
Here in Lincoln, NE, everything was locked down to the point where open air parks had bright orange fencing around the playground equipment.
Grocery stores, Home Depot and Walmart were all that were open.
Walmart had a block long line, socially distanced of people waiting to get in. A Walmart employee was controlling the flow and ensuring masks.
The streets were empty. You couldn't go anywhere even if you wanted to.
So where authoritarianism doesn't exist they're pointless because they're ineffectual symbolism? In any case it appears they should be eschewed. If something severe enough comes along people will do what needs done, I reckon.
And I dunno, Louis Rossman has a lot of videos up, NYC was definitely impacted.
And I dunno, Louis Rossman has a lot of videos up, NYC was definitely impacted.
Other then the businesses actually being closed? Streets were empty in San Francisco at least. People were allowed to exercise outside but that was about it. Saying that was effectively not a shutdown is a bit disengenious.
Lockdown orders across a lot of the US required non essential businesses to close. It wasn't a "recommendation" as people were thrown in jail for having businesses open
Well, here a recommendation have been the same as "You must do this".
Only the legislation does not support using that wording, so recommendation was chosen.
Only the legislation does not support using that wording, so recommendation was chosen.
I would be curious to know if they were sufficiently able to remove confounding variables to make this claim. For comparison to another statistical quirk: someone I know made this chart which fails to show any correlation between vaccination rates and death rates in the last 14 days on a state-by-state basis in the US: https://docs.google.com/spreadsheets/d/1x9sKFsr-3VpdjvjZqHql...
Now, we have evidence from other sources that the vaccine is definitely highly effective in every particular state (this should not require a citation, but here you go anyways: https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-s...). But it seems there are too many confounding variables here (age, population density, etc.) such that attempting a simple region-by-region comparison over any particular time period might incorrectly conclude that the vaccine does not work.
Was JHU able to address that data collection and comparison problem here?
Now, we have evidence from other sources that the vaccine is definitely highly effective in every particular state (this should not require a citation, but here you go anyways: https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-s...). But it seems there are too many confounding variables here (age, population density, etc.) such that attempting a simple region-by-region comparison over any particular time period might incorrectly conclude that the vaccine does not work.
Was JHU able to address that data collection and comparison problem here?
If the majority of people receiving the vaccine are new to the vaccine and from 5-25 years, then you won't see any correlation between vaccination rates and death rates.
It's also interesting that lockdowns seem to be a wasted effort. Much suck for Ireland that imposed some of the worst lockdowns.
https://m.belfasttelegraph.co.uk/news/health/coronavirus/nis...
Thankfully all restrictions have just been lifted here in Denmark.
It's also interesting that lockdowns seem to be a wasted effort. Much suck for Ireland that imposed some of the worst lockdowns.
https://m.belfasttelegraph.co.uk/news/health/coronavirus/nis...
Thankfully all restrictions have just been lifted here in Denmark.
"... you won't see any correlation between vaccination rates and death rates."
That sums it up nicely.
Good that some of Europe is opening.
That sums it up nicely.
Good that some of Europe is opening.
It’s hard to consider .2% reduction in mortality non-significant. Nearly 6 million people have died from COVID as of now. 0.2% of that is nearly 12,000 lives. Calling SIPOs ineffective as well because they only reduced mortality by 2.9% is a bit deceptive since that is nearly 174,000 lives.
Those percentages only apply during active lockdowns; your premise is that there's been a continuous, worldwide lockdown for the past 2 years. The actual numbers will be far less.
Also, this study only measures impacts of lockdowns on Covid mortality, and doesn't include the human and financial costs of lockdowns.
Also, this study only measures impacts of lockdowns on Covid mortality, and doesn't include the human and financial costs of lockdowns.
I was curious how claims like this line up with the incredibly stark difference between, say, the US and New Zealand:
https://91-divoc.com/pages/covid-visualization/?chart=countr...
The PDF here actually mentions New Zealand, as one of the studies is about it. But reading that, it doesn't compare New Zealand to other countries, but does within-country analyses (different parts of the same country, like US states, or the same parts at different times).
I am not an expert on this topic, but isn't it fair to say that New Zealand's massively lower death rate is due, in part, to lockdowns? Without a lockdown to get things under control things likely would have progressed as in almost all other countries.
With that said, I think it's possible that for most countries lockdowns might have a minor effect. If say California goes into lockdown but other states don't, for example, then the spread might reach it anyhow eventually. So I would bet that both things are true: lockdowns can be a critical part of a COVID response, even if on average perhaps they are not.
Regardless, all this is moot at this point. The early lockdowns were critical for reasons like US hospitals not having enough masks and other protective equipment, and vaccines were far off. Lockdowns bought us time - they were justified back then. The situation is obviously different now, and perhaps they are not justified today in most places.
(Again, caveats that I am not an expert on any of this.)
https://91-divoc.com/pages/covid-visualization/?chart=countr...
The PDF here actually mentions New Zealand, as one of the studies is about it. But reading that, it doesn't compare New Zealand to other countries, but does within-country analyses (different parts of the same country, like US states, or the same parts at different times).
I am not an expert on this topic, but isn't it fair to say that New Zealand's massively lower death rate is due, in part, to lockdowns? Without a lockdown to get things under control things likely would have progressed as in almost all other countries.
With that said, I think it's possible that for most countries lockdowns might have a minor effect. If say California goes into lockdown but other states don't, for example, then the spread might reach it anyhow eventually. So I would bet that both things are true: lockdowns can be a critical part of a COVID response, even if on average perhaps they are not.
Regardless, all this is moot at this point. The early lockdowns were critical for reasons like US hospitals not having enough masks and other protective equipment, and vaccines were far off. Lockdowns bought us time - they were justified back then. The situation is obviously different now, and perhaps they are not justified today in most places.
(Again, caveats that I am not an expert on any of this.)
> I was curious how claims like this line up with the incredibly stark difference between, say, the US and New Zealand:
From the discussion section of the paper:
>We propose four factors that might explain the difference between our conclusion and the view embraced by some epidemiologists.
>First, people respond to dangers outside their door. When a pandemic rages, people believe in social distancing regardless of what the government mandates [...]
>Second, mandates only regulate a fraction of our potential contagious contacts and can hardly regulate nor enforce handwashing, coughing etiquette, distancing in supermarkets, etc. [...]
>Third, even if lockdowns are successful in initially reducing the spread of COVID-19, the behavioral response may counteract the effect completely, as people respond to the lower risk by changing behavior. [...]
It's plausible that new zealand was already predisposed to contain a pandemic well (because they're well isolated) and/or that their citizens are conscientious.
From the discussion section of the paper:
>We propose four factors that might explain the difference between our conclusion and the view embraced by some epidemiologists.
>First, people respond to dangers outside their door. When a pandemic rages, people believe in social distancing regardless of what the government mandates [...]
>Second, mandates only regulate a fraction of our potential contagious contacts and can hardly regulate nor enforce handwashing, coughing etiquette, distancing in supermarkets, etc. [...]
>Third, even if lockdowns are successful in initially reducing the spread of COVID-19, the behavioral response may counteract the effect completely, as people respond to the lower risk by changing behavior. [...]
It's plausible that new zealand was already predisposed to contain a pandemic well (because they're well isolated) and/or that their citizens are conscientious.
Aren't the first and second point in conflict?
Point 1 is basically "lockdowns are unnecessary because people will behave in a safe manner regardless".
Point 2 is basically "lockdowns are ineffective because they don't stop all forms of dangerous behavior".
If people are willing to continue some dangerous behavior as part of point 2, why do we think they would stop other dangerous behavior without the lockdown enforcing that decision?
Point 1 is basically "lockdowns are unnecessary because people will behave in a safe manner regardless".
Point 2 is basically "lockdowns are ineffective because they don't stop all forms of dangerous behavior".
If people are willing to continue some dangerous behavior as part of point 2, why do we think they would stop other dangerous behavior without the lockdown enforcing that decision?
There's certainly no logical contradiction there, right?
You have one group of Careful Carlas who always behave safely, lockdown or not. You also have a group of Reckless Rogers, standing too close to people in supermarkets and not washing their hands. If either of these two groups is too big, you won't see a positive effect from lockdowns.
You have one group of Careful Carlas who always behave safely, lockdown or not. You also have a group of Reckless Rogers, standing too close to people in supermarkets and not washing their hands. If either of these two groups is too big, you won't see a positive effect from lockdowns.
Is your argument that lockdowns have no impact on the behavior of the Reckless Rogers? If that is the case, why is there any objection to lockdowns when they can be ignored?
It's not so much that they have no effect, it's that the effect isn't enough to bring R_0 < 1, so it's going to be at best a slowing of the natural spread, which in practice, you aren't going to be able to measure or prove.
You could say that NZ, australia and china did something very different from the partial lockdowns in the west. they decided to eradicate the virus, while that was never the goal in europe/us
I’d argue that most is due to at-border quarantines, not within-country lockdowns.
If the authors are going to argue that the common conclusion among epidemiologists is wrong, I am going to be more skeptical of their paper.
The fact that they discarded 83 of 117 possible studies, including large notable studies that disagree with their results leaves a lot of room for selection bias. Plus they include non-peer-reviewed studies, despite being otherwise extremely prejudiced with their selections.
I think this is the kind of thing where you should wait for some peer review at the very least before drawing any conclusions, or sending it to the front page of hacker news.
The fact that they discarded 83 of 117 possible studies, including large notable studies that disagree with their results leaves a lot of room for selection bias. Plus they include non-peer-reviewed studies, despite being otherwise extremely prejudiced with their selections.
I think this is the kind of thing where you should wait for some peer review at the very least before drawing any conclusions, or sending it to the front page of hacker news.
This whole fiasco has me convinced that the medical industry suffers from the same hubris, profiteering, and strange collective delusion and ignorance that caused the 2008 financial crisis.
I'm old enough to remember the financial crisis, when it was always assumed that things couldn't be as bad as they were because there's no way thousands of high paid bankers could all be so reckless and have it wrong at once. After all, these are the smartest people in the world, right? Surely they saw this coming. Surely they're not that foolish...
Well, it turns out they didn't see it coming and they were that foolish. It turns out they were all consumed by arrogance and, collectively, were far more incompetent than anyone was willing to give them credit for.
The inescapable fact is we don't know the long term effects of lockdowns.
I'm old enough to remember the financial crisis, when it was always assumed that things couldn't be as bad as they were because there's no way thousands of high paid bankers could all be so reckless and have it wrong at once. After all, these are the smartest people in the world, right? Surely they saw this coming. Surely they're not that foolish...
Well, it turns out they didn't see it coming and they were that foolish. It turns out they were all consumed by arrogance and, collectively, were far more incompetent than anyone was willing to give them credit for.
The inescapable fact is we don't know the long term effects of lockdowns.
My rule of thumb is that the more people who are educated on a topic agree on something, the less likely it is they're wrong. It happens, but not very often.
Additionally, it would be very surprising to learn that lockdowns are ineffective given that covid spreads via human-to-human interaction, and lockdowns enforce a reduction in those interactions.
So, while I believe it's not impossible you are right, I would be very surprised.
Additionally, it would be very surprising to learn that lockdowns are ineffective given that covid spreads via human-to-human interaction, and lockdowns enforce a reduction in those interactions.
So, while I believe it's not impossible you are right, I would be very surprised.
The larger picture is animal and human transmission.
I think the generalizations of lockdowns as:
"Lockdowns are defined as the imposition of at least one compulsory, non-pharmaceutical intervention (NPI). NPIs are any government mandate that directly restrict peoples’ possibilities, such as policies that limit internal movement, close schools and businesses, and ban international travel."
renders the exercise kind of useless because it conflates unsuccessful half-measures implemented in most countries with countries that followed lockdown and elimination strategies. For China, New Zealand and a few others which largely eliminated the disease the almost complete prevention of deaths proposed by the models discussed in the articles seems accurate.
And while I suppose you can write NZ off as a small island nation, China is the most populous country on earth. Yet it appears in the paper once in the introduction.
"Lockdowns are defined as the imposition of at least one compulsory, non-pharmaceutical intervention (NPI). NPIs are any government mandate that directly restrict peoples’ possibilities, such as policies that limit internal movement, close schools and businesses, and ban international travel."
renders the exercise kind of useless because it conflates unsuccessful half-measures implemented in most countries with countries that followed lockdown and elimination strategies. For China, New Zealand and a few others which largely eliminated the disease the almost complete prevention of deaths proposed by the models discussed in the articles seems accurate.
And while I suppose you can write NZ off as a small island nation, China is the most populous country on earth. Yet it appears in the paper once in the introduction.
This. It's clearly just another one of the myriad of deceptive Covid papers that we have been seeing recently. Get them on a pre-print server (no peer review) and spread them to the faithful.
Calling masks a form of lockdown is utterly bogus.
And even if they had proven their point all they would be showing is that half measures don't work.
Simple thought experiment: If the world had basically been put on pause for April 2020--everyone stocks up in March, then spends the entirety of April at home where would we be now? (Use the stocks of PPE to protect those who have to be at their posts or people will die and they do not go home.)
(Now, I'm not sure if there was enough food and the like around to actually permit this.)
Calling masks a form of lockdown is utterly bogus.
And even if they had proven their point all they would be showing is that half measures don't work.
Simple thought experiment: If the world had basically been put on pause for April 2020--everyone stocks up in March, then spends the entirety of April at home where would we be now? (Use the stocks of PPE to protect those who have to be at their posts or people will die and they do not go home.)
(Now, I'm not sure if there was enough food and the like around to actually permit this.)
Who do you include in "everyone"? First responders? Military? Healthcare providers? Farmers? Homeless? Utility workers? Garbage collectors?
The fundamental assumption of this paper is wrong.
In an epidemic, there is a sharp transition between exponential growth and decline. There is also a fundamental difference between temporarily reducing case numbers and then letting them grow again, and reducing case numbers to zero.
Some countries, like China, New Zealand and Australia, competely eliminated the virus using lockdowns and other measures (like contact tracing).
Other countries locked down, but not hard enough to get rid of the virus. Then they reopened and let the virus spread like wildfire.
Treating these two strategies as the same is nonsensical.
The zero-CoVID strategy (China, NZ, etc.) is fundamentally different from the mitigation strategy (most countries). They both use lockdowns, but in very different ways and with competely different outcomes.
In an epidemic, there is a sharp transition between exponential growth and decline. There is also a fundamental difference between temporarily reducing case numbers and then letting them grow again, and reducing case numbers to zero.
Some countries, like China, New Zealand and Australia, competely eliminated the virus using lockdowns and other measures (like contact tracing).
Other countries locked down, but not hard enough to get rid of the virus. Then they reopened and let the virus spread like wildfire.
Treating these two strategies as the same is nonsensical.
The zero-CoVID strategy (China, NZ, etc.) is fundamentally different from the mitigation strategy (most countries). They both use lockdowns, but in very different ways and with competely different outcomes.
The zero-Covid strategy is not sustainable.
https://www.cbsnews.com/news/covid-in-china-cases-lockdown-o...
China is still locking down whole cities. Denmark is back to normal. Once Omicron gets into a country, that's it. Eventually, they will have to bite the bullet.
https://www.cbsnews.com/news/covid-in-china-cases-lockdown-o...
China is still locking down whole cities. Denmark is back to normal. Once Omicron gets into a country, that's it. Eventually, they will have to bite the bullet.
There is currently no major city in China under lockdown. China relies much more heavily on contact tracing and mass testing than on large-scale lockdowns.
At the height of the "wave" this winter (which means about 200 infections/day), about 20 million people in China were under lockdown, out of a population of 1.4 billion (that's less than 2% of the population). That "wave" was successfully contained, and the major city that was under lockdown, Xi'an, reopened (the lockdown lasted 3 weeks).
The vast majority of people in China have not experienced a lockdown since April 2020.
> Once Omicron gets into a country, that's it.
China has already successfully controlled a few Omicron outbreaks. Omicron is a bit harder to control, because the serial interval (the time from one infection to the next in a transmission chain) is a bit shorter, but it's not fundamentally different. Your contact tracing has to be faster to control Omicron, and Chinese contact tracing is very fast. They identify all close contacts of an infected person within hours.
> Denmark is back to normal.
The vast majority of China has been back to normal since April 2020. The advantage of zero-CoVID is that it allows life for the vast majority of people to go back much closer to normal for the vast majority of the time. If your neighborhood has an outbreak or if you're a close contact of an infected person, you may have to quarantine, but outbreaks are few and far between in China, so these measures only ever affect relatively few people.
Danish people have been living with on-and-off restrictions for two years. The average Dane's daily life has been more restricted than that of the average Chinese person.
> Eventually, they will have to bite the bullet.
Not in the way that most countries have "bitten the bullet." Chinese public health experts have said that they will reevaluate the policy when drugs and vaccines render SARS-CoV-2 less deadly than the flu. We're not at that point yet. When/if China allows the virus to spread, it will be much less deadly, and China will not suffer the same sort of enormous death toll that the US and Europe have suffered.
At the height of the "wave" this winter (which means about 200 infections/day), about 20 million people in China were under lockdown, out of a population of 1.4 billion (that's less than 2% of the population). That "wave" was successfully contained, and the major city that was under lockdown, Xi'an, reopened (the lockdown lasted 3 weeks).
The vast majority of people in China have not experienced a lockdown since April 2020.
> Once Omicron gets into a country, that's it.
China has already successfully controlled a few Omicron outbreaks. Omicron is a bit harder to control, because the serial interval (the time from one infection to the next in a transmission chain) is a bit shorter, but it's not fundamentally different. Your contact tracing has to be faster to control Omicron, and Chinese contact tracing is very fast. They identify all close contacts of an infected person within hours.
> Denmark is back to normal.
The vast majority of China has been back to normal since April 2020. The advantage of zero-CoVID is that it allows life for the vast majority of people to go back much closer to normal for the vast majority of the time. If your neighborhood has an outbreak or if you're a close contact of an infected person, you may have to quarantine, but outbreaks are few and far between in China, so these measures only ever affect relatively few people.
Danish people have been living with on-and-off restrictions for two years. The average Dane's daily life has been more restricted than that of the average Chinese person.
> Eventually, they will have to bite the bullet.
Not in the way that most countries have "bitten the bullet." Chinese public health experts have said that they will reevaluate the policy when drugs and vaccines render SARS-CoV-2 less deadly than the flu. We're not at that point yet. When/if China allows the virus to spread, it will be much less deadly, and China will not suffer the same sort of enormous death toll that the US and Europe have suffered.
I agree that the average Dane's life has been more affected (I live in Denmark). I am also not in any way a China basher. I have just experienced how fast it goes when Omicron gets a toehold. I don't believe they can keep it up. And more importantly, why? If very few people get seriously ill, why are economically destructive policies justified. I've felt that way from the beginning of the pandemic.
> I don't believe they can keep it up.
People have been saying this for a year, with every new variant, yet China has been perfectly capable of keeping CoVID-19 under control and 98% or more of the country open. Contact tracing, mass testing and the other measures China uses work.
> And more importantly, why?
Because the risks of letting CoVID-19 spread in China are poorly known but potentially massive.
Looking outside China, the US is currently going through its 2nd most lethal CoVID-19 wave. There are more deaths per day now than there were at the height of the Delta wave.
It's prudent to wait and continue to assess the situation, rather than gambling with public health, as most countries are doing. China is able to do so.
> If very few people get seriously ill, why are economically destructive policies justified. I've felt that way from the beginning of the pandemic.
Well, first of all, China has had better economic performance than any other major country during the pandemic. One of the reasons is that it has spent far less time under lockdown or with restrictive social distancing measures than most countries. That's because it quickly eliminated the virus. International travel is affected, but factories can run normally, people can go to work in person, public venues are open, etc.
Second of all, if China had responded the same way as Europe and the US, it is likely that around 4 million people would have died in China. That's not "very few people."
People have been saying this for a year, with every new variant, yet China has been perfectly capable of keeping CoVID-19 under control and 98% or more of the country open. Contact tracing, mass testing and the other measures China uses work.
> And more importantly, why?
Because the risks of letting CoVID-19 spread in China are poorly known but potentially massive.
Looking outside China, the US is currently going through its 2nd most lethal CoVID-19 wave. There are more deaths per day now than there were at the height of the Delta wave.
It's prudent to wait and continue to assess the situation, rather than gambling with public health, as most countries are doing. China is able to do so.
> If very few people get seriously ill, why are economically destructive policies justified. I've felt that way from the beginning of the pandemic.
Well, first of all, China has had better economic performance than any other major country during the pandemic. One of the reasons is that it has spent far less time under lockdown or with restrictive social distancing measures than most countries. That's because it quickly eliminated the virus. International travel is affected, but factories can run normally, people can go to work in person, public venues are open, etc.
Second of all, if China had responded the same way as Europe and the US, it is likely that around 4 million people would have died in China. That's not "very few people."
It is useful to describe what happened, ie what we got for the price we actually paid.
You are correct that it is not useful for evaluating the outcome for what didn't happen.
You are correct that it is not useful for evaluating the outcome for what didn't happen.
>However, if lockdowns have a notable effect, we should see this effect regardless of the timing, and we should identify this effect more correctly by excluding studies that exclusively analyze timing
This seems like a really weird take. The entire concept of a lockdown is solely about timing, since the whole purpose of the exercise is to reduce the R value in order to buy time for healthcare services.
This seems like a really weird take. The entire concept of a lockdown is solely about timing, since the whole purpose of the exercise is to reduce the R value in order to buy time for healthcare services.
> in order to buy time for healthcare services.
By that part alone I'd call them a total failure: Healthcare didn't take advantage of it to prepare, instead the lockdowns just kept going on.
If anything the opposite has happened, with hospitals firing nurses and ending up with reduced capacity.
By that part alone I'd call them a total failure: Healthcare didn't take advantage of it to prepare, instead the lockdowns just kept going on.
If anything the opposite has happened, with hospitals firing nurses and ending up with reduced capacity.
I think it depends on which lockdowns you are talking about.
I've been living in Germany, where lockdowns seem to happen at the time you expect them to happen (when cases start to spike), and the deaths-per-capita are about half that of the UK, where they happened at the last minute (after cases had peaked).
In countries like Korea, Japan, and China, they had very early lockdowns, and have had basically negligible Covid impact.
I would really like it if everybody sat down and started consciously copying the states with approaches that worked, rather than trying to solve the problem from first principles. Public health is complicated, but what's not complicated is that some states are obviously way better at it, and these successes should be emulated.
I've been living in Germany, where lockdowns seem to happen at the time you expect them to happen (when cases start to spike), and the deaths-per-capita are about half that of the UK, where they happened at the last minute (after cases had peaked).
In countries like Korea, Japan, and China, they had very early lockdowns, and have had basically negligible Covid impact.
I would really like it if everybody sat down and started consciously copying the states with approaches that worked, rather than trying to solve the problem from first principles. Public health is complicated, but what's not complicated is that some states are obviously way better at it, and these successes should be emulated.
I find it unfortunate that most studies that this data meta-analyzed were for data periods ending in the Spring or early Summer of 2020.
I would want to see longer data periods that would tell me that early lockdowns slowed down the spread enough to identify better treatment options as well as allow more people to survive till vaccines were available in 2021. In other words, whether people who caught Covid in the fall 2020/winter 2021 had better survival odds than if they caught it in the Spring/Summer of 2020.
I would want to see longer data periods that would tell me that early lockdowns slowed down the spread enough to identify better treatment options as well as allow more people to survive till vaccines were available in 2021. In other words, whether people who caught Covid in the fall 2020/winter 2021 had better survival odds than if they caught it in the Spring/Summer of 2020.
The lockdown strategy pursued by China has been enormously effective, but also quite severe, and economically costly. Not sure its sustainable.
https://www.foreignaffairs.com/articles/china/2022-01-26/chi...
https://www.foreignaffairs.com/articles/china/2022-01-26/chi...
It’s also simply not possible in any country that doesn’t have an already existing overarching highly authoritarian government that is already feared by the populace.
I doubt that you would be very successful at attempting to bolt Americans inside their homes even in the bluest of blue cities and states.
I doubt that you would be very successful at attempting to bolt Americans inside their homes even in the bluest of blue cities and states.
It was certainly costly at the start but how does it fare in the long run?
Also, while it worked well against the earlier strains they were already having some trouble with Delta and I think they're going to fail spectacularly against Omicron. It seems to be outrunning the ring fencing.
Also, while it worked well against the earlier strains they were already having some trouble with Delta and I think they're going to fail spectacularly against Omicron. It seems to be outrunning the ring fencing.
Even if they can't outrun Omicron, the lockdowns got them to the point that vaccines were available.
That's really huge.
Now, even if Omicron rips through the population, you will have a small fraction of the deaths that you would have otherwise.
That's really huge.
Now, even if Omicron rips through the population, you will have a small fraction of the deaths that you would have otherwise.
Well, from what I understand, China's sinopharm vaccine doesn't work well, and they've not wanted to use Pfizer/Moderna even though there are no technical or legal obstacles for them to do so. They do have a couple new vaccines on the way though.
Except they used their home-grown killed-virus vaccine. It worked about as well as you would expect a killed-virus coronavirus vaccine to work--not worth much against the variants.
Note that this paper was published by economists (as opposed to epidemiologists) and does not appear to have undergone peer-review.
Update: It has been pointed out that the methodology used to arrive at the -0.2% number is incredibly strange. The authors selected seven studies to include in their calculation, with estimates ranging from 0.0% to -35.3%.
The arithmetic average across the seven studies is -7.3% and the median is -2.4%, however the authors instead calculate a "precision-weighted average" where one study is weighted significantly higher than the rest (7390 vs 11-256 for the others, see Table 3 for details) and the number from that one study (0.1%) pretty much overwhelms all the others.
I don't think there is a reasonable explanation for doing the calculation this way unless you are intentionally trying to massage the numbers to support a pre-determined outcome. Very suspicious.
The arithmetic average across the seven studies is -7.3% and the median is -2.4%, however the authors instead calculate a "precision-weighted average" where one study is weighted significantly higher than the rest (7390 vs 11-256 for the others, see Table 3 for details) and the number from that one study (0.1%) pretty much overwhelms all the others.
I don't think there is a reasonable explanation for doing the calculation this way unless you are intentionally trying to massage the numbers to support a pre-determined outcome. Very suspicious.
At this point that's kind of what COVID feels like - nothing we tried really worked except one thing: vaccinations mean you don't get sick/die. Everything else is super muddy.
What about contact tracing? We're figuring out that masks, lockdowns, hygiene, etc. don't have that much of an effect. But where do people get COVID, shouldn't we have pretty good data on that now? It seems like a few superspreader events have a lot to do with it but that's the only anecdote that stuck with me.
What about contact tracing? We're figuring out that masks, lockdowns, hygiene, etc. don't have that much of an effect. But where do people get COVID, shouldn't we have pretty good data on that now? It seems like a few superspreader events have a lot to do with it but that's the only anecdote that stuck with me.
>masks, lockdowns, hygiene, etc. don't have that much of an effect.
Clearly you haven't looked at the death rates in Japan or Australia.
Clearly you haven't looked at the death rates in Japan or Australia.
Sure, some countries are doing better but why? That's what the article is asking, is it because Japan/Australia's citizens are better behaved, something else? That's the question behind the obvious but wrong conclusion "good country A is doing X this so X must be good"
It's b/c of lockdowns, masks and vaccines. In China you have authoritarian enforcement. Australia is less so but still you had businesses actually locked down.
In that set you have 3 different "cultures" already. Plenty of controls.
In that set you have 3 different "cultures" already. Plenty of controls.
Australia’s biggest success was controlling the virus at the border, also. They spent large parts of the pandemic without ever locking down, and when there were lock downs after early 2020, it was localized to a specific city or state where the virus had escaped containment rather than the whole country (sometimes people seem to not realize this).
There was never really an analogous situation in the USA since we maintained open borders to the virus (US citizens were allowed to come back from Europe even after the travel ban in March 2020, seeding the virus across the country.)
There was never really an analogous situation in the USA since we maintained open borders to the virus (US citizens were allowed to come back from Europe even after the travel ban in March 2020, seeding the virus across the country.)
This is defacto not true.
What about just looking at the most vulnerable populations? My elderly grandma was certainly safer with her self-imposed lockdown, since by avoiding most people she avoided being infected. If that population benefitted from the lockdown, how is it possible that society as a whole did not benefit?
If vulnerable people had been told to and had in fact decided to lockdown themselves voluntarily society would have had the same benefit. That is no reason to force the rest into some kind of behavior.
And in fact they would have been better off because society would not have incurred the monumental monetary costs of lockdowns and would have saved a very large amount of money that is now not going to be spent on the elderly.
And in fact they would have been better off because society would not have incurred the monumental monetary costs of lockdowns and would have saved a very large amount of money that is now not going to be spent on the elderly.
Has their been a study on the effects on our medical systems if Covid-19 had spread thru the population much faster?
Interesting that the research completely ignores the impact lockdowns have had when the governments actually enforce them and combine them with widespread testing. Paper literally mentioned China was the first country to deploy lockdowns, then never mentions China again.
All and all, pretty obvious lockdowns work if they’re actually enforced.
All and all, pretty obvious lockdowns work if they’re actually enforced.
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How do they adjust for the reasons for lockdowns? Surely a lockdown is introduced because things are bad. Is the analysis separating that out adequately?
I'm not at all surprised.
The high level of noncompliance we saw made it pretty much useless. Half measures cause economic pain without providing much benefit.
The careful people wear masks anyway, the reckless won't obey the protective measures.
The high level of noncompliance we saw made it pretty much useless. Half measures cause economic pain without providing much benefit.
The careful people wear masks anyway, the reckless won't obey the protective measures.
I don't follow this argument. If, say, half the people completely ignored the rules then doesn't that make them only half as effective and cause half the economic pain?
Lots of people don't comply with speed limits but that doesn't prove speed limits ineffective.
Lots of people don't comply with speed limits but that doesn't prove speed limits ineffective.
It’s the old no true lockdown argument; if the lockdown fails it’s because it wasn’t tough enough or because it was followed or enforced strictly enough.
An easy fallacy to handwave away the possibility that the lockdown strategy just doesn’t work so well. Which is kind of obvious if you think it through; either the result is you eradicate the virus completely or the lockdown just delays the inevitable. And it should be clear by now that eradication is simply impossible and from very early on in the pandemic was just never going to happen.
An easy fallacy to handwave away the possibility that the lockdown strategy just doesn’t work so well. Which is kind of obvious if you think it through; either the result is you eradicate the virus completely or the lockdown just delays the inevitable. And it should be clear by now that eradication is simply impossible and from very early on in the pandemic was just never going to happen.
Yes, the argument that it would have worked _if_only_ is similar to the Marxist argument that it would have worked if only all countries had gone full Marxist. Top-down government control of economy and medicine rarely achieves the stated goals.
Very true, but if you can delay the inevitable long enough to get a substantial part of the population vaccinated, then there is value in that.
However, that strategy fails when you don't have access to the vaccine.
However, that strategy fails when you don't have access to the vaccine.
If you consider the few months of protection granted against severe disease, and not against infection, good enough and believe it’s possible and wise to keep giving people more and more ‘boosters’, and believe the risks of vaccines and an infinite list of boosters remain smaller than the risk of the disease itself and, should one choose to implement a mandate, the cost of losing the right to decide for yourself if you want the vaccine/boosters or not.
I was only addressing the situation where nobody is vaccinated and the vaccine is being distributed.
With booster shots it should never be an option to shut down society.
With booster shots it should never be an option to shut down society.
If a business is half fixed costs and half profit, then cutting their revenue in half will cut their profit to zero.
Speed limits are a good counter-example though, where they can provide a baseline expectation (eg mask wearing is good in crowded places) and then begins the negotiations from there for what is expected social behavior.
Speed limits are a good counter-example though, where they can provide a baseline expectation (eg mask wearing is good in crowded places) and then begins the negotiations from there for what is expected social behavior.
That's perhaps an argument against lockdowns, but not an argument that lockdowns don't work because of noncompliance.
I did not mean to imply it was an argument either way. I meant it more as a way of demonstrating that we need to be careful to be precise about the actual relative impacts of each option, since they each have non-linear side-effects (including rates of compliance). So we should not get caught making absolute statements that something is always better or that it never works in this case, but instead look at the Pareto optimality frontier for each particular region when making policy recommendations and analysis.
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"Overall, our meta-analysis fails to confirm that lockdowns have had a large, significant effect on mortality rates. Studies examining the relationship between lockdown strictness (based on the OxCGRT stringency index) find that the average lockdown in Europe and the United States only reduced COVID-19 mortality by 0.2% compared to a COVID-19 policy based solely on recommendations. Shelter-in-place orders (SIPOs) were also ineffective. They only reduced COVID-19 mortality by 2.9%."
But there is some nuance in there, worth reading.