The claim that lockdowns end more lives than they save is misleading

University of Bristol
24-Mar-2021 9:20 AM EDT, by University of Bristol

Fact Check By: Dr Howard H.Z. Thom, Research Fellow in Statistical Modelling and lecturer in Health Economics at the University of Bristol Medical School: Population Health Sciences, University of Bristol

Truthfulness: Mostly False

Claim:

The data shows lockdowns end more lives than they save.

Claim Publisher and Date: John Tierney, New York Post on 2021-03-22

In response to the opinion piece published in the New York Post on March 22, 2021, by John Tierney, titled, "The data shows lockdowns end more lives than they save"

The central claim of this article isn't supported by the evidence provided by the author. 

The author claims "The United States will experience more than 1 million excess deaths in the United States during the next two decades as a result of the massive “unemployment shock” last year, according to a team of researchers from Johns Hopkins and Duke, who analyzed the effects of past recessions on mortality."

The author does not provide a reference but the article is likely that of Bianchi and colleagues (https://www.nber.org/papers/w28304). This is an excellent study but wrongly assumes that unemployment and economic losses are attributable solely to government restrictions. Evidence on which is the greater factor is limited, but the IMF, for example, used changes in travel, electricity use and unemployment insurance claims at the start of 2020 to show economic conditions deteriorated before government restrictions were introduced and began to recover before they were lifted (https://www.imf.org/en/Publications/WEO/Issues/2020/09/30/world-economic-outlook-october-2020). It concluded that lockdowns and voluntary social distancing had a near-identical economic impact. A further preprint study found that consumer spending in Denmark and Sweden fell by similar amounts during the first wave, despite Denmark introducing a stringent lockdown and Sweden using mostly voluntary restrictions (https://arxiv.org/pdf/2005.04630.pdf). You could go further and compare the IMF GDP 2020 growth and WHO death rates of Sweden (-4.7%, with ~54,000 deaths per million), to those of its less lenient neighbours Denmark (-4.5% with ~33,000 deaths per million), Finland (-4.0% with ~7500 deaths per million), and Norway (-2.8%, with ~11,000 deaths per million). It seems that lockdowns save lives and protect the economy, thus preventing more deaths from economic deprivation. 

It is therefore grossly misleading to attribute the 1 million excess deaths solely to response. 

The author also claims "When the 50 states are ranked according to the stringency of their lockdown restrictions, you can see one obvious pattern: The more restrictive the state, the higher the unemployment rate. But there is no pattern in the rate of COVID-19 mortality."

This ignores the confounding effect of severity of local epidemic and the question of what would have happened if there had been no restrictions. States with more restrictions may be responding to a more severe epidemic, which would have a related impact of more severe unemployment (see response to point above). Differences in absolute mortality are meaningless on their own as they ignore important demographic effects (density, urban vs rural, age, and comorbidities) that would lead to more severe epidemics in the absence of response. As an illustration, consider my own analysis of lives saved in the UK, Ireland, Spain, Germany, and Sweden up to 22nd July, counted as the first wave of the pandemic (https://doi.org/10.1093/eurpub/ckab019). Simply comparing deaths per 1000 would suggest that the UK (6/1000), Spain (6/1000) and Sweden (6/1000) did worse than Germany (1/1000) and Ireland (4/1000). However, calculating deaths prevented per thousand compared to an R0=2.7 "no mitigation" scenario tells a different story, with Ireland (40/1000) and Sweden (56/1000) saving fewer lives than the UK (58/1000), Spain (60/10000) and Germany (60/1000). These patterns are likely driven by demographics as much by stringency of response. 

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