12 ms·

Review and meta-analysis of the effects of lockdowns on Covid-19 mortality [pdf]

112 points by k2enemy 5y ago

LorenPechtel 5y ago
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.
- eli 5y ago
  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.
  - manwe150 5y ago
    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.
    - eli 5y ago
      That's perhaps an argument against lockdowns, but not an argument that lockdowns don't work because of noncompliance.
      - manwe150 5y ago
        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.
  - amluto 5y ago
    Not even close, sadly. Consider New Zealand, Taiwan, and China: if you take extreme measures and eliminate all COVID, then there is no COVID. It doesn’t appear from nowhere. (Just like in 2018 there was no COVID.) On the other hand, if you eliminate half the transmission of a highly contagious disease, everyone may well still get it, and while you have flattened the curve, you haven’t actually saved many lives. For those who remember Chicken Pox, almost everyone got chicken pox. To the extend any NPIs reduced transmission (e.g. keeping kids out of school), the primary result was delaying chicken pox or avoiding major outbreaks, and delaying chicken pox may have been a bad thing. As a different analogy, if you have a Windows XP system in the Internet, it will get pwned. If you update it to Vista, you get a worse UI and it still gets pwned. Sometimes half measures are much less than half effective.
    - eli 5y ago
      Wouldn't you MUCH rather get covid today than in April 2020?
      - amluto 5y ago
        Yes. I’m not claiming that NPIs are useless. I’m saying that half an NPI may be vastly less than half as effective. I think the OP can speak for itself.
    - cassianoleal 5y ago
      > if you eliminate half the transmission of a highly contagious disease, everyone may well still get it, and while you have flattened the curve, you haven’t actually saved many lives. Assuming all other things are equal in both cases, sure. In reality though, by flattening the curve we have avoided greater collapse of health systems, we got more time to understand better what works and what doesn't when fighting the disease, we got more vaccinated people, etc. These things combined might have saved a lot of lives. I'm not sure why delaying chicken pox may have been a bad thing, what do you mean by that?
      - abakker 5y ago
  - deleted 5y ago
    [deleted]
  - tinus_hn 5y ago
    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.
    - sharken 5y ago
      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.
      - tinus_hn 5y ago
        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.
        sharken 5y ago
        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.
    - landemva 5y ago
      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.
- thisisnotatest1 5y ago
gilbetron 5y ago
From the study: "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.
- eli 5y ago
  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.
  - brg 5y ago
    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.
    - eli 5y ago
      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.
  - aantix 5y ago
    The first few months where everything was closed, including parks and beaches?
    - ryandrake 5y ago
      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.
rich_sasha 5y ago
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?
azakai 5y ago
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=countries-normalized&highlight=United%20States&show=highlight-only&y=both&scale=linear&data=deaths&data-source=jhu&xaxis=right&extra=New%20Zealand#countries-normalized 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.)
- jdrc 5y ago
  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
- gruez 5y ago
  > 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.
thisisnotatest1 5y ago
vladgur 5y ago
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.
newaccount2021 5y ago
nodamage 5y ago
Note that this paper was published by economists (as opposed to epidemiologists) and does not appear to have undergone peer-review.
- nodamage 5y ago
  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.
pasabagi 5y ago
>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.
- Izkata 5y ago
  > 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.
  - pasabagi 5y ago
    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.
JaimeThompson 5y ago
Has their been a study on the effects on our medical systems if Covid-19 had spread thru the population much faster?
thenayr 5y ago
zwieback 5y ago
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.
- sjg007 5y ago
  >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.
  - zwieback 5y ago
    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"
    - sjg007 5y ago
      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.
      - javagram 5y ago
        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.)
sgustard 5y ago
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?
- tinus_hn 5y ago
  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.
Barrin92 5y ago
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.
- LorenPechtel 5y ago
  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.)
  - nradov 5y ago
    Who do you include in "everyone"? First responders? Military? Healthcare providers? Farmers? Homeless? Utility workers? Garbage collectors?
  - DiogenesKynikos 5y ago
    It's already known that CoVID can be eliminated in individual countries. A number of countries got rid of it all the way back in early-to-mid 2020: China (including Taiwan and Hong Kong), New Zealand, Australia, Vietnam, Singapore, and several other places. The places that eliminated CoVID-19 in 2020 did far better than those that didn't, both in terms of preventing death (no cases means no CoVID deaths) and keeping society functioning more or less normally. Once CoVID is gone, you can reopen bars, restaurants, etc. without having to worry about the virus spreading. The main challenge after local elimination is preventing the virus from getting back in and reestablishing itself. The first line of defense is border quarantine. Behind that, you need ongoing surveillance (e.g., test everyone who shows up at a clinic with a fever or sore throat) to detect new outbreaks early. Once you detect an outbreak, you need to use tools like contact tracing (with mandatory quarantine and isolation), mass testing and, when absolutely necessary, local lockdowns to end it. The question is why more countries didn't follow this strategy. For any country able to pull it off, it was obviously worth it. China reopened in April 2020. Most people haven't experienced a lockdown since, life has been mostly normal, and there hasn't been any large outbreak since (the largest one was about 2,000 people in total). The main cost is that international travel is difficult, because you have to quarantine for 3 weeks when you return, but that doesn't affect most people.
jonnycomputer 5y ago
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/chinas-immunity-gap https://www.foreignaffairs.com/articles/china/2022-01-26/chi...
- LorenPechtel 5y ago
  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.
  - bsder 5y ago
    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.
    - jonnycomputer 5y ago
      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.
    - LorenPechtel 5y ago
      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.
- kcplate 5y ago
  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.
erglkjklhrt 5y ago
cowpig 5y ago
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.
- infamouscow 5y ago
  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.
  - cowpig 5y ago
    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.
    - landemva 5y ago
      The larger picture is animal and human transmission.
deleted 5y ago
[deleted]
O__________O 5y ago
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.

112 points by k2enemy 5y ago

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.

eli 5y ago
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.
- manwe150 5y ago
  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.
  - eli 5y ago
    That's perhaps an argument against lockdowns, but not an argument that lockdowns don't work because of noncompliance.
    - manwe150 5y ago
      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.
- amluto 5y ago
  Not even close, sadly. Consider New Zealand, Taiwan, and China: if you take extreme measures and eliminate all COVID, then there is no COVID. It doesn’t appear from nowhere. (Just like in 2018 there was no COVID.) On the other hand, if you eliminate half the transmission of a highly contagious disease, everyone may well still get it, and while you have flattened the curve, you haven’t actually saved many lives. For those who remember Chicken Pox, almost everyone got chicken pox. To the extend any NPIs reduced transmission (e.g. keeping kids out of school), the primary result was delaying chicken pox or avoiding major outbreaks, and delaying chicken pox may have been a bad thing. As a different analogy, if you have a Windows XP system in the Internet, it will get pwned. If you update it to Vista, you get a worse UI and it still gets pwned. Sometimes half measures are much less than half effective.
  - eli 5y ago
    Wouldn't you MUCH rather get covid today than in April 2020?
    - amluto 5y ago
      Yes. I’m not claiming that NPIs are useless. I’m saying that half an NPI may be vastly less than half as effective. I think the OP can speak for itself.
  - cassianoleal 5y ago
    > if you eliminate half the transmission of a highly contagious disease, everyone may well still get it, and while you have flattened the curve, you haven’t actually saved many lives. Assuming all other things are equal in both cases, sure. In reality though, by flattening the curve we have avoided greater collapse of health systems, we got more time to understand better what works and what doesn't when fighting the disease, we got more vaccinated people, etc. These things combined might have saved a lot of lives. I'm not sure why delaying chicken pox may have been a bad thing, what do you mean by that?
    - abakker 5y ago
- deleted 5y ago
  [deleted]
- tinus_hn 5y ago
  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.
  - sharken 5y ago
    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.
    - tinus_hn 5y ago
      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.
      - sharken 5y ago
        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.
  - landemva 5y ago
    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.
thisisnotatest1 5y ago

gilbetron 5y ago

From the study: "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.

eli 5y ago
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.
- brg 5y ago
  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.
  - eli 5y ago
    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.
- aantix 5y ago
  The first few months where everything was closed, including parks and beaches?
  - ryandrake 5y ago
    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.

rich_sasha 5y ago

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?

azakai 5y ago

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=countries-normalized&highlight=United%20States&show=highlight-only&y=both&scale=linear&data=deaths&data-source=jhu&xaxis=right&extra=New%20Zealand#countries-normalized 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.)

jdrc 5y ago
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
gruez 5y ago
> 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.

thisisnotatest1 5y ago

vladgur 5y ago

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.

newaccount2021 5y ago

nodamage 5y ago

Note that this paper was published by economists (as opposed to epidemiologists) and does not appear to have undergone peer-review.

nodamage 5y ago
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.

pasabagi 5y ago

>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.

Izkata 5y ago
> 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.
- pasabagi 5y ago
  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.

JaimeThompson 5y ago

Has their been a study on the effects on our medical systems if Covid-19 had spread thru the population much faster?

thenayr 5y ago

zwieback 5y ago

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.

sjg007 5y ago
>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.
- zwieback 5y ago
  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"
  - sjg007 5y ago
    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.
    - javagram 5y ago
      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.)

sgustard 5y ago

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?

tinus_hn 5y ago
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.

Barrin92 5y ago

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.

LorenPechtel 5y ago
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.)
- nradov 5y ago
  Who do you include in "everyone"? First responders? Military? Healthcare providers? Farmers? Homeless? Utility workers? Garbage collectors?
- DiogenesKynikos 5y ago
  It's already known that CoVID can be eliminated in individual countries. A number of countries got rid of it all the way back in early-to-mid 2020: China (including Taiwan and Hong Kong), New Zealand, Australia, Vietnam, Singapore, and several other places. The places that eliminated CoVID-19 in 2020 did far better than those that didn't, both in terms of preventing death (no cases means no CoVID deaths) and keeping society functioning more or less normally. Once CoVID is gone, you can reopen bars, restaurants, etc. without having to worry about the virus spreading. The main challenge after local elimination is preventing the virus from getting back in and reestablishing itself. The first line of defense is border quarantine. Behind that, you need ongoing surveillance (e.g., test everyone who shows up at a clinic with a fever or sore throat) to detect new outbreaks early. Once you detect an outbreak, you need to use tools like contact tracing (with mandatory quarantine and isolation), mass testing and, when absolutely necessary, local lockdowns to end it. The question is why more countries didn't follow this strategy. For any country able to pull it off, it was obviously worth it. China reopened in April 2020. Most people haven't experienced a lockdown since, life has been mostly normal, and there hasn't been any large outbreak since (the largest one was about 2,000 people in total). The main cost is that international travel is difficult, because you have to quarantine for 3 weeks when you return, but that doesn't affect most people.

jonnycomputer 5y ago

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/chinas-immunity-gap https://www.foreignaffairs.com/articles/china/2022-01-26/chi...

LorenPechtel 5y ago
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.
- bsder 5y ago
  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.
  - jonnycomputer 5y ago
    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.
  - LorenPechtel 5y ago
    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.
kcplate 5y ago
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.

erglkjklhrt 5y ago

cowpig 5y ago

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.

infamouscow 5y ago
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.
- cowpig 5y ago
  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.
  - landemva 5y ago
    The larger picture is animal and human transmission.

deleted 5y ago

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O__________O 5y ago

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.