Do lockdowns reduce deaths from COVID-19? April 28, 2020

Lockdowns and quarantines are procedures  called “Non Pharmaceutical Interventions” that are currently being advocated and used to slow the spread of highly contagious, infectious disease, such as COVID-19. However, despite these “social distancing” measures that appeared to lower death rates in previous pandemics like the 1918 flu, we are not seeing the same benefits that would be expected in the current pandemic.

Why are lockdown orders not working like we think they should? I know this is controversial, but stick with me. Let’s look at a few things:

1. The death rate for COVID-19 in children under age 18 is vanishingly small, despite claims to the contrary from public officials and news media who soberly reminded us that  “COVID-19 kills in all age groups”. This is a huge distortion of the truth. According to the CDC, the flu death rate this season alone is 26 times higher than COVID-19 death rate in children up to age 14. Despite all this, states began closing schools on March 12 in order to enforce “social distancing” to slow the spread. However, since that time, and despite all that time isolated at home away from school, more children died of the flu in the 4 weeks following March 12, 2020 than in the 4 weeks following March 12, 2019, March 12, 2018, and March 12, 2017. So much for closing schools to “slow the spread”. To recap: Closing schools in 2020 did nothing to reduce death and hospitalizations from either flu or COVID-19 in children.
2. While California was the first state to mandate a state-wide stay at home orders on March 20, the states of Iowa, Nebraska, and North and South Dakota have not issued such orders, despite derision and ridicule from the news media, epidemiologists, and political figures. As of this date, California has 43 deaths per million population, while those 4 states that did not lockdown all have death rates lower than California, including 3 states having less than half of California’s mortality rate. Additionally, trying to compare dates of lockdown orders in each state with mortality rates have yielded no noticeable correlation, leaving one to wonder about the necessity for statewide lockdown orders at all. The currently available evidence does NOT support mandated state-wide lockdowns to reduce mortality.
3. While lockdowns were constructed to “flatten the curve” of peak demand on hospital resources, they were not constructed to lower the overall death rate outside of death resulting from exceeding peak capacity at hospitals. Hospital capacity has never been challenged outside of regional “hotspots” like New York City, Detroit, and New Orleans, and even these were temporary. I do not want to dilute the problem of  the exhaustive strain on the hospital systems over a few days, but this is hardly a reason to shut down an entire country. All the field hospitals, including the Javit Center in New York and the USNS Comfort stood relatively empty the entire time. The curve is flattened. Additionally, no available historical evidence exists in literature that I can find that shows that removing a lockdown expeditiously will lead to a rebound effect in deaths. It is a theory only.
4. Most states with the most draconian lockdown measures are also suffering from the highest death rates. New York, New Jersey, Connecticut, Massachusetts, Louisiana, Michigan, and Washington, DC all have strict stay at home orders, yet have much higher death rates than Iowa, North Dakota, and Arkansas which have little to none stay at home orders.To suggest that all states need to act as a “one size fits all” despite vast differences in age, ethnic origin, and cultural practices stretches the most stable and sane imagination.
5. Models used by decision makers have over-predicted COVID-19 deaths, ventilator, and ICU requirements by up to 50%. They have not been close. Of course, these numbers are revised down as observations are made, but there exists no evidence that these models have any accuracy more than 7 days into the future. Why do we keep making policies using models that have been proven to be wildly unreliable?

In short, there exists no evidence-based reason to continue lockdowns, starting next week, starting this week, starting tomorrow. While any death is a tragedy, it is also something that we unfortunately can’t get out of in this life. The vast majority of those dying are the elderly with underlying medical conditions. Why we didn’t quarantine the elderly and let everyone else work and play and live makes no sense. Nonetheless,  here we are. With 55,000 to 60,000 Americans dying per week as a background death rate during March and April on average the past 3 years, we are, about 5% over the average background the past 2 weeks, but overall 4% under the average since February 1. This means that our overall current death rate is actually DOWN since February compared to the past 2 years covering the same time range. While lockdowns may have been helpful in the 1918 flu pandemic, they have fallen short in reducing death during the COVID-19 pandemic.

 

References:

Peter Caley et. al. 2007Quantifying social distancing arising from pandemic influenzaJ. R. Soc. Interface.5631–639. http://doi.org/10.1098/rsif.2007.1197 Grinberg, Maya. Learning from the 1918 Pandemic. Risk Management; New York Vol. 54, Iss. 8, (Aug 2007): 10. https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm Accessed 4/25/2020. https://www.cdc.gov/flu/weekly/#S2 Accessed 4/25/2020. https://www.worldometers.info/coronavirus/country/us/ Accessed 4/25/2020. https://www.worldometers.info/coronavirus/country/us/ Accessed 4/25/2020. https://covid19.healthdata.org/united-states-of-america Accessed 4/25/2020. https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm Accessed 4/25/2020.