Most Covid Measures Were About as Effective As a Harvest Dance
Most Covid Measures Were About as Effective As a Harvest Dance
As the pandemic subsides across most of the world, public health officials and governments will do their best to take credit for the retreat of Covid-19 or, to be more accurate, the reduction of Covid disease to acceptable levels. Blissfully ignoring the fact that similar rises and falls in disease occurred in parts of the world with practically no mask mandates and very few intrusive Covid restrictions, such as Sweden and Florida, public officials will keep telling us that they have saved lives by locking down populations and abridging civil liberties.
Government leaders and their advisers will stand up and tell us, with a straight face - as they have done throughout the pandemic - that by compelling healthy citizens to mask up in supermarkets, shutting down schools and businesses for months on end, testing asymptomatic citizens, and imposing vaccine controls domestically and internationally, they have saved us from the coronavirus, or at least greatly mitigated its harms.
Dearth of evidence for efficacy of lockdowns and masks
But there is no convincing empirical evidence demonstrating that harsh lockdowns, vaccine passports, widespread asymptomatic testing, and universal mask mandates made more than a marginal global impact, if any, on public health measures like life expectancy and physical and mental health, even if lockdowns had some effect in the short term.
If there were any strong evidence, beyond contingent correlations here and there, to support the efficacy of lockdowns, community masking, or vaccine passes, I am quite certain that at least one of the pro-lockdown governments would by now have brought it to our attention. And even if lockdowns had some marginal impact on infections, this is unlikely to have offset the massive collateral harms of lockdowns to health and well-being, from depression and anxiety to poverty and untreated disease.
The continuing dearth of evidence for the efficacy of these measures may come as a surprise to some, given that they continued to be employed throughout 2020 and 2021, but the fact that aggressive lockdowns and community masking were not vindicated by studies during the pandemic is nothing but a corroboration of pre-pandemic science. Like it or not, harsh non-pharmaceutical interventions (NPIs) were not part of the traditional tool kit for handling epidemics prior to 2020, were not validated by available scientific studies at the start of 2020, and were not recommended by the World Health Organisation’s 2019 guidelines for managing pandemic threats.
In the absence of compelling scientific evidence that lockdowns, mask mandates, and vaccine mandates tend to have any beneficial impact on public health outcomes, governments have tried to pull the wool over citizens’ eyes with the same sort of sleight-of-hand governments use during an economic upturn, namely, the simplistic equation of correlation with causation.
Just as governments that have the good fortune to come into power at the outset of an economic boom say, “look, we came into power, and then we fixed the economy,” in a similar way, those who happen to be in power when Covid case numbers fall tell us, “Look, we ordered a lockdown, and then the cases dropped,” or “look, we imposed a mask mandate, and finally, managed to get the hospitalisation numbers down.”
Covid Measures Are About As Effective as Harvest Dances
This is the same sort of reasoning that might support the efficacy of a harvest dance. Let’s suppose a community engaged in a harvest dance ritual every summer season, to petition the gods for a rich and abundant harvest. When a harvest goes reasonably well - which may well be very often, with or without the dance - the farming community might very well assume that they have the harvest dance to thank for it. When they reap a bad harvest, they might just assume it was because the dancers lacked faith or their performance was not up to snuff.
Whatever happens, it can be taken as confirmation of the efficacy of the Harvest Dance, or at least as consistent with it. This is a classic case of confirmation bias, which renders a hypothesis almost impossible to falsify in the eyes of its believers: “True believers” tend to validate evidence that appears to confirm their desired conclusions, and invalidate any evidence that seriously challenges those conclusions.
This sort of confirmation bias is also operative in those who assert that lockdowns, or masks, or vaccine mandates, are what saved us from the worst of Covid-19.
Since all pandemics, without exception, reach a point of equilibrium or endemicity, in which they become integrated into the normal cycle of colds and flus; and since viral epidemics generally generate a disease curve every winter season that increases and later diminishes as population immunity builds and the climate becomes less favourable to viral activity, there is an ebb and flow to epidemics that is largely independent from human interventions.
This does not mean that all human interventions aimed at mitigating disease are useless. For example, it seems pretty obvious that better antiviral treatments and better staffed and managed hospitals and care homes should reduce the total disease burden of an epidemic. And it is indisputable that safe and well tested vaccines have greatly reduced the disease and death toll from transmissible diseases like measles and polio.
However, without solid evidence, it would be be naive and disingenuous in the extreme to infer that a specific drop-off in disease or hospitalisation, which was going to happen sooner or later anyway, is caused by a specific package of human interventions, be they border controls, vaccine mandates, mask mandates, or lockdowns, that happened to precede it.
The only way to establish a probable causal relationship with any degree of confidence would be to compare two or more societies exposed to the virus, one with, and the other without such interventions. Ideally, they would have to be societies that are broadly similar climactically, socio-economically, and culturally; and we would would have to control for relevant differences, such as the proportion of people over 60, the density of the population centres, the state of the health system, and the relative presence or absence of risk factors like obesity and diabetes.
Of course, this is notoriously difficult to do well. But it is not impossible. Several analysts have attempted to compare outcomes in regimes with and without aggressive NPIs (non-pharmaceutical interventions). The preponderance of studies do not find any clear advantage from an epidemiological perspective for regimes with more aggressive lockdown and masking policies.
Why Population-Wide Mandates Are Unlikely to Succeed
This might at first seem counter-intuitive. Surely locking people up in their homes or threatening them with fines for socialising should reduce viral infections substantially? Yet if we think through the net benefits of coercive interventions, it becomes clear why they are unlikely to work well:
To begin with, Covid hits populations in a highly selective manner, inflicting much greater harm on older and sicker populations compared with younger and healthier populations. This makes population-wide interventions of any sort - whether masks or lockdowns - extremely inefficient and often counterproductive.
In addition, it is likely that even without involuntary lockdowns, at the height of a pandemic many people will significantly curtail their social life, especially if they are themselves vulnerable or have close contact with vulnerable persons.
Similarly, since diseases tend to be most infectious when people actually have symptoms, it is likely that people would stay at home, or heavily reduce their social interactions, at times when they are most infectious.
In short, those who might have benefited from lockdowns and other protective measures, such as the elderly, the chronically sick, and those living in close proximity to them, are likely to voluntarily make many of the adjustments they need to reduce disease spread, with or without lockdown orders or mask mandates. For these reasons, police-enforced restrictions inflicted willy-nilly on healthy and unhealthy alike, are unlikely to be much more effective at controlling disease than voluntary compliance with basic norms of public health.
So the next time you see some public health official brag on primetime TV that their timely lockdown or mask mandates saved us from Covid-19, notice how they refuse to explain comparable outcomes in light touch regimes like Sweden and Florida, and remember how the annual Harvest Dance is supposed to usher in a better harvest.
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By way of illustration, consider the excess mortality levels during the pandemic in regimes like Florida and Sweden, with very few intrusive Covid restrictions and no mask mandates throughout most of the pandemic, compared with regimes like California and UK, with much more intrusive restrictions during large chunks of the pandemic. Lockdown regimes do not fare any better than non-lockdown regimes, according to most studies. Here are two graphs, just by way of illustration, for excess call cause mortality in California vs. Florida, and UK vs. Sweden. I prefer to use excess all cause mortality because it is less susceptible to distortion and manipulation than Covid mortality.
Given the complexity of the variables affecting disease outcomes, it is difficult to isolate the effects of lockdowns in a precise manner. Nonetheless, it is notable that many studies find that lockdowns have minimal if any success at reducing disease and mortality. See, inter alia, Bendavid, Oh, Bhattacharya, and Ionnaidis, ‘Assessing mandatory stay-at-home and business closure effects on the spread of Covid-19’, European Journal of Clinical Investigation 51-4, April 2021; Larochelambert, Marc, Antero, Bourg and Toussaint, ‘Covid-19 Mortality: A Matter of Vulnerability Among Nations Facing Limited Margins of Adaptation’, Frontiers in Public Health, 19 November 2020; Morris Altman, ‘Smart thinking, lockdown and Covid-19: Implications for public policy’, Journal of Behavioral Economics for Policy 4: p. 23-33, June 2020; Chin, Ioannidis, Tanner and Cripps, ‘Effects of non-pharmaceutical interventions on Covid-19: A Tale of Three Models’, medRxiv, December 1, 2020; Berry CR, Fowler A, Glazer T, Handel-Meyer S & MacMillen A, ‘Evaluating the effects of shelter-in-place policies during the COVID-19 pandemic’, Proceedings of the National Academy of Sciences of the USA (PNAS), 118-15, 2021; Agrawal V, Cantor JH, Sood N & Whaley CM (2021), ‘The Impact of the COVID-19 Pandemic and Policy Responses on Excess Mortality’, National Bureau of Economic Research (NBER), June 2021.
I am using this imaginary example to make a point, not engaging in real-world anthropology. People who actually engage in harvest dances might very well have more sophisticated beliefs about causality than the ones depicted in this example.
See studies cited in endnote 2.