Last week I wrote that U.S. states which locked down over the winter had a higher Covid death toll on average than those which did not.
Some people argued that I should have only looked at deaths over the winter rather than in total for it to be a fair comparison. I disagree. That would mean places which had a high death toll in spring would look better just because they had already been hit hard, lost a lot of people, and built up some immunity. Also, in lockdown theory, lockdowns only defer deaths, they don’t prevent them, so any state which didn’t lock down in winter should have suffered then any deaths deferred by earlier measures. Thus the fairest comparison for understanding whether lockdowns are necessary to prevent a catastrophic death toll – the central claim at stake – is the total number of deaths, not just those in one season.
Today I’m updating the figures. At the same time I’ve done a fresh review of the measures different states took (using these two handy websites which have collected them all together) to ensure I’m putting each state in the correct category.
Nineteen states issued an actual stay-at-home order this winter. While most of these (except for Oregon and New Mexico) were advisory, they all made clear that people should stay at home as much as possible and were accompanied by other severe restrictions such as business closures and bans on gatherings. A further 14 states, though not issuing a stay-at-home order, imposed similar strong restrictions that served the same basic purpose. These I’ve classified as the winter lockdown states (they include Washington, D.C.).
The other group of states imposed much lighter restrictions, such as business capacity limits (often around 50%) or gathering limits (such as 50) but did not issue a stay-at-home order, close businesses or ban private gatherings. There are 18 of these – the 11 I included last time, plus seven I’d overlooked, including Arizona and Mississippi. These two states in particular are up in the top six states states for Covid deaths per million so I was concerned this would shift the average for the no-lockdown states above the lockdown states. However, the no-lockdown states still come out lower (albeit with a smaller gap) – 1,730 vs 1,736. (Death and population data from Worldometer.)
As noted before, we shouldn’t get too hung up on the precise numbers here, which will be affected by various factors such as the population density and demographics of the state and the precise way the state counts Covid deaths. The important point is the big picture: the fact that in one big country with lots of different regions responding to an epidemic in different ways, there was no obvious relationship between interventions and outcomes. In particular, those which didn’t lock down did not suffer “hundreds of thousands” more deaths (or the population-size equivalent) than those which did, contrary to what all the mathematical models predicted. Their epidemics peaked and declined in the same way as lockdown states.
This point becomes even clearer when we focus in on the six states which kept restrictions to a minimum this winter – Florida, Georgia, South Dakota, South Carolina, Utah and Nebraska. These states had 1,629 Covid deaths per million on average, well below the 1,736 average of the lockdown states.
Some might want to quibble with which category some of the more middling states in terms of severity of winter restrictions should go in. Given how close the two groups are when it comes to deaths per million, I wouldn’t be surprised if a subtle shifting of criteria could put the no-lockdown states just ahead in terms of total deaths. (For example, you could argue about whether Maryland’s restrictions belong in the strong or light category.) But this wouldn’t change the big picture – that lockdowns are not preventing mass deaths from COVID-19, they are not holding back the flood. Rather, they are making no discernible difference to outcomes, despite their immense social and economic costs and the disruption they cause to people’s lives.
I have addressed before why, despite their intuitive appeal as a way of suppressing viral spread, lockdowns have no significant effect on controlling the coronavirus. The chief reason is because much of the spread, particularly that which leads to serious disease and death, occurs in hospitals and care homes. Forty per cent of Covid deaths in England and Wales in the spring were care home residents, while Public Health Scotland found that between a half and two thirds of serious infections in the winter were picked up in hospital. Between these and transmission in private homes (which is more likely to happen when people are forced to stay at home), this accounts for much of it.
In terms of community transmission, even during a stringent lockdown such as the one we’ve had in the UK this winter, around half the workforce are travelling to work, while only around a third work exclusively from home. Add to that that many people still use supermarkets and other shops, and many children still attend school (even where the schools are only open for key workers’ children), and that’s a lot of social interaction. We also know from a major UK survey that less than half of people with Covid symptoms fully self-isolate, giving reasons such as going to work, going to the shops or regarding the symptoms as mild. This means we don’t need to resort to unsubstantiated ideas of asymptomatic infection being a major driver of transmission (which is unsupported by evidence, since, as with other similar viruses, asymptomatic carriers of the disease are barely infectious and contribute very little to spread) to explain ongoing community transmission.
Masks and distancing have little or no effect on transmission, mainly because they do not (and cannot, since people must breathe) prevent virus-carrying aerosols from filling the air in a poorly ventilated space such as most rooms we spend any amount of time in (we are after all trying to keep them warm). Breathing such air is likely the main mode of transmission.
There may be other factors too, but these are the main ones.
The game’s up. The data are in. Lockdowns are a failure as a tool of public health policy. Time to change the game.
Stop Press: Rowen Dean, editor of Spectator Australia, referred to our figures comparing the Covid death rate in US states that locked down last winter to that of the states that didn’t on Sky News Australia. You can watch the clip here.