A new paper in BMJ Global Health purports to debunk lockdown sceptics’ claim that “the cure is worse than the disease”. However, it misses the big picture; in fact, it hasn’t shifted my priors one jot.
The paper contains no new data or analysis. Rather, it comprises a review of the existing literature. The authors focus on the claim that “lockdowns cause more health harms than COVID-19 by examining their impacts on mortality, routine health services, global health programmes and suicide and mental health”.
In other words, they attempt to show that lockdowns do not cause more health harms than they prevent. Notice: this is not the same as showing that lockdowns pass an overall cost-benefit test. Even if lockdowns were a net positive for public health, they could still be a massive net negative for society (taking into account their effects on the economy, education and civil liberties).
The strongest argument the authors make (with which I was already familiar) is that excess mortality in countries like Australia and New Zealand – which managed to contain the virus – was zero or negative last year. Since these countries did not experience an epidemic of COVID-19, but did see weeks or even months of lockdown, the lack of excess mortality suggests that lockdowns themselves do not cause many deaths.
However, some lockdown sceptics would argue that – even if lockdowns don’t cause many deaths in the short-term – they do cause more deaths in the long-term, via missed cancer screenings, drug overdoses etc. And here the authors are much less persuasive.
They concede that “the connection between lockdowns and missed contact with health systems is very well established”. However, they claim this association “may be related to lack of capacity of healthcare services or impacts of the pandemic itself rather than measures taken by governments”.
There is “no doubt”, the authors admit, “that global health programmes have been disrupted”. But they argue such disruptions were caused by “multiple complex direct and indirect consequences of COVID-19, not just stay-at-home orders”.
So they acknowledge that lockdowns do have harmful long-term effects. And given that those long-term effects are yet to be quantified, the authors have little basis for concluding that lockdowns are “unlikely to be causing harms more extreme than the pandemic itself”.