Do lockdowns work?

[brewsterbudgen]

Interesting article, especially in light of Thailand's gradual move to another partial lockdown, published in The Daily Telegraph (UK).   Unfortunately they have a pay-wall.  Hopefully it's OK to copy & paste the gist of it here.  

 

Politicians, journalists and academics are wrong to blame the public for the failure of lockdowns since “the population [has never] sacrificed so much to comply with public health mandates”, say two of the authors of the Great Barrington Declaration (GBD). Writing in the Telegraph, Martin Kulldorff and Jay Bhattacharya – professors of medicine at Harvard and Stanford respectively – say that lockdown proponents need to acknowledge that eschewing focused protection and quarantining entire populations indiscriminately has led to the “biggest public health fiasco in history”.

 

A year ago, there was no evidence that lockdowns would protect older high-risk people from Covid. Now there is evidence.

Their article is very much worth reading in full.

 

https://www.telegraph.co.uk/news/2021/04/24/lockdown-proponents-cant-escape-blame-biggest-public-health/

 

By Michael Curzon  /  24 April 2021 • 11.41

Edited April 26, 2021 by metisdead
14) You will not post any copyrighted material except as fair use laws apply (as in the case of news articles). Please only post a link, the headline and the first three sentences.

[thaibeachlovers]

22 hours ago, brewsterbudgen said:

A year ago, there was no evidence that lockdowns would protect older high-risk people from Covid. Now there is evidence. They did not.

With so many Covid deaths, it is obvious that lockdown strategies failed to protect the old. Holding the naïve belief that shutting down society would protect everyone, governments and scientists rejected basic focused protection measures for the elderly. While anyone can get infected, there is more than a thousand-fold difference in the risk of death between the old and the young. The failure to exploit this fact about the virus led to the biggest public health fiasco in history.

Indeed, and some of us were pointing that out a year ago, only to be shouted down.

22 hours ago, brewsterbudgen said:

Lockdowns have, nevertheless, generated enormous collateral damage across all ages. Depriving children of in-person teaching has hurt not only their education but also their physical and mental health. Other public health consequences include missed cancer screenings and treatments and worse cardiovascular disease outcomes. Much of this damage will unfold over time and is something we must live with – and die with – for many years to come.

Exactly as some of us said a year ago, but even now, some continue to want to be locked up, or in the case of some governments to lock US up.

22 hours ago, brewsterbudgen said:

The blame game for this fiasco is now in full swing. Some scientists, politicians, and journalists are complaining that people did not comply with the rules sufficiently.

Ah, of course it's never THEIR fault, is it?

[Nonthaburi Boy]

On 4/24/2021 at 6:49 PM, brewsterbudgen said:

A year into the pandemic, one would think that politicians and journalists writing about Covid would have bothered to acquire some basic knowledge of infectious disease epidemiology.

 

You did not say this (important to point that out) but since you posted the article I assume you share the general attitude that politicians and journalists are likely to blame for the failure of the world to follow the ‘herd immunity’ option. Personally, the GBD people are one of the last groups of respected scientists I would want to listen to on the efficacy of lockdowns. Perhaps the rest of the article mentions that even epidemiologists who have long been aware that lockdowns only work to keep the transmission rate low and fully expected that covid would keep on flaring up do not then agree that the answer is the GBD’s ‘herd immunity’ and ‘protection’ - even without taking into account the immense political difficulty of such a solution? I am sure there are better policies than those generally being applied but the GBD don’t really offer anything practical, and never have.

 

Much more relevant to the failure of the GBD to affect government policy than the unwillingness of politicians and journalists to inform themselves is that relevant scientists disagreed substantially with the conclusions of the GBD from the beginning (while sympathising with some of the points made). Certainly some of the key GBD signatories have been exposed to some very unfair and uninformed reaction, but we should consider that particular S@#*storm was spurred by certain political actors seizing on the GBD with cherry-picking glee and essentially proving the conclusion of the John Snow Memorandum  (a response to the GBD): “We cannot afford distractions that undermine an effective response; it is essential that we act urgently based on the evidence” https://www.johnsnowmemo.com i.e. there was a risk that bad actors were going to use GBD to undermine the health response and since there was not (and is not) enough actual scientific evidence to support the arguments of GBD as a basis for public health policy, their ideas were not helpful or useful. Were their views ignored because everybody else was scared to speak up or was it because they were not credible enough?

 

There were always serious ethical problems with the route of ‘herd immunity’, even if it was a plausible response statistically (which, importantly, remains unsupported by evidence, even models). For example, most of the dead would clearly come from certain groups in society. If you could identify these, you would essentially know who you were condemning. If you could not identify those groups in advance (much more likely than the GBD presupposed beyond the elderly - and Sweden’s efforts to protect the elderly suggest that might have been an impractical approach, if theoretically sound) then protecting them all is likely to be impossible. The time to vaccination was also a huge factor in number of deaths predicted, never considered by the GBD team. Who did the GBD think was going to break the news to those groups that “We have this nice theory. Honestly, we are essentially rolling the dice with you lot, but we think - not really sure - it might be for the greater good.” Good luck finding a politician that brave (also potentially unethical, but that would be to easier to find). In practice, outside of Sweden you mainly got the “it’s all going to be fine” and “it’s just a flu” nonsense from politicians. Spoiler: it wasn’t fine. 

 

The science behind the declaration also seems to significantly underplay the effect of health services reaching breaking point and the effects of mild or asymptomatic cases of COVID on longer-term health (the very recent, large-scale study in Nature supports the supposition that this is a problem - significantly higher death rates in the 6 months after mild infection, with no real idea how much longer that higher rate will persist). They also seemed not to have factored in the number of variants that arise with greater virulence (an inevitable consequence of a herd immunity approach) and the grave danger that with enough variants, antibodies and vaccines might no longer offer enough protection. 

 

Here is an example of the reasonable scientific reaction in opposition to the original declaration, made at the time, without any benefit of hindsight.

 

Prof James Naismith FRS FRSE FMedSci, Director of the Rosalind Franklin Institute, and University of Oxford, said:

“The main signatories include many accomplished scientists and I read it with interest.  I will not be signing it however.

“At one level this declaration is a statement of a series of scientific truths and as such is non-controversial.  The declaration identifies the elderly and vulnerable to be at far far greater risk from covid-19 than the bulk of the population, an established fact. 

 

*Edited for Fair Use*

 

https://www.sciencemediacentre.org/expert-reaction-to-barrington-declaration-an-open-letter-arguing-against-lockdown-policies-and-for-focused-protection/

 

Six months on, they are still failing to win over or listen to the likes of Prof. Naismith, who appears very sympathetic to their ‘challenge the orthodoxy’ approach but not to their decision to offer scientific advice in a public forum without thinking things through. What the GBD people really needed (and still need) is more research and better evidence so the likes of Prof. Naismith can be more enthusiastic about their ideas. Much of what they unfortunately seem to produce now is content for misleading newspaper articles. 

 

Edited April 26, 2021 by Scott
Fair Use

[brewsterbudgen]

39 minutes ago, Nonthaburi Boy said:

 

You did not say this (important to point that out) but since you posted the article I assume you share the general attitude that politicians and journalists are likely to blame for the failure of the world to follow the ‘herd immunity’ option. Personally, the GBD people are one of the last groups of respected scientists I would want to listen to on the efficacy of lockdowns. Perhaps the rest of the article mentions that even epidemiologists who have long been aware that lockdowns only work to keep the transmission rate low and fully expected that covid would keep on flaring up do not then agree that the answer is the GBD’s ‘herd immunity’ and ‘protection’ - even without taking into account the immense political difficulty of such a solution? I am sure there are better policies than those generally being applied but the GBD don’t really offer anything practical, and never have.

 

Much more relevant to the failure of the GBD to affect government policy than the unwillingness of politicians and journalists to inform themselves is that relevant scientists disagreed substantially with the conclusions of the GBD from the beginning (while sympathising with some of the points made). Certainly some of the key GBD signatories have been exposed to some very unfair and uninformed reaction, but we should consider that particular S@#*storm was spurred by certain political actors seizing on the GBD with cherry-picking glee and essentially proving the conclusion of the John Snow Memorandum  (a response to the GBD): “We cannot afford distractions that undermine an effective response; it is essential that we act urgently based on the evidence” https://www.johnsnowmemo.com i.e. there was a risk that bad actors were going to use GBD to undermine the health response and since there was not (and is not) enough actual scientific evidence to support the arguments of GBD as a basis for public health policy, their ideas were not helpful or useful. Were their views ignored because everybody else was scared to speak up or was it because they were not credible enough?

 

There were always serious ethical problems with the route of ‘herd immunity’, even if it was a plausible response statistically (which, importantly, remains unsupported by evidence, even models). For example, most of the dead would clearly come from certain groups in society. If you could identify these, you would essentially know who you were condemning. If you could not identify those groups in advance (much more likely than the GBD presupposed beyond the elderly - and Sweden’s efforts to protect the elderly suggest that might have been an impractical approach, if theoretically sound) then protecting them all is likely to be impossible. The time to vaccination was also a huge factor in number of deaths predicted, never considered by the GBD team. Who did the GBD think was going to break the news to those groups that “We have this nice theory. Honestly, we are essentially rolling the dice with you lot, but we think - not really sure - it might be for the greater good.” Good luck finding a politician that brave (also potentially unethical, but that would be to easier to find). In practice, outside of Sweden you mainly got the “it’s all going to be fine” and “it’s just a flu” nonsense from politicians. Spoiler: it wasn’t fine. 

 

The science behind the declaration also seems to significantly underplay the effect of health services reaching breaking point and the effects of mild or asymptomatic cases of COVID on longer-term health (the very recent, large-scale study in Nature supports the supposition that this is a problem - significantly higher death rates in the 6 months after mild infection, with no real idea how much longer that higher rate will persist). They also seemed not to have factored in the number of variants that arise with greater virulence (an inevitable consequence of a herd immunity approach) and the grave danger that with enough variants, antibodies and vaccines might no longer offer enough protection. 

 

Here is an example of the reasonable scientific reaction in opposition to the original declaration, made at the time, without any benefit of hindsight.

 

Prof James Naismith FRS FRSE FMedSci, Director of the Rosalind Franklin Institute, and University of Oxford, said:

“The main signatories include many accomplished scientists and I read it with interest.  I will not be signing it however.

“At one level this declaration is a statement of a series of scientific truths and as such is non-controversial.  The declaration identifies the elderly and vulnerable to be at far far greater risk from covid-19 than the bulk of the population, an established fact. 

 

https://www.sciencemediacentre.org/expert-reaction-to-barrington-declaration-an-open-letter-arguing-against-lockdown-policies-and-for-focused-protection/

 

Six months on, they are still failing to win over or listen to the likes of Prof. Naismith, who appears very sympathetic to their ‘challenge the orthodoxy’ approach but not to their decision to offer scientific advice in a public forum without thinking things through. What the GBD people really needed (and still need) is more research and better evidence so the likes of Prof. Naismith can be more enthusiastic about their ideas. Much of what they unfortunately seem to produce now is content for misleading newspaper articles. 

 

Thanks for this response.  I still think there is some merit in "focused protection" rather than locking down entire populations, with all the harm that that causes, but it's maybe too late for that now.

Edited April 26, 2021 by Scott

[Credo]

Lockdowns work.  The question, however, are they feasible?  There are huge risks and costs to having lockdowns.  First, people are social creatures.  We don't do well in isolation.  We are not self-sufficient.  We need others.  That means that there are risks in lockdowns that people will start going to great extents to have interactions with others and those are dangerous.   

Second, there are the threats to institutions, everything from organizations, social groups and schools suffer greatly.   

 

Finally, there is the economic impact and the disruption to supply chains and delivery of goods, not to mention lost wages.   

But without lockdowns, countries run the risk of completely overwhelming the medical care system and when that breaks, it is not just those with Covid that suffer.   Most lockdowns were designed to save the healthcare system (and secondarily, save lives), but it was more about flattening the curve.   

So, when lockdowns are instituted, it's a good idea to have a goal in mind.   That might be time for a vaccine or treatments.   But long term, bad things happen and the virus continues.

 

[Nonthaburi Boy]

7 hours ago, brewsterbudgen said:

Thanks for this response.  I still think there is some merit in "focused protection" rather than locking down entire populations, with all the harm that that causes, but it's maybe too late for that now.

Yes, me too. We can’t do all this again in 2023 for sure! 

[Danderman123]

The January lockdown in the UK saved tens of thousands of lives. That lockdown worked.

[Danderman123]

For Brits, this question is analogous  to asking the question in WWII, does the RAF effectively work to prevent German bombings of London? Or, should we just surrender to the Nazis?

 

An anti-RAF type might argue that the results show that German bombers do a lot of damage to London. A pro-RAF type would argue that the damage might be catastrophic without the RAF.

 

This is the same argument for and against lockdowns.

[sezze]

Lockdown surely works , the better the lockdown the better it works . China went all the way with their lockdown , but after 2 months , everything was over and more or less normal ( well the new normal , but closer to the old normal then in most places over the world ) . It works better in several degrees , 1st is that all contacts are out of the question , in so no virus can spread . 2nd and much more important , looking at it from +1y down the line is that it was only 2 months , while in most other places, we are still struggling along and while the initial shock is much greater in the Chinese version , the people just can't keep doing this semi lockdowns for long time .

Consider the lockdowns as seatbelts in a car . The hard version is the one you got in F1 car , together with all other kinds of safety features , is a serious hassle but works very good . A normal seatbelt from a normal car also works in a carcrash , but not at all to the same degree .

[Jeffr2]

Lockdowns are just one part of a strategy to deal with this virus.  Social distancing, testing, contact tracing, masks, etc, are all part of this strategy.  In the end, the vaccines are what will allow us to get back to a "new" normal.  Globally, that's probably 2 years away.

[brewsterbudgen]

4 hours ago, Danderman123 said:

The January lockdown in the UK saved tens of thousands of lives. That lockdown worked.

That's interesting.  Do you have a link to this statistic?

[Danderman123]

10 minutes ago, brewsterbudgen said:

That's interesting.  Do you have a link to this statistic?

Here is the mortality data from Worldometer. The lockdown was instituted a week or so before the peak in deaths. 

 

You don't have to be a rocket scientist to see that, if there were no lockdown, and the number of cases had stabilized at the peak - or increased as is happening in India - the number of additional deaths would have been in the 10s of 1000s.

 

Update: for a comparison, I have added the official mortality figures from India, to show what happens without a heavy lockdown. 

Edited April 27, 2021 by Danderman123

[robblok]

2 minutes ago, Danderman123 said:

Here is the mortality data from Worldometer. The lockdown was instituted a week or so before the peak in deaths. 

 

You don't have to be a rocket scientist to see that, if there were no lockdown, and the number of cases had stabilized at the peak - or increased as is happening in India - the number of additional deaths would have been in the 10s of 1000s.

Don't bring logic into the discussion. They want to believe that lockdowns don't work. No matter that the number of cases and deaths drop after lockdowns.

 

Also lockdowns indeed don't cure covid. They slow it down so the health authorities can cope. That has been said from the beginning. Look at india what happens if the health system can't take it anymore.

 

Its tiresome to see people denying that lockdowns work as they do work if people keep to them. Less contact is less spread. The spread in the bars would not have happened if they bars would have been locked down. Its all so simple yet the deniers don't like to accept it.

 

 

[robblok]

If lockdowns don't work is mainly because deniers flaunt the rules and thus rendering lockdowns useless. Lockdowns work as long as the rules are followed. 

 

Everyone was saying songkran was going to spread the disease and it did. So would a spread have happened if they had locked BKK down and no song krang.. it would have been much less. You don't even have to think about it to know it works.

 

It just depends on how strict people follow the rules. 

[Jeffr2]

6 minutes ago, robblok said:

Don't bring logic into the discussion. They want to believe that lockdowns don't work. No matter that the number of cases and deaths drop after lockdowns.

 

Also lockdowns indeed don't cure covid. They slow it down so the health authorities can cope. That has been said from the beginning. Look at india what happens if the health system can't take it anymore.

 

Its tiresome to see people denying that lockdowns work as they do work if people keep to them. Less contact is less spread. The spread in the bars would not have happened if they bars would have been locked down. Its all so simple yet the deniers don't like to accept it.

 

 

People read what they want to hear.  If they believe lockdowns don't work, they gravitate towards articles that support it, and ignore others that don't.  Sad, but true.  Impossible to change their minds.  Again, sad, but true.

 

A great example is the election in the US.  Some 50% of Republicans still think the election was full of fraud.  Boggles my mind.

[Ventenio]

YES!!!  100%  Fact.

 

In my lockdown, everyone is put in a container 2 meters from any living thing.  fed food and water from elaborate tube system.  YES, covid will end.

 

it's when the cure is worse than the disease....

 

the current "lockdown," is only like a semi-lockdown.  not every lockdown is the same.

[robblok]

1 minute ago, Ventenio said:

YES!!!  100%  Fact.

 

In my lockdown, everyone is put in a container 2 meters from any living thing.  fed food and water from elaborate tube system.  YES, covid will end.

 

it's when the cure is worse than the disease....

 

the current "lockdown," is only like a semi-lockdown.  not every lockdown is the same.

People expect too much from lockdowns. They are used to curb the spread so the healthcare system does not get overwhelmed. It was never designed to work 100%. That is impossible unless you have a lockdown like the one your thinking about. 

 

In China their lockdowns were pretty effective. So lockdowns do work but its the people who are locked down that don't follow the rules are sabotaging it.

[brewsterbudgen]

Some good points made.  I totally accept that a complete lockdown would stop the virus spreading.  But does anyone think a complete lockdown (like I understand they had in China) in Thailand would be worth the harmful consequences it would have on life in general?  I'm genuinely not sure.  

[Jeffr2]

6 minutes ago, brewsterbudgen said:

Some good points made.  I totally accept that a complete lockdown would stop the virus spreading.  But does anyone think a complete lockdown (like I understand they had in China) in Thailand would be worth the harmful consequences it would have on life in general?  I'm genuinely not sure.  

I think we should lock down the government officials responsible for this outbreak due to their trip across the border....

[robblok]

35 minutes ago, brewsterbudgen said:

Some good points made.  I totally accept that a complete lockdown would stop the virus spreading.  But does anyone think a complete lockdown (like I understand they had in China) in Thailand would be worth the harmful consequences it would have on life in general?  I'm genuinely not sure.  

But its not about totally stopping the virus, as that will not work. Just slowing the amount of people that enter the health system. Just imagine how long it will take for the Thai health system to explode (already saw it happening) if they did not lockdown or put any new measures in place. 

 

 

[thaibeachlovers]

On 4/26/2021 at 2:00 PM, Nonthaburi Boy said:

Who did the GBD think was going to break the news to those groups that “We have this nice theory. Honestly, we are essentially rolling the dice with you lot, but we think - not really sure - it might be for the greater good.” Good luck finding a politician that brave (also potentially unethical, but that would be to easier to find).

I might have more sympathy for your viewpoint if it was not a fact that governments have never been loath in the past to consign their young men by the hundreds of thousands to die in wars, some of which were, IMO, entirely pointless.

[thaibeachlovers]

22 hours ago, robblok said:

If lockdowns don't work is mainly because deniers flaunt the rules and thus rendering lockdowns useless. Lockdowns work as long as the rules are followed. 

How much collateral damage is acceptable then ie business failures, poverty, suicide, lost learning, family breakdown etc etc etc?

[Jeffr2]

12 minutes ago, thaibeachlovers said:

How much collateral damage is acceptable then ie business failures, poverty, suicide, lost learning, family breakdown etc etc etc?

Good point.  But how many deaths from the virus is acceptable due to relaxation of the safety guidelines?  Over 3MM are now dead globally.  And we all know that's an under count.  I'd say that's more than have committed suicide. 

 

No easy answers right now.

[Phillip9]

21 hours ago, brewsterbudgen said:

But does anyone think a complete lockdown (like I understand they had in China) in Thailand would be worth the harmful consequences

 

China only locked down part of the country for a month or two.  They have been back to near normal for more than a year now. 

 

Surely the next year or more of continuous softer restrictions that Thailand now faces until they can vaccinate most of the population is far worse than that.

[cmarshall]

Of course, lockdowns work if done correctly as in Wuhan where the 77 day lockdown vanquished the virus by May, 2020 which was confirmed when the Chinese government tested all eleven million inhabitants of Wuhan and found only a handful of asymptomatic cases.  Since then Wuhan, and indeed all of China, has been Covid-free.

 

Biden should have announced a total lockdown on the US beginning Jan. 20.  Had he done so the epidemic in the US would be over by now, no matter how many Trumpheads refuse to be vaccinated.

 

However, as the WHO points out a lockdown is a failure of public health policy.  The most capable governments have been able to control the virus without nationwide lockdowns by instituting vigorous programs of testing, isolation of positives, and contact tracing as was done in S. Korea, Taiwan, Viet Nam, Australia, and New Zealand.  Almost all of the Western countries failed spectacularly, because they weren't paying attention or simply refused to fulfill the role of government as in the US, UK, Brazil, Sweden, and others. 

 

By continuing to focus on lockdown/no lockdown the TV crowd continues to miss the point.  You need to look at countries whose Covid deaths per million are in the single digits as models.

[brewsterbudgen]

16 minutes ago, cmarshall said:

Of course, lockdowns work if done correctly as in Wuhan where the 77 day lockdown vanquished the virus by May, 2020 which was confirmed when the Chinese government tested all eleven million inhabitants of Wuhan and found only a handful of asymptomatic cases.  Since then Wuhan, and indeed all of China, has been Covid-free.

 

Biden should have announced a total lockdown on the US beginning Jan. 20.  Had he done so the epidemic in the US would be over by now, no matter how many Trumpheads refuse to be vaccinated.

 

However, as the WHO points out a lockdown is a failure of public health policy.  The most capable governments have been able to control the virus without nationwide lockdowns by instituting vigorous programs of testing, isolation of positives, and contact tracing as was done in S. Korea, Taiwan, Viet Nam, Australia, and New Zealand.  Almost all of the Western countries failed spectacularly, because they weren't paying attention or simply refused to fulfill the role of government as in the US, UK, Brazil, Sweden, and others. 

 

By continuing to focus on lockdown/no lockdown the TV crowd continues to miss the point.  You need to look at countries whose Covid deaths per million are in the single digits as models.

 

In regard to your last point, would you say that Thailand is one of those countries?

[cmarshall]

Just now, brewsterbudgen said:

 

In regard to your last point, would you say that Thailand is one of those countries?

 

Well, that's the question, isn't it?

[Jeffr2]

4 minutes ago, brewsterbudgen said:

 

In regard to your last point, would you say that Thailand is one of those countries?

If you judge Thailand purely by the number of CV19 deaths, they are doing great!  Look at the US with over 500k.

 

But Singapore, Vietnam, Taiwan, Cambodia, all have a lower number of deaths. 

 

If it wasn't for their stupid actions regarding Songkran, and allowing hi-so's to cross the border illegally, we wouldn't be in a 3rd wave.

[thaibeachlovers]

23 hours ago, Jeffr2 said:

Good point.  But how many deaths from the virus is acceptable due to relaxation of the safety guidelines?  Over 3MM are now dead globally.  And we all know that's an under count.  I'd say that's more than have committed suicide. 

 

No easy answers right now.

OK, so how many died OF corona, and how many died WITH it? People die early all the time of war, starvation, car accidents, preventable diseases etc, but IMO the world doesn't do much about those problems compared with what it's doing about corona.

 

BTW, corona doesn't cause poverty and suicide etc- that's down to government response to it, IMO. How many would not have committed suicide had not lockdowns destroyed their lives?

[Jeffr2]

17 minutes ago, thaibeachlovers said:

OK, so how many died OF corona, and how many died WITH it? People die early all the time of war, starvation, car accidents, preventable diseases etc, but IMO the world doesn't do much about those problems compared with what it's doing about corona.

 

BTW, corona doesn't cause poverty and suicide etc- that's down to government response to it, IMO. How many would not have committed suicide had not lockdowns destroyed their lives?

Don't deflect.  Come on.  And impossible to even try to compare suicides to the more than 3MM that have died so far.  And the millions more who ended up in the hospital or now have long covid.  Ridiculous comparison.