Wednesday, May 27, 2020

What a 'lockdown' is, and is not

Lockdowns Don’t Work | The Public Discourse - Lyman Stone:

April 21, 2020 - "[W]e need to define what 'lockdowns' are and, especially, what they are not. I define lockdowns as having three characteristics.
  1. First, people are ordered to stay at home or required to provide a reason for movement outside of home. ["lockdowns" proper - gd]
  2. Second, assemblies are limited to a very small (usually single-digit) threshold. 
  3. Third, many businesses and activities are forced to close, even if they do not technically constitute assemblies and would like to stay open. ["shutdowns" - gd]
"Stay-at-home orders, low assembly thresholds, and business closures together constitute a lockdown. Without those three features, it’s not a lockdown.

"School cancellations aren’t lockdowns.... Travel restrictions, like setting up interstate checkpoints with mandatory testing at state borders, are not lockdowns.... Moderate assembly limits, such as bans on assemblies over 100 people, are not lockdowns.... Centralized quarantine orders, where individuals who test positive or individuals who have had contact with COVID-infected people are forced to be quarantined ... in hotels or special-purpose spaces ... [and] Requirements that people wear masks are not lockdowns....

"These other policies — travel restrictions, large-assembly limits, centralized quarantine, mask requirements, and school cancellations — do work. Because COVID is an extremely severe disease that, if left unchecked, will kill hundreds of thousands of Americans, it is vitally important that policymakers focus their efforts on policies that do work (masks, central quarantines, travel restrictions, school cancellations, large-assembly limits), and avoid implementing draconian, unpopular policies that don’t work (lockdowns)....

"There are very few documented cases of lockdowns being used to fight epidemic diseases in the past.... Nor does the 1918 influenza pandemic provide much help.... The most severe restrictions during that pandemic, which dramatically reduced deaths, were in St. Louis. St. Louis’s measures included closures of specific assemblies like churches, closure of all “amusements,” restricted business hours, mask orders, school cancellations, and centralized quarantine procedures. St. Louis never issued a stay-at-home order, and only imposed a complete cancellation of business for about forty-eight hours....

"I’ve built a model to predict county-level deaths per 100,000 people as of April 19. My specific interest is to know if policies like stay-at-home orders reduce deaths. Luckily, the research team at Johns Hopkins University has coded up what measures are in place for every county, and when they were put in place. I have merged this with county-level data like density, metro area size, college-educated share, racial mix, population share born in Italy (a good measure of exposure to European outbreaks), transit-usage, and how long it has been since a county’s first death (a good measure of duration of exposure to a COVID outbreak), to produce a statistical regression with a similar structure as that used by other researchers.

"My findings are striking: for every eight days (including weekends) since school cancellations began, a county tends to have one less death per 100,000 people. For every nine days a ban on gatherings over 500 people has been in place, there’s one less death per 100,000 people. These policies work. But the correlation flips for bans on gatherings of fifty people or for stay-at-home orders. For every two weeks a stay-at-home order is in place, the death rate rises by one person per 100,000. For bans of gatherings of fifty people, it’s every eleven days.... All the underlying data can be downloaded publicly.

"The only US-based academic study empirically linking lockdowns to lower deaths is a recent economics paper identifying California’s lockdown as the reason for its lower death rate. The problem with this paper is that the authors find that the lockdown began to reduce California’s deaths just five days after being implemented. The effect is too early to derive from the supposed cause....

"We don’t need to have a national debate about whether the economic costs of lockdowns outweigh their public health benefits, because lockdowns do not provide public health benefits. Many policies do provide public-health benefits. Masks work.... School cancellations are hugely important.... Bans on large assemblies are an obvious policy with good support. Restrictions on long-distance travel help reduce the occurrence of new outbreaks. Centralized quarantine helps actively reduce the spread of COVID-19 to a very low level.

"But ordering people to cower in their homes, harassing people for having playdates in the park, and ordering small businesses to close up shop regardless of their hygienic procedures simply has no demonstrated effectiveness. These policies should be replaced by stringent mask requirements, large-scale centralized quarantine protocols, and renewed emphasis on empowering people to protect themselves and their neighbors by adopting social distancing during their everyday life."

Lyman Stone is Chief Information Officer at the population consulting firm Demographic Intelligence, a Research Fellow at the Institute for Family Studies, and an Adjunct Fellow at the American Enterprise Institute. He, his wife, and their baby daughter live in Hong Kong.

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