Since early in the coronavirus pandemic, critics of unprecedented lockdown measures seen worldwide have argued that these interventions cause more harm than the disease itself. But an analysis of global health data suggests there is little evidence to support the idea that the cure is worse than the disease.
The analysis, published in the journal BMJ Global Health, considered claims that lockdowns cause more health harms than Covid-19 by examining their impacts on measures including death rates, routine health services and mental health.
As part of their study, researchers examined countries which imposed heavy restrictions with few Covid cases to assess whether the intervention was triggering excess mortality, said author Prof Gavin Yamey, from the Duke Global Health Institute at Duke University.
Using an international dataset of all-cause mortality from 94 countries, the researchers found that countries such as New Zealand and Australia experienced no excess mortality last year. In contrast, places with few Covid restrictions such as Brazil, Sweden, Russia and at times parts of the US had large numbers of excess deaths over the course of the pandemic.
“It is … one of the most compelling pieces of evidence to support the notion that the cure was not worse than the disease,” said Yamey. “It does seem that countries that acted quickly and aggressively often had fewer deaths than in previous years. One study showed that lockdown may have reduced annual mortality by up to 6% from eliminating flu transmission alone.”
The excess-mortality data could not rule out harms caused by lockdown or conclude whether lockdowns have a net benefit, however, especially given very high excess mortality in many nations that did pursue such strategies such as the UK, the researchers wrote.
Another avenue of inquiry was healthcare services. Although data suggests a clear reduction in attendance for vital non-Covid health services during lockdowns, overwhelmed health services or a high perceived risk of infection at health facilities would also disincentivise people from accessing care, the researchers suggested. “With current evidence, it is simply not possible to support either causal assertion adequately,” they concluded.
The relationship between mental health and lockdowns is often highlighted but the link between large-scale Covid outbreaks and depression and anxiety is often overlooked, the researchers noted. “Missing school clearly affects children’s mental health, but so does losing a loved one to Covid-19.”
The paper, which does not include economic considerations, argues that it is likely that lockdowns have negative effects. However, “the fact that there are no locations anywhere in the world where a lockdown without large numbers of Covid cases was associated with large numbers of excess deaths shows quite convincingly that the interventions themselves cannot be worse than large Covid outbreaks, at least in the short term”.
Dr Dean Burnett, honorary research associate at Cardiff University, who was not involved in the analysis, said the study suggests many problems attributed to lockdowns cannot be easily distinguished from those caused by the pandemic itself.
“The main takeaway is that ‘deciding’ between lockdown or pandemic is a very flawed premise,” he said. “The pandemic exists, whether there’s a lockdown or not. While lockdown may have a number of negative consequences for mental health, there’s little or no evidence to say that these consequences are any worse than what we’d see in the same situation in the absence of lockdown. It’s far more likely that the opposite would be true.”