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Review Article


COVID-19 LOCKDOWN COST/BENEFITS: A CRITICAL ASSESSMENT OF THE LITERATURE

Douglas W. AllenDepartment of Economics, Simon Fraser University, Burnaby,
CanadaCorrespondenceallen@sfu.ca

Pages 1-32 | Published online: 29 Sep 2021
Pages 1-32
Published online: 29 Sep 2021
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 * https://doi.org/10.1080/13571516.2021.1976051
   
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Abstract

Abstract

An examination of over 100 Covid-19 studies reveals that many relied on false
assumptions that over-estimated the benefits and under-estimated the costs of
lockdown. The most recent research has shown that lockdowns have had, at best, a
marginal effect on the number of Covid-19 deaths. Generally speaking, the
ineffectiveness stemmed from individual changes in behavior: either
non-compliance or behavior that mimicked lockdowns. The limited effectiveness of
lockdowns explains why, after more than one year, the unconditional cumulative
Covid-19 deaths per million is not negatively correlated with the stringency of
lockdown across countries. Using a method proposed by Professor Bryan Caplan
along with estimates of lockdown benefits based on the econometric evidence, I
calculate a number of cost/benefit ratios of lockdowns in terms of life-years
saved. Using a mid-point estimate for costs and benefits, the reasonable
estimate for Canada is a cost/benefit ratio of 141. It is possible that lockdown
will go down as one of the greatest peacetime policy failures in modern history.

Keywords:

Covid-19lockdowncostsbenefitsSIRmodel

JEL CLASSIFICATIONS:

I18I38D61





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NOTES

1 Other island countries with this strategy include many Pacific island nations
(like Samoa and Tonga), Caribbean islands (like Cuba and Jamaica), and Iceland.

2 It has been a sad irony that Covid-19 policy has not been driven by economics,
the discipline that specializes in the study of costs and benefits, but by
epidemiologists who have ‘no expertise in weighing health benefits against other
costs’ (Boettke and Powell 2021 Boettke, P., and B. Powell. 2021. The Political
Economy of the Covid-19 Pandemic. Southern Economic Journal 87 (4): 1090–1106.
doi:https://doi.org/10.1002/soej.12488.[Crossref], [Web of Science ®] , [Google
Scholar], p. 1092). For example, Miles et al. (2020 Miles, D., M. Stedman, and
A. Heald. 2020. Living with Covid-19: Balancing Costs against Benefits in the
Face of the Virus. National Institute Economic Review 253: R60–R76.
doi:https://doi.org/10.1017/nie.2020.30.[Crossref], [Web of Science ®] , [Google
Scholar]) provide an excellent economic assessment of the first pandemic wave in
Europe. They pointed out the need to consider all costs and benefits, and
recognized that the costs of widespread severe restrictions likely exceeded
costs. They also pointed out that economics suggests using more targeted
measures to deal with the particular effects of Covid-19. Unfortunately,
lockdown proponents have often portrayed arguments like this as a type of ‘moral
bankruptcy.’

3 The vast majority of studies have focused on cases and deaths, and so that is
what is dealt with here. Issues of ‘long-covid’ and other non-mortality costs
that might be reduced by lockdown are not addressed. See Kniesner and Sullivan
(2020 Kniesner, T. J., and R. Sullivan. 2020. The Forgotten Numbers: A Closer
Look at Covid-19 Non-Fatal Valuations. Journal of Risk and Uncertainty 61 (2):
1–176. doi:https://doi.org/10.1007/s11166-020-09339-0.[Crossref], [Web of
Science ®] , [Google Scholar]) for a discussion of non-fatal Covid-19 outcomes.

4 It has become a stylized fact that lockdown was successful during the Spanish
flu pandemic in 1918–1919. However, Barro (2020 Baron, E. J., E. Goldstein, and
C. Wallace. 2020. Suffering in Silence: How COVID-19 School Closures Inhibit the
Reporting of Child maltreatment. Journal of Public Economics 190: 104258.
doi:https://doi.org/10.1016/j.jpubeco.2020.104258.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]), showed early on in this pandemic that school
closures, prohibitions on public gatherings, and isolation orders had no
significant effect on overall mortality during the second wave of the great
1918–1919 pandemic. It is also the case that prior to Covid-19 the WHO was
opposed to widespread border and school closures, stay at home orders, and
lockdowns.

5 This model depends on number of people susceptible (S), infectious (I), or
recovered (R).

6 This was the lowest value considered. Other predictions used values as high as
3.3, with considerably more deaths predicted.

7 Estimates of the IFR have continued to fall over the year. Ioannidis (2020
Ioannidis, J. 2020. Infection Fatality Rate of COVID-19 Inferred from
Seroprevalence Data. Bulletin of the World Health Organization,
99(1):19-33.[PubMed], [Web of Science ®] , [Google Scholar]) estimated that the
median IFR was 0.27% across 51 locations around the world. He noted that this
IFR was ‘much lower than estimates made earlier in the pandemic’ (p.1).
Ioannidis (2021 Ioannidis, J. 2021. Reconciling Estimates of Global Spread and
Infection Fatality Rates of COVID-19: An Overview of Systematic evaluations.
European Journal of Clinical Investigation 51 (5): e13554. March .
doi:https://doi.org/10.1111/eci.13554.[Crossref], [PubMed], [Web of Science
®] , [Google Scholar]) later estimated the average global IFR at 0.15%.

8 There are many forms of SIRs models, and the exact channel by which the virus
mechanically progresses varies across studies. For example, Ambikapathy and
Krishnamurthy (2020 Ambikapathy, B., and K. Krishnamurthy. 2020. Mathematical
Modelling to Assess the Impact of Lockdown on COVID-19 Transmission in India:
Model Development and Validation. JMIR Public Health and Surveillance 6 (2):
e19368. Maydoi:https://doi.org/10.2196/19368.[Crossref], [PubMed] , [Google
Scholar]) model the exponential viral growth using a system of differential
equations that mimic a SIR model. Given the assumed parameters in the model,
lockdowns inhibit the transmission rates and produce a predicted benefit. See
also Sjödin et al. 2020 Sjödin, H., A. Wilder-Smith, S. Osman, Z. Farooq, and J.
Rockl’’ov. 2020. Only Strict Quarantine Measures Can Curb the Coronavirus
Disease (COVID-19) Outbreak in Italy. Euro Surveillance 25 (13).
doi:https://doi.org/10.2807/1560-.7917.ES.2020.25.13.2000280[PubMed] , [Google
Scholar], or Liu et al. May 2020 for other examples of mechanical virus models.
One problem with SIR models that is not addressed here is their sensitivity to
model specification. Chin et al. (2021 Chin, V., J. Ioannidis, M. Tanner, and S.
Cripps. 2021. Effect Estimates of Covid-19 Non-Pharmaceutical Interventions Are
Non-Robust and Highly Model-Dependent. Journal of Clinical Epidemiology 136:
96–132. doi:https://doi.org/10.1016/j.jclinepi.2021.03.014.[Crossref], [PubMed],
[Web of Science ®] , [Google Scholar]) show that the original SIR models used by
the ICL were ‘… non-robust and highly sensitive to model specification,
assumptions and data employed to fit models.’ (p. 102).

9 The notion that epidemiological models should contain endogenous human
behavior was explained in a classic paper by Philipson (2000 Philipson, T. 2000.
Chapter 33, Economic Epidemiology and Infectious Diseases. In Handbook of Health
Economics. Vol 1. (Amsterdam: Elsevier). [Google Scholar]). This feature is
common in economic models of Covid-19. For example Farboodi et al. (2020
Farboodi, M., G. Jarosch, and R. Shimer. 2020. Internal and external effects of
social distancing in a pandemic. NBER WP: 27059, July 2020. [Google Scholar])
and Luther (2020 Luther, W. Behavioral and Policy Responses to COVID-19:
Evidence from Google Mobility Data on State-Level Stay-at-Home Orders. AIER
Sound Money Project Working Paper No. 2020-06, 2020. May 8,
https://ssrn.com/abstract=3596551. or
doi:https://doi.org/10.2139/ssrn.3596551.[Crossref] , [Google Scholar]) found
that individual responses to the virus were substantial and happened before
lockdowns were mandated. Leeson and Rouanet (2021 Leeson, P., and L. Rouanet.
2021. Externality and Covid-19. Southern Economic Journal 87 (4): 1107–1118.
April doi:https://doi.org/10.1002/soej.12497.[Crossref], [Web of Science
®] , [Google Scholar]) point out the various ways this endogenous response
self-limits the externality of infection, which reduces the presumed rationale
for lockdowns in the first place.

10 The effects of lockdown on transmission turned out to be much more nuanced.
For example, Mulligan (2021 Mulligan, C. 2021. The Backward Art of Slowing the
Spread? Congregation Efficiencies during COVID-19. Becker Friedman Institute,
WP: 2021–51. [Google Scholar]) found that workplaces quickly adopted safety
protocols, making them safer places than households where people were locked
down. Social networks, patterns of immunity, population age distributions, and
the like all played large roles in transmissions and interfered with the naive
lockdown predictions.

11 An example of this is found in Hsiang et al. (2020 Hsiang, S., D. Allen, S.
Annan-Phan, K. Bell, I. Bolliger, T. Chong, H. Druckenmiller, et al. 2020. The
Effect of Large-Scale anti-Contagion Policies on the COVID-19 Pandemic. Nature
584 (7820): 262–267. doi:https://doi.org/10.1038/s41586-020-2404-8.[Crossref],
[PubMed], [Web of Science ®] , [Google Scholar]), who use the pre-lockdown
growth rates of the virus in their calculation of the counterfactual trajectory
of new cases. This ignores the fact that transmission and infection rates vary
over time, and that a major reason for this variation is voluntary changes in
behavior.

12 The use of these models has continued into 2021 with respect to covid-19
variants. Michael Osterholm, director of the Center for Infectious Disease
Research and Policy at the University of Minnesota, stated on February 2, 2021
that the new variant would cause a ‘hurricane’ of new cases, and ‘The fact is
that the surge that is likely to occur with this new variant from England is
going to happen in the next six to fourteen weeks. And, if we see that happen,
which my forty-five years in the trenches tell me we will, we are going to see
something like we have not seen yet in this country …’. Quoted from
https://nationalinterest.org/blog/coronavirus/health-expert-prepare-category-5-coronavirus-hurricane-177476.
According to OurWorldInData, on February 2, 2021 there were 428 cases per
million (cpm) people in the U.S. Six weeks later on March 14 there were 163 cpm;
fourteen weeks later on May 4 there were 145 cpm. Cases did not rise to
unprecedented hurricane levels, but rather fell by more than two times. By late
August cases were up to 258 cpm, but due to a different (delta) variant and
behavior changes caused by vaccinations.

13 Furthermore, these two responses are inter-related:

The endogenous behavioral response … may also limit the effectiveness of efforts
to reduce the spread of COVID-19. A lockdown, for example, that does not end the
pandemic may suppress disease prevalence temporarily only to encourage behavior
that leads the disease to become just as prevalent as before the lockdown.

[Leeson and Rouanet, p. 1111, 2021 Leeson, P., and L. Rouanet. 2021. Externality
and Covid-19. Southern Economic Journal 87 (4): 1107–1118. April
doi:https://doi.org/10.1002/soej.12497.[Crossref], [Web of Science ®] , [Google
Scholar]]

14 For example, if only 10% of change in cases is caused by mandated lockdown
and 90% is caused by voluntary changes in behavior, then attributing all of the
effect to lockdown over-estimates the lockdown effect by nine times. The less
important mandated lockdowns are, the greater the over-estimation. This issue
was publicly known as early as April 2020. Abouk (2020 Abouk, R., and B.
Heydari. 2020. The Immediate Effect of COVID-19 Policies on Social Distancing
Behavior in the United States. MedRxiv.
doi:https://doi.org/10.1101/2020.04.07.20057356.[Crossref] , [Google Scholar])
examined differences in policies across the U.S. and separated out the voluntary
effect. He noted (p. 2):

While there is strong evidence for reduced social contact in the US, not all of
these reductions can be attributed to NPIs: mobility data show that people in
most states had already started to reduce the time they spend outside their
homes before any NPI was implemented.

He found that stay-at-home orders had a substantial effect on confirmed cases,
but business and school closures, along with bans of large gatherings did not.

15 Many object to the assignment of a number to the value of a life. To do so,
however, makes it impossible to compare the costs and benefits of a policy
decision. Arguing that assigning values to lives is immoral has been one method
used to prevent the policy discussions from using cost/benefit analysis.

16 The major alternative to using VSL is a ‘quality of life adjusted years’
(QALY), which takes into account the health status of the individual. Given the
age and health of most people who died of Covid-19, the QALY produces a value of
life generally lower than the VSL. I ignore the debate over which method is more
appropriate since most cost/benefit studies used the VSL; however, see Miles et
al. for an example of the use of QALY in a Covid-19 study.

17 See Hammitt (2020 Hammitt, J. 2020. Valuing Mortality Risk in the Time of
COVID-19. SSRN. https://ssrn.com/abstract=3615314. or
doi:https://doi.org/10.2139/ssrn.3615314.[Crossref] , [Google Scholar]) for an
excellent discussion of the VSL and descriptions of how it varies with age.

18 It has been understood for some time that those dying of Covid-19 have
comorbidities. Accord- ing to the March 17, 2021 CDC weekly update
(https://www.cdc.gov/nchs/nvss/vsrr/covidweekly/index.htm#ExcessDeaths) only 6%
of Covid-19 deaths in the U.S. were attributed to Covid-19 alone. The average
number of comorbidities of those who died was 3.8. Thus, even assigning a VSL of
$2,000,000 for individuals with multiple comorbidities is too high.

19 The absurdity of such a conclusion points to the problem of using a marginal
value of life to estimate a total value. If the entire economy of the US was
actually closed for one year, the total loss of life would be in the hundreds of
millions.

20 Taken from Bureau of Economic Analysis: https://www.bea.gov/news/2021/.

21 As of March 2021, 95.9% of deaths were to individuals over age 60, and 69.1%
of deaths were to individuals over 80. Source:
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html.

22 I ignore the issue of ‘homogeneity’ in SIR models (the idea that everyone in
the model is the same) because most empirical work ignored it. However, this is
another significant shortcoming of many models. Acemoglu et al., as early as May
2020 Acemoglu, D., V. Chernozhukov, I. Werning, and M. Whinston. 2020. Optimal
Targeted Lockdowns in a Multi-Group SIR Model. NBER.[Crossref] , [Google
Scholar], produced a SIR model where there were three different age cohorts,
with age-increasing risks from Covid-19. Not too surprisingly, in such a model a
uniform, blanket lockdown is not optimal. By June of 2020 models started
appearing where individuals could differ in many characteristics like
transmissibility, locations, ages, occupations, etc. Both Ellison (2020 Ellison,
G. 2020. Implications of Heterogeneous SIR Models for Analyses of COVID-19. NBER
WP: 27373, doi:https://doi.org/10.3386/w27373.[Crossref] , [Google Scholar]),
and Akbarpour et al. (2020 Akbarpour, M., Cook, C. Marzuoli, A., Mongey, S.
Nagaraj, A. Saccarola, M. Tebaldi, P. Vasserman, S. and H. Yang. 2020.
Socioeconomic Network Het- Erogeneity and Pandemic Policy Response. NBER WP:
27374,[Crossref] , [Google Scholar]) showed that introducing heterogeneity
resulted in herd immunity being reached much faster, and which raised the costs
of blanket lockdowns.

23 See for example, this March 23, 2020 article:
https://www.nationalreview.com/corner/a-covid-cost-benefit-analysis/which
assumed lockdown saved one million lives all valued at $9M each, and made no
guess at costs, but concluded ‘I still think the benefits will easily prevail…’.
Another article from March 31, 2020
(https://www.sciencemag.org/news/2020/03/modelers-weigh-value-lives-and-lockdown-costs-put-price-covid-19),
assumed a constant value of life of $9.5M, and a loss of GDP caused by lockdown
of 22%, argued that ‘even a yearlong lockdown makes economic sense.’

24 Almost all of the cost/benefits studies I found from the early spring
suffered from the problems of using a standard SIR model to estimate the
counterfactual, constant and high VSL, high transmission and infection fatality
rates, and costs based on GDP. These include Eichenbaum et al. (2020 Eichenbaum,
M., M. de Matos, F. Lima, S. Rebelo, and M. Trabandt. 2020. How do People
Respond to Small Probability Events with Large, Negative Consequences?, NBER WP:
27988, October, 2020. [Google Scholar]), Bethune and Korinek (2020 Bethune, Z.,
and A. Korinek. 2020. Covid-19 Infection Externalities: Trading off Lives vs.
Livelihoods. NBER WP: 27009.[Crossref] , [Google Scholar]), Jones et al. (2020
Jones, C., T. Philippon, and V. Venkateswaran. 2020. Optimal Mitigation Policies
in a Pandemic: Social Distancing and Working from Home, 2020. NBER WP: 26984.
doi:https://doi.org/10.3386/w26984.[Crossref] , [Google Scholar]), Baker et al.
(2020 Baker, S., N. Bloom, S. Davis, and S. Terry. 2020. COVID-Induced Economic
Uncertainty. NBER WP: 26983.
doi:https://doi.org/10.3386/w26983.[Crossref] , [Google Scholar]), Bloom et al.
(2020 Bloom, N., P. Bunn, P. Mizen, P. Smietanka, and G. Thwaites. 2020. The
Impact of Covid-19 on Productivity, NBER WP: 28233.
doi:https://doi.org/10.3386/w28233.[Crossref] , [Google Scholar]), Hall et al.
(2020 Hall, R., C. Jones, and P. Klenow. 2020. Trading Off Consumption and
COVID-19 Deaths, 2020. NBER WP: 27340.
doi:https://doi.org/10.3386/w27340.[Crossref] , [Google Scholar]), Basili and
Nicita (2020 Basili, M., and A. Nicita. 2020. The Covid-19/SARS-CoV-2 Pandemic
Outbreak, the Risk of Institutional Failures and a Coherent Health Policy.
Department of Economics University of Siena 838, Siena. [Google Scholar]), and
Cutler and Summers (2020 Cutler, D., and L. Summers. 2020. The COVID-19 Pandemic
and the $16 Trillion Virus. Jama 324 (15): 1495–1496.
Octoberdoi:https://doi.org/10.1001/jama.2020.19759.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]). An interesting example is Rowthorn and
Maciejowski (2020 Rowthorn, R., and J. Maciejowski. 2020. A Cost-Benefit
Analysis of the COVID-19 Disease. Oxford Review of Economic Policy 36
(Supplement_1): S38–S55.
doi:https://doi.org/10.1093/oxrep/graa030.[Crossref] , [Google Scholar]).
Although it came out later in the summer, it still used a basic SIR model in its
cost/benefit analysis. What makes it interesting is that the authors recognized
how critical the VSL number was. When a life is worth £2m, then only a lockdown
of 5.3 weeks was justifiable. When the VSL is £10m it still only justified a 10
week lockdown.

25 These challenges came from professionals in public health as well as
economics. Rangel et al. (2020 Rangel, J. C., S. Ranade, P. Sutcliffe, E.
Mykhalovskiy, D. Gastaldo, and J. Eakin. 2020. Covid-19 Policy
measures-Advocating for the Inclusion of the Social Determinants of Health in
Modelling and Decision making. Journal of Evaluation in Clinical Practice 26
(4): 1078–1080. doi:https://doi.org/10.1111/jep.13436.[Crossref], [PubMed], [Web
of Science ®] , [Google Scholar]) pointed out very early that narrow models that
only focused on a few outcomes would lead to terrible public health outcomes.

26 Other early studies showing that lockdown reduced cases include Born et al.
(2020 Born, B.,. A. Dietrich, and G. Mueller. 2020. The Lockdown Effect: A
Counter-factual for Sweden. CEPR Discussion Paper, 32, July, 2020.
https://cepr.org/active/publications/discussionpapers/dp.php?dpno=14744. [Google
Scholar]), Courtemanche et al. (2020 Courtemanche, C., J. Garuccio, A. Le, J.
Pinkston, and A. Yelowitz. 2020. Strong Social Distancing Measures in the United
States Reduced the COVID-19 Growth Rate. Health Affairs (Project Hope) 39 (7):
1237–1246. https://doi.org/10.1377/hlthaff.2020.00608.
doi:https://doi.org/10.1377/hlthaff.2020.00608.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]), Dehning et al. (2020 Dehning, J., J. Zierenberg,
F. P. Spitzner, M. Wibral, J. P. Neto, M. Wilczek, and V. Priesemann. 2020.
Inferring Change Points in the Spread of Covid-19 Reveals the Effectiveness of
Interventions. Science (New York, N.Y.) 369 (6500)
doi:https://doi.org/10.1126/science.abb9789.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]), and Hannah et al. (2020 Hannah M. K., D.
Alexander, I. Miller, B. Grenfell, C. Jessica E. Metcalf, and M. Mina.
“Quantifying the impact of us state non-pharmaceutical interventions on covid-19
transmission.” medRxiv, 2020. doi:https://doi.org/10.1101/2020.06.30.20142877.
URL
https://www.medrxiv.org/content/early/2020/07/01/2020.06.30.20142877. [Google
Scholar]) and Dhaval, Friedson, Matsuzawa, and Sabia (2020 Dhaval, D., A.
Friedson, K. Matsuzawa, J. Sabia, and S. Safford. 2020. Were Urban Cowboys
Enough to Control COVID-19? Local Shelter-in-Place Orders and Coronavirus Case
Growth, NBER WP: 27229. doi:https://doi.org/10.3386/w27229.[Crossref] , [Google
Scholar]). Most of the early studies are based on modeling exercises, which
again, depend critically on the model’s counterfactual prediction. An exception
was Banerjee and Nayak (2020 Banerjee, T., and A. Nayak. 2020. U.S. county Level
Analysis to Determine If Social Distancing Slowed the Spread of COVID-19.
Revista panamericana de salud publica = Pan American journal of public health
44: e90. doi:https://doi.org/10.26633/RPSP.2020.90.[PubMed], [Web of Science
®] , [Google Scholar]) who looked at county level mobility data in the U.S. and
did a difference-in-difference analysis between counties with and without
lockdown. They found a positive effect of lockdown, but their data only spanned
February 1 – March 31 2020, and over this period most of the states without
mandated lockdowns had almost no infections. Hence there is a serious
endogeneity problem with the cross-section analysis. That is, the lack of
response is being attributed to the absence of lockdown, when it likely reflects
the absence of the virus.

27 Even Flaxman et al. recognize the problem of exogenous behavior: ‘We do not
account for changes in behaviour; in reality, even in the absence of government
interventions we would expect Rt to decrease and therefore would overestimate
deaths in the no-intervention model.’

28 Lewis (2020), and Lemoine (2020 Lemoine, P. 2020. Lockdowns, science and
voodoo magic.
https://necpluribusimpar.net/lockdowns-science-and-voodoo-magic/. [Google
Scholar]) both write devastating critiques of the Flaxman et al. paper. In
analyzing the Flaxman et al. supplementary material these two critiques also
point out that the study’s findings related to Sweden refute the study’s
conclusion.

29 Ibarra-Vega (2020 Ibarra-Vega, D. 2020. Lockdown, One, Two, None, or Smart.
Modeling Containing Covid-19 Infection. A Conceptual Model. The Science of the
Total Environment 730: 138917. August .
doi:https://doi.org/10.1016/j.scitotenv.2020.138917.[Crossref], [PubMed], [Web
of Science ®] , [Google Scholar]) uses a similar approach where the
counterfactual number of in- fections is determined by a SIR model with
exogenous behavior, and then shows that in such an imaginary model lockdowns are
effective.

30 Evidence that the virus was not exponentially out of control was available
very early on. Harris (2020 Harris, J. 2020. The Coronavirus Epidemic Curve is
Already Flattening in New York City. NBER WP: 26917.[Crossref] , [Google
Scholar]) shows that after one month the case load was flattening in NY.

31 See Eksin, Paarporn, and Weitz (2019 Eksin, C., K. Paarporn, and J. Weitz.
2019. Systematic Biases in Disease Forecasting? The Role of Behavior Change.
Epidemics 27: 96–105.
doi:https://doi.org/10.1016/j.epidem.2019.02.004.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]) for a study of the effect of human behavior on
the progression of disease. Adding behavioral responses to SIR models in
economics goes back at least to Philipson and Posner (1993 Philipson, T. J., and
R. A. Posner. 1993. Private Choices and Public Health. Cambridge, MA: Harvard
University Press, [Google Scholar]). It is not a new idea. Dhaval, Friedson,
Matsuzawa, Sabia, et al. (2020 Dhaval, D., A. Friedson, K. Matsuzawa, J. Sabia,
and S. Safford. 2020. Were Urban Cowboys Enough to Control COVID-19? Local
Shelter-in-Place Orders and Coronavirus Case Growth, NBER WP: 27229.
doi:https://doi.org/10.3386/w27229.[Crossref] , [Google Scholar]) had shown
early on that in the context of a large political rally local individuals
recognized the increased risk of transmission and adjusted their behavior to
mitigate this risk, leading to no change in transmission rates.

32 Gupta et al. (2020 Gupta, S., K. Simon, and C. Wing. 2020. Mandated and
Voluntary Social Distancing During The COVID-19 Epidemic: A Review, NBER WP:
28139. [Google Scholar]) survey the literature on social distancing and claim
that mandates have an effect, but the volunteer response is larger.

33 This paper, which is likely the most sophisticated econometric causal study,
found that lockdowns have a direct effect on cases and mortality. However, in a
detailed analysis and replication Lemoine (2021 Lemoine, P. 2020. Lockdowns,
science and voodoo magic.
https://necpluribusimpar.net/lockdowns-science-and-voodoo-magic/. [Google
Scholar]) found that none of their results were robust.

34 Using a natural experiment methodology in Denmark, Kepp and Bjørnskov (2020)
find that ‘efficient infection surveillance and voluntary compliance make full
lockdowns unnecessary.’ A different type of study is Savaris et al. (2021
Savaris, R., G. Pumi, J. Dalzochio, and R. Kunst. 2021. Stay-at-Home Policy is a
Case of Exception Fallacy: An Internet-Based Ecological Study. Scientific
Reports 11 (1): 5313. March .
doi:https://doi.org/10.1038/s41598-021-84092-1.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]) that uses mobility data to identify time spent at
home, and looked at over 3700 pairwise jurisdictional comparisons, they found ‘…
no evidence that the number of deaths/million is reduced by staying at home.’
Most notably, they were not studying lockdown stay-at-home orders, but actual
stay-at-home behaviors. Elenev et al. 2021 Elenev, V., L. Quintero, A. Rebucci,
and E. Simeonova. 2021. Direct and Spillover Effects from Staggered Adoption of
Health Poloicies Evidence from Covid-19 Stay-at- Home Orders. NBER WP:
29088,[Crossref] , [Google Scholar]) show that people in neighboring
jurisdictions voluntarily respond to stay at home orders elsewhere. Berry et al.
(2021 Berry, C. R., A. Fowler, T. Glazer, S. Handel-Meyer, and A. MacMillen.
2021. EvaluatIng the Effects of Shelter-in-Place Policies during the Covid-19
Pandemic. Proceedings of the National Academy of Sciences of the United States
of America 118 (15). doi:https://doi.org/10.1073/pnas.2019706118.[Web of Science
®] , [Google Scholar], p. 1) found that ‘shelter-in-place orders had no
detectable health benefits, only modest effects on behavior, and small but
adverse effects on the economy. … Many people had already changed their
behaviors …’.

35 This paper received a number of critical letters and comments to the journal.
The authors responded in Bendavid et al. (2021 Bendavid, E., C. Oh, J.
Bhattacharya, and J. Ioannidis. 2021. Assessing Mandatory Stay-at-Home and
Business Closure Effects on the Spread of COVID-19. European Journal of Clinical
Investigation. 51(4).[Web of Science ®] , [Google Scholar]), showing that the
criticisms were invalid. They conclude in their reply:

Given their many uncontestable harms to health and society, we believe that the
extant literature does not provide strong support for their [NPI] effectiveness
at reducing case spread, and should be subjected to careful, critical and
rigorous evaluation. If the benefits of such measures are negligible (or worse),
their perpetuation may be, on balance, detrimental to the health of the public.
p. 3.

36 Sweden’s GDP growth taken from:
https://tradingeconomics.com/sweden/gdp-growth.

37 Canada’s GDP levels are from: https://tradingeconomics.com/canada/gdp.

38 Data taken from Statistics Canada’s economic dashboard:
https://www150.statcan.gc.ca/n1/pub/71-607-x/71-607-x2020009-eng.htm.

39 The role of education in the formation of human capital and its importance
for individual well being and economic growth is well established in economics.
See Becker (1994 Becker, G. 1994. Human Capital: A Theoretical and Empirical
Analysis with Special Reference to Education. Chicago: The University of Chicago
Press. [Google Scholar]) for a classic treatment.

40 Although not a research study, a Unicef bulletin contains a long list of
lockdown and school closures on children. These include: lost days of education
(especially for early education), food insecurity, lost access to health care,
increased stress, increased risk of abuse at home, poorer infant and maternity
care, failure to receive regular vaccinations, and increased mental health
issues. See
https://downloads.unicef.org.uk/wp-content/uploads/2020/04/Unicef-UK-Children-In-Lockdown-Coronavirus-Impacts-Snapshot.pdf

41 Loades et al. (2020 Loades, M., E. Chatburn, N. Higson-Sweeney, S. Reynolds,
R. Shafran, A. Brig- den, C. Linney, M. McManus, C. Borwick, and E. Crawley.
2020. Rapid Systematic Review: The Impact of Social Isolation and Loneliness on
the Men- Tal Health of Children and Adolescents in the Context of COVID-19.
Journal of the American Academy of Child & Adolescent Psychiatry 59 (11):
1218–1239. doi:https://doi.org/10.1016/j.jaac.2020.05.009..[Crossref], [PubMed],
[Web of Science ®] , [Google Scholar]) survey 80 studies related to isolation
and children and conclude ‘… increased the risk of depression, and possibly
anxiety at the time at which loneliness was measured…’.

42 For other effects of closing schools see also Fuchs-Schndeln et al. (2020
Fuchs-Schndeln, N., D. Krueger, A. Ludwig, and I. Popova. 2020. The Long-Term
Distributional and Welfare Effects of Covid-19 School Closures, NBER WP: 27773,
Sept. doi:https://doi.org/10.3386/w27773.[Crossref] , [Google Scholar]), or
Buonsenso et al. (2020 Buonsenso, D., D. Roland, C. De Rose, P. Vsquez-Hoyos, B.
Ramly, J. Nandipa, J. Chakakala-Chaziya, A. Munro, and S. Gonzlez-Dambrauskas.
2020. Schools Closures during the COVID-19 Pandemic: A Catastrophic Global
Situation. Preprints
doi:https://doi.org/10.20944/preprints202012.0199.v1.[Crossref] , [Google
Scholar]).

43 See Roelfs et al. (2011 Roelfs, D., E. Shor, K. Davidson, and J. Schwartz.
2011. Losing Life and Livelihood: A Systematic Review and Meta-Analysis of
Unemployment and All-Cause Mortality. Social Science & Medicine (1982) 72 (6):
840–854. January doi:https://doi.org/10.1016/j.socscimed.2011.01.005.[Crossref],
[PubMed], [Web of Science ®] , [Google Scholar]) and references that show this
relationship has been understood for some time. Lindo (2011 Lindo, J. 2011.
Parental Job Loss and Infant Health. Journal of Health Economics 30 (5):
869–879. September
doi:https://doi.org/10.1016/j.jhealeco.2011.06.008.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]) also shows that unemployment contributes to
higher infant death.

44 This channel has been known for some time. See Steptoe et al. (2013 Steptoe,
A., A. Shankar, P. Demakakos, and J. Wardle. 2013. Social Isolation, Loneliness,
and All-Cause Mortality in Older Men and Women. Proceeding of the National
Academy of Sciences 110 (15): 5797–5801.
doi:https://doi.org/10.1073/pnas.1219686110.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]) and references, or Holt-Lunstad et al. (2015
Holt-Lunstad, Julianne, Timothy B. Smith, Mark Baker, Tyler Harris, and David
Stephenson. 2015. Loneliness and Social Isolation as Risk Factors for Mortality:
A Meta-Analytic Review. Perspectives on Psychological Science : a Journal of the
Association for Psychological Science 10 (2): 227–237.
doi:https://doi.org/10.1177/1745691614568352.[Crossref], [PubMed] , [Google
Scholar]) who showed that physical isolation and social loneliness increased
mortality. The CDC reported in August 2020 (Czeisler et al. (2020 Czeisler, Mark
É., Rashon I. Lane, Emiko Petrosky, Joshua F. Wiley, Aleta Christensen, Rashid
Njai, Matthew D. Weaver, et al. 2020. Mental Health, Substance Use, and Suicidal
Ideation during the COVID-19 Pandemic - United States, June 24-30, 2020. MMWR.
Morbidity and Mortality Weekly Report 69 (32): 1049–1057.
https://doi.org/10.15585/mmwr.mm6932a1externalicon.
doi:https://doi.org/10.15585/mmwr.mm6932a1.[Crossref], [PubMed], [Web of Science
®] , [Google Scholar]) that there were elevated mental health conditions brought
on by the pandemic, and Newlove-Delgado et al. (2021 Newlove-Delgado, T., S.
McManus, K. Sadler, S. Thandi, T. Vizard, C. Cartwright, and T. Ford. 2021.
Child Mental Health in England before and during the COVID-19 Lockdown. The
Lancet. Psychiatry 8 (5): 353–354.
doi:https://doi.org/10.1016/S2215-0366(20)30570-8.[Crossref], [PubMed], [Web of
Science ®] , [Google Scholar]) found that lockdown contributed to increased
mental health problems among U.K. youth and that this problem was most serious
among young women.

45 Awareness about the effect of lockdown on violence against women was
available as early as March 2020 when the WHO released a statement:
https://www.who.int/reproductivehealth/publications/emergencies/COVID-19-VAW-full-text.pdf.
Binge drinking is strongly associated with stay at home orders (Weerakoon et al.
(2021 Weerakoon, S. M., K. Jetelina, and G. Knell. 2021. Longer Time Spent at
Home during COVID-19 Pandemic is Associated with Binge Drinking among US adults.
The American Journal of Drug and Alcohol Abuse 47 (1): 98–106. DOI:
https://doi.org/10.1080/00952990.2020.1832508[Taylor & Francis Online], [Web of
Science ®] , [Google Scholar]).)

46 See also Agrawal et al. (2021 Agrawal, V., J. Cantor, N. Sood, and C. Whaley.
2021. The Impact of the Covid-19 pandemic and policy responses on excess
mortality. NBER WP: 28930.[Crossref] , [Google Scholar]) for similar findings of
increased excess deaths, using data from 43 countries and all US states. Other
effects range from increased major amputations, longer wait list times, fewer
organ transplants (Manara et al. (2020 Manara, Alex R., Lisa Mumford, Chris J.
Callaghan, Rommel Ravanan, and Dale Gardiner. 2020. Donation and Transplantation
Activity in the UK during the COVID-19 Lockdown. Lancet (London, England) 396
(10249): 465–466. doi:https://doi.org/10.1016/S0140-6736(20)31692-5.[Crossref],
[PubMed], [Web of Science ®] , [Google Scholar])). Many primary care
appointments switched to telephone and online appointments, which are often
inferior substitutes for in-person treatments.

47
https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

48
https://knoema.com/atlas/Canada/topics/Demographics/Age/Life-expectancy-at-age-80-years

49 The life expectancy of a 25 year old Canadian is 55.2 years, so the 6.3m lost
life years is the equivalent of losing 114,130 25 year olds

50 This upper bound was not statistically significant, and Lemoine (2021
Lemoine, P. 2020. Lockdowns, science and voodoo magic.
https://necpluribusimpar.net/lockdowns-science-and-voodoo-magic/. [Google
Scholar]) later showed that it was not robust.

51 As noted in Table 1, the Ferguson et al. model predicted that lockdowns saved
134,054 lives (266, 741-132, 687) until the end of July 2020, which was
presumably to be the end of the pandemic.

52 Lally (2021 Lally, M. 2021. The Costs and Benefits of Covid-19 Lockdowns in
New Zealand. medRxiv July
doi:https://doi.org/10.1101/2021.07.15.21260606.[Crossref] , [Google Scholar])
performs a cost benefit study for New Zealand and compares the cost per QALY to
estimates of lost GDP and other costs of lockdown. He concludes these costs ‘…
to be at least 13 times the generally employed figure of $62,000 for health
interventions in New Zealand; the lockdowns were therefore not justified.’

53 Whether these deaths were actually caused by Covid-19 is an important matter,
but one that I have not dealt with in this paper.

54 All numbers from OurWorldInData are as of March 28, 2021.
https://ourworldindata.org/grapher/covid- stringency-index

55 Gardner, et al. (2020 Gardner, J., W. Van Der Wijngaart, L. Kamerlin, N.
Brusselaers, and P. Kasson. 2020. Intervention Strategies against COVID-19 and
Their Estimated Impact on- Swedish Healthcare Capacity. MedRxiv April 15,
doi:https://doi.org/10.1101/2020.04.11.20062133.[Crossref] , [Google Scholar]),
claimed the following about Sweden: ‘This individual-based modelling project
predicts that with the current mitigation approach approximately 96,000 deaths
(95% CI 52,000 to 183,000) can be expected before 1 July, 2020.’ The original
ICL model, Report 12 (appendix) also predicted 90,157 deaths in Sweden by the
end of July, 2020. On March 28, 2021 the total number of deaths in Sweden was
13,402. Klein et al. (2020 Klein, D. B., J. Book, and C. Bjørnskov. 2020. 16
Possible Factors for Sweden?s High COVID Death Rate among the Nordics (August
14, 2020). GMU Working Paper in Economics No. 20-27,
https://ssrn.com/abstract=3674138 or
doi:https://doi.org/10.2139/ssrn.3674138.[Crossref] , [Google Scholar]) pointed
out 16 different factors for Sweden compared to other Nordic countries that
explained their worse experience with the virus. The most important factor was
the ‘dry tinder’ situation; that is, Sweden had a light flu season in the year
prior to Covid-19 which meant that it had a large number of elderly people who
would have normally died in the previous year. The lower excess deaths in 2019
was then made up by the higher than average excess deaths in the spring of 2020.
Overall, the excess deaths for Sweden in 2020 was just 1.5% higher than average.
Source: https://www.cebm.net/covid-19/excess-mortality-across-countries-in-2020/
This dry tinder effect accounted between 25–50% of the difference in death rates
across the Nordic countries.

56 See John Hopkins Coronavirus Resource Center for lockdown information:
https://coronavirus.jhu.edu/data/state-timeline/.

57 Texas, which removed all lockdown restrictions on March 10, 2021, is another
very public case. The reaction to opening up was overwhelmingly negative: the
California Governor called it ‘absolutely reckless,’ Dr. Fauci said ‘It just is
inexplicable why you would want to pull back now,’ and President Joe Biden said
it was ‘a big mistake’ and the result of ‘Neanderthal thinking.’ However, cases
and deaths continued to fall after the removal of lockdown restrictions.

58 Simply regressing cumulative deaths per million on lockdown stringency across
the 36 countries available with information from OurWorldInData, produces:

Cum.Death/M =352.66+10.64(0.80) (1.59)

where the t-statistic is in the parentheses. The small positive correlation is
the wrong sign for lockdown efficacy and is not statistically significant. One
should not put too much stock in such a simple cross section regression, my
point is only that a simple correlation isn’t found.

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