A meta-analysis of 24 papers showed that lockdowns did not significantly decrease the number of COVID-19 deaths.
The paper, A Literature Review and Meta-Analysis of the Effects of Lockdowns on COVID-19 Mortality, was published by the Johns Hopkins Institute for Applied Economics, Global Health, and the Study of Global Enterprise in January 2022.
The study defines a Non-Pharmaceutical Interventions (NPI) as any government mandate which directly restricts peoples’ possibilities. It includes mandated interventions such as limiting internal movement, closing schools or businesses, banning international travel, requiring face masks, etc. A lockdown is any policy consisting of at least one NPI as described above.
Method
A search was made among 18,950 studies to identify papers that answered the following questions:
1. Does the study measure the effect of lockdowns on mortality?
2. Does the study use an empirical ex-post (actual) difference-in-difference approach?
Research that answers “yes” to both questions gets included in the study. Twenty-four were qualified to be included in the meta-analysis.
Difference-in-differences studies look at the differential effect of a treatment on a ‘treatment group’ versus a ‘control group.’ This meta-analysis calculated the impact of a treatment (NPI/lockdown) on an outcome (COVID-19 deaths).
The figure below is from Columbia Public Health and not from the study but is used here to provide a graphical explanation of a difference-in-difference estimation. The change in the direction of the red line represents the outcome after the intervention (vertical blue line).
The end of the red line or the intervention effect results from the “treatment.” The green line represents the control group that did not get “treatment.”
Results
The effects of the 24 studies were grouped into lockdown stringency index studies, shelter-in-place order (SIPO) studies, and specific NPI studies. The results are discussed below.
For all the tables/values shown below, a negative number corresponds to fewer deaths, so -5% means 5% lower COVID-19 mortality.”
Lockdown Stringency Index
The Oxford Covid-19 Government Response Tracker (OxCGRT) defines the stringency index as a composite measure based on nine response indicators, including school closures, workplace closures, and travel bans, rescaled to a value from 0 to 100 (100 = strictest). The whole list is below.
- School closing
- Workplace closing
- Canceling public events
- Restrictions on gatherings
- Closing of public transport
- Stay at home requirements
- Restrictions on internal movement
- International travel controls
- Public information campaigns (not included in the study)
Effects of Lockdown Stringency
Seven studies about the effect of government stringency on COVID-19 deaths were put together. Below is an overview of the seven studies.
Lockdowns, on average, have reduced COVID-19 mortality rates by 0.2% in Europe and the United States.
The authors said,
Compared to a policy based solely on recommendations, we find little evidence that lockdowns had a noticeable impact on COVID-19 mortality.
Only one study, Fuller et al. (2021), finds a substantial effect, while the rest of the studies find little to no effect.
In other words, school and workplace closing, canceling public events, restricting gatherings, closing public transport, stay at home requirements, and international travel controls prevented only 0.2% of COVID-19 deaths based on this study.
Effects of Shelter in Place Orders
A shelter-in-place order instructs or requires people to remain in their current location until the danger has passed. The table below shows the thirteen SIPO studies with their estimated COVID-19 deaths averted.
Result: Shelter-in-place orders (SIPOs) reduced COVID-19 mortality by -2.9% (on a precision weighted average).
Effects of Specific Non-Pharmaceutical Interventions
The specific Non-Pharmaceutical Interventions are as follows:
- Lockdown (complete/partial) (0.6%)
- Facemasks/Employee face masks (-21.2%)
- Business closure (/bars & restaurants) (-10.6%)
- Border closure (/quarantine) (-0.1%)
- School closures (-4.4%)
- Limiting gatherings (1.6%)
The table below shows the studies of each NPIs. The overall result that is shown above is inside the red rectangle.
Notice that facemasks and business closures lower the deaths by 21.2% and 10.6%, respectively. The authors have a comment on those.
Because of the heterogeneity in NPIs across studies, it is difficult to draw strong conclusions based on the studies of multiple specific measures.
An example is a study like Spiegel & Tookes (2021) which studied the effects of facemasks and business closures. This makes it challenging to know which caused more impact on the lower deaths.
Overall, their conclusions about the specific NPIs are,
We find no evidence that lockdowns, school closures, border closures, and limiting gatherings have had a noticeable effect on COVID-19 mortality.
There is some evidence that business closures reduce COVID-19 mortality, but the variation in estimates is large and the effect seems related to closing bars.
Notice the wide range of results on Business closures from 0.3% to -50.2%. Spiegel & Tooke’s (2021) study with a -50.2% decrease in mortality is about bar closures.
There may be an effect of mask mandates, but just two studies look at this, one of which [Spiegel & Tooke’s (2021)] only looks at the effect of employee mask mandates.
Summary and Conclusions
Overall, our meta-analysis fails to confirm that lockdowns have had a large, significant effect on mortality rates.
Studies examining the relationship between lockdown strictness (based on the OxCGRT stringency index) find that the average lockdown in Europe and the United States only reduced COVID-19 mortality by 0.2% compared to a COVID-19 policy based solely on
recommendations.Shelter-in-place orders (SIPOs) were also ineffective. They only reduced COVID-19 mortality by 2.9%.
Studies looking at specific NPIs (lockdown vs. no lockdown, facemasks, closing non-essential businesses, border closures, school closures, and limiting gatherings) also find no broad-based evidence of noticeable effects on COVID-19 mortality.
However, closing non-essential businesses seems to have had some effect (reducing COVID-19 mortality by 10.6%), which is likely to be related to the closure of bars.
Also, masks may reduce COVID-19 mortality, but there is only one study that examines universal mask mandates.
The effect of border closures, school closures and limiting gatherings on COVID-19 mortality yields precision-weighted estimates of -0.1%, -4.4%, and 1.6%, respectively.
Lockdowns (compared to no lockdowns) also do not reduce COVID-19 mortality.
Policy Implications
Having found that lockdowns have minimal effect on COVID-19 deaths, the authors have a policy recommendation.
Our study fails to demonstrate significant positive effects of mandated behavioral changes (lockdowns). This should draw our focus to the role of voluntary behavioral changes.
Here, more research is needed to determine how voluntary behavioral changes can be supported. But it should be clear that one important role for government authorities is to provide information so that citizens can voluntarily respond to the pandemic in a way that mitigates their exposure.
Adverse Effects of the Lockdowns
Lockdowns have unintended consequences. Emphasis added.
The use of lockdowns is a unique feature of the COVID-19 pandemic. Lockdowns have not been used to such a large extent during any of the pandemics of the past century.
However, lockdowns during the initial phase of the COVID-19 pandemic have had devastating effects.
They have contributed to reducing economic activity, raising unemployment, reducing schooling, causing political unrest, contributing to domestic violence, and undermining liberal democracy.
These costs to society must be compared to the benefits of lockdowns, which our meta-analysis has shown are marginal at best.
Authors Final Words
Such a standard benefit-cost calculation leads to a strong conclusion: lockdowns should be rejected out of hand as a pandemic policy instrument.
Something to think about
The focus of this study is the effect of NPIs on COVID-19 mortality. If medications like ivermectin, hydroxychloroquine, fluvoxamine, and supplements like Vitamin D3, Zinc, Nigella Sativa, Quercetin, and many others were widely used in COVID-19 patients, the COVID-19 death rates would have been much lower.
If doctors and COVID-19 patients were allowed to use them, mandates would have been unnecessary.
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Reference:
- Herby, J, Jonung, L, Hanke, S., A Literature Review and Meta-Analysis of the Effects of Lockdowns on COVID-19 Mortality. Studies in Applied Economics. No. 200. January 2022
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