Were the Lockdowns Effective at All?

With a lot of the country either locking down again or getting close to the brink, worth noting a study published yesterday in The Lancet. I know, The Lancet has been badly politicized and unreliable in recent years (and months), but it does still pull great weight with the establishment, so our public health Faucists should know about it at least.

The study bears the typically dense academic-style title, “A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes.” Here’s the beginning of the long abstract describing what the researchers did:

A country level exploratory analysis was conducted to assess the impact of timing and type of national health policy/actions undertaken towards COVID-19 mortality and related health outcomes. . . We built a country-level model, incorporating data from 50 different countries, to assess country-specific socioeconomic factors and healthcare capabilities on COVID-19-related outcomes such as new case burden, critical cases, and mortality. . .

To our knowledge, no published articles have used a country-level analysis, pooling data across multiple countries, to report the impact of population health interventions, country-specific socioeconomic factors, and healthcare capacity on overall COVID-19 cases (recovered or critical), and associated mortality.

Now there’s a bombshell hidden in the dry prose typical of such studies about their findings—see the boldface sentence below:

Increasing COVID-19 caseloads were associated with countries with higher obesity, median population age and longer time to border closures from the first reported case. Increased mortality per million was significantly associated with higher obesity prevalence and per capita gross domestic product (GDP). Reduced income dispersion reduced mortality and the number of critical cases . Rapid border closures, full lockdowns, and wide-spread testing were not associated with COVID-19 mortality per million people. However, full lockdowns and reduced country vulnerability to biological threats (i.e. high scores on the global health security scale for risk environment) were significantly associated with increased patient recovery rates.

Translation: Lockdowns had little effect on the course of severe COVID-19 cases, with the exception of helping with recovery rates, which ratifies the “flatten the curve” logic so as not to overwhelm hospitals. More important were social distancing practices, and bans on foreign travel. (Or as the authors put it in the main body of the study, “government actions such as border closures, full lockdowns, and a high rate of COVID-19 testing were not associated with statistically significant reductions in the number of critical cases or overall mortality.” My emphasis.) This means that if what we care about most is mortality risk rather than mere infection rate, total lockdowns should be viewed skeptically.

But as the full study makes clear, much more important in the outcomes were underlying demographics and health co-morbidities, and the general economic profile of the country—essentially another ratification of Aaron Wildavsky’s shorthand axiom that “wealthier is healthier.” (Hard to believe such a common sense idea needs empirical demonstration.) Although richer countries experienced a higher rate of infection for reasons the study explains, they tended to have better recovery rates, as one would expect of wealthier countries that have more robust health care resources.

There’s also this little twist deep in the study:

The final unexpected finding was the lower frequency of critical cases and deaths in countries with a higher smoking prevalence. . .  A potential protective effect of smoking was identified in a recent evaluation of 17 million adult patients within the National Health Service of the United Kingdom, with 5683 COVID related deaths. In their analysis, current smokers were associated with a reduced risk of COVID-19 related mortality.

Maybe every carton of face masks should come with a coupon for a carton of cigarettes, just to be extra safe.