Brief Thoughts on “Lockdown Effectiveness: Much More Than You Wanted to Know”
Scott Alexander posted “Lockdown Effectiveness: Much More Than You Wanted to Know” last week. It’s a long read that, in my opinion, while better than most mainstream analysis, still gives lockdowns entirely too much credit and largely operates within a worldview in which lockdowns are simply assumed to work as advertised. A few quick objections/clarifications, off the top of my head:
1. Scott claims “Both Denmark (stricter lockdown) and Sweden (weaker lockdown) were eventually able to control the explosive growth phase of the pandemic, but that doesn’t mean they both did equally well.” IMO, this is a pretty significant bait and switch. In basically every case, lockdowns were sold as a necessary measure, solely and specifically to prevent the hospitals from being overwhelmed. Given that the hospitals were never overwhelmed in Sweden, we can say that, on the basis by which lockdowns were proposed/supported/tolerated, they did no good.
They may have done some good in reducing the overall amount of COVID deaths - but not only was this not the proposed justification for them, it was something all the "experts" proposing them never even theorized might actually happen. Remember, the sales pitch for lockdowns in March 2020 was “the hammer and the dance.” We were told that this disease was so infectious that, left to its own devices, it would infect huge amounts of the population in a matter of weeks, leading to us tripping over bodies in the streets. We were told that everyone we knew would become infected, the only real question was whether this would happen all at once, or whether we could spread it out over a longer period of time. All of that turned out to be wrong. After over a year, there isn't a single jurisdiction in the entire world that has come close to reaching herd immunity via natural infection. Most people I know in suburban/rural Texas have been completely ignoring all suggestions and living life as normal since last summer, and most of them have still never caught COVID.
Thus, the experts either lied to us intentionally, or they were just colossally wrong in their earnest predictions. In either case, the fact that their recommended policies ended up contributing to a different goal, one that they never intended or even theorized might be possible, is not a cause for celebration or increased confidence in these people. If you go to a doctor and he says "You have a deadly illness, drink this potion or you'll be dead by tomorrow" and it turns out he was wrong, you had no deadly illness, many others with your same condition didn't drink the potion and didn't die, but the potion did cause you to lose 10lbs and make you generally healthier, this is not evidence of an expert doctor who has developed a highly effective “general health potion.” It's evidence of a charlatan who either tricked you or accidentally got lucky.
2. It's worth keeping in mind that the only reason Scott can do this analysis now, that he can declare the pandemic "mostly over" is because of vaccines. What was the expert consensus on vaccines in March 2020? From what I remember, there was approximately one major public figure suggesting a vaccine might be developed by the end of the year: Donald Trump. And then all the mainstream news outlets "fact checked" this claim and declared it utterly impossible and insisted that the right timeframe to think about vaccine development was decades, rather than months.
In a way, Sweden's problem is that they trusted the experts too much. If the experts were right about this, if in fact the only way out of this pandemic was naturally acquired herd immunity, then the best/most effective strategy would have been whichever one reached herd immunity the fastest without overwhelming the hospitals. In a world where there's no vaccine coming for another 10 years, Sweden having a bunch more cases in the summer of 2020 gets them closer to the finish line with no extra cost whatsoever compared to Denmark or whoever. This was "the hammer and the dance" approach almost exactly. The point of the dance phase was to get as many cases as you possibly could in a given time without overwhelming the hospitals.
There were people loudly advocating for “challenge trials” and other efforts to speed up the vaccine-development process, but in terms of lockdown policy, as of March 2020, "X action will reduce the total number of cases we experience throughout the entire length of the pandemic, which will lead to fewer deaths" was not a logical statement. Nobody was claiming that was possible. Now, their actions perhaps indicate that maybe they believed it was, and they were just lying to us, like they lied about so many other things, possibly to get Trump out of office (hence Pfizer delaying results about the vaccine until after the election).
It's also worth noting that it seems like it was sometime around "early summer 2020" when we suddenly realized that ventilators were doing more harm than good - and death rates, in general, across all ages, basically everywhere, improved dramatically after that. The fact that the earliest places to have an infection wave are the ones with all the worst death rates is almost entirely attributable to very bad treatment methods.
3. In terms of “trusting the experts too much,” my operating theory as to why the Northeast went with their whole "send all the COVID-infected elderly back to the nursing homes!" strategy was related to this. It was a triage measure. They were so sure that the hospitals were about to become overwhelmed, they were deliberately sacrificing the elderly to free up hospital capacity for the young/healthy/productive. Had all the experts been right and had that actually been the case, they may have been justified. Triage exists for a reason, after all. But it sure does look bad today…
The only other theory I have for why you might implement this policy is some sort of, let's say, "discrimination prevention" idea. Something like "we don't want COVID-infected people to seem unclean, so we're going to make it policy that you cannot say, kick them out of their accommodation, just for having COVID." Which isn't much better, but given how early these decisions were made, is roughly in-line with DeBlasio's recommendation of "take the subway to Chinatown and hug an Asian person to prove how not racist we all are!"