Lockdowns: the evidence revisited

Friday, 10 June 2022 — HART

The greatest policy failure in modern history

 

Professor Marilyn James, Professor of Health Economics, Professor David Paton, Professor of Industrial Economics

“It is possible that lockdown will go down as one of the greatest peacetime policy failures in modern history”
Professor Douglas Allen[1]

In March 2021, we wrote two sections in ‘Covid-19 the evidence’, namely ‘Economic impacts – the true cost of lockdown’ and ‘Lockdowns – do they work?’.  Over a year later, we have revisited not only the financial costs of lockdowns but also the societal costs, the impact on healthcare and the lack of evidence for overall benefit.

Assessing the economic costs of lockdowns and other Covid-19 restrictions is not easy, partly because the pandemic itself would have impacted economic activity independent of Government restrictions. However, we do now have considerable evidence that both voluntary behaviour change and government restrictions have significant economic effects.[2],[3] Further, voluntary changes tend to have most impact on the activity of groups most vulnerable to Covid, whilst Government restrictions have a disproportionate effect on those least vulnerable. This means that not only do most mandatory restrictions have a significant economic impact, but any benefits in terms of reductions in hospitalisations or deaths are minimal.[4]

Many of the immediate economic consequences of lockdowns were masked by the eye-watering amount of money spent by governments on furlough and business support schemes.  Given the limited evidence that stay-at home measures and business closures have any significant impact on infection rates[5], the question needs to be asked whether the billions spent paying business to shut down and people not to work could have been used better by building up capacity in the health system. The stay at home message of “protect the NHS” may have been no more than elaborate code for don’t highlight years of dwindling funding that failed to keep pace with growing population and demand in health care, with the NHS entering the pandemic with spending per GDP at the lowest level since 2009.[6]

Although furlough and business support schemes have had success in limiting the impact on unemployment, the longer-term economic consequences of lockdowns are now becoming clear. The lack of spending opportunities during lockdown contributes to a build-up of personal and corporate savings. As restrictions have eased, people begin to spend these savings and, combined with the supply chain issues that have built up in the meantime, sustained inflation is the inevitable result. Even worse, having spent about £70 billion[7] paying healthy people not to work via the furlough scheme and some £150 billion in total on support measures[8], the ability of the government to respond to this lockdown-induced cost-of-living crisis via either tax cuts or increased benefits, is limited due to the hit to public finances caused by lockdown-induced government spending.

It is perhaps no surprise that a series of research papers looking at data from Australia[9], the UK[10], Canada[11] and the US[12], have concluded that the costs of lockdowns exceed any plausible estimate of the benefits many times over.

The pandemic saw one disease prioritised over all others. It is now painfully clear that the “all others” are set to suffer with longer and larger health consequences than those of the covid-19 crisis itself. The report issued by the BMA is terrifying in every sense.[13] At the start of the pandemic 4.24m were waiting for elective treatment this now stands at 6.18m. Ridsdale makes the point “stay home” may well have contributed to excess deaths as people died at home without access to care and government policy prioritised covid above all other health concerns[14]. This figure of 6.18m masks and continues to mask the lack of referrals that occurred. There is no reason to suppose demand has dropped for elective care, yet, since the pandemic there have been 4.51 m fewer elective referrals. The latest figures show some 300,000 are waiting over a year for treatment. Again, this figure is masked by GPs under referring, reporting their ability to make referrals is severely constrained, yet the patients are still sitting at primary care level needing care. If the elective surgical figure continues to remain well below pre pandemic levels, NHS waiting lists will only continue to rise. Add to this routinely soaring long waits of over 12 hours at emergency department level and the gap between target time for cancer surgery and actual time to getting surgery increasing, the health picture created by covid prioritisation in the UK is frightening.

Lockdowns created isolation from our social and working worlds. The latest report from MIND states “Isolation and loneliness have made people’s mental health worse – with young people particularly badly affected.”[15] Similar can be said for older people especially those in care homes. The unintended consequences of removing activity, family and social interaction from the elderly may be more serious than the direct disease consequences of covid, with isolation being listed as cause of death in a number of care homes in the USA.[16]

Given what we now know, it is hard to disagree with the conclusion of Professor Doug Allen’s analysis of lockdown costs and benefits in Canada that “lockdown will go down as one of the greatest peacetime policy failures in modern history.”1

References

  1. https://doi.org/10.1080/13571516.2021.1976051
  2. www.sciencedirect.com/science/article/pii/S0047272720301754?dgcid=rss_sd_all
  3. https://direct.mit.edu/rest/article-abstract/doi/10.1162/rest_a_01108/107399/Do-Stay-at-Home-Orders-Cause-People-to-Stay-at
  4. https://link.springer.com/article/10.1007/s42973-021-00077-9
  5. https://onlinelibrary.wiley.com/doi/10.1111/eci.13484
  6. https://www.health.org.uk/news-and-comment/charts-and-infographics/health-spending-as-a-share-of-gdp-remains-at-lowest-level-in
  7. Coronavirus Job Retention Scheme: statistics – House of Commons Library (parliament.uk)
  8. https://commonslibrary.parliament.uk/research-briefings/cbp-9309/#:~:text=Current%20estimates%20of%20the%20cost,per%20person%20in%20the%20UK
  9. https://link.springer.com/content/pdf/10.1007/s40592-021-00148-y.pdf
  10. https://www.cambridge.org/core/journals/national-institute-economic-review/volume/87652BB968C8244B2E478DAA353C7DF9
  11. https://doi.org/10.1080/13571516.2021.1976051
  12. https://sites.krieger.jhu.edu/iae/files/2022/01/A-Literature-Review-and-Meta-Analysis-of-the-Effects-of-Lockdowns-on-COVID-19-Mortality.pdf
  13. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis
  14. http://dx.doi.org/10.1136/bmj.m3515
  15. https://www.mind.org.uk/media/8962/the-consequences-of-coronavirus-for-mental-health-final-report.pdf
  16. https://www.nbcnews.com/news/us-news/hidden-covid-19-health-crisis-elderly-people-are-dying-isolation-n1244853

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