Consensus that lockdowns are no longer good?

Opinions are converging; lockdowns harder to be justified...

This article was originally published on 12/08/2020 for my informal email list. I’m re-posting some of my earlier newsletters here as a gradual process to shift to Substack.

My philosophy professor Peter Singer hosted a discussion yesterday titled “Are Lockdowns Justified? Evaluating the costs and benefits.” The three panelists are Olga Yakusheva (a UMichigan health economist), Jay Bhattacharya (a Stanford public health economist with an MD background), and Michael Plant (an Oxford philosopher with a background in Effective Altruism). I’m using their first names for simplicity; you can read more about their work in the link above. There were some very eye-opening arguments.

Were lockdowns justified from a lives saved or well-being perspective?

Olga’s research shows that the lockdown saved between 1-2.7 million lives in the U.S., while the economic cost will likely result in 50-300k deaths going forward. The exact numbers may be wrong, but the greater point is the lockdowns so far are justified if thinking from a lives saved perspective. 

Jay disagrees. He believes that Olga’s number of 50-300k underestimates the deaths caused by the lockdown because we have to also consider deaths from other diseases – more heart attacks, diabetes, etc. have been untreated (his argument is more elaborate but you get the idea).

Michael also disagrees – because from a philosophical standpoint it’s not just about lives saved, but well-being at large. His team conducts surveys about how happy people are during lockdowns (as well as other factors) and shows that there is a significant negative impact on people’s well-being in the long run. 

Infection rate vs. case count

Jay argues a better outcome could’ve been achieved – saving both more lives and the economy – had we done targeted population protection. He makes the crucial distinction between infection and case count. When you look at John Hopkins data, they count the cases, but not those who were infected, had antibodies, but were never tested/exhibited symptoms. His team did extensive field work in CA and found that there are 40 times more infections than cases in LA county, which means that significantly more people are surviving Covid than data currently shows.

His research shows that there is a over 90% survival rate for those above 70 and a 99.95% survival rate for those below 70. In other words, Covid death rate is largely divided along age (not other medical factors), and had you protected the vulnerable population, everything would’ve been fine. 

Jay also says that the whole idea of children dying from Covid is overblown (more children under 18 have died this year because of flu than Covid), and more accurate genetics studies done in CA and Iceland show that there’s little spread between children and adults (whereas less accurate studies done in South Korea and US show otherwise). The spread still predominantly occurs between adults, and adult-children spread isn't as severe. In other words, the previous data/studies justifying that "we shouldn't reopen schools because kids will spread Covid back to their parents" are inaccurate. 

Vague definition for lockdown

Olga and Jay both seem to agree that the definition and counterfactual outcomes for lockdown are not well-defined. They give interesting examples that in a small county in Arizona where most people work in essential businesses, having a lockdown doesn’t bring down the spread because people go to work anyways. In a well-off area where people are naturally deterred from leaving their estates, not imposing lockdown would’ve achieved largely the same outcome. What we’ve seen in the data is that the case spread rate R0 has all been at around 1.0 across places with vastly different degrees of lockdown policies. 

Are the opinions converging?

We’ve all been watching this debate between lockdown trade-offs for a while, with one side saying that Covid kills people and the other saying that the economic costs of lockdowns might kill more people. The interesting thing I’ve noticed is that the opinions are now somewhat converging, even though not fully. 

1. People who supported the initial lockdown in spring/summer (like Olga mentioned in my email Tuesday) are having an increasingly difficult time to justify it with the data we’re getting today. One of Olga’s arguments was that “we didn’t really have an alternative back in March because nobody understood what’s going on with this virus.” In other words, in hindsight we didn’t have a clear choice, but had we known what we know today, it would’ve been tougher to justify. 

2. People who supported the initial lockdown are having an even harder time justifying going into lockdown again. This is only partly because of the good news from vaccines, but I think mostly from all the data and discussions that have come out in the past few months. 

The dramatic shift of public sentiment

The public sentiment on lockdowns has shifted dramatically over the past few months. The perceived sense of physical harm of the virus has come down drastically (given how we now know the death rate and case spread rate are much lower than we imagined), while the perceived sense of psychological harm of the lockdowns has increased much more. 

Dave Chappelle said on Joe Rogan that the lockdowns are like a standup comedian who repeatedly says “one more thing before I go” and never leaves the stage; we initially said that we’d go into lockdown because we don’t want to overwhelm the hospitals, then three more weeks, and then a bit more and so on…