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Lockdown Comparisons

In case you need something concrete, or at least wet concrete, regarding the relative effectiveness of “hard” lockdowns, there is a paper by Eran Bendavid et al titled “Assessing Mandatory Stay‐at‐Home and Business Closure Effects on the Spread of COVID‐19”, first published on 5 January 2021.

The study basically compares the effect of case growth under more restrictive non-pharmaceutical interventions (mrNPIs) to less restrictive non-pharmaceutical interventions (lrNPIs). Ten countries are included: England, France, Germany, Iran, Italy, Netherlands, Spain, US, South Korea and Sweden.

South Korea and Sweden did not implement mandatory stay-at-home and business closures (lrNPIs) and are both compared to the other eight countries.

According to the study:

In none of the 8 countries and in none out of the 16 comparisons (against Sweden or South Korea) were the effects of mrNPIs significantly negative (beneficial). The point estimates were positive (point in the direction of mrNPIs resulting in increased daily growth in cases) in 12 out of 16 comparisons (significantly positive in 3 of the 12, in Spain and in England compared with Sweden). The only country where the point estimates of the effects of mrNPIs were negative in both comparisons was Iran (-0.07 [95CI -0.21 -0.07] compared with Sweden; -0.02 [95CI -0.28 -0.25] compared with South Korea).

So, “hard” lockdowns are apparently worse in 12 out of 16 comparisons. To be fair, this could be due to increased testing coverage. But then again, South Korea managed the problem with crazy testing. In any case, the article did point out the following:

While it is hard to draw firm conclusions from these estimates, they are consistent with a recent analysis that identified increase transmission and cases in Hunan, China during the period of stay-at-home orders from increased intra-household density and transmission. In other words, it is possible that stay-at-home orders may facilitate transmission if they increase person-to-person contact where transmission is efficient such as closed spaces.

And this leads to a commonsensical conclusion:

In summary, we fail to find strong evidence supporting a role for more restrictive NPIs in the control of COVID in early 2020. … The data cannot fully exclude the possibility of some benefits. However, even if they exist, these benefits may not match the numerous harms of these aggressive measures. More targeted public health interventions that more effectively reduce transmissions may be important for future epidemic control without the harms of highly restrictive measures.

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