Thursday, August 06, 2020

Did lockdowns work? evidence says no

With talk of ordering more widespread shutdowns to fight the resurgence of COVID-19 cases, it is worth taking note of a paper released over the weekend on the Social Science Research Network (SSRN) by Prof. Christian Bjørnskov of Aarhus University in Denmark. The paper is “Did Lockdown Work? An Economist’s Cross-Country Comparison.”

The abstract is both direct and concise (a rarity in academic writing):

I explore the association between the severity of lockdown policies in the first half of 2020 and mortality rates. Using two indices from the Blavatnik Centre’s Covid 19 policy measures and comparing weekly mortality rates from 24 European countries in the first halves of 2017-2020, and addressing policy endogeneity in two different ways, I find no clear association between lockdown policies and mortality development.

The main text of the paper reviews a couple other recent studies that reach the same conclusion, but some of Prof. Bjørnskov’s language in his conclusion leads me to think not all Danes are as far gone as the cliches might lead us to suggest:

The lockdowns in most Western countries have thrown the world into the most severe recession since World War II and the most rapidly developing recession ever seen in mature market economies. They have also caused an erosion of fundamental rights and the separation of powers in large part of the world as both democratic and autocratic regimes have misused their emergency powers and ignored constitutional limits to policy-making. It is therefore important to evaluate whether and to which extent the lockdowns have worked as officially intended: to suppress the spread of the SARS-CoV-2 virus and prevent deaths associated with it. Comparing weekly mortality in 24 European countries, the findings in this paper suggest that more severe lockdown policies have not been associated with lower mortality. In other words, the lockdowns have not worked as intended. . .

Although much has been claimed about Sweden’s relatively high mortality rate, compared to the other Nordic countries, the present data show that the country experienced 161 fewer deaths per million in the first ten weeks, and 464 more deaths in weeks 11-22. In total, Swedish mortality rates are 14 percent higher than in the preceding three years, which is slightly more than France, but considerably fewer than Italy, Spain and the United Kingdom that all implemented much stricter policies.

The problem at hand is therefore that evidence from Sweden as well as the evidence presented here does not suggest that lockdowns have significantly affected the development of mortality in Europe. It has nevertheless wreaked economic havoc in most societies and may lead to a substantial number of additional deaths for other reasons. A British government report from April for example assessed that a limited lockdown could cause 185,000 excess deaths over the next years (DHSC, 2020). Evaluated as a whole, at a first glance, the lockdown policies of the Spring of 2020 therefore appear to be substantial long-run government failures.

Like I say, I think I like this guy.



Why the coronavirus nightmare may soon be over/b>

Matt Ridley writes from Britain

Like the ancient mariner, the virus refuses to leave us alone. Resurging in Blackburn, Spain, and America, it is still going to be around here when the winter comes. As we head indoors, it will be back for a dreaded second wave, disguised among a host of colds and flus. Yet I am now optimistic that the nightmare will end this year or at least by the spring. Here are five reasons.

First, vaccine trials were promising. Having proved safe and capable of raising both a T-cell response and an antibody response, Oxford University’s vaccine, developed in collaboration with Astrazeneca, is now more likely to succeed than to fail, so long as its side effects are manageable in the elderly. And behind it comes a stream of other vaccines, some of which will surely work.

The second reason for hope is that, as Oxford University’s epidemiologist Sunetra Gupta has argued, herd immunity may be achieved more easily than we first thought. Indeed, from the way that infections have continued to dwindle despite lessening social distancing it seems probable that herd immunity has already been achieved in London at least. Half the population could be immune already because of recent exposure to coronavirus colds, while children seem to resist catching Covid-19, let alone passing it on. As the chief medical officer Chris Whitty has conceded, the epidemic was already in retreat before lockdown began. That is because the virus depends heavily on a few superspreaders, and pre-lockdown measures we were taking in March are remarkably effective: no handshakes, frequent hand washing, no large gatherings and so on.

So the third reason for optimism is that as long as we continue with these measures then this virus will struggle to keep spreading in the community. The one place where the virus did spread with horrible ease was in care homes and hospitals. Why was this? T-cell senescence is an issue, so old people’s immune systems are just not as good at coping with this kind of infection, and there were dreadful policy mistakes made, like stopping testing people, clearing patients out of hospitals to care homes without tests, and assuming no asymptomatic transmission. Healthcare and care home staff were not properly protected and were allowed to go from site to site. Many were infected and became carriers.

The fourth cause for cheer is therefore that now we know about asymptomatic transmission, we have more protective equipment and we have a better, if still imperfect, capacity to test, track and isolate cases, it is likely that the hospital-acquired epidemic of the spring will not be repeated.

My fifth excuse for being hopeful is that we now know better how to treat people who get seriously ill. Ventilation is not necessarily the answer, blood clotting is a real threat, making patients lie face down is helpful, dexamethasone can save lives and some antiviral drugs are showing promise.

These are reasons that even if a lot of people catch the virus this winter, fewer will die. Colds and flu viruses usually peak in mid winter when we are indoors. Viruses survive longer in colder and drier conditions, and centrally heated air dries out our protective mucus membranes. Covid-19 will certainly be hoping to peak then. But Australia offers a glimmer of reassurance. It’s winter there now, and this is proving to be the country’s weakest flu season on record. From January to the end of June, 21,000 Australians were diagnosed with flu. Last year more than 132,000 people were diagnosed in the same period. Social distancing is presumably the main reason. If that is repeated here, then not only will Covid have fewer flus and colds to hide behind, but it too will struggle to mount a seasonal peak. And fewer people will die from flu.

If we can beat this virus, then we can beat most respiratory ones. The ridiculous way in which we tolerate cold-spreaders, mocking them for taking a day off and praising them for trudging into work while feeling miserable, has to stop. It should be socially unacceptable to go to a party with a cold, let alone kiss the host on the cheek when you get there. Our children’s permanently runny noses need not be inevitable.

Ten years from now, I predict that we will not only have defeated Covid-19, but made colds rarer too.

Our bigger challenge this winter will be to tackle the backlog of treating cancer and other medical problems delayed by Covid. And to unleash economic growth to help those who lost their jobs.



What's the risk of catching COVID-19 on public transportation?

The chances of catching COVID-19 on public transportation depend a lot on where you sit, with those closest to an infected person at the highest risk and those farther away at a relatively low risk, a new study suggests.

The study, which included thousands of passengers who traveled on China's high-speed trains, known as G trains, found that the rate of transmission to nearby passengers varied from near 0% to about 10%, with those who sat closest to infected passengers for the longest periods at the highest risk.

"Our study shows that although there is an increased risk of COVID-19 transmission on trains, a person's seat location and travel time in relation to an infectious person can make a big difference as to whether it is passed on," study lead author Dr. Shengjie Lai, a research fellow at the University of Southampton in the United Kingdom, said in a statement. "The findings suggest that during the COVID-19 epidemic it is important to reduce the density of passengers and promote personal hygiene measures, the use of face coverings and possibly carry out temperature checks before boarding."

Indeed, other recent studies from around the world suggest that when passengers wear masks and adhere to social-distancing guidelines, public transportation may pose a relatively low risk of infection.

For example, in Paris, public health officials found that of the 386 recent clusters of COVID-19 in the city between May and mid-July, none were linked with public transportation, according to The New York TImes. Similar findings were seen in both Tokyo and parts of Austria, the Times reported.

In the new study, published July 29 in the journal Clinical Infectious Diseases, researchers analyzed information from passengers who traveled on G trains between mid-December 2019 and late February 2020, which covers the period from before COVID-19 was identified to the peak of the outbreak in China.

The researchers identified more than 2,300 passengers known as "index patients" who developed COVID-19 within 14 days of their train trip, and more than 72,000 passengers who sat near these cases — within three rows (widthwise) and five columns (lengthwise) of the index patients.

Overall, 234 of the 72,000 nearby passengers developed a COVID-19 infection linked to their train ride. That means the average "attack rate" — or percent who tested positive out of the overall group — was about 0.32%.

Those who sat directly next to an infected person had the highest risk of contracting the infection, with an average attack rate of 3.5%.

For those sitting in the same row, but not necessarily adjacent to the infected person, the average attack rate was 1.5%. That's about 10 times higher than the attack rate for people sitting just one or two rows back from the infected person, the study found.

The amount of time a person traveled also affected their risk — on average, the attack rate increased 0.15% for every hour a person traveled with an infected passenger; and for those sitting next to an infected person, the attack rate increased 1.3% every hour.

But after an infected person disembarked the train, those who sat in the same seat seemed to be at a low risk of infection. Among the 1,342 people who sat in a seat previously occupied by an infected person, just one person later contracted the disease, an attack rate of just 0.075%, according to CTV News.

The researchers concluded that to prevent COVID-19 spread, passengers should be seated at least two seats apart within the same row, and limit travel time to 3 hours.

"We hope it can help to inform authorities globally about measures needed to guard against the virus and in turn help to reduce its spread," said study co-author Andy Tatem, a professor of spatial demography and epidemiology at the University of Southampton and director of WorldPop, a collaboration of scientists that works to provide data on human population distributions.

The authors noted that their study had limitations. For example, the researchers could not prove that the 234 passengers definitely contracted the virus on the train, although public health officials had determined that this was the most likely source of their infection, CTV News reported. In addition, the study did not have information on whether the passengers were wearing protective gear such as masks, the authors said.



President Trump Signs Executive Order Instructing Federal Agencies to 'Hire American'

President Trump signed an executive order that aims to prioritize American workers on Monday, hoping to promote “hiring American,” by barring federal agencies from replacing domestic workers with foreign contractors. The order targets job outsourcing within federal agencies that replaces American jobs with inexpensive foreign labor via H-1B visas.

“We believe jobs must be offered to American workers first,” the president said.

This executive order mirrors President Trump’s commitment to putting American workers first, especially given the economic downturn caused by COVID-19 that is felt by Americans in all job sectors.



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