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Is the cure really worse than the disease? The health impacts of lockdowns during COVID-19
  1. Gideon Meyerowitz-Katz1,2,
  2. Samir Bhatt3,4,
  3. Oliver Ratmann4,
  4. Jan Markus Brauner5,
  5. Seth Flaxman4,
  6. Swapnil Mishra4,
  7. Mrinank Sharma5,
  8. Sören Mindermann5,
  9. Valerie Bradley5,
  10. Michaela Vollmer4,
  11. Lea Merone6,
  12. Gavin Yamey7
  1. 1 Western Sydney Diabetes, Western Sydney Local Health District, Blacktown, New South Wales, Australia
  2. 2 School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
  3. 3 Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
  4. 4 Faculty of Medicine, School of Public Health, Imperial College London, London, UK
  5. 5 Oxford Applied and Theoretical Machine Learning (OATML) Group, Department of Computer Science, University of Oxford, Oxford, UK
  6. 6 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
  7. 7 Duke Global Health Institute, Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr Gideon Meyerowitz-Katz; gideon.meyerowitzkatz{at}health.nsw.gov.au

https://doi.org/10.1136/bmjgh-2021-006653

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    Summary box

    • Restrictive non-pharmaceutical interventions against COVID-19 (known as ‘lockdowns’) are associated with health harms

    • However, it is challenging to determine whether lockdowns have caused the harms or whether these harms are a direct consequence of the underlying health disaster of the pandemic

    • Careful analysis of excess mortality suggests that lockdowns are not associated with large numbers of deaths in places that avoided large COVID-19 epidemics (eg, Australia, New Zealand)

    • This evidence must be weighed against the very severe harms caused by COVID-19 itself, as seen for example in Brazil and India

    • It is unlikely that government interventions have been worse than the pandemic itself in most situations using data collected to date

    Introduction

    During the pandemic, there has been ongoing and contentious debate around the impact of restrictive government measures to contain SARS-CoV-2 outbreaks, often termed ‘lockdowns’. We define a ‘lockdown’ as a highly restrictive set of non-pharmaceutical interventions against COVID-19, including either stay-at-home orders or interventions with an equivalent effect on movement in the population through restriction of movement. While necessarily broad, this definition encompasses the strict interventions embraced by many nations during the pandemic, particularly those that have prevented individuals from venturing outside of their homes for most reasons.

    The claims often include the idea that the benefits of lockdowns on infection control may be outweighed by the negative impacts on the economy, social structure, education and mental health. A much stronger claim that has still persistently appeared in the media as well as peer-reviewed research concerns only health effects: that there has been a large toll of death and disease attributable directly to government action against COVID-19, a toll larger than that of COVID-19 itself.1 2 The tagline for this claim is that “the cure is worse than the disease”.3

    Here, we consider the claim that lockdowns …

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