Share on PinterestA woman looks on from her window on April 26, 2020, in Barcelona, Spain. David Ramos/Getty ImagesCritics of stay-at-home orders or lockdowns often argue that the resulting harms to mental and physical health are worse than the direct harms from COVID-19.A new analysis of excess mortality figures in countries that imposed lockdowns but did not experience high numbers of cases helps refute these claims.While restrictive measures are associated with harm to health, there is no evidence that lockdowns rather than the pandemic itself are to blame.Conversely, COVID-19 has had a devastating impact on health in countries, such as Brazil and India, that did not introduce restrictive control measures.
Opponents of government restrictions on personal freedoms during the COVID-19 pandemic argue that lockdowns have taken a greater toll on the public’s health than the disease itself.
They cite factors, such as missed opportunities to screen for illnesses and provide vaccinations, lengthening waiting times for consultations and surgical procedures, and the mental health toll of loneliness and isolation.
People sometimes sum these up as “the cure is worse than the disease.”
Writing in BMJ Global Health, public health experts emphasize that it is challenging to disentangle the health effects of lockdowns from the health effects of the pandemic.
However, their own analysis suggests that it is unlikely that government interventions have been worse for public health — at least in the short term — than the pandemic itself.
They considered not only overall mortality rates but also disruptions to health services, mental health effects, and the number of suicides.
The research was an international collaboration between scientists in Australia, Denmark, the United Kingdom, and the United States.
Excess mortality
To tease apart the health effects of the pandemic and lockdown restrictions, the researchers turned to the World Mortality Dataset.
The dataset includes figures for “excess mortality” in 94 countries between the start of the pandemic in 2020 and the middle of 2021.
It defines “excess mortality” as the difference between the actual number of deaths and the predicted number, given trends before the pandemic.
In Australia and New Zealand, which imposed several lockdowns but experienced relatively few COVID-19 cases, the researchers found no excess mortality during 2020.
If it were true that “the cure is worse than the disease,” lockdowns would have increased death rates in these countries compared with previous years, even in the absence of severe outbreaks.
The researchers found a similar story in South Korea, Taiwan, and Thailand, which imposed lockdowns despite having few or no COVID-19 cases.
These countries either recorded no excess mortality or relatively small increases.
On the flip side, countries that imposed few restrictions, including Brazil, Sweden, and Russia, have recorded large numbers of excess deaths throughout the pandemic.
“[I]f areas that locked down but had low COVID-19 cases did not see deaths from other causes rise, lockdowns themselves cannot be the cause of deaths per se,” said lead author Gideon Meyerowitz-Katz, an epidemiologist at the School of Health and Society at the University of Wollongong in Australia.
“It is possible that they have had mixed benefits, but the evidence is not consistent with a situation where lockdowns cause large numbers of deaths in the short term,” he told Medical News Today.
Complex web of effects
The authors emphasize that the possibility remains that lockdowns have detrimental effects on health, both in the short and long term.
For example, a U.K. study found an increase in heart attacks within the community during the first wave of COVID-19. However, the research was unable to determine whether government restrictions or COVID-19 caused this growth.
Another study suggested that missed cancer screenings could lead to a large increase in cancer deaths in the U.K. But reduced screening could also result from the reallocation of healthcare staff to pandemic-related work.
Commenting on the new analysis for the Science Media Centre in London, Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh in the U.K., said:
“The authors reach the unsurprising conclusion that the short-term impact of lockdown on mortality rates is considerably less than the impact of COVID-19, while correctly acknowledging that it is extremely difficult to disentangle the direct and indirect effects of either. This is a useful exercise but falls far short of demonstrating that the cure will not prove to be worse than the disease in the long term.”
Other researchers are concerned that the long-term consequences of the disease could be far ranging, particularly with potentially lasting effects on the brain.
Impact on mental health
The authors report that there is “consistent and robust” evidence that government measures to control COVID-19 have not led to increased deaths from suicide.
They acknowledge that there is also abundant evidence that mental health has declined since the onset of the pandemic.
But they emphasize that it is challenging to disentangle the effects of lockdown and the pandemic itself, which has led to anxiety about infection and a high burden of bereavement.
Dean Burnett, Ph.D., honorary research associate at Cardiff Psychology School in the U.K., told MNT that the focus on case numbers, death rates, and hospital occupancy risked sidelining the pandemic’s toll on mental health.
Dr. Burnett, who was not involved in the new research, lost his own father to COVID-19 in 2020.
“The raw numbers are useful for tracking the progress and pattern of the pandemic, but every one of those numbers is actually a complex individual human, with all the emotional connections and relationships that entails,” he said.
“As a result, their sickness or death will have a wide range of negative consequences for the well-being of those around them.”
International long COVID data missing
It is important to note that the study was unable to include information about the impact of long COVID due to the lack of comparable data across countries.
Long COVID, or post-COVID syndrome — the persistence of symptoms for 3 months or more — affects around 1 in 10 people with COVID-19.
The fewer people who develop COVID-19, the fewer people will be affected by long COVID, therefore pushing the balance further towards the disease being worse than lockdowns.
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