Even back at the very beginning of the pandemic, it was easy to calculate the scale of the potential threat. At the time, the disease was generating over a 4% fatality rate in China, and epidemiologists were predicting that, left unchecked, an infection rate of 70% could be executed in dealing with a highly infectious, novel disease where there was no underlying pool of immunity. That’s over 9 million dead in America alone. That’s how the worst-case scenario for COVID-19 looked then. That’s how it still looks now.
The response to that kind of staggering threat was clear: Reduce the rate of transmission. By slowing the spread of the disease, hospitals would not be overwhelmed, doctors and scientists would have more time to investigate treatments and vaccines, and patients could benefit from the latest knowledge. To make that happen, it was critical to impose strict social distancing—lockdowns—that broken the chain of transmission. As a number of studies are starting to show, those lockdowns worked. In fact, they have already been effective to the tune of saving millions of lives. And that evidence needs to get more attention, because it’s past time to lock down again.
Of course, the idea that America ever locked down in the first place isn’t true. Some states locked down. Others never did. And even among those that put in place some official “stay-at-home” order, many gave the idea little more than unenforced lip service (see Tennessee) while others had a lockdown for such laughably brief periods (check out Missouri) that they barely had a chance to act as a stumbling block for the racing pandemic.
Because the United States had no federal guidance on when to shut down, and because Donald Trump constantly derided the idea, there was nothing like a nationwide lockdown. Instead, Trump supported armed protesters who terrorized state capitols in the name of “freedom,” threatened to withhold federal assistance from governors who locked down more than Trump wanted, and praised those states that never issued a stay at home order.
However, a paper published in Nature last month made it clear that not only were these stay-at-home orders among the most effective measures around the world, they had prevented tens of millions of infections—hundreds of millions worldwide. Stay-at-home orders performed exactly as predicted: slowing the disease and saving lives.
A second paper published on Social Science Research Network is even more definitive. Not only did the stay-at-home orders that were issued save the lives of between 900,000 and 2,700,000 Americans, this far exceeds any potential threat generated from any economic downturn or limits on access generated through a lockdown. Under the worst possible assumptions, the loss generated by lockdowns is a fraction of what’s generated by failing to take appropriate action. Because there are potential downsides to stringent lockdown procedures, the authors (economists Eline van den Broek-Altenburg and Adam Atherly from University of Vermont, Olga Yakusheva from the University of Michigan, and Gayle Brekke from the University of Kansas) stop short of assigning a direct number value to each side of the equation, but it’s clear that both the human and the economic cost is far higher when governments fail to act.
The projections from back in March still hold true. Failure to act will result in the loss of more lives. Thanks to stay-at-home orders and other measures taken to restrict transmission back then, the number of cases, and deaths, has been greatly reduced. And buying that time has also meant a chance to trial multiple therapies, and to better understand the disease. However, if hospitals become overrun by a flood of new patients, the hard-won lessons of April and May will not matter.
And one thing hasn’t changed: Donald Trump still will not support new stay-at-home orders and will continue to press states to open faster than they should. Trump is already campaigning on the idea that America is “getting back to work” and putting COVID-19 in the rear view. Trump isn’t about to support any evidence that doesn’t fit that view.
It’s going to be up to states and governors to do the right thing. And to citizens of those states to demand it.
PROJECTED DEATHS FROM UNCONSTRAINED CORONAVIRUS