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The case against lockdown

Following my post a couple of months ago about objections to the anti-lockdown case, I thought I would share/save this formulation of the case against lockdown from epidemiologist John Ioannidis published in May last year as part of a superb exchange in the Boston Review.

We know that prolonged lockdown of the entire population has delayed cancer treatments and has made people with serious diseases such as heart attacks avoid going to the hospital. It is leading hospital systems to furlough and lay off personnel, it is devastating mental health, it is increasing domestic violence and child abuse, and it has added at least 36.5 million new people to the ranks of the unemployed in the United States alone. Many of these people will lose health insurance, putting them at further risk of declining health and economic distress. Prolonged unemployment is estimated to lead to an extra 75,000 deaths of despair in the United States alone over the coming decade. At a global level, disruption has increased the number of people at risk of starvation to more than a billion, suspension of mass vaccination campaigns is posing a threat of resurgence of infectious diseases that kill children, modeling suggests an excess of 1.4 million deaths from tuberculosis by 2025, and a doubling of the death toll from malaria in 2020 is expected compared with 2018. I hope these modeling predictions turn out to be as wrong as several COVID-19 modeling predictions have, but they may not. All of these impacts matter, too. Policymakers must consider the harms of restrictive policies, not just their benefits.

https://bostonreview.net/science-nature/john-p-ioannidis-totality-evidence

I was wondering how his view had evolved since then and there’s an overview here (albeit one of unpersuasive provenance) of recent publications from him which argue the cost of lockdowns outweigh their small benefits. He argued early in the pandemic (March 2020) that lockdown could prove to be a “once-in-a-century evidence fiasco” in a way which, Marc Lipsitch argues, gives the impression of rejecting early interventions without ever having said this.

It left me thinking about this in terms of the precautionary/proactionary distinction. Can the argument about lockdowns be usefully characterised in these terms? Has the answer to this question changed over time?