Lockdowns had a role: they saved lives

There are threats and lists and all manner of abuse aimed at those who promoted or supported measures that saved lives during the COVID-19 pandemic. I just want to make it clear that I supported measures to protect life until we could be adequately vaccinated. And I’ll support them again if a new deadly pathogen emerges tomorrow for which we have no specific treatments or vaccines.

In those countries that effectively used stay-at-home orders (“lockdowns”), closed borders and mandated masks, a lower proportion of lives were lost compared to countries that got on board well after the virus was already established in their jurisdiction.

Even then, many of those countries continued to import viruses through travel. Early and thorough use of a range of restrictions prevented the levels of death seen in countries where the response was slow or partial.

The aim – although not always well stated – was only to do this until understanding improved, and vaccines, drugs and better management of the sick were available and accessible for all. For all? Phah!We’re nowhere near that yet for a large swathe of humanity.

Sixty-four countries in the bottom grouping of 180 based on first and second COVID-19 vaccination dose. But hey, what’s the holdup on my 4th dose?
Graph snipped from the Australian ABC’s website.[24]

Restrictions caused harm but their delay/absence resulted in death

If we can take the heat out of our feelings for a moment, perhaps we can stand back in 2022 and honestly say that are no easy or harmless ways to protect lives during a pandemic. There are only ways of keeping people away from each other and hopefully doing that while minimising all the other harm – hopefully all much less severe than death – that can result from that. A pandemic is just an utterly crappy event. There’s no good. There’s just bad and not so bad.

We needed to be better at explaining why we had to be subjected to the things we were. We needed to be quicker to lift restrictions when they were not useful. We needed to tailor them with more finesse where possible. We needed to be authentic when we could see one restriction contradicted another – discussing why, even though the answer was something like “because we need this to keep being done”.

While lockdowns caused a range of harms [a few recent examples: 8,9,10,11,12,13,15], others have not found such a clear correlation [a few recent examples: 1,4,5,7] and in some cases, there were improvements to health and levels of infectious disease.[6,14,16,17]

Lists, threats and restrictions

I’m not complaining about being singled out, abused or threatened with being put on trial as I’ve had few of those approaches compared to many others. Although I block a lot quicker than I used to as well.

Most recently I’ve been added to a list of 101 people who “pushed for lockdowns”.[2] The premise of this particular article is kinda dumb though. It’s correlating the current lockdowns in Shanghai in 2022 with comments made before good vaccination levels were attained in other parts of the world. From my perspective, I was supportive of Australia’s border closures early in 2020.[3] I wouldn’t be now. But 2020 was a very different and pre-vaccine stage of the pandemic – it just isn’t comparable to the use of lockdowns in 2022 anywhere today.

The false dichotomy that was always a lie

“It’s either health or the economy!” …they told us.

And of course, many believed them. But it was never that. It was health and the economy.

We saw some great evidence to support this back in July 2021 from the Grattan Institute’s report, Race to 80: our best shot at living with COVID.[19]

From the Grattan Institute’s July 2021 report, Race to 80: our best shot at living with COVID.[19]

If we look at those top countries versus countries that were late to lockdown or lockout or to respond with restrictions in general, the death rate tells a standout tale.

Even Taiwan suffered “prevention fatigue” – a term that sums up what happened anywhere there were humans in 2021.[20] But to their credit and that of their leadership, they turned that outbreak around.[21]

Countries that responded quickly and strongly to the pandemic – including Taiwan, Australia, New Zealand and South Korea – did not suffer as high a case fatality rate as did countries that did respond less quickly.
From Our World In Data, Mortality Risk of COVID-19 [22].

In some instances – for example, in Australia and New Zealand – the removal of influenza and other inflammatory respiratory viruses from the winter mix due to the cessation of the global influenza travellator, may have added to a reduction of annual death compared to the average year pre-pandemic.

Countries that responded quickly and strongly to the pandemic – including Taiwan, Australia, New Zealand and South Korea – did not suffer the high rate of excess death seen in countries that did not respond as quickly.
From Our World In Data, Mortality Risk of COVID-19 [22].

And despite the use of lockdowns, Australia (overall – sorry Victoria, I know you guys suffered extra hard) and New Zealand actually had a lot of time not locked down than did some other countries. We dipped in, and once back under control, we relaxed those lockdowns and went on with life, relying on a hotel quarantine (HQ) system at the border. For a while that was leaky, but then it sealed up as the airborne nature of transmission finally (?maybe) was addressed. We didn’t hear as much about HQ working as we did when it failed though.

From the Grattan Institute’s July 2021 report, Race to 80: our best shot at living with COVID.[19]

Of course, one Australian State (New South Wales) lost control of the virus not long after this and spread it to other sites. It, like Victoria after it, also suffering from the public’s prevention fatigue, couldn’t maintain the martial mindset needed to prevent an efficient virus from transmitting.

Until then, restrictions, including lockdowns, quarantine, testing, tracing, isolation and (eventually) masks, had been working across all of Australia’s States and Territories to keep the virus out and contain the spread when it got in, while vaccines were ordered and administered. Lives were saved. When employed quickly, they were also able to be turned off fairly quickly as their effect allowed contact tracing to get ahead of spread.

But despite our economy bouncing back from lockdowns, once the virus started to spread without restriction, even in an 80% vaccinated population, we have now seen firsthand that businesses, hospitals, aged care, airlines, you name it – they’ve all struggled to field enough staff because of illness. And we’ve seen lots of trouble with unstocked shelves due to supply chain interruptions (something we spoke about in 2020 [23]) both in delivery at this end and production and manufacture at the source. “Oh but that’s just because of the rules to isolate”. That is part;y true, but in case you’ve missed it, COVID-19 can leave you exhausted, mentally foggy and not a little sick. Even before this pandemic, it wasn’t a great idea to go to work sick. You infect others and suddenly the job is more understaffed. But further, operating complex equipment and machinery or performing complex tasks when your mind isn’t all there carries risk. Mistakes cost money and cause injury.

Lockdowns in 2022

Now I sound defensive. But there really isn’t a reason for lockdowns in the post-vaccine age. Before vaccines, we saw a huge number of deaths. And even though we know most COVID-19 deaths occur among the elderly and those with underlying conditions, they were each the death of loved ones and they added to eth anxiety, depression and loss this pandemic is responsible for.

As we now know – even though severe disease and death happen in a relatively small proportion of those infected, when millions are infected that small percentage becomes a big very number of lost loved ones!

What’s my point?

Lockdowns had a role, as did stopping travel, using quarantine and enforcing isolation. Masks still do have a role as does completely revamping our indoor air quality. It’s appalling that during the current election campaign in Australia we have yet to hear any talk from a “leader” about a plan to fund measures to keep us safe from the inherent dangers of contaminated air. So many lessons, so little learned.

The role of lockdowns was to save lives that would have been lost if not enacted quickly. Australia, New Zealand, Taiwan and others observed time and time again that lives were lost due to slow responses. Lockdowns could have been done better but when used surgically – quickly on, quickly off with financial support, communication and enhanced mental and other health support – they reduced lockdown-related harms while also preventing the death they were intended for.

I don’t stand down from my support of these measures in the early stages of the pre-vaccine pandemic. Despite what threatening lists and articles may be trying for.

But to be clear, lockdowns don’t have a place now because we got through that temporary need.

References

  1. The impact of Victorian COVID-19 lockdowns on the presentation and management of acute appendicitis
    https://pubmed.ncbi.nlm.nih.gov/35429210/
  2. Who Pushed for Lockdowns? 101 Leading Voices
    https://brownstone.org/articles/who-pushed-for-lockdowns-101-leading-voices/
  3. COVID-19 cases slow a little in Australia
    https://virologydownunder.com/covid-19-cases-slow-a-little-in-australia/
  4. A Global Longitudinal Study Examining Social Restrictions Severity on Loneliness, Social Anxiety, and Depression
    https://pubmed.ncbi.nlm.nih.gov/35418888/
  5. Lockdown surgery: the impact of coronavirus disease 2019 measures on cardiac cases
    https://pubmed.ncbi.nlm.nih.gov/35416983/
  6. The impact of lockdowns during the COVID-19 pandemic on work-related accidents in Austria in 2020
    https://pubmed.ncbi.nlm.nih.gov/35412051/
  7. Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel
    https://pubmed.ncbi.nlm.nih.gov/35409535/
  8. Rise in depression and anxiety during the COVID-19 pandemic: results from a cross-sectional national survey
    https://pubmed.ncbi.nlm.nih.gov/35388716/
  9. Adolescents, Suicide, and the COVID-19 Pandemic
    https://pubmed.ncbi.nlm.nih.gov/35417315/
  10. The impact of the COVID-19 pandemic on eating disorders: A systematic review
    https://pubmed.ncbi.nlm.nih.gov/35384016/
  11. Impact of the first national COVID-19 lockdown on referral of women experiencing domestic violence and abuse in England and Wales
    https://pubmed.ncbi.nlm.nih.gov/35291956/
  12. The links of stress, substance use and socio-demographic factors with domestic violence during the Covid-19 pandemic in Portugal
    https://pubmed.ncbi.nlm.nih.gov/35312006/
  13. Women’s mental health: acute impact of COVID-19 pandemic on domestic violence
    https://pubmed.ncbi.nlm.nih.gov/33068161/
  14. Impact of the COVID-19 pandemic and multiple community lockdowns on total live birth rates and preterm births in Melbourne, Australia
    https://obgyn.onlinelibrary.wiley.com/doi/10.1111/ajo.13527
  15. Impacts of COVID-19 lockdowns on frailty and wellbeing in older people and those living with long-term conditions
    https://pubmed.ncbi.nlm.nih.gov/34821484/
  16. Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic
    https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.29.2100186
  17. Air pollution declines during COVID-19 lockdowns mitigate the global health burden
    https://pubmed.ncbi.nlm.nih.gov/33152273/
  18. Influenza and respiratory syncytial virus during the COVID-19 pandemic: Time for a new paradigm?
    https://pubmed.ncbi.nlm.nih.gov/34644459/
  19. Race to 80: our best shot at living with COVID
    https://grattan.edu.au/report/race-to-80/
  20. ‘Prevention fatigue’ driving sudden COVID surge in Taiwan: Expert
    https://www.aljazeera.com/news/2021/6/9/prevention-fatigue-fuelled-sudden-covid-surge-in-taiwan-expert
  21. Why Taiwan Is Beating COVID-19 – Again
    https://thediplomat.com/2021/07/why-taiwan-is-beating-covid-19-again/
  22. Mortality Risk of COVID-19 – Our World in Data
    https://ourworldindata.org/mortality-risk-covid
  23. So you think you’re about to be in a pandemic?
    https://virologydownunder.com/so-you-think-youve-about-to-be-in-a-pandemic/
  24. https://www.abc.net.au/news/2021-03-02/charting-australias-covid-vaccine-rollout/13197518#region

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