If My Grandmother Had Had Wheels (to Scoot Away from the Grandkids), We Wouldn’t Have Needed a Lockdown …
Author: Dov Chernichovsky Alex Weinreb Avi Weiss

Would those with 20/20 hindsight be willing to take responsibility for the 3,300 extra deaths we would have had without the lockdown?

Israel is full of people in the know, politicians and distinguished academics among them, who with 20/20 hindsight maintain that the coronavirus lockdown was unnecessary, or at least unnecessarily stringent. Their “proof”? To date, just over 300 people have died of the coronavirus in Israel. In other words, the lockdown’s actual outcome has become proof that the lockdown was unnecessary to begin with. As far as these folks are concerned, the fact that we will never know how Israel would have fared without the lockdown is irrelevant.

“What if” statements (as in “If my grandmother had had wheels”) – known collectively as “counterfactuals” – make up a key philosophical issue in the sciences. The accepted, and contradictory, statistical approach to the counterfactual mode is to try and find a real-life “comparable similarity” between two groups or series. In this case, it would seem, we have an after-the-fact comparison between countries that instituted relatively strict lockdowns, and countries that either had no lockdown or whose lockdown was “soft.”

But that’s not the situation we actually have. The 20/20-hindsight crew’s “counterfactual” is based on only partial information (think President Trump’s “bleach” recommendation), or even on mere feeling, which these sages treat as proven, evidence-based fact. Where Covid-19 is concerned, the logical extension of this approach, which might be expressed as “To heck with lockdowns, masks, and social distancing – it’s all nonsense … Look what (didn’t) happen,” is profoundly dangerous to public health. In the face of this danger, the owners of Twitter have decided to block trending terms associated with remarks made by the President of the United States.

There can be no doubt that some of these people, such as the British Prime Minister, the President of Brazil, and President Trump, have genuinely believed that the coronavirus is similar in effect to the seasonal flu. But between this belief and the claim that Israel’s lockdown, as reflected in its outcomes, was unnecessary, lies nothing but intellectual fraud. That argument disregards the vaccine that we have for the flu, as well as the fact that we will never know, with complete certainty, what really would have happened without the lockdown.

Yet the “what if” question remains, and we can now try to answer it based on the information that has accumulated over the past two months, using the comparable-similarity method. Since the start of the pandemic, the University of Oxford’s Blavatnik School of Government has been collecting daily information on government response stringency in a number of countries. This information was used to develop a Government Response Stringency Index based on the following criteria: school and workplace closings, cancellation of public events, restrictions on gatherings, public transport closings, stay-at-home requirements, restrictions on internal movement, and international travel controls.

The comparison index we have chosen weights the measures taken up to March 15 – the period when the pandemic was at its peak in Italy and when other countries in Europe and elsewhere, including Israel, took strict measures in response to the Italian situation and the emerging situations in Spain and France. The coronavirus mortality outcomes of those measures were collected up to June 1 – just a short time ago.

In order to obtain the most comparable outcomes possible, we focused on Western European countries other than Italy, Spain, France, and San Marino, which were already in the throes of the pandemic by mid-March. We added the US, as a point of general interest to Israelis. The UK, Sweden, the Netherlands, and the US – which took almost no measures against Covid-19 until mid-March – show the lowest index scores of all the comparison countries. Slovakia (like Czechia, which is not shown here), Austria, Germany, Greece, Denmark, and Israel represent countries with high lockdown index scores. As shown in the figure, the less stringent the lockdown, the higher the coronavirus mortality rate.

It should be noted that in the UK and Sweden, the disease had begun to spread before the lockdown went into effect, while in other countries, the lockdown preceded the spread of the disease. In other words, the UK and Sweden, and the US, paid twice: in relatively high mortality, and in GDP loss.

A study published recently in the prestigious JAMA: Journal of the American Medical Association, supports these findings. The study shows the lockdown policy’s relative efficacy in preventing contagion and hospitalization in four US states (the individual US states differ in their lockdown policies, meaning that there is room for comparison after the fact).

This isn’t exact science. But the data indicate that, had Israel adopted policies like those of the UK or Sweden, there would have been 3,600 deaths by now, or about 12 times the current number. On March 25, the Taub Center published an assessment that coronavirus deaths in Israel would not exceed a few hundred. Given the Italian and Chinese outcomes that were then available, we were unable to determine that there was, therefore, no need for a lockdown. On the contrary: our assessment was predicated on the existence of a lockdown.

Was it necessary to “sacrifice” a substantial percentage of GDP to prevent 3,300 deaths? Based on another Taub Center study, Israel has likely paid a higher price than was actually “necessary.” At the time the lockdown was instituted, though, we did not know how much we would be paying, and we still don’t have a clear idea of the price today. In retrospect, and with the data available to us today, it may have been a “bad bet” – like many other bets, including political ones that generally have much worse cost-benefit ratios, at least on the public policy plane.

Of course, now that we’re a little wiser, we can perhaps refine the bet. But anyone making a proposal of any kind regarding restriction types or severity (non-closing of schools, businesses, and the like) should have to publicly disclose the number of deaths his or her proposal entails. To be a “kibitzer” – to hide behind the Ministry of Health in the television studio, or in governmental forums, and offer cheap advice – is easy, noncommittal, and above all, a form of public fraud. In this area, the Israeli news media could learn a thing or two from Twitter.

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