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What QALYs reveal about lockdowns

Was lockdown 'one of the greatest peacetime failures in modern history'? Credit: Getty

December 12, 2023 - 5:45pm

In a key section of Rishi Sunak’s evidence to the Covid inquiry yesterday, the Prime Minister explained that studies based on quality-adjusted life years, or QALYs, found that the first Covid lockdown generated costs that were greater than the likely benefit. It was a striking admission, perhaps the first time that a senior member of the Government has admitted that lockdowns may have been the wrong policy choice.

A disconcerted Hugo Keith KC responded by saying, “I don’t want to get into quality life assurance models [sic].” With that dismissive reference, Keith revealed his lack of familiarity with the most basic approach to health policy analysis. So what are QALYs, and how are they relevant to lockdowns?

QALYs are a standard tool for evaluating the benefits of a health intervention in terms of a single measure that takes account of additional years of life, as well as the level of health experienced during those years. The UK’s National Institute for Health and Care Excellence (NICE) has long used QALYs to evaluate the benefit of treatments relative to their costs. The standard NICE cost-effectiveness threshold is that a treatment likely to increase life expectancy for a patient by the equivalent of a year in full health is worthwhile if it costs no more than about £30,000. When it comes to lockdowns, researchers similarly try to compare the costs incurred by restrictions with the additional number of healthy years of life expectancy which the lockdown may have enabled.

The QALY approach is not without critics and alternatives include wellbeing-adjusted life years (WELLBYs) and the valuation of a statistical life (VSL). The latter typically leads to higher estimates of the value of lives than QALYs. Yet the general principle that a health intervention cannot always be justified, even if it extends some lives, is not controversial. Put simply, trade-offs are important: if lockdowns prevent some deaths from Covid but also cause costs to other people, potentially including deaths due to higher poverty or isolation, we need tools to work out where the appropriate balance lies.

A number of peer-reviewed studies have now conducted cost-benefit analyses of lockdowns using one or other of these approaches, focusing on the global situation as well as on the experience of particular countries such as Australia, Canada and the UK. Whichever life valuation method is used, all these studies find not only that the costs of lockdowns exceeded the benefits, but that they did so by a very large margin. 

One reason for these results is that the costs of lockdowns (separate from the costs of Covid itself) have been enormous. The economic costs to business and public finances are well known and huge. But we also need to take into account lower wellbeing from missed education, increased poverty, and widespread loneliness.

An even bigger issue is that lockdowns were simply not very effective in reducing mortality. Some studies find lockdowns had no significant impact at all in reducing deaths associated with the pandemic. However, we can’t rule out that lockdowns had some marginal impact on Covid deaths, at least in the short run. A recent meta-analysis looking at all relevant studies of the impact of lockdowns on mortality concluded that, on average, lockdowns reduced deaths associated with Covid in the immediate term by about 3.2%.

Whether there was any effect on longer-term Covid mortality is more questionable. Even more importantly, there is now good evidence that lockdowns did not reduce overall excess mortality (i.e. deaths from all causes) and if anything may have increased it. In other words, deaths caused by lockdowns due to isolation, poverty or delayed healthcare probably exceeded the number of Covid deaths averted.

In that context, the precise value placed on deaths averted — whether using QALYs or any other method — becomes irrelevant as the ratio of costs to benefit from lockdowns approaches infinity.

Not without reason, Professor Doug Allen of Simon Fraser University in Canada concluded his cost-benefit study by saying that lockdowns “will go down as one of the greatest peacetime failures in modern history”.


David Paton is a Professor of Industrial Economics at Nottingham University Business School.

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Jim Veenbaas
Jim Veenbaas
7 months ago

I’ll keep pounding the table on this – 165 million people have been pushed into $2 a day poverty since 2020. That ended 25 years of continuous declines in global poverty.

Tyler Durden
Tyler Durden
7 months ago
Reply to  Jim Veenbaas

Precisely what China wanted. And we in the West can thank Dr A Fauci for his complicity on our behalf.

Jim Veenbaas
Jim Veenbaas
7 months ago

Here’s what I am confused about. Do lockdown advocates support the intervention irrespective of the collateral damage, or do they argue the collateral damage was insignificant in comparison to lives saved?

Martin M
Martin M
7 months ago
Reply to  Jim Veenbaas

My best guess is that they attach different values to the outcomes. Thus, a person who had a relative die of COVID (whom they felt would have lived with earlier, harder lockdowns) would attach a significantly negative value to that which far outweighs the economic costs associated with the lockdowns. By contrast, a person who lost their business because of lockdowns would see it the other way round.

Andrew Nugee
Andrew Nugee
7 months ago
Reply to  Jim Veenbaas

This might help.
A sister-in-law of mine, quite left-wing but also intelligent, articulate, altruistic and well-meaning, and I were discussing trade-offs around masking / closing schools. Inevitably I asked at some point: how many deaths then is too many. Inevitably her reply: a single one. A single death is too many.
This is the tyranny of solving for a single variable – at the time of course that we thought we could even do this, ie that closing schgools would in fact meaningfully reduce the probability of death in schools.

Carol Forshaw
Carol Forshaw
7 months ago
Reply to  Andrew Nugee

Surely the follow up question to your relative is ask her views on the early deaths and also delayed diagnoses for those who avoided the NHS during the lockdown as instructed by the Government at the time. Do those deaths and those suffering now, not matter because they did not die of covid? Does she think the restrictions were worth it for them?

Lewis Eliot
Lewis Eliot
7 months ago
Reply to  Carol Forshaw

Carol, I’m afraid Andrew would be wasting his time even attempting to engage his sister in law on the point. She doesn’t think; she feels. “No deaths” is just an innate response to that question. It’s pure romanticism – the absolute centrality of the self. To be fair to Andrew’s sister in law, it’s her world now. The application of enlightenment thinking is of no value.

Lewis Eliot
Lewis Eliot
7 months ago
Reply to  Andrew Nugee

Andrew – better than that, as good unherd readers we can do the maths for ourselves. Here goes: we know one QALY is worth ÂŁ30k, because NICE tells us so.
We know the average age of death in the U.K. in 2020 was 81 (world bank dataset).
We know the average age of death in the U.K. from (note: not ‘with’) Covid between mar 2020 and jul 2023 was 83 (ONS dataset).
We know from actuarial tables that the average life expectancy of an 83 year old male is 6.76 years and an 83 year old female is 7.86 years (ONS dataset) – so I’m going to call it 7 years.
If you believe Neil Ferguson and the imperial college estimate of 500,000 deaths in the absence of intervention and accept in round numbers that 250,000 died from Covid, then the government interventions must have saved 1,750,000 years of life (I’ll assume they were good quality years) at a cost of £400,000,000,000.
I work that out at £228,571 per year of life saved, or about 7.6 times what you’d normally consider reasonable.
On the other hand I’m just a history graduate


Andrew F
Andrew F
7 months ago
Reply to  Lewis Eliot

I tried to run similar calculations by STEM educated people during covid and was called all sorts of names.
Fasc**t was the milder one.

Archibald Tennyson
Archibald Tennyson
7 months ago
Reply to  Andrew Nugee

Your friend doesn’t sound particularly intelligent. Sounds like her desire to appear altruistic overrides her ability to make meaningful ethical judgments.

Andrew F
Andrew F
7 months ago
Reply to  Andrew Nugee

Whoever your sister in law is, she is definitely not intelligent.
Based on the story you told us.

Robert Ballard
Robert Ballard
7 months ago
Reply to  Jim Veenbaas

In my experience they get defensive and angry if you question them about it.

Gordon Hughes
Gordon Hughes
7 months ago

As often is the case, the comments reflect very limited knowledge of the studies that David Paton refers to, so let me offer two clarifications.
A. QALYs (or the alternative measures) are complicated and should not be relied upon. Yes, measuring QALYs involves a slew of technical assumptions but the broad methods are not controversial. More importantly, if you dismiss the use of QALYs you would throw away the majority of health policy analysis of the last 50 years without putting anything in its place. Some measure of health trade-offs when money is limited cannot be avoided. Discard QALYs and you have to reinvent them under another name.
B. The cost-benefit studies make unreliable assumptions about the health consequences of lockdowns. That is not the case for the original study by David Miles et al and many other studies. These are straightforward cost-effectiveness studies. At the time, lockdown policies were claimed to save X lives and Y cases of Covid. They involved a huge expenditure of public money. Thus, the issue was whether lockdown policies were a good way of spending money on public health relative to the cut-offs that we apply when assessing new medicines or other health policies. The pretty consistent answer was that lockdown policies were wildly expensive relative to what we have been spending on drugs, surgical procedures, mental health policies, etc over the last two decades. This is nothing to do with the later consequences of lockdown for public health but the reality that lockdowns diverted money from other ways of improving public health.
A final point. We should make a clear distinction. The original lockdown in March 2020 was implemented in a classic confusion of war situation – or more harshly in sheer panic – as a notional circuit breaker. However, the decision to extend it and later decisions to reimpose lockdowns were completely different. There was lots of evidence available to anyone who cared to look showing that lockdowns were very expensive and ineffectual. The Miles et al study was circulated in mid-Summer 2020 and there were other studies pointing in the same direction. One can have an open mind about whether the first lockdown might have been defensible while concluding that policy from mid-2020 onwards was utterly inept.
No matter what the official inquiry may conclude, no independent external observer can be other than extremely critical of the nonsense put out by so-called scientific and medical advisers from May 2020 onwards. Anyone who cannot keep their head and intellectual capacity in the middle of a crisis should be got rid of immediately. I have been there and done that. The performance of the UK’s health and scientific bureaucracy in 2020-21 was about as bad as I have encountered in any place or circumstances.

Andrew F
Andrew F
7 months ago
Reply to  Gordon Hughes

I am not sure that government advisers were incapable of seeing problems with their approach to covid management.
Decisions about lockdowns were taken on political grounds and so called scientific opinion was just window dressing.
You could argue though based both on opinion polls and seeing behaviour of my, now former, friends, that government did what 70% of the public wanted.

Right-Wing Hippie
Right-Wing Hippie
7 months ago

When an event occurs, it is the expectation that the government will do something. The lockdowns were something. Ergo, the government’s actions were justified. What, would you have preferred the government have done nothing? What are you, a fascist?

andrew harman
andrew harman
7 months ago

I think as is often the case, a few of the, shall we say, less perceptive readers have missed the irony in your post.

Jim Veenbaas
Jim Veenbaas
7 months ago

Sad but true.

Gerard A
Gerard A
7 months ago

If we use just a Quantity of Life basis rather than a full Quality one I think we have probably already reached the point where the lives prolonged during lockdown have been outweighted by the subsequent excess non-covid deaths amongst the younger population.
With a rule of thumb that Covid killed the frailest 10%, the vast majority would have had a life expectancy of less than a year, whereas a 40 year old cancer victim will have been deprived of 40 years or more.

Last edited 7 months ago by Gerard A
Lewis Eliot
Lewis Eliot
7 months ago
Reply to  Gerard A

Gerard, that’s why the measure is QALY and not QAL; the Y stands for years. That means we can do the maths and add up all of the years “saved” by the lockdowns and compare it to the £30k NICE guide. It’s more tricky assessing the impact of your non-diagnosed 40 year old cancer victim, but it should be possible.

UnHerd Reader
UnHerd Reader
7 months ago
Reply to  Gerard A

QALYs were very much the rage when I was undertaking my own Nursing education back in the 1980s (as a mature student). Coming from a background in Theology, the trouble I had with them was their tendency to measure quality in terms of longevity; but not in terms of the intrinsic value of ‘being human’ and ‘having human being’.

Dominic A
Dominic A
7 months ago

Fascinating to read this article from 2021, particularly the comments. My general takeaway is that the full-on pro-lockdown arguments have now been proven to be wildly wrong – there was much talk of the need to persue a ‘zero-covid’ outcome (the idea that it’ll become endemic is dismissed as fatalistic), which seems stunningly naive. Moreover, even the lockdown sceptics wildly over-estimated the possible negative outcomes of a light approach (eg 500,000 deaths); the (lost opportunity) costs (100-200 billion); and under-estimated, or rather ignored, the long-term negative side effects.
https://www.theguardian.com/world/2021/feb/14/coronavirus-covid-19-cost-price-life
But let some calm prevail – people were frightened, the future was not clear, almost every country was going down the same path, irrespective of who was in charge. What I do not forgive is the current, and on-going failure to admit that – ‘we were scared and, without a crystal ball, we got in wrong: here’s how’. Instead it’s business as usual – powerful groups covering their own backs, spinning rhetoric and claiming, ‘we’d do it all again’ (panic, and follow whatever China, Italy and Neil Ferguson says).

michael harris
michael harris
7 months ago

This expensive procedure is wrongly named.
It should go by the title ‘Strictly Limited Come Enquiring’.

Edward De Beukelaer
Edward De Beukelaer
7 months ago

The exchanges in the comments on this article seem to divide between those who see the living as as machines (a virus kills and that is it) and those who can appreciate that illness is complex, individual and has so many possible causes that you have to at least attempt to make a complex evaluation in order to approach reality. (APPROACH reality)
One of the major causes of long term poor health is lack of education…..
Seeing things trough the lens of illness is a fabrication of the industry of illness, seeing things though a lens of health and resilience is the pov of those who value health, the complexity of life and quality of life….
It is between those who want to see us function as linear mathematical mechanics (old fashioned physics and chemistry) and those who accept that the living also experience quantum effects, is non-linear, complex and inherently linked to the environment. One is free to choose but you cannot have is both ways…

Dominic A
Dominic A
7 months ago

One of the great lost opportunities was to explain, expose the extent to which covid death & illness is not just a function of the virus (God/nature), and the ‘in-loco-parentis’ (govt, NHS)… but of lack of fitness, old age (comes to us all apparently), obesity, and your own choices. Instead, what we’ve witnessed, now and then, is an orgiastic wail of, ‘they did this to me! how dare they!’.

It now occurs to me that there is something soothing about the ‘God works in mysterious ways’ rationalisation, because the alternative is too often, ‘I know who is to blame, and it happens to be the enemy I’ve always wanted to blame’. Hmm.

Doug Mccaully
Doug Mccaully
7 months ago

Trade offs are important, but to do this we need to be able define and quantify the things being traded off. How do we do this with deaths ‘from poverty and loneliness,’ for example? We can calculate covid deaths, but the rest is highly speculative, particularly, as Sunak rightly said, ‘some consequences of covid will take years to be apparent.’ Then there’s the issue of how competently the lockdowns were implemented. Our UK botched lockdowns saved too few lives and caused greater societal/economic damage than was necessary, but better lockdowns saved more lives and cost less. Then there’s the issue of calculating how much damage was caused by the fact of the pandemic, and how much can be put down to lockdowns. In the UK lockdowns didn’t increase deaths, I notice the author hasn’t mentioned the drop off in deaths caused by other infections due to the fact that we were isolated from all illness, not just covid. ‘QALYs are a standard tool for evaluating the benefits of a health intervention in terms of a single measure,’ states the author, just so, and the further away from analysis of a clear, single intervention, the effects of which are well boundaried, measurable, and comparable, affecting a single person or small homogenous group, the less use QALYs are.

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Doug Mccaully

Exactly!!

Rocky Martiano
Rocky Martiano
7 months ago
Reply to  Doug Mccaully

“better lockdowns saved more lives and cost less”. Better lockdowns? As in China?
“I notice the author hasn’t mentioned the drop off in deaths caused by other infections due to the fact that we were isolated from all illness, not just covid.” Did you actually read the article?  there is now good evidence that lockdowns did not reduce overall excess mortality (i.e. deaths from all causes) and if anything may have increased it”.

Doug Mccaully
Doug Mccaully
7 months ago
Reply to  Rocky Martiano

Better lockdowns as in Taiwan, Singapore, Vietnam, Greece, Norway, Denmark, Senegal, etc. The author doesn’t give his evidence, I can give mine.

Andrew F
Andrew F
7 months ago
Reply to  Doug Mccaully

If you believe official statistics, uk was far from worse country but not the best.
You can not seriously compare isolated country like Norway with uk.
Senegal? What is the average age of the population?
Idiotic comparison.
Reality is that uk is the most obese country in Europe after Malta, with aging and unhealthy population.
Care to study ONS data on covid.
Over 90% of so called victims were obese, diabetics with 2.7 other comorbidities on a way out.
Average age was 83.
I am sorry but wrecking the country to extend life of these people by six months or a year was terrible decision.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Doug Mccaully

So essentially what you’re saying is we can’t measure these things accurately so let’s not bother trying and just trust that if we locked down harder and faster everything would be okay.

Everyone in the world is living with the consequences of lockdowns today – inflation, high interest rates, lower standard of living, increased poverty etc
Even states that locked down harder and faster are suffering economically.

I have stated many times here that 165 million people have been pushed into $2 a day poverty starting in 2020. This is not in dispute. You have never once made a persuasive argument that these were not caused by lockdowns.

Doug Mccaully
Doug Mccaully
7 months ago
Reply to  Jim Veenbaas

We’re also dealing with the consequences of living through a pandemic and what I’m saying is that we can’t evaluate everything, but we can look at the broad evidence, which is that better lockdowns meant fewer deaths and less economic damage. Did you read my last reply to you, my persuasive, evidenced arguments are there.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Doug Mccaully

I did read your last reply, but the conversation was shifting so far from the original argument that I didn’t bother with a counter argument.

And we’re in danger of doing it again here. I agree that better lockdowns saved more lives, but it doesn’t eliminate the collateral damage caused by lockdowns.

If some countries suffer fewer consequences from lockdowns, it’s not because they locked down better, it’s because they have more robust and resilient economy, a better education system, a more culturally cohesive society etc


Lockdowns hurt everyone, but sh!t rolls downhill and people and countries at the bottom of the pile suffer the most.

Doug Mccaully
Doug Mccaully
7 months ago
Reply to  Jim Veenbaas

Shit does indeed roll downhill, but also because of mass sickness and death from the virus, not just from lockdowns. Why won’t you accept this obvious fact and when will you stop talking about lockdowns is if they were all the same, and not part of a larger package of measures needing to be delivered at the right time? If you criticise, at least understand the thing you’re criticising.
Resilient economies help but Senegal, for instance, did very well in the lockdown and no one can say Senegal has a resilient economy. Having a resilient health service helps but the very fact that Senegal doesn’t have one pushed it into a more effective lockdown because it couldn’t afford to get it wrong. Look at the tiny death rates of countries that did it right compared to ours, it makes no sense to claim this was because they were orders on magnitude more culturally cohesive, economically resilient etc. Why don’t you reply to all the hard data I’m giving you?  By saying nothing, you’re hiding from the evidence.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Doug Mccaully

The only hard data either of us have provided is that 165 million people have been pushed into poverty because of lockdowns. You need to show me this would have occurred even without lockdowns, or would hdve been worse. You haven’t done that.

Don’t bother showing me data that this country or that country had lower covid deaths because of better lockdowns. That’s not the argument I’m making – although it should be noted that places like South Dakota had very low deaths even though it never had lockdowns.

I’m not arguing that covid itself didn’t have an impact. I’m arguing that the collateral damage caused by lockdowns was worse than the damage caused by the disease. This should be obvious because the vast majority of people severely impacted by Covid – the elderly and infirm – were not actively involved in the economy.

I’ll try to explain it the way I did with Rasmus. My healthy wife got extremely sick from Covid in February, 2020, a couple months before it was even considered a pandemic. I have never seen her so sick and she missed an entire week of work. Over the next two years she and all the other staff were probably locked out of the office for a total of four months, maybe more. What is a bigger disruption to the economy and society – one person missing one week or the entire office for four months intermittently? You can’t argue that lockdowns saved the lives of her fellow office workers because virtually all of them got sick at one point, despite the lockdowns, and none of them died.

She happens to work with people suffering from physical and developmental disabilities. Her clients suffered incalculable harm from the lockdowns. Those with jobs were basically fired, not just during the lockdown periods, but for the entire two years. They were deprived of social interactions, reduced in-home care, and outings with other clients. They have about 70 clients. I would say five of them have suffered permanent damage from the lockdowns.

PS. Senegal has one of the strongest economies in Africa, but even its growth suffered during and after Covid.

Doug Mccaully
Doug Mccaully
7 months ago
Reply to  Jim Veenbaas

I’ve given stacks of hard data but you’ve chosen to ignore it because ‘that’s not the argument you’re making,’ but it is the argument you’re making, it undermines your arguments so you ignore it. If I need to definitely show you that people were pushed into poverty without lockdowns then you need to show me that all [or most] extra poverty was caused by lockdowns. Neither of us can provide that level of evidence because its impossible to do so, so we’re talking about common sense and the balance of probabilities. You’re completely wrong that the only people hit by covid were the elderly and infirm, vast numbers of people became sick, very many chronically sick and unable to work, and the amount of disruption and fear obviously severely impacted on the economy, how could it not be so. Elderly and infirm people aren’t a hermetically sealed group, so if covid levels are high, they get covid. You know all this but choose to ignore it because ‘its not the argument you’re making.’ I’m sorry to hear about your wife but in a way your story makes my point. People getting that sick [ or in fear of getting that sick] must affect productivity, particularly as the virus is so infectious and in the beginning, so untreatable. You haven’t once acknowledged the near collapse of health and social care services, even though your wife works in this area, and that was the immediate reason for lockdowns. It sounds like your wife works for a lousy organisation, and lockdowns aren’t responsible for that. Here in the UK health and social care carried on through the crisis.
Ps. Senegal’s economy is 18th in the list of African economies, about a third of a way down in a very troubled continent.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Doug Mccaully

I don’t know what to say. You will not be persuaded by reason and logic.

You haven’t provided any data – at all. None. Please give me an example of the data. You have said Korea. Singapore, Taiwan and Senegal had lower covid deaths. I accept this as being true, even if I believe measuring only covid deaths is fraught with pitfalls – such as ignoring excess deaths.

Here is some more data. Britain spent $200 billion during the first year of Covid – just on income replacement programs and business support programs. This massive injection of unproductive tax revenue triggered inflation, which triggered interest rate hikes. And together these have created a cost of living crisis.

Here is an interesting link that explains the damage caused by early lockdowns on supply chains.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046185

Here is a link detailing the impact of late lockdowns on the chip making industry.

https://www.ctvnews.ca/mobile/business/china-s-xi-an-lockdown-hits-some-of-the-world-s-largest-chipmakers-1.5723164

I don’t expect you to read any of this because I think you have staked out your position and have dug in. You are not arguing honestly. Maybe I didn’t explain my wife’s job properly. They work as an outreach agency and community support. They get people jobs in the community. Her agency didn’t fire these people. The outside businesses did.

Last edited 7 months ago by Jim Veenbaas
Doug Mccaully
Doug Mccaully
7 months ago
Reply to  Jim Veenbaas

I assumed that you’ve read my replies to other contributors, but if not, then my mistake. I reprint part of an answer to J Strauss.
 â€˜Here are the figures from Worldometer stats from Feb 23, a reputable site using the same calculation criteria worldwide: Norway, [population 5.5 million] 5732 covid deaths. Denmark [population 5.9 million] 8804 deaths. Sweden [population 10.5 million] 26018 deaths. Japan 74694 deaths [population 123 million] S. Korea 35934 deaths [pop 51.5 million]. I’ll leave you to do the maths and compare. Screwups with decanting sick people into care homes was widespread throughout the world, the UK screwed up bigtime on this. The Nordic countries did better than most other European countries because of the conditions in the Nordic countries, and Sweden did spectacularly worse than her Nordic neighbours.’
All stats concerning such a global [ in every sense] event are fraught with pitfalls, and as I’ve said before, interpretations will harden up as the numbers are crunched, but there is a large degree of unanimity in expert circles that these stats are broadly correct, and that outlying views are just that. What caused excess deaths? Lockdowns? Health and social care services still ran, clogged up hospitals? Clogged up with what? Covid do you think? Some excess deaths decreased because lockdowns suppressed all infectious disease. Beware of pontificating on foreign countries to those who live in those countries. The UK govt spent a lot during covid [the USA spent 14 trillion, I believe] all countries spent a lot because they had no choice, so what percentage of UK spending can be put down to lockdowns lasting less than three months out of two and half years of pandemic, can you tell me? I looked at your links, we already know that lockdowns hit the global economy, but you would have to be wilfully blind not to see that the pandemic itself didn’t hit the economy as well. Can we quantify the extent of the damage caused by each? Eventually we’ll have a clearer idea so we’ll have to wait. What would have happened to the global economy if the industrialised countries just let the virus rip? Nothing, according to your logic. Still nothing on the need to protect health services, the prime reason for lockdowns, and you suggest I’m being dishonest in my arguments.

Rasmus Fogh
Rasmus Fogh
7 months ago

Well, do we have a scientific consensus here – or do we just have the anti-lockdowners finding what they always knew was there (also known as confirmation bias)?

Elaine Gladys-Lieper, do you have any info on this?

Robbie K
Robbie K
7 months ago
Reply to  Rasmus Fogh

Unherd has turned into an echo chamber on this subject. It’s the kind of thing one would find on Reddit forums, quoting and linking spurious reports and the usual sceptic suspects. They really are dredging the swamp.

John Serrano-Davey
John Serrano-Davey
7 months ago
Reply to  Robbie K

KRobbie:
I don’t understand your hostility.
The author is a credible UK Professor no?
The paper he quotes at the end appears to be credible too.

so whilst I accept that those seeking “confirmation bias” will undoubtedly like this article, it doesn’t per se mean that the article is erroneous.

There is absolutely no doubt whatsoever that the cost of lockdowns to ourselves, and future generations was massive.
Surely we need a cost-benefit analysis in order to have any meaningful discussion and learn form events.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Robbie K

This is not actually an argument of course. You’re simply saying people disagree with me so they must be misinformed.

Peter Paton
Peter Paton
7 months ago
Reply to  Rasmus Fogh

Well do we have someone who totally misunderstands that this article is about the effectiveness of policies that have been implemented and little to do with science here – or do we just have a lockdown zealot who is incapable of rational thought?

Kids, the poor and the vulnerable do you have any info on this?

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Peter Paton

We are talking about a study of the overall effect of some quite complex measures. I call that science – social science if you like. As always with social or economic problems the way to certainty is much harder than in epidemiology (let alone physics), and there is a lot of room for different methods getting vastly different results – so that each can choose the ones he prefers. And the pitfalls are pretty obvious. When you look at the effect fo lockdown and COVID policy, what are you really comparing with? A world with no COVID? That will get you the biggest apparent costs, but that is obviously misleading. What would have happened with alternative policies? Well, you do not know that. How many would have died? Would the hospitals have been overwhelmed, leading to cancelled cancer screenings and people dying from other diseases? Would shopping and dining out have crashed anyway, because people were afraid of disease? Would people have reduced social distancing anywyay (so gaining nothing from the extra freedom), or would they have mingled aggressively (thus increasing the number of cases dramatically)? How much of the social effects, like increasing inequality, are due to COVID, and how much are trends that were already operating before the virus came?

I am not going to be reading these articles – not that they are necessarily wrong, but (unlike the medicine) I have not even the slightest background to check for weak points. I’ll wait for someone who can be trusted to be neutral, who has read and compared articles on both sides of the debate, and who can signal if there is some kind of consensus forming.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Rasmus Fogh

So what explains the learning loss to children, the jncreased suicide, domestic abuse and addiction? What explains the inflation, high interest rates and economic conditions today – Covid itself or the unprecedented injection of unproductive money into the economy?

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Jim Veenbaas

Learning loss? Probably closing the schools (though how even that would have been with a let-it-rip policy is hard to know exactly). There were certainly costs to the lockdown, compared to other policies, they are just hard to pin down. As for what explains inflation and high interests (and how they would have been with alternative policies) – well, if I knew that I would be rich and running a hedge fund. Which is why I am waiting for some kind of consensus among the learned.

Last edited 7 months ago by Rasmus Fogh
Rocky Martiano
Rocky Martiano
7 months ago
Reply to  Rasmus Fogh

Your arguments are disingenuous at best. The choice was not between hard lockdown and a ‘let it rip’ policy. Sensible alternatives were proposed by the authors of the Great Barrington Declaration and others. These were not only ignored, but actively suppressed by government censorship.
Inflation is caused when the money supply increases faster than the rate of economic growth. It’s economics 101, you don’t have to be a hedge fund manager to understand basic principles. Are you seriously suggesting that the printing of $4trillion by the Fed and other central banks had no impact on inflation?

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
7 months ago
Reply to  Rocky Martiano

For the Nth time :
The only practical suggestion Gupta came up with at the time the GBD was published was “putting vulnerable people in hotels”
So who are the vulnerable ?
Lets look at some numbers for the UK :
A.    1.49 million people in the UK are in receipt of adult social care (private and NHS and Local authority and direct payment recipients). According to Statista about 490,000 of these are in care homes.
There are 1.52 million social care workers (potential transmitters to this vulnerable population in 2020). This doesn’t include those that are being cared for by immediate family members about 13.6 million informal carers according to this paper :
COVID-19 and UK family carers: policy implications
https://www.sciencedirect.com/science/article/pii/S2215036621002066#!
B.   The population at risk of severe COVID-19 in 2020 (aged ≄70 years, or with an underlying health condition with a fully adjusted hazard ratio (HR) of getting severe covid of 1.13 or greater) comprised 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals.
C.    34% of households in the UK are multigenerational – 9 million homes.
D.    According to the Actuaries Friday report # 51 : Priority Groups 1 to 9 i.e. over 50s, Health & Care Staff, Extremely Clinically Vulnerable and “At Risk” amounts to around 31m people.
E.   There were about 900,000 hotel rooms in the UK in 2020. I don’t know about you but I have never been in a hotel bathroom that has a bath hoist for infirm crinklies.

Prashant Kotak
Prashant Kotak
7 months ago
Reply to  Rasmus Fogh

Confirmation bias cuts both ways, does it not?

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Prashant Kotak

Most likely. In fact lockdowns have become like the inheritability of intelligence, or innate differences between the sexes: The field is so difficult, and the partisanship so intense, that you cannot trust even the reports you would like to agree with.

Last edited 7 months ago by Rasmus Fogh
Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Rasmus Fogh

Explain how covid itself pushed 165 million people into $2 a day poverty starting in 2020? This was a virus that didn’t have a significant impact on working age and healthy people. I say it was caused by more than two years of economic disruption caused govt intervention. What is another plausible explanation?

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Jim Veenbaas

First please explain what would have happened to the economy, poverty, and death rates with a let-it-rip policy. And of course how you know. Then we can start making comparisons.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Rasmus Fogh

I’ll try to explain it this way. My healthy wife got extremely sick from Covid in February, 2020, a couple months before it was even considered a pandemic. I have never seen her so sick and she missed an entire week of work. Over the next two years she was probably locked out of the office for a total of four months, even though she never got sick again. What is a bigger disruption to the economy and society – one week out of the office or four months intermittently?

She happens to work with people suffering from physical and developmental disabilities. Her clients suffered incalculable harm from the lockdowns. Those with jobs were basically fired, not just during the lockdown periods, but for the entire two years. They were deprived of social interactions, reduced in-home care, and outings with other clients. They have about 70 clients. I would say five of them have suffered permanent damage from the lockdowns.

PS. If you oppose lockdowns, it doesn’t imply you support let er rip.

Last edited 7 months ago by Jim Veenbaas
Andy Moore
Andy Moore
7 months ago
Reply to  Rasmus Fogh

Could you explain, how things would have been if we hadn’t locked down, and of course how you know. I’ve posted in response to you previously, that the assumptions used by Fergusson, which put us into lockdown, were based on prior evidence.

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Andy Moore

Either you are being ironical, or there is something wrong with my understanding, or with your grammar. My entire point is that we do not know what might have happened with different policies. Worse, in the debate we often do not know which alternative policies people have in mind. Jimmy Veenbas, for instance, says that “If you oppose lockdowns, it doesn’t imply you support let er rip.” Which is fine, but what does he support? What kind of scenario is he imagining? That we do not make anything mandatory, but people cut down social interactions anyway? That is close to what happened in Sweden, but you get many of the same costs and restaurant closures, they are just not the result of a diktat, but of fear and social pressure. That everybody continue exactly as if COVID had never happened? That could have caused a lot of dead bodies in the hospital morgues (as it did in Italy), until people would likely have stopped behaving normally anyway. How many elective surgeries and cancer screenings would we have had if the hospitals had been full up with COVID patients? Would the health system have broken down without the effort to ‘flatten the curve’? How many people would have had time to get vaccinated before they got the disease? Are we assuming that there is a major effort to shield the millions of particularly vulnerable people in Britain, and if so what would it cost and how would it be made to work? How many economic disruptions would we have got just from the ripple effect of the Chinese lockdowns? How much third-world poverty would we have got anyway just from a collapse in tourism?

Doug Mccaully puts it better than I can. What we need is some humility – from both sides – and a careful effort to determine the costs and benefits of individual measures, and what factors control them. Not a wholesale condemnation of ‘lockdown’, whatever that means. Next time, should we keep the schools open for a disease that mostly spares children? That could well be. Should we lock down fast, early, but only for short periods? Maybe. Does anyone have a realistic plan for protecting millions of vulnerable and old people without interfering with the rest of population? If so, please let us hear it. Should we refuse to spend more than a minimum and let people die? Maybe, but let someone make the argument openly, and say clearly who he thinks ought to die next time. Only let us get out of this debate about ‘we knew all along, lockdown was bad, Fauci is a criminal, admit that we were right and you were wrong‘.

Last edited 7 months ago by Rasmus Fogh
Andy Moore
Andy Moore
7 months ago
Reply to  Rasmus Fogh

I think you’re missing the point. We took a path, which hadn’t been tried before and had zero scientific evidence to support it. The models were based on assumptions, which had zero scientific evidence to support them, in fact they went against what we already knew about coronaviruses. The let it rip, was just a saying used to try and shutdown debate, by people who blindly supported lockdowns.
The approach we should have taken was to protect the vulnerable and let others get on with their lives with limited restrictions.

Andrew F
Andrew F
7 months ago
Reply to  Rasmus Fogh

I have family in Sweden. Sweden did not have lockdowns.
So there is clear example that alternative policy was possible.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
7 months ago
Reply to  Jim Veenbaas

You keep quoting this statistic. Citation please so that those of us on this forum with inquiring minds can do the necessary research to establish its veracity.
As for “no significant impact on working age and healthy people” well, depends on what you mean by “significant”.
Suffice to say that the mean age of people occupying critical care beds in the UK during the first 18 months of the pandemic was around 59 and the median 60. About 11% of these admissions had very severe co-morbidities and yes, about 70% had BMIs > 25 (see the ICNARC Covid 19 reports to remind yourself what was actually going on in hospitals particualrly in January 2021).

Graham Stull
Graham Stull
7 months ago
Reply to  Rasmus Fogh

When you’ve advocated for a failed strategy and been shown to be wrong, this is the strategy you’re left with: Obfuscate, muddy the waters, ‘mud, mud, mud – it’s impossible to know what is right and what is wrong’.
The problem, of course, is that the onus is on your side to show an effect, because you are the ones advocating for an unprecedented intervention and limitation of personal freedoms.
And nothing in the data is consistent with a demonstrable beneficial effect from lockdowns. You will say and do anything to avoid admitting you were wrong.

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Graham Stull

That is a classic argument, actually. When it is impossible to prove the answer to a difficult question, you decree that you are right by default, and challenge your opponent to prove you are wrong, or declare forfeit. The first time I saw it was from a lady who knew for certain that pornography causes rape. Obviously she felt that pornography should be banned, but she was generously willing to allow it, provided the proponents could *prove* (to her satisfaction) that it had no such effect whatsoever.

Rocky Martiano
Rocky Martiano
7 months ago
Reply to  Rasmus Fogh

It’s not impossible at all to prove the answer to the question. Every credible study has shown no discernable effects of lockdowns on the ultimate total of excess deaths. You just have to look at Sweden which has the lowest cumulative excess deaths of any developed nation from 2020 to 2022. But of course you’ll prefer to carry on obfuscating.

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
7 months ago
Reply to  Rocky Martiano

“You just have to look at Sweden which has the lowest cumulative excess deaths of any developed nation from 2020 to 2022.”
Depends what baseline you use for your excess death calculation
+ the SvD data is not adjusted for age or population changes
+ aprox 3% of Swedish deaths during the period in question have no exact known date.
Even with these caveats, Sweden did pretty well but not necessarily top of the Euro league.
Also worth noting that Australia, New Zealand, Taiwan and Iceland also did pretty well, each with their own unique, country specific prescription for how to deal with the unknown.
Objectively why did Sweden do so well ? Well I would put money on the following :
1.People did as they were toldThere is generous sick pay benefits – people coud afford to take time off work
2.Over 50% of households are single person
3.Sweden has the smallest average household size in the OECD (1.99)
4.The largest age group in Sweden is 25 – 34 years cohort
5.A 2017 study by statistics Sweden found that more then 55% of 16 – 24 year olds don’t socialise with any close relatives
6.They were very keen on immunising the >65. The most vulnerable had 5 doses by October 2022

Last edited 7 months ago by Elaine Giedrys-Leeper
Alan Elgey
Alan Elgey
7 months ago
Reply to  Rasmus Fogh

The question is, are they looking at this? From Keith’s response to Sunak it would appear not.
We have always known that the economic costs of lockdown were huge; this was not disputed and was calculated and discussed by ministers, who took it as a badge of honour at the time, and in govt conferences as well I think.
Then we have always suspected that the death rates from Covid responses woud be large and some expert medical commentators did say so, but it is only now that somebody could (and should) be working this out. It would not be at all surprising if, as suggested here, they exceeded those for Covid.
So is this just confirmation bias – I don’t think so. Do we have scientific consensus? Surely this is what the Covid Enquiry should be determining; maybe it will, but the title-tattle in the media seems to suggest it is focusssing on the wrong issues and will not do so. I hope this is incorrect and what we hear reported is just a feature of the media’s usual childish games as they pretend to ‘speak truth to power’.

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Alan Elgey

An offical enquiry is not a good place to thrash out a scientific consensus on a difficult and controversial subject. You can find out what happened, what people did and decided and what they knew when they did so, but that is as far as it goes.

Rocky Martiano
Rocky Martiano
7 months ago
Reply to  Rasmus Fogh

One thing we do know from this enquiry is that there was absolutely no consideration of the potential harms caused by lockdowns.

Andrew F
Andrew F
7 months ago
Reply to  Rasmus Fogh

You are very intelligent person and I usually upvote you on most subject but you seem to have quasi religious believe in success of covid policies.
Why should we as a society limit spending on medical intervention to 30k per year per person as per NICE guidelines, but in case of covid we spent at least 20 times more.
People you call anti-lockdowners are just pro business, pro children education etc.
You ignore all consequences of covid policies as if saving already seriously ill 83 years old people should be main task of government.

Rasmus Fogh
Rasmus Fogh
7 months ago
Reply to  Andrew F

I do not ignore them – and I do believe in balancing costs and benefits. You do need to balance saving lives against other considerations, and we do it all the time. I just object to the cherry-picking and the triumphalist cries of ‘YES! we always knew we were right, it was always obvious, you lot were criminals and fools, now finally admit it!’ that is all through these pages. When people cannot say precisely what better policies they are comparing with, let alone how they know what would have happened then, you cannot even begin to say that ‘lockdown was wrong’ You are not even defining what you mean. It was not obvious then, and it is still not clear. These evaluations are very difficult – except for those who know the answer beforehand and just select the evidence to suit. Do the investigations, measure by measure, accumulate enough evidence to convince some sceptics, and I shall let myself be convinced as well. Of course, people who talk about ‘mRNA treatments’ when the normal word is ‘vaccine’ are unlikely to convince me of anything.

Also, call me soft if you like, but I do have a bias against policies that say people should die to keep the restaurant business running. It will sometimes be the right trade-off, yes. But as a minimum those who propose it should admit openly which people and how many they want to die, and not hide behind obfuscation and statements like ‘pro-business’. If you are not willing to admit to what you do, you should not be doing it in the first place.

Robbie K
Robbie K
7 months ago

The author seems to dismiss QALY’s as credible and plausible yet wrote the article anyway! Meta-analysis. Good Lord – face/palm.

Jim Veenbaas
Jim Veenbaas
7 months ago
Reply to  Robbie K

He didn’t say that at all. He said there are three typical measurement tools and all three reveal the costs exceeded the benefits.

Steve Murray
Steve Murray
7 months ago
Reply to  Jim Veenbaas

Sometimes, it comes down to a matter of basic comprehension, which is where the respondent you reply to consistently fails.

Rocky Martiano
Rocky Martiano
7 months ago
Reply to  Robbie K

Good Lord. Not even basic reading skills.