Cassandra has moved. Ugo Bardi publishes now on a new site called "The Seneca Effect."

Monday, April 20, 2020

How effective is a hard lockdown against the COVID epidemics? The data say not so much



Data about the mortality of the coronavirus epidemic start being available. Above, a list of mortality rates for Western European countries (including the US) taken from the Institute for Health Metrics and Evaluation (IHME) of the University of Washington. The data are ordered by the projected number of deaths per million inhabitants. In addition, I built a "lockdown score," also based on the data reported by IHME (except for the US, where different states chose different options). It would be difficult to say that these data support the idea that a "hard" lockdown that includes a stay home order is more effective than a looser kind of lockdown. (for a live version of the table, write to me at ugo.bardi(whirlette)unifi.it)



Your friend has a headache. She takes a pill and, after a while, she feels much better. And she is sure that it was because of the pill. Maybe, but how does she know that the headache didn't go away by itself? Was the pill a homeopathic medicine? In this case, you could tell her that she ingested pure sugar, unlikely to cure anything. But, if you ever tried something like that, you know that it is nearly impossible to un-convince someone who believes to have been healed by the miraculous powers of homeopathy or the like. It is a typical problem of medical studies: how do you know that a treatment is effective? That's why there exist precise rules defining how you can test a new drug or treatment.

Now, let's go to the coronavirus epidemic: practically every region in the world has been affected and practically every government has implemented some kind of rules to stop the epidemic from diffusing, from voluntary social distancing (Sweden) to stay home orders enforced by the police. Almost everywhere, most people are convinced that the lockdown has been effective in reducing the spread of the epidemics. Maybe, but how can we say? Not having a "blank experiment" to compare with, it might be argued that all these new rules are the equivalent of homeopathic pills: a little sugar and nothing else.

Right now, the data are still uncertain, but they are accumulating and I think we can at least try some sort of preliminary analysis by comparing the results of countries where the lockdown rules have been implemented in different ways. An especially interesting way to do that is to look at the data from the Institute for Health Metrics and Evaluation (IHME) of the University of Washington. These data are good for this purpose because:

1. The IHME provides a large dataset for several relatively homogeneous countries in Europe in addition to the US.

2. The data include projections for the total mortality at the end of the epidemic cycle and so we can compare countries where the epidemic started at different moments

3. The data also include a list of the rules implemented by each government, whether they include "stay home" orders which we may see as defining a "hard" lockdown, or just invites to citizens to maintain a certain distance from each other. (but note that a "hard" lockdown in Western countries is much softer than the versioni implemented in China and other Asian countries)

Here is an example of the IHME projections. In the case of Italy, you see how the epidemic follows its typical curve and it is going down after the acute phase is over.

Note that I focused on the records on mortality because they seem to be the most reliable ones, unlike those on infected people that depend on the number of tests. About Italy, I checked with independent data on the excess mortality from all causes from the Euromomo site. It seems that the mortality rates coincide, these data are reasonably good.

The results I found for several countries are shown in the table at the beginning of this post (not the complete data set, only Western Europe). You can peruse the table yourself (for a "live" version, write to me) and come to your own conclusion. In practice, the mortality rates range from a maximum of about 700/million to a minimum of 10-20. I cannot find a clear relationship between the mortality rate and the harshness of the rules imposed by local governments.

My impression is that the kind of "hard" lockdown imposed in countries such as Italy or Spain didn't help so much, perhaps not at all. For instance, Germany and Austria do well in the list without the need for a stay home order. But, of course, you might also focus on Sweden's relatively poor performance to argue that very loose rules are not a good idea. However, in this case, you might also note that Norway, a country similar to Sweden, is doing much better also with a relatively soft lockdown. Then you might consider other factors, for instance, population density. A colleague of mine (Claudio Della Volpe) examined the data for this factor and he found that there may be a weak dependence but, at present, it cannot be said for sure.

So, my conclusion is that the hard lockdown is unjustified and probably useless, but let me repeat: these are PRELIMINARY data and this is a TENTATIVE analysis, justified only on the urgency we have to manage the epidemic the best we can. Consider that the lockdown is causing a lot of suffering for a lot of people and risks leading us to complete collapse. We should try to do what we can to understand if it is effective. Let me also note that I am NOT DENYING that the COVID-19 virus is killing people, and I AM NOT SAYING that nothing should be done to stop the spreading the epidemics. (and I am not saying that the virus is an engineered bioweapon, or that it is an evil plot to enslave all of us, gosh!). I just placed on line the data I found for the benefit of the readers of Cassandra's Legacy who may interpret them the way they like. When we'll have better data, we'll be able to arrive at more solid conclusions.

As a final note, the story of the coronavirus epidemics shows how we humans tend to politicize/polarize everything. Not that the virus itself, poor critter, is left- or right-leaning, but by now the Right and the Left have taken sides. The right in the US is against a hard lockdown, while the left favors it. At this point, speaking against the lockdown turns you automatically into a Trumpist and a supporter of the NRA, if not of the Ku-Klux-Clan (and of Bolsonaro, too!).

As an example, yesterday I posted on Facebook a link to a study by Yitzhak Ben Israel, (*) of Tel Aviv University that seems to support the idea that most lockdown rules are not very effective against the virus (and note that I didn't even say I thought the paper was correct -- I can't read Hebrew!). But, as I should have expected  I was defamed and abused just for having linked that obvious piece of Israeli propaganda, surely a hoax thought to support the bad orange man and his ilk (surprisingly, my readers on Facebook seem to be familiar enough with Hebrew to be able to easily detect the mistakes in a scientific paper written in that language).

So, why is the stay-home ruling "Left" while no stay home is "Right"? Beats me. For those of you who can understand Italian, I leave you with a scene from a movie by Francesco Nuti, where he examines various kinds of cold meats concluding, among other things, that mortadella (bologna) is communist, while prosciutto cotto (cooked ham) is fascist.







(*) Dr. Ben Israel was so kind to send me a version of his paper in English. If you would like to have it, write to me






Who

Ugo Bardi is a member of the Club of Rome, faculty member of the University of Florence, and the author of "Extracted" (Chelsea Green 2014), "The Seneca Effect" (Springer 2017), and Before the Collapse (Springer 2019)