Just a little longer now…
A few more weeks of lockdown, then we will all be able to go back to our normal lives. We will be able to see our friends and family again, play sports, and shop without worrying about the person who is going the wrong way down the new one-way isles in the grocery store. If we just commit to the lockdown a few more weeks, we can get rid of the masks and feel the sweet air against our faces. Just a little longer!
How long have we been told that?
At what point did we become sheep, aimlessly following the heard without any one of us knowing where we are headed or why?
We need to examine our current position and trajectory and at least have a discussion about whether the costs we are paying are worth it.
The Initial Reasoning for Lockdowns
I understand the reasoning behind the initial lockdown — or at least I believe so — which goes something like this:
- We’re encountering a new virus that we don’t understand well.
- It seems as though it is more dangerous than the “normal” viruses.
- Due to the points above, we are anticipating that the spread of the virus will lead to a shortage of hospital beds for people who need to hospitalized upon contracting the virus.
- We recognize the damage caused by a lockdown, but in order to not overwhelm the hospitals and thus have to turn away people who will depend on medical care, we will initiate a lockdown to flatten the curve (the concept is explained here).
- NOTE: The purpose of the lockdown is not to eradicate COVID, but to curb the demand for hospital beds so as to not exceed the supply.
The above seems like a reasonable approach which, importantly, recognized that lockdowns do not come without costs. In the face of the potentially devastating costs of letting the pandemic run rampant, this is a cost I am willing to pay.
But somewhere along the way we forgot that the lockdowns are not the status quo, they are not the endgame, and they are not free. And I am not talking about the monetary costs, though the lockdowns are certainly not free in that regard either.
What happened to simply flattening the curve? Most hospitals have plenty of free capacity; too much free capacity in fact. I know several people in the healthcare sector who say they are no where near full.
The Cost of Lockdowns
At some point, other factors than COVID-deaths need to be considered when making decisions about our collective path forward. We need to re-examine the cost of the new status quo to determine if it is still worth it.
Here are the few factors I have come up with, but this is hardly and exhaustive list:
- Additional cancer deaths due to delays in diagnosis and treatment.
- Lost years of life, as I would propose this past year should at the very least be discounted.
- Social and psychological costs, particularly for (but not limited to) children.
- Other Consequences.
Additional Cancer Deaths
Even before COVID came into the world, people died (*gasps*). Cancer was and is one of the causes of quite a few of these deaths and though treatment has gotten better over the years, a key to defeating many cancers is early detection.
According to an article in the medical journal The Lancet, it is “estimated that across the four major tumour types, breast, colorectal, lung, and oesophageal, 3291 to 3621 avoidable deaths and an additional 59 204 to 63 229 YLLs will be attributable to delays in cancer diagnosis alone as a result of the COVID-19 lockdown in the UK.” Other estimates put the number of additional cancer deaths as high as 35,000, and this is only in the UK.
Make of it what you may, the upshot is this: COVID lockdowns will certainly cause some non-trivial amount of additional cancer deaths due to delays.
Lost Years of Life
Besides deaths, we can measure the cost of the lockdowns by using the metric of years of life lost (YLL). One benefit of using this metric is that it captures costs incurred by the whole population; whereas deaths are incurred by a small subset. Let’s run through some simple calculations.
The YLL Cost of Lockdowns
Clearly, the past year of lockdowns has not come with all the opportunities for enjoyment, fulfillment, and experiences one expects from a year. Safe to say, then, that we should discount the value of this year due to all the restrictions. Let us be very generous and say the past year was worth 90% of a normal year. In other words, each person lost the equivalent of 10% of the value of a year of life.
We need some frame of reference to understand what this means, so we’ll use the USA (most people are somewhat familiar with the country) with its roughly 330 million inhabitants. Not all citizens will feel the negative effect of the lockdowns — babies, for instance, probably don’t notice much of a difference — so it is not fair to use the full population. Again, let’s be on the safe side and use a low number, such as 200 million.
From here on out, the math is pretty simple:
200 million people * 10% of a year per person = 20 million years of life lost.
Keep in mind, this is just in the US.
The YLL Cost of a COVID Death
As a comparative, we need to look at the years of life lost due to COVID deaths. I’ll use numbers from Alberta, Canada, as they are easily available. Here in Alberta, the average age at death due to COVID is 82; the life expectancy in Alberta is also 82*. As there is no difference between these numbers, one could almost conclude that COVID is not responsible for any years of life lost whatsoever.
This does not seem right, as the very fact that people are of dying from COVID means, by its definition, that it is robbing people of some time on this Earth. Instead of the 0 YLL suggested by age at COVID death being equal to life expectancy, let’s assume that one death results in an average of 4 YLL. Once again, I believe this is a generous estimate.
Comparing the Two
Using the estimates from above, the lockdowns have been responsible for the YLL cost equal to the equivalent of 5 million deaths (20 million YLL / 4 YLL per death). As the US is currently sitting at around 500,000 COVID deaths, this 10x the amount caused by the virus. That is a staggering cost to pay!
Granted, the numbers for COVID deaths would likely be higher if there had been no lockdowns, but that much higher? Keep in mind that all of the estimates used in the calculations were very generous to the other side of this issue (by this, I mean that they all contribute to a smaller cost estimate for the lockdowns). For example, some might say that the value of the past year should be set at 80%, which would double the YLL cost of lockdowns. COVID deaths leading to an average of 4 years of life lost also seems high, as people affected are primarily at an age where death not far away. Yet, even with all of these safety margins and buffers included, the cost paid is disproportionate to what we get out of these measures.
This is a thought experiment — please don’t take it the wrong way — it is simply one way of comparing costs. Lockdowns are not free.
*The life expectancy in Alberta, Canada, as of 2019 was actually 81.6, but I’ve rounded up to 82 for sake of simplicity and to add a cushion to the estimates.
Social and Psychological Costs
In addition to the abovementioned costs, which are more tangible and easy to evaluate, there are social and psychological costs that are far harder to estimate. Nevertheless, the lockdowns have, unquestionably, had a negative impact on mental health. Even in the best of cases, the lack of face-to-face interactions with friends, loved ones, and even coworkers is a very unpleasant experience for most of us (being social animals and all) — particularly for children. There is a reason why solitary confinement is an additional punishment used in prisons.
I don’t think I need to say more on this topic; most will intuitively understand this one.
Of course, there are consequences of the lockdowns too, which I have not covered. What about the lack of physical activity due to gyms and sports being closed, for instance? There’s the potential for increased rates of cardiovascular disease and other ailments resulting from this.
What about all the small businesses (and larger businesses too) that have been forced to shut down? Will there be long-term consequences, such as decreased entrepreneurial activity, or will we bounce right back?
The list of potential negative consequences goes on as far as your imagination will take it.
As is so often the case, there are no black and white answers — I don’t know, definitely, what I would do if I were in charge.
We need to consider more than one factor, though. Imagine judging the value of modern, high-speed vehicles only by the number of fatal accidents. Caring only about the deaths, the clear choice would be to remove all high-speed vehicles from the world. But what about all the benefits of being able to travel and transport goods rapidly? We all understand that the one factor is not enough to gauge the true value in this case, so why not for COVID measures too?
Human beings are intelligent, but it is impossible for one person to think of all the factors that should be considered to get a clear picture. Thus, we need to be able to have discussions with people — particularly those who hold opinions differing from our own — in order to be more well informed and make the best decisions. Generally, we make better decisions as a well-informed group.
This is what I believe, at least. Disagreement is welcome though, so if you disagree with anything I have said, please let me know.
Thank you for reading and have a wonderful rest of your day!