Abstract
The SARS-CoV-2 pandemic has caused tragic morbidity and mortality. In attempt to reduce this morbidity and mortality, most countries implemented population-wide lockdowns. Here we show that the lockdowns were based on several flawed assumptions, including “no one is protected until everyone is protected,” “lockdowns are highly effective to reduce transmission,” “lockdowns have a favorable cost-benefit balance,” and “lockdowns are the only effective option.” Focusing on the latter, we discuss that Emergency Management principles provide a better way forward to manage the public emergency of the pandemic. Specifically, there are three priorities including the following: first, protect those most at risk by separating them from the threat (mitigation); second, ensure critical infrastructure is ready for people who get sick (preparation and response); and third, shift the response from fear to confidence (recovery). We argue that, based on Emergency Management principles, the age-dependent risk from SARS-CoV-2, the minimal (at best) efficacy of lockdowns, and the terrible cost-benefit trade-offs of lockdowns, we need to reset the pandemic response. We can manage risk and save more lives from both COVID-19 and lockdowns, thus achieving far better outcomes in both the short- and long-term.
Highlights
The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that causes Coronavirus Disease 2019 (COVID-19) was declared a pandemic in March 2020
We argue that a better response to the pandemic must occur, one that saves more lives, causes fewer harms, and restores trust
We find a positive association between SIP policies and excess deaths... countries that implemented SIP policies experienced a decline in excess mortality prior to implementation compared to countries that did not implement SIP policies [the pre-existing trend reversed following implementation of SIP policies]... do not observe differences in excess death trends before and after the implementation of SIP policies based on pre-SIP COVID-19 death rates [the trajectory of the pandemic when policies were implemented]...”
Summary
The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that causes Coronavirus Disease 2019 (COVID-19) was declared a pandemic in March 2020. Governments have made (often suboptimal) decisions to manage the pandemic crisis, often focusing only on the many cases and deaths worldwide caused by COVID-19. Attempting to “flatten the curve” of cases and deaths, governments have implemented unprecedented restrictions on Charter rights and freedoms, the lockdowns and “circuit-breakers” (time-limited lockdowns that were not timelimited). By lockdown we mean any combination of non-pharmaceutical interventions (NPIs) that imposed mandated social distancing measures and/or restrictions on mobility (e.g., school closures, restaurants and large shopping centers closure, workplace closures, limits on gathering sizes, closure of public transport, stay-at-home orders, and even curfews). Many studies we will refer to used a stringency index to indicate the severity of these lockdown measures; as stringency becomes more severe, the collateral damage may become worse.
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