There are quite a few risk increases associated with general shutdown. This is one with large impact. Another large impact is mental illness, in particular presenting in suicide and substance abuse. On the other side, many other common risks are reduced: workplace injury, other transmissible ailments.
If the purpose of the analysis is to determine whether the preventive measure is effective and not overwrought, an excess deaths analysis is a good one because it helps infer what the toll would be in absence of the measure.
If the purpose is to attribute cause of death, it’s just a heuristic. But a useful one when other methodologies are (rightly or wrongly) suspect.
If the purpose of the analysis is to determine whether the preventive measure is effective and not overwrought, an excess deaths analysis is a good one because it helps infer what the toll would be in absence of the measure.
How do you know what the toll would be in the absence of the measure? Excess deaths tells us how many deaths are from virus+shutdown. I don't see how we can use this data to find out how many deaths there would be in a virus (no shutdown) scenario, or in a shutdown (no virus) scenario.
There are quite a few risk increases associated with general shutdown. [...] Another large impact is mental illness
Although there clearly is a harmful impact on mental health caused by "general shutdown", it's not clear that it's a net negative. Compared to the potential alternative (higher mortality, overwhelmed health systems, and anxiety about insufficient measures being taken) it may be a net positive.
Yes, but we're not limiting people's freedoms to avoid a negative mental health impact. That's a separate observation.
We have these restrictions to avoid collapse of our health systems. The hospitalisation rate of an uncontrolled spread of the virus far exceeds any country's healthcare capacity. The maths is inescapable.
Are you arguing that Sweden is allowing an uncontrolled spread of the virus? They've had strong voluntary measures in place all year.
In the past month they've also imposed several enforced measures to restrict the spread of the virus, including a limit on gatherings to 8 people, a bar curfew, and they've just closed secondary schools for at least a month.
"Don’t go to gyms, don’t go to libraries, don’t host dinners. Cancel." - Swedish Prime Minister Stefan Lofven.
Despite these measures they are seeing rising hospitalisations. Further measures look inevitable.
I love how the No True Swedish Man, when the numbers are going down, is following the voluntary measures to the dot but when the numbers are going up retroactively is not.
By the way despite all the drama hospitalizations are still not at the level they were beginning of the year. But I’m sure that’s because they are following the rules again?
Another large impact is mental illness, in particular presenting in suicide
At least one study didn't find an uptick in suicides as a result of the lockdowns. Situation may differ in America because it's run by idiots that cut off state income support and didn't commit to locking down till the situation was under control.
"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides.
Women make up a larger percentage of part-time workers in the hotel, food service and retail industries -- where layoffs have been deep.
In a global study of more than 10,000 people, conducted by non-profit international aid organization CARE, 27% of women reported increased challenges with mental health during the pandemic, compared to 10% of men.
Compounding those worries about income, women have been dealing with skyrocketing unpaid care burdens, according to the study.
This is not an article in an academic journal and we don't know how scientifically valid the CARE survey was - which btw wasn't specifically about Japan. It would almost certainly cover countries that were unable to effectively subsidise their shutdowns. Having said that, it does intuitively make sense that the economic down turn would place additional stress on those most affected by it.
The lockdown, however, was not the source of the economic down turn, but rather the virus roaming about killing people was the cause. An effective lockdown, supported by government subsidies and contact tracing, has been proven to be beneficial to the economy. After the shutdown, consumers can roam about in the comfort of knowing that they have almost zero chance of contracting the virus. Australia and New Zealand are now so confident in their success that they can fill entire stadiums with people as though a vaccine had already arrived.
Still though, as noted by the paper, there hasn't been a shutdown in Japan:
Without introducing lockdown measures or strict domestic movement restrictions during the state of emergency, authorities requested non-essential businesses to close or opt to work remotely. Stores and restaurants were asked to operate for reduced hours. The state of emergency was lifted on May 25, 2020.
Yes economic down turns can increase the suicide rate shock, but shutdowns are obviously not a factor for Japan as they haven't imposed nearly as onerous containment measures as other countries. The main reason for Japan's current plight is that its economy is heavily susceptible to external economic shocks such as decreased global consumption due to an ongoing pandemic.
For white collar workforce, it just becomes at-home injury, whatever it is. Transmission generally might not be so greatly reduced either - there are jobs which have to go to work (like my wife who is a doctor) so whole household is exposed, there are schools/kindergardens still open in many countries (so our baby can easily bring covid from it while I haven't been sitting in the office since mid march).
Using face masks and washing hands might be helping more with spread, something that was ridiculous and laughed at in western culture still 1 year ago. I was a fan of it even for regular flu as done in south east asia for a long time, but no way you could have done it here.
I'm not sure there are -net- additional risks with shutdown though. Fewer miles driven means fewer road deaths. More isolation and precautions also lead to fewer non covid deaths like flu and other more serious communicable illnesses, etc.
Comments
There are quite a few risk increases associated with general shutdown. This is one with large impact. Another large impact is mental illness, in particular presenting in suicide and substance abuse. On the other side, many other common risks are reduced: workplace injury, other transmissible ailments.
If the purpose of the analysis is to determine whether the preventive measure is effective and not overwrought, an excess deaths analysis is a good one because it helps infer what the toll would be in absence of the measure.
If the purpose is to attribute cause of death, it’s just a heuristic. But a useful one when other methodologies are (rightly or wrongly) suspect.
How do you know what the toll would be in the absence of the measure? Excess deaths tells us how many deaths are from virus+shutdown. I don't see how we can use this data to find out how many deaths there would be in a virus (no shutdown) scenario, or in a shutdown (no virus) scenario.
Although there clearly is a harmful impact on mental health caused by "general shutdown", it's not clear that it's a net negative. Compared to the potential alternative (higher mortality, overwhelmed health systems, and anxiety about insufficient measures being taken) it may be a net positive.
Don’t you think the evidence for this level of infringing on peoples basic rights should be less flimsy than ‘may be a net positive’?
Yes, but we're not limiting people's freedoms to avoid a negative mental health impact. That's a separate observation.
We have these restrictions to avoid collapse of our health systems. The hospitalisation rate of an uncontrolled spread of the virus far exceeds any country's healthcare capacity. The maths is inescapable.
Clearly the example of Sweden shows that that isn’t true.
Are you arguing that Sweden is allowing an uncontrolled spread of the virus? They've had strong voluntary measures in place all year.
In the past month they've also imposed several enforced measures to restrict the spread of the virus, including a limit on gatherings to 8 people, a bar curfew, and they've just closed secondary schools for at least a month.
"Don’t go to gyms, don’t go to libraries, don’t host dinners. Cancel." - Swedish Prime Minister Stefan Lofven.
Despite these measures they are seeing rising hospitalisations. Further measures look inevitable.
Or if not, what are you arguing?
I love how the No True Swedish Man, when the numbers are going down, is following the voluntary measures to the dot but when the numbers are going up retroactively is not.
By the way despite all the drama hospitalizations are still not at the level they were beginning of the year. But I’m sure that’s because they are following the rules again?
At least one study didn't find an uptick in suicides as a result of the lockdowns. Situation may differ in America because it's run by idiots that cut off state income support and didn't commit to locking down till the situation was under control.
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
As a counterpoint, Japan seems to be undergoing a startling rise in suicide rates.
https://edition.cnn.com/2020/11/28/asia/japan-suicide-women-...
Interesting quote from your article:
"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides.
A bit further down:
Doesn't exactly sound "very minimal" for women.
This is not an article in an academic journal and we don't know how scientifically valid the CARE survey was - which btw wasn't specifically about Japan. It would almost certainly cover countries that were unable to effectively subsidise their shutdowns. Having said that, it does intuitively make sense that the economic down turn would place additional stress on those most affected by it.
The lockdown, however, was not the source of the economic down turn, but rather the virus roaming about killing people was the cause. An effective lockdown, supported by government subsidies and contact tracing, has been proven to be beneficial to the economy. After the shutdown, consumers can roam about in the comfort of knowing that they have almost zero chance of contracting the virus. Australia and New Zealand are now so confident in their success that they can fill entire stadiums with people as though a vaccine had already arrived.
That's not a great source.
https://www.medrxiv.org/content/10.1101/2020.10.06.20207530v...
Still though, as noted by the paper, there hasn't been a shutdown in Japan:
Yes economic down turns can increase the suicide rate shock, but shutdowns are obviously not a factor for Japan as they haven't imposed nearly as onerous containment measures as other countries. The main reason for Japan's current plight is that its economy is heavily susceptible to external economic shocks such as decreased global consumption due to an ongoing pandemic.
https://www.businesstoday.in/current/world/covid-19-effect-j...
Japan and China always had problems with suicide, because of culture.
That doesn't explain the rise in the graph this year, does it?
For white collar workforce, it just becomes at-home injury, whatever it is. Transmission generally might not be so greatly reduced either - there are jobs which have to go to work (like my wife who is a doctor) so whole household is exposed, there are schools/kindergardens still open in many countries (so our baby can easily bring covid from it while I haven't been sitting in the office since mid march).
Using face masks and washing hands might be helping more with spread, something that was ridiculous and laughed at in western culture still 1 year ago. I was a fan of it even for regular flu as done in south east asia for a long time, but no way you could have done it here.
I'm not sure there are -net- additional risks with shutdown though. Fewer miles driven means fewer road deaths. More isolation and precautions also lead to fewer non covid deaths like flu and other more serious communicable illnesses, etc.