How many of our current problems are due to COVID-19 policy vs. the virus itself vs. unrelated

In his March 17, 2020 stat op-ed John Ioannidis warned that:

“… we don’t know how long social distancing measures and lockdowns can be maintained without major consequences to the economy, society, and mental health. Unpredictable evolutions may ensue, including financial crisis, unrest, civil strife, war, and a meltdown of the social fabric….”

Sadly, we have seen several of these materialize: war, civil unrest, inflation and supply chain disruptions. Of course, some of this was due to the virus, but much of it was due to our particular policy response. And perhaps some was unrelated entirely. How can we separate these possibilities?

As a first pass. Consider a thought experiment. Imagine how many of these would have occurred if the imperial college model was taken with a grain of salt— these modellers are often wrong, a wise person might have noted. What if someone was at the table like D.A. Henderson who would have opposed lockdowns or other draconian measures. Imagine that instead of Fauci telling the American people to “hunker down,” we had the following speech:

“The situation is uncertain, and I worry the times ahead will be tough. Right now, all signs suggest that kids are not the major target of this virus. We will try to maintain as normal a life for them as possible. School will not stop. If we stop school, we risk doing more harm than good.

We will perform daily random seroprevalance/ blind testing in many cities and report those results publicly (alongside numerous other indicators), and we will test many NPIs in a series of cluster RCTs that we call the RATIONAL trials portfolio. I know some people think cloth masks might help, but the pre-existing evidence base is weak and we need to run a trial to see if that has changed.

We won’t close businesses without making some attempt to understand if that is helping. All of our measures will be time restricted, and if we cannot demonstate benefit by 6 wks, they will halt.

We will of course also pursue Operation Warp Speed….”

And you can imagine the rest. A light touch response unless evidence suggests otherwise. Something closer to Sweden, but with a bit more evidence generation.

As you imagine it, consider that other nations would have followed our lead. They closed schools in part because we did. They lockdown in part because America— the land of freedom—felt it necessary.

Then run through John’s list in your mind:

• financial crisis,

• unrest

• civil strife

• war

• a meltdown of the social fabric

I think supply chain disruptions, and capital injection into the markets would have been different. Inflation might still occur, but not like this. Civil unrest, mental health. You can imagine yourself. The virus will still take its unfortunate toll, but would deaths be higher? For a number of reasons, I will detail in a future post, there is a good chance it would be rather comparable. COVID-19 would not have been so polarizing as it would have disrupted our lives less.

Ultimately, careful research will try to untangle these possibilities, but the first step to generate a research model is to make sure you think through the full counterfactual (including spill over effects to other nations).

It should not be forgotten however that our response was extreme and driven by a handful of influential people.