Are pandemic lockdowns causing more harm than good?

YES

Unnecessary suffering, but same mortality rates

Every medical treatment plan comes with potential side effects and every physician needs to consider whether the treatments they propose could cause more harm than good.

When it comes to the COVID-19 pandemic, the benefits of lockdowns to prevent deaths are far from proven. The very best paper evaluating whether lockdowns save lives was performed by researchers at the University of Toronto, Drs. Chaudry and Riazi, and published by the Lancet. They took data from 50 countries reporting COVID-19 mortality and performed statistical analyses to see whether those that enacted strict lockdowns had fewer COVID-19 deaths. They did not.

A similar analysis, by a Dr. Leffler and colleagues, used data from 200 countries and was published in the American Journal of Tropical Medicine and Hygiene. It likewise found no effect of lockdowns on COVID-19 mortality.

These papers can be criticized, and perhaps better data will one day supersede them.

But for now, the cold, hard fact is that lockdowns do not seem to achieve what one might hope.

This might seem counterintuitive. Surely, if we all stay home, we cannot transmit the virus to each other, and if the virus doesn’t transmit, it cannot kill, right? Well, no, it’s more complicated than that.

For one thing, we will never have a perfect lockdown in which absolutely everyone stays home for all the time. More importantly, COVID-19 is not an equal opportunity killer. While the overall mortality is low (a recent World Health Organization bulletin estimated a less than 0.3 per cent mortality rate), it is up to 1,000 times more likely to kill someone over 70 than someone under 30.

Therefore, the total number of deaths in a COVID-19 pandemic will not depend so much on how many cases there are, but rather in whom those cases occur.

It’s easy to imagine situations in which a general lockdown could inadvertently expose vulnerable people to COVID-19: if universities shut down and students are sent home to their older parents, if working people can no longer afford their rent and enter multi-family living arrangements, if daycares are closed so health-care workers have to involve grandparents for child care, etc.

This is why I favour a focused protection plan in which we pour resources into protecting society’s most vulnerable, rather than subsidizing less vulnerable people to make unnecessary sacrifices.

And such resources we had to pour! The federal government has gone $350 billion in debt this year to pursue misguided lockdowns.

For reference, $350 billion, adjusted for inflation, is more than we spent fighting the Second World War over six years.

That $350 billion could have built two new hospitals in every city and town in Canada! If we purport to care about our elders, we must stop and imagine what $350 billion could have done to ameliorate the chronic understaffing and sometimes squalid physical conditions of our long-term-care homes.

How many lives could that strategy have saved? We need to ask such questions before we shoot ourselves in the other foot with a second lockdown.

So much for the supposed benefits, what about the harms?

Evidence thereof is mounting. Three times as many Canadians were contemplating suicide this summer compared to last. In British Columbia, overdose deaths nearly tripled. I do not expect such trends to improve during a cold, dark winter of lockdowns with no Christmas.

The Globe and Mail reported a spike in violence against women back in May and a slew of missed cancer diagnoses up to October. In my own medical practice, I met only seven patients with COVID-19 over nine months, but I was admitting folks to hospital with lockdownrelated illness almost every day.

One woman in her 80s, living in a retirement home, relied on family members to come feed her meals. When they were disallowed from the premises, she stopped eating.

She was eventually sent to hospital for symptoms of confusion and weakness where she was found to have biochemical evidence of starvation. In Canada. In 2020. The sheer inhumanity of that scene will stick with me for a long time. I could describe many others.

Underlying each of those statistics, and all of the clinical vignettes I could share, is an ocean of individual suffering and family grieving that is not captured in the rising COVID-19 case counts featured in daily media reports.

COVID-19 is a devil of a problem, but we must be mindful not to employ unproven strategies with the potential of making the problem worse. I am very hopeful that by focusing our attention and effort where it matters most, we could see our way through this in better shape overall.