LOCKDOWNS' HIGH COSTS.

I was not a big fan of Doug Ford. And I'm not so sure he's doing the right thing about the pandemic. But one very good thing about him is that, unlike the smooth intoner of prepared statements from the steps of Rideau Cottage, he seems genuinely anguished by some of the things he feels forced to do. Having been involved in a family business, he obviously understands how wrenching it must be to have the government tell you to suspend operations or sell only from the sidewalk or online. The guy seems in real pain up there with his impeccably tailored support group lined up in a “V” behind him, like a flight of Canada geese. Bill Clinton was always supposed to feel people's pain. I'm not sure he did. (We might ask Hillary.) Doug Ford sure seems to.

Which is good. Because pain there is. And deciders need to be aware of it. It's a depressing subject for the middle of January, as Seasonal Affective Disorder (SAD) peaks in many parts of the country, but two new U.S. studies suggest the mortality cost of COVID-19 unemployment could be in the millions.

One is by Casey Mulligan of the University of Chicago. He's interested in “deaths of despair.” Nobel Prize winner Angus Deaton and his fellow Princeton economist and spouse, Anne Case, inaugurated this field of study with their 2015 paper on rising morbidity and mortality among middle-aged and older white males in the U.S.

The worsening fate of this demographic, whose members featured so prominently in the invasion of the U.S. Capitol, is widely seen as an indictment of capitalism. Case and Deaton's latest book is called Deaths of Despair and the Future of Capitalism. Mulligan argues, by contrast, that what seems to be a surge in unexplained deaths in 2020 may be at least partly from locking down capitalism.

Fine-grained U.S. death data (yech!) are published only at a lag so Mulligan has to infer what he can from broader-gauge data. What he finds are more U.S. deaths in 2020 than in earlier years even after accounting for both COVID itself and possible under-counting of COVID deaths. Moreover, the extra deaths were “disproportionately experienced by working aged men” — in other words, exactly the folk who have been dying deaths of despair. Detailed data already available from San Francisco and Chicago report, respectively, 59 per cent and 53 per cent increases in overdose deaths in 2020 compared with 2019.

“Presumably,” Mulligan concludes, “social isolation is part of the mechanism that turns a pandemic into a wave of deaths of despair.” He is all economist, however, when it comes to thinking about how exactly the mechanism works. Is it that fewer people are around to see an overdose take place and call for help? Is it that doctors are more or less likely to provide prescriptions to people they see only remotely? Is it that government emergency payments gave the majority of 2020's unemployed “more income than they (received) when they were working,” some of which they then spent on opioids? All that will be studied when the complete data are finally in.

In the meantime, another new study looks at past effects of unemployment shocks on life expectancy and mortality rates and then forecasts from them. It's by three researchers at Duke, Harvard Medical School and Johns Hopkins (Francesco and Giada Bianchi and Dongho Song, respectively). The COVID unemployment shock isn't all due to lockdowns — many of us wouldn't be travelling through the air in sealed aluminum tubes, for instance, even if the government hadn't advised against it — but it is big, from two to five times greater than the average unemployment shock.

Unlike Mulligan, however, they don't find a big short-term hit in terms of extra deaths as a result of unemployment. In fact, in one of their correlation exercises, deaths initially fall and life expectancy rises as unemployment rises. Their explanation is that with fewer people heading off to work each day “deaths due to motor vehicle or work-related accidents diminish.”

But there are marked long-term effects. “For the overall population, the increase in the death rate following the COVID-19 pandemic implies a staggering … 1.37 million excess deaths over the next … 20 years.” And the toll on women and African-Americans is higher than for the population as a whole. In sum: “the recession caused by the pandemic can jeopardize population health for the next two decades.”

The researchers stress that these effects are not all down to lockdowns. “Without any doubt, lockdowns save lives, but they also contribute to the decline in real activity that can have severe consequences on health.” They suggest accompanying lockdowns with more policies that could help people's health. (My town has responded to Quebec's new curfew by putting more skating rinks in parks, on the theory, I suppose, that a good skate in the afternoon makes it easier to go to bed at 8 p.m.)

But lockdowns are certainly part of why the recession has been so bad and the jump in future excess deaths may be so high. Doug Ford's constantly furrowed brow suggests he understands that perfectly.

PART OF WHY THE RECESSION HAS BEEN SO BAD AND THE JUMP IN FUTURE

EXCESS DEATHS MAY BE SO HIGH.