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10. The benefits and the unknown cost of lockdown

Earlier this week I wrote about the difficulty of truth in a world where trust in all institutions is collapsing. In this environment it’s easier for malign forces to stir the pot.

Many of us learned at school that “nature abhors a vacuum” — even if we might not have understood that statement fully at the time. That goes all the way back to Aristotle, who theorized that in physics, any vacuum will be consumed by the denser material that surrounds it.

The term has long been debated in physics, and has moved outside of science into all other areas, including social ideas. And so, for example, if we fear a vacuum of leadership in the world, the one certainty is not that there will be no leadership, but that there will be different leadership, perhaps of a kind that we might not like.

Put another way, when there’s a gap, something always fills the gap. If there is a void of trust in the world, something will step in to fill that void, and that something may not be pretty. As Nassim Nicholas Taleb wrote in the book Skin in the Game, “we are vastly better off complaining about lawyers than complaining about not having them”.

The lockdown reality many of us have been living with for much of the past year has shown signs of fanning the flames of the sort of extremism that might easily step in to fill the gap left by possibly well-meaning but ultimately weak or bumbling political leaders. As humans, there’s something almost inexplicable in our psychology that we seem to prefer strong leadership and less freedom than weak leadership and more freedom.

We are, then, at some level afraid of our own freedom. We are afraid of what freedom allows or compels us to do. Better the devil of some sort of entrapment — a mortgage, a corporate career, a loveless marriage — than the devil of freedom to do whatever it is we might really want.

For this reason, perhaps, lockdown has been welcomed by the majority of people ever since the first lockdowns were introduced in open democratic countries around the world in February and March 2020.

What purpose do lockdowns serve? How are we to judge their success?

Let’s say that the success of a lockdown is judged by keeping people alive. Well, then, how are we to judge whether that’s working? One way is to find reliable data and interpret, as best we can, what they’re telling us.

One such dataset is presented by the European Mortality Monitoring Project (EuroMOMO), a project run out of the Denmark-based Statens Serum Institut (SSI) and with participation from public health bodies in 24 European countries as well as the European Centre for Disease Control and the World Health Organisation.

EuroMOMO collects basic mortality information from its members. Not cause of death, which can be convoluted or problematic. Did Person A die from the cancer that had been ravaging her body for five years, or from the pneumonia which overtook her in hospital? Did Person B die from suicide, or from a reaction to a cocktail of prescribed medicines, or from complications from longstanding schizophrenia?

EuroMOMO counts none of that. It just counts mortality. Numbers of deaths. And over time, these cold, clinical numbers in spreadsheets and graphs can give us a clear sense of excess deaths, when more people than normal are dying.

And judged on the graphs and charts presented by EuroMOMO, it’s not hard to see that on the question of “Do lockdowns prevent deaths?”, the answer is clearly “Yes”.

This 24-second animation shows a map of Europe coloured by its excess death figures — ranging from no excess to extraordinarily high excess — since the beginning of 2019. Watch for the deep blue bruises across the continent first in March and April 2020, and then winter of 2020/21, indicating periods of high or extraordinarily high excess death rates.

 

For the question, do lockdowns prevent deaths, the answer seems to be, “Yes”. Lockdowns work by keeping people from moving around, and therefore limiting the spread of the virus, and therefore keeping deaths down to normal levels. Whenever lockdown is eased, it seems to follow fairly consistently that more people will die.

But life is complicated, and public health is complicated.

Is public health simply to keep the most people alive? Or is public health about keeping the most people healthy?

I remember talking to a CEO of a health and advocacy charity not long ago (but before the pandemic). He was interested in ageing and the wellbeing of the older population, and he talked persuasively about “quality of life years” rather than just “life years”.

Is it better to have three years of dignity and freedom and the ability to take care of oneself, or nine years which may include a decline into serious dementia and/or a daily cocktail of powerful medication and/or round-the-clock care?

These are troubling questions, and there are no easy answers.

When we look at lockdowns through a short-term gaze of “are we keeping people alive?”, then the answer appears to be a resounding yes.

But put on a different lens, and we might see a different picture.

Habits can form quickly enough. The research says strong habits are generally formed with persistent participation in a specified activity for a period of time of between 18 and 254 days, with 66 days being the average time it takes to form a new habit. It’s now more than 365 days since the first lockdowns were announced in Ireland, the UK and the US in March 2020.

What habits have been formed since then?

Habits of social isolation? Habits of genuine fear in how contact with other people could ruin our lives? Habits of withdrawal away from the real, physical world around us (and all the beauty and limitations it gives us) and into a virtual world owned by big tech companies, which removes most of those limitations and offers us a filtered, distorted version of real-world beauty?

So, again, what purpose do lockdowns serve? How are we to judge their success?

As with everything, the truth is nuanced, messy, complex.

There are no easy answers in any of this, and maybe it’s understandable that we resort to short-term success indicators, especially when the people making the decisions are elected officials and the democratic political system is built on short-term judgment calls at the polls every 3-5 years.

But there’s no getting away from the suspicion that the long-term impacts are likely to include a range of unintended but very real consequences that leave tens of millions of people fighting their own private battles against mental and physical health issues, possibly for the rest of their lives.

What are we to do?

Perhaps, it’s to take the best care we can of ourselves, so we can take care of those who need us as best we can. And it’s up to each of us to decide what good care-taking looks like in our own gorgeous, too short lives.

This is part of a series of 30 short essays to make the Covid-19 pandemic, one year on. Sign up below to receive these pieces by email each day for 30 days.