With the arrival of a vaccine, the world has set forth on a mission to vaccinate the masses, for protection against the coronavirus. But scientists are still conducting studies to prepare us better, in case of another epidemic in the future. One such study that concluded recently, was conducted to study the effectiveness of the stringent stay-at-home rule that was imposed almost a year back.
Most of us have never witnessed a large-scale lockdown in our lives. But this isn’t the first time in history, that governments had to take drastic measures, to curb the spread of disease. History tells us of times when poorly-planned, at times appalling, lockdowns were imposed, to contain disease — the Black Death in the 14th century.
Giovanni Boccaccio, of the Renaissance period in Europe, beautifully described the uncertain times in his book The Decameron.
"Tedious were it to recount, how citizen avoided citizen, how among neighbors was scarce found any that shewed fellow-feeling for another, how kinsfolk held aloof, and never met, or but rarely; enough that this sore affliction entered so deep into the minds of men a women, that in the horror thereof brother was forsaken by brother nephew by an uncle, brother by sister, and oftentimes husband by wife: nay, what is more, and scarcely to be believed, fathers and mothers were found to abandon their own children, untended, unvisited, to their fate, as if they had been strangers. Wherefore the sick of both sexes, whose number could not be estimated, were left without resource but in the charity of friends (and few such there were), or the interest of servants....."
The Decameron
Now that most countries have lifted the restrictive measures, we get a chance to look at the effectiveness of the lockdown. In early 2020, the impositions of restrictive policies to stay-at-home and business closures were justified, as the virus was spreading rapidly. There was little knowledge about the virus, and the cases had begun overwhelming the health systems. But were restrictive measures necessary in the first place? Dr Eran Bendavid, an infectious diseases physician and an Associate Professor of Medicine at Stanford University, conducted a study around the same topic.
Dr Bendavid and Professor Ioannidis, published a paper in the European Journal of Clinical Observation, to discuss restrictive measures and case growth. Their study concluded that the imposition of a stringent lockdown had small benefits, but did not account for a significant effect.
The study analysed the effectiveness of more-restrictive non-pharmaceutical interventions (NPI) including business closures and mandatory stay-at-home, to less-restrictive NPI, including social distancing, and reduced social activities.)
The pair considered ten countries – England, France, Germany, Iran, Italy, Netherlands, Spain, and the United States – that imposed more-restrictive NPI. They also considered Sweden and South Korea as countries that imposed less-restrictive NPIs.
In the paper, the Stanford faculty pointed out that all previous studies assumed the beneficial effects to be a result of the last severe measures. But, they fail to take into account the dynamic nature of an epidemic curve. They expected the cases to rise at the same rate, as before imposing strict measures.
They found that implementing any NPIs led to a significant reduction in case growth in 9 out of 10 countries (Spain had a non-significant effect). They concluded that “no clear, significant beneficial effects” were found in countries that imposed strict stay-at-home rules and business closures. Taking France as an example, the effects of more-restrictive NPIs on case growth in the country was just 7 per cent more, when compared with Sweden, a country which only imposed social distancing norms while appealing to its citizens to reduce social activities.
The paper says:
“While small benefits cannot be excluded we do not find significant benefits on case growth of more restrictive NPIs. Similar reductions in case growth may be achievable with less restrictive interventions… We do not question the role of all public health interventions, or of co-ordinated communications about the epidemic, but we fail to find an additional benefit of stay at home orders and business closures.”
While the findings by Dr Bendavid and Professor Ioannidis does shine a new light on the debate around the effectiveness of the lockdown, it can’t be used to completely neglect the various studies that claim full-lockdowns (more restrictive NPIs) helped in reducing the infection rate.
