COVID-19 lockdowns
During the early stages of the COVID-19 pandemic, a number of non-pharmaceutical interventions, particularly lockdowns, were implemented in numerous countries and territories around the world. By April 2020, about half of the world's population was under some form of lockdown, with more than 3.9 billion people in more than 90 countries or territories having been asked or ordered to stay at home by their governments.
In addition to the health effects of lockdown restrictions, researchers had found the lockdowns may have reduced crime and violence by armed non-state actors, such as the Islamic State, and other terrorist groups. In addition, lockdowns had increased the uptake of telecommuting, reduced airborne pollution, and increased adoption of digital payment systems.
Research has also documented profound negative economic impacts, in addition to worsened school academic performance and negative mental health consequences.
Large-scale protests were organized worldwide against lockdowns, with demonstrators arguing that stay-at-home orders infringed on constitutional rights, constituted excessive government control and violated civil liberties.
Efficacy
Several researchers, from modeling and demonstrated examples, have concluded that lockdowns were somewhat effective at reducing the spread of, and deaths caused by, COVID-19. Lockdowns are thought to be most effective at containing or preventing COVID-19 community transmission, healthcare costs and deaths when implemented earlier, with greater stringency, and when not lifted too early.A study investigating the spread based on studies of the most common symptoms such as loss of taste and smell in France, Italy and the UK showed a marked decrease in new symptoms just a few days after the start of confinement on the countries with the strongest lockdowns. Modelling on the United States pandemic suggested "the pandemic would have been almost completely suppressed from significantly taking off if the lockdown measures were implemented two weeks earlier" and that the second wave would have been less severe had the lockdown lasted another two weeks.
The stringent lockdown in Hubei in early 2020 proved effective at controlling the COVID-19 outbreak in China. The relatively high number of cases and deaths in Sweden, which kept much of its society open during the pandemic, when compared to its neighbours with comparable demographics Norway, Denmark and Finland that did enforce lockdowns, is thought to be at least partly attributable to this difference in policy. Similarly, modelling on Australian data concluded that achieving zero community transmission through a strict lockdown lowers healthcare and economic costs compared to less stringent measures that allow transmission to continue, and warned that early relaxation of restrictions have greater costs. This "zero community transmission" approach was adopted in Australia, and a strict four-month lockdown in the state of Victoria during an outbreak in Melbourne, combined with other measures, averted a wider outbreak in the country in 2020. New Zealand and Vietnam also adopted a "Zero-COVID" strategy throughout 2020 that included targeted lockdowns. A natural experiment study finds that the partial lockdown in Kyrgyzstan was just as effective as the full lockdown in Kazakhstan at reducing the spread of the virus.
The emergence of the highly transmissible SARS-CoV-2 Delta variant in 2021 led some commentators to suggest that although lockdowns continue to reduce the spread of COVID-19, they have become less effective at containing it. Lockdowns in Australia and Vietnam in response to Delta outbreaks proved less effective at containment than previous lockdowns were against the spread of other variants.
Voluntary versus mandatory restrictions
One study led by an economist at the University of Chicago found that involuntary lockdowns had little impact, with voluntary distancing making up nearly 90% of the fall in consumer traffic as people feared the virus itself. Similarly, a National Bureau of Economic Research study found stay-at-home orders increased staying at home by just 5–10%. Another study from Yale University found that most social distancing was voluntary, driven primarily by "media coverage of morbidity and mortality".On the other hand, some studies have argued that coercive measures probably decreased interactions, while accepting that most of the reduction may have been voluntary. One of those two studies, by Flaxman et al., has been criticized, among other things for having a country-specific adjustment factor, without which the model would predict a massive number of deaths for Sweden. One widely cited economic simulation asserting that shelter-in-place orders reduced total cases three-fold, however, held voluntary distancing constant. Another study found a 30% difference among border-counties where stay-at-home orders were imposed.
Another study that compared the impact of 'less restrictive interventions' on the spread of COVID-19 in Sweden and South Korea, with mandatory stay-at home orders in 8 other countries, such as France and Spain, did not find evidence for greater disease control in the countries with more restrictions. However, the findings of the study have been questioned due to its numerous limitations, including the small sample size of countries.
Some research has also found that an "advisory" approach is not adequate to control COVID-19 outbreaks. An analysis of an outbreak in northern Italy found that an effective reduction in community transmission occurred during a strict national lockdown, and that earlier less stringent measures were ineffective at reducing mobility to a level low enough to reduce the spread of COVID-19.
Since the beginning of the pandemic, Google has consistently collected data on movements, showing rapid declines in public activity long before legal restrictions were imposed. An April 2020 poll found that 93% of Americans voluntarily chose to only leave home when necessary, regardless of legal restrictions.
Reception
A February 2021 review of 348 articles concluded there was acknowledgement of the importance of non-pharmaceutical interventions in controlling the spread of COVID-19. However, later research also acknowledges high societal costs, though in some circumstances less than the costs of allowing the pandemic to spread without mitigation.Related to epidemiology
Epidemiological evidence supports generalized non-pharmaceutical interventions to curb the spread of COVID-19.During the early stages of the pandemic in Europe and the United States, statistical modeling which advised that restrictions were helpful to prevent a large number of deaths were used as the basis for lockdowns. This includes an Imperial College projection, led by epidemiologist Neil Ferguson. Despite some criticisms, academics defended the Imperial projection as fundamentally sound, while admitting the code was "a buggy mess". Retrospective evaluation of lockdowns and computer modeling has verified that they have significantly contributed to reducing mortality and morbidity from COVID-19.
A notable opponent of lockdowns has included Sweden's state epidemiologist Anders Tegnell, who has frequently criticised the strategy. The Swedish government's approach has included minimal restrictions and has been controversial in part due to the relatively high death toll due to widespread transmission. However, the Swedish government began considering enacting a lockdown in early 2021.
While arguing in August 2020 for the need for further lockdowns in the United States, physicians Ranu Dhillon and Abraar Karan argued for "smarter lockdowns" that impose restrictions on areas with high levels of transmission, and to increase support to vulnerable populations in these locations to offset the economic costs.
A number of medical experts signed the Great Barrington Declaration in October 2020 which called for "Focused Protection" on high risk groups and minimal restrictions on the general population to achieve herd immunity through COVID-19 infection. However, the majority of medical experts and the WHO have strongly criticised this proposed strategy for its lack of scientific basis and for being unethical. The declaration has also attracted controversy over its funding and the authenticity of its signatures.
Related to social impacts
The lockdowns had multiple effects on people's everyday lives. Some of these were direct effects, such as cancelling or postponing a social event, and others had indirect effects, such as losing a sense of identity. For example, teachers often derive meaning and a sense of life purpose from teaching, but the schools were closed, which caused many of them to feel disconnected from their identity as teachers. Many people also felt that they could not trust that the things and people around them were safe. People also lost a sense of time, with the feelings of unpredictability developing into the opposite of the normal human ontological security. Instead of knowing what to do, what to trust, and what to expect in the future, people felt disconnected and at a loss. It also made people more aware of the pre-existing problems they were facing, such as abuse, addiction, and racism. The sociologist Ann Swidler compared the social changes to anomie, an absence of social norms that was first described at the end of the Industrial Revolution, as the prior, socially agreed-upon system of interpersonal connections, values, interdependence, and ideas about normal behavior was set aside, and a new system had not yet emerged.Some commentators have suggested that stay-at-home orders are unconstitutional, or that states' use of emergency powers to restrict freedom of assembly and movement are authoritarian and may result in long-term democratic backsliding. Centralization of power by political leadership in Hungary, Poland, China and Cambodia in response to the COVID-19 pandemic have been cited as examples. Many states restricted religious gatherings.
Some researchers have noted that COVID-19 pandemic restrictions have come with mental health costs, compounded by those caused by the COVID-19 pandemic itself. Systematic reviews and meta-analyses indicate that the COVID-19 lockdowns were associated with increased rates of depression, anxiety, psychological distress, and a decline in health-related quality of life among children and adolescents, largely driven by school closures, social isolation, and disrupted routines. A rapid review published in the Lancet found that quarantine and lockdown measures were frequently associated with adverse psychological effects. Factors such as prolonged quarantine restrictions and inadequate information contributed to anxiety and post-traumatic stress symptoms.
Lockdowns during the COVID-19 pandemic also led to strained relationships, increased cyberbullying, and physical consequences like abuse, accidental poisonings, and foreign object injuries. Pandemic policies were associated with increased depressive symptoms, decreased physical activity, poorer nutrition, reduced emergency department visits, higher child mortality in Cameroon, a drop in immunizations in Pakistan, and an increase in physical child abuse trauma cases in one U.S. center.
Due to their closure, educational institutions worldwide transitioned to online learning. Teachers and faculty had to learn new ways to engage with students while in a COVID-19 pandemic. Examples of online teaching tools are podcasts, videos, and virtual classrooms. Prolonged COVID-19 school closures and the ineffectiveness of remote learning, especially in low- and middle-income countries, exacerbated educational inequities, leading to substantial learning losses that could cost this generation of students $17 trillion in lifetime earnings. The COVID-19 pandemic disrupted education for 1.6 billion students at its peak, exacerbating the gender divide with disproportionately greater learning losses among girls and increased risks of child labor, gender-based violence, early marriage, and pregnancy in some countries. School closures during the pandemic resulted in significant learning loss, although some countries managed to limit the impact. The closures also led to a significant reduction in child abuse reporting, especially in Florida, where allegations of child abuse and neglect dropped by nearly one-third. This decline has been attributed to the limited access that teachers and school staff had to students, who typically serve as key reporters of child abuse.
UN Women warned in an April 2020 report that COVID-19 pandemic restrictions exacerbate gender inequalities and have led to an increase in domestic violence. Many women, were being forced to 'lockdown' at home with their abusers at the same time that services to support survivors are being disrupted or made inaccessible. For instance, in France there was around a 30% spike in cases of violence against women since the lockdown in March 2020.
Telehealth had an important role to allow physicians not to miss the follow-up of patients with different chronic diseases and potentially helped to contain SARS-CoV-2 spreading among both patients and healthcare providers.
In late 2023, former Director of the National Institutes of Health Francis Collins went viral online amongst critics of the lockdown response when he discussed the lack of weight that public health authorities had given to the potential downsides of the lockdown measures when they were formulating the official response to COVID-19.