No significant effect of lockdowns on Covid-19 spread.

[PeterNSteinmetz]

A peer-reviewed study showing no significant effect of more restrictive policies like lockdowns on the spread of Covid-19 in a trans-national comparison. "After subtracting the epidemic and lrNPI effects, we find no clear, significant beneficial effect of mrNPIs on case growth in any country."

Cautions in interpretation would be that this is one study which must be weighed with others and is an observational study. Some of the strengths are that it attempted to account for normal growth of the pandemic and less restrictive measures like recommending social distancing.

https://doi.org/10.1111/eci.13484.

I will leave it to the moderators to decide whether this post is still permitted under the Covid-19 discussion policy, or if due to being a trans-national comparison, is too violative of the no politics rule.

 

[Sac Arrow]

It falls in the category of 'why don't you tell me something I can't figure out on my own.'

 

[denverpilot]

It’s been fairly clear that “spikes” haven’t occurred after large mass gatherings back into the July 4th holiday here and other holidays elsewhere.

Haven’t been able to figure out any patterns as to why in the numbers, but it’s been fascinating.

We’ve been half-jokingly saying there’s still something we really don’t understand yet about this little viral bastard. But numbers do seem to indicate that.

 

[steingar]

The problems with studies like this is there are two variables you just can't measure. One is what things would look like if everyone actually obeyed the government, really locked down, masked up, and distanced. The other is if no one did. Since you can't measure these things such studies have in my opinion little utility.

@PeterNSteinmetz seems to have quite a dog in this hunt. One wonders why.

 

[SoonerAviator]

The problems with studies like this is there are two variables you just can't measure. One is what things would look like if everyone actually obeyed the government, really locked down, masked up, and distanced. The other is if no one did. Since you can't measure these things such studies have in my opinion little utility.

@PeterNSteinmetz seems to have quite a dog in this hunt. One wonders why.

Interesting, so that would give little utility to any study that had variables for which there is no realistic way to control . . .

 

[David Megginson]

Agreed with @steingar that comparisons are usually complicated by the fact that people may or may not change their behaviour voluntarily, by demographic and population differences, etc.

There has been one very clear (and tragic) natural experiment in this area, however. Denmark, Norway, and Sweden have almost-identical economies, demographics. climates (in the parts where most people live), urban population density, etc. Two of those countries, Denmark and Norway, have done fairly-strict shutdowns, while Sweden did a deliberately-lax one until recently (they've been forced to change course now). The differences are dramatic (source); note that I've added the U.S. just for reference, but since its economy, demographics, etc are different, it's not meant as a direct comparison with the other three:



And there's one final sad irony. While Sweden resisted a shutdown to protect their economy, they ended up with a significantly bigger hit in unemployment than Denmark or Norway did. I don't think it's directly related, but it does show that protecting jobs in a pandemic is more complicated than just shutting down or not shutting down.

 

[Sac Arrow]

The problems with studies like this is there are two variables you just can't measure. One is what things would look like if everyone actually obeyed the government, really locked down, masked up, and distanced. The other is if no one did. Since you can't measure these things such studies have in my opinion little utility.

@PeterNSteinmetz seems to have quite a dog in this hunt. One wonders why.

Well I'll be damned. We actually agree on something.

 

[RyanB]

The problems with studies like this is there are two variables you just can't measure. One is what things would look like if everyone actually obeyed the government, really locked down, masked up, and distanced. The other is if no one did. Since you can't measure these things such studies have in my opinion little utility.

@PeterNSteinmetz seems to have quite a dog in this hunt. One wonders why.

Well I'll be damned. We actually agree on something.

Make that three of us!

 

[Matthew Rogers]

@PeterNSteinmetz Care to comment on the overall data comparing the rates of death per capita between Sweden, Denmark, and Norway as David M has shown? Raw death data does not have any implicit bias built in as studies often have. Unless you can claim that the death data is truly an over-counting of COVID-related deaths (even though many sources show that the death data is actually an under count of COVID deaths).

 

[dmspilot]

This study is comparing countries with mandatory lockdowns versus voluntary ones. It is reasonable to expect that some people in non-mandatory countries voluntarily self-isolate and at the same time people in mandatory countries ignore lockdown rules. You can't therefore use this study to draw much of a conclusion of how social distancing effects viral spread. It is more a study on the relationship of how laws alter human behavior—and the answer might be not a whole lot. The same thing is seen when measuring the effect of speed limits on the actual speed people drive.

 

[PeterNSteinmetz]

@PeterNSteinmetz Care to comment on the overall data comparing the rates of death per capita between Sweden, Denmark, and Norway as David M has shown? Raw death data does not have any implicit bias built in as studies often have. Unless you can claim that the death data is truly an over-counting of COVID-related deaths (even though many sources show that the death data is actually an under count of COVID deaths).

That is interesting to look at the graphs. What is interesting here is that Sweden was one of the less severe interventions which was studied by Benavid at al. linked at the start. They controlled for time course of development of the pandemic using a temporal development model. I do not know what the results of applying such a model to the current more recent data would be or including Denmark and Norway in the comparison.

I just checked and I don't see any peer-reviewed articles or preprints of this question on the servers. That itself makes me suspicious of this graphical argument. If it were that obvious, I should think it would already be published or at least in preprint form. I see that this is a popular argument and graphical comparison in the lay literature with a lot of people making arguments on both sides of the issue.

OTOH, the following article says that there was little change in all-cause mortality in Norway and Sweden during the initial parts of the pandemic, which strongly suggests your hypothesis that some of this has to do with how things are counted could account for at least a substantial portion of this graphical effect (https://www.medrxiv.org/content/10.1101/2020.11.11.20229708v1). This article looked through July, which includes a large portion of the initial difference which is shown in the graphical comparison presented above.

In general I don't think one can draw strong causal conclusions from trans-national comparisons generally without controlling for a lot of other variables and temporal development.

I do agree that death rates are subject to less bias than case counts, which are correlated with testing levels. Though they are still subject to some reporting bias as death cause assignment is not a cut and dry sort of determination.

What is rather clear in terms of death rates is that in the US the introduction of coercive lockdown measures was not significantly correlated with a decrease in deaths attributed to Covid-19 when comparing states. So that is definitely at variance with what the graphical comparison of death rates in these 4 countries would suggest.

 

[PeterNSteinmetz]

This study is comparing countries with mandatory lockdowns versus voluntary ones. It is reasonable to expect that some people in non-mandatory countries voluntarily self-isolate and at the same time people in mandatory countries ignore lockdown rules. You can't therefore use this study to draw much of a conclusion of how social distancing effects viral spread. It is more a study on the relationship of how laws alter human behavior—and the answer might be not a whole lot. The same thing is seen when measuring the effect of speed limits on the actual speed people drive.

This is an important point to realize, though I would argue that if one is interested in the effects of such lockdown policies, this study has a fairly good utility. Considered by itself, it argues that such policies don't slow the spread of Covid-19. That could be due to the fact that people don't really follow them.

The Google mobility data actually would argue that this may well be the case. People started voluntarily reducing their travel by about 40-50% 2-3 weeks before any of the coercive lockdowns were put in place. In most states, average mobility after the lockdown orders actually began to increase and was back near baseline about 4 weeks later. One could make a Devil's argument that the lockdown orders caused those increases, but I suspect it was just an effect of people reaching their limit with that type of thing.

 

[PeterNSteinmetz]

Interesting, so that would give little utility to any study that had variables for which there is no realistic way to control . . .

I think it would be fair to say that all scientific studies have their limitations. I would not agree that the study has "little" utility in terms of telling us whether coercive lockdown measures slow the spread of Covid-19. I would argue that this study, considered individually, argues fairly strongly that such measures do not slow the spread. Even though it did not find a significant effect of such interventions, one can consider what the data imply as an estimate of the effect on the rate of spread. And that analysis says the lockdown orders actually INCREASED the rate of spread by 7-13%, but there is rather large chance that increase was simply due to random chance.

I have said it before in these discussions that when considering these results it is important to recognize that studies in the biomedical sciences are very rarely as certain as those in the hard sciences like physics or something like engineering testing. The data will always be softer given the inherent limitations of the field. The presence of an uncontrolled variable does not necessarily imply a study is somehow worthless or fatally flawed. Rather, it must be judged relative to the totality of the evidence available in all studies. These studies can generally be grouped into 3 categories in terms of decreasing strength of the evidence: randomized controlled studies, observational studies, and in-vitro or laboratory studies.

There are several observational studies on the effects of lockdown policies on Covid-19 cases or deaths. This study adds to the body of evidence that such policies have no or a negative effect in terms of health outcomes.

 

[YKA]

Notice that the flu hasn't been truly discussed in 2020, or so far into 2021. The flu didn't just disappear, they are lumping flu numbers in, to raise the number of cases they call covid. It has been blown way out of proportion!

 

[PeterNSteinmetz]

Notice that the flu hasn't been truly discussed in 2020, or so far into 2021. The flu didn't just disappear, they are lumping flu numbers in, to raise the number of cases they call covid. It has been blown way out of proportion!

I suspect this true from what data I have seen, though have not investigated deeply. I suppose it is possible that basically COVID-19 has taken over as the flu strain for this season.

 

[Matthew Rogers]

Notice that the flu hasn't been truly discussed in 2020, or so far into 2021. The flu didn't just disappear, they are lumping flu numbers in, to raise the number of cases they call covid. It has been blown way out of proportion!

This, sir, is Fake News, to use a popular term.

I wonder why another, less infectious, respiratory virus (flu) has a low case count this year. Perhaps because most people are wearing masks designed to prevent the spread of airborne respiratory viruses? Perhaps because there is significantly less contact among members of the public and certainly less contact between different family groups? Perhaps because there has been much less international travel to spread a seasonal virus around the world?

Nah....can't be any of that. It's a conspiracy. Let's take the most likely stance that doctors are intentionally skewing the data to make COVID look worse.

I suspect this true from what data I have seen, though have not investigated deeply. I suppose it is possible that basically COVID-19 has taken over as the flu strain for this season.

Peter, if you don't trust any of the doctors that are the source of the data on flu and COVID rates and numbers, then you also can't trust any of the studies that are created by the doctors either. So there is no point at looking at anything.

 

[asicer]

Notice that the flu hasn't been truly discussed in 2020, or so far into 2021.

What makes you say that?
https://www.cdc.gov/flu/weekly/

 

[PeterNSteinmetz]

Peter, if you don't trust any of the doctors that are the source of the data on flu and COVID rates and numbers, then you also can't trust any of the studies that are created by the doctors either. So there is no point at looking at anything.

I agree and as I say have not investigated this very deeply. @asicer’s post suggests that the seasonal flu may not have decreased, but a comparison to the numbers over the last several years would be informative on this point.

Here is a link to the cases through 2019. https://www.statista.com/statistics/861113/estimated-number-of-flu-cases-us/

 

[Matthew Rogers]

I agree and as I say have not investigated this very deeply. @asicer’s post suggests that the seasonal flu may not have decreased, but a comparison to the numbers over the last several years would be informative on this point.

But you agreed with @YKA statement that there is intentional data coverups and flu is being reported as COVID to raise the COVID numbers and make it seem worse. This is just a conspiratorial statement that is not grounded in fact at all.

 

[PeterNSteinmetz]

But you agreed with @YKA

Please read what I wrote. I said I suspect it is true and have not looked deeply.

I am looking for a direct comparison of flu cases from 2020 to years before presently.

 

[Matthew Rogers]

 

[eman1200]

What makes you say that?
https://www.cdc.gov/flu/weekly/

help me understand this chart........is it saying that in week 40 there were roughly 40 positive cases of the flu in the entire country?

 

[Matthew Rogers]

help me understand this chart........is it saying that in week 40 there were roughly 40 positive cases of the flu in the entire country?

Yes. Exactly, and expected with the measures in place to prevent respiratory virus spread.

Israel had an absolutely terrible flu season last year and was super worried about a repeat this year along with COVID, but they have also had remarkably low influenza infections so far.

 

[PeterNSteinmetz]

View attachment 93441

So that suggests that the 2019-20 season was perhaps a bit worse in terms of % of visits for influenza than 2017-2108. Though not shockingly so. Not a ton lower or higher.

But would that estimate include the cases for Covid-19? The source of this graph would be useful in that regard.

Another interesting item is that the start of the 2010-2021 season appears to starting on the lower end.

 

[Bob Noel]

Another possible factor could be that this year's flu vaccine was more effective than normal.

And, yeah, some of the "probable" or "suspected" COVID-19 cases could actually be the flu. But what is the count of "probable" or "suspected" COVID-19 cases? Here in maskachusetts, these numbers are very small compared to the confirmed cases.

 

[Matthew Rogers]

So that suggests that the 2019-20 season was perhaps a bit worse in terms of % of visits for influenza than 2017-2108. Though not shockingly so. Not a ton lower or higher.

But would that estimate include the cases for Covid-19?

Another interesting item is that the start of the 2010-2021 season appears to starting on the lower end.

I would guess that some small amount of covid cases in Jan-March 2020 were misreported as Flu as there were no available tests in the US at that time. But the number is probably only a few percent otherwise across the country. In NYC, it could have been significant as COVID was already raging there by April.

 

[PeterNSteinmetz]

Yes. Exactly, and expected with the measures in place to prevent respiratory virus spread.

Israel had an absolutely terrible flu season last year and was super worried about a repeat this year along with COVID, but they have also had remarkably low influenza infections so far.

That interpretation seems at variance with the other graph and with the CDC data estimating flu cases here https://www.cdc.gov/flu/about/burden/past-seasons.html.

Normally they are estimating 35 million cases per year.

If you look carefully at the @asicer graph it seems like the axes may be mislabeled. It would be good to have a link for the source.

 

[Sac Arrow]

Yes. Exactly, and expected with the measures in place to prevent respiratory virus spread.

Israel had an absolutely terrible flu season last year and was super worried about a repeat this year along with COVID, but they have also had remarkably low influenza infections so far.

Did you even read eman's post, or understand his question?

 

[Matthew Rogers]

That interpretation seems at variance with the other graph and with the CDC data estimating flu cases here https://www.cdc.gov/flu/about/burden/past-seasons.html.

Normally they are estimating 35 million cases per year.

But this is just an estimate (which appears to already be too high based on current reports) and we may need to wait a few months till the CDC can catch back up on its work now that it is not constrained by the executive branch.

 

[Matthew Rogers]

Did you even read eman's post, or understand his question?

Eman was questioning the validly of the data in that there were very low numbers of flu cases reported in this country. Was he not?

I was also pointing out that other countries are experiencing very low flu rates this season. Also that this should be expected because we are taking pretty serious measures to prevent respiratory virus spread, of all types, flu, cold, COVID, etc.

 

[PeterNSteinmetz]

I would guess that some small amount of covid cases in Jan-March 2020 were misreported as Flu as there were no available tests in the US at that time. But the number is probably only a few percent otherwise across the country. In NYC, it could have been significant as COVID was already raging there by April.

Perhaps the source of the graph so we might understand their methodology? The critical question is whether a case of Covid-19 would be counted as an ILI by this reporting network.

If so and that is the intention of their definition, I think the graph argues for exactly @YKA’s point. There has been no appreciable change in the rate of ILIs when when counts seasonal influenza and Covid 19 together as ILIs.

 

[Sac Arrow]

Eman was questioning the validly of the data in that there were very low numbers of flu cases reported in this country. Was he not?

I was also pointing out that other countries are experiencing very low flu rates this season. Also that this should be expected because we are taking pretty serious measures to prevent respiratory virus spread, of all types, flu, cold, COVID, etc.

Yes, he was, but I felt he got a non response

 

[PeterNSteinmetz]

Yes, he was, but I felt he got a non response

I agree. I think the idea there were 40 cases seems incredible. And that there is something wrong with the scale of those graphs. Need the source to understand it.

 

[Matthew Rogers]

Both charts are from this link from the CDC.
https://www.cdc.gov/flu/weekly/index.htm

My chart does come with a waiver that it could be picking up COVID, but the one from @ascier is for lab confirmed tests of influenza.
There have been 468,064 lab tests for influenza with only 1,159 positive (0.2%) this year so far.

 

[PeterNSteinmetz]

Both charts are from this link from the CDC.
https://www.cdc.gov/flu/weekly/index.htm

My chart does come with a waiver that it could be picking up COVID, but the one from @ascier is for lab confirmed tests of influenza.
There have been 468,064 lab tests for influenza with only 1,159 positive (0.2%) this year so far.

Thanks. So doesn’t that suggest that the total number of cases of ILIs in 2019-2020 is about the same as 2017-2018? That the majority of these are Covid-19, which has essentially displaced the normal seasonal flu.

And isn’t that sort of what @YKA was suggesting was the case?

I find this plausible in terms of how viruses evolve and compete with each other. A more “successful” virus like Covid-19 infects all the susceptible hosts that the seasonal flu used to.

ETA: I note the CDC says the graph of the seasonal comparisons explicitly states it will capture SARS-Cov-2, the pathogen in Covid-19.

 

[YKA]

This, sir, is Fake News, to use a popular term.

I wonder why another, less infectious, respiratory virus (flu) has a low case count this year. Perhaps because most people are wearing masks designed to prevent the spread of airborne respiratory viruses? Perhaps because there is significantly less contact among members of the public and certainly less contact between different family groups? Perhaps because there has been much less international travel to spread a seasonal virus around the world?

Nah....can't be any of that. It's a conspiracy. Let's take the most likely stance that doctors are intentionally skewing the data to make COVID look worse.


Peter, if you don't trust any of the doctors that are the source of the data on flu and COVID rates and numbers, then you also can't trust any of the studies that are created by the doctors either. So there is no point at looking at anything.

My live in GF is an RN, and I spend a LOT of time talking with docs and nurses, they all agree that it is true. To get more money, and a lot of money, not just a measly amount, hospitals and clinics call almost everything covid. So your statement is 100% false!

 

[David Megginson]

Notice that the flu hasn't been truly discussed in 2020, or so far into 2021. The flu didn't just disappear, they are lumping flu numbers in, to raise the number of cases they call covid. It has been blown way out of proportion!

Influenza is way down because it needs human-to-human contact to spread, and there's been a lot less of that. Having influenza won't make you test positive for COVID-19. We've also set records for the number of people getting the flu shot in Canada, and I'm sure the same is true in the U.S., so there's more immunity as well as less opportunity for spread.

 

[falconkidding]

My live in GF is an RN, and I spend a LOT of time talking with docs and nurses, they all agree that it is true. To get more money, and a lot of money, not just a measly amount, hospitals and clinics call almost everything covid. So your statement is 100% false!

If we're throwing out anecdata my wifes an rn and hasnt had that experience at all. Ive gone 30 years with not knowing anyone anyone pass from flu and this year im up to 5 people in my circle who've passed from covid. My airport mgr, one of my flight attendants, the lady who did my atp ride, my uncle, and a healthy 55year old from church. Before we moved covid really started ramping up in august and the ICU was packed my wife wanted to quit cause it was getting to be an ordeal at work now she wont go back to nursing till at least fall. I dont doubt that there is probably an incentive to call stuff covid but just from personal experience i dont think hospitals are faking covid results in any major way.

 

[David Megginson]

My live in GF is an RN, and I spend a LOT of time talking with docs and nurses, they all agree that it is true. To get more money, and a lot of money, not just a measly amount, hospitals and clinics call almost everything covid. So your statement is 100% false!

It's fine to state an opinion, but please don't try to bolster it with appeals to anonymous and unverifiable medical authority ("they all agree that it is true"). It's extremely unlikely that most doctors and nurses believe this, or that they've managed to bribe the labs and state public health authorities to collude with them.

 

[Sac Arrow]

Guys, ease up. We have a lot to sort out here. Let's sort it out, rather a thread lock.