COVID-19 Stay-at-Home Policies Resulted in Excess Deaths: Study

A demonstrator holds a sign at the Virginia State Capitol, in Richmond, Va, on April 16, 2020. Zach Gibson/Getty Images
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Public health officials’ efforts to protect citizens from COVID-19 infection and avert death may have backfired, a new study published in Health Economics suggests. What’s more, the efforts could be linked to excess deaths.

Mandatory masking and social distancing became everyday directives for millions worldwide when the COVID-19 virus exploded onto the scene in 2020. Shelter-in-place (SIP) or stay-at-home orders quickly followed despite evidence supporting the protocol remaining mixed.

Now, a cross-collaborative team of scientists from California, Rhode Island, and Massachusetts is expressing confidence based on results from rigorous research examining whether stay-at-home orders may not have been as effective as health officials initially hoped. In fact, they may have resulted in both short- and long-term health consequences.

SIP Policies Did Not Reduce Excess Deaths

After examining SIP protocols from dozens of countries, researchers determined that restricting people from leaving their homes did not reduce excess mortality. The protocols may have also contributed to excess “deaths of despair” unrelated to the virus but to social and economic isolation effects.

To measure policy impacts, researchers took a deep dive into data using the Oxford COVID-19 Government Response Tracker. The resource allowed them to extract daily information at both country and U.S. state levels, but they averaged the data to create a weekly value before and after restrictions were put in place.

Specifically, the researchers looked at data from 43 countries and all 50 U.S. states and examined weekly death rates leading up to the restrictions for the years 2015–2019. They then compared these to weekly rates in 2020 after community mitigation strategies were implemented for 25 weeks. Data were assessed with the first data point marked by the first COVID-19 death in each region. Researchers also looked at how long it took states and countries to implement restrictions after the first death.

Deaths due to COVID-19 and all other unrelated causes of death were calculated using incidence rates for both the U.S. states and the 43 countries and compared to regions that did not enforce stay-at-home orders.

Regarding excess deaths, countries averaged 1.68 per 100,000 in the first 50 weeks of 2020, while the United States averaged 2.13 per 100,000 in the first 47 weeks while SIP policies were in place.

“In both settings, we fail to find that SIP policies reduced excess deaths,” the authors wrote in the paper. “SIP policies might increase or decrease COVID-19 related mortality, and at the same time might also increase mortality from other causes.” Differences in excess deaths before and after the implementation of SIP policies were not observed even when accounting for pre-SIP COVID-19 death rates, they added.

Deeper Dive

If SIP policies were meant to reduce COVID-19 deaths, there should have been a negative association between deaths and SIP measures over the 25 weeks, the authors asserted in the paper. However, they found the opposite. The longer people were sheltered, the higher the death rates from COVID-19 internationally and domestically. An upswing also occurred in relation to overall causes of death. Internationally, an estimated 10 per 100,000 excess deaths occurred compared to pre-SIP implementation. In the United States, that number was 5 per 100,000. However, the confidence interval was wide, indicating much uncertainty in the estimate.
“The results ... suggest that differences in excess mortality between countries that implemented SIP policies versus countries that did not implement SIP policies were trending downwards in the weeks prior to SIP implementation,” the study authors wrote. “Similar to international comparisons, we find that SIP implementation was associated with an increase in excess mortality.”

Benefits and Risks

During the pandemic, many global government officials announced strict orders intended to limit people’s contact with each other to slow the spread of COVID-19. In theory, slowing the spread of the disease would curb infections and prevent hospitals from becoming overwhelmed.

Even if shelter-in-place policies reduced viral transmission, as some studies suggest, their impact on other health behaviors may have led to other harmful effects on physical and mental well-being, with some consequences linked to suicide and accidental death.

Furthermore, one 2021 study revealed COVID-19 is actually more transmissible when shelter-in-place orders are enacted. Informal get-togethers like birthday celebrations and other holiday gatherings, which SIP protocols did not prevent, resulted in relaxed mitigation efforts compared to those enforced in formal settings like work environments, which SIP protocols did address. These informal gatherings were associated with increased transmission rates within households.
According to a 2020 study published in JAMA Network Open, alcohol sales more than doubled in late March 2020, indicating people consumed alcohol to cope with things like anxiety, depression, and boredom associated with stay-at-home orders. Alcohol has been linked to cancer, heart disease, stroke, liver damage, and other health problems.
Other studies showed child and domestic abuse during pandemic isolation increased, and cancer screenings postponed during lockdowns may have resulted in worse cancer outcomes. Drug overdoses and homicides also increased.
Mary Gillis
Mary Gillis
Author
Mary Elizabeth Gillis is a health reporter and cardiopulmonary specialist with over a decade of experience. After graduating with her doctorate in applied physiology, she earned a master of science degree in journalism from Columbia University.
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