Pueyo on Lockdowns

Tomas “Hammer and Dance” Pueyo is back. He asks, “Should we aim for herd immunity like Sweden?” I’m convinced we shouldn’t. Even Sweden seems convinced now. Granted, I was more open to the idea initially, when I thought Sweden was much further along the path to herd immunity than was the case. But that doesn’t imply that Pueyo’s own lockdown-then-manage (hammer and dance) strategy is optimal either.

Pueyo points out that most countries that “crushed the virus” in fact imposed lockdowns. To his credit, he lists five that did not: Cuba, Japan, Taiwan, Iceland, and South Korea. He writes, “All [are] islands (South Korea is de facto an island since its only ground border is with North Korea and it’s sealed) and all five had advanced methods to deal with the virus. Taiwan and South Korea took all the right preventative measures, as did Cuba. Japan had massive mask wearing and a strong healthcare network with contact tracing experience. Iceland went straight into dancing, testing a massive share of the population (around 17%) and isolating all the positive cases.” He discusses Hong Kong elsewhere, which, notably, is not an island.

Here’s something odd about his Chart 7, though, which shows “countries that beat the coronavirus.” The only thing that matters to Pueyo here is whether a country’s infection line goes up quickly and then comes down quickly; he doesn’t care what the magnitude of the peak is. Hence, he includes countries with almost no COVID deaths, such as New Zealand, with countries with incredibly high COVID deaths, such as Italy, Spain, and Belgium. Indeed, Belgium has the absolutely highest rate of deaths per million. I’m pretty skeptical of any approach that treats New Zealand and Belgium equally as success stories.

This bit is interesting: “For countries that applied very heavy Hammers, their case growth stops around two weeks after the Hammer.” But not so fast. Pueyo’s Chart 8 shows that, in New York and Spain, social mobility declined steadily headed into the lockdown and and pretty much bottomed out around the time the lockdowns went into effect. So there are two ways to interpret this. 1. “The lockdowns themselves didn’t cause the reduction in cases; the lockdowns and the increased social distancing both were caused by public fear of the disease.” 2. “The lockdowns did something important on top of measured social distancing to slow the disease.” (See my May 22 updates for a discussion of some of the causal complexities involved.)

Granted, it’s easier to stop a disease on an island. Given that, the interesting question is, is it possible for other countries to stop a disease without lockdowns? Some people claim that just universal mask wearing can bring the effective reproduction rate under 1. I’m convinced that, if the U.S. had had an effective hygiene-test-trace-isolate strategy from the outset, along with moderate social distancing, lockdowns and intense social distancing could have been avoided. In Pueyo’s terms, you don’t need a hammer to dance.

Pueyo comes close to granting this. He writes, “The Hammer and the Dance was meant for countries that were overwhelmed with cases and didn’t know how to handle the situation, to limit the outbreak while figuring out what to do. But now we know what to do. We can keep the economy open and reduce the caseload, the way South Korea, Taiwan, Vietnam or Hong Kong have been able to. Many measures can be taken to stop the coronavirus, including testing, contact tracing, isolations, quarantines, universal masks, hygiene, physical distancing, public education, sewage testing, travel restrictions and crowds restrictions. All countries should apply these measures, since they’re mostly proven, much cheaper, and can dramatically reduce the epidemic. . . . Whether it’s admitting it or not, the US is pursuing a Herd Immunity strategy. At this point, it’s not realistic to apply new lockdowns everywhere. Thankfully, they’re not needed: States can apply all the measures mentioned above. They’re affordable and doable. Dozens of countries are doing it, many US states are doing it too.”

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