Do happiness and quality of life matter?

COVID policies may have saved 800,000 person-years of life in averted COVID deaths. But they have already caused increased major clinical depression that results in 30 times—yes, 30 times!—as many person-years of life lost in time spent with major clinical depression as person-years of life saved in averted COVID deaths.

Our lockdown response to COVID may have prevented a large number of COVID deaths. We all hope it has.  But it unquestionably has inflicted enormous harms on us.  The biggest harm, in my view, is that it has made us all more unhappy and thrown many of us into clinical depression.  How many were thrown into depression? Reference 1 found these increases in the percentage of the U.S. population with depression symptoms:

Summing the severe, moderately severe, and moderate increases, we threw 19.3% of the population into moderate to severe depression because of our response to COVID (not because of COVID, but because of our response to COVID).  Moderate to severe depression is classified as major depression. So we threw 19.3% of the U.S. population or 63.3 million people into major depression.  That number should be staggering to you.

COVID-Sanity estimates our COVID lockdown response has prevented perhaps as many as 200,000 COVID deaths.  We have had in the U.S. as of Dec. 31, 2020, COVID deaths of 354,380.  So we have thrown 178 people into major depression for each COVID death that has happened and 316 people into major depression for each 1 COVID death our policies may have averted.

Essentially all of that increase in depression is because of our response to COVID, not because of COVID.  Grief at the deaths of loved ones, especially when those loved ones are elderly and sick, as the large majority of COVID dead are, is not a major cause of depression.  And in any case, deaths have only increased about 10% in 2020, so even if death of loved ones was the sole cause of depression, it would only have caused a 10% increase in depression, not a 327% increase, as has happened.

People become depressed basically because of a lack of social contact—a lack of friends and a lack of feeling connected to others or appreciated and loved by others.  Our COVID policy was to deliberately isolate everyone from each other: order everyone to stay home, close restaurants, bars, churches, health clubs, schools, and businesses, and for the businesses that remained open order everyone to work from home if possible.  And order everyone to wear masks so we cannot see each other’s faces. The policy was literally to reduce contact with other human beings as much as possible and for the contact that cannot be prevented order people to wear masks so they cannot see each other’s faces. If you wanted a policy deliberately designed to make people unhappy, you could not have come up with a better policy.*

It is as if our leaders have no familiarity with human beings and what makes them happy or what makes life valuable!  Social connection and interacting with other humans is the source of most of our happiness.

Again, we threw 316 people into major depression for every 1 person whose COVID death we might have prevented.  Was that worth it?

It is comparing apples and oranges so initially we might not be certain whether it is worth it to throw 316 people into major depression to save one life.  Certainly we would think it was worth it to make one person unhappy for awhile, or even depressed, in order to save one other person’s life.  Is there a way we can compare depression to death or lives saved?

Yes, I think there is.  Depression can be viewed as a lost time of life.  If you could just go to sleep or be temporarily dead while you are depressed and wake up when it is over, you may well take that deal.  If a depressed person believes his depression will never lift, he is in fact quite likely to kill himself.  He is likely to prefer death to living with depression.  Think about it this way, would you rather now, at whatever age you are now, suffer major depression for the next 12 months, or at the end of your life, whenever that will be, die 12 months earlier than you are otherwise going to die?  I think it is not an easy choice, which shows it is fair to consider depression as lost time of life.

I presented this idea of depression as lost time of life to a friend and she said, “No, it is worse than death. Death is oblivion; depression is pain.”  So again, I think it is fair to consider time spent depressed as lost time of life, which means it can be compared to the time of life extended or saved when we prevent a COVID death.

We have elsewhere estimated that our lockdown response to COVID may be averting as many as 200,000 COVID deaths, and that the people dying of COVID have on average 4 years of life expectancy remaining, if they had not contracted the virus that causes COVID.

200,000 COVID deaths averted times 4 years life expectancy = 800,000 person-years of life saved.

The average episode of major depression lasts for 20 weeks or 0.38 years (reference 2).

63.3 million people thrown into major depression * 0.38 years = 24 million person-years of life lost = 30 times the person-years of life saved in COVID deaths averted!

It should be noted, the depression number is not an estimate.  It is actual measured increase in depression that has already happened and is continuing to happen.**  The number of COVID deaths prevented is an estimate, but we think it is a generous estimate and more likely to be an overestimate than underestimate.  Even if it were a 2-fold underestimate, we would still be causing 15 times as much loss of life in time spent in depression as person-years of life saved in COVID deaths averted.

Look at that figure. The debate should be over.  Was our COVID lockdown response worth it?  Did it do more good than harm?  Of course it was not worth it! Of course it did more harm than good!  It’s not even close.  It is not even debatable. The only way you can conclude that our COVID response was worth it is if you consider depression, happiness, joy, and quality of life as of absolutely no consequence.  The only way is if you say, “I don’t care about quality of life.  I don’t care about happiness and joy.  The only thing that matters is duration of life.  The only thing that matters is how long you live.”  If that is your attitude, then perhaps you can consider our lockdown response to COVID to have been worth it and good policy. Otherwise, no, you cannot.

Notes:

* Well, a couple of other ideas came to mind when I tried to imagine what else you could do if your goal was to make people as unhappy as possible:  You could bar them from owning dogs or other pets and you could bar them from exercising.  Aside from being emotionally connected to other people, the other major contributors to happiness are owning a pet, especially a dog (in other words loving and being loved by a person who happens not to be human), and exercising. And we sort of have tried to prevent exercising: we closed the health clubs.  Regarding pets, I have seen stories asking whether dogs and cats are carriers of COVID, as though if they were we should get rid of them.

** In fact, it is low because it was the depression measured in April 2020. Those people presumably suffered depression for 20 weeks on average.  But the lockdowns did not stop causing depression in the spring.  More depression was undoubtedly caused by the lockdowns and restrictions throughout the rest of 2020 and now in 2021.

References

  1. Ettman, CK et al. Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic.  JAMA Netw Open. 2020;3(9):e2019686. https://doi:10.1001/jamanetworkopen.2020.19686.

Similar results were found by the Colorado Dept. of Health: https://www.cpr.org/2020/05/05/colorado-survey-finds-heightened-rates-of-depression-anxiety-and-stress-during-pandemic/

  1. Solomon DA et al. Predicting recovery from episodes of major depression. J Affect Disord. 2008 Apr; 107(1-3): 285–291. https://doi:10.1016/j.jad.2007.09.001