Updated and More Accurate Cost-Benefit Analysis of Our Response

Benefits of the Mandatory Business and School Closings and other Mandatory Measures

We now have very good estimates of how many people will die from COVID-19 through July.  With very good estimates now of how many total deaths we will have in the U.S. from COVID-19, and comparisons to the few nations that are taking the response I would have taken of essentially only voluntary measures to control the infections—South Korea, Sweden, and Iceland—and comparison to the states that have not closed business, we can make better estimates of how many lives the involuntary measures we have taken—closing schools and universities, closing “non-essential” businesses, closing churches—have saved.

                We are going to wind up with about 66,000 COVID-19 deaths in the U.S. by August 1, with fewer than 1,000 of those after June 1, according to the University of Washington Model that has been the most accurate so far.  To give every benefit of the doubt to those who argue for the efficacy and importance of the non-voluntary measures we have taken, let’s say this is undercounted, and the true number of deaths from COVID-19 will be 130,000, or almost double.  Let’s say further that the involuntary measures saved an equal number of lives, or 130,000 lives.  That is very generous.  There is actually no evidence the involuntary measures have saved any lives.  South Korea had a much lower death rate per capita than the U.S. or Europe, despite not closing any schools or businesses and adopting essentially the response I would propose. Sweden also did not close schools for children under age 17, and did not close any businesses, but they did close universities.  Iceland did not close any schools or businesses.

 

Here are COVID-19 deaths per million population by nation as of April 22

Spain                    465

Italy                      415

France                  319

United Kingdom  267

The Netherlands  237

Sweden                192

U.S.                      139

Denmark                66

Germany                61

Norway                  34

Iceland                  29

South Korea           5

The nations that did not close schools or businesses and are taking the essentially voluntary approach I would advocate are in bold.  They do not have a higher death rate.  Sweden’s is about in the middle of the pack for Europe.  Iceland and South Korea are lower.

                And let’s look at U.S. states.  Minnesota and its neighbors are a test case because Minnesota has had a shelter in place order and closed non-essential businesses and its neighbors of Iowa and North and South Dakota have not.  Their deaths per million are shown below.

         Minnesota          36

         Iowa                    31

         North Dakota     20

         South Dakota     10



                Again, the bolded states are those that did not close businesses, although they did close schools and universities, and they all have lower death rates than Minnesota, which did close businesses.

                I am unable to discern that any evidence that closing schools and businesses has decreased deaths.  If anything, the data suggests it increased deaths, but that does not make sense so presumably it decreased deaths to a small extent.

                At worst if we had not taken the involuntary steps we have taken of closing schools, universities, churches, health clubs, restaurants, bars, and other business we would have doubled the number of COVID-19 deaths.  So at best they saved 130,000 lives in the U.S.

                The dead from COVID are overwhelmingly elderly and in poor health even for their age.  Of the deaths so far in Spain, 87.6% were age 70+, and only 2.1% under age 50.  The U.S. profile is similar.  The majority of the dead so far in Minnesota were in nursing homes, and the median age of the dead is 88!  To estimate person-years of life expectancy saved by saving those 130,000 lives, I am using this calculation:

130,000 total persons

                88% life expectancy of 3 years (44% 1-year and 44% 5 years) = 343,000 person-years

                10% life expectancy of 15 years                                                  = 195,000 person-years

                2% life expectance 35 years                                                         = 91,000 person-years

Total                                                                                                                      = 629,000 person-years

And again, that is a high estimate, assuming the true COVID deaths is double the official number and that the involuntary measures will have saved as many lives as were lost, even though there is no evidence from comparisons of nations and states that they save any lives.  The true number of lives and person-years of life saved by our involuntary measures will never be known, but I would estimate it is actually about half of the 629,000 person-years maximal estimate above.

Costs of the Involuntary Closings and Social Distancing in Lives Alone

                The U.S. had 47,000 suicides in 2018.  In the first week of these social distancing measures it was already reported that calls to suicide hotlines had doubled. A more recent report is they have increased 8-fold.  Even assuming the business closings end by the end of May and that schools and colleges reopen in the fall, I would predict suicides would double this year.  So we would have an additional 47,000 suicides.  The median age of suicides is about 45, with a life expectancy at that age of 34 years.  So a doubling of suicides would cost the U.S. 1.6 million person years, almost 3 times a maximal estimate of the number of person-years we are saving by these involuntary measures.

                Even in total person-years of lives saved alone, more likely than not increased suicides due to our involuntary social distancing measures will cost more person-years of life than we are saving in decreased COVID-19 deaths!

                Again, the only benefit of our involuntary coronavirus restrictions of business and school closings is to save lives, or really extend lives of those who would otherwise have died.  It destroys the economy and decreases happiness for everyone, but supposedly it saves lives overall.  But even that is false.   More likely than not, and I would say almost certainly, it will have caused more loss of person-years of life in increased suicides than it will have saved in decreased COVID deaths.

Economic and Quality of Life Costs

On top of the suicides are the other more familiar costs of our involuntary social distancing:



  • Lost happiness from socialization and touch for at least 98% of the population (maybe 2% of us are sociopaths who have no need for touch or socialization).
  • Increased depression – at a guess maybe 5% of the population thrown into clinical depression (6.7% of the U.S. population has a current diagnosis of clinical depression).
  • Some period, apparently the remainder of the school year or about 3 months, of lost or diminished education and socialization for all of our children and college students while their schools are closed, even though these people are at essentially zero risk of death from this virus.
  • Mandatory lost enjoyment of spectator sports, live music, and eating out for everyone.
  • Unemployment, with all of its psychological and social devastation, for 20% of workers.

Caveats:
It is true that some of these costs would have still been incurred even if we had taken the Sweden approach of warning people of the risks, educating them to wash their hands and avoid touching their faces, and advocating that the elderly and those at risk quarantine themselves and avoid social contact, but not closing schools, churches, or businesses, and not barring large gatherings. People would still have modified their behavior by going to restaurants less and touching each other less and keeping their distance from each other, and this would have made some feel more alienated and depressed and more prone to suicide, and restaurants and other businesses would still suffer some economic loss.  But the economic losses, depression, and suicides would have been far less than they have been and will be because of our mandatory responses. 

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