COVID-19 lockdown revisionism | CMAJ

Locks

Anti-lockdown discourse is common on social media, in political rhetoric and in news articles.4^{6 Locks are often presented as a full lock false binary versus no measurement. However, democratic governments around the world have attempted to strike a complex balance in their implementation of a mix of public health measures to address the threat of COVID-19, which varied as the pandemic and evidence scientists were evolving. In some popular discourse, lockdowns have been portrayed as reckless and unscientific, as junk science, as an excuse to permanently oppress populations, as gaslights with ever-changing goals, and as parts of various wild conspiracies.4,7,8 The idea that the lockdowns didn’t work has been internalized by some as a truism. Paid lockdown advertisements and social media posts have garnered widespread engagement.9 In the media, supporters of the Great Barrington Statement, a 2020 open letter that has been scientifically discredited, have strongly challenged the public health measures.ten}

Some dissatisfaction with public health measures could be linked to miscommunications by governments and others, and the haphazard way in which scientific evidence has accumulated during the pandemic. Not all measures have been implemented ideally in terms of costs versus benefits. Competing priorities, such as child development versus infection risk in relation to school closures, have created spaces for reasonable disagreement and also generated fertile ground for the development of doubt and disinformation. Careful auditing of missteps and successes could usefully inform more targeted public health measures, if and when they are needed in the future. However, other powerful forces bear a great responsibility in promoting containment revisionism. The ability of social media to allow misinformation to be disproportionately amplified;11 the creation in popular media of platforms and the consequent legitimization of individuals who disseminate misleading or misinforming information, through false reports or otherwise;12 and how some politicians generated or joined in misleading rhetoric the convoy that occupied Ottawa for part of 2022 received high profile political support for its anti-lockdown messages are examples of such forces.

Measuring the effects of public health measures

Revisionism has been noted on a wide range of topics related to the COVID-19 pandemic. Some actors have decried SARS-CoV-2 vaccines as ineffective, despite overwhelming evidence that they have prevented several million deaths worldwide.13 Now that variants have evolved to diminish the ability of vaccines to prevent viral transmission, some have argued that vaccine mandates, many of which were instituted before the emergence of immuno-evasive variants of Omicron, had a discriminatory intent and did not support public health. Although vaccine mandates are clearly socially and scientifically complex, evidence has shown that they increase SARS-CoV-2 vaccine uptake.14 Additionally, a National Bureau of Economic Research study found that vaccination mandates implemented in US colleges saved an estimated 7,300 lives during a period of just 13 weeks in the fall of 2021.15

Masking policies have also been reframed by some as a form of medically unnecessary confinement, despite having no impact on freedom of movement. Masking is a complex intervention to study, as the quality of masks and the contexts in which they are worn vary greatly. Masks and masking policies continue to generate much scientific and public debate.16^{19 It is clear, however, that high quality masks can reduce the spread of pathogens and prevent infections.20 A case-control study of 1,828 participants, conducted by the US Centers for Disease Control and Prevention and published in 2022, found that self-reported use of a respirator in indoor public places resulted in an 83% lower likelihood to test positive for SARS-CoV-2 in California.21 Additionally, a study comparing English hospitals found that upgrading personal protective equipment (e.g. surgical masks) to air-operated respiratory protection (e.g. FFP3 respirators) for healthcare workers patients with COVID-19 was associated with a 33% reduced risk of hospital-acquired infection. infection during the Delta wave.22 Additionally, a differences-in-differences analysis of tiered policy implementation, studying school districts in Massachusetts, found that 29.4% of all COVID-19 cases over a 15-week period after the end of its 2022 statewide school masking policy were tied to ending universal masking.23}

Public health measures have largely achieved the objectives for which they were implemented, with a few exceptions.24^,25 Despite claims that they have induced widespread economic damage, the evidence related to this issue is equivocal and further study is warranted. Severe restrictions, often of relatively short duration in democratic countries, have clearly had negative effects on certain sectors of activity.26 However, concerns about the broader long-term economic damage of public health measures may be unwarranted. Sweden’s relaxed public health response, which has led to relatively high rates of hospital admissions and deaths, has not benefited its economy in the short term, compared to other countries, a study has found. Nordic.27 Additionally, the COVID-19 pandemic alone has caused and arguably continues to cause widespread global economic damage, given the burden of disease and loss of consumer confidence. An economic analysis conducted by the European Central Bank suggested that swift action to reduce the spread of SARS-CoV-2 could have helped economies.28