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Culture War Roundup for the week of October 30, 2023

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To break even the lock down needed to save the lives of one million frail old people. It is not remotely plausible that it did so.

Yes, this is my main criticism of lockdowns from the perspective of health, and why I was deeply skeptical of them from day 1. There's no possible way for anything but short lockdowns that inexplicably eradicate covid forever to be a net QALY gain. You don't even need to look at long-term second and third order effects to determine that. Just the immediete acute loss in QALY from being put under lockdown restrictions already does more damage than covid could possibly do.

As for how big the effect on quality of life is, EQ-5D-5L puts a moderate reduction in ability to do usual activities (work, study, school, all sorts of things lockdowns prohibit) as a 12% reduction in quality of life. Severe as a 22% reduction. Severe + slight anxiety or depression as a 28% reduction. Severe in both is a 47% reduction. So the actual answer for lockdown's median effect on QALY probably is somewhere between 10% and 50%. This is a question that absolutely could be answered by chucking some money into getting a randomly sampled survey done.

But how did it happen? The experts were socialized into an "identified cause" model of morbidity. If something specific kills you, that counts. If something makes you a year older, that counts zero. Since zero times anything is still zero, it doesn't matter how many people are affected. Basically expertise here was so narrow in scope that the fact that people grow old and die lay outside of its scope and was neglected.

As much as simple ignorance would be a comforting explanation, prior to lockdowns, experts in public health were perfectly happy to use QALY thinking for decisionmaking. They only abandoned such cost/benefit analysis specifically when doing lockdowns, which suggests more ideological or malicious intentions.