Introduction
In early March 2020, it seemed that the COVID-19 virus in the United
Kingdom was spreading exponentially with no clear sign of imminent
slowing; the fatality rate was unknown and the ability of the National
Health Service (NHS) to deal with rapidly rising numbers of seriously
ill people was unclear. Estimates made at that time put the likely level
of UK deaths if there was no change in behaviour at 500,000 (1). Based
on that, and other, assessments the UK government followed the example
of several other European countries in introducing severe restrictions
on individual movement. The key message was to stay at home; this was a
lockdown. That served both to slow the spread of the virus and to signal
in a very clear way that people needed to quickly change behaviours, but
it also generated great costs. The extent to which the lockdown
contributed to a subsequent slowing in the rate of new infections and
deaths is not clear. This paper summarises the evidence on this as part
of a wider assessment of costs and benefits of severe restrictions –
“lockdowns”. We do so to inform the decisions on how restrictions in the UK should be lifted.
While it is clear that the cost of the lockdown has been large, just how
great it is will not be known for many years. This cost – as well as
the benefits of lockdowns - should be measured in terms of human welfare
in the form of length and quality of lives. Such measurement is
profoundly difficult. Yet measurement of the costs of restrictions needs
to be weighed against the benefits of different levels of restrictions
to assess what is the best policy now. The cost of severe restrictions
plausibly rises more than in proportion to the length of a lockdown. Two
months of missed treatments for cancer, of company closures, of
postponed screening for serious health conditions, of lessons missed at
schools and universities, of many people living in very stressful
situations is likely more than twice as bad as one month. In contrast,
the benefits of maintaining a severe set of restrictions – the lockdown
– may be diminishing as described in Bongaerts et al (2020) (2).
Decisions on how to ease restrictions are therefore of immediate
significance.
In this article, we aim to calibrate what the costs and benefits of
severe restrictions might be and what that implies about the policy that
should now be followed. We look at evidence from many countries,
focusing particularly on European countries with similar levels of
income and healthcare resources. We then draw out what this implies for
policy in the UK.