In response to the COVID-19 pandemic, many countries implemented social distancing and SIP policies. These policies are designed to slow COVID-19 transmission by limiting physical interaction. While early U.S. and international evidence suggests that these policies did slow COVID-19 transmission (Aleman et al. 2020; Courtemanche et al. 2020), the longer-run and more comprehensive effects of these policies are not fully understood (Berry et al. 2021).
We used data from 43 countries and all U.S. states and find the introduction of SIP policies did not lead to reductions in excess deaths. This study is not without limitations. First, how COVID-19 deaths are defined is not standard across countries (Beaney et al. 2020). For this reason, we rely on total mortality, instead of cause-specific mortality. However, total mortality can also suffer from measurement error. For example, there could be a lag in registering deaths and upward revision of mortality data is common in many countries. It is also possible that deaths are simply undercounted especially in developing countries or rural areas due to lack of resources. Second, enforcement and implementation of SIP policies could vary across countries or U.S. states and our main analysis does not implement heterogenous treatment effects—although the country by country and state by state event studies suggest that the findings were qualitatively similar other than for a few island countries and Hawaii. For this reason, we emphasize that our results should be interpreted using an intent-to-treat framework. We do not estimate the effect of “ideal” SIP policies or of improved compliance with SIP policies, but rather evaluate the “real world” impact of SIP 16policies that were implemented. Third, it is possible that SIP policies were implemented with other policies related to the pandemic and we cannot completely isolate the causal effects of SIP policies. Finally, the counterfactual trajectory of the pandemic in the absence of SIP policies is difficult to estimate and might vary across countries and states, which could bias estimates.However, we do not find differences in the impact of SIP policies based on the trajectory of the COVID-19 pandemic when policies were implemented. Nonetheless,
the implementation of SIP policies does not appear to have met the aim of reducing excess mortality. There are several potential explanations for this finding. First, it is possible that SIP policies do not slow COVID-19 transmission. As discussed earlier, prior studies find only a modest effect of SIP policies on mobility. A potential reason for the modest impact on mobility may be that
individuals change behavior to avoid COVID-19 risk even in the absence of SIP policies. It is also unclear whether modest reductions in mobility could slow the spread of an airborne pathogen. Second,
it is possible that SIP policies increased deaths of despair due to economic and social isolation effects of SIP policies. Recent estimates in the U.S between March and August 2020 show that drug overdoses, homicides, and unintentional injuries increased in 2020, while suicides declined (Faust et al. 2021). Third, existing studies suggest that
SIP policies led to a reduction in non-COVID-19 health care, which might have contributed to an increase in non-COVID-19 deaths (Cantor et al. 2020; Ziedan, Simon, and Wing 2020). For example,
one study in the United Kingdom predicts that there will be approximately an additional 3,000 deaths within five years due to a delay in diagnostics because of the COVID-19 pandemic (Maringe et al. 2020). In light of this evidence, continued reliance on SIP policies to slow COVID-19 transmission may not be optimal. Instead, the best policy response may be pharmaceutical interventions in the 17form of vaccinations and therapeutics when they become available. Early evidence suggests that initial vaccination efforts have led to large reductions in COVID-19 incidence (Christie 2021; X. Chen et al. 2021; Haas et al. 2021). Policy efforts to promote vaccination are thus likely to have large positive impacts.
w28930.pdf (nber.org)