What difference did the COVID vaccine and masking make in the US?
The US economy appears to be emerging from the recent recession (pace the Fed interest rate decisions). There’s a general consensus that that recession was largely caused by the COVID-19 pandemic and consequent supply chain disruptions. What lessons might be learned on how to maximally blunt the impact of future pandemics while minimizing negative economic consequences?
Here’s a cross-sectional analysis including all 50 US states plus the District of Columbia to evaluate the impact of various interventions on excess COVID-19 deaths over a 2-year analysis period.
“Mask requirements and vaccine mandates were negatively associated with excess deaths, prohibitions on vaccine or mask mandates were positively associated with death rates, and activity limitations were mostly not associated with death rates. If all states had imposed restrictions similar to those used in the 10 most restrictive states, excess deaths would have been an estimated 10% to 21% lower than the 1.18 million that actually occurred during the 2-year analysis period; conversely, the estimates suggest counterfactual increases of 13% to 17% if all states had restrictions similar to those in the 10 least-restrictive states. The estimated strong vs weak state restriction difference was 271 000 to 447 000 deaths, with behavior changes associated with 49% to 79% of the overall disparity.”
While the findings, published in the Journal of the American Medical Association, do not support the claims that COVID-19 restrictions were *ineffective*, some were less effective than others. For example, school closings, likely provided minimal benefit while imposing substantial cost.
I certainly don’t consider this study dispositive, but it brings the receipts to back its conclusions.
Lessons from the COVID-19 pandemic
Here’s a cross-sectional analysis including all 50 US states plus the District of Columbia to evaluate the impact of various interventions on excess COVID-19 deaths over a 2-year analysis period.
“Mask requirements and vaccine mandates were negatively associated with excess deaths, prohibitions on vaccine or mask mandates were positively associated with death rates, and activity limitations were mostly not associated with death rates. If all states had imposed restrictions similar to those used in the 10 most restrictive states, excess deaths would have been an estimated 10% to 21% lower than the 1.18 million that actually occurred during the 2-year analysis period; conversely, the estimates suggest counterfactual increases of 13% to 17% if all states had restrictions similar to those in the 10 least-restrictive states. The estimated strong vs weak state restriction difference was 271 000 to 447 000 deaths, with behavior changes associated with 49% to 79% of the overall disparity.”
While the findings, published in the Journal of the American Medical Association, do not support the claims that COVID-19 restrictions were *ineffective*, some were less effective than others. For example, school closings, likely provided minimal benefit while imposing substantial cost.
I certainly don’t consider this study dispositive, but it brings the receipts to back its conclusions.
Lessons from the COVID-19 pandemic
A couple areas I would recommend re-thinking here if they have the opportunity. For vaccine mandates, it looks as if the various mandates are category imposed and not general statewide, yet the response (excess death) at least seems to be statewide. Presuming that the response is driven by the effects of vaccination, was the data somehow corrected for non-mandated vaccination rates in the states?
Another area is the decision to exclude March 2020 through end of June 2020 mortality. The report indicates they found a lot of the limitations they were studying (more than just masks and vaccines) to be in place in that period. A potential problem with this is the July 2020 populations have already lost individuals that might fit high risks of mortality to your study.
This seems particularly questionable as the authors discuss this decision acknowledging that COVID specific mortality was highly concentrated in limited parts of the country. Perhaps a better choice would be to set some objective standard for that period and then remove from the study states that exceeded that. There is no way for me to dive as deep as possible in 30 minutes, so maybe these get addressed somehow.
Slight tangent, but where are the mask mandates now? If these mandates do have non-trivial positive effects, they should be in place now. COVID is out there in a big way, even if the news media has lost a lot of interest.
@Eric,
Thanks for your comments.
I don’t have a good answer to your queries, but I do have a question. What material difference do you believe it would it make if the data were adjusted in the ways you suggest?
We can stipulate that this study, like *every* research study, falls short of metaphysical perfection. And like all scientists, I certainly welcome controversy and disagreement–that’s where real understanding can emerge. But can you help me understand how your concerns alter the big picture?
It is immaterial which actions were, in hindsight, effective. Trusting scientific methodology means recognizing that relevant experts will be groping for understanding when something g new arrives; but the precautionary principle requires that expert advice needs to be to be taken when such actions are minimally costly compared to the possible result of doing nothing.
@Rick,
Thanks for your thoughtful comment.
Hindsight can be material as a guide to future action. In the heat of the moment–a life-threatening pandemic–arguments from authority will likely be better than inaction, as you imply. But in the long run, we must be guided by facts and evidence. That’s where hindsight is material, once the facts and evidence come to light. Trust, but verify.
Generals are notoriously prepared to fight the last war. Examining history critically can better prepare us for fighting the *next* war. Viruses take no prisoners.
This is true. On scientific questions, scientists are not always right, but they are far more likely to be right than politicians, priests, or talk-radio rabble-rousers.