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Do Lockdowns Save Lives? A Swedish Case Study
Matt Pencer
12-15 minutes
Warning: I’m a statistician. This article uses lots of numbers. Because I am a scientist and I check the evidence.
As we all know, the COVID-19 pandemic has spread from country to country, killing hundreds of thousands of people. It goes without saying that our governments must take this threat seriously and do whatever they can to mitigate the pain caused by this unforeseen disease.
Every country in the world — even Sweden, the popularly used example of a “no restrictions” government intervention — has practiced some form of “moderate” social distancing (banning large events, encouraging hand-washing, mask-wearing, or voluntarily working from home when possible). These measures have been successful at “flattening the curve” so that hospitals have not been and will not be overwhelmed.
To be clear (as I have been accused of underplaying this fact) — it is critical that we practice at least some social distancing so hospitals are not overwhelmed.
So what is the best way to social distance while maintaining some semblance of the society and economy we’ve fought so hard to build? Most governments have decided that “lockdowns” are the key to preventing deaths. But given the evidence, do lockdowns even serve this basic function? It is still very unclear how many COVID-19 deaths are prevented by lockdowns. What is clear, though, is the tremendous toll these measures have taken on society. In addition to severely curtailing people’s civil liberties, lockdowns are causing Great Depression levels of unemployment, which will certainly lead to many thousands of “deaths of despair.”
Sweden is notable for being one of few Western countries that have not implemented a lockdown. This article will compare Sweden to neighbouring countries to try to quantify the number of COVID-19 deaths that lockdowns prevent, as well as a rough estimate of the number of deaths which are collateral damage of lockdowns.
As it stands today, there is no clear evidence that countries which implement lockdowns fare any better than those which preserve relative freedom for their citizens.
This page ranks countries by number of COVID-19 deaths per million population. Belgium, Italy, Spain, United Kingdom, France, and the state of New York have all implemented extremely harsh lockdowns, yet they have more deaths per capita than Sweden, the Netherlands, Switzerland, and Iceland — each of which has been significantly more lenient in its approach.
Critics of Sweden often choose to compare it to its neighbor Denmark, which has implemented a lockdown and has fewer COVID-19 deaths than Sweden. This is an incontrovertible fact; Denmark’s death per million is lower than Sweden’s. But Denmark also has over 3x as many deaths per capita as Iceland,
a fellow Nordic country that has not implemented a strict lockdown.
It is my opinion that comparing Sweden to Denmark is unfair to critics of lockdowns. Sweden has the highest death toll of the “non-lockdown countries,” while Denmark has one of the lowest death tolls of “lockdown countries.” If we were to compare Iceland (28 deaths per million) to extreme-lockdown Spain (581 deaths per million), we might conclude that lockdowns
cause COVID-19 deaths!
That being said, I will go along with this Sweden Vs. Denmark dichotomy that’s been set up by the pro-lockdown contingent to see if the comparison is really as dire as it has been made out to be.
Let’s start with the simplest figures: Sweden has 340 deaths per million population while Denmark has 92.
Therefore, at best, one could argue that lockdowns save up to 248 lives per million population.
A useful (albeit difficult to obtain) statistic is how many years of life lost were prevented by a lockdown. Like most countries,
most deaths in Sweden are among the elderly, especially those in nursing homes. Of those that died:
- 25% were at least 90 years old
- 41% were between 80 and 89 years old
- 22% were between 70 and 79 years old
- 7% were between 60 and 69 years old
- 3% were between 50 and 59 years old
- 2% were under 50 years old
I wasn’t able to find actuarial tables of life expectancy by age for Sweden, so I will use the
American tables. For those 80–89 years old I will assume the average age was 86, and will do the same for all other decades. I’ll assume the average age of those under 50 is 40 years old.
55% of deaths in Sweden are men and I’ll assume that holds for each age group. Therefore, I estimate that:
- The 25% of fatalities aged 90 and above had an average age of 96. The life expectancy of a 96 year old is 2.64 for American Men and 3.09 for American Women, or 2.84 years for the weighted (55% men, 45% women) average life expectancy.
- Those 80–89 had a life expectancy of 5.93 years.
- 70–79 had a life expectancy of 11.30 years
- 60–69 had a life expectancy of 18.29 years
- 50–59 had a life expectancy of 26.16 years
- Under 50 had a life expectancy of 40.32 years
Therefore, I estimate that the average life expectancy of Swedish victims of COVID-19 was 8.5 years. However, it is well known that those who die of COVID-19 usually have multiple comorbidities and are likely to have lower than average life expectancies, so this number is probably a significant overestimate.
If we assume that a lockdown would have brought Sweden’s death rate down to that of Denmark (248 fewer deaths per million),
the lockdown would have saved 248*8.5=2,108 life years per million population.
In my opinion, this is an ABSOLUTE UPPER BOUND for deaths that can be prevented by lockdowns. This is because:
- We’re comparing Sweden to Denmark instead of Iceland to Spain, so 248 deaths per million prevented by a lockdown should be considered as an upper bound
- We’re assuming a 76 year old who died of COVID-19 has the average life expectancy for a 76 year old, and ignoring the fact that they were likely in bad health (and half were in nursing homes)
- Every country may reach herd immunity anyways! Many recent studies have shown that far more people have been infected than previously believed. It will likely take at least two or three years until we have a vaccine. If most people eventually get infected (enough to reach herd immunity), the lockdowns would have been for nothing. All we can do is make sure the hospitals don’t get overwhelmed, which with minimal social distancing no longer seems to be a threat. If anything, a lockdown would likely cause more COVID-19 deaths: by allowing most young and healthy people to quickly contract the disease and gain immunity, we would lower the likelihood of the elderly and more vulnerable population contracting it in the future.
- On the other hand, this is the death toll for only a few months, not a whole year. The disparity between Sweden and Denmark may grow. But I think it’s unlikely, especially as Denmark is forced to relax restrictions (nobody can put up with lockdowns forever) and Sweden gets its act together and starts to better protect its nursing homes, which they admit has been their biggest failure. Combined with all the previous points, it seems like a big stretch to claim that lockdowns would save more than 2,108 life years per million population.
Let’s put that number into context though. How much is 2,108 life years per million population?
- 0.002 years, or less than one day, in increased life expectancy per person.
- In 2006, 5.9 million life-years were lost due to accidents of any kind in the US. There were 298.4 million people in the US in 2006, so that means 19,772 life years per million population were lost to accidents. Lockdown-preventable life years lost to COVID-19 so far are only 11% of those lost to all accidents.
- Car crashes cause 124 deaths per million population in the US. The median age in the US is 38. I assume the average is higher, but car crash victims tend to be younger than average, so I think it’s safe to say the average car crash victim is younger than 35. The average 35 year old has a life expectancy of 45 years. Therefore approximately 124*45 = 5,580 life years per million population are lost to car crashes every year. Lockdown-preventable life years lost to COVID-19 are only 38% of those lost to car crashes! Even if the disparity between Sweden and Denmark grows, life years lost to COVID-19 for the year are likely to stay in the range of car crashes.
At this point, the numbers clearly point to
lockdowns NOT being worth it. Here’s why:
- It’s unclear whether lockdowns make any difference (compared to moderate, Swedish-style restrictions) since Italy, Spain, Belgium, UK, France, New York, etc. are faring much worse than other countries which have foregone lockdowns.
- If lockdowns do make a difference, the math indicates that they save at most 2,108 life years per million population.
- The numbers show that banning cars would likely save as many lives as implementing a lockdown. If everybody reduced driving by 50%, we might save more lives than a lockdown does. Would you rather cut your commute in half, or give up most of your civil liberties and let millions of people lose their jobs? As a bonus, we’d also reduce pollution and greenhouse-gas emissions, saving even more lives.
I’m not an economist, so I’ll keep this short:
- The unemployment rate in the US is likely already at 25%, a level not seen since the Great Depression. It will likely get worse if we continue lockdowns. Sweden’s unemployment is projected to only reach 10%, and even that number, low as it is, is mostly due to Sweden’s small size and heavy reliance on trade. The US would likely do much better.
- The US government has spent over $3 Trillion so far on mitigating the damage from the lockdown, and will likely spend at least $6 trillion in total. For the same price, the government could have skipped the lockdown and given every single American $20,000! I think the average poor or middle class family of four would rather $80,000, even if it meant sacrificing a day of life expectancy (on average). Since poverty is highly correlated with life expectancy, I expect the gains in life from the $80,000 would far outweigh the loss of life from Coronavirus.
- The lockdowns may cause up to 150,000 deaths of despair. The victims will likely be younger people with otherwise high life expectancies.
- Millions of livelihoods will be ruined, especially those of small business owners and artists.
- There will likely be terrible mental-health consequences. I’ll cite the studies when they’re published in 2030.
- Many people suffering from cancer or heart attack are likely to die as a result of delaying treatment. Over 9 million essential patients may have their treatment delayed.
- Instead of Coronavirus, the Hunger Will Kill Us. 130 million additional people worldwide may starve to death as a result of the economic downturn.
- And many more….
In summary:
- There is no scientific evidence that lockdowns save lives when compared to moderate social distancing. The countries with the most deaths (Belgium, Spain, Italy, UK, France) have all instated harsh lockdowns. Iceland is doing great without a harsh lockdown, and the Netherlands, and Switzerland are also doing relatively well.
- Even if lockdowns do save lives today, they may lead to more deaths in the future if they delay herd immunity.
- Even if you compare Sweden (highest death rate among “no-lockdown countries”) with Denmark (one of the “lockdown countries” with the lowest death rates), the difference is relatively small: 2,108 life years per million population. While this number looks large at first glance, it’s less than the life years lost to car crashes every year. Or less than one day of life expectancy per person. Personally, I would rather accept a very low risk of death (less than the risk of driving a car) to end this lockdown and save the jobs and livelihoods of tens of millions of my fellow citizens, especially the less-fortunate. (I also want to see my friends and family, sit on the beach, and eat at my local restaurants!)
- We don’t know how many people will die because of the economic downturn caused by the lockdowns. The number may end up in the hundreds of millions.
- Instead of a lockdown and its 6 trillion dollar price tag, we could have simply given people $20,000 each, pulling many out of poverty and likely saving far more lives than a lockdown would ever save.
- Overall, it’s clear that the lockdowns are likely to cause more deaths than they prevent. Therefore, even if we don’t care at all about civil liberties, mental health, small business owners, artists, restaurants, or unemployment rates (which we do!), we should end the lockdowns as soon as possible. Switching to Swedish-style moderate social distancing will minimize overall deaths, not just deaths from COVID-19.
