Some History of Lockdowns and Social Distancing

In class in January 2020 I emphasized that it was a hugely unusual move for China to lock down healthy citizens. I noted that quarantine was what you do to the ill, not to the well.

In class in March I noted that extent epidemiological models (SIQR models) have not even been developed which incorporate isolating the well.

By this time, Italy — following China's example — was considering isolating the well. They did so in stages, beginning on February 21st, and extending to the whole country by March 9th.

In the U.S. system of federalized government, lockdowns are the decisions of governors and mayors. San Francisco's mayor was the first to impose a lockdown on March 17th. The Governor of California followed suit 2 days later.

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Three months on, it's not clear how useful lockdowns have been. I don't think anyone doubts that they help fight disease, but reasonable people can and do disagree about whether that is worth the cost (here is an anti-lockdown estimate).

The American Institute for Economic Research (AEIR), an austrian outfit, has the historical details. It's ugly.

Slogans like “flatten the curve” massively oversimplify social processes and human choices, and presume to know far too much about cause and effect.

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Remarkably, none of the models even considered the impact of the virus on long-term care facilities, and hence contributed to gross neglect of the population that should have received the bulk of the focus.

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... Epidemiology similarly took a turn for the worse around 2006, when agent-based modeling strategies displaced the accumulated wisdom...

And what happened in 2006?

Let’s start with the phrase social distancing, which has mutated into forced human separation. The first I had heard it was in the 2011 movie Contagion. The first time it appeared in the New York Times was February 12, 2006:

If the avian flu goes pandemic while Tamiflu and vaccines are still in short supply, experts say, the only protection most Americans will have is “social distancing,” which is the new politically correct way of saying “quarantine.”

But distancing also encompasses less drastic measures, like wearing face masks, staying out of elevators — and the [elbow] bump. Such stratagems, those experts say, will rewrite the ways we interact, at least during the weeks when the waves of influenza are washing over us.

Maybe you don’t remember that the avian flu of 2006 didn’t amount to much.

And what about lockdowns? It gets worse.

The administration of Bush II was concerned about pandemics, so it tasked an intensive care doctor and an oncologist with no experience in pandemics to formulate a plan.WTF?

It gets worse. They relied on a seminal piece of work — based on a high school science project — by a young woman who now refuses to talk about it. She'd written an article with her dad (a serious mathematician, with no experience in medicine or economics) which showed that because school kids have bigger networks, shutting down schools is the most effective tool to reduce infectious spread.

It gets worse.

The Bush II administration ended up choosing lockdowns as a policy over the objections of epidimiologists. More on that in a moment.

The import of this is that the Obama administration inherited a "playbook" for pandemics that included lockdowns. It was a major news story for a few days in mid-May that the Trump administration had ignored it. But the thing is ... apparently they didn't. They may have thrown out the paper version but the mental model of how to proceed was ingrained into the swamp.

The New York Times has the whole political story. Why Bush II? Homeland security concerns. But here's what the epidimiologists wrote:

There are no historical observations or scientific studies that support the confinement by quarantine of groups of possibly infected people for extended periods in order to slow the spread of influenza. … It is difficult to identify circumstances in the past half-century when large-scale quarantine has been effectively used in the control of any disease. The negative consequences of large-scale quarantine are so extreme (forced confinement of sick people with the well; complete restriction of movement of large populations; difficulty in getting critical supplies, medicines, and food to people inside the quarantine zone) that this mitigation measure should be eliminated from serious consideration…

They were outvoted.