When following the science, were lockdowns the best course of action?

Were lockdowns necessary? The lockdowns we endured during the Covid-19 pandemic were justified at the time as the best way to save lives, or so it was claimed. But is that true? After all, as the Scottish Government has recognised throughout, lockdown was extremely damaging to wider healthcare provision, mental health, education and the economy. In my most recent work, I make the case that there were better ways of saving lives than the wholesale shutting down of society. Back in March 2020 one influential mathematical modelling study implied that without lockdown half a million UK residents would die. That analysis compared a full lockdown with doing nothing at all, an implausible scenario where we all continue to behave normally as the epidemic rages around us. Subsequent research has found that the marginal benefit of strict stay-at-home orders was small, and that less drastic interventions can be as effective as lockdown, particularly if they are implemented earlier. Despite lockdowns, Covid-19 has killed over ten thousand people in Scotland. Most of those deaths were among the elderly, frail and infirm; the young and healthy were always at much lower risk. The main argument in favour of lockdown for all was that a smaller epidemic meant that the vulnerable minority were less likely to be exposed. That’s true as far as it goes but it misses one crucial fact: the majority of deaths during the first wave were the result of infections acquired during lockdown. Failing to protect the most vulnerable, not only in care homes but also in the community, was perhaps the greatest weakness of our Covid-19 response. In 2020, those who wanted to do more were shouted down by others who insisted that suppressing the virus was the only acceptable strategy. It should have been obvious that by doing both you can save more lives and reduce the time spent in lockdown. I believe that this overly narrow focus on suppressing the virus arose from a reluctance to accept that COVID-19 is here to stay. Once we recognise that, it becomes apparent that we need interventions that are sustainable, which lockdown clearly is not. That means shifting from restricting social contacts to making those contacts safe, and quickly dropping measures that have limited public benefit, such as banning outdoor activities or closing schools. Though epidemiologists knew from as early as February 2020 that we would end up ‘living with the virus’, this idea was fiercely resisted by others and did not become mainstream thinking in Scotland until well into 2021. The public inquiries into the pandemic response in Scotland and the UK must take a critical view of the role of lockdowns. We cannot undo the harms they caused in 2020 and 2021 but we can do better when the next pandemic arrives. Professor Mark Woolhouse FRSE is the Professor of Infectious Disease Epidemiology at the University of Edinburgh, and a Fellow of the Royal Society of Edinburgh. Knowledge in sound is an audio transcription of the Royal Society of Edinburgh's blog series. Featuring in-depth analysis and opinion pieces from some of Scotland's leading thinkers. The articles offer personal views on a variety of issues. These views are not those of the Royal Society of Edinburgh and are intended to provide different perspectives on a range of current issues.