Would a National Lockdown Have Saved the U.S. From COVID-19?
A comparison of Texas and California suggests that legal edicts matter less than The New York Times thinks.
The United States has seen more COVID-19 deaths per capita than all but 10 countries. In a one-year retrospective on the pandemic, The New York Times blames the lack of "a unified national strategy," which it says led to a "fractur[ed]" response.
At bottom, that critique—like federal COVID-19 adviser Anthony Fauci's complaint that "the states are very often given a considerable amount of leeway in doing things the way they want"—is an objection to the American system of government. Under the Constitution, the federal government is limited to specifically enumerated powers, which do not include a general authority to protect the public from communicable diseases. That responsibility lies primarily with the states, which retain a broad "police power" that goes far beyond the authority vested in the president or Congress.
The Times complains that President Donald Trump "turned over control" of the epidemic to the nation's governors back in April, telling them, "You're going to call your own shots." But contrary to Trump's assertion that he had "total" authority over COVID-19 control measures, that power was never his to grant. And it is odd that the Times wishes Trump had taken complete control of the situation, given his resistance to the sweeping social and economic restrictions that the Times favors. Any "unified national strategy" imposed by Trump almost certainly would have entailed overriding the lockdowns imposed by states such as California and New York, which the Times credits with saving many lives.
It's not clear the Times is right about that. Quoting Jeffrey Shaman, an infectious disease expert at Columbia, it says "the rush to reopen" was "the opportune moment that was lost." If so, states that imposed lockdowns early, lifted them gradually, and quickly re-imposed restrictions in response to surges in cases and deaths should have fared better than less cautious states. But a comparison of Texas and California, the two most populous states, does not provide much evidence to support that hypothesis.
In Texas, the Times says, Gov. Greg Abbott "quickly pivot[ed] toward reopening" by late April, which it says led to a spike in cases and deaths last summer. Yet after Texas "opened back up" on May 1, a month and a half passed before the state saw a sharp increase in the seven-day average of daily new cases.
Abbott closed bars and reduced the legal limit on restaurant occupancy to 50 percent in late June. But Texas remained more or less open, and newly identified infections, which peaked in mid-July, dropped to relatively low levels until the surge that began in October, which has intensified since late December.
In California, Gov. Gavin Newsom imposed the nation's first statewide lockdown on March 19, two weeks before Abbott issued a similar order. Newsom did not allow business to reopen until June, and he did so gradually. He closed "nonessential" businesses again in mid-November and ordered a new lockdown on December 3, tied to regional ICU capacity.
California, like Texas, saw an increase in daily new cases last summer, but it was not as dramatic. Between the end of October and December 21, however, California's seven-day average rose more than tenfold. As of yesterday, it was still nearly 10 times as high as the level recorded on October 31. In Texas, meanwhile, newly identified infections nearly quadrupled between late September and late November, then started another steep climb in late December. As of yesterday, the seven-day average was six times the number in late September.
The story is similar for daily deaths. The seven-day average rose more than eightfold in California between late November and yesterday. During the same period in Texas, that number more than doubled.
In other words, California, despite taking a much more restrictive approach than Texas, has seen much bigger increases in cases and deaths this fall and winter. That difference may partly explain why Newsom has been more aggressive than Abbott, since bigger spikes provide a stronger motivation for new regulations. But it is clear that the two governors are acting on different predispositions that have little to do with COVID-19 trends: Abbott has always assigned more weight to the costs of lockdowns than Newsom does.
How does the Times explain California's lackluster performance in curtailing the epidemic? It nods toward "pandemic fatigue" and mentions one of the factors that reinforces it: the hypocrisy of politicians, such as Newsom and San Francisco Mayor London Breed, who disregard the precautions they expect everyone else to follow. The Times adds that "disdain for masks and business closures resonated in more conservative parts of Southern California" and notes that "health officials pointed to people who had let their guard down at Thanksgiving as a turning point."
These factors underline the importance of individual choices, as opposed to legal edicts. Contact tracing data from New York indicate that "household/social gatherings" accounted for three-quarters of infections in that state this fall. Mobility data show that Americans sharply curtailed their public activities last spring before most states had imposed lockdowns and began moving around more before those lockdowns were lifted. The pattern in both Texas and California was similar to the nationwide trends, notwithstanding their markedly different policies. In both states, mobility peaked in the fall and has declined since then. These data suggest that government policy does not play as important a role in the behavior that drives virus transmission as the Times seems to think.
In terms of per capita deaths, California so far has done better than Texas. Its rate is about 25 percent lower. But both states are below the national average, and the five states with the highest death rates include four (New Jersey, New York, Massachusetts, and Rhode Island) with highly restrictive policies as well as one (South Dakota) that has taken a much looser approach. Similarly, the countries that rank higher in per capita deaths than the United States include Belgium, Italy, and the U.K., all of which implemented national lockdowns. Sweden, which eschewed broad restrictions last spring, ranks lower than the United States and a bunch of European countries that imposed lockdowns but much higher than its Scandinavian neighbors.
Simple comparisons like these cannot definitively resolve the issue of how effective lockdowns were. In a National Bureau of Economic Research paper published last August, UCLA economist Andrew Atkeson and two other researchers, after looking at COVID-19 trends in 23 countries and 25 U.S. states that had seen more than 1,000 deaths from the disease by late July, found little evidence that variations in policy explain the course of the epidemic in different places. Other analyses have reached different conclusions.
Do the benefits of lockdowns outweigh their costs? That question is crucial not just in setting current policy but also in deciding how to deal with future epidemics. Without the "fractured" approach that the Times decries, it would be a lot harder to answer.