The COVID-19 pandemic elicited unprecedented government interventions into American life. Yet, the stringency and duration of government measures varied considerably across the U.S.
A new Paragon Health Institute study we coauthored confirms what many long suspected: more severe lockdowns did not significantly improve health outcomes but led to much worse economic and education outcomes. States that eschewed federal proclamations tended to do far better than states that adopted severe measures, like closing businesses and schools.
Under our constitutional system of government, public health decisions are generally reserved to the states. The different approaches each state took to deciding which measures to impose and for how long created a natural experiment.
We compared a quantitative index created by Oxford University of government measures taken to combat COVID-19 – including workplace and school closures, public event cancellations, stay-at-home requirements, and masking policies – to health, economic and educational outcomes across states. States with more severe government interventions did not have better health outcomes, as measured by COVID deaths (adjusted for age and pre-existing conditions) and all-cause excess mortality than less restrictive states.
States with more stringent lockdowns, though, had much worse economic outcomes (increased unemployment and decreased GDP) and much worse education outcomes (less in-person schooling). Other studies show severe learning deficits associated with the loss of in-person education, and that the economic and educational impacts of lockdowns disproportionately affected lower-income families.
The severity of government pandemic measures also influenced people’s decisions about where to live. Census data on domestic migration revealed that annual average movement between states increased 44% in the pandemic period (July 1, 2020, to June 30, 2022) compared with the five-year pre-pandemic average.
A significant correlation between states’ degree of lockdowns and out-migration, suggests that people voted with their feet, leaving states with more severe restrictions and moving to states with less severe measures
States’ COVID response performances were starkly illustrated by comparing the divergent approaches of two of the nation’s largest states – California and Florida. California imposed severe and prolonged lockdowns. Florida relaxed general lockdowns after a short time and focused protection measures on the vulnerable elderly. These policies were noteworthy since COVID infection mortality rates were known to be much higher for the elderly. Florida has one of the oldest populations and California one of the youngest.
The two states had roughly equal health outcomes scores, suggesting little, if any, health benefit from California’s severe approach. But California suffered far worse economic and education outcomes than average while Florida’s outcomes were well above average.
Prior to the pandemic, California and Florida led the nation in annual out and in-migration respectively. But the numbers jumped during the pandemic. California’s annual out-migration surged 154% in the pandemic years over pre-pandemic averages as people fled severe lockdowns. Florida’s open schools and businesses boosted in-migration by nearly 60%. One of us (Blase) moved his family from Virginia to Florida in early 2021, mainly so his kids could resume in-person schooling and a normal life.
Prior to COVID-19, the World Health Organization and most countries’ health agencies had rejected lockdowns as a legitimate strategy for pandemics. What accounts for the disastrous policy shift during COVID?
Policymakers stubbornly relied on flawed modeling that over-predicted deaths and that over-estimated lockdown benefits. Influential modelers such as Imperial College London consciously failed to account for peoples’ voluntary risk avoidance behaviors that limit the benefit of government restrictions. They utilized inflated COVID infection mortality and transmission rates. Relying on their inflated estimates, the modelers recommended imposing lockdown measures until a vaccine became available.
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In addition, public health officials refused to consider, much less balance, the economic and educational consequences, and excess non-COVID mortality that lockdowns would cause. Federal officials were fixated on direct COVID health effects and state officials who considered other outcomes were unfairly vilified.
Future pandemics – whether from variants of known viruses or yet unknown organisms – are inevitable. Policymakers must avoid severe, prolonged, and one-size-fits-all restrictions and be prepared to balance the benefits of their responses against the economic, educational, health and social costs. They need to recognize that individuals’ choices – to undertake voluntary risk mitigation, comply with government measures, or move to states whose policies better reflect their cost-benefit calculations – are the decisive determinants of pandemic outcomes.
Brian Blase, who served as a special assistant to President Trump at the National Economic Council, is president of Paragon. The Paragon study was coauthored with Casey Mulligan and Eric Sun.
