The lockdown effect: A counterfactual for Sweden.
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ABSTRACT:
SUBMITTER: Born B
PROVIDER: S-EPMC8031244 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Using the synthetic control method, we construct counterfactuals for what would have happened if Sweden had imposed a lockdown during the first wave of the COVID-19 epidemic. We consider eight different indicators, including a novel one that we construct by adjusting recorded daily COVID-19 deaths to account for weakly excess mortality. Correcting for data problems and re-optimizing the synthetic control for each indicator, we find that a lockdown would have had sizable effects within one week. The much longer delay estimated by two previous studies focusing on the number of positives cases is mainly driven by the extremely low testing frequency that prevailed in Sweden in the first months of the epidemic. This result appears relevant for choosing the timing of future lockdowns and highlights the importance of looking at several indicators to derive robust conclusions. We also find that our novel indicator is effective in correcting errors in the COVID-19 deaths series and that the quantitative effects of the lockdown are stronger than previously estimated.
| S-EPMC8926176 | biostudies-literature
Project description:The UK and Sweden have among the worst per-capita COVID-19 mortality in Europe. Sweden stands out for its greater reliance on voluntary, rather than mandatory, control measures. We explore how the timing and effectiveness of control measures in the UK, Sweden and Denmark shaped COVID-19 mortality in each country, using a counterfactual assessment: what would the impact have been, had each country adopted the others' policies? Using a Bayesian semi-mechanistic model without prior assumptions on the mechanism or effectiveness of interventions, we estimate the time-varying reproduction number for the UK, Sweden and Denmark from daily mortality data. We use two approaches to evaluate counterfactuals which transpose the transmission profile from one country onto another, in each country's first wave from 13th March (when stringent interventions began) until 1st July 2020. UK mortality would have approximately doubled had Swedish policy been adopted, while Swedish mortality would have more than halved had Sweden adopted UK or Danish strategies. Danish policies were most effective, although differences between the UK and Denmark were significant for one counterfactual approach only. Our analysis shows that small changes in the timing or effectiveness of interventions have disproportionately large effects on total mortality within a rapidly growing epidemic.
| S-EPMC8358009 | biostudies-literature
Project description:BackgroundDuring the first wave of the COVID-19 pandemic, the United Kingdom experienced one of the highest per-capita death tolls worldwide. It is debated whether this may partly be explained by the relatively late initiation of voluntary social distancing and mandatory lockdown measures. In this study, we used simulations to estimate the number of cases and deaths that would have occurred in England by 1 June 2020 if these interventions had been implemented one or two weeks earlier, and the impact on the required duration of lockdown.MethodsUsing official reported data on the number of Pillar 1 lab-confirmed cases of COVID-19 and associated deaths occurring in England from 3 March to 1 June, we modelled: the natural (i.e. observed) growth of cases, and the counterfactual (i.e. hypothetical) growth of cases that would have occurred had measures been implemented one or two weeks earlier. Under each counterfactual condition, we estimated the expected number of deaths and the time required to reach the incidence observed under natural growth on 1 June.ResultsIntroducing measures one week earlier would have reduced by 74% the number of confirmed COVID-19 cases in England by 1 June, resulting in approximately 21,000 fewer hospital deaths and 34,000 fewer total deaths; the required time spent in full lockdown could also have been halved, from 69 to 35 days. Acting two weeks earlier would have reduced cases by 93%, resulting in between 26,000 and 43,000 fewer deaths.ConclusionsOur modelling supports the claim that the relatively late introduction of social distancing and lockdown measures likely increased the scale, severity, and duration of the first wave of COVID-19 in England. Our results highlight the importance of acting swiftly to minimise the spread of an infectious disease when case numbers are increasing exponentially.
| S-EPMC9009677 | biostudies-literature
Project description:Context remarkably affects learning behavior by adjusting option values according to the distribution of available options. Displaying counterfactual outcomes, the outcomes of the unchosen option alongside the chosen one (i.e., providing complete feedback), would increase the contextual effect by inducing participants to compare the two outcomes during learning. However, when the context only consists of the juxtaposition of several options and there is no such explicit counterfactual factor (i.e., only partial feedback is provided), it is not clear whether and how the contextual effect emerges. In this research, we employ Partial and Complete feedback paradigms in which options are associated with different reward distributions. Our modeling analysis shows that the model that uses the outcome of the chosen option for updating the values of both chosen and unchosen options in opposing directions can better account for the behavioral data. This is also in line with the diffusive effect of dopamine on the striatum. Furthermore, our data show that the contextual effect is not limited to probabilistic rewards, but also extends to magnitude rewards. These results suggest that by extending the counterfactual concept to include the effect of the chosen outcome on the unchosen option, we can better explain why there is a contextual effect in situations in which there is no extra information about the unchosen outcome.
| S-EPMC9127865 | biostudies-literature
Project description:BACKGROUND: The counterfactual approach provides a clear and coherent framework to think about a variety of important concepts related to causation. Meanwhile, directed acyclic graphs have been used as causal diagrams in epidemiologic research to visually summarize hypothetical relations among variables of interest, providing a clear understanding of underlying causal structures of bias and effect modification. In this study, the authors aim to further clarify the concepts of bias (confounding bias and selection bias) and effect modification in the counterfactual framework. METHODS: The authors show how theoretical data frequencies can be described by using unobservable response types both in observational studies and in randomized controlled trials. By using the descriptions of data frequencies, the authors show epidemiologic measures in terms of response types, demonstrating significant distinctions between association measures and effect measures. These descriptions also demonstrate sufficient conditions to estimate effect measures in observational studies. To illustrate the ideas, the authors show how directed acyclic graphs can be extended by integrating response types and observed variables. RESULTS: This study shows a hitherto unrecognized sufficient condition to estimate effect measures in observational studies by adjusting for confounding bias. The present findings would provide a further understanding of the assumption of conditional exchangeability, clarifying the link between the assumptions for making causal inferences in observational studies and the counterfactual approach. The extension of directed acyclic graphs using response types maintains the integrity of the original directed acyclic graphs, which allows one to understand the underlying causal structure discussed in this study. CONCLUSIONS: The present findings highlight that analytic adjustment for confounders in observational studies has consequences quite different from those of physical control in randomized controlled trials. In particular, the present findings would be of great use when demonstrating the inherent distinctions between observational studies and randomized controlled trials.
| S-EPMC3765813 | biostudies-other
Project description:Previous research has linked perceived social isolation (loneliness) to reduced antiviral immunity, but the immunologic effects of the objective social isolation imposed by pandemic “shelter in place” (SIP) policies is unknown. We assessed the immunologic impact of SIP by relocating 21 adult male rhesus macaques from 2000 sq-m field cage communities of 70-132 other macaques to 2 wks of individual housing in indoor shelters. SIP was associated with down-regulation of Type I interferon (IFN) antiviral gene expression. This effect emerged within the first 48 hrs of SIP, persisted for at least 2 wks, and abated within 4 wks of return to social housing. A subsequent round of SIP in the presence of a novel juvenile macaque abrogated this effect. These results identify a significant adverse effect of SIP social isolation on antiviral immune regulation in circulating immune cells and they suggest a potential behavioral strategy for ameliorating such effects by promoting pro-social engagement during SIP.
2021-07-28 | GSE174065 | GEO
Project description:Background and objectiveCounterfactual thinking (CFT) refers to the generation of mental simulations of alternatives to past events, actions and outcomes. CFT is a pervasive cognitive feature in every-day life and is closely related to decision-making, planning and problem-solving - all of which are cognitive processes linked to unimpaired frontal lobe functioning. Huntington's Disease (HD) is a neurodegenerative disorder characterised by motor, behavioral and cognitive dysfunctions. Because an impairment in frontal and executive functions has been described in HD, we hypothesised that HD patients may have a CFT impairment.MethodsTests of spontaneous counterfactual thoughts and counterfactual-derived inferences were administered to 24 symptomatic HD patients and 24 age- and sex-matched healthy subjects.ResultsOur results show a significant impairment in the spontaneous generation of CFT and low performance on the Counterfactual Inference Test (CIT) in HD patients. Low performance on the spontaneous CFT test significantly correlates with impaired attention abilities, verbal fluency and frontal lobe efficiency, as measured by Trail Making Test - Part A, Phonemic Verbal Fluency Test and FAB.ConclusionsSpontaneous CFT and the use of this type of reasoning are impaired in HD patients. This deficit may be related to frontal lobe dysfunction, which is a hallmark of HD. Because CFT has a pervasive role in patients' daily lives regarding their planning, decision making and problem solving skills, cognitive rehabilitation may improve HD patients' ability to analyse current behaviors and future actions.
| S-EPMC4466481 | biostudies-literature
Project description:BackgroundCounterfactual thinking is a specific type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Although it has been broadly studied in the general population, research on schizophrenia is still scarce. The aim of the current study was to further examine counterfactual reasoning in this illness.MethodsForty schizophrenia patients and 40 controls completed a series of tests that assessed the influence of the "causal order effect" on counterfactual thinking, and the ability to generate counterfactual thoughts and counterfactually derive inferences from a hypothetical situation. Socio-demographic and clinical characteristics, as well as neurocognitive variables, were also examined.ResultsCompared to controls, the schizophrenia patients generated fewer counterfactual thoughts when faced with a simulated scenario. The pattern of response when assessing the causality effect of the order was also different between the groups, with the patients being more frequently unable to attribute any ordering of events than the control subjects. Additionally, the schizophrenia patients showed more difficulties when deriving normative counterfactual inferences from hypothetical social situations. None of the counterfactual reasoning measures was associated to any of the cognitive functions or clinical and socio-demographic variables assessed.ConclusionsA global impairment in counterfactual thinking characterizes schizophrenia patients. Because of the potential impact of such deficits on psychosocial functioning, targeting counterfactual reasoning for improvement might be considered in future treatment approaches.
| S-EPMC4734710 | biostudies-literature
Project description:Causal judgments are widely known to be sensitive to violations of both prescriptive norms (e.g., immoral events) and statistical norms (e.g., improbable events). There is ongoing discussion as to whether both effects are best explained in a unified way through changes in the relevance of counterfactual possibilities, or whether these two effects arise from unrelated cognitive mechanisms. Recent work has shown that moral norm violations affect causal judgments of agents, but not inanimate artifacts used by those agents. These results have been interpreted as showing that prescriptive norm violations only affect causal reasoning about intentional agents, but not the use of inanimate artifacts, thereby providing evidence that the effect of prescriptive norm violations arises from mechanisms specific to reasoning about intentional agents, and thus casting doubt on a unified counterfactual analysis of causal reasoning. Four experiments explore this recent finding and provide clear support for a unified counterfactual analysis. Experiment 1 demonstrates that these newly observed patterns in causal judgments are closely mirrored by judgments of counterfactual relevance. Experiment 2 shows that the relationship between causal and counterfactual judgments is moderated by causal structure, as uniquely predicted by counterfactual accounts. Experiment 3 directly manipulates the relevance of counterfactual alternatives and finds that causal judgments of intentional agents and inanimate artifacts are similarly affected. Finally, Experiment 4 shows that prescriptive norm violations (in which artifacts malfunction) affect causal judgments of inanimate artifacts in much the same way that prescriptive norm violations (in which agents act immorally) affect causal judgments of intentional agents.
| S-EPMC6871661 | biostudies-literature
Project description:In observational studies, treatment may be adapted to covariates at several times without a fixed protocol, in continuous time. Treatment influences covariates, which influence treatment, which influences covariates, and so on. Then even time-dependent Cox-models cannot be used to estimate the net treatment effect. Structural nested models have been applied in this setting. Structural nested models are based on counterfactuals: the outcome a person would have had had treatment been withheld after a certain time. Previous work on continuous-time structural nested models assumes that counterfactuals depend deterministically on observed data, while conjecturing that this assumption can be relaxed. This article proves that one can mimic counterfactuals by constructing random variables, solutions to a differential equation, that have the same distribution as the counterfactuals, even given past observed data. These "mimicking" variables can be used to estimate the parameters of structural nested models without assuming the treatment effect to be deterministic.
| S-EPMC5531214 | biostudies-literature