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The "Great Lockdown": Inactive workers and mortality by Covid-19.

ABSTRACT: In response to the Covid-19 outbreak, the Italian Government imposed an economic lockdown on March 22, 2020, and ordered the closing of all non-essential economic activities. This paper estimates the causal effects of this measure on mortality by Covid-19 and on mobility patterns. The identification of the causal effects exploits the variation in the active population across municipalities induced by the economic lockdown. The difference-in-differences empirical design compares outcomes in municipalities above and below the median variation in the share of active population before and after the lockdown within a province, also controlling for municipality-specific dynamics, daily shocks at the provincial level, and municipal unobserved characteristics. Our results show that the intensity of the economic lockdown is associated with a statistically significant reduction in mortality by Covid-19 and, in particular, for age groups between 40 and 64 and older (with larger and more significant effects for individuals above 50). Back of the envelope calculations indicate that 4793 deaths were avoided, in the 26 days between April 5 and April 30, in the 3518 municipalities which experienced a more intense lockdown. Several robustness checks corroborate our empirical findings.

SUBMITTER: Borri N

PROVIDER: S-EPMC8420205 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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The "Great Lockdown": Inactive workers and mortality by Covid-19.

Borri Nicola N Drago Francesco F Santantonio Chiara C Sobbrio Francesco F

Health economics 20210711 10

In response to the Covid-19 outbreak, the Italian Government imposed an economic lockdown on March 22, 2020, and ordered the closing of all non-essential economic activities. This paper estimates the causal effects of this measure on mortality by Covid-19 and on mobility patterns. The identification of the causal effects exploits the variation in the active population across municipalities induced by the economic lockdown. The difference-in-differences empirical design compares outcomes in munic ...[more]

PMID: 34250694

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Project description:Background: Despite variation in the types of COVID-19 vaccines and genetic variation in the SARS-CoV-2 genome, using preventive measures remains the first choice to reduce risks associated with COVID-19 infection. Methods: This cross-sectional study highlights students' knowledge, attitudes, and practices toward SARS-CoV-2 infection during lockdown. The study was conducted at the Imam Abdulrahman Bin Faisal University (IAU), Eastern Province, Saudi Arabia. Data was collected from 43 male preparatory students via an online self-structured questionnaire. Knowledge level was determined using mean scores, while chi-square and t-tests were performed to detect significant differences between groups. Results: Males aged 17-20 years displayed better knowledge regarding COVID-19 than other groups (t = 2.03, p = 0.049). Most participants recognized the typical symptoms and transmission routes; 93% indicated they viewed social distancing as a crucial preventive measure. Following lockdown, a 1.7-fold increase in the number of participants who believed that mask-wearing was an effective preventive measure was observed; however, 37.2% did not trust this practice. There was a 2.2-fold increase in the number of participants who took part in awareness programs during lockdown. Students' knowledge increased from 73.2% to 81.5% following the lockdown. Specifically, mean knowledge regarding the role of contaminated tools in disease transmission increased from 33.7% to 75.5%. After lockdown, 58.1% of participants were anxious and afraid of having contact with their colleagues, while 39.5% missed their classes due to anxiety. Two sources of information impacted students' knowledge following the lockdown: university studies (t = 2.149, p = 0.038) and friends (t = 2.6, p = 0.013). Conclusions: The findings suggest that IAU preparatory-year students have acceptable knowledge, awareness, and attitudes towards COVID-19 infection. The study reflects the impact of media on improvement in preventive measure uptake. Knowledge of the pandemic may increase if health education programs are designed to target students.

Project description:Using provisional or opportunistic data, three nationwide studies (The Netherlands, the USA and Denmark) have identified a reduction in preterm or extremely preterm births during periods of COVID-19 restrictions. However, none of the studies accounted for perinatal deaths. To determine whether the reduction in extremely preterm births, observed in Denmark during the COVID-19 lockdown, could be the result of an increase in perinatal deaths and to assess the impact of extended COVID-19 restrictions, we performed a nationwide Danish register-based prevalence proportion study. We examined all singleton pregnancies delivered in Denmark during the COVID-19 strict lockdown calendar periods (March 12-April 14, 2015-2020, N = 31,164 births) and the extended calendar periods of COVID-19 restrictions (February 27-September 30, 2015-2020, N = 214,862 births). The extremely preterm birth rate was reduced (OR 0.27, 95% CI 0.07 to 0.86) during the strict lockdown period in 2020, while perinatal mortality was not significantly different. During the extended period of restrictions in 2020, the extremely preterm birth rate was marginally reduced, and a significant reduction in the stillbirth rate (OR 0.69, 0.50 to 0.95) was observed. No changes in early neonatal mortality rates were found.Conclusion: Stillbirth and extremely preterm birth rates were reduced in Denmark during the period of COVID-19 restrictions and lockdown, respectively, suggesting that aspects of these containment and control measures confer an element of protection. The present observational study does not allow for causal inference; however, the results support the design of studies to ascertain whether behavioural or social changes for pregnant women may improve pregnancy outcomes. What is Known: • The aetiologies of preterm birth and stillbirth are multifaceted and linked to a wide range of socio-demographic, medical, obstetric, foetal, psychosocial and environmental factors. • The COVID-19 lockdown saw a reduction in extremely preterm births in Denmark and other high-income countries. An urgent question is whether this reduction can be explained by increased perinatal mortality. What is New: • The reduction in extremely preterm births during the Danish COVID-19 lockdown was not a consequence of increased perinatal mortality, which remained unchanged during this period. • The stillbirth rate was reduced throughout the extended period of COVID-19 restrictions.

Project description:The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused the Coronavirus Disease 2019 (COVID-19) worldwide pandemic in 2020. In response, most countries in the world implemented lockdowns, restricting their population's movements, work, education, gatherings, and general activities in attempt to "flatten the curve" of COVID-19 cases. The public health goal of lockdowns was to save the population from COVID-19 cases and deaths, and to prevent overwhelming health care systems with COVID-19 patients. In this narrative review I explain why I changed my mind about supporting lockdowns. The initial modeling predictions induced fear and crowd-effects (i.e., groupthink). Over time, important information emerged relevant to the modeling, including the lower infection fatality rate (median 0.23%), clarification of high-risk groups (specifically, those 70 years of age and older), lower herd immunity thresholds (likely 20-40% population immunity), and the difficult exit strategies. In addition, information emerged on significant collateral damage due to the response to the pandemic, adversely affecting many millions of people with poverty, food insecurity, loneliness, unemployment, school closures, and interrupted healthcare. Raw numbers of COVID-19 cases and deaths were difficult to interpret, and may be tempered by information placing the number of COVID-19 deaths in proper context and perspective relative to background rates. Considering this information, a cost-benefit analysis of the response to COVID-19 finds that lockdowns are far more harmful to public health (at least 5-10 times so in terms of wellbeing years) than COVID-19 can be. Controversies and objections about the main points made are considered and addressed. Progress in the response to COVID-19 depends on considering the trade-offs discussed here that determine the wellbeing of populations. I close with some suggestions for moving forward, including focused protection of those truly at high risk, opening of schools, and building back better with a economy.

Dataset Information

The "Great Lockdown": Inactive workers and mortality by Covid-19.

Publications

The "Great Lockdown": Inactive workers and mortality by Covid-19.

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