On the effectiveness of COVID-19 restrictions and lockdowns: Pan metron ariston

I examine the dynamics of confirmed case (and death) growth rates conditional on different levels of severity in implemented NPIs, the mobility of citizens and other non restrictive policies. To account for the endogeneity of many of these variables, and the possibility of correlated latent (unobservable) country characteristics, I estimate a four structural model of the evolution of case growth rates, death growth rates, average changes in mobility and the determination of the severity of NPIs. There are strongly decreasing returns to the stringency of NPIs, especially for extreme lockdowns, as no significant improvement in the main outcome measures is found beyond NPIs corresponding to a Stringency Index range of 51–60 for cases and 41–50 for deaths. A non-restrictive policy of extensive and open testing has half of the impact on pandemic dynamics as the optimal NPIs, with none of the associated social and economic costs resulting from the latter. Decreases in mobility were found to increase, rather than decrease case growth rates, consistent with arguments that within-household transmission–resulting from spending more time at residences due to mobility restrictions–may outweigh the benefits of reduced community transmission. Vaccinations led to a fall in case and death growth rates, however the effect size must be re-evaluated when more data becomes available. Governments conditioned policy choice on recent pandemic dynamics, and were found to de-escalate the associated stringency of implemented NPIs more cautiously than in their escalation, i.e., policy mixes exhibited significant hysteresis. Finally, at least 90% of the maximum effectiveness of NPIs can be achieved by policies with an average Stringency index of 31–40, without restricting internal movement or imposing stay at home measures, and only recommending (not enforcing) closures on workplaces and schools, accompanied by public informational campaigns. Consequently, the positive effects on case and death growth rates of voluntary behavioral changes in response to beliefs about the severity of the pandemic, generally trumped those arising from mandatory behavioral restrictions. The exception being more stringent mandatory restrictions on gatherings and international movement, which were found to be effective. The findings suggest that further work should be directed at re-evaluating the effectiveness of NPIs, particularly towards empirically determining the optimal policy mix and associated stringency of individual NPIs.