As the winter has deepened, the pandemic has surged. In the United States, case counts and hospitalizations are hitting and exceeding their highest points since the pandemic began. Countries across Europe have reinstated lockdowns and there are rumblings that states across the country could soon follow suit — some parts of California, for instance, have instituted new stay-at-home orders.
Renewed lockdowns may be necessary, but they would be no panacea for public health, and we should not put them in place without carefully considering the human costs, which are broad and deep. It is imperative that we learn from and apply the lessons of the initial lockdowns.
Extended social isolation can have serious health implications, from heart disease and dementia to depression and death. During the pandemic, our diets and lifestyles got worse, increasing our vulnerability to the very disease that isolation is meant to help address.
Our mental health suffers, too. The psychological effects of loneliness are a health risk comparable with risk obesity or smoking. Anxiety and depression have spiked since lockdown orders went into effect. The weeks immediately following them saw nearly an 18 percent jump in overdose deaths and, as of last month, more than 40 states had reported increases. One in four young adults age 18 to 25 reported seriously considering suicide within the 30-day window of a recent study. Experts fear that suicides may increase; for young Americans, these concerns are even more acute. Calls to domestic violence hotlines have soared. America’s elderly are dying from the isolation that was meant to keep them safe.
To be sure, the increasing prevalence of mental health challenges is not all due to the lockdowns. The attendant health risks of a global pandemic to an individual or their loved ones must certainly be a contributing factor, too. But our understanding that social isolation can seriously damage physical and mental health predates the pandemic.
Some researchers worry that the social isolation has inflicted damage to mental health that will outlast even the worst of the pandemic. We may not have a full accounting of the consequences for years to come.
There will be significant longterm consequences from school closures as well. About half of the country’s school districts held remote classes, either exclusively or partially, at the start of the year. This approach has meaningfully reduced educational quality, particularly for children of color.
These losses don’t even take into account the direct effects of the lockdowns on the economy. Small businesses have closed their doors at very high rates as the American economy sputtered in response to stay-at-home orders. One study estimates that 60 percent of the millions of jobs lost between January and April were a result of the lockdowns, not the virus itself. The economic uncertainty caused by unemployment comes with its own health risks.
While the potential consequences of locking down states and cities were an important part of the debate in late March when the idea seemed far-fetched, they’ve since fallen from the discussion. Even suggesting that the negative effects of lockdowns can be measured on the same scale as those of the virus itself has been consigned to the fringes of public opinion.
Part of the problem is that the weight of the lockdown has not been evenly borne. For millions of Americans, these restrictions have been merely an inconvenient drain on the joys of everyday life. For many, lockdown has even been financially beneficial; some people are paying off debt and avoiding big purchases. It can be easy to assume that everyone else is experiencing these circumstances the same way.
It’s also hard to tally the indirect fallout of lockdowns. A death certificate can tell us that someone died of Covid-19. It cannot tell us that the social isolation of lockdown was a factor in someone’s drug overdose. There is no nightly ovation for survivors of domestic violence.
These tragedies have become an ambient backdrop to everyday life: present but forgotten, real but ignored. Perhaps America has simply gotten comfortable ignoring the quiet suffering of others.
It can be easier to shut our eyes to the outcome, wait for a vaccine and try to move on. But doing so would be a mistake — the virus is not behind us, and how to best mitigate its damage is a question of the present, not of the past.
Research suggests that, to mitigate negative side effects, lockdowns should be well communicated and as short as possible. In many cities and states, one or both of these guidelines were ignored. When lockdowns seemed wanton and capricious, many Americans felt deceived. If new lockdowns are absolutely needed — something that the World Health Organization and some health experts believe is inadvisable — then policymakers must avoid both the reality and appearance of hypocrisy.
This is particularly true because, unlike many other wealthy countries, the United States is not providing any type of ongoing direct aid to those who are struggling. Simply expecting millions of Americans — many newly out of work or struggling to put food on the table — to sit idly at home without financial support is untenable and unreasonable.
And the decision facing public officials is not between entirely shutting down cities and towns or leaving them entirely open; targeted policy can prohibit the most risky activities, while allowing outdoor events and other activities less likely to put people at risk to continue.
The cost of coronavirus has been enormous. America has soared past 250,000 deaths — a quarter-of-a-million empty seats around tens of thousands of tables for the holidays. But we can’t let the enormous scope of the tragedy cloud our judgment for the decisions yet to be made about how best to respond.
Finding a path forward in dealing with the coronavirus will require a reckoning with the harm, the hurt and the death that lockdown, not the virus itself, has caused. While it may prove preferable to the alternative, it has been a tragedy, too.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
Drew Holden (@DrewHolden360) is a public affairs consultant in Washington, D.C., and a former Republican congressional staff member.
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