It was ‘a simple instruction’ to the British people, said the Prime Minister: ‘You must stay at home.’
With that sombre televised address, shown on March 23, 2020 – two years ago last week – the country was plunged into its first national lockdown.
After weeks of surging Covid infections, and horrified by the staggering scale of hospitalisations and deaths in Spain and Italy, the Government had concluded there was no option but to issue an unprecedented order to curb the growing pandemic crisis. It was following the science, after all.
Doom-laden epidemiological models had pointed to a possible UK death toll of 250,000 within five months.
Efforts to ‘flatten the curve’ – to drive down infection numbers and protect the NHS – had not been enough, Government advisers had concluded.
Just a week earlier, on March 16, Boris Johnson had advised Britons to stop going to pubs and restaurants, to avoid non-essential travel and to work from home if they could.
Within days, schools were shut and those considered most vulnerable to the virus – pregnant women, the over-70s and people with serious health conditions – were advised not to go outside.
After weeks of surging Covid infections, and horrified by the staggering scale of hospitalisations and deaths in Spain and Italy, the Government had concluded there was no option but to issue an unprecedented order to curb the growing pandemic crisis. It was following the science, after all. (Pictured: Boris Johnson addressing the nation in 2020)
Advocates for England’s previous lockdowns, Chief Scientific Adviser Patrick Vallance (left) and Britain’s Chief Medical Officer for England Chris Whitty (right) walk through Westminster on February 21, 2022
By March 20, all pubs, restaurants and cafes were ordered to close, along with cinemas, gyms and leisure centres.
‘We are going to defeat this disease with a huge national effort to slow the spread by reducing unnecessary social contact,’ the PM told the nation.
That was Friday. By Monday, the Government had issued its most draconian stay-at-home order, a legal mandate that permitted people to leave their homes only for specific purposes: to shop for basic supplies, for medical purposes, for exercise or for work.
This lasted seven weeks, and led to some of the most heartbreaking and damaging moments of the pandemic.
Listen to the debate on Medical Minefield
Dying patients said goodbye to loved ones via a video call. Women gave birth without their partners.
Mental health issues, particularly in the young, began to take root. Reports of domestic violence rose dramatically as women were trapped with their abusers.
And it wasn’t the last. In November 2020 there was a second national lockdown, lasting four weeks.
And then, in January 2021 came the big one: a lockdown that lasted almost three months.
The true toll won’t be known for some time.
However the general scientific consensus, rarely challenged, is that these measures were a necessary evil that saved lives. But just how true is that?
While there is no doubt that robust measures were necessary against a new and devastating virus, was lockdown truly the only route through those dark days of the pandemic, or the right one?
For the past few weeks, in a series of reports probing the science that has underpinned key pandemic decisions, The Mail on Sunday has investigated the accuracy of PCR tests and the chaotic way Covid-related deaths were recorded.
Today, in the final part, we talk to the growing number of experts who say that lockdowns had little benefit – a cure that was worse than the disease.
One of them is Professor Mark Woolhouse, an epidemiologist at the University of Edinburgh, who has recently published a book, The Year The World Went Mad, about the UK’s pandemic policy failures.
Speaking this week on The Mail on Sunday’s Medical Minefield podcast, Prof Woolhouse said: ‘I think that lockdown will be viewed by history as a monumental mistake on a global scale, for a number of reasons.
‘The obvious one is the immense harm the lockdown, more than any other measure, did in terms of the economy, mental health and on the wellbeing of society.
‘Clearly things needed to be done to bring waves of infection under control.
‘But many analyses suggest that lockdown itself didn’t have a huge impact on reducing the health burden. That was achieved in other ways.’
Analysing the effect of any single Covid measure is difficult, and researchers have managed it with varying degrees of success.
In the UK, ‘lockdown’ refers specifically to the stay-at-home order. But some studies also include school and border closures, business closures and curfews in their definition of lockdown.
And when all these measures are looked at together, they do indeed have an impact – reducing infection rates by up to 80 per cent.
One paper that did attempt to tease out the benefits of individual measures, published last month, found stay-at-home orders reduced global Covid deaths by just 2.9 per cent.
By comparison, business closures cut deaths by ten per cent and school closures by nearly five per cent.
The authors, economists linked to Johns Hopkins University in the US, have been accused of bias – one has repeatedly equated lockdown measures with fascism – and ‘cherry-picking’ papers to suit their hypothesis.
‘If you start with a premise and select studies which are likely to back that premise, you don’t come to an objective answer,’ says epidemiologist and Government adviser Dr Raghib Ali, at the University of Cambridge.
But intriguingly, Dr Ali and others also admit the researchers have a point.
In a critique of the paper, Australian epidemiologist Gideon Meyerowitz-Katz describes it as an ‘extremely poor quality study’.
But he also points out that, while the figures quoted are ‘pretty meaningless, the general idea is not totally wild’.
He wrote: ‘If we define lockdown as ‘the marginal benefit of stay-at-home orders on top of many other restrictions’ it’s probably fair to argue that the benefit might be quite small.
‘Indeed, that’s been shown before, and is quite a reasonable position based on the evidence.’
Another study that backs this, published in Science in February last year, found ‘stay at home’ measures reduced Covid transmission by an average of 13 per cent on top of other measures such as closing schools and non-essential shops, and banning small gatherings.
The study, which looked at evidence from 41 countries around the world, concluded this was a ‘small effect’ and meant ‘some countries could control the epidemic while avoiding stay-at-home orders’.
It also found something intriguing: lockdowns could, in a worst-case scenario, actually increase transmission of the virus by up to five per cent.
This may be an effect of allowing it to spread within households, experts say.
Prof Woolhouse has argued that, if the aim was partially to protect society’s most vulnerable, lockdowns failed.
‘We focused on this idea that if we stopped the virus transmitting among everybody, that this would somehow be sufficient to protect those who were at risk,’ he says. ‘And it wasn’t.’
Prof Woolhouse also argues that for lockdown to have had an effect it would need to have been imposed earlier.
This is what worked in Australia and New Zealand, which pursued a ‘zero Covid’ strategy.
In the UK, lockdown was seen – at a point of desperation – as the only option left remaining. (Pictured: The Stay Home, Protect The NHS, Save Lives slogan)
Prof Woolhouse has argued that, if the aim was partially to protect society’s most vulnerable, lockdowns failed. (file photo)
‘We passed that point in the second half of February 2020,’ he says.
‘Lockdown as an intervention only makes sense in the context of zero Covid, and by the time it was imposed it was no longer the appropriate tool.
‘There are ways we could have responded to the pandemic that would have avoided most of the lockdown, and saved more lives.
‘But lockdown happened anyway because by that stage no one – including me – was prepared to risk waiting to find out if [restrictions introduced prior to our full lockdown on March 23] had worked.’
But that stay-at-home order was, for most, the hardest part of the pandemic. ‘It made everything so much harder than it might have been,’ he adds.
Countries that had earlier lockdowns, better testing capacity and were able to identify and isolate cases fared better during the initial wave of the pandemic.
In the UK, lockdown was seen – at a point of desperation – as the only option left remaining.
But Prof Woolhouse argues people had already become more cautious. Studies using anonymised mobile phone location tracking data show contacts between people plummeted in early March (although the biggest drop was March 24, the day after lockdown).
Dr Ali says: ‘The purpose of lockdown is to reduce contacts, but if people are doing that anyway, the additional benefit [of making it a legal requirement to stay at home] is obviously somewhat reduced.
‘Case numbers at the time weren’t really available because there was no community testing, so we’ve had to work backwards from hospital admissions. From that, there’s actually some evidence that Covid cases may have peaked before lockdown came in, or around that time.
‘If we had known then what we know now, I don’t think we would have needed to lock down.’
A recent inquiry by officials in Sweden into the handling of its pandemic – where there was no lockdown and the population was expected to voluntarily follow ‘advice and recommendations’ – found this reliance on people’s behaviour was ‘fundamentally correct’.
Lockdowns across Europe were also neither necessary nor defensible, the report added.
Would this have worked in the UK? The evidence shows the impact of interventions were less effective in the second wave precisely because people were already socialising less frequently and masks, hand sanitiser and safety screens were in use.
This led Dr Ali and others to advise Ministers not to impose lockdown a fourth time in December 2021, with the emergence of highly transmissible Omicron.
‘In the second and third lockdowns, in November 2020 and again in January 2021, we have a better idea of when cases peaked and again it seems this happened just before lockdown came in,’ Dr Ali says.
Mr Meyerowitz-Katz adds: ‘A lot of people underestimated the impact of voluntary behaviour change on Covid-19 death rates.’
Prof Woolhouse believes that the second and third lockdown are ‘very hard to defend’.
‘We had the tools in place, the knowledge in place, the systems in place to do it a different way,’ he says. ‘And we didn’t do that.’
But again, it’s easy to say in hindsight.
Dr Ali, who backed all three lockdowns, says: ‘At the time of the second lockdown we hadn’t started the vaccination programme, we had predictions that hospitals would be overwhelmed, particularly intensive care units, so for that reason alone I thought it was reasonable.
‘The third was different – we had vaccines, so lockdown was about flattening the curve, postponing infections until people had their jabs.’
The UK is now facing a significant further wave of infections from a more transmissible variant of Omicron, but with a highly vaccinated population even the most cautious experts agree the benefits of another lockdown are unlikely to outweigh the harms.
Like many experts, Professor Stephen Griffin, virologist at the University of Leeds and a member of Independent Sage, believes there is ‘no question whatsoever’ that locking down first time round ‘prevented hospitalisations and deaths’.
He says: ‘In the absence of a vaccine – and we need to remember we didn’t have anything to treat this virus back then other than oxygen – we needed to reduce cases.
‘If we’d let it run, we’d have had an even more profoundly upsetting mortality rate than we’ve already seen.’
However, he adds: ‘No one would realistically say lockdown should be a strategy any more. There are so many things we could do to get transmission down.’
Samir Bhatt, professor of statistics and public health at Imperial College London, agrees.
‘Once you close the shops, suggest people stop going out to work in an office and stop people gathering, the incremental effects of each measure become less and less.
‘But that doesn’t mean lockdowns weren’t necessary to drive the R rate below one.’
In the end, what we don’t know is what scientists call ‘the counterfactual’ – in other words, what would have happened in the UK if we had not locked down.
Looking just at home nations, which are comparable because of broadly similar populations, Dr Ali says that ‘despite England having less stringent restrictions we’ve had, if anything, a slightly lower death rate [than in Scotland, Wales and Northern Ireland]. It suggests there’s no obvious relationship between restrictions, mandatory interventions and death rates.’
A study published in The Lancet came to a similar conclusion. Sweden, which took a relatively relaxed approach, recorded a similar rate of deaths to neighbouring Denmark and Finland – both of which imposed strict lockdowns – at about 90 per 100,000.
In comparison, the UK – which had tougher restrictions than all three – recorded 127 excess deaths per 100,000.
Yet that is still well behind Spain, at 187, and Italy at 227 – both of which had particularly stringent lockdowns.
Australia, New Zealand, Taiwan and Singapore, which had strict border controls, quarantine and testing regimes, did not record any excess deaths.
In Hong Kong, where the zero Covid strategy failed spectacularly to keep Omicron out, the death rate at present is bewilderingly high.
And China, still attempting to keep Covid out, has just put vast swathes of the country under lockdown.
As Dr Ali puts it: ‘Some people say lockdowns were beneficial, others that they were really terrible.
‘The reality actually is much closer to the idea that it didn’t make much difference either way.’
For those who made painful sacrifices, that won’t be an easy truth to swallow.