Economists Are Fueling the War Against Public Health

A new report is being hailed by conservatives—but doesn’t stand up to scrutiny.

Garrett-Laurie-foreign-policy-columnist9
Garrett-Laurie-foreign-policy-columnist9
Laurie Garrett
By , a columnist at Foreign Policy and former senior fellow for global health at the Council on Foreign Relations.
A face mask is seen in front of the New York Stock Exchange (NYSE) on May 26, 2020 at Wall Street in New York City.
A face mask is seen in front of the New York Stock Exchange (NYSE) on May 26, 2020 at Wall Street in New York City.
A face mask is seen in front of the New York Stock Exchange (NYSE) on May 26, 2020 at Wall Street in New York City. JOHANNES EISELE/AFP via Getty Images

A new report that has grabbed headlines on Fox News and other Murdoch-owned news outlets claims that regulations aimed at curtailing spread of the coronavirus through mandatory masking, lockdowns, and school closures in 2020 only reduced deaths from SARS-CoV-2 infections by 0.2 percent. The 62-page study, much-hailed by leading Republican politicians, has grabbed mainstream media headlines, as well. But closer scrutiny reveals that it is an example of motivated reasoning, indulging in scientific cherry-picking to prove a preferred thesis about public health.

Described as a “Johns Hopkins” study, the report was in reality published online by the Institute for Applied Economics, Global Health, and the Study of Business Enterprise at Johns Hopkins University, an academic enterprise tightly linked to the libertarian Cato Institute think tank. The institute is separate from the famed medical institution and school of public health affiliated with the university. It is co-directed by one of the authors of the new report, economist Steve Hanke, who also directs the Troubled Currencies Project at the Cato Institute.

The other two authors of the report are Scandinavian economists Jonas Herby and Lars Jonung. Herby advises the Center for Political Studies, in Copenhagen, a self-described “independent, liberal, free-market think tank in Denmark” that strongly opposes coronavirus lockdown policies across the Nordic region and is generally anti-regulation. He is also tied to the American Institute for Economic Research, where he has written in favor of the Swedish government’s very loose pandemic policies in 2020 that resulted, by the end of the summer of that year, in death rates more than five times higher than in neighboring Denmark, over 9 times greater than in Finland, and more than 11 times worse than the toll in Norway. Herby wrote that Sweden’s huge mortality was due to a mild flu season in the country in 2019, which left too many “dry tinder” vulnerable people, particularly the elderly, who “burned up” with coronavirus infections.

A new report that has grabbed headlines on Fox News and other Murdoch-owned news outlets claims that regulations aimed at curtailing spread of the coronavirus through mandatory masking, lockdowns, and school closures in 2020 only reduced deaths from SARS-CoV-2 infections by 0.2 percent. The 62-page study, much-hailed by leading Republican politicians, has grabbed mainstream media headlines, as well. But closer scrutiny reveals that it is an example of motivated reasoning, indulging in scientific cherry-picking to prove a preferred thesis about public health.

Described as a “Johns Hopkins” study, the report was in reality published online by the Institute for Applied Economics, Global Health, and the Study of Business Enterprise at Johns Hopkins University, an academic enterprise tightly linked to the libertarian Cato Institute think tank. The institute is separate from the famed medical institution and school of public health affiliated with the university. It is co-directed by one of the authors of the new report, economist Steve Hanke, who also directs the Troubled Currencies Project at the Cato Institute.

The other two authors of the report are Scandinavian economists Jonas Herby and Lars Jonung. Herby advises the Center for Political Studies, in Copenhagen, a self-described “independent, liberal, free-market think tank in Denmark” that strongly opposes coronavirus lockdown policies across the Nordic region and is generally anti-regulation. He is also tied to the American Institute for Economic Research, where he has written in favor of the Swedish government’s very loose pandemic policies in 2020 that resulted, by the end of the summer of that year, in death rates more than five times higher than in neighboring Denmark, over 9 times greater than in Finland, and more than 11 times worse than the toll in Norway. Herby wrote that Sweden’s huge mortality was due to a mild flu season in the country in 2019, which left too many “dry tinder” vulnerable people, particularly the elderly, who “burned up” with coronavirus infections.

Lars Jonung is retired from the Lund University Department of Economics in Sweden, where he for decades favored conservative financial policies. Since the pandemic emerged, Jonung has argued that the Swedish constitution renders such actions as mask mandates and business closures illegal.

Now the trio of economists claims, in a meta-analysis of allegedly thousands of coronavirus studies, to show that none of the nonpharmaceutical measures taken by governments—like mask wearing, social distancing, bar closures, virtual school, and stay-at-home orders—have had any clear benefit in reducing the burden of death in the pandemic. Their lengthy literature review has not been peer-reviewed or submitted for review to a major journal.

The “effect of border closures, school closures and limiting gatherings on COVID-19 mortality yields precision-weighted estimates” of -0.1 percent, -4.4 percent, and 1.6 percent, respectively, they wrote. They added that lockdowns, compared to no lockdowns, “also do not reduce COVID-19 mortality.”

They reached this conclusion by culling though Google Scholar and a coronavirus economic research website affiliated with the University of Cambridge for papers about the spring 2020 lockdowns in Europe and North America. They said they found 18,590 relevant papers. The first 13 pages of their study explains how and why they decided that only 34 of those 18,590 papers merited inclusion in their analysis. They tossed out studies that fail to provide what they deem as “high quality” and long-term evidence of association between specific anti-COVID nonpharmaceutical policies and deaths. Though few public health interventions can typically be credited with averting specific deaths, that is what they are demanding.

By this measure, studies that show, for example, that measles vaccination in Africa decreased child death rates during famines would be tossed out for lack of a clear cause-and-effect relationship between the vaccine and a subsequent comparative resilience of a child against starvation. In the case of COVID, the authors reject studies that point to declines in deaths due directly to diabetes or suicide, though it is clear that lowering the pandemic burden on urgent care facilities allows health care providers time and resources to address other medical issues.

Most of the selected 34 papers were written by economists, rather than public health experts, and only 22 of them have been peer-reviewed. After all of this cherry-picking, the trio further discounts contrary findings by declaring that the methodology of some of these 34 papers are of low quality, according to their vague standards, or cannot be reconciled with higher forms of analysis. This conveniently leaves only a handful of solid papers from which they draw the conclusion favored by right-wing and libertarian politicians: Public health restrictions to curb the spread of the coronavirus are a sham.

There are many reasons, both methodological and analytical, why the new report is wrong, which have been noted elsewhere. But the most obvious evidence that lockdowns—however authoritarian or heinous they may be—stop the spread of SARS-CoV-2 and prevent associated mortality is China. Though the pandemic started in Wuhan in late 2019 and the coronavirus spread widely across the nation of 1.4 billion people, the “zero COVID” policy pushed by President Xi Jinping, which entails the world’s most aggressive lockdowns whenever and wherever a handful of cases are found, leaves it with one of the lowest death rates on earth.

The United States, by contrast, imposed among the longest periods of school closures of any country in part to make up for its failure to stringently enforce other public health interventions. The difference in results is stark. The United States has suffered around 2,690 deaths per million people. The rate in China has been around 3 deaths per million. (Among OECD nations, the United States has the highest death rate, by far.)

China’s policies have, of course, been brutal, shutting entire cities of 14 million or more people off from the rest of the nation when fewer than a dozen suspected cases have been identified, and placing hundreds of thousands of households under quarantines so strict that families faced starvation as they were prohibited from shopping.

But less despotic lockdowns surely help explain why New Zealand has had only 11 deaths per million people, South Korea at 132, and Japan at 150. (The authors also don’t acknowledge that strict border closures imposed by countries like New Zealand, Australia, and China may have played a role in limiting the spread of the coronavirus.) By excluding all Asian nations from their analysis, the trio ends up comparing measures in the dismally-mortality-stricken United States and the similarly hard-hit European Union, which has 2,150 deaths per million.

In the United States, multiple studies show markedly higher mortality rates in counties that voted Republican in the 2020 presidential election, where regulatory actions to address the pandemic are less likely to be in place, compared to counties that voted Democrat. Similarly, getting vaccinated, wearing masks, and taking the debunked ivermectin treatment for COVID all follow partisan lines in the United States.

A new study published by the Centers for Disease Control and Prevention and California health authorities found that people in that state who wore any type of masks when among others in indoor settings reduced their odds of infection by 56 percent. If they wore N95 or K95 masks their risk dropped by a whopping 83 percent. Imposing mask-wearing guidelines in this pandemic appears to spare millions of infections and related deaths.

The appalling pseudo-science produced by Herby, Jonung and Hanke can be easily dismissed by public health advocates and scientists. But that will not be the end of it. The enemies of public health measures in the West are already using the study to fuel their ire. From Sean Hannity and Tucker Carlson to Alex Jones and Senator Rand Paul the message is loud and clear: All community precautions aimed at stemming the spread of SARS-CoV-2 are violations of our liberties—and do not work to boot.

For months, Republican leaders have attacked all forms of public health mandates across the United States, both nonpharmaceutical and vaccine-based. Republican governors led the charge against Biden administration efforts to impose vaccine mandates on large employers, an effort overturned by the Supreme Court in a partisan vote. In December, one faction of the Republican Party threatened to shut down the federal government to block mandates. They were eventually overruled by Senator Mitch McConnell and other Republican leaders.

Rand Paul, whose father, Ron, led the Libertarian Party and named his son after libertarian icon Ayn Rand, has for two years led Republican opposition to wearing masks, outdoor dining orders, and social distancing measures, and insists that millions of Americans are, like himself, “naturally immune” after having COVID. He also supported the Great Barrington Declaration, which advocates allowing SARS-CoV-2 to spread freely and spawn herd immunity that would allegedly lead to disappearance of the coronavirus. As with this new report, the herd immunity claims drew accolades from right-wing media, and led President Donald Trump to bring advocate Scott Atlas into his White House pandemic response team.

With more than 900,000 coronavirus deaths in the United States, the most in any nation, and the pandemic nearing its third year, Americans are understandably fed up and vulnerable to messages that direct their rage while providing justification for abandoning disease control measures. This “Johns Hopkins” report is easily cast aside as bogus science, but it will nevertheless live on, exacerbating partisan divides and casting doubt on the Biden administration’s COVID response. It should not. It is mere disinformation.

Laurie Garrett is a columnist at Foreign Policy, a former senior fellow for global health at the Council on Foreign Relations, and a Pulitzer Prize-winning science writer. Twitter: @Laurie_Garrett

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