link to original reddit post by /u/goingbankai
tl;dr at bottom
I've spent far too much time recently digging in to just how uninformed the average person is when it comes to COVID and everything surrounding it, even after 1 year (!) of this mess. I'm clearly biased as I went in already being a fan of this sub, but I did not expect just how uninformed the average person was about COVID. This has clearly and obviously been taken advantage of by the state to push obscenely unscientific policies that go against virtually every recommendation made pre-2020.
Public Opinion: Totally off-base
I am sure everyone can draw from anecdotes here about the crazy lengths some people have gone to avoid COVID. Here in Australia people rushed out to buy all the toilet paper off the shelves as soon as news came out about lockdowns. Plenty of people I've seen posting on social media supported state mandates for people to wear masks while alone in their vehicles. It's unquestionable absurd.
This "Understanding America" study by USC is a far better source to use than anecdotes. I found it in a post on the lockdownskeptics subreddit, and in summary people are vastly overestimating both the risk of getting COVID and the risk they have of dying from COVID. You can see this on the USC site by selecting "average perceived change of getting or dying from the coronavirus" from the left dropdown and sorting by age. People under 39 years of age think they have between 10-15% chance of dying from COVID. This is about two orders of magnitude greater than the current worst case estimate of deaths per million by the CDC. This can be found in Table 1 linked. If you take their worst case IFR for the age range of 18-49 (1,700 per million or 0.17%) people are still estimating this virus to be over 50 times as deadly as it is.
Government overreach: based on what?
It should come as no surprise that governments the world over are happy to take advantage of any crisis to seize power. It's far better for them when the population is in many cases literally asking for it. Although even the government's own data is showing COVID to be a far lower risk than the average American seems to believe (and I would suspect it's not just Americans who believe this) this is still not discussed to any degree in the public square, at least by many prominent government officials. What could they possibly be basing their policies on then? Well, certainly nothing that has existed pre-2020.
This report put out by the WHO in September 2019, yes that is about 6 months before COVID hit the US, quite literally states the concerns about NPIs outright. Directly quoting from page 13 of the linked pdf, section number 8:
During an emergency, it should be expected that implementation of some NPIs, such as travel restrictions and quarantine, might be pursued for social or political purposes by political leaders, rather than pursued because of public health evidence. WHO should rapidly and clearly articulate its opposition to inappropriate NPIs, especially when they threaten public health response activities or pose increased risks to the health of the public.
Emphasis my own. They state quite plainly that NPIs may not be pursued because of public health evidence. Of course the next sentence includes a caveat, and we did not see the WHO in any way rapidly and clearly articulate its opposition to most NPIs in place today. This is likely because they agree with them, but I digress. A worse offender is the following bullet point:
WHO and national authorities will need to provide strong evidenced-backed reasoning for the necessity of NPIs in order to effectively implement them and to communicate their role and necessity to the public, especially for NPIs such as social distancing that inherently limit civil liberties. Therefore, they should undertake directly or support research on NPIs and disseminate their findings on these analyses.
Now this is much worse than the previous point. The WHO report states, again very plainly, that they need to do more research on NPIs themselves. More research on something they briefly discuss as a method which could be used for other (obviously nefarious) purposes.
Page 56 of that pdf is where they begin discussing NPIs. Lots of weasel words are used here, because for many of these NPIs there is little to no evidence for efficacy. This report even discusses how travel restrictions appear to be used mostly to placate people, which is where an uninformed population is helpful:
NPIs such as travel restrictions have also been employed by countries as a political or social measure to abate fear rather than a necessary public health measure. While national public health guidelines generally recommend NPIs during an outbreak to limit contact frequency between individuals and to decrease the potential risk of spread of respiratory pathogens, there is a broad lack of evidence of efficacy and a lack of understanding about secondary adverse impacts.
There's even a lack of evidence that many of the NPIs in general work. The WHO has put out good documentation covering this as well. It should not surprise anyone that there is relatively little evidence for most of these measures, with restrictions on the healthy being the most mind-bogglingly dumb measure of them all.
This next report put out by the WHO, again in 2019, outlines their recommendations on NPIs for epidemic/pandemic influenza. Obviously a caveat here is that COVID is not the flu, I am only concerned with the evidence that they provide for NPIs here. As far as I am aware the mechanism COVID & influenza spread by is similar enough for the comparison to be reasonable.
A wonderful table is given on page 9 of the pdf (labelled 3 bottom right) which shows the recommendations of NPI usage by severity of the hypothetical outbreak. Most interesting is the section of NPIs they believe to be "not recommended under any circumstances":
UV light
Modifying humidity
Contact tracing
Quarantine of exposed individuals
Entry and exit screening
Border closure
Contact tracing and quarantine of exposed individuals are both interesting for different reasons. For anyone who doesn't know, contact tracing is in use in Australia (I have to sign in if I sit down at a restaurant) and some other places around the globe. Naturally the WHO doesn't recommend this, but does not seem bothered by it. More interesting is "quarantine of exposed individuals". This does not even consider lockdowns, but rather is simply quarantine of people who are exposed to the virus.
For yet more interesting material, another table is provided on page 19 of the pdf (labelled 13). This outlines the recommendations and quality of evidence for them in an easy to read format. There are some almost unbelievable points made in this table which I was quite surprised to read when I did. I'll put all of them (emphasis included) that I find interesting below:
Face masks:
Face masks worn by asymptomatic people are conditionally recommended in severe epidemics or pandemics, to reduce transmission in the community. Although there is no evidence that this is effective in reducing transmission, there is mechanistic plausibility for the potential effectiveness of this measure.
A disposable surgical mask is recommended to be worn at all times by symptomatic individuals when in contact with other individuals. Although there is no evidence that this is effective in reducing transmission, there is mechanistic plausibility for the potential effectiveness of this measure.
Contact tracing:
Active contact tracing is not recommended in general because there is no obvious rationale for it in most Member States. This intervention could be considered in some locations and circumstances to collect information on the characteristics of the disease and to identify cases, or to delay widespread transmission in the very early stages of a pandemic in isolated communities.
Quarantine of exposed individuals
Home quarantine of exposed individuals to reduce transmission is not recommended because there is no obvious rationale for this measure, and there would be considerable difficulties in implementing it.
This is all from the WHO report's summary. Look at it yourself if you want to check, but the WHO effectively did not recommend any of the widespread measures we see today in 2019 because there was a lack of evidence they even work. I have gone through and read some of the more detailed discussions they have in the paper, so I'll give brief summaries and the page numbers from the pdf so you can verify if you want.
Masks - pdf page 32
10 RCTs are discussed which show a marginal (not statistically significant) reduction in transmission of lab-confirmed influenza. Presumably the best quality study was discussed, it had RR 0.78 p=0.25 - essentially there is reason to believe there is a small effect, but it's not statistically significant (p >>> 0.05). In total the studies apparently have a total of >6000 participants, so this is not just 10 small RCTs with tiny scope.
They conclude there is no evidence that face masks are effective at reducing spread of influenza. I would be generous and say that by the one study they mention, there is limited evidence supporting a very minimal impact.
Contact tracing - pdf page 43
Quite literally all studies they found were simulations. Not one practical experiment with contact tracing has been done apparently.
Imo the fact that this doesn't just throw the idea right out the window is baffling to me.
Quarantine of exposed individuals - pdf page 50
Much here is relevant to influenza, but I will disregard this. There are actually practical studies done which suggest voluntarily staying at home had an impact in Japan (ref 137, have not looked at RR/CI/p-value), and one from Australia which showed that you were more likely to be at risk of flu if you were a household contact of someone who was stuck in quarantine with a sick person.
Even the studies they provide mention that there's variable effectiveness and it only reduces the peak of a pandemic/endemic disease. However, one important caveat:
A survey in Turkey showed that a moderate percentage of students (69.4%) believed that quarantine was an effective intervention in reducing the transmission of influenza (145) ... However, a (separate) study reported that 86.9% of the respondents held an optimistic attitude towards the effectiveness of quarantine (149).
Once again, it's that damn public opinion. A majority of turkish students apparently believed that a public health measure with what the WHO admits is at best unproven levels of efficacy are effective. Additionally, the separate study found that an overwhelming majority of respondents felt quarantines are effective. Even more interestingly, more studies are cited which discuss public acceptability:
Acceptability and compliance of quarantine are variable, but are generally at a moderate level (125). In a telephone survey conducted in Australia, more than 90% of respondents reported being willing to stay at home, especially after being given brief information about pandemic influenza (94.1% before and 97.5% after) (151). Two other studies had a similar conclusion, with 94% (152) and 92.8% (149) of respondents reported to adhere to a quarantine recommendation
Keep in mind that these are typically discussing quarantine of sick individuals. None of these studies would have been considering wide-scale (societal) lockdowns. Nevertheless, most people seem to support these public health measures despite qualitative lack of evidence.
A recent study published in Nature was also unable to find statistical significance between mobility data (from Google, ourworldindata and a Brazilian site) and mortality/million of an area. This paper has apparently been subject to criticism, but as it did still get published it got through peer review. No doubt many more papers like this one will come out in the coming years, showing that there is the expected minimal impact of all state measures (particularly lockdowns).
END/tl;dr
Not sure if/how anyone has made it through this wall of text. I wrote this mostly to vent as I was shocked at how little evidence there was behind many of the measures put forward by governments across the world to "slow the spread" as they said a whole year ago.
Not only does this show there is basically no statistically significant scientific evidence showing that government mandates (lockdowns, mask mandates, contact tracing) work at all, some of the measures wouldn't be considered even in literally the worst case pandemic the WHO panel thought up a year before COVID.
#tl;dr: There is little to no evidence supporting most of the NPIs implemented by the state to deal with COVID-19. Most people are incredibly misinformed about COVID and NPIs, and their support for NPIs is what allows the government to implement them.