Preprint Review Version 2 Preserved in Portico This version is not peer-reviewed

COVID-19: Rethinking the Lockdown Groupthink

Version 1 : Received: 14 October 2020 / Approved: 15 October 2020 / Online: 15 October 2020 (16:02:58 CEST)
Version 2 : Received: 3 November 2020 / Approved: 4 November 2020 / Online: 4 November 2020 (10:14:33 CET)

A peer-reviewed article of this Preprint also exists.

Joffe AR. COVID-19: Rethinking the lockdown groupthink. Frontiers in Public Health 2021;9:625778 Joffe AR. COVID-19: Rethinking the lockdown groupthink. Frontiers in Public Health 2021;9:625778


The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused the Coronavirus Disease 2019 (COVID-19) worldwide pandemic in 2020. In response, most countries in the world implemented lockdowns, restricting their population’s movements, work, education, gatherings, and general activities in attempt to ‘flatten the curve’ of COVID-19 cases. The public health goal of lockdowns was to save the population from COVID-19 cases and deaths, and to prevent overwhelming health care systems with COVID-19 patients. In this narrative review I explain why I changed my mind about supporting lockdowns. First, I explain how the initial modeling predictions induced fear and crowd-effects [i.e., groupthink]. Second, I summarize important information that has emerged relevant to the modeling, including about infection fatality rate, high-risk groups, herd immunity thresholds, and exit strategies. Third, I describe how reality started sinking in, with information on significant collateral damage due to the response to the pandemic, and information placing the number of deaths in context and perspective. Fourth, I present a cost-benefit analysis of the response to COVID-19 that finds lockdowns are far more harmful to public health than COVID-19 can be. Controversies and objections about the main points made are considered and addressed. I close with some suggestions for moving forward.


COVID-19; Public Health; Lockdowns; Cost-benefit analysis; Groupthink


Medicine and Pharmacology, Immunology and Allergy

Comments (2)

Comment 1
Received: 4 November 2020
Commenter: Ari Joffe
Commenter's Conflict of Interests: Author
Comment: This version has the following changes:

1. Updated with several more recent references to support the evidence base.

2. Added some paragraphs to improve the manuscript: the inequality of the effects of our response to COVID-19 [in section 3.1]; a reply to statements that 'herd immunity is a dangerous idea' [in added section 5.1.2]; and a brief discussion os some research priorities to improve the evidence base for our response [in added section 5.2].

3. Added Table 8: a cost-benefit analysis for the USA, based on a published paper in JAMA.

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Comment 2
Received: 21 December 2020
The commenter has declared there is no conflict of interests.
Comment: What's a lockdown? This paper does not bother to define it in a meaningful way, and the author also endorses restrictions. So which restriction specifically creates a lockdown?
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