The One Million Lives Saved Claim

The policies adopted to combat Covid-19 are producing a worldwide inflationary economic meltdown. This macro outcome follows an endless array of individual suffering and tragedy. Yes, from Covid-19 itself, but also from lockdowns, closures, mandates, treatment limitations, and the resulting cascade of social, health, and microeconomic effects. The pandemic also provided opportunity to stomp on basic rights, as when government health and law enforcement agencies cooperated with Big Tech firms to suppress speech and scientific debate.

According to one school of thought, however, America’s pandemic policy was often successful but, where it fell short, was hindered by too little action by aggressive authorities. In a new essay for the Niskanen Center, “Incapacitated: How a lack of state capacity doomed pandemic results,” Brink Lindsey concludes that

The failure to formulate and execute a strategy for victory was, at bottom, a failure of imagination: a failure to shake off a compliance mindset wedded to following established procedures and adopt instead a war-fighting mindset dedicated to achieving desired results.

This is a bold argument. It brings to mind the apparent zero-Covid strategy of China, which is still locking down major cities and monitoring citizens’ every move with smartphone passports. Many Western public health authorities ventured far past their historic territory and essentially ran many nations for two years. Lindsey thinks the U.S. should have pushed even further. Unpacking Lindsey’s argument is going to require several posts. The pandemic is endlessly multifaceted. It’s difficult to address the detailed scientific data, health outcomes, policy angles, international comparisons, and also weave all the chapters into a convincing overarching story. Lindsey does a good job building these micro episodes into a coherent macro theme, at least as he sees them.

Lindsey claims that:

• broad lockdowns saved many lives and were mostly worthwhile, and we could have saved even more people in 2020 with even more stringent lockdowns;

• school closures may have been overdone but aren’t a big deal;

• American government and society showed it could mobilize on a large scale. Political dysfunction prevented us from even bigger mobilizations, which could have crushed the virus;

• the CDC’s early testing fiasco had a devastating impact on the trajectory of the pandemic. If we’d had better tests earlier, we could have saved most victims in 2020;

• the vaccines were among the greatest scientific successes in history.

What he leaves out is perhaps even more revealing. Lindsey doesn’t address or barely acknowledges:

• the costs of lockdowns and school closures;

• the possibility that early treatment with widely available, inexpensive, generic drugs may have saved hundreds of thousands of lives and also changed the trajectory of the virus, nor the FDA and NIH’s crackdown on these everyday drugs;

• estimates of infection fatality rates (IFRs), demonstrating the extreme risk differential among age and health cohorts, one of Covid-19’s most striking features;

• international comparisons, including the fact that many low-income nations with little state capacity (or developed nations who pursued a light-touch strategy, such as Sweden) outperformed many rich nations with big state capacity;

• the downsides of vaccine mandates, which invaded personal autonomy, cost jobs and educations, shrunk the labor force, damaged military readiness, and imposed a one-size-fits-all policy on a disease with extreme risk stratification;

• the potential downsides, risks, and effectiveness of the vaccines, including individual adverse events, ongoing immune dysfunction, and population level evolutionary dynamics;

• the basics of virology and epidemiology, including fundamental concepts like herd immunity;

• the jarring rise in all-cause and non-Covid excess mortality in the U.S. and many developed nations, still ongoing today;

• the failure to conduct robust public debates, or the causes of such under-discussion, such as censorship by Big Media, Big Tech, and Big Medicine; and

• the macroeconomic results of these robust and unprecedented assertions of state capacity – dramatically slashing supply of output, labor, and webs of production while juicing demand with trillions in money spending and printing.

We could go on. We will address many of these claimed successes, exaggerated hiccups, underestimated harms, ignored concepts, and discounted failures in future articles.

The Big Claim

But first, we take on the biggest assertion undergirding his analysis – the claim that the vaccines saved more than one million American lives in 2021 alone. Lindsey swoons:

The one area where the U.S. pandemic response not only met but exceeded expectations was in vaccine development…

The result was a spectacular and historic success – one that deserves to be mentioned in the same breath with the Manhattan Project, the Berlin airlift, and Project Apollo.

Such a belief would naturally elevate one’s assessment of the overall effectiveness of pandemic policy in particular and of state capacity in general. One million is a lot of people! Total all-cause U.S. deaths for 2021 were 3,457,517. The failure to save a million people would have boosted total American deaths last year by an astonishing 31%.¹

But does this “1 million saved claim” hold up under scrutiny? Let’s take a look.

The claim comes from a January 2022 study by the Commonwealth Fund.² The Commonwealth model estimates that between mid-December 2020 and November 30, 2021, Covid-19 vaccines spared the lives of 1.087 million Americans. Running their analysis through the end of December 2021 would have produced even more lives saved. So our critique, which only assumes they claim 1.087 million saved for the entire year, is conservative from our point of view.

To understand how extraordinary the 1 million saved claim is, we need to look at what actually happened.

In the diagram below, you can see Our World in Data’s chart, showing actual cumulative U.S. Covid-19 deaths – 350,555 in 2020 and 475,059 in 2021. You can also see our annotations in pink, blue, and gray. Despite the administration of 520 million vaccine doses in 2021, Covid took 124,504 more American lives in 2021 than 2020. Blowing right past this apparent failure, Lindsey and Cowen claim, based on the Commonwealth Fund analysis, that vaccines saved 1.087 million Americans from dying in 2021. How can this be?

This diagram shows official cumulative U.S. Covid-19 deaths, compared to claims that Covid-19 vaccines saved 1.087 million American lives in 2021.

The “1.087 million saved” claim implies that without vaccines, 1.562 million Americans would have died from Covid-19 in 2021. This would have required a shocking acceleration in Covid-19 deaths – nearly 4.5 times the number who died in 2020. They assume that in a world where many of our most vulnerable citizens had succumbed to Covid-19 in 2020, where presumably we were getting better at treating the disease, four-and-a-half times more people were going to die in 2021. Does that seem plausible?

As previously mentioned, the model in fact only ran through November 2021, so they are really claiming more than 1.087 million saved throughout 2021.

An Implausible Acceleration

Using the conservative 1.087-million-saved-in-2021 figure, however, consider what 1.562 million total Covid-19 deaths implies:

• That’s 4,279 Covid-19 deaths every day for the entire year.

• Back in the real world, no single day ever reached that level.

• Only seven days ever topped 4,000 deaths in the U.S.

• All seven of these days occurred after the vaccine rollout began. (January 8, 12, 20, 27, and December 22, 2021; January 28 and February 4, 2022.)

• Zero days pre-vaccine topped 4,000 deaths.

• The model’s counterfactual peak during August-October 2021 generates unprecedented daily death rates over many weeks, more than double the very highest seen anywhere in the world – even for a day or two, let alone a multi-week period – from the beginning of the pandemic.

• During this peak, the model generates daily death rates for several weeks four to six times higher than anything seen in the U.S. throughout the pandemic.

• Total all-cause U.S. deaths for 2021 were 3,457,517. The 1.087 million claim implies, without Covid vaccines, the U.S. would have suffered 31% more total deaths from any cause, on top of the worst year ever.

Another Lancet paper, using similar analysis, claims 20 million lives saved worldwide in 2021. The HART Group from Britain analyzed that paper here and gave one example of how bogus the model is.

South East Asia also tells an important story. These countries are heavily vaccinated and yet with the latest Omicron wave they have experienced mortality amounting to 300, 400 or even more per million. This is the same order of magnitude as Europe experienced in Spring 2020, with the original variant and before vaccination. The claim that vaccinations prevent 80%+ of covid deaths does not fit with what is happening in the real world.

Dr. Clare Craig tweeted a short video about the model’s inexplicable counterfactual death acceleration required to save 20 million people.

HART Group analysis of the Imperial College model, which generates a gigantic counterfactual spike of deaths in 2021 compared to 2020.

A normal person might assume that a successful vaccine would reduce deaths from the target disease. Below you can see a purely hypothetical scenario in which a semi-successful vaccine softens the slope of deaths after the rollout. In this case, the vaccine reduces deaths in 2021 to around 175,000, or half that of 2020.

Here is a purely notional scenario in which a semi-successful vaccine reduces Covid-19 deaths by half in 2021 compared to 2020. Instead, mass deployment of 520 million doses of a non-sterilizing “leaky” vaccine led to convergence on more infectious variants, which escaped vaccine protection, extended the life of the pandemic, resulted in far more deaths in 2021 than 2020, and then propelled even faster viral transmission into 2022.

Instead, through the art of modeling, where counterfactual deaths are inflated beyond all plausibility, we are told that a 35% acceleration of Covid-19 deaths in the second year of a pandemic – with 520 million vaccine doses! – is a smashing success. Now that’s a bold assertion.

Remember, the latest estimate of Covid-19’s infection fatality rate (IFR) for unvaccinated, never-infected people under 70 years old is .095%. It comes once again from Stanford professor John Ioannidis and colleagues. Analyzing numerous IFR studies from around the world, they update the age-stratified IFRs below. In addition to other unlikely assumptions, the 1 million saved claim would require Covid-19’s IFR to have jumped roughly by a factor of five in 2021. Delta appeared to be somewhat more pathogenic than previous variants. But five times worse? (In future posts, we will address an even more complex dynamic – how convergence on the more infectious, more pathogenic, vaccine evading Delta was likely the result of extreme evolutionary pressure exerted by the mass vaccination campaign.)

These latest IFR estimates are derived from studies of hundreds of millions of unvaccinated, never-infected individuals across the globe.

We’ve not yet even addressed the crucial measure of all-cause mortality, which makes all this look far worse. After billions of vaccine doses, both Covid-19 deaths and non-Covid-19 deaths – and thus all deaths – are way up. In nearly all developed nations with high vaccine rates, overall health is far worse now than before the vaccine rollout.

The reliance on an analysis with such obvious and gigantic flaws is instructive. It helps explain the thinking and actions not only of public health experts but also the broader public policy community.

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Comments on State Capacity Covidology

The One Million Lives Saved Claim: Part 1

Double Down Hallucination: Part 2

Who Really Wanted to Speed Remedies?: Part 3

Defending Steph Curry: A Computer Model: Part 4

Where Did All the Workers Go?: Part 5

A Narrative That’s Too Big To Fail: Part 6

Mortality Play: 2020 vs. 2021-22: Part 7

Dr. Frieden’s Follies: Part 8

Japan Matches Germany's 2022 Mortality Spike: Part 9

Society of Actuaries Shows Continued Young Adult Mortality Spike: Part 10

Dr. Hotez’s Data Is Highly Flawed: Part 11

Covid and the Golly Folly: The blind spot of gee whiz technology futurism: Part 12

1. This belief gives us much deeper insight into the mindset of the state capacity Covidians. In recent interviews and articles, George Mason University economist Tyler Cowen also cited the one million figure. We are genuinely grateful for Lindsey’s article. It finally specifies the arguments of one “side” of the debate. Too often over the last several years this worldview was presented in a series of TV assertions and social media harangues. In fact, the lack of nearly any detailed debate over the last two-plus years was a giant flaw of public policy and democracy.

2. Here are more citations: a Vox article on the Commonwealth study; a JAMA paper using a similar model; a Lancet study asserting 20 million lives saved worldwide in 2021; and an Economist article on the Lancet study.