Freedom Wins: States with Less Restrictive COVID Policies Outperformed States with More Restrictive COVID Policies

States with more limited government interventions did not have diminished health outcomes, and helped workers and students. 

From The Paragon Institute.

"Overview

The most important health event of the recent past was the COVID-19 pandemic. Policymakers must now learn which government responses were helpful and which were not. Paragon’s new report, “Freedom Wins: States with Less Restrictive COVID Policies Outperformed States with More Restrictive COVID Policies,” assesses the impact of state government pandemic measures on health, economic, education, and domestic migration outcomes.

The paper was coauthored by Paragon’s Public Health and American Well-being Initiative director Dr. Joel Zinberg, Paragon’s President Brian Blase, Dr. Eric Sun at Stanford University, and economist Casey Mulligan at the University of Chicago. 

Methodology

The study compared a quantitative measure of state government response measures developed by Oxford University to health, economic, and educational outcome measures in all 50 states and the District of Columbia that had been developed by Casey Mulligan in an earlier paper. Oxford’s index measured government interventions including mandatory, state-enforced closures of businesses, schools, and recreational and religious facilities; restrictions on public gatherings; stay-in-place orders; and masking and social distancing requirements. The study also compared the Oxford index to changes in state-to-state migration patterns. 

Government interventions did not produce health benefits but had large economic and education costs

• States with severe government interventions did not significantly improve health outcomes (age-adjusted and pre-existing-condition adjusted COVID mortality and all-cause excess mortality) compared to states with more restrained approaches. This may be partly because government interventions appear to have increased excess mortality from non-COVID health conditions.
• Severe government interventions were strongly correlated with worse economic (increased unemployment and decreased GDP) and educational (fewer days of in-person schooling) outcomes. The economic and education damage was most severe for lower-income families and children. 

People voted with their feet and moved away from states with severe restrictions to states that took a more restrained approach

• Census data on domestic migration (movements across states) showed a substantial increase in domestic migration during the pandemic (July 1, 2020—June 30, 2022) compared to pre-pandemic trends (July 1, 2014—June 30, 2019). 
• Severe government interventions were strongly correlated with net out migration from states, suggesting that people fled states with more severe lockdowns and moved to states with less severe measures.

Florida outperformed California

The paper contains a case study of California and Florida, two large states with some common characteristics but that took much different pandemic responses. Despite its less severe approach and older population, Florida’s outcomes were far superior to California’s outcomes.
 
Here are a few key findings about the two states’ approaches and outcomes from the paper:

• Florida relaxed general lockdowns after a short time, resulting in a low Oxford index score. Florida focused its remaining measures on protecting the people most vulnerable to COVID.
• California imposed strict and prolonged lockdowns and had one of the highest Oxford index scores in the nation. 
• The two states had roughly equal health outcomes scores, suggesting little, if any, health benefit from California’s severe approach.
• California suffered far worse economic and education outcomes than Florida, which scored well above average on each. 
• California’s severe lockdowns seemed to elicit a jump in its already high out-migration, while Florida experienced a significant in-migration increase during the pandemic as compared with pre-pandemic trends. 

Florida’s approach was similar to Sweden’s approach of avoiding lockdowns, keeping schools open, and relying on individuals to make their own decisions. The paper discusses how well Sweden and Florida fared relative to other countries and states.

Recommendation

In future pandemics, policymakers should avoid severe, prolonged, and generalized restrictions and instead carefully tailor government responses to specific disease threats, encouraging state and local governments to balance the health benefits against the economic, educational, health, and social costs of specific response measures."