Non-Pharmaceutical Interventions vs. Covid Mostly Didn't Work, According to a New 'Study'

You're in for a wild ride (and some laughs), as public health officialdom 'discovers' that NPIs didn't work 'in previous pandemics, incl. influenza'--and, guess what, they didn't work now (/sarcasm)

Today, we’re in for a special treat: Kamineni et al., in a paper entitled, ‘Effects of non-compulsory and mandatory COVID-19 interventions on travel distance and time away from home, Norway, 2021’, assessed a whole range of non-pharmaceutical interventions (NPIs) in a Nordic country that isn’t Sweden. Appearing in Eurosurveillance (vol. 28, no. 17, 27 April 2023), the paper claims to be the best available assessment of such NPIs available.

While I read the study so you don’t have to suffer from vacuous academese, I encourage everyone to read the ‘study’—really: most like a ‘working paper’—and draw your own conclusions from it.

As always, ‘spot’ commentary [in squared parentheses], emphases, and bottom lines are mine. Moreover, I’ve removed the references in the below posting.

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Key Public Health Message

What did you want to address in this study?

• We wanted to understand how compliant people were with non-mandatory and follow-up mandatory measures in Norway, which we measured through their impact on reducing human mobility. If non-mandatory measures are effective in reducing mobility, they may be sufficient to generate compliance.

What have we learnt from this study?

• People travelled shorter distances from home after non-compulsory measures were introduced. In urban areas, distance decreased further when the measures were made mandatory [what a surprising finding]. Travelling times also became shorter, and this effect was stronger after mandated than after non-compulsory interventions, in both rural and urban regions. Stricter metre rules and reopening of gyms, restaurants and shops prompted changes in people’s behaviour.

What are the implications of your findings for public health?

• In less populated areas, making the recommendations mandatory did not make people reduce their travelling distance much more than they already had after the initial recommendations. Therefore, less invasive and costly non-mandatory measures may be sufficiently effective in less urbanised areas in Norway.

Introduction

Current understanding of the effects of individual non-pharmaceutical interventions (NPI) on COVID-19 transmission is still limited…It is difficult to analyse how NPI impact infections in observational studies owing to seasonality, new strains, self-regulating behaviour and multiple interventions being implemented and/or lifted simultaneously [or in a staggered fashion]. Moreover, interventions are often lifted during periods with little transmission and few cases, so finding significant differences requires strong effects…

Norway, alongside the other Nordic countries, has extensively employed non-mandatory advice to reduce social contacts and sometimes, during epidemic spikes, made these interventions obligatory. Non-mandatory measures are less invasive and costly than stricter alternatives and have been recommended in previous pandemics, including influenza [oh, look, we’ve not done this in earlier ‘pandemics’—go figure]…We also analysed the effects of specific NPI, such as limitations on private guests, events and alcohol serving [goody, let’s see if this was ‘helpful’].

Investigating the effects of NPI on mobility requires careful choice of data, and we used mobile phone data that are unique in their high coverage of the Norwegian population, estimated at ca 47.5% of mobile phone users in 2019…We propose alternate metrics, radius of gyration and time away from home, which provide different insights into human behaviour compared with origin–destination mobility data. Radius of gyration describes distance travelled from home and is useful to study regional interventions thanks to its sensitivity to local effects [keep the data input in mind, as this is too important not to discuss at some length in the bottom lines].

Results

Distance and time away from home decreased after initial national non-mandatory measures in December 2021 in Norway. TimeAway [from home] further decreased after follow-up mandates. In urban areas, all metrics decreased after follow-up mandates, while in rural areas, only timeAway was reduced. In major cities, none of the metrics changed after non-mandatory regional measures, but time and distance travelled decreased after follow-up regional mandatory measures. In rural regions, only meanDistAway decreased following initial regional measures, and timeAway declined after follow-up regional mandates.

Behold the masterful aggregation of results of a surely complicated statistical operation: it’s all dashes and arrows: well done, public health officials, for doing such a good job (the sound you’re hearing is public health officialdom patting themselves on their backs for a job well done)

Effects of Intervention Categories

Table 4 shows statistically significant features associated with WeekMobilityChange in meanDistAway, timeAway, and maxDistAway.

NPIs worked like a charm, that is, in 4—or 33%—of the listed categories presented in Tab. 4; in other words: NPIs were twice as likely to show no statistically significant effect. Put bluntly: NPIs don’t work; and while we kinda knew that before, now we’re got ‘da science™’ to prove this. Doh.

Stricter metre rules were associated with reductions in meanDistAway. Restaurant and shop re-openings were associated with timeAway increasing, while easing physical distancing measures was associated with reductions in timeAway. In addition, reopening gyms was correlated with reductions in maxDistAway but not in meanDistAway. Interventions related to teleworking, schools, alcohol serving and face mask requirements were not associated with any significant mobility changes. [There you go: home office, schools, restrictions on bars and restaurants, and donning face diapers did nothing.]

Discussion

Distance and time travelled decreased following non-mandatory national measures, while after regional non-mandatory measures, distance only decreased in rural areas…we observed higher relative distance and time travelled reductions in urban areas…Since distance travelled did not decline after follow-up mandates in less populated areas, non-mandatory measures, which are less costly and invasive, may be more appropriate to generate compliance…

Stricter metre [social distancing] rules were associated with decreased distance travelled. Reduced physical distancing measures were correlated with decreased time travelled, perhaps because people feel safer with recommendations in place [talk about weaponising woke-ified nonsense]. Gyms reopening was associated with decreased maxDistAway, possibly because people were training outside and further away from their homes when gyms were closed. Further investigation is necessary to determine the validity of interventions that did not have significant effects in our analysis. NPI with non-significant effects on all metrics included measures related to teleworking, schools, alcohol serving and face masks [so, basically, none of the lockdown stuff worked, and we’re none the wiser now].

[Limitations]

This observational study has many limitations. With the before–after analysis, potential confounders include temperature and weather. While we analysed mobility trends before interventions were enacted, there were no controls. Yet, because we studied short periods before and after NPI, it is reasonable to assume that the differences in the absence of interventions were constant. Results from the before–after analysis should be interpreted as associations and not as cause and effect…

We did not assess how interventions impacted COVID-19 incidence, owing to factors such as under-reporting of cases and delays between transmission and testing positive for COVID-19…mobility and transmission were not always correlated, especially during later waves of the pandemic…mobility is only a proxy for a reduction in contact rate and there may be a selection bias in mobile phone use and ownership.

[Curiously, what’s not mentioned here—but a bit earlier in the section on ‘Analysis of national interventions’, is the following statement: ‘the before–after analysis has limitations, including the lack of controls’, which is, I’d argue, of utmost importance here]

Conclusions

Nationally, mobility declined following initial non-mandatory measures in all cities and counties studied. Distance travelled decreased following non-mandatory measures in less populated areas and declined further after follow-up mandates in more populated areas. We found that stricter metre rules, reopening of gyms and of restaurants and shops were significantly associated with changes in mobility. These observations have important policy implications on which NPI to implement, the choice between non-mandatory or mandatory measures, and using regional or national interventions. Since distance travelled declined less after follow-up mandates than after initial recommendations in less populated areas, less invasive and costly non-mandatory measures may be sufficiently effective for rural areas in the case of Norway.

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Bottom Lines

Now, anyone could derisively downplay this piece of ‘research’ as yet another garbage in-garbage out ‘study’, and doing so would be perhaps the best way to describe it. Yet, we note, in passing, the similarity of the above-discussed ‘study’ to the multitude of papers on ‘vaccine efficacy’, which also typically do not include a control group. Hence, apologies for wasting your time.

As to the matters at-hand that beg additional consideration, we note, yet again, the discrepancy between the ‘Key messages’ and the ‘Conclusions’ vs. ‘the stuff in-between’, that is, the ‘study’.

What I found particularly appalling is the pseudo-scientific veneer the authors are employing to convey their results. This becomes particularly apparent in the sections that show where these NPIs did not work, i.e., in 2 out of 3 instances, most notably,

NPI with non-significant effects on all metrics included measures related to teleworking, schools, alcohol serving and face masks

In other words: NPIs related to mandatory remote work, the closing of schools and hospitality venues, and the most odious of compliance-signalling stuff, face diapers, did not work along ‘all metrics’.

Moreover, anonymised cell phone data was used as data input, and the corresponding author, Meghana Kameneni, although listing the Oslo Centre for Biostatistics and Epidemiology as her institutional affiliation, uses a harvard.edu email address as means to reach her. That means that any of the data used in this ‘study’ crossed international borders, which renders it subject to dragnet surveillance by the Five Eyes’ ‘intelligence community’; in other words: all the cell phone data has been vacuumed up by at least the US, too.

In summary: beware the notion that ‘lockdowns’ or Covid-inspired measures to ‘combat climate change’ or whatever will do much to curb CO2 emissions, reduce consumption patterns, or improve whatever other metric.

I suppose that, keeping in line with most other things related to ‘Covid’, no amount of evidence will do anything about future impositions. ‘Evidence-based’ whatever will become more and more like many other things: an Orwellian term devoid of meaning.

Good grief.