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Non-Pharmaceutical Interventions and Mortality in U.S. Cities during the Great Influenza Pandemic, 1918-1919

Robert J. Barro

NBER Working Paper No. 27049
Issued in April 2020, Revised in July 2020
NBER Program(s):Economic Fluctuations and Growth, Health Economics, Public Economics

A key issue for the ongoing COVID-19 pandemic is whether non-pharmaceutical public-health interventions (NPIs) retard death rates. The best information about these effects likely comes from flu-related excess deaths in large U.S. cities during the second wave of the Great Influenza Pandemic, September 1918-February 1919. NPIs, as measured by Markel, et al. (2007), are in three categories: school closings, prohibitions on public gatherings, and quarantine/isolation. Although an increase in NPIs clearly flattened the curve in the sense of sharply reducing the ratio of peak to average death rates, the estimated effect on overall deaths is small and statistically insignificant. One possibility is that the NPIs were not more successful in curtailing overall mortality because the average duration of NPIs was only around one month. Another possibility is that NPIs mainly delay deaths rather than eliminating them.

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Document Object Identifier (DOI): 10.3386/w27049

 
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