The unintended health effects of US COVID-19 lockdowns: a systematic review

Abstract

Introduction: US lockdowns and school closures implemented during the COVID-19 pandemic were intended to mitigate viral transmission and protect public health. However, the broader health effects of these interventions remain unclear. Methods: We conducted a systematic review of peer-reviewed studies that assessed the impact of US lockdowns and school closures on health-related outcomes excluding COVID-19 transmission and mortality. Results: A total of 132 studies met inclusion criteria, yielding 454 unique outcomes. Lockdowns and school closures were associated with detrimental health effects in the majority of outcomes analyzed, including over 90% of mental health, obesity-related, and health-related social need outcomes (child development/education, employment, access to food, and economic/financial stability). Analyses focused on vulnerable populations, such as racial and ethnic minorities, low-income groups, and individuals with disabilities, were significantly more likely to report detrimental outcomes than the general population. Conclusion: Given how lockdowns and school closures may affect population well-being, policymakers should carefully weigh both the benefits and harms of these interventions, including how they may affect vulnerable populations. We conclude with policy recommendations to mitigate ongoing harms and inform more evidence-based decision-making.