Movie depictions of human sacrifice are usually pretty straightforward: There’s an altar. There’s a knife. Sometimes the scenes take place on a big pyramid to better show off a stream of blood or a tumbling head.
But during the COVID-19 pandemic, Americans witnessed an actual mass human sacrifice that came with a different kind of ceremony and distinctive ritual chants. Those ceremonies took place in red state governors’ offices and the chants intoned “freedom” as these elected officials fought against closing schools, blocked mask mandates, and belittled the effectiveness of vaccines.
According to a paper published this week in the Journal of the American Medical Association, an enormous number of Americans died unnecessarily during the COVID-19 pandemic. Those deaths can’t be laid at the feet of Donald Trump for his diminishment of the threat and mishandling of the consequences. This tragic phenomenon was more local.
As many as one-quarter of a million Americans died simply because their state governments refused to impose good public health standards. They died as appeasements to the twin gods of ignorance and politics.
The results of the study are clear—and brutal.
If all states had imposed restrictions similar to those used in the 10 most restrictive states, excess deaths would have been an estimated 10% to 21% lower than the 1.18 million that actually occurred during the 2-year analysis period; conversely, the estimates suggest counterfactual increases of 13% to 17% if all states had restrictions similar to those in the 10 least-restrictive states.
In other words, if every state had followed the steps used in the 10 states that the study determined did the most to prevent COVID-19 through mask mandates, vaccination requirements, and limits on public gatherings, somewhere between 118,000 and 248,000 Americans would not have died.
“The death toll was probably considerably higher than it would otherwise have been in states that resisted imposing these restrictions, banned their use, or implemented them for only relatively short periods of time,” wrote Dr. Christopher Ruhm from the Frank Batten School of Leadership and Public Policy at the University of Virginia.
Conversely, if all states had followed the laissez-germ attitude of the least restrictive states, the number of unnecessary deaths would have jumped to between 271,000 and 447,000.
Not all restrictions were equally effective. Even though it may seem like an obvious step, the study indicates that widespread school closures and restricting visitors to nursing homes had a minimal impact, and may have actually done more harm than good when it comes to factors including educational outcomes and social isolation. But other restrictions (like mask mandates) had a direct and significant impact, especially when comparing states at opposite ends of the spectrum when it comes to pandemic-era restrictions.
“At the extreme,” wrote Ruhn, “the excess death rate in Massachusetts was less than one-fifth that of Mississippi (115 vs 590 per 100,000)” people.
Ruhn isn’t holding Mississippi and similar states to an impossible standard. He’s comparing their approach to the restrictions that were imposed in Massachusetts by Republican Gov. Charlie Baker.
But in Mississippi, Gov. Tate Reeves made opposition to public health measures a theme of his administration, quickly ending mandates for masks and restrictions on schools and businesses even though the high level of deaths was immediately visible. He has continued that approach since the study ended in 2022. That has included a bill blocking schools and public agencies from checking vaccination status, and reiterating his opposition to mask mandates,
As the study shows, states largely followed the same patterns in the early days of the pandemic: All of them had declared a “state of emergency” by March 15, 2020, and the overall level of restrictions was high by early April.
However, a few months into the pandemic, things began to change as right-aligned groups applied pressure on lawmakers.
Considerable policy variation emerged in the second half of 2020, with states reducing or eliminating activity limitations and, somewhat later, mask requirements. Mobility reductions also declined rapidly during this period, as did mask use after the start of 2021. Vaccinations first became available in December 2020 and quickly became widespread, but with considerable geographic heterogeneity.
To make that more clear, red states quickly ended limits on gatherings and mask mandates. When vaccines became available, those same states failed to impose mandates on schools or government agencies, resulting in low vaccination rates.
As those policy differences grew, so did the difference in excess deaths. These deaths didn’t happen in the early days of the pandemic when COVID-19 was poorly understood, treatment was uncertain, and there were shortages of necessary medical equipment. They came months into the pandemic, at a time when some of the states that had been the first to face the disease had effectively brought it under control.
These deaths came while Florida Gov. Ron DeSantis was issuing an order that blocked mask mandates, threatening cruise lines that tried to check vaccination status, and defunding schools that tried to follow guidelines from the Centers for Disease Control.
The deaths mounted as Texas Gov. Greg Abbott was blocking vaccine mandates even at private businesses, making mask mandates illegal, and stripping power from local governments and health agencies. They came as South Dakota Gov. Kristi Noem was bragging about how she had kept her state “open” and demeaning the use of masks.
And those governors are still at it. DeSantis made his nonresponse to COVID-19 the center of his aborted presidential campaign. Abbott refuses to cede “emergency powers” that allow him to block vaccine mandates and other health guidelines. Noem was still crowing about her refusal to protect South Dakota citizens at the Republican National Convention this month.
Again, none of what they had to do was impossible—other states did it. They can’t even defend their actions through concerns about cost. The study also shows that the cost of lives lost was far in excess of any other expense.
Using value of statistical life estimates ranging from $4.7 million to $11.6 million, the estimated lives saved from strong (vs weak) restrictions over the 2-year period were worth $1.3 trillion to $5.2 trillion—6% to 22% of 2021 gross domestic product—providing a possible benchmark against which to evaluate this loss.
Those are jaw-dropping numbers. But then, the value of human lives is extremely high. You might think state governors would know that.
The sheer number of people who died because a group of red state governors chose to—not had to, but chose to—implement policies they could brag about at the next big Republican event is simply devastating. Those amoral governors may never answer for these lost lives in any meaningful way, but voters can make sure those who are still in office get their just desserts at the ballot box.
Help elect a candidate with real concerns about public health and a belief in science by contributing $5 to Kamala Harris’ campaign.
