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International Journal of
Population Studies Human behaviors during the COVID-19 pandemic

respiratory syndrome coronavirus 2 (SARS-CoV-2) is a number of deaths by age in the US, corresponding to an
relatively mild virus that has caused huge societal impacts. overall 2.5% death rate.
The 23,000-page document contains approximately The global COVID-19 death rate would have been
22,000 paper summaries drawn from 2,250 sources. Most lower than that of the US due to its lower overall age rate.
of these papers originate from journals and platforms Globally, if there had been no behavioral changes, there
such as Nature, Cell, Science, Frontiers, MDPI, Sage, would have been about 115 million deaths or a 1.5% case
Cureus, JAMA, the American Health Association, The fatality rate.
British Medical Journal, New England Journal of Medicine,
PLOS, BMC, Wiley, Proceedings of the National Academy With the Wuhan variant of COVID-19, which had a
of Sciences, bioRxiv, medRxiv, preprints.org, SSRN, viral reproduction number (R ) of 2.5, cases would have
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Research Square, and the Centers for Disease Control grown exponentially—as observed in the first few weeks
and Prevention (CDC). The six chapters—“How People in the US outbreak (later in the pandemic, SARS-CoV-2’s
Behaved,” “Avoiding COVID,” “Politics and National R reached double digits). Under this scenario, everyone
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COVID Responses,” “Herd Immunity,” “Superspreaders in the US would have been infected by mid-summer,
and Superspreading Events,” and “Pandemic Medical rendering vaccines ineffective, and hospitals would have
Impacts”—along with the 4,500 paper summaries, form been extremely overloaded. This scenario epitomizes the
the foundation of this review. remark by Boris Johnson, then Prime Minister of the
United Kingdom, that “COVID is just nature’s way of
2. The significance of behavior during a dealing with old people.”
pandemic The October 2020 Great Barrington Declaration, which

Let us consider a Gedanken thought experiment to see what was endorsed by the US President at the time, Donald
would have happened if no one had changed their behavior Trump, suggested that elderly individuals stay home, while
during the pandemic. An April 2021 CDC Mortality and allowing others to become infected, thereby achieving herd
Morbidity Weekly Report paper presented data on COVID-19 immunity and avoiding school closures. Assuming this
approach had been implemented early in the pandemic,
in the United States (US) in 2020, as shown in Figure 1.
herd immunity might have been attainable if people aged
This 4.9% rate is consistent with Our World of Data’s 50 and older stayed home; however, the number of deaths
world case fatality rates, which were 5.2% for the same would be equal to the actual pandemic toll. If the threshold
interval. Case fatality rates are calculated as confirmed had been raised to isolate the 60+ age group instead, deaths
deaths divided by confirmed cases. Confirmed cases would have doubled. To complicate matters further, new
typically represent symptomatic cases, which accounted for variants would have required subsequent Great Barrington
only 60% of the cases. In addition, many mild cases would Declarations.
have been interpreted as the flu or a mild cold. Thus, it is
reasonable to assume that the actual number of cases was 2.1. Differences between countries
twice as high, resulting in an estimated case fatality rate of COVID-19 deaths and excess deaths dramatically reflected
2.5% for all infections. Assuming no changes in behavior the impacts of different countries’ pandemic behavioral
and applying these death rates, Table 1 shows the projected responses. Had the US matched the average performance

Figure 1. United States COVID deaths. Image obtained from Ahmad et al., 2021.

Volume 11 Issue 5 (2025) 2 https://doi.org/10.36922/IJPS025110040