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LIVING WITH COVID-19: BALANCING COSTS AGAINST BENEFITS IN THE FACE OF THE VIRUS

Published online by Cambridge University Press:  28 July 2020

David Miles ,
Mike Stedman  and
Adrian Heald
David Miles
Affiliation:
Professor of Economics, Imperial College, London. E-mail: d.miles@imperial.ac.uk.
Mike Stedman
Affiliation:
RES Consortium. E-mail: mstedman@resconsortium.com.
Adrian Heald
Affiliation:
The School of Medicine, University of Manchester. E-mail: adrian.heald@manchester.ac.uk.
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Abstract

This paper analyses the costs and benefits of lockdown policies in the face of COVID-19. What matters for people is the quality and length of lives and one should measure costs and benefits in terms of those things. That raises difficulties in measurement, particularly in valuing potential lives saved. We draw upon guidelines used in the UK for public health decisions, as well as other measures, which allow a comparison between health effects and other economic effects. We look at evidence on the effectiveness of past severe restrictions applied in European countries, focusing on the evidence from the UK. The paper considers policy options for the degree to which restrictions are eased. There is a need to normalise how we view COVID because its costs and risks are comparable to other health problems (such as cancer, heart problems, diabetes) where governments have made resource decisions for decades. The lockdown is a public health policy and we have valued its impact using the tools that guide health care decisions in the UK public health system. The evidence suggests that the costs of continuing severe restrictions in the UK are large relative to likely benefits so that a substantial easing in general restrictions in favour of more targeted measures is warranted.

Keywords

value of lives savedcost benefit analysisCOVID-19I18D61E65
Type
Research Article
Information
National Institute Economic Review , Volume 253 , August 2020 , pp. R60 - R76
Copyright
© National Institute of Economic and Social Research, 2020

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Footnotes

The authors thank two anonymous referees and Jagjit Chadha for many helpful comments on an earlier draft.

References

REFERENCES

Adler, M. (2020), ‘What should we spend to save lives in a pandemic? A critique of the value of statistical life”, Covid Economics, 33, June.Google Scholar
Aum, S., Lee, S.Y. (Tim) and Shin, Y. (2020), ‘Doesn’t need lockdowns to destroy jobs: the effect of local outbreaks in Korea’, CEPR Discussion Paper 14822.CrossRefGoogle Scholar
Arulampalam, W., Gregg, P. and Gregory, M. (2001), ‘Unemployment scarring’, The Economic Journal, 111(475), F577–F584.CrossRefGoogle Scholar
Beaudet, A., Clegg, J., Thuresson, P., Lloyd, A. and McEwan, P. (2014), ‘Review of utility values for economic modeling in Type 2 Diabetes’, Value in Health, 17, 4, June, pp. 462–70.CrossRefGoogle ScholarPubMed
Bonadio, B., Huo, Z., Levchenko, A.A. and Pandalai-Nayar, N. (2020), ‘Global supply chains in the pandemic’, NBER Working Paper 27224, May.CrossRefGoogle Scholar
Bongaerts, D., Mazzola, F. and Wagner, W. (2020), ‘Closed for business’, CEPR Discussion Paper 14814, May.Google Scholar
Born, B., Dietrich, A.M. and Müller, G.J. (2020), ‘Do lockdowns work? A counterfactual for Sweden’, Covid Economics, 16, May.Google Scholar
Bradley, J., Ruggieri, A. and Spencer, A.H. (2020, ‘Twin peaks: Covid-19 and the labor market’, Covid Economics, 21, May 2020.Google Scholar
Clarke, P., Gray, A. and Holman, R. (2002), ‘Estimating utility values for health states of type 2 diabetic patients using the EQ-5D (UKPDS 62)’, Med Decision Making, 22, pp. 340–9.CrossRefGoogle Scholar
Coibion, O., Gorodnichenko, Y. and Weber, M. (2020a), ‘Labor markets during the Covid-19 crisis: a preliminary view’, Covid Economics, 21, May.CrossRefGoogle Scholar
Coibion, O., Gorodnichenko, Y. and Weber, M. (2020b), ‘The cost of the COVID-19 crisis: lockdowns, macroeconomic expectations, and consumer spending’, Covid Economics, 20, May.CrossRefGoogle Scholar
Martin, J., Conyon, L. H. and Thomsen, S. (2020), ‘Lockdowns and COVID-19 deaths in Scandinavia’, Covid Economics, 26, pp. 17–42.Google Scholar
Deb, P., Furceri, D., Ostry, J.D. and Tawk, N. (2020), ‘The economic effects of Covid-19 containment measures’, Covid Economics, 24, May.Google Scholar
Dimdore-Miles, O. and Miles, D. (2020), ‘Assessing the spread of the novel coronavirus in the absence of mass testing’, Covid Economics, 16, pp. 161–76, May.Google Scholar
Ferguson, et al. (2020), ‘Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand’, Imperial College COVID 19 Response team report, 16 March.Google Scholar
Friston, K.J., Parr, T., Zeidman, P., Razi, A., Flandin, G., Jean Daunizeau, J., Hulme, O.J., Billig, A.J., Litvak, V., Moran, R.J., Price, C.J. and Lambert, C. (2020), ‘Dynamic 19 causal modelling of Covid 19’, Technical Report available at https://arxiv.org/ftp/arxiv/papers/2004/2004.04463.pdf.CrossRefGoogle Scholar
Goldstein, J.R. and Lee, R.D. (2020), ‘Demographic perspectives on mortality of COVID-19 and other pandemics’, NBER Working Paper 27043.CrossRefGoogle Scholar
Krueger, D., Uhlig, H. and Xie, T. (2020), ‘Macroeconomic dynamics and reallocation in an epidemic’, Covid Economics, 5, April.CrossRefGoogle Scholar
Layard, R., Clark, A., De Neve, J-E., Krekel, C., Fancourt, D., Hey, N. and O’Donnell, G. (2020), When to Release the Lockdown: A Wellbeing Framework for Analysing Costs and Benefits, LSE CEPR, Occasional paper 49.Google Scholar
Levitt, M. (2020), ‘The corona chronologies’ available at: ‘https://www.dropbox.com/s/r4gxdvlcnrxet1i/1.The_Corona_Chronologies.%20Part%20I%20-%20China.%20Part%20II.%20Rest_of_World_Michael_Levitt%2CStanford_r.pdf?dl=0.Google Scholar
Lourenço, J., Paton, R., Ghafari, M., Kraemer, M.,Thompson, C., Simmonds, P., Klenerman, P. and Gupta, S. (2020), ‘Fundamental principles of epidemic spread highlight the immediate need for large-scale serological surveys to assess the stage of the SARS-CoV-2 epidemic’, medRxiv preprint doi: https://doi.org/10.1101/2020.03.24.20042291, March.CrossRefGoogle Scholar
Murphy, K.M. and Topel, R.H. (2006), ‘The value of health and longevity’, Journal of Political Economy, 114, 5, October, pp. 871–904.CrossRefGoogle Scholar
Mackie, D., Alexandersson, L. and Monks, A. (2020), Sweden’s Approach to COVID-19: Some Early Comparisons, JP Morgan Report, 25 June.Google Scholar
NICE (2013), How NICE measures value for money in relation to public health interventions, 1 September, available at: nice.org. uk/guidance/lgb10.Google Scholar
Propper, C., Stoye, G. and Zaranko, B. (2020), ‘The wider impacts of the coronavirus pandemic on the NHS’, IFS briefing, available at: https://www.ifs.org.uk/publications/14798, April.CrossRefGoogle Scholar
Stedman, M., Davies, M., Lunt, M., Verma, A., Anderson, S.G. and Heald, A.H. (2020), ‘A phased approach to unlocking during the COVID-19 pandemic – lessons from trend analysis’, forthcoming in International Journal of Clinical Practice.CrossRefGoogle ScholarPubMed
Tumino, A. (2015), ‘The scarring effect of unemployment from the early ‘90s to the Great Recession’, Institute for Economic and Social Research Working Paper 2015-5.Google Scholar
Valabhji, J., Holman, N., Knighton, P., Kar, P., O’Keefe, J., Curley, M., Weaver, A., Barron, E., Bakhai, C., Khunti, K., Wareham, N., Sattar, N. and Young, B. (2020), ‘Type 1 and Type 2 diabetes and COVID-19 related mortality in England: a cohort study in people with diabetes’, pre print available at https://www.england.nhs.uk/wp-content/uploads/2020/05/Valabhji-COVID-19-and-Diabetes-Paper-2-Full-Manuscript.pdf.Google Scholar
Viscusi, W.K. (2018), Pricing Lives: Guideposts for a Safer Society, Princeton University Press.Google Scholar
Viscusi, W.K. (2020), ‘Pricing the lives saved by coronavirus policies’, New IZA World of Labor Commentaries on the Coronavirus Crisis, 27 March: https://wol.iza.org/opinions.Google Scholar
Wieland, T. (2020), ‘Flatten the curve! Modeling SARS-CoV-2/ COVID-19 growth in Germany on the county level’, pre print available at https://www.medrxiv.org/content/10.1101/2020.05.14.20101667v2.CrossRefGoogle Scholar