The common interests of health protection and the economy: evidence from scenario calculations of COVID-19 containment policies

A novel, scenario-based approach to comparing non-pharmaceutical intervention strategies across nations

Comparing COVID-19 response strategies across nations is a key step in preparing for future pandemics. Conventional comparisons, which rank individual non-pharmaceutical intervention (NPI) effects, are limited by: (i) a focus on epidemiological outcomes; (ii) NPIs typically being applied as packages of interventions; and (iii) different political, economic and social conditions among nations. Here, we develop a coupled epidemiological-behavioural-macroeconomic model that can transfer NPI effects from a reference nation to a focal nation. This approach quantifies epidemiological, behavioural and economic outcomes while accounting for both packaged NPIs and differing conditions among nations. As a first proof of concept, we take Germany as our focal nation during Spring 2020, and New Zealand and Switzerland as reference nations with contrasting NPI strategies. Our results suggest that, while New Zealand's more aggressive strategy would have yielded modest epidemiological gains in Germany, it would have resulted in substantially higher economic costs while dramatically reducing social contacts. In contrast, Switzerland's more lenient strategy would have prolonged the first wave in Germany, but would also have increased relative costs. More generally, these findings indicate that our approach can provide novel, multifaceted insights on the efficacy of pandemic response strategies, and therefore merits further exploration and development.

Ethical dilemma arises from optimizing interventions for epidemics in heterogeneous populations

Interventions to mitigate the spread of infectious diseases, while succeeding in their goal, have economic and social costs associated with them. These limit the duration and intensity of the interventions. We study a class of interventions which reduce the reproduction number and find the optimal strength of the intervention which minimizes the final epidemic size for an immunity inducing infection. The intervention works by eliminating the overshoot part of an epidemic, and avoids a second wave of infections. We extend the framework by considering a heterogeneous population and find that the optimal intervention can pose an ethical dilemma for decision and policymakers. This ethical dilemma is shown to be analogous to the trolley problem. We apply this optimization strategy to real-world contact data and case fatality rates from three pandemics to underline the importance of this ethical dilemma in real-world scenarios.

The spatial linkage mechanism: medical level, public health security, and economic climate from 19 OECD EU countries

Introduction

The global spread of the COVID-19 has brought about global changes, especially in terms of economic growth. Therefore, it has become a global issue to explore the impact of public health security on the economy.

Methods

Employing a dynamic spatial Durbin model, this study analyzes the spatial linkage mechanism of medical level, public health security, and economic climate in 19 countries as well as investigates the relationship between economic climate and COVID-19 by the panel data of 19 OECD European Union countries from March 2020 to September 2022.

Results

Results show that an improvement in the medical level can reduce the negative impact of public health security on the economy. Specifically, there is a significant spatial spillover effect. The degree of economic prosperity hurts the reproduction rate of COVID-19.

Discussion

Policymakers should consider both the severity of the public health security issues and the economic level when developing prevention and control policies. Given this, corresponding suggestions provide theoretical support for formulating policies to reduce the economic impact of public health security issues.

The challenge of estimating the direct and indirect effects of COVID-19 interventions - Toward an integrated economic and epidemiological approach

Decisions on public health measures to contain a pandemic are often based on parameters such as expected disease burden and additional mortality due to the pandemic. Both pandemics and non-pharmaceutical interventions to fight pandemics, however, produce economic, social, and medical costs. The costs are, for example, caused by changes in access to healthcare, social distancing, and restrictions on economic activity. These factors indirectly influence health outcomes in the short- and long-term perspective. In a narrative review based on targeted literature searches, we develop a comprehensive perspective on the concepts available as well as the challenges of estimating the overall disease burden and the direct and indirect effects of COVID-19 interventions from both epidemiological and economic perspectives, particularly during the early part of a pandemic. We review the literature and discuss relevant components that need to be included when estimating the direct and indirect effects of the COVID-19 pandemic. The review presents data sources and different forms of death counts, and discusses empirical findings on direct and indirect effects of the pandemic and interventions on disease burden as well as the distribution of health risks.

Longitudinal study of mental health changes in residents affected by an initial outbreak of COVID-19 in China

Introduction

The COVID-19 pandemic is ongoing, and the world continues to work to defeat it. We designed this study to understand the longitudinal change in the mental health of residents who experienced the initial disease outbreak in China and to explore the long-term influencing factors.

Methods

The Perceived Stress Scale (PSS), Generalized Anxiety Scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were administered to the same sample four times: during the initial outbreak (T1), 1 month later (T2), 18 months later (T3), and 26 months later (T4).

Results

A total of 397 participants completed all of the follow ups. The mean PSS scores among the four time points showed significant differences (F = 183.98, P < 0.001), with the highest score at T1 (15.35 ± 7.14), a sharp decline at T2 (11.27 ± 6.27), an obvious rebound at T3 (15.17 ± 7.46), and finally a slight decrease at T4 (14.41 ± 7.99). Among the four mean GAD-7 scores, significant differences were also found (F = 242.0, P < 0.001), with the trend that from T1 (7.42 ± 6.03) to T2 (7.35 ± 5.88), the scores remained steady, while they showed an apparent decline at T3 (5.00 ± 5.30) and no obvious change at T4 (4.91 ± 4.81). There were no significant differences among the mean PHQ-9 scores (F = 1.256, P < 0.284). The long-term influencing factors differed for stress, anxiety and depression, but all three were influenced by a history of psychosis at T4, quarantine status and whether the participants' family members were infected during the initial outbreak.

Discussion

The survey revealed that repeated outbreaks in other areas also had an impact on those who experienced the initial outbreak, with a return of stress, a decline in anxiety, and no change in depression, which provides direction for interventions in the future.

Italians locked down: people's responses to early COVID-19 pandemic public health measures

At the beginning of 2020, the widespread diffusion of SARS-CoV-2 rapidly became a worldwide priority. In Italy, the government implemented a lockdown for more than two months (March 9-May 18). Aware of the uniqueness of such an experience, we designed an online qualitative study focused on three main dimensions: daily life during the lockdown, relationships with others, and public health issues. The aim was to gain insights into people's experiences of, and attitudes toward, the changes caused by public health measures implemented as a response to the COVID-19 pandemic. We conducted 18 semi-structured interviews with Italian residents. The interviewees were recruited through mediators using purposive sampling to obtain a balanced sample with respect to age, gender, education, and geographical residence. Interviews were analyzed through qualitative content analysis. The lockdown affected a variety of aspects of people's life, resulting in a significant re-shaping of daily activities and relationships. These changes, which entailed both positive and negative aspects, were met with resilience. Even though public health measures were generally considered acceptable and adequate, they were also perceived to generate uncertainty and stress as well as to reveal tensions within the public health system. When tasked with imagining a scenario with saturated intensive care units and the need for selection criteria, respondents showed a tendency to dodge the question and struggled to formulate criteria. Media and news were found to be confusing, leading to a renewed critical attitude toward information. The findings shed some light on the impact of the lockdown on people's daily life and its effects on relationships with others. Furthermore, the study contributes to an understanding of people's reasons for, and capacity to respond to, emergency public health measures.

Distributional effects of macroeconomic shocks in real-time: A novel method applied to the COVID-19 crisis in Germany

The highly dynamic nature of the COVID-19 crisis poses an unprecedented challenge to policy makers around the world to take appropriate income-stabilizing countermeasures. To properly design such policy measures, it is important to quantify their effects in real-time. However, data on the relevant outcomes at the micro level is usually only available with considerable time lags. In this paper, we propose a novel method to assess the distributional consequences of macroeconomic shocks and policy responses in real-time and provide the first application to Germany in the context of the COVID-19 pandemic. Specifically, our approach combines different economic models estimated on firm- and household-level data: a VAR-model for output expectations, a structural labor demand model, and a tax-benefit microsimulation model. Our findings show that as of September 2020 the COVID-19 shock translates into a noticeable reduction in gross labor income across the entire income distribution. However, the tax benefit system and discretionary policy responses to the crisis act as important income stabilizers, since the effect on the distribution of disposable household incomes turns progressive: the bottom two deciles actually gain income, the middle deciles are hardly affected, and only the upper deciles lose income.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10888-021-09489-4.