Analysis of the Tradeoff Between Health and Economic Impacts of the Covid-19 Epidemic

The impact of COVID-19 pandemic on the world's major economies: based on a multi-country and multi-sector CGE model

Objective

To quantitatively assess the impact of COVID-19 pandemic on public health, as well as its economic and social consequences in major economies, which is an international public health concern. The objective is to provide a scientific basis for policy interventions.

Subject and methods

This study utilizes a multi-country, multi-sector CGE-COVID-19 model to analyze the repercussions of the pandemic in 2022. The re-search focuses on quantifying the effects of COVID-19 on the macroeconomy and various industry sectors within six economies: the United States, China, the EU, the United Kingdom, Japan, and South Korea.

Results

The COVID-19 pandemic shock had the most significant impact on China and the EU, followed by notable effects observed in the United States and the United Kingdom. In contrast, South Korea and Japan experienced relatively minimal effects. The reduction in output caused by the pandemic has affected major economies in multiple sectors, including real industries such as forestry and fisheries, and the services such as hotels and restaurants.

Conclusion

The overall negative macroeconomic impact of the epidemic on major economies has been significant. Strategic interventions encompassing initiatives like augmenting capital supply, diminishing corporate taxes and fees, offering individual subsidies, and nurturing international cooperation held the potential to mitigate the detrimental economic consequences and enhance the global-economic amid the pan-demic. Consequently, this study contributes to the advancement of global anti-epidemic policies targeting economic recovery. Moreover, using the CGE-COVID-19 model has enriched the exploration of general equilibrium models in PHEIC events.

COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?

INTRODUCTION

Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown's impact on COVID-19 cases and associated healthcare costs.

METHODS

Using daily case data for 84 days (9 March-31 May 2020), we modeled the epidemic's trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R₀), daily reproduction number (R_e), and case doubling time. Based on pre-restriction and Phase 1 R₀, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis.

RESULTS

The estimated median R₀ during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, -15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, -204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83).

CONCLUSION

Maharashtra's early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.

The micro-economic effects of COVID-19 containment measures: A simple model and evidence from China

Optimizing the trade-off between economic growth and public health is a major goal of public administration, especially during public health events. Although containment measures are widely used to combat the Covid-19 outbreak, it is still debated how the measures affect the economy. Using a simplified susceptible-infected-recovered (SIR) model, this study investigates the dynamic impact of lockdown policy on social costs during the epidemic and the underlying mechanism, revealing that the lockdown policy has both a "shutdown effect" and an "anti-epidemic effect", and should be implemented and lifted in a timely manner. Based on a micro-level dataset of 57,547 private enterprises in China in 2020, this study provided empirical evidence for the presence of negative "shutdown effect" and positive "anti-epidemic effect" of lockdown on reopening, both of which are in part mediated by labor input, factor mobility, and market demand recovery. Furthermore, the shutdown effect is weaker in regions with sufficient testing and quarantine resources, government capacity and preference for targeted response, whereas the anti-epidemic effect is stronger in densely populated areas with relatively low public compliance. Additionally, digital measures can aid in the containment of epidemics. The findings not only contribute to a better understanding of the rationality and effectiveness of the lockdown policy, but also provides practical evidence and implications for the government to improve the synergistic efficiency of epidemic control tools and strengthen the resilience of local economic growth.

Epidemic Management via Imperfect Testing: A Multi-criterial Perspective

Diagnostic testing may represent a key component in response to an ongoing epidemic, especially if coupled with containment measures, such as mandatory self-isolation, aimed to prevent infectious individuals from furthering onward transmission while allowing non-infected individuals to go about their lives. However, by its own nature as an imperfect binary classifier, testing can produce false negative or false positive results. Both types of misclassification are problematic: while the former may exacerbate the spread of disease, the latter may result in unnecessary isolation mandates and socioeconomic burden. As clearly shown by the COVID-19 pandemic, achieving adequate protection for both people and society is a crucial, yet highly challenging task that needs to be addressed in managing large-scale epidemic transmission. To explore the trade-offs imposed by diagnostic testing and mandatory isolation as tools for epidemic containment, here we present an extension of the classical Susceptible-Infected-Recovered model that accounts for an additional stratification of the population based on the results of diagnostic testing. We show that, under suitable epidemiological conditions, a careful assessment of testing and isolation protocols can contribute to epidemic containment, even in the presence of false negative/positive results. Also, using a multi-criterial framework, we identify simple, yet Pareto-efficient testing and isolation scenarios that can minimize case count, isolation time, or seek a trade-off solution for these often contrasting epidemic management objectives.

Leadership and international collaboration on COVID-19 research: reducing the North-South divide?

The COVID-19 pandemic triggered unprecedented scientific efforts worldwide and launched several initiatives to promote international cooperation. Because international scientific collaborations between high-income countries (HICs) and low- and middle-income countries (LMICs) are not always balanced, analyzing research leadership helps to understand the global dynamics of knowledge production during COVID-19. In this study, we focused on HIC-LMIC collaborations on COVID-19 research in 469,937 scientific publications during the first 2 years of the pandemic (2020-2021). Co-authorship and authors' affiliation were used to identify international collaborations, according to country income level. The leadership analysis considered the countries of the first and last authors of publications. The results show that (i) most publications with international collaborations (49.3%) involved researchers from HICs and LMICs; (ii) collaborative research between HICs and LMICs addressed relevant public health needs; (iii) HIC-LMIC collaborations were primarily led by researchers from the United States, China, the United Kingdom, and India; (iv) most HIC-LMIC publications (44%) had shared leadership, with research interests linked to national expertise and global interests. This study contributes to the analysis of research collaborations on COVID-19 and sheds light on North-South relations in the production and dissemination of scientific knowledge.

Optimizing two-dose vaccine resource allocation to combat a pandemic in the context of limited supply: The case of COVID-19

The adequate vaccination is a promising solution to mitigate the enormous socio-economic costs of the ongoing COVID-19 pandemic and allow us to return to normal pre-pandemic activity patterns. However, the vaccine supply shortage will be inevitable during the early stage of the vaccine rollout. Public health authorities face a crucial challenge in allocating scarce vaccines to maximize the benefits of vaccination. In this paper, we study a multi-period two-dose vaccine allocation problem when the vaccine supply is highly limited. To address this problem, we constructed a novel age-structured compartmental model to capture COVID-19 transmission and formulated as a nonlinear programming (NLP) model to minimize the total number of deaths in the population. In the NLP model, we explicitly take into account the two-dose vaccination procedure and several important epidemiologic features of COVID-19, such as pre-symptomatic and asymptomatic transmission, as well as group heterogeneity in susceptibility, symptom rates, severity, etc. We validated the applicability of the proposed model using a real case of the 2021 COVID-19 vaccination campaign in the Midlands of England. We conducted comparative studies to demonstrate the superiority of our method. Our numerical results show that prioritizing the allocation of vaccine resources to older age groups is a robust strategy to prevent more subsequent deaths. In addition, we show that releasing more vaccine doses for first-dose recipients could lead to a greater vaccination benefit than holding back second doses. We also find that it is necessary to maintain appropriate non-pharmaceutical interventions (NPIs) during the vaccination rollout, especially in low-resource settings. Furthermore, our analysis indicates that starting vaccination as soon as possible is able to markedly alleviate the epidemic impact when the vaccine resources are limited but are currently available. Our model provides an effective tool to assist policymakers in developing adaptive COVID-19 likewise vaccination strategies for better preparedness against future pandemic threats.

Biophysical and Biochemical Characterization of the Receptor Binding Domain of SARS-CoV-2 Variants

The newly emerging SARS-CoV-2 variants are potential threat and posing new challenges for medical intervention due to high transmissibility and escaping neutralizing antibody (NAb) responses. Many of these variants have mutations in the receptor binding domain (RBD) of SARS-CoV-2 spike protein that interacts with the host cell receptor. Rapid mutation in the RBD through natural selection to improve affinity for host receptor and antibody pressure from vaccinated or infected individual will greatly impact the presently adopted strategies for developing interventions. Understanding the nature of mutations and how they impact the biophysical, biochemical and immunological properties of the RBD will help immensely to improve the intervention strategies. To understand the impact of mutation on the protease sensitivity, thermal stability, affinity for the receptor and immune response, we prepared several mutants of soluble RBD that belong to the variants of concern (VoCs) and interest (VoIs) and characterize them. Our results show that the mutations do not impact the overall structure of the RBD. However, the mutants showed increase in the thermal melting point, few mutants were more sensitive to protease degradation, most of them have enhanced affinity for ACE2 and some of them induced better immune response compared to the parental RBD.

Variations of COVID-19 mortality are affected by economic disparities across countries

BACKGROUND

When the COVID-19 case number reaches a maximum in a country, its capacity and management of health system face greatest challenge.

METHODS

We performed a cross-sectional study on data of turning points for cases and deaths for the first three waves of COVID-19 in countries with more than 5000 cumulative cases, as reported by Worldometers and WHO Coronavirus (COVID-19) Dashboard. We compared the case fatality rates (CFRs) and time lags (in unit of day) between the turning points of cases and deaths among countries in different development stages and potential influence factors. As of May 10, 2021, 106 out of 222 countries or regions (56%) reported more than 5000 cases. Approximately half of them have experienced all the three waves of COVID-19 disease. The average mortality rate at the disease turning point was 0.038 for the first wave, 0.020 for the second wave, and 0.023 for wave 3. In high-income countries, the mortality rates during the first wave are higher than that of the other income levels. However, the mortality rates during the second and third waves of COVID-19 were much lower than those of the first wave, with a significant reduction from 5.7% to 1.7% approximately 70%. At the same time, high-income countries exhibited a 2-fold increase in time lags during the second and the third waves compared to the first wave, suggesting that the periods between the cases and deaths turning point extended. High rates in the first wave in developed countries are associated to multiple factors including transportation, population density, and aging populations. In upper middle- and lower middle-income countries, the decreasing of mortality rates in the second and third waves were subtle or even reversed, with increased mortality during the following waves. In the upper and lower middle-income countries, the time lags were about 50% of the durations observed from high-income countries.

INTERPRETATION

Economy and medical resources affect the efficiency of COVID-19 mitigation and the clinical outcomes of the patients. The situation is likely to become even worse in the light of these countries' limited ability to combat COVID-19 and prevent severe outcomes or deaths as the new variant transmission becomes dominant.

Multi-dimensional impacts of Coronavirus disease 2019 pandemic on Sustainable Development Goal achievement

BACKGROUND

Health, social and economic crises triggered by the Coronavirus disease pandemic (COVID-19) can derail progress and achievement of the Sustainable Development Goals. This commentary analyses the complex nexus of multi-dimensional impacts of the pandemic on people, prosperity, planet, partnership and peace. From our analysis, we generate a causal loop diagram explaining these complex pathways and proposed policy recommendations.

MAIN TEXT

Health systems, health and wellbeing of people are directly affected by the pandemic, while impacts on prosperity, education, food security and environment are indirect consequences from pandemic containment, notably social measures, business and school closures and international travel restrictions. The magnitude of impacts is determined by the level of prior vulnerability and inequity in the society, and the effectiveness and timeliness of comprehensive pandemic responses.

CONCLUSIONS

To exit the acute phase of the pandemic, equitable access to COVID-19 vaccines by all countries and continued high coverage of face masks and hand hygiene are critical entry points. During recovery, governments should strengthen preparedness based on the One Health approach, rebuild resilient health systems and an equitable society, ensure universal health coverage and social protection mechanisms for all. Governments should review progress and challenges from the pandemic and sustain a commitment to implementing the Sustainable Development Goals.

The Trade-Offs/Synergies and Their Spatial-Temporal Characteristics between Ecosystem Services and Human Well-Being Linked to Land-Use Change in the Capital Region of China

With the rise of the strategy of Coordinated Development for the Beijing-Tianjin-Hebei Region, it is necessary to evaluate the trade-offs/synergies of the survival environment and human well-being in Hebei, the capital region of China. However, existing methods cannot analyze and express trade-offs/synergies of two or more variables simultaneously. Therefore, this paper proposes a new framework to express the trade-offs/synergies among land-use intensity, ecosystem services, and human well-being. In this paper, we first identified the land-use intensity change and land-use transformation and evaluated ecosystem services and human well-being in Hebei from 2000–2015 under the Millennium Ecosystem Assessment framework. Then, the trade-offs/synergies of the three indicators were determined by GIS-based methods and MATLAB. The results show that land-use intensity and human well-being mainly present a synergistic relationship, while ecosystem services and land-use intensity mainly present a trade-off relationship, and ecosystem services and human well-being also present a trade-off relationship in Hebei during 2000–2015. In addition, some regional solutions to achieve sustainable development were proposed: region 1 needs to adjust land-use structure, region 2 needs to protect the ecological environment to improve the supply of ecosystem services, and region 3 needs to commit to improving the regional comprehensive human well-being. This study not only proposes a new framework for analyzing trade-offs/synergies of land use intensity, ecosystem services, and human well-being, but it also provides regional solutions for Hebei to achieve sustainable development.

The Configuration of Incentives in Small and Medium-Sized Content Platform Enterprises Under the Normalization of COVID-19

The COVID-19 pandemic has made the advantages of online knowledge communities with cross-space, time, interpersonal, and other characteristics fully demonstrated. Exploring the configurations of platform incentives to improve knowledge collaboration performance can provide a reference for the efficient and sustainable development of the platforms under the normalization of the COVID-19 pandemic. With the help of the fuzzy set qualitative comparative analysis method, taking the social Q&A platform enterprises as an example, this study analyzed the configurations of platform incentives for the high knowledge collaborative performance from the dimensions of market incentives and social incentives, and the heterogeneity of knowledge capital appreciation and social capital appreciation is also discussed. The results show that each of the platform incentives (virtual currency, cash benefit, community reputation, social identity, skill training, and communication) does not constitute a necessary condition for high performance. There are four and three types of configurations for intellectual capital appreciation and social capital appreciation, respectively. The important findings are that nearly 30% of users may participate in knowledge production based on pure economic benefits, and there may be so-called “get the best deal” behavior. Social identity, community reputation, and skill training have an important incentive effect on knowledge collaboration. Communication supplemented by a little economic incentives can significantly promote the appreciation of social capital.

Mental Health and the City in the Post-COVID-19 Era

The article describes the risks for the mental health and wellbeing of urban-dwellers in relation to changes in the spatial structure of a city that could be caused by the COVID-19 pandemic. A year of lockdown has changed the way of life in the city and negated its principal function as a place of various meetings and social interactions. The danger of long-term isolation and being cut-off from an urban lifestyle is not only a challenge facing individuals, but it also creates threats on various collective levels. Hindered interpersonal relations, stress, and the fear of another person lower the quality of life and may contribute to the development of mental diseases. Out of fear against coronavirus, part of the society has sought safety by moving out of the densely populated city centres. The dangerous results of these phenomena are shown by research based on the newest literature regarding the influence of COVID-19 and the lockdown on mental health, urban planning, and the long-term spatial effects of the pandemic such as the urban sprawl. The breakdown of the spatial structure, the loosening of the urban tissue, and urban sprawl are going to increase anthropopressure, inhibit access to mental health treatment, and will even further contribute to the isolation of part of the society. In addition, research has shown that urban structure loosening as a kind of distancing is not an effective method in the fight against the SARS-COV pandemic. Creating dense and effective cities through the appropriate management of development during and after the pandemic may be a key element that will facilitate the prevention of mental health deterioration and wellbeing. It is also the only possibility to achieve the selected Sustainable Development Goals, which as of today are under threat.