A University of Michigan-led study has attempted to evaluate the cost and benefits of large-scale community lockdowns implemented throughout the U.S. during the early months of the COVID-19 pandemic in an effort to reduce the spread of coronavirus and to save lives.
The study, published Friday, Jan. 21 in the journal PLOS ONE, looked at empirical correlations between loss of income and mortality. Researchers came up with ranges of estimates for potential lives saved thanks to the lockdowns, and compared them to estimates of potential lives lost due to the $2.3 million economic downturn.
In other words, researchers wanted to form an apples-to-apples comparison of lives saved by slowing the spread of the virus, versus lives lost as collateral damage to the public health measures put in place. For the latter, they looked at lost income and the loss off jobs that left workers without employer-provided health insurance and unable to pay for health care, including life-saving medications.
“This is tough for people to agree upon,” said Olga Yakusheva, a health economist and associate professor at the University of Michigan School of Nursing, in a prepared statement. “Typically, people are in one of two camps—pragmatics who worry about the economy and ethicists who say any amount of money is worth saving a life. Some value loved ones more, or their own lives. It’s very subjective.”
What the researchers determined was that the number of lives saved by the spring-summer lockdowns and other COVID mitigation strategies was greater than the number of lives potentially lost due to the economic downturn.
The retrospective cost-benefit analysis found that from March through August 2020, implementing widespread lockdowns and other mitigation in the U.S. potentially saved anywhere between 866,000 and 1.7 million lives. That’s considerably more than the potentially 58,000 to 245,000 lost lives attributable to the economic downturn, according to the study.
However, because many of the people saved were high-risk older adults with multiple illnesses and fewer healthy years left to live, researchers also came up with ranges that measured by “quality-adjusted life expectancy,” or years of perfect health. Those results were more ambiguous.
The study estimated that the quality-adjusted life expectancy added by the lockdown was somewhere between 4.89 million and 9.65 million years, compared to 2.09 to 8.86 million years lost due to the economic downturn.
“We know how many people died with public health measures in place, but we can’t know how many people would have died without those measures in place,” Yakusheva said. “We tried to be very careful and produced a range of numbers of lives potentially saved and lost, and we hope the true numbers lie within those ranges.”
Yakusheva said the study should not be used to justify more lockdown measures, nor is it a retroactive endorsement of the strict economic lockdown approach imposed by the U.S. in 2020.
“We evaluated the full packet of public health measures as it was implemented in the beginning of the pandemic, but lesser mitigation measures may have worked just as well to reduce lives lost,” Yakusheva said. “The fact is, we just will never know. At the time, we had to work with the information that we had. We knew the pandemic was deadly, and we did not have therapeutics or a vaccine.”
Compared to the early months of the pandemic, health systems have come a long way in determining how to detect, treat and prevent cases of COVID-19. Vaccines have changed the scope of the pandemic, as have therapeutics like monoclonal antibodies and anti-viral pills under emergency use authorization, “limiting a need for future blanket restrictions,” notes the study.
U-M researchers behind the study called it the first known paper to measure the effect of pandemic lockdown mitigation measures on lives saved and lost, as opposed to typical economic evaluations, which examine the cost per life saved.
“Moving forward, it is essential that we emerge from the pandemic with the smallest humanitarian cost from the combination of disease impact from the virus and the lost economic opportunity,” reads the study’s conclusion.
The full study is available in the journal PLOS ONE, here. It’s titled “Lives saved and lost in the first six months of the US COVID-19 pandemic: A retrospective cost-benefit analysis.”
As of Friday, the U.S. death toll for COVID-19 stood at about 860,000 deaths, including at least 28,980 confirmed deaths in Michigan.
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