Mitigating Future Respiratory Pandemics in Low-, Middle- and High-Income Countries: A Modelling Study of Health, Economic and Educational Losses

There is scant evidence on the broader societal losses of pandemics, though this is crucial for evaluating mitigation strategies and quantifying benefits of pandemic preparedness investments. We project the socioeconomic loss of respiratory pandemics, the sum of health, economic and educational losses, under four reactive business and school-closure strategies, six hypothetical diseases and three country-income groups using epidemiological economic modelling. The socioeconomic loss varies considerably between pandemics, with means ranging (as % of annual GDP) from 2.9% to 439.5%, 2.3% to 359.4% and 1.9% to 288.4% in low-/lower-middle-, upper-middle and high-income countries respectively. Stringent closure strategies are more likely to minimise losses for severe diseases, high-income countries and higher life-year valuations. Strategies with reactive school and business closures usually outperform those with long-term school closures, but the latter may be preferable under fiscal/political constraints. These findings provide decision-makers with crucial evidence to better prepare for and respond to future pandemics.