Modeling Years of Life Lost Due to COVID-19, Socioeconomic Status, and Nonpharmaceutical Interventions: Development of a Prediction Model
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Abstract
Research in the COVID-19 pandemic focused on the health burden, thereby largely neglecting the potential harm to life from welfare losses.
Objective
This paper develops a model that compares the years of life lost (YLL) due to COVID-19 and the potential YLL due to the socioeconomic consequences of its containment.
Methods
It improves on existing estimates by conceptually disentangling YLL due to COVID-19 and socioeconomic status. By reconciling the normative life table approach with socioeconomic differences in life expectancy, it accounts for the fact that people with low socioeconomic status are hit particularly hard by the pandemic. The model also draws on estimates of socioeconomic differences in life expectancy to ascertain potential YLL due to income loss, school closures, and extreme poverty.
Results
Tentative results suggest that if only one-tenth of the current socioeconomic damage becomes permanent in the future, it may carry a higher YLL burden than COVID-19 in the more likely pandemic scenarios. The model further suggests that the socioeconomic harm outweighs the disease burden due to COVID-19 more quickly in poorer and more unequal societies. Most urgently, the substantial increase in extreme poverty needs immediate attention. Avoiding a relatively minor number of 4 million unemployed, 1 million extremely poor, and 2 million students with a higher learning loss may save a similar amount of life years as saving 1 million people from dying from COVID-19.
Conclusions
Primarily, the results illustrate the urgent need for redistributive policy interventions and global solidarity. In addition, the potentially high YLL burden from income and learning losses raises the burden of proof for the efficacy and necessity of school and business closures in the containment of the pandemic, especially where social safety nets are underdeveloped.
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SciScore for 10.1101/2021.04.23.21256005: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources Current empirical projections for the global pandemic estimate up to 5 million deaths by August 2021.1 With vaccine role out slow in most parts of the world and uncertain protection against new virus variants, it cannot be ruled out that this number multiplies over the next years. Augustsuggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The approach comes …
SciScore for 10.1101/2021.04.23.21256005: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources Current empirical projections for the global pandemic estimate up to 5 million deaths by August 2021.1 With vaccine role out slow in most parts of the world and uncertain protection against new virus variants, it cannot be ruled out that this number multiplies over the next years. Augustsuggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The approach comes with a number of important limitations. Even though measurement issues are likely to outweigh causal concerns by far, the assumptions on the extent of socioeconomic determination of the life expectancy and the size of the socioeconomic gap in life expectancy in low and middle income countries is based on rather weak empirical evidence. Furthermore, the model does not account for the non-lethal health impact, for example, from “Long-Covid” or the psychosocial consequences from NPIs. Future research could inform an extended estimate using quality-adjusted estimates such as the healthy life expectancy (HALE). Finally, the model does not account for the Covid-related disease burden on economic activity which is sometimes invoked to justify harsher NPIs as in fact reducing the socioeconomic damage in the pandemic. However, existing research into the question has been unable to disentangle the role of subjective fears and the objective health burden in reducing economic activity, leaving the attribution between NPIs and Covid-19 undetermined.62
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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