November 30, 2020

expert reaction to government’s analysis of the health, economic and social effects of COVID-19 and the approach to tiering

The government have recently published their analysis of the health, economic and social effects of COVID-19 and the approach to tiering.

Dr Katharina Hauck, Reader in Health Economics and Deputy Director, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, said:

“The impact on existing regional inequalities in economic opportunity of the tier system are not mentioned in the report. With respect to the economic impact section 7, the report bases an assessment of the economic impact of the tier system on a previous report by the Office for Budget Responsibility from 25 November. However, the OBR’s forecasts were for the whole UK economy, and not for regional economies. It is problematic to apply OBR economic projections on an unweighted average level of restrictions across regions with different tier systems. This is because regional economies differ in average incomes, in how strongly they rely on different economic sectors, and importantly in the contribution they make to GDP. Putting a region that makes less contribution to national GDP (such as the North East) into tier 3 will have less impact on the overall UK economy than a region that makes high contribution to GDP (such as London). There are exceptions, but in tendency more economically deprived regions that make less contribution to national GDP also happen to be the areas that the government class as being most at risk for spread of SARS-CoV-2 and have been put into tier 3, whereas those areas which contribute more to GDP happen to be in tier 2. This is not mentioned in the report – probably for good political reasons, but it means that the tier system is likely to worsen existing regional inequalities in economic opportunity.

“There is little mention in the report that a more equitable strategy would be to differentiate lockdown by economic sector, not by geographical region. Report 35 from the Imperial College COVID-19 response team estimates the costs of a blanket lockdown (such as under tier 3). Blanket lockdowns are a very blunt tool that indiscriminately closes down sectors, even sectors which contribute little to transmission and a lot to GDP. We have estimated that a strategy that differentiates closure of sectors based on both GDP and transmission contribution, results in a gain of GDP by between 24% and 31% compared to a blanket lockdown.”

Dr Flavio Toxvaerd, University Lecturer at the Faculty of Economics, University of Cambridge, who specialises in the economics of infectious diseases and economic epidemiology, said:

“Sensibly, the Treasury has this time sought to present the health impacts of the epidemic alongside an analysis of the economic and social effects.

“However, I suspect that this analysis will please few, as it is short on detail and has important methodological shortcomings.

“The key difficulty in analysing the effects of the lockdown is to assess what would happen with the disease and the economy in the absence of restrictions. The Treasury’s release is clear on this important point but stops short of performing the required analysis. To make things worse, they don’t heed their own advice and in places suggest that government restrictions have had significant impact on the economy. The evidence they present does not support this conclusion, as the economic effects we see are the consequences of both the epidemic and of the restrictions introduced to contain it.

“The government’s analysis falls well short of a full impact study and will be of limited use to justify either the lockdown or a return to a tiered system of regional restrictions. This is regrettable, as a careful impact study could help take the sting out of an unnecessarily polarised debate over how to contain the disease.”

Prof Dame Til Wykes, Vice Dean Psychology and Systems Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“The effects of Covid-19 on anxiety and depression have now been accepted and we knew that this was likely to occur for people with Covid and those health staff looking after them. This pandemic has given us more information on what affects mental health in the community.

“We have demonstrated that social and economic circumstances both have an impact, but so does uncertainty, and that is what this pandemic has in spades. Clear messaging and re-assessment points will help to reduce uncertainty. We are missing that communication strategy to tell us what we need to do and transparent decision making on moving from tier to tier. Uncertainty is also reduced by test and trace and this must go side by side with the tier system.

“If Covid-19 were to overwhelm our NHS then there is likely to be devastating effects on those currently in contact with mental health services, as much as on those with physical health problems.

“Although not reported in the paper there are mental health effects across the age groups, and children in particular are at risk, as their education and peer contacts have been disrupted. Keeping schools open will therefore have a positive outcome on their mental health, despite the uncertainty of potential “bubble closure” as children test positive.

“The report makes clear that the response to Covid-19 has mental health effects, but letting it rip through our community is likely to increase uncertainty and worry and overwhelm our NHS. This would produce greater harm to the mental health and wellbeing of NHS staff, Covid patients, those with mental health problems and the general public. The tier response is therefore the obvious best option.”

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/939876/Analysis_of_the_health_economic_and_social_effects_of_COVID-19_and_the_approach_to_tiering_FINAL__SofS_.pdf

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www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.