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COVID-19 in the UK has had a profound impact on population health and other socially important outcomes, including on education and the economy. Although a range of evidence has guided policy, epidemiological models have been central. It is less clear whether models to support decision making have sought to integrate COVID-19 epidemiology with a consideration of broader health, wellbeing and economic implications. We report on a rapid review of studies seeking to integrate epidemiological and economic modelling to assess the impacts of alternative policies. Overall, our results suggest that few studies have explored broader impacts of different COVID-19 policies in the UK. Three studies looked only at health, capturing impacts on individuals with and without COVID-19, with various methods used to model the latter. Four models considered health and wider impacts on individuals’...

Objectives To evaluate the cost effectiveness of an asymptomatic SARS-CoV-2 whole area testing pilot. Design Epidemiological modelling and cost effectiveness analysis. Setting The community of Merthyr Tydfil County Borough between20 Nov and 21 Dec 2020. Participants A total of 33,822 people tested as part of the pilot in Merthyr Tydfil County Borough, 712 of whom tested positive by lateral flow test and reported being asymptomatic. Main outcome measures Estimated number of cases, hospitalisations, ICU admissions and deaths prevented, and associated costs per quality-adjusted life years (QALYs) gained and monitory cost to the healthcare system. Results An initial conservative estimate of 360 (95% CI: 311 – 418) cases were prevented by the mass testing, representing a would-be reduction of 11% of all cases diagnosed in Merthyr Tydfil residents during the same period....

COVID-19 has become a global health pandemic forcing governments introducing unprecedented steps to contain the spread of the virus. On the 23rd of March, 2020, the UK government addressed the nation to announce extraordinary measures as a response to slow down the spread of the coronavirus, which have influenced the well-being and finances of millions of people. As a result people had to make difficult adjustments and to follow different coping strategies in order to respond to income losses. The main objective of this study is to examine the impact of various coping strategies, due to the lockdown measures, on the respondents’ subjective well-being by gender and ethnic background. We apply a difference-in-differences framework using data from the UK Household Longitudinal Study (UKHLS) combined with the UKHLS COVID-19 survey conducted in April 2020. Furthermore, using the Life...

    We study mechanisms for reopening economic activities that explore the trade off between containing the spread of COVID-19 and maximizing economic impact. This is of current importance as many organizations, cities, and states are formulating reopening strategies. Our mechanisms, referred to as group scheduling, are based on partitioning the population into groups and scheduling each group on appropriate days with possible gaps (when all are quarantined). Each group interacts with no other group and, importantly, any person who is symptomatic in a group is quarantined. Specifically, our mechanisms are characterized by three parameters $(g,d,t)$, where $g$ is the number of groups, $d$ is the number of days a group is continuously scheduled, and $t$ is the gap between cycles. We show that our mechanisms effectively trade off economic activity for more effective control of the...

COVID-19 has disrupted healthcare operations and resulted in large-scale cancellations of elective surgery. Hospitals throughout the world made life-altering resource allocation decisions and prioritised the care of COVID-19 patients. Without effective models to evaluate resource allocation strategies encompassing COVID-19 and non-COVID-19 care, hospitals face the risk of making sub-optimal local resource allocation decisions. A discrete-event-simulation model is proposed in this paper to describe COVID-19, elective surgery, and emergency surgery patient flows. COVID-19-specific patient flows and a surgical patient flow network were constructed based on data of 475 COVID-19 patients and 28,831 non-COVID-19 patients in Addenbrooke’s hospital in the UK. The model enabled the evaluation of three resource allocation strategies, for two COVID-19 wave scenarios: proactive cancellation...

The British government has been debating how and when to escape from the lockdown without provoking a resurgence of the Covid-19 disease. There is a growing recognition of the damage the lockdown is causing to economic and social life, including deaths and illness amongst the non-infected population. This paper presents a simple cost-benefit analysis based on optimal control theory and incorporating the SIR model of disease propagation. It concludes by presenting some simulations informed by the theoretical discussion. The main conclusions are: (1) the lockdown should be continued for some weeks, and (2) if there is an inexpensive way of reducing the net reproductive rate of the disease to r = 1, this policy should be adopted within a few weeks of exiting lockdown. It is not cost-effective to linger in intermediate stages with more expensive policies designed to keep r well below...

We construct a quantitative model of an economy hit by an epidemic. People differ by age and skill, and choose occupations and whether to commute to work or work from home, to maximize their income and minimize their fear of infection. Occupations differ by wage, infection risk, and the productivity loss when working from home. By setting the model parameters to replicate the progression of COVID-19 in South Korea and the United Kingdom, we obtain three key results. First, government-imposed lock-downs may not present a clear trade-off between GDP and public health, as commonly believed, even though its immediate effect is to reduce GDP and infections by forcing people to work from home. A premature lifting of the lock-down raises GDP temporarily, but infections rise over the next months to a level at which many people choose to work from home, where they are less productive, driven...

Policy makers responding to COVID-19 need to know people’s relative valuation of health over wealth. Loosening and tightening lockdowns moves a society along a (perceived) health-wealth trade-off and the associated changes have to accord with the public’s relative valuation of health and wealth for maximum compliance. In our survey experiment (N=4,618), we randomize information provision on economic and health costs to assess public preferences over this trade-off in the UK and the US. People strongly prioritize health over wealth, but the treatment effects suggest these priorities will change as experience of COVID-19 deaths and income losses evolves. Information also has heterogeneous/polarizing effects. These results encourage policy caution. Individual differences in health-wealth valuation highlight this study’s importance because they map onto compliance with current lockdown...

We nowcast the economic effects of the Covid-19 pandemic and related lockdown measures in the UK and then analyse the distributional and budgetary effects of the estimated individual income shocks, distinguishing between the effects of automatic stabilisers and those of the emergency policy responses. Under conservative assumptions about the exit strategy and recovery phase, we predict that the rescue package will increase the cost of the crisis for the public budget by an additional £26 billion, totalling over £60 billion. However, it will allow to contain the reduction in the average household disposable income to 1 percentage point, and will reduce poverty rate by 1.1 percentage points (at a constant poverty line), with respect to the pre-Covid situation. We also show that this progressive effect is due to the increased generosity of Universal Credit, which accounts for only 20%...

Social distancing is a matter of individuals’ choices as well as of regulation, and regulation arguably responds to those choices. We analyse weekly panel data on such behaviour for English Upper Tier Local Authorities (UTLAs) from March to July 2020, paying attention to the influence of poverty, as measured by free school meals provision. Panel regressions suggest that, although more stringent regulation and slightly lagged local cases of infection increase social distancing, both effects are weaker in UTLAs with higher levels of poverty. Thus motivated, we develop a two-class (rich/poor) model, in which a Nash non-cooperative equilibrium arises from individual choices in a regulatory regime with penalties for non-compliance. The model yields results in keeping with the empirical findings, indicating the desirability of generous measures to furlough workers in low-paid jobs as a...