“Consideration of Trade-offs Regarding COVID-19 Containment Measures in the United States: Implications for Canada,” by Mayvis Rebeira and Eric Nauenberg: A commentary

Abstract

Rebeira and Nauenberg’s paper presents an exploratory analysis of a challenging question which I paraphrase as: “Were the extraordinarily costly social responses to the COVID-19 pandemic economically justified?” They wade bravely into the always controversial topic of assessing whether what governments spend to achieve health gain – or in this case prevent its loss – are worth it, in economic terms. They apply well-known methods of modelling incremental cost-effectiveness analysis for value of life years gained, balancing that with comparisons to value of statistical life years measures used in different sectors. They encounter and detail many uncertainties in assembling the evidence on the effects and costs of social restrictions to prevent COVID-19 infection and spread, and the economic support programs used to buffer the negative effects of the pandemic. Their conclusion, perhaps not surprisingly, is for the United States – maybe – and for Canada, with more apparent success in epidemic control, perhaps a bit better. Perhaps the greater value of their paper is not its conclusions, but rather its posing of the questions. Here are some things it led me to ponder:

Keywords

• covid-19
• containment strategies
• lockdown
• value-for-money
• economic evaluation