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?:abstract
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Background In responding to covid-19, governments have tried to balance protecting health while minimising Gross Domestic Product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain, and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalisations, and deaths under \'mitigation\' to modelled events under \'no mitigation\' to 20th July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at GBP 20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared to Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Findings The UK saved 3.17 (0.32-3.65) million QALYs, GBP 33 (8-38) billion healthcare costs, and GBP 1416 (220-1637) HRNB per capita at GBP 20,000/QALY. Per capita, this is comparable to GBP 1,455 GDP loss using Sweden as comparator and offsets 46.1 (7.1-53.2)% of total GBP 3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Interpretation The benefit of government covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. Funding Elizabeth Blackwell Institute; UK MRC; UK NIHR.
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