Abstract
The COVID-19 pandemic has transformed lives across the world. In the UK
there has been a public health driven policy of population ‘lockdown’
that had enormous personal and economic impact. We compare UK
response/outcomes including excess deaths with European countries with
similar levels of income/healthcare resources. We calibrate estimates of
the economic costs as different %loss in GDP against possible benefits
of avoiding life years lost, for different scenarios where local
COVID-19 mortality/comorbidity rates were used to calculate the loss in
life expectancy. We apply quality-adjusted life years (QALY) value of
£30,000 (maximum under NICE guidelines). The implications for future
lockdown easing policy in the UK are also evaluated. The spread of cases
across European countries was extremely rapid. There was significant
variation both in severity and timing of both implementation and
subsequent reductions in social restrictions. There was less variation
in the trajectory of mortality rates and excess deaths, which have
fallen across all countries during May/June 2020. The average age at
death and life expectancy loss for non-COVID-19 was 79.1 and 11.4years
respectively while COVID-19 were 80.4 and 10.1years; including for
life-shortening comorbidities and quality of life reduced this to 5QALY
for each COVID-19 death. The lowest estimate for lockdown costs incurred
was 50% higher than highest benefits from avoiding the worst mortality
case scenario at full life expectancy tariff and in more realistic
estimation they were over 50 times higher. Application to potential
future scenarios showed in the best case a QALY value of £220k (7xNICE
guideline) and in the worst-case £3.7m (125xNICE guideline) was needed
to justify the continuation of the lockdown. The evidence suggests that
the costs of continuing severe restrictions in the UK are so great relative to
likely benefits in numbers of lives saved so that a substantial easing in
restrictions is now warranted.