How fast should social restrictions be eased in England as COVID-19 vaccinations are rolled out?
Abstract
Vaccination against the COVID-19 virus began in December 2020 in the UK
and is now running at 5% population/week. High Levels of social
restrictions were implemented for the third time in January 2021 to
control the second wave and resulting increases in hospitalisations and
deaths. Easing those restrictions must balance multiple challenging
priorities, weighing the risk of more deaths and hospitalisations
against damage done to mental health, incomes and standards of living,
education outcomes and provision of non-Covid-19 healthcare.
Weekly and
monthly officially published values in 2020/21 were used to estimate the
impact of seasonality and social restrictions on the spread of COVID-19
by age group, on the economy and healthcare services. These factors were combined with the estimated impact of vaccinations and immunity from past infections into a model that retrospectively
reflected the actual numbers of reported deaths closely both in 2020 and
early 2021. It was applied prospectively to the next 6 months to
evaluate the impact of different speeds of easing social restrictions.
The
results show vaccinations are significantly reducing the number of
hospitalisations and deaths. The central estimate is that relative to a
rapid easing, the avoided loss of 57,000 life years from a strategy of
relatively slow easing over the next 4 months comes at a cost in terms of
GDP reduction of around £0.4 million/life-year loss avoided. This is
over 10 times higher than the usual limit the NHS uses for spending
against Quality Adjusted Life Years (QALYs) saved. Alternative
assumptions for key factors affecting give significantly different
trade-offs between costs and benefits of different speeds of easing. Disruption of non-Covid-19 Healthcare provision also increases in times
of higher levels of social restrictions.
In most cases, the results
favour a somewhat faster easing of restrictions in England than current
policy implies.