£4.8m per coronavirus death

[hamstersarse]

The cost of ‘managing’ the virus so far has been £213bn. This is just actual spend, not the losses from the economy and future unemployment costs etc.

There have been 44500 deaths in the UK

That means, we’ve spent £4.8m per cv death.

This is pretty extraordinary. NICE who have been around for many years, do the financial assessments on cost / benefits of new treatments and drugs and regularly ‘turn down’ new treatments based on a cost/benefit calculation.

I wonder how coronavirus would fare in their financial assessments? Would we really be able to justify this spend when considering all the other ways in which people are dying and perhaps not receiving similar amounts of spend?

Do we know for a fact that our economy is the worst hit economically in the entire world ? Seems a little soon to say.

There always funds for wars etc. Nobody is dropping bombs on us but there are many casualties. Any government is obliged to protect its citizens, and covid19 is an immediate threat.

There are

So potentially the number of lives that could be lost would be the number of people in the UK x the % who would die if they catch this.

Difficult to estimate exactly.

Initially thought to be 3-4% mortality by WHO

Now thought to be lower because of

• medical advances, using steroids, better practice around ventilation etc

but

if large numbers get infected the health service could get overwhelmed again (there was high initial mortality in health services that were overwhelmed) and

also flu combined with covid could be extra deadly (?double mortality)

then if people are ill at home the % mortality will increase and also people would die of other causes

There were 2 papers on worst case scenarios suggesting 80k or 120k deaths but who knows?

I think that is what they are trying to avoid.

Any government is obliged to protect its citizens, and covid19 is an immediate threat.

Yes, but the response has to in proportion to the threat.

I just worry that our children and grandchildren will have to pay back huge debts for years.

hamstersarse

You’ve got that all wrong.

If you want to have a conversation about cost, fine.

But at least apply an ounce of thought and common sense, before just pasting the first random crap that comes into your head!

We could spend more on cancer, diabetes, heart disease....but we don’t.

The difference is they are not contagious.

Yes @KarmaNoMore

Don't forget millions have been spent on PPE not adequate, systems that don't work, and it goes on - totally mismanaged in all areas.

From the government. A reckoning of our lives.

The table in page 8 summarises Years of Life Lost (YLL) and Quality of Life Years (? think that’s right)

It’s all in there.

The most depressing ledger I’ve ever read.

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/907616/s0650-direct-indirect-impacts-covid-19-excess-deaths-morbidity-sage-48.pdf

A lot of excess deaths as a result of lockdown measures and the economic impact.

So yes, it's important that we consider the long term impact of these measures.

Any government is obliged to protect its citizens, and covid19 is an immediate threat.

So is poverty and the MH crisis we are experiencing but little is being done to protect the citizens from them. A response should be proportionate to the threat of covid and the measures in place around it is plunging millions into poverty (proven to lower life expectancy and quality of life) proportionate?

This has been my gut feeling against UK Lockdown strategy from beginning. The precedent has been set for years to value NHS QALYs more at end of life than at start though, so we're just seeing more of that practice in 2020 no matter how much I don't like it. Is well-established principle.

Do I have below math wrong?
My guess is the economists are keeping quiet because no one wants to hear from them. Or maybe my math below is wrong.
1 x NICE QALY (not for end of life) has value about 33k right now (off top of my head). If we saved 2 years of perfect quality life (more likely 8 yrs at 25% of full quality) for the average person who didn't die due to covid control measures, assuming the premature deaths are from covid or other causes during this period:

Lockdown saved so many deaths -> QALYs gained from Lockdown
10,000 -> 2x 10k*£33k = £660 million
100,000 -> 200k* £33k = £6.7 billion
300,000 -> 600k* £33k = £20 billion
600,000 -> = £40 billion

Not done spending. It's hard to attribute the excess deaths tbf. An accurate estimate of the costs can't be tallied up for another 20 yrs or so. I thought the costs of UK covid controls so far was about £458 billion.

Above is Not including Long Covid obviously, no one knows how to value that yet. Could tilt the scales, though seems like only tiny minority of survivors get it to a life-limiting level.

The economists are going to have the best scientific articles out of this whole mess, eventually.

850 people died of cervical cancer in the UK last year.

When you think of all the money we spend on screening and the HPV jab, and divide it between those 850 deaths, it's a complete waste of money, isn't it?

Based on the our spend on Covid however, we are effectively saying that each Covid victim is more worthy of saving than six or seven victims of other diseases?

No. Come on, all the early posters explained it to you. Your sun is meaningless.

Say 500,000 people would have died with no action to stop the spread. That would be about 480k per life saved.

Except most of the money spent is trying to head off economic damage, not save lives. The economic damage of rampant Covid would be far worse so that money is gone either way.

So really it's more like 40bn to save 440k lives, so 90k per life.

Now YWNBU to say that the government pissed a lot of that up the wall. There are far more cost effective ways to pump prime the economy than paying people's restaurant bills or subsidising house prices.

If we'd shut airports to non-essential travel early on, made face masks mandatory from the start, kept to one clear message (aaarrrgh beach you groceries/it's fine, go out for tea), put sensible precautions in schools and closed large gatherings much sooner then we could have avoided a lock down and spent far less money.

A lot of excess deaths as a result of lockdown measures and the economic impact.

Citation needed.

The excess deaths map precisely with the age vulnerability to Covid. Excess deaths returned close to normal as Covid deaths decreased, even though restrictions continued.

The estimates from the ONS and the insurance industry that I've seen are fairly consistent and all put real Covid deaths much higher than the official figures because we missed so many early on through lack of testing.

That's not to say lockdown didn't cause deaths (particularly cancer patients and the very elderly people who became completely isolated) but I've seen no evidence it's large enough to skew the numbers.

Happy to read sources which show otherwise.

@Northernsoulgirl45

We could spend more on cancer, diabetes, heart disease....but we don’t.

The difference is they are not contagious.

And in many cases are contributed to by the actions of the person themselves, i.e. smoking, over-eating, lack of exercise, so pretty hefty contributory actions.

@May09Bump

Don't forget millions have been spent on PPE not adequate, systems that don't work, and it goes on - totally mismanaged in all areas.

That's just par for the course with governmental/public sector spending over the past few decades really. Successive governments have been quite good at wasting money regardless of whether there was a pandemic or not.

@raddledoldmisanthropist and @medschoolrat

I’d be very grateful for your take on the table if the government’s own data, that I referred to in this thread at 9:36 Am.

It seems like the loss of life and quality of life is roughly equal but the loss from unmitigated Covid is all in one year and the loss from socio and economic deprivation is over 50 years, according to that table??

It seems like the loss of life and quality of life is roughly equal but the loss from unmitigated Covid is all in one year and the loss from socio and economic deprivation is over 50 years, according to that table?

I didn't use the table (though I'm familiar with it). My calculation is very rough to make the point about how silly OPs calculation is.

The OP only makes sense if the Gov is paying to have people killed, not the other way around.

I don't think it's possible to make the kind of calculation you suggest. Economics does it all the time but it's usually wrong. The hope is predictions are right enough to point to useful public policy directions.

In this scenario there are so many variables (many of which we will never get accurate data for) that numbers will really only be even the right ball park once it's all over.

You can still make qualitative judgements- like paying half the cost of people's food is an incredibly inefficient way of pump priming the economy.

The most cost effective things those billions could have been spent on were: education, capital investment, construction of infrastructure and subsidising transition to new business models in affected industries. That would be true no matter what the cause of the recession.

Nice usually take years to put out guidelines, consulting many people, research studies. That kind of thing was not and is not possible with COVID - because consequences happen v quickly.

We have a choice to do nothing or to take various combinations of choices. We have imperfect information as to the costs and benefits of each of these. Bear in mind that doing nothing could have a negative economic and health impact (compared to certain interventions).

Wuhan and north Italy situations were neither beneficial for the economy nor for non corona conditions. Hospitals were so overloaded that you couldn’t do the other treatments. If you tried to conduct non COVID treatments under those conditions, mortality would almost certainly be higher because staff would be spread more thinly (have to look after more patients and more staff sickness) and also patients have higher risk of catching corona while In hospital, thus adding to their risk.

@everythingthelighttouches,
that report is very big so I'm not going to pretend to comment on it fully.

Annex G, March '20-March '21 reckons 6 QALYs lost per covid-caused premature death, and 6-10 QALYs lost per non-covid other premature death (due to overwhelmed health service). 6 QALYs lost each seems high, surprised me, but presumably they have good sources for that.

I'm not sure if that report costed up non-fatal covid hospitalisations or long covid effects. Because it's 1am I'm going to guess that covid hospitalisations + long covid = as much harm as covid-death-QALYs lost. I also pretend that sum (all other types of harm from Lockdown )= sum(other types of harm from zero mitigations).

If UK spends £600 billion to contain covid until a vaccine works in March 2021... we need to see how many QALYs 50% of that £600 bln should save. £300 bln/(6 x £33k) = 1.5 million. i.e., govt needs to prevent 1.5 million deaths for the £600 bln to be the same as the NHS would spend to usually save each of those lives and prevent other covid-harms. Annex G says 1.6 million lives saved by not having "reasonable worst case" zero mitigation scenario. The RWC by definition is unlikely but not totally implausible. I'm not sure if the SAGE report considers another control strategy that is closer to Dutch or Swedish strategy but not Zero-mitigation, either. I wonder how the math works out in other control strategies.

One day, (many PhDs later) Someone will work out what each country spent to save how many QALYs...

Above is Very back of envelope. Maybe I did math wrong. Thanks for the report, since I had not seen that & it's exactly what I wanted to see the govt trying to do.

As someone also wrote on here, it also needs to be taken into account allowing the virus to spread considerably will also effect the economy as many will be off sick and people will not go out much if they know there is wide virus spread in the community.

Nice normally approves interventions if the ‘cost per life year saved’ is below £20,000 to £30,000. Someone here said the average age of death of someone with Covid is 82. Remaining life expectancy for an 82 year old is 7.3 years (male) or 8.5 years (female). So from what you're saying NICE would approve an intervention of up to £219000 (male) or £255000 (female).

• ie in line with Nice guidelines.