User:Maxwell.Bailey137/Economic epidemiology

Economics, Epidemiology, and Pandemics: - DRAFT

The idea of intertwining epidemiology and economics is relatively new with it first appearing in the early 1990's amidst the HIV/AIDS epidemic. Epidemiologists at the time realized that the disease was spread through one's decisions around sex, and reasoned that it must then be considered an endogenous variable within the Nash-Equilibrium, therefor linking this with economics as the outcomes could then be predicted. Both Economics and Epidemiology however have influence from Utilitarianism in the form of, "doing the most good for the most amount of people" or cost-benefit analysis as both fields of study hope to find net positives in the outcomes of their decisions. However, the SARS-CoV-2 Pandemic and its fallout, has brought extremely relevant and timely data to researchers in this field. From January 1st, 2020 until December 4th, 2022 there has been a centrally estimated 1,277,204 excess deaths relating from the Covid-19 pandemic, with a majority of deaths consisting of the disease. Somewhat similar to John Snow discovering the vector for cholera through water pumps, epidemiologists were able to track community spread of Covid-19 through municipal wastewater systems. These excess deaths are often thought of in terms of the human loss, the relationships and families members we no longer possess, but there is also an economic side to these excess mortalities. According to data from the World Bank, in 2021 the average GDP per capita for someone living in the United States was $69,288. Despite the shortcomings of Gross Domestic Product in this scenario it serves as a decent variable to describe the lost economic output due to these excess deaths. Doing the arithmetic of excess deaths to GDP per capita we can see that the United States has lost around $88.5 billion in total output due to excess deaths during the Covid-19 Pandemic. The costs of the pandemic can also be extrapolated out into the cost of vaccine development/deployment, the cost of shutdowns or lack thereof (i.e. lost work/lost spending/low risk areas being closed), the extra health spending for patients that did not need it or could have avoided hospitalization if vaccinated, the fiscal stimulus provided by our government, the lost values to retirement accounts, and the broader effects of inflation.

Individuals have a something to lose as well when it comes to contracting the disease of SARS-CoV-2. For many hourly workers, this sick time off results in lost income and many salaried workers are able to do some work from a home office. Both of these situations can have positive and negative outcomes; whether it's getting additional assistance from the enhanced unemployment benefits for the greater part of 2021, or working from home with poor internet connectivity or no dedicated workspace. These headaches for many potentially contributed to the difference in reported incidence versus estimated-actual incidence rates of Covid-19 within a population. A 2020 cross-sectional study published in the JAMA Internal Medicine Journal performed blood testing on a convenience sample in 10 geographic sites across the United States and found that based on seroprevalence there were 10 times more cases than was being reported.

Covid-19

The idea of intertwining epidemiology and economics is relatively new with it first appearing in the early 1990's amidst the HIV/AIDS epidemic. Epidemiologists at the time realized that the disease was spread through one's decisions around sex, and reasoned that it must then be considered an endogenous variable within the Nash-Equilibrium, therefor linking this with economics as the outcomes could then be predicted. Both Economics and Epidemiology however have influence from Utilitarianism in the form of, "doing the most good for the most amount of people" or cost-benefit analysis as both fields of study hope to find net positives in the outcomes of their decisions. However, the SARS-CoV-2 Pandemic and its fallout, has brought extremely relevant and timely data to researchers in this field. From January 1st, 2020 until December 4th, 2022 there has been a centrally estimated 1,277,204 excess deaths relating from the Covid-19 pandemic, with a majority of deaths consisting of the disease. Somewhat similar to John Snow discovering the vector for cholera through water pumps, epidemiologists were able to track community spread of Covid-19 through municipal wastewater systems. These excess deaths are often thought of in terms of the human loss, the relationships and families members we no longer possess, but there is also an economic side to these excess mortalities. According to data from the World Bank, in 2021 the average GDP per capita for someone living in the United States was $69,288. Despite the shortcomings of Gross Domestic Product in this scenario it serves as a decent variable to describe the lost economic output due to these excess deaths. Doing the arithmetic of excess deaths to GDP per capita we can see that the United States has lost around $88.5 billion in total output due to excess deaths during the Covid-19 Pandemic. The costs of the pandemic can also be extrapolated out into the cost of vaccine development/deployment, the cost of shutdowns or lack thereof (i.e. lost work/lost spending/low risk areas being closed), the extra health spending for patients that did not need it or could have avoided hospitalization if vaccinated, the fiscal stimulus provided by our government, the lost values to retirement accounts, and the broader effects of inflation.

Individuals have a something to lose as well when it comes to contracting the disease of SARS-CoV-2. For many hourly workers, this sick time off results in lost income and many salaried workers are able to do some work from a home office. Both of these situations can have positive and negative outcomes; whether it's getting additional assistance from the enhanced unemployment benefits for the greater part of 2021, or working from home with poor internet connectivity or no dedicated workspace. These headaches for many potentially contributed to the difference in reported incidence versus estimated-actual incidence rates of Covid-19 within a population. A 2020 cross-sectional study published in the JAMA Internal Medicine Journal performed blood testing on a convenience sample in 10 geographic sites across the United States and found that based on seroprevalence there were 10 times more cases than was being reported.

Pandemics

Covid-19 presents a recent, measurable event where we can calculate outcomes from lockdowns/job losses/morbidity/mortality from the pandemic. Overarching lockdowns effective regardless of the incidence rate is costly by itself (healthy people not being able to work/consume).

October 2020

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124042/

Positive Analysis to use economics into epidemiological problems for epidemic policy ----- what will happen if we do x

Normative Analysis to evaluate preferred strategies for epidemics ------ is x the best choice of policy decisions?

Indirect effects such as schools closing and a parent having to forego work or reduce hours to take care of children.

Covid 19 governments put focus on not overwhelming health system over societal and economic consequences.

UK government said that between mitigation and suppression, mitigation would not work because health systems would become overwhelmed.

Used Observed deaths and Upper Bound Threshold deaths in across all United States from 2020 through the end of October 2022 and have shown there are around 770,000 excess deaths across the country in that time period. There were less deaths from car accidents, flu, and other transmissible diseases and instead Covid-19 was the majority player in deaths of 0.33% of the country.

Row Labels	Sum of Observed Number	Sum of Upper Bound Threshold
Alabama	525,413	500,604
Alaska	45,146	46,659
Arizona	639,617	589,839
Arkansas	316,653	308,601
California	2,651,582	2,526,564
Colorado	395,406	381,258
Connecticut	293,910	303,501
Delaware	92,768	96,999
District of Columbia	58,340	64,428
Florida	2,065,521	1,959,759
Georgia	869,041	805,341
Hawaii	105,806	116,886
Idaho	142,323	143,976
Illinois	1,014,328	982,845
Indiana	640,162	631,350
Iowa	283,332	290,751
Kansas	254,497	253,650
Kentucky	471,017	461,538
Louisiana	448,201	434,031
Maine	138,987	145,590
Maryland	474,954	484,806
Massachusetts	541,953	564,651
Michigan	938,583	904,242
Minnesota	424,045	427,383
Mississippi	318,013	298,242
Missouri	619,670	617,070
Montana	100,557	102,357
Nebraska	158,126	166,281
Nevada	264,979	261,336
New Hampshire	115,779	126,831
New Jersey	709,864	706,245
New Mexico	191,618	184,395
New York	950,476	929,109
New York City	554,388	506,736
North Carolina	935,671	908,598
North Dakota	67,257	72,816
Ohio	1,175,776	1,174,773
Oklahoma	386,517	374,999
Oregon	357,277	347,430
Pennsylvania	1,262,297	1,258,773
Puerto Rico	281,275	286,614
Rhode Island	95,716	103,776
South Carolina	506,424	480,816
South Dakota	78,232	83,772
Tennessee	746,008	716,535
Texas	2,094,335	1,929,453
Utah	189,225	189,210
Vermont	55,151	57,597
Virginia	680,144	658,449
Washington	554,052	549,222
West Virginia	224,619	218,511
Wisconsin	505,545	505,443
Wyoming	46,660	47,652
Grand Total	28,057,236	27,288,293

Difference

768,943

Data was downloaded from https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm and analyzed in Excel by the author. Data is reported by individual jurisdictions from 1/4/2020 to 10/29/2022. Upper bound threshold is generally considered the 'action' point in Epidemiology, the historical highest mortality values are pooled and calculated with one-sided confidence intervals .

Challenges to an economic and epidemiologic approach.

Policy????

"Doing the most good for the most amount of people" Economics and epidemiology have this in common.

Epidemiologists are more narrowly focused, minimizing adverse health outcomes.

Want net positive benefits

"Kaldor-Hicks Compensation Test" - do the winners win more than the losers lose

Lockdowns was more advantageous for old people and hurt young working aged people more

Cost benefit analysis (CBA)

"Elimination is not economic optimal"

Discounted as a strategy at the beginning of covid.

Economics, Epidemiology, and Pandemics: - DRAFT

https://sites.duke.edu/mcadams/files/2020/08/McAdams-Economic-Epidemiology.pdf

The idea of intertwining epidemiology and economics is relatively new, with it first appearing in the early 1990's amidst the HIV/AIDS epidemic. This was because the transmission of HIV/AIDs is based around how people were having sex which is considered an economic condition (Duke.edu).

https://www.japan.go.jp/tomodachi/2020/autumn2020/worlds_fastest_computer.html#:~:text=The%20Japanese%20supercomputer%20Fugaku%20has,amalgamation%20of%20Japanese%20technological%20prowess.

Japan's Fugaku super computer was responsible for finding drugs that would be able to combat Covid-19, before we had vaccines made. It was able to analyze 2,128 different drugs taking in all kinds of factors to narrow down the picks to less than two dozen, all in under 10 days which would have taken a normal supercomputer a year to do.