Guest Post: The Medicine is Definitely Worse

Kiwiblog | 9 May 2020

Since my guest post on the cost/benefit of New Zealand’s Level 4 lockdown, it has become evident that the benefits of Level 4 are much lower than we all thought – when expressed in terms of lives saved.

”Many people who die of Covid would have died anyway within a short period,” says

Prof Sir David Spiegelhalter at the University of Cambridge: “Nearly 10% of people aged over 80 will die in the next year … and the risk of them dying if infected with coronavirus is almost exactly the same.”

Sir David has produced an astonishing graph to demonstrate that no age group’s risk of dying during 2020 has been materially increased by the arrival of the new coronavirus. Let me repeat that:  Covid-19 has not increased anybody’s statistical risk of dying in this current year.

“Many people who die of Covid .. would have died anyway within a short period,” he says.

Knowing exactly how many is impossible to tell at this stage, but Prof Neil Ferguson, the lead modeller at Imperial College London, has suggested it could be up to two-thirds.

If our Government had decided to stay with Level 2 Alert restrictions, instead of opting for world-leading restrictions, we would almost certainly have had far fewer deaths than Sweden. That’s because Sweden has suffered 225 deaths per million of population while no country in the Southern Hemisphere has seen figures worse than 10 deaths/million. However, conservatively assuming that we mirrored Sweden, Level 2 could have seen 1,100 New Zealand deaths – of which about one-third might not otherwise have happened this year. That’s 367 extra deaths.

This does not mean that the 367 additional people who survived 2020 would have lived for very much longer. We know that they would all have been sick and would be aged around 82 on average. Let’s assume that they will now live for a further five years, on average, as a result of the Level 4 lockdown. That’s 1,835 life-years.

If saving 1,835 life-years were costless, Level 4 would have been a no-brainer for the Government. But of course it wasn’t. We all know that the price was very high, whether expressed in dollars or in lives. And some recent work at the University of Bristol allows us to estimate how high.

As the BBC reports, researchers have measured the lost life-expectancy from a prolonged economic dip and found that it could outweigh the benefit of a long-term lockdown in reducing premature deaths. And the tipping point, they say, is a 6.4% decline in the size of the economy – on a par with what happened following the 2008 financial crash.

A 6.4% decline would see a loss of three months of life on average across the population,  because of factors such declining living standards and poorer health care. Accordingly, an  economic decline of that magnitude would eventually cost each of 4,900,000 New Zealanders a quarter of a year off their lifespans – the equivalent of 1,225,000 life years.

Will the Level 4 decision cause a 6.4% decline in New Zealand? The best available evidence is the independent opinion of the International Monetary Fund in their World Economic Outlook of April 2020. The IMF projections “show the depth of pain New Zealand’s economy will feel due to the coronavirus, forecasting a contraction of 7.2 per cent this year… The IMF believes New Zealand will see the biggest fall outside of Europe, except for Venezuela…”

So, we can now offer the first ever cost/benefit analysis for the Level 4 lockdown –

Cost:      1,225,000 life-years lost

Benefits:      1,835 life-years saved

This speaks for itself. It’s crude of course, but I’m confident it’s the best attempt that’s yet been published in this country. And it’s expressed in lives-vs-lives, which helps those slow commentators who can’t be bothered to understand any other currency.

Cost-benefit analyses that come before Cabinet are usually more sophisticated. For example, they would bring in the quality (quality-adjusted life-years or QALYs) as well as the quantity of lives lost and saved. They would recognise that some portion of the coming economic pain did not not flow solely from the Government’s determination to lead the world. They would resist New Zealand being bracketed with Venezuela. But the outcome would be much the same.

The mounting evidence that “the medicine is worse than the cure” (thanks, Simon) should not be a surprise for much longer. The development of serology-based tests is now revealing that Covid’s true infection-fatality-rate (IFR) could be a 0.2% – not significantly different from the seasonal ‘flu that we live with each year.

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