Exploring Equity in Health and Poverty Impacts of Control Measures for SARS-CoV-2 in Six Countries

Theo Prudencio Juhani Capeding,Nichola R Naylor,Chil Covid Working Group,Rosalind M Eggo,Anna Vassall,Don Mudzengi,Matthew Quaife,Maryam Huda,Mark Jit,Lela Serebryakova,Sedona Sweeney,Veronica Vargas,Segio Torres-Rueda,Simon R Procter

doi:10.2139/ssrn.3783099

Abstract

Background: Policy makers need to be rapidly informed about the potential equity consequences of different COVID-19 strategies, alongside their broader health and economic impacts. While there are complex models to inform both potential health and macro-economic impact, there are few tools available to rapidly assess potential equity impacts of interventions.Methods: We created an economic model to simulate the impact of lockdown measures in Pakistan, Georgia, Chile, United Kingdom, Philippines, and South Africa. We consider impact of lockdown in terms of inability to socially distance, and income loss during lockdown, and tested the impact of assumptions on social protection coverage in a scenario analysis.Findings: In all examined countries, lower socioeconomic quintiles were likely to experience disproportionately more income loss and greater inability to socially distance during lockdown. Improving social protection increased the percentage of the workforce able to socially distance from 40% (30% Chile - 55% UK) to 60% (57% Chile - 67% UK). We estimate the cost of this social protection would be equivalent to an average of 0.5% GDP.Interpretation: We illustrate the potential for using publicly available data to rapidly assess the equity implications of social protection and non-pharmaceutical intervention policy. We highlight potential for social protection to mitigate inequitable health and economic impacts of lockdown. Although social protection is usually targeted to the poorest, middle quintiles will likely also need support as they suffer the worst income losses and are disproportionately more exposed.Funding: This work was supported by the UK Foreign, Commonwealth and Development Office and Wellcome [grant number 221303/Z/20/Z].Declaration of Interests: We declare no competing interests.

Highlights

In the early stages of the COVID-19 pandemic, many countries around the world adopted stringent non-pharmaceutical interventions (NPIs) to slow the spread of SARS-CoV-2 and avoid exceeding hospital bed capacity.[1]
We do not METHODS Model structure and data sources We created an economic model to illustrate and simulate the equity consequences of the initial stringent lockdowns imposed to curb the spread of COVID-19 in six countries, including two lower-middle-income countries consider individual perceptions of health risk or willingness to socially distance for reasons other than economic concerns, nor do we evaluate variations in access to sanitation measures to protect against COVID-19 infection
The UK has a higher number of managers and professionals, and a larger proportion of the workforce can work from home

Summary

Introduction

In the early stages of the COVID-19 pandemic, many countries around the world adopted stringent non-pharmaceutical interventions (NPIs) to slow the spread of SARS-CoV-2 and avoid exceeding hospital bed capacity.[1]. Business closures and requirements to work from home, and are sometimes broadly termed termed ‘lockdown’.2 3–6 These policies were designed to mitigate the spread of infection with SARS-C oV-2 and reduce the burden of COVID-19 on the health system, and were effective in areas where they were implemented before widespread transmission.[7 8] the magnitude of the social and economic impacts of lockdown policies has given rise to heated debates surrounding the net benefit of further restrictions.[9] As the pandemic continues and until vaccines can be widely implemented, there is an ongoing need for difficult policy decisions on further NPIs. Policy makers need to be rapidly informed about the potential equity consequences of different COVID-19 strategies, alongside their broader health and economic impacts. Social protection is usually targeted to the poorest, middle quintiles will likely need support as they are most likely to suffer income losses and are disproportionately more exposed

Objectives

Methods

Results

Discussion

Conclusion