Abstract
We study the effectiveness of non-pharmaceutical interventions (NPIs) against COVID-19 on the allocation of scarce resources in the hospital sector in Scandinavia. Denmark and Norway imposed strict NPIs, but Sweden followed an extraordinarily lenient approach. We use an event study to compare COVID-19 hospitalizations, intensive-care (ICU) patients, and deaths in Sweden with Denmark and Norway. The outcome variables initially follow a common trend, but diverge 2–3 weeks after lockdown. Both the timing of the effect and the similarity in the trend between Denmark and Norway are highly consistent with a causal effect of the lockdown. We use our event study to build a counterfactual model that predicts the outcome variables for Denmark and Norway if they had followed Sweden’s approach. In the absence of strict NPIs, the peak number of hospitalizations would have been 2.5 (3.5) times as large in Denmark (Norway). Overall, Denmark (Norway) would have had 334 (671) percent more hospital-patient days, 277 (379) percent more ICU-patient days, and 402 (1015) percent more deaths. The benefit of lockdown in terms of healthcare and mortality costs amounts to between 1 and 4 (0.9 and 3.5) percent of GDP in Denmark (Norway).
Highlights
COVID-19 puts a large burden on the healthcare system since many patients with COVID-19 require hospitalization or intensive care (ICU)
We study the effectiveness of non-pharmaceutical interventions (NPIs) against COVID-19 on the allocation of scarce resources in the hospital sector in Scandinavia
The similarity between the three Scandinavian countries in all aspects except NPIs provides a unique source that allows us to isolate the causal effect of the NPIs on hospital resources
Summary
COVID-19 puts a large burden on the healthcare system since many patients with COVID-19 require hospitalization or intensive care (ICU). This study provides direct causal evidence on the relationship between NPIs and the demand for hospital resources. Our study provides evidence from the three Scandinavian countries Denmark, Norway and Sweden. Community spread of COVID-19 started at the same time; Norway reported its 100th case on March 4, Sweden on March 6, and Denmark on March 9. Throughout the pandemic, the three countries have maintained high-quality comparable databases regarding hospitalizations and ICU admissions, allowing us to provide direct evidence from the hospital sector. Denmark and Norway introduced strong NPIs early in the pandemic. The similarity between the three Scandinavian countries in all aspects except NPIs provides a unique source that allows us to isolate the causal effect of the NPIs on hospital resources.
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