Smart public health approaches save more lives and money than herd immunity

Anton Korinek
That’s one of the main findings from a new study presented at a Geneva Graduate Institute webinar Tuesday that looked at contrasting strategies for tackling the novel disease, presented by authors Anton Korinek and Zachary Bethune, both associate professors at the University of Virginia. Said Korinek:

“We don't want to let the COVID-19 outbreak spread…. we want to contain it through a smart public health strategy. In that scenario, the outbreak is quickly defeated, its economic costs are much [smaller than in herd immunity] and we arrive at a much faster recovery.”

Some context: As many countries ranging from China to Switzerland deployed strict containment  measures against Covid-19, others like Sweden and the Russian Federation opted for more “laissez faire” approaches with the aim of building immunity among younger and healthier people exposed, who would effectively protect older and more vulnerable groups - so-called herd immunity. However, the strategy has generally led to higher-than-average infection and death rates. **The approach** nhas also spawned heavy criticism from health experts, who say that true herd immunity is unattainable without a vaccine.

The study: Bethune and Korinek’s paper quantifies the trade-offs between public health system attempts to bend the curve of COVID-19 infections and mortality and the economic costs of measures using a range of mathematical models - which policymakers ultimately rely upon for critical disease control decisions.

Key findings

Economic downturns due to COVID-19 are ‘much milder’ when policy-makers pursue aggressive case reporting, tracking and containment, as compared to either strict lockdowns or laissez-faire measures aimed at developing herd immunity. For instance, the study projects that aggregate economic output would be reduced by about 8% in countries and regions where people’s infection status is well reported, in comparison to an 18% drop in economic output when people’s infection status is largely unknown.

  • The social and economic cost of Covid-19 infections is undervalued by a factor of three in many models, because they don’t take into account the risk one infection poses to other individuals.

  • When public health systems aggressively track and know who is infected, each additional infection costs about US$ 250,000 as compared to US$ 300,000 when infection status is unknown - e.g. a US$ 50,000 savings..

  • In the US alone, US$ 10 trillion could be saved through smarter deployment of diagnosis, tracking and containment strategies;

The ‘optimal’ approach

Knowing who's infected is the cheapest and most life-saving way to go. When policy-makers aggressively diagnose and track infected individuals, they can isolate them from the rest of the population and allow uninfected people to go to work. That both saves lives and mitigates economic impacts that will be much more crippling over the long-term should ‘no-intervention’ policies like herd immunity be deployed. Says Zachary Bethune, a study co-author and associate professor at the University of Virginia:

“What’s best from the epidemiological perspective is also best for the economy.”