Health economics and emergence from COVID-19 lockdown: the great big marginal analysis
Health economics and emergence from COVID-19 lockdown: the great big marginal analysis
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DOI：
10.1017/s1744133120000304
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发表时间：
2022-04-01
影响因子：
1.7
通讯作者：
Mitton, Craig
中科院分区：
文献类型：
--
作者：
Donaldson, Cam;Mitton, Craig
尽管政治家和其他顾问否认，但在针对 2019 年冠状病毒病大流行及其社会和经济后果的许多政策决定中，权衡已经很明显。在这里，我们阐述了为什么从福祉的角度来看，认识到这种权衡是很重要的，并为此提供一个基于“边际分析”的经济概念的框架。我们通过考虑优化降低病毒繁殖率（R）和进一步开放经济之间的平衡来说明其潜力。该框架容纳了健康与经济辩论中的两种观点，根据我们在边际分析框架内的位置，要么允许健康问题占主导地位，要么在低于R阈值和/或感染背景水平的情况下，健康和经济考虑可以相互权衡。鉴于这种权衡的不可避免性，该框架暴露了需要解决的关键问题，例如： R 和/或背景感染的临界值，高于该临界值时，健康考虑占主导地位，并且该值可能因管辖区而异；随着经济逐步开放，R 和/或背景感染水平的小幅上升可能不得不容忍，从而导致生命损失的价值。
Despite denials of politicians and other advisors, trade-offs have already been apparent in many policy decisions addressing the coronavirus disease 2019 pandemic and its social and economic consequences. Here, we illustrate why it is important, from a wellbeing perspective, to recognise such trade-offs, and provide a framework, based on the economic concept of 'marginal analysis', for doing so. We illustrate its potential through consideration of optimising the balance between reducing the reproductive rate (R) of the virus and further opening of the economy. The framework accommodates both perspectives in the health-vs-economy debate whereby, depending on where we are within the marginal analysis framework, either health issues are allowed to dominate or, below some threshold of R and/or background level of infection, health and economic considerations can be traded off against each other. Given the inevitability of such trade-offs, the framework exposes crucial questions to be addressed, such as: the critical value of R and/or background infection, above which health considerations predominate, and which may vary from jurisdiction to jurisdiction; and the value of lives forgone resulting from the small increases in R and/or background infection levels that may have to be tolerated as the economy is gradually opened.