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  1. Article: The impact of Covid-19, associated behaviours and policies on the UK economy: A computable general equilibrium model.

    Keogh-Brown, Marcus R / Jensen, Henning Tarp / Edmunds, W John / Smith, Richard D

    SSM - population health

    2020  Volume 12, Page(s) 100651

    Abstract: We estimate the potential impact of COVID-19 on the United Kingdom economy, including direct disease effects, preventive public actions and associated policies. A sectoral, whole-economy macroeconomic model was linked to a population-wide epidemiological ...

    Abstract We estimate the potential impact of COVID-19 on the United Kingdom economy, including direct disease effects, preventive public actions and associated policies. A sectoral, whole-economy macroeconomic model was linked to a population-wide epidemiological demographic model to assess the potential macroeconomic impact of COVID-19, together with policies to mitigate or suppress the pandemic by means of home quarantine, school closures, social distancing and accompanying business closures. Our simulations indicate that, assuming a clinical attack rate of 48% and a case fatality ratio of 1.5%, COVID-19 alone would impose a direct health-related economic burden of £39.6bn (1.73% of GDP) on the UK economy. Mitigation strategies imposed for 12 weeks reduce case fatalities by 29%, but the total cost to the economy is £308bn (13.5% of GDP); £66bn (2.9% of GDP) of which is attributable to labour lost from working parents during school closures, and £201bn (8.8% of GDP) of which is attributable to business closures. Suppressing the pandemic over a longer period of time may reduce deaths by 95%, but the total cost to the UK economy also increases to £668bn (29.2% of GDP), where £166bn (7.3% of GDP) is attributable to school closures and 502bn (21.9% of GDP) to business closures. Our analyses suggest Covid-19 has the potential to impose unprecedented economic costs on the UK economy, and whilst public actions are necessary to minimise mortality, the duration of school and business closures are key to determining the economic cost. The initial economic support package promised by the UK government may be proportionate to the costs of mitigating Covid-19, but without alternative measures to reduce the scale and duration of school and business closures, the economic support may be insufficient to compensate for longer term suppression of the pandemic which could generate an even greater health impact through major recession.
    Keywords covid19
    Language English
    Publishing date 2020-10-14
    Publishing country England
    Document type Journal Article
    ISSN 2352-8273
    ISSN 2352-8273
    DOI 10.1016/j.ssmph.2020.100651
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The welfare implications of public healthcare financing: a macro-micro simulation analysis of Uganda.

    Kabajulizi, Judith / Keogh-Brown, Marcus R / Smith, Richard D

    Health policy and planning

    2017  Volume 32, Issue 10, Page(s) 1437–1448

    Abstract: Studies on global health and development suggest that there is a strong correlation between the burden of disease and a country's level of income. Poorer countries tend to suffer more deaths from preventable causes such as communicable, maternal, ... ...

    Abstract Studies on global health and development suggest that there is a strong correlation between the burden of disease and a country's level of income. Poorer countries tend to suffer more deaths from preventable causes such as communicable, maternal, perinatal and nutritional conditions, compared with high-income countries. In low-income countries, the government health expenditure share in the general government budget is low and out-of-pocket payments for healthcare relatively high. They also rely heavily on external resources for health funding, yet sustainability of external resource flows is not guaranteed. This article explores increasing public healthcare funding from domestic resources mobilization, and evaluates the impact of measures to achieve this on sectoral growth and poverty reduction rates in Uganda using a dynamic computable general equilibrium model. This article shows that increasing the government health budget share, facilitates expanded healthcare services, improved population health, higher sectoral growth and reduced poverty. The agricultural sector is predicted to post the highest growth when compared with services and industry sectors under both domestic taxation and aid funding scenarios, while national poverty is predicted to decline from 31 to 12% of the population by 2020. This article demonstrates that the most effective measure is to frontload investment in healthcare and generate additional domestic funding for health from a household tax earmarked for health.
    MeSH term(s) Delivery of Health Care/economics ; Developing Countries ; Female ; Financing, Government ; Global Health ; Health Expenditures ; Health Services/economics ; Health Services/supply & distribution ; Healthcare Financing ; Humans ; Models, Economic ; Poverty ; Pregnancy ; Uganda
    Language English
    Publishing date 2017-12-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 632896-9
    ISSN 1460-2237 ; 0268-1080
    ISSN (online) 1460-2237
    ISSN 0268-1080
    DOI 10.1093/heapol/czx125
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Correction: COVID-19 vaccination in Sindh Province, Pakistan: A modelling study of health impact and cost-effectiveness.

    Pearson, Carl A B / Bozzani, Fiammetta / Procter, Simon R / Davies, Nicholas G / Huda, Maryam / Jensen, Henning Tarp / Keogh-Brown, Marcus / Khalid, Muhammad / Sweeney, Sedona / Torres-Rueda, Sergio / Eggo, Rosalind M / Vassall, Anna / Jit, Mark

    PLoS medicine

    2022  Volume 19, Issue 5, Page(s) e1003990

    Abstract: This corrects the article DOI: 10.1371/journal.pmed.1003815.]. ...

    Abstract [This corrects the article DOI: 10.1371/journal.pmed.1003815.].
    Language English
    Publishing date 2022-05-04
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 2185925-5
    ISSN 1549-1676 ; 1549-1277
    ISSN (online) 1549-1676
    ISSN 1549-1277
    DOI 10.1371/journal.pmed.1003990
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Integrating economic and health evidence to inform Covid-19 policy in low- and middle- income countries.

    Vassall, Anna / Sweeney, Sedona / Barasa, Edwine / Prinja, Shankar / Keogh-Brown, Marcus R / Tarp Jensen, Henning / Smith, Richard / Baltussen, Rob / M Eggo, Rosalind / Jit, Mark

    Wellcome open research

    2022  Volume 5, Page(s) 272

    Abstract: Covid-19 requires policy makers to consider evidence on both population health and economic welfare. Over the last two decades, the field of health economics has developed a range of analytical approaches and contributed to the institutionalisation of ... ...

    Abstract Covid-19 requires policy makers to consider evidence on both population health and economic welfare. Over the last two decades, the field of health economics has developed a range of analytical approaches and contributed to the institutionalisation of processes to employ economic evidence in health policy. We present a discussion outlining how these approaches and processes need to be applied more widely to inform Covid-19 policy; highlighting where they may need to be adapted conceptually and methodologically, and providing examples of work to date. We focus on the evidential and policy needs of low- and middle-income countries; where there is an urgent need for evidence to navigate the policy trade-offs between health and economic well-being posed by the Covid-19 pandemic.
    Language English
    Publishing date 2022-07-25
    Publishing country England
    Document type Journal Article
    ISSN 2398-502X
    ISSN 2398-502X
    DOI 10.12688/wellcomeopenres.16380.2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Will More of the Same Achieve Malaria Elimination? Results from an Integrated Macroeconomic Epidemiological Demographic Model.

    Smith, Richard D / Keogh-Brown, Marcus R / Chico, R Matthew / Bretscher, Michael T / Drakeley, Chris / Jensen, Henning Tarp

    The American journal of tropical medicine and hygiene

    2020  Volume 103, Issue 5, Page(s) 1871–1882

    Abstract: Historic levels of funding have reduced the global burden of malaria in recent years. Questions remain, however, as to whether scaling up interventions, in parallel with economic growth, has made malaria elimination more likely today than previously. The ...

    Abstract Historic levels of funding have reduced the global burden of malaria in recent years. Questions remain, however, as to whether scaling up interventions, in parallel with economic growth, has made malaria elimination more likely today than previously. The consequences of "trying but failing" to eliminate malaria are also uncertain. Reduced malaria exposure decreases the acquisition of semi-immunity during childhood, a necessary phase of the immunological transition that occurs on the pathway to malaria elimination. During this transitional period, the risk of malaria resurgence increases as proportionately more individuals across all age-groups are less able to manage infections by immune response alone. We developed a robust model that integrates the effects of malaria transmission, demography, and macroeconomics in the context of
    MeSH term(s) Disease Eradication/economics ; Disease Eradication/methods ; Health Policy ; Humans ; Malaria/economics ; Malaria/epidemiology ; Models, Economic
    Language English
    Publishing date 2020-10-27
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.19-0472
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The impact of Covid-19, associated behaviours and policies on the UK economy

    Keogh-Brown, Marcus R. / Jensen, Henning Tarp / Edmunds, W. John / Smith, Richard D.

    SSM - Population Health

    A computable general equilibrium model

    2020  , Page(s) 100651

    Keywords covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ISSN 2352-8273
    DOI 10.1016/j.ssmph.2020.100651
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: The macroeconomic and epidemiological impacts of Covid-19 in Pakistan

    Jensen, Henning Tarp / Keogh-Brown, Marcus R. / Eggo, Rosalind M. / Pearson, Carl A. B. / Torres-Rueda, Sergio / Huda, Maryam / Khalid, Muhammad / Zulfiqar, Wahaj / CMMID COVID-19 Working Group / Smith, Richard D. / Jit, Mark / Vassall, Anna

    medRxiv

    Abstract: 9Coronavirus Disease 20199 (C19) is a respiratory illness caused by 9new Coronavirus9 SARS-CoV-2. The C19 pandemic, which engulfed the world in 2021, also caused a national C19 epidemic in Pakistan, who responded with initial forced lockdowns (15-30 ... ...

    Abstract 9Coronavirus Disease 20199 (C19) is a respiratory illness caused by 9new Coronavirus9 SARS-CoV-2. The C19 pandemic, which engulfed the world in 2021, also caused a national C19 epidemic in Pakistan, who responded with initial forced lockdowns (15-30 March 2020) and a subsequent switch to a smart lockdown strategy, and, by 31 December 2020, Pakistan had managed to limit confirmed cases and case fatalities to 482,506 (456 per 100,000) and 10,176 (4.8 per 100,000). The early switch to a smart lockdown strategy, and successful follow-up move to central coordination and effective communication and enforcement of Standard Operating Procedures, was motivated by a concern over how broad-based forced lockdowns would affect poor households and day-labour. The current study aims to investigate how the national Pakistan C19 epidemic would have unfolded under an uncontrolled baseline scenario and an alternative set of controlled non-pharmaceutical intervention (NPI) policy lockdown scenarios, including health and macroeconomic outcomes. We employ a dynamically-recursive version of the IFPRI Standard Computable General Equilibrium model framework (Lofgren, Lee Harris and Robinson 2002), and a, by now, well-established epidemiological transmission-dynamic model framework (Davies, Klepac et al 2020) using Pakistan-specific 5-year age-group contact matrices on four types of contact rates, including at home, at work, at school, and at other locations (Prem, Cook & Jit 2017), to characterize an uncontrolled spread of disease. Our simulation results indicate that an uncontrolled C19 epidemic, by itself, would have led to a 0.12% reduction in Pakistani GDP (-721mn USD), and a total of 0.65mn critically ill and 1.52mn severely ill C19 patients during 2020-21, while 405,000 Pakistani citizens would have lost their lives. Since the majority of case fatalities and symptomatic cases, respectively 345,000 and 35.9mn, would have occurred in 2020, the case fatality and confirmed case numbers, observed by 31. December 2020 represents an outcome which is far better than the alternative. Case fatalities by 31. December 2020 could possibly have been somewhat improved either via a more prolonged one-off 10 week forced lockdown (66% reduction) or a 1-month forced lockdown/2-months opening intermittent lockdown strategy (33% reduction), but both sets of strategies would have carried significant GDP costs in the order of 2.2%-6.2% of real GDP.
    Keywords covid19
    Language English
    Publishing date 2023-10-06
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2023.10.06.23296657
    Database COVID19

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  8. Article ; Online: The macroeconomic and epidemiological impacts of Covid-19 in Pakistan.

    Jensen, Henning Tarp / Keogh-Brown, Marcus R. / Eggo, Rosalind M / Pearson, Carl A. B. / Torres-Rueda, Sergio / Huda, Maryam / Khalid, Muhammad / Sulfiqar, Wahaj / CMMID COVID-19 Working Group / Smith, Richard D. / Jit, Mark / Vassall, Anna

    medRxiv

    Abstract: 9Coronavirus Disease 20199 (C19) is a respiratory illness caused by 9new Coronavirus9 SARS-CoV-2. The C19 pandemic, which engulfed the world in 2021, also caused a national C19 epidemic in Pakistan, who responded with initial forced lockdowns (15-30 ... ...

    Abstract 9Coronavirus Disease 20199 (C19) is a respiratory illness caused by 9new Coronavirus9 SARS-CoV-2. The C19 pandemic, which engulfed the world in 2021, also caused a national C19 epidemic in Pakistan, who responded with initial forced lockdowns (15-30 March 2020) and a subsequent switch to a smart lockdown strategy, and, by 31 December 2020, Pakistan had managed to limit confirmed cases and case fatalities to 482,506 (456 per 100,000) and 10,176 (4.8 per 100,000). The early switch to a smart lockdown strategy, and successful follow-up move to central coordination and effective communication and enforcement of Standard Operating Procedures, was motivated by a concern over how broad-based forced lockdowns would affect poor households and day-labour. The current study aims to investigate how the national Pakistan C19 epidemic would have unfolded under an uncontrolled baseline scenario and an alternative set of controlled non-pharmaceutical intervention (NPI) policy lockdown scenarios, including health and macroeconomic outcomes. We employ a dynamically-recursive version of the IFPRI Standard Computable General Equilibrium model framework (Lofgren, Lee Harris and Robinson 2002), and a, by now, well-established epidemiological transmission-dynamic model framework (Davies, Klepac et al 2020) using Pakistan-specific 5-year age-group contact matrices on four types of contact rates, including at home, at work, at school, and at other locations (Prem, Cook & Jit 2017), to characterize an uncontrolled spread of disease. Our simulation results indicate that an uncontrolled C19 epidemic, by itself, would have led to a 0.12% reduction in Pakistani GDP (-721mn USD), and a total of 0.65mn critically ill and 1.52mn severely ill C19 patients during 2020-21, while 405,000 Pakistani citizens would have lost their lives. Since the majority of case fatalities and symptomatic cases, respectively 345,000 and 35.9mn, would have occurred in 2020, the case fatality and confirmed case numbers, observed by 31. December 2020 represents an outcome which is far better than the alternative. Case fatalities by 31. December 2020 could possibly have been somewhat improved either via a more prolonged one-off 10 week forced lockdown (66% reduction) or a 1-month forced lockdown/2-months opening intermittent lockdown strategy (33% reduction), but both sets of strategies would have carried significant GDP costs in the order of 2.2%-6.2% of real GDP.
    Keywords covid19
    Language English
    Publishing date 2023-10-06
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2023.10.06.23296657
    Database COVID19

    Kategorien

  9. Article: The impact of Covid-19, associated behaviours and policies on the UK economy: A computable general equilibrium model

    Keogh-Brown, Marcus R / Jensen, Henning Tarp / Edmunds, W John / Smith, Richard D

    SSM Popul Health

    Abstract: We estimate the potential impact of COVID-19 on the United Kingdom economy, including direct disease effects, preventive public actions and associated policies. A sectoral, whole-economy macroeconomic model was linked to a population-wide epidemiological ...

    Abstract We estimate the potential impact of COVID-19 on the United Kingdom economy, including direct disease effects, preventive public actions and associated policies. A sectoral, whole-economy macroeconomic model was linked to a population-wide epidemiological demographic model to assess the potential macroeconomic impact of COVID-19, together with policies to mitigate or suppress the pandemic by means of home quarantine, school closures, social distancing and accompanying business closures. Our simulations indicate that, assuming a clinical attack rate of 48% and a case fatality ratio of 1.5%, COVID-19 alone would impose a direct health-related economic burden of £39.6bn (1.73% of GDP) on the UK economy. Mitigation strategies imposed for 12 weeks reduce case fatalities by 29%, but the total cost to the economy is £308bn (13.5% of GDP); £66bn (2.9% of GDP) of which is attributable to labour lost from working parents during school closures, and £201bn (8.8% of GDP) of which is attributable to business closures. Suppressing the pandemic over a longer period of time may reduce deaths by 95%, but the total cost to the UK economy also increases to £668bn (29.2% of GDP), where £166bn (7.3% of GDP) is attributable to school closures and 502bn (21.9% of GDP) to business closures. Our analyses suggest Covid-19 has the potential to impose unprecedented economic costs on the UK economy, and whilst public actions are necessary to minimise mortality, the duration of school and business closures are key to determining the economic cost. The initial economic support package promised by the UK government may be proportionate to the costs of mitigating Covid-19, but without alternative measures to reduce the scale and duration of school and business closures, the economic support may be insufficient to compensate for longer term suppression of the pandemic which could generate an even greater health impact through major recession.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #857177
    Database COVID19

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  10. Article ; Online: COVID-19 vaccination in Sindh Province, Pakistan: A modelling study of health impact and cost-effectiveness.

    Pearson, Carl A B / Bozzani, Fiammetta / Procter, Simon R / Davies, Nicholas G / Huda, Maryam / Jensen, Henning Tarp / Keogh-Brown, Marcus / Khalid, Muhammad / Sweeney, Sedona / Torres-Rueda, Sergio / Eggo, Rosalind M / Vassall, Anna / Jit, Mark

    PLoS medicine

    2021  Volume 18, Issue 10, Page(s) e1003815

    Abstract: Background: Multiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health ... ...

    Abstract Background: Multiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health Organization has published guidelines for vaccine prioritisation, but most vaccine impact projections have focused on high-income countries, and few incorporate economic considerations. To address this evidence gap, we projected the health and economic impact of different vaccination scenarios in Sindh Province, Pakistan (population: 48 million).
    Methods and findings: We fitted a compartmental transmission model to COVID-19 cases and deaths in Sindh from 30 April to 15 September 2020. We then projected cases, deaths, and hospitalisation outcomes over 10 years under different vaccine scenarios. Finally, we combined these projections with a detailed economic model to estimate incremental costs (from healthcare and partial societal perspectives), disability-adjusted life years (DALYs), and incremental cost-effectiveness ratio (ICER) for each scenario. We project that 1 year of vaccine distribution, at delivery rates consistent with COVAX projections, using an infection-blocking vaccine at $3/dose with 70% efficacy and 2.5-year duration of protection is likely to avert around 0.9 (95% credible interval (CrI): 0.9, 1.0) million cases, 10.1 (95% CrI: 10.1, 10.3) thousand deaths, and 70.1 (95% CrI: 69.9, 70.6) thousand DALYs, with an ICER of $27.9 per DALY averted from the health system perspective. Under a broad range of alternative scenarios, we find that initially prioritising the older (65+) population generally prevents more deaths. However, unprioritised distribution has almost the same cost-effectiveness when considering all outcomes, and both prioritised and unprioritised programmes can be cost-effective for low per-dose costs. High vaccine prices ($10/dose), however, may not be cost-effective, depending on the specifics of vaccine performance, distribution programme, and future pandemic trends. The principal drivers of the health outcomes are the fitted values for the overall transmission scaling parameter and disease natural history parameters from other studies, particularly age-specific probabilities of infection and symptomatic disease, as well as social contact rates. Other parameters are investigated in sensitivity analyses. This study is limited by model approximations, available data, and future uncertainty. Because the model is a single-population compartmental model, detailed impacts of nonpharmaceutical interventions (NPIs) such as household isolation cannot be practically represented or evaluated in combination with vaccine programmes. Similarly, the model cannot consider prioritising groups like healthcare or other essential workers. The model is only fitted to the reported case and death data, which are incomplete and not disaggregated by, e.g., age. Finally, because the future impact and implementation cost of NPIs are uncertain, how these would interact with vaccination remains an open question.
    Conclusions: COVID-19 vaccination can have a considerable health impact and is likely to be cost-effective if more optimistic vaccine scenarios apply. Preventing severe disease is an important contributor to this impact. However, the advantage of prioritising older, high-risk populations is smaller in generally younger populations. This reduction is especially true in populations with more past transmission, and if the vaccine is likely to further impede transmission rather than just disease. Those conditions are typical of many low- and middle-income countries.
    MeSH term(s) COVID-19/economics ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19 Vaccines/administration & dosage ; COVID-19 Vaccines/economics ; Cost-Benefit Analysis/methods ; Cost-Benefit Analysis/trends ; Health Impact Assessment/economics ; Health Impact Assessment/methods ; Health Impact Assessment/trends ; Humans ; Models, Economic ; Pakistan/epidemiology ; Quality-Adjusted Life Years ; Vaccination/economics ; Vaccination/trends
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-10-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2185925-5
    ISSN 1549-1676 ; 1549-1277
    ISSN (online) 1549-1676
    ISSN 1549-1277
    DOI 10.1371/journal.pmed.1003815
    Database MEDical Literature Analysis and Retrieval System OnLINE

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