An effortless and comprehensive approach to burden of illness reviews
Heoro’s June paper of the month (POM) estimated the productivity loss and DALY rate in Italy during the COVID-19 pandemic. This study highlights the catastrophic burden of the disease on both life and the economy.
As of the 13th July there have been 12.8 million confirmed cases of COVID-19 and 566,355 confirmed deaths worldwide. It is evident the coronavirus is impacting every aspect of life and is a major global public health emergency. The disease has the ability to leave vulnerable people critically ill and devastatingly lead to premature death or long term health effects. Additionally, with the world on the brink of recession, it is clear the economic burden of the pandemic is, and will be, catastrophic. 41% of France's workforce have been furloughed and unemployment in the United States has risen from 3.5% to 10.4%. Independent of the increasing unemployment and furlough, workers becoming ill or having to quarantine minimises productivity due to the amount of absenteeism, with mild cases having a recovery time of 2 weeks and severe cases needing 6 to 8 weeks.
Italy especially has been hit hard by COVID-19, with 243,230 confirmed cases and 34,967 deaths and unemployment rising from 10% to 12.7% during the pandemic and leaving 29% of its workforce on furlough. To give an insight into the burden on society and the economy, the authors of Heoro’s POM estimate, during the COVID-19 pandemic, Italy’s productivity loss and Disability-Adjusted life years (DALYs), which represent one year of ‘healthy’ life lost due illness, disability or premature death.
Nurchis et al, carried out an observational study to calculate both Temporary Productivity Loss (TPL) and Permanent Productivity Loss (PPL) using data from the Istituto Nazionale della Previdenza Sociale (INPS). In brief, TPL incorporated number of cases, weeks off work and median wages. Alternatively, for PPL they used death, unemployment and labour force rates and the national Gross Domestic Product (GDP), to produce an estimate. Data to calculate DALYs were sourced from the Istituto Superiore di Sanita (ISS), Years of Life Lost (YLL) and Years Lost to Disability (YLD) formulae were summed to give the estimate.
The researchers concluded that on 28th April 2020 for COVID-19 the Italian DALY rate was 2.01 DALYs per 1000 persons, the results by gender are presented in table 1.
Table 1 - Adapted from Nurchis et al (2020)
Results were also categorised by age group and sex, they found that the 80 to 89 group had the highest burden of disease and males were also had a significantly higher DALYs rate than females (figure 1).
Figure 1 - Taken from Nurchis et al (2020)
The total TPL was €100 million, which accounts for the productivity lost due to absenteeism from work. The total PPL was €300 million with a 0.17% impact on GDP, which demonstrates the economic impact of premature deaths on the country. The PPL as a percentage of GDP, increased with each age group with 60 to 69 having the highest percentage (figure 2).
Figure 2 - Taken from Nurchis et al (2020)
The authors noted that they did not include and consider the economic impacts caused by lockdown, quarantine policy and direct healthcare costs. This further highlights the negative true productivity cost. A study which simulated the impact of COVID-19 on GDP using a standard global computable general equilibrium model, estimated that a baseline global pandemic scenario would make global GDP fall by 2%, with a decline of 2.5% in developing countries and 1.8% for industrial countries. This study suggests the fall is greater than estimated in Nurchis et al.
In conclusion, there are clear detrimental economic and social consequences of COVID-19. With the possibility of a second wave, this research is vital to advise governments on the impact on the individual, the community and the economy, in the hope that future policy may soften the COVID-19 blow.
POM Citation: Nurchis, M. C. et al. (2020) ‘Impact of the Burden of COVID-19 in Italy: Results of Disability-Adjusted Life Years (DALYs) and Productivity Loss’, International Journal of Environmental Research and Public Health. MDPI AG, 17(12), p. 4233. doi: 10.3390/ijerph17124233. URL:https://www.mdpi.com/1660-4601/17/12/4233