The challenge of estimating the direct and indirect effects of COVID-19 interventions - Toward an integrated economic and epidemiological approach

Schools and the transmission of Sars-Cov-2: Evidence from Italy

This paper studies the effect on the spread of Sars-Cov-2 in Italy of schools' re-openings and closures. Exploiting different re-opening dates across regions after the summer break of 2020, I show that early-opening regions experienced more cases in the 40 days following school re-openings compared with late-opening ones. However, there is great uncertainty around the estimates, and this suggests a wide dispersion in the effects of school re-openings on Sars-Cov-2 transmission. I also study the effect of school closures in Campania, one of the biggest regions in Southern Italy. Using a synthetic control approach, I show that school closures are associated with lower numbers of cases relative to the counterfactual group, particularly in younger age groups. In contrast, I find no significant effects on older age groups, which are more likely to require hospitalization. Finally, by exploiting survey data, I provide descriptive evidence on the increased incidence rate among teachers and students relative to the general population, following school re-openings.

Investigating mortality trends in Italy during the COVID-19 pandemic: life expectancy changes within provinces and vaccination campaign impact up to December 2022

OBJECTIVES

We used publicly available population data from 1 January 2019 up to 31 December 2022, to investigate mortality trends in Italy during the COVID-19 pandemic, evaluating changes in life expectancy (LE) at birth within provinces and the impact of COVID-19 vaccinations.

STUDY DESIGN

Aggregate data analysis.

METHODS

Annual period life tables were used to estimate sex-specific LEs within provinces from 2019 to 2022. We used Arriaga decomposition to analyze the contribution of age groups (<60 years and ≥60 years) to annual LE changes. We implemented a Quasi-Poisson regression model to estimate the number of averted deaths by the achieved COVID-19 vaccination rates from January 2021 up to December 2022, simulating a counterfactual scenario where vaccine doses were not administered.

RESULTS

The results revealed geographical heterogeneity in annual LE changes across Italian provinces during the pandemic. By the end of 2022, LE was below the prepandemic levels in 88% of provinces for females and in 76% for males. In addition, we estimated that the achieved vaccination rates averted 460,831 deaths (95% confidence interval: 250,976-707,920), corresponding to a 25% reduction in expected all-cause mortality.

CONCLUSIONS

Overall, the study highlighted the significant role of COVID-19 vaccinations in averting a considerable number of deaths and improving LE. However, by the end of 2022, LE had not fully recovered to prepandemic levels in many provinces. This could be attributed to concurrent factors, including enduring COVID-19 pandemic effects, intense summer heat waves and early onset of seasonal flu. Further research and continuous monitoring are essential to fully comprehend long-term mortality trends and optimize public health strategies.

The common interests of health protection and the economy: evidence from scenario calculations of COVID-19 containment policies

We develop a novel approach integrating epidemiological and economic models that allows data-based simulations during a pandemic. We examine the economically optimal opening strategy that can be reconciled with the containment of a pandemic. The empirical evidence is based on data from Germany during the SARS-CoV-2 pandemic. Our empirical findings reject the view that there is necessarily a conflict between health protection and economic interests and suggest a non-linear U-shape relationship: it is in the interest of public health and the economy to balance non-pharmaceutical interventions in a manner that further reduces the incidence of infections. Our simulations suggest that a prudent strategy that leads to a reproduction number of around 0.75 is economically optimal. Too restrictive policies cause massive economic costs. Conversely, policies that are too loose lead to higher death tolls and higher economic costs in the long run. We suggest this finding as a guide for policy-makers in balancing interests of public health and the economy during a pandemic.