nep-hea New Economics Papers
on Health Economics
Issue of 2020‒04‒20
27 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Disability Insurance: Error Rates and Gender Differences By Hamish low; Luigi Pistaferri
  2. Application and Award Responses to Stricter Screening in Disability Insurance By Mathilde Godard; Pierre Koning; Maarten Lindeboom
  3. Household responses to disability shocks: Spousal labor supply, caregiving, and disability insurance By Lee, Siha
  4. Health Risk and the Welfare Effects of Social Security By Shantanu Bagchi; Juergen Jung
  5. Mandatory Helmet Use and the Severity of Motorcycle Accidents: No Brainer?† By Magdalena Blanco; José María Cabrera; Felipe Carozzi; Alejandro Cid
  6. The Effects of State Scope of Practice Laws on the Labor Supply of Advanced Practice Registered Nurses By Sara Markowitz; E. Kathleen Adams
  7. Effects of the Affordable Care Act Dependent Coverage Mandate on Health Insurance Coverage for Individuals in Same-Sex Couples By Christopher S. Carpenter; Gilbert Gonzales; Tara McKay; Dario Sansone
  8. The Rise of For-Profit Experimental Medicine By Pierre Azoulay; Ariel Fishman
  9. The Incubator of Human Capital: The NBER and the Rise of the Human Capital Paradigm By Claudia Goldin; Lawrence F. Katz
  10. The Coronavirus Epidemic Curve is Already Flattening in New York City By Jeffrey E. Harris
  11. The Brazilian Bombshell? The Long-Term Impact of the 1918 Influenza Pandemic the South American Way By Amanda Guimbeau; Nidhiya Menon; Aldo Musacchio
  12. The Impact of COVID-19 on Gender Equality By Titan M. Alon; Matthias Doepke; Jane Olmstead-Rumsey; Michèle Tertilt
  13. Compliance with COVID-19 Social-Distancing Measures in Italy: The Role of Expectations and Duration By Guglielmo Briscese; Nicola Lacetera; Mario Macis; Mirco Tonin
  14. Impact of rumors or misinformation on coronavirus disease (COVID-19) in social media By Tasnim, Samia; Hossain, Md Mahbub; Mazumder, Hoimonty
  15. The effect of stay-at-home orders on COVID-19 infections in the United States By James H. Fowler; Seth J. Hill; Remy Levin; Nick Obradovich
  16. Triage Protocol Design for Ventilator Rationing in a Pandemic: A Proposal to Integrate Multiple Ethical Values through Reserves By Parag A. Pathak; Tayfun Sönmez; M. Utku Ünver; M. Bumin Yenmez
  17. Data Gaps and the Policy Response to the Novel Coronavirus By James H. Stock
  18. Urgently Needed for Policy Guidance: An Operational Tool for Monitoring the COVID-19 Pandemic By Stéphane Luchini; Miriam Teschl; Patrick A. Pintus; Mickael Degoulet
  19. Economic Impacts of Coronavirus Disease (COVID-19) in Developing Countries By Rodela, Tahmina Tasnim; Tasnim, Samia; Mazumder, Hoimonty; Faizah, Farah; Sultana, Abida; Hossain, Md Mahbub
  20. An SEIR Infectious Disease Model with Testing and Conditional Quarantine By David W. Berger; Kyle F. Herkenhoff; Simon Mongey
  21. The Benefits and Costs of Social Distancing in Rich and Poor Countries By Zachary Barnett-Howell; Ahmed Mushfiq Mobarak
  22. Projecting the Spread of COVID19 for Germany By Jean Roch Donsimoni; René Glawion; Bodo Plachter; Klaus Wälde
  23. Google It Up! A Google Trends-based analysis of COVID-19 outbreak in Iran By Mohammad Reza Farzanegan; Mehdi Feizi; Saeed Malek Sadati
  24. Communication on COVID-19 to community – measures to prevent a second wave of epidemic By Bikbov, Boris; Bikbov, Alexander
  25. Spillover of COVID-19: Impact on the Global Economy By Ozili, Peterson; Arun, Thankom;
  26. Vulnerable groups at increased risk of COVID-19 in sub-Saharan Africa: The case of the HIV population By Nepomuceno, Marília
  27. Covid-19 pandemic and economic crisis: The Nigerian experience and structural causes By Ozili, Peterson K

  1. By: Hamish low (University of Oxford and Institute for Fiscal Studies); Luigi Pistaferri (Stanford University, SIEPR, NBER and CEPR)
    Abstract: We show the extent of errors made in the award of disability insurance using matched survey-administrative data. False rejections (Type I errors) are widespread, and there are large gender differences in these type I error rates. Women with a severe, work-limiting, permanent impairment are 20 percentage points more likely to be rejected than men, controlling for the type of health condition, occupation, and a host of demographic characteristics. We investigate whether these gender differences in Type I errors are due to women being in better health than men, to women having lower pain thresholds, or to women applying more readily for disability insurance. None of these explanations are consistent with the data. We use evidence from disability vignettes to suggest that there are different acceptance thresholds for men and women. The differences by gender arise because women are more likely to be assessed as being able to find other work than observationally equivalent men. Despite this, after rejection, women with a self-reported work limitation do not return to work, compared to rejected women without a work limitation.
    Keywords: Disability Insurance, Gender Differences.
    JEL: I38 J16
    Date: 2019–11–21
    URL: http://d.repec.org/n?u=RePEc:nuf:econwp:1909&r=all
  2. By: Mathilde Godard (GATE Lyon Saint-Étienne - Groupe d'analyse et de théorie économique - ENS Lyon - École normale supérieure - Lyon - UL2 - Université Lumière - Lyon 2 - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - UJM - Université Jean Monnet [Saint-Étienne] - Université de Lyon - CNRS - Centre National de la Recherche Scientifique); Pierre Koning (Universiteit Leiden [Leiden]); Maarten Lindeboom (VU - Vrije Universiteit Amsterdam [Amsterdam])
    Abstract: We examine the targeting effects of stricter screening in the Dutch Disability Insurance (DI) program induced by a major nationwide reform. The drastic 2003 "Gatekeeper Protocol" raised DI application costs and revealed more information about individual true ability to work. Discontinuity-in-Time regressions on administrative data show substantial declines in DI application rates (a 40% decrease in one year), with the largest decline occurring in difficult-todiagnose impairments and less severe health disorders. This resulted in a more deserving pool of applicants. At the same time, those who stopped applying had worse health, worked less, and were more likely to be on UI and social assistance than workers who did not apply in the old system. There are no additional targeting gains at the point of the award decision, implying that changes in average health conditions of awardees were fully driven by self-screening and work resumption in the DI waiting period.
    Keywords: Disability Insurance,Screening,Targeting efficiency,Targeting efficiency JEL codes: H2,I3
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-02533693&r=all
  3. By: Lee, Siha
    Abstract: This paper examines married women's time allocation to market hours and spousal care in the event of their husbands' disability and its implications for evaluating the insurance value of the Social Security Disability Insurance (SSDI) program. First, I find that while spousal labor supply responses to husbands' disability are small, wives spend a sizable amount of time in spousal care after their husbands become disabled. Motivated by these facts, I develop a dynamic model of married households that incorporates husbands' disability status, wives' time allocation choices, health state dependent utility, and the institutional features of SSDI. Counterfactual experiments indicate that caregiving needs substantially attenuate spousal labor supply responses and increase the insurance value of SSDI relative to its costs. Furthermore, policy
    Keywords: disability,social security,spousal labor supply,caregiving
    JEL: D13 H53 H55 I38 J22
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:zbw:clefwp:21&r=all
  4. By: Shantanu Bagchi (Department of Economics, Towson University); Juergen Jung (Department of Economics, Towson University)
    Abstract: We examine the welfare effects of Social Security in a general equilibrium environment with realistic labor income, mortality, and health risks. We construct an overlapping generations model with rational-expectations households facing idiosyncratic health risk, profit maximizing firms, incomplete insurance markets, and a government that provides pensions and health insurance. We calibrate this model to the U.S. economy and perform two sets of computational experiments: (i) modifying the progressivity of the Social Security's benefit-earnings rule, and (ii) cutting Social Security's payroll tax. We find that both experiments have a larger effect on overall welfare in the presence of health risk, because health risk increases the importance of short-term consumption smoothing, both within work-life and retirement. Increased progressivity allows households to better smooth old-age consumption risk, and the payroll tax cut increases disposable income and allows better self-insurance against early-life health risk. We also find that labor supply is an important self-insurance tool in the presence of health risk, as increasing Social Security's progressivity has a smaller effect on overall welfare and cutting the payroll tax has a larger effect on overall welfare when labor supply is fixed. Finally, low-income households experience larger welfare gains both from increasing Social Security's progressivity and cutting the payroll tax, because of their relatively low ability to self-insure against health risk in general.
    Keywords: Health risk, Social Security, benefit-earnings rule, consumption smoothing, general equilibrium.
    JEL: E62 E21 H31 H55 I14
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:tow:wpaper:2020-02&r=all
  5. By: Magdalena Blanco; José María Cabrera; Felipe Carozzi; Alejandro Cid
    Abstract: We study the impact of mandatory motorcycle helmet use laws on the severity and volume of road accidents in Uruguay by exploiting a change in the enforcement of the traffic law. Using event-study, differences-in-difference and synthetic control methods, we report a sharp increase in helmet use and a 40 percent reduction in the incidence of serious or fatal motorcyclist accidents. We find no evidence of other behavioral responses in terms of either the volume or type of accidents. We show that additional costs of enforcement for the relevant government agencies were negligible and estimate the health benefits of the policy.
    Keywords: Law Enforcement; Safety and Accidents; Helmet Use
    JEL: I12 I18 R41 H89
    Date: 2019
    URL: http://d.repec.org/n?u=RePEc:mnt:wpaper:1906&r=all
  6. By: Sara Markowitz; E. Kathleen Adams
    Abstract: This paper studies the effects of changes in states’ scope of practice laws (SOP) for advanced practice registered nurses (APRNs) on individual labor supply decisions. Restrictive SOP impose costs and other barriers to practice that may affect these decisions. Using survey data on APRNs, we analyze employment in nursing, work hours, part-time work status, multiple job holding, self-employment, wages, and migration. Results show that the level of SOP restrictions are not strong determinants of many labor market decisions, with a few exceptions. We find that hours worked and self-employment both increase when nurses practice in regulatory environments that are free from physician oversight requirements.
    JEL: I1 J01 K0
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26896&r=all
  7. By: Christopher S. Carpenter; Gilbert Gonzales; Tara McKay; Dario Sansone
    Abstract: A large body of research documents that the 2010 dependent coverage mandate of the Affordable Care Act was responsible for significantly increasing health insurance coverage among young adults. No prior research has examined whether sexual minority young adults also benefitted from the dependent coverage mandate, despite previous studies showing lower health insurance coverage among sexual minorities and the fact that their higher likelihood of strained relationships with their parents might predict a lower ability to use parental coverage. Our estimates from the American Community Surveys using difference-in-differences and event study models show that men in same-sex couples age 21-25 were significantly more likely to have any health insurance after 2010 compared to the associated change for slightly older 27 to 31-year-old men in same-sex couples. This increase is concentrated among employer-sponsored insurance, and it is robust to permutations of time periods and age groups. Effects for women in same-sex couples and men in different-sex couples are smaller than the associated effects for men in same-sex couples. These findings confirm the broad effects of expanded dependent coverage and suggest that eliminating the federal dependent mandate could reduce health insurance coverage among young adult sexual minorities in same-sex couples.
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2004.02296&r=all
  8. By: Pierre Azoulay; Ariel Fishman
    Abstract: Beginning around 1990, academic medical centers have ceased to be the primary locus of industry-sponsored clinical trial activity. Instead, clinical trials have increasingly been conducted in private practices and for-profit, dedicated study sites. We examine the underlying causes of this startling evolution. On the demand side, the greater availability of non-academic investigators has enabled pharmaceutical firms to better match physicians' skills with specific projects. On the supply side, we argue that the growth of managed care health insurance has contributed to a rise in the number of non-academic physicians performing clinical research. We find evidence consistent with these claims using a unique data set containing information about 85,919 site contracts for 7,735 clinical trials between 1991 and 2003. Furthermore, we examine the gap in prevailing prices for comparable procedures conducted for clinical trials versus conventional medical care, and conclude that the effect of managed care on entry is consistent with non-academic physicians “inducing demand” so as to resist downward pressures on their income.
    JEL: I13 I23 O31
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26892&r=all
  9. By: Claudia Goldin; Lawrence F. Katz
    Abstract: The human capital construct is deep in the bones of economics and finds reference by many classical economists, even if they did not use the phrase. The term “human capital,” seldom mentioned in economics before the 1950s, increased starting in the 1960s and blossomed in the 1990s. The upsurge in NBER publications was even greater. Using EconLit codes from 1990 to 2019, the use of human capital among NBER books increased from 5% to 25%, whereas all economics books changed from 3% to 6%. For NBER working papers, 3% referenced human capital around 1990, but 10% have more recently. The figures for all economics articles are 4% and 6%. The NBER played an outsized role in the rise of the concept of human capital mainly because of the emphasis on empiricism at the NBER. We explore how the NBER was an incubator of human capital research and the ways human capital theory brought the NBER into the modern era of economics.
    JEL: B0 J24
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26909&r=all
  10. By: Jeffrey E. Harris
    Abstract: New York City has been rightly characterized as the epicenter of the coronavirus pandemic in the United States. Just one month after the first cases of coronavirus infection were reported in the city, the burden of infected individuals with serious complications of COVID-19 has already outstripped the capacity of many of the city’s hospitals. As in the case of most pandemics, scientists and public officials don’t have complete, accurate, real-time data on the path of new infections. Despite these data inadequacies, there already appears to be sufficient evidence to conclude that the curve in New York City is indeed flattening. The purpose of this report is to set forth the evidence for – and against – this preliminary but potentially important conclusion. Having examined the evidence, we then inquire: if the curve is indeed flattening, do we know what caused to it to level off?
    JEL: I1 I12 I18 I28
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26917&r=all
  11. By: Amanda Guimbeau; Nidhiya Menon; Aldo Musacchio
    Abstract: We analyze the repercussions of the 1918 Influenza Pandemic on demographic measures, human capital formation, and productivity markers in the state of Sao Paulo, Brazil's financial center and the most populous city in South America today. Leveraging temporal and spatial variation in district-level estimates of influenza-related deaths for the period 1917-1920 combined with a unique database on socio-economic, health and productivity outcomes constructed from historical and contemporary documents for all districts in Sao Paulo, we find that the 1918 Influenza pandemic had significant negative impacts on infant mortality and sex ratios at birth in 1920 (the short-run). We find robust evidence of persistent effects on health, educational attainment and productivity more than twenty years later. Our study highlights the importance of documenting the legacy of historical shocks in understanding the development trajectories of countries over time.
    JEL: I15 J10 N36 O12
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26929&r=all
  12. By: Titan M. Alon; Matthias Doepke; Jane Olmstead-Rumsey; Michèle Tertilt
    Abstract: The economic downturn caused by the current COVID-19 outbreak has substantial implications for gender equality, both during the downturn and the subsequent recovery. Compared to “regular” recessions, which affect men’s employment more severely than women’s employment, the employment drop related to social distancing measures has a large impact on sectors with high female employment shares. In addition, closures of schools and daycare centers have massively increased child care needs, which has a particularly large impact on working mothers. The effects of the crisis on working mothers are likely to be persistent, due to high returns to experience in the labor market. Beyond the immediate crisis, there are opposing forces which may ultimately promote gender equality in the labor market. First, businesses are rapidly adopting flexible work arrangements, which are likely to persist. Second, there are also many fathers who now have to take primary responsibility for child care, which may erode social norms that currently lead to a lopsided distribution of the division of labor in house work and child care.
    JEL: D10 E24 J16 J22
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26947&r=all
  13. By: Guglielmo Briscese; Nicola Lacetera; Mario Macis; Mirco Tonin
    Abstract: We study how intentions to comply with the self-isolation restrictions introduced in Italy to mitigate the COVID-19 epidemic respond to the length of their possible extension. Based on a survey of a representative sample of Italian residents (N=894), we find that respondents who are positively surprised by a given hypothetical extension (i.e., the extension is shorter than what they expected) are more willing to increase their self-isolation. In contrast, negative surprises (extensions longer than expected) are associated with a lower willingness to comply. In a context where individual compliance has collective benefits, but full enforcement is costly and controversial, communication and persuasion have a fundamental role. Our findings provide insights to public authorities on how to announce lockdown measures and manage people’s expectations.
    JEL: C42 D91 H12 H41 I12
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26916&r=all
  14. By: Tasnim, Samia; Hossain, Md Mahbub; Mazumder, Hoimonty
    Abstract: The COVID-19 pandemic has not only caused significant challenges for health system all over the globe but also fueled the surge of numerous rumors, hoaxes and misinformation, regarding etiology, outcomes, prevention, and cure of the disease. This misinformation are masking healthy behaviors and promoting erroneous practices that increase the spread of the virus and ultimately result in poor physical and mental health outcomes among individuals. Myriad incidents of mishaps caused by these rumors was reported across the world. To address this issue the frontline healthcare providers should be equipped with the most recent research findings and accurate information. The mass media, health care organization, community-based organizations, and other important stakeholders should build strategic partnerships and launch common platforms in disseminating authentic public health messages. Advanced technologies like natural language processing or data mining approaches should be applied in detection and removal online content with no scientific basis from all social media platforms. Those involved with the spread of such rumors should be brought to justice. Telemedicine based care should be established at a large scale to prevent depletion of limited resources.
    Date: 2020–03–29
    URL: http://d.repec.org/n?u=RePEc:osf:socarx:uf3zn&r=all
  15. By: James H. Fowler; Seth J. Hill; Remy Levin; Nick Obradovich
    Abstract: In March and April 2020, public health authorities in the United States acted to mitigate transmission of COVID-19. These actions were not coordinated at the national level, which creates an opportunity to use spatial and temporal variation to measure their effect with greater accuracy. We combine publicly available data sources on the timing of stay-at-home orders and daily confirmed COVID-19 cases at the county level in the United States (N = 132,048). We then derive from the classic SIR model a two-way fixed-effects model and apply it to the data with controls for unmeasured differences between counties and over time. Mean county-level daily growth in COVID-19 infections peaked at 17.2% just before stay-at-home orders were issued. Two way fixed-effects regression estimates suggest that orders were associated with a 3.8 percentage point (95% CI 0.7 to 8.6) reduction in the growth rate after one week and an 8.6 percentage point (3.0 to 14.1) reduction after two weeks. By day 22 the reduction (18.2 percentage points, 12.3 to 24.0) had surpassed the growth at the peak, indicating that growth had turned negative and the number of new daily infections was beginning to decline. A hypothetical national stay-at-home order issued on March 13, 2020 when a national emergency was declared might have reduced cumulative infections by 62.3%, and might have helped to reverse exponential growth in the disease by April 5. The results here suggest that a coordinated nationwide stay-at-home order may have reduced by hundreds of thousands the current number of infections and by thousands the total number of deaths from COVID-19. Future efforts in the United States and elsewhere to control pandemics should coordinate stay-at-home orders at the national level, especially for diseases for which local spread has already occurred and testing availability is delayed.
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2004.06098&r=all
  16. By: Parag A. Pathak (MIT); Tayfun Sönmez (Boston College); M. Utku Ünver (Boston College); M. Bumin Yenmez (Boston College)
    Abstract: In the wake of the Covid-19 pandemic, the rationing of medical resources has become a critical issue. Nearly all existing triage protocols are based on a priority point system, in which an explicit formula specifies the order in which the total supply of a particular resource, such as a ventilator, is to be rationed for eligible patients. A priority point system generates the same priority ranking to ration all the units. Triage protocols in some states (e.g. Michigan) prioritize frontline health workers giving heavier weight to the ethical prin- ciple of instrumental valuation. Others (e.g. New York) do not, reasoning that if medical workers obtain high enough priority, there is a risk that they obtain all units and none remain for the general community. This debate is particularly pressing given substantial Covid-19 related health risks for frontline medical workers. In this paper, we propose that medical resources be rationed through a reserve system. In a reserve system, ventilators are placed into multiple categories. Priorities guiding allocation of units can reflect different ethical values between these categories. For example, while a reserve category for essential personnel can emphasize the reciprocity and instrumental value, a reserve category for general community can give higher weight to the values of utility and distributive justice. A reserve system provides additional flexibility over a priority point system because it does not dictate a single priority order for the allocation of all units. It offers a middle-ground approach that balances competing objectives. However, this flexibility requires careful attention to implementation, most notably the processing order of reserve categories, given that transparency is essential for triage protocol design. In this paper, we describe our mathematical model of a reserve system, characterize its potential outcomes, and examine distributional implications of par- ticular reserve systems. We also discuss several practical considerations with triage protocol design.
    JEL: D45 D47 D63 I18
    Date: 2020–04–05
    URL: http://d.repec.org/n?u=RePEc:boc:bocoec:997&r=all
  17. By: James H. Stock
    Abstract: This note lays out the basic Susceptible-Infected-Recovered (SIR) epidemiological model of contagion, with a target audience of economists who want a framework for understanding the effects of social distancing and containment policies on the evolution of contagion and interactions with the economy. A key parameter, the asymptomatic rate (the fraction of the infected that are not tested under current guidelines), is not well estimated in the literature because tests for the coronavirus have been targeted at the sick and vulnerable, however it could be estimated by random sampling of the population. In this simple model, different policies that yield the same transmission rate β have the same health outcomes but can have very different economic costs. Thus, one way to frame the economics of shutdown policy is as finding the most efficient policies to achieve a given β, then determining the path of β that trades off the economic cost against the cost of excess lives lost by overwhelming the health care system.
    JEL: E60 I10
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26902&r=all
  18. By: Stéphane Luchini (Aix-Marseille Univ, CNRS, EHESS, Ecole Centrale, AMSE); Miriam Teschl (Aix-Marseille Univ, CNRS, EHESS, Ecole Centrale, AMSE); Patrick A. Pintus (Aix-Marseille Univ, CNRS, EHESS, Ecole Centrale, AMSE); Mickael Degoulet (INT, Aix-Marseille University, CNRS)
    Abstract: The radical uncertainty around the current COVID19 pandemics requires that governments around the world should be able to track in real time not only how the virus spreads but, most importantly, what policies are effective in keeping the spread of the disease under check. To improve the quality of health decision-making, we argue that it is necessary to monitor and compare acceleration/deceleration of confirmed cases over health policy responses, across countries. To do so, we provide a simple mathematical tool to estimate the convexity/concavity of trends in epidemiological surveillance data. Had it been applied at the onset of the crisis, it would have offered more opportunities to measure the impact of the policies undertaken in different Asian countries, and to allow European and North-American governments to draw quicker lessons from these Asian experiences when making policy decisions. Our tool can be especially useful as the epidemic is currently extending to lower-income African and South American countries, some of which have weaker health systems.
    Keywords: acceleration; convexity; covid-19; data dashboard; detection of infectious diseases; public health policy; sensitivity
    JEL: I18 H12
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:aim:wpaimx:2009&r=all
  19. By: Rodela, Tahmina Tasnim; Tasnim, Samia; Mazumder, Hoimonty; Faizah, Farah; Sultana, Abida; Hossain, Md Mahbub
    Abstract: The coronavirus disease (COVID-19) has critically impacted global health systems and economies, especially in developing countries. Those countries have been struggling to address the preexisting burden of diseases with limited resources, which will become even more challenging during COVID-19. The economic implications related to COVID-19 in those countries include a high cost of care, market failures in pluralistic health systems, high out-of-pocket expenses, the added burden of noncommunicable diseases, missed economic opportunities, and socioeconomic consequences like unemployment and poverty. It is essential to assess the prevalent gaps, mobilize resources, strengthen health systems financing and leadership, enhance research capacities informing evidence-based policymaking, and foster effective partnerships for addressing health and economic disparities due to COVID-19.
    Date: 2020–04–04
    URL: http://d.repec.org/n?u=RePEc:osf:socarx:wygpk&r=all
  20. By: David W. Berger; Kyle F. Herkenhoff; Simon Mongey
    Abstract: We extend the baseline Susceptible-Exposed-Infectious-Recovered (SEIR) infectious disease epidemiology model to understand the role of testing and case-dependent quarantine. Our model nests the SEIR model. During a period of asymptomatic infection, testing can reveal infection that otherwise would only be revealed later when symptoms develop. Along with those displaying symptoms, such individuals are deemed known positive cases. Quarantine policy is case-dependent in that it can depend on whether a case is unknown, known positive, known negative, or recovered. Testing therefore makes possible the identification and quarantine of infected individuals and release of non-infected individuals. We fix a quarantine technology—a parameter determining the differential rate of transmission in quarantine—and compare simple testing and quarantine policies. We start with a baseline quarantine-only policy that replicates the rate at which individuals are entering quarantine in the US in March, 2020. We show that the total deaths that occur under this policy can occur under looser quarantine measures and a substantial increase in random testing of asymptomatic individuals. Testing at a higher rate in conjunction with targeted quarantine policies can (i) dampen the economic impact of the coronavirus and (ii) reduce peak symptomatic infections—relevant for hospital capacity constraints. Our model can be plugged into richer quantitative extensions of the SEIR model of the kind currently being used to forecast the effects of public health and economic policies.
    JEL: E24 I18
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:26901&r=all
  21. By: Zachary Barnett-Howell; Ahmed Mushfiq Mobarak
    Abstract: Social distancing is the primary policy prescription for combating the COVID-19 pandemic, and has been widely adopted in Europe and North America. We estimate the value of disease avoidance using an epidemiological model that projects the spread of COVID-19 across rich and poor countries. Social distancing measures that "flatten the curve" of the disease to bring demand within the capacity of healthcare systems are predicted to save many lives in high-income countries, such that practically any economic cost is worth bearing. These social distancing policies are estimated to be less effective in poor countries with younger populations less susceptible to COVID-19, and more limited healthcare systems, which were overwhelmed before the pandemic. Moreover, social distancing lowers disease risk by limiting people's economic opportunities. Poorer people are less willing to make those economic sacrifices. They place relatively greater value on their livelihood concerns compared to contracting COVID-19. Not only are the epidemiological and economic benefits of social distancing much smaller in poorer countries, such policies may exact a heavy toll on the poorest and most vulnerable. Workers in the informal sector lack the resources and social protections to isolate themselves and sacrifice economic opportunities until the virus passes. By limiting their ability to earn a living, social distancing can lead to an increase in hunger, deprivation, and related mortality and morbidity. Rather than a blanket adoption of social distancing measures, we advocate for the exploration of alternative harm-reduction strategies, including universal mask adoption and increased hygiene measures.
    Date: 2020–04
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2004.04867&r=all
  22. By: Jean Roch Donsimoni; René Glawion; Bodo Plachter; Klaus Wälde
    Abstract: We model the evolution of the number of individuals that are reported to be sick with COVID-19 in Germany. Our theoretical framework builds on a continuous time Markov chain with four states: healthy without infection, sick, healthy after recovery or after infection but without symptoms and dead. Our quantitative solution matches the number of sick individuals up to the most recent observation and ends with a share of sick individuals following from infection rates and sickness probabilities. We employ this framework to study inter alia the expected peak of the number of sick individuals in a scenario without public regulation of social contacts. We also study the effects of public regulations. For all scenarios we report the expected end of the CoV-2 epidemic.
    Keywords: Corona, COVID19, SARS-CoV-2, spread of infection, Markov model, Germany, projection.
    JEL: I18 E17 C63
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:ces:ceswps:_8183&r=all
  23. By: Mohammad Reza Farzanegan (Philipps-University Marburg); Mehdi Feizi (Ferdowsi University of Mashhad); Saeed Malek Sadati (Ferdowsi University of Mashhad)
    Abstract: Soon after the first identified COVID-19 cases in Iran, the spread of the new Coronavirus has affected almost all its provinces. In the absence of credible data on people's unfiltered concerns and needs, especially in developing countries, Google search data is a reliable source that truthfully captures the public sentiment. This study examines the within province changes of confirmed cases of Corona across Iranian provinces from 19 Feb. 2020 to 9 March 2020. Using real-time Google Trends data, panel fixed effects, and GMM regression estimations, we show a robust negative association between the intensity of search for disinfection methods and materials in the past and current confirmed cases of the COVID-19 virus. In addition, we find a positive and robust association between the intensity of the searches for symptoms of Corona and the number of confirmed cases within the Iranian provinces. These findings are robust to control for province and period fixed effects, province-specific time trends, and lag of confirmed cases. Our results show how not only prevention could hinder affection in an epidemic disease but also prophecies, shaped by individual concerns and reflected in Google search queries, might not be self-fulfilling.
    Keywords: Google Trends, COVID-19, Iran, epidemic disease
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:mar:magkse:202017&r=all
  24. By: Bikbov, Boris; Bikbov, Alexander
    Abstract: The manuscript highlights available data on gap in public awareness about recent clinical and scientific facts about COVID-19, insufficient community knowledge about symptoms and preventive measures during COVID-19 and previous MERS-CoV epidemic, and lack of monitoring the community perception and adherence to preventive measures. We also summarize literature evidence about reluctance to change social behavior and disregard recommendations for social distancing among persons who percept to having low risk of infection or complications, and briefly describe destructive psychological response and misleading communications. Our analysis could be translated into important policy changes in two directions: (1) to communicate recent scientific discoveries about COVID-19 pathophysiology to better prepare public opinion to longer period of extraordinary measures; (2) to implement sociological feedback on knowledge, attitudes and practices among general public and some vulnerable social groups.
    Date: 2020–03–25
    URL: http://d.repec.org/n?u=RePEc:osf:osfxxx:ea9jm&r=all
  25. By: Ozili, Peterson; Arun, Thankom;
    Abstract: How did a health crisis translate to an economic crisis? Why did the spread of the coronavirus bring the global economy to its knees? The answer lies in two methods by which coronavirus stifled economic activities. First, the spread of the virus encouraged social distancing which led to the shutdown of financial markets, corporate offices, businesses and events. Second, the exponential rate at which the virus was spreading, and the heightened uncertainty about how bad the situation could get, led to flight to safety in consumption and investment among consumers, investors and international trade partners.
    Keywords: Covid-19, Coronavirus, SARS-CoV-2, outbreak, pandemic, financial crisis, global recession, public health, spillovers, monetary policy, fiscal policy, liquidity provision, Central banks.
    JEL: E3 G15 G28 H81 H84 I1
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:99317&r=all
  26. By: Nepomuceno, Marília
    Abstract: More recently, the COVID-19 infection is advancing fast towards different settings. Regions with a high burden of infectious diseases such as HIV, malaria, and dengue including Latin America and Africa are experiencing an increasing number of confirmed cases and deaths. Since the distribution of relevant co-morbidities varies substantially by country, the risk profile for COVID-19 could be very different in countries with high prevalence of individuals living with HIV.
    Date: 2020–03–31
    URL: http://d.repec.org/n?u=RePEc:osf:osfxxx:uyzjv&r=all
  27. By: Ozili, Peterson K
    Abstract: The economic downturn in Nigeria was triggered by a combination of declining oil price and spillovers from the Covid-19 outbreak, which not only led to a fall in the demand for oil products but also stopped economic activities from taking place when social distancing policies were enforced. The government responded to the crisis by providing financial assistance to businesses, not to households, that were affected by the outbreak. The monetary authority adopted accommodative monetary policies and offered a targeted 3.5trillion loan support to some sectors. These efforts should have prevented the economic crisis from occurring but it didn’t. Economic agents refused to engage in economic activities for fear of contracting the Covid-19 disease that was spreading very fast at the time. In this paper, I analyse the Covid-19 spillovers to Nigeria and the structural weaknesses in Nigeria’s infrastructure that helped bring on the current economic crisis and discuss prospects for reform.
    Keywords: Nigeria, Covid-19, Coronavirus, SARS-CoV-2, outbreak, pandemic, financial crisis, global recession, public health, spillovers, monetary policy, fiscal policy, liquidity provision, Central banks.
    JEL: G1 G15 G18 G21
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:99424&r=all

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