nep-hea New Economics Papers
on Health Economics
Issue of 2021‒04‒19
28 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Overconfident health workers provide lower quality healthcare By Kovacs, Roxanne J.; Lagarde, Mylene; Cairns, John
  2. The Long-Run Effects of Sports Club Vouchers for Primary School Children By Marcus, Jan; Siedler, Thomas; Ziebarth, Nicolas R.
  3. Effects of Passive Smoking on Prenatal and Infant Development: Lessons from the Past By Carlo Ciccareli; Gianni De Fraja; Daniela Vuri
  4. Reconsidering Risk Aversion By Daniel J. Benjamin; Mark Alan Fontana; Miles Kimball
  5. The Impact of the COVID-19 Pandemic on Scientific Research in the Life Sciences By Massimo Riccaboni; Luca Verginer
  6. Equity Impacts of Dollar Store Vaccine Distribution By Judith A. Chevalier; Jason L. Schwartz; Yihua Su; Kevin R. Williams
  7. COVID-19 and the failure of pharmaceutical innovation for the global South: The example of "neglected diseases" and emerging infectious diseases By Raza, Werner G.
  8. Pandemic economics: optimal dynamic confinement under uncertainty and learning By Christian Gollier
  9. Optimal Epidemic Control in Equilibrium with Imperfect Testing and Enforcement By Thomas Phelan; Alexis Akira Toda
  10. Loneliness and Social Isolation: An unequally shared burden in Europe By d'Hombres, Beatrice; Barjaková, Martina; Schnepf, Sylke V.
  11. COVID-19 in the Democratic Republic of Congo By Gorpudolo, C.Z.; Akello, A.C.
  12. COVID-19, Race, and Gender By Graziella Bertocchi; Arcangelo Dimico
  13. Instructional interventions for improving COVID-19 knowledge, attitudes, behaviors: Evidence from a large-scale RCT in India. By Mistree, Dinsha; Loyalka, Prashant; Fairlie, Robert; Bhuradia, Ashutosh; Angrish, Manyu; Lin, Jason; Karoshi, Amar; Yen, Sara J; Mistri, Jamsheed; Bayat, Vafa
  14. Working from Home: Its Effects on Productivity and Mental Health By KITAGAWA Ritsu; KURODA Sachiko; OKUDAIRA Hiroko; OWAN Hideo
  15. Covid-19 Crisis Fuels Hostility against Foreigners By VojtÄ›ch BartoÅ¡; Michal Bauer; Jana Cahlíková; Julie Chytilová
  16. Estimating the Financial Impact of Gene Therapy in the U.S. By Chi Heem Wong; Dexin Li; Nina Wang; Jonathan Gruber; Rena M. Conti; Andrew W. Lo
  17. The Hammer and the Dance: Equilibrium and Optimal Policy during a Pandemic Crisis By Tiziana Assenza; Christian Hellwig; Fabrice Collard; Martial Dupaigne; Patrick Fève; Sumudu Kankanamge; Nicolas Werquin
  18. Bayesian Estimation of Epidemiological Models: Methods, Causality, and Policy Trade-Offs By Jonas E. Arias; Jesús Fernández-Villaverde; Juan F. Rubio-Ramírez; Minchul Shin
  19. Decoding China's Covid-19 "virus exceptionalism": Community-based digital contact tracing in Wuhan By Boeing, Philipp; Wang, Yihan
  20. The COVID-19 Pandemic and Mental Health: Disentangling Crucial Channels By Siflinger, Bettina M.; Paffenholz, Michaela; Seitz, Sebastian; Mendel, Moritz; Gaudecker, Hans-Martin von
  21. How Fast Must Vaccination Campaigns Proceed in Order to Beat Rising Covid-19 Infection Numbers? By Claudius Gros; Daniel Gros
  22. The relationship between pandemic containment measures, mobility and economic activity By Corinna Ghirelli; María Gil; Samuel Hurtado; Alberto Urtasun
  23. On the Economic and Health Impact of the COVID-19 Shock on Italian Regions: A Value Chain Approach By Tommaso Ferraresi; Leonardo Ghezzi; Fabio Vanni; Alessandro Caiani; Mattia Guerini; Francesco Lamperti; Severin Reissl; Giorgio Fagiolo; Mauro Napoletano; Andrea Roventini
  24. Perception de la COVID-19 et comportement des ménages en Argentine By Pascale Phélinas; Valérie Hernandez; Camille Ciriez
  25. The COVID-19 Pandemic's Effects on Voter Turnout By Matteo Picchio; Raffaella Santoloni
  26. SARS-CoV-2 spread, detection, and dynamics in a megacity in Latin America By Rachid Laajaj; Camilo De Los Rios; Ignacio Sarmiento-Barbieri; Danilo Aristizabal; Eduardo Behrentz; Raquel Berna; Giancarlo Buitrago; Zulma Cucunubá
  27. Analysis of the tradeoff between health and economic impacts of the Covid-19 epidemic By Samson Lasaulce; Chao Zhang; Vineeth Varma; Irinel Constantin Morarescu
  28. Drivers of Covid-19 Vaccinations: Vaccine Administration and Delivery Efficiency in the United States By Rajeev K. Goel; Michael A. Nelson

  1. By: Kovacs, Roxanne J.; Lagarde, Mylene; Cairns, John
    Abstract: While a growing body of evidence suggests that healthcare workers in low and middle-income countries often provide poor quality of care, the reasons behind such low performance remain unclear. The literature on medical decision-making suggests that cognitive biases, or failures related to the way healthcare providers think, explain many diagnostic errors. This study investigates whether one cognitive bias, overconfidence, defined as the tendency to overestimate one's performance relative to others, is associated with the low quality of care provided in Senegal. We link survey data on the overconfidence of health workers to objective measures of the quality of care they provide to standardised patients – enumerators who pose as real patients and record details of the consultation. We find that about a third of providers are overconfident – meaning that they overestimate their own abilities relative to their peers. We then show that overconfident providers are 26% less likely to manage patients correctly and exert less effort in clinical practice. These results suggest that the low levels of quality of care observed in some settings could be partly explained by the cognitive biases of providers, such as overconfidence. Policies that encourage adequate supervision and feedback to healthcare workers might reduce such failures in clinical decision-making.
    Keywords: cognitive bias; medical decision making; overconfidence; overplacement; quality of care; Senegal; standardised patients
    JEL: D01 I10
    Date: 2020–01–01
  2. By: Marcus, Jan (University of Hamburg); Siedler, Thomas (University of Hamburg); Ziebarth, Nicolas R. (Cornell University)
    Abstract: Starting in 2009, the German state of Saxony distributed sports club membership vouchers among all 33,000 third graders in the state. The policy's objective was to encourage them to develop a long-term habit of exercising. In 2018, we carried out a large register-based survey among several cohorts in Saxony and two neighboring states. Our difference-indifferences estimations show that, even after a decade, awareness of the voucher program was significantly higher in the treatment group. We also find that youth received and redeemed the vouchers. However, we do not find significant short- or long-term effects on sports club membership, physical activity, overweightness, or motor skills.
    Keywords: physical activity, voucher, primary school, obesity, habit formation, objective health measures, school health examinations, windfall gains, crowd-out, taxpayer subsidies
    JEL: I12 I14 I18 I28 I38 Z28 H71
    Date: 2021–04
  3. By: Carlo Ciccareli; Gianni De Fraja; Daniela Vuri
    Abstract: This paper studies the effect of passive smoking on child development. We use data from a time when the adverse effects of smoking on health were not known, and when tobacco was not an inferior good. This allows us to disentangle the effect on foetuses and infants of smoking frm that of other indicators of social and economic conditions. We exploit a set of unique longitudinal historical datasets defined at a detailed level of geographical disaggregation, namely the 69 Italian provinces. The datasets record precise information on the per capita consumption of tobacco products, the heights of twenty-year old conscripts in the second half of the 19th century Italy, and other relevant controls. We find a strong negative effect of smoking in the period before and after birth on the height at age 20. Results are robust to changes in specification and consistent across the height distribution.
    Keywords: passive smoking, stature, nineteenth century Italy, infant development.
    Date: 2020
  4. By: Daniel J. Benjamin (University of California Los Angeles & NBER); Mark Alan Fontana (Hospital for Special Surgery & Weill Cornell Medical College); Miles Kimball (University of Colorado Boulder & NBER)
    Abstract: Risk aversion is typically inferred from real or hypothetical choices over risky lotteries, but such “untutored” choices may reflect mistakes rather than preferences. We develop a procedure to disentangle preferences from mistakes : after eliciting untutored choices, we confront participants with their choices that are inconsistent with expected-utility axioms (broken down enough to be self-evident) and allow them to reconsider their choices. We demonstrate this procedure via a survey about hypothetical retirement investment choices administered to 596 Cornell students. We find that, on average, reconsidered choices are more consistent with almost all expected-utility axioms, with one exception related to regret.
    Keywords: risk aversion, mistakes, retirement investing, framing effects, expected utility
    JEL: D63 D81 G11 H8
    Date: 2020–10–21
  5. By: Massimo Riccaboni; Luca Verginer
    Abstract: The COVID-19 outbreak has posed an unprecedented challenge to humanity and science. On the one side, public and private incentives have been put in place to promptly allocate resources toward research areas strictly related to the COVID-19 emergency. But on the flip side, research in many fields not directly related to the pandemic has lagged behind. In this paper, we assess the impact of COVID-19 on world scientific production in the life sciences. We investigate how the usage of medical subject headings (MeSH) has changed following the outbreak. We estimate through a difference-in-differences approach the impact of COVID-19 on scientific production through PubMed. We find that COVID-related research topics have risen to prominence, displaced clinical publications, diverted funds away from research areas not directly related to COVID-19 and that the number of publications on clinical trials in unrelated fields has contracted. Our results call for urgent targeted policy interventions to reactivate biomedical research in areas that have been neglected by the COVID-19 emergency.
    Date: 2021–01
  6. By: Judith A. Chevalier (Yale School of Management); Jason L. Schwartz (Yale School of Public Health); Yihua Su (Yale School of Public Health); Kevin R. Williams (Cowles Foundation, Yale University)
    Abstract: We use geospatial data to examine the unprecedented national program currently underway in the United States to distribute and administer vaccines against COVID- 19. We quantify the impact of the proposed federal partnership with the company Dollar General to serve as vaccination sites and compare vaccine access with Dollar General to the current Federal Retail Pharmacy Partnership Program. Although dollar stores have been viewed with skepticism and controversy in the policy sector, we show that, relative to the locations of the current federal program, Dollar General stores are disproportionately likely to be located in Census tracts with high social vulnerability; using these stores as vaccination sites would greatly decrease the distance to vaccines for both low-income and minority households. We consider a hypothetical alternative partnership with Dollar Tree and show that adding these stores to the vaccination program would be similarly valuable, but impact different geographic areas than the Dollar General partnership. Adding Dollar General to the current pharmacy partners greatly surpasses the goal set by the Biden administration of having 90% of the population within 5 miles of a vaccine site. We discuss the potential benefits of leveraging these partnerships for other vaccinations, including against influenza.
    Date: 2021–04
  7. By: Raza, Werner G.
    Abstract: The debate about the lack of access to COVID-19 vaccines for the countries of the Global South joins a long history of struggle for effective and affordable treatments for those several dozen diseases for which the World Health Organisation (WHO) uses the telling adjective "neglected". Empirical evidence shows that the pharmaceutical innovation system, built over the last thirty years around the global protection of so-called intellectual property rights (IPR), has failed across the board in providing treatments for these diseases. The same applies to the category of new infectious diseases, which also includes coronaviruses. Here, too, there has been little research and development effort, even though the dangers of the diseases they cause had been known for 20 years. The COVID-19 pandemic should therefore be used for a fundamental reform with the aim of aligning pharmaceutical innovation more closely with public health goals. In addition to a stronger financial commitment from the EU, the pharmaceutical industry should also be required to make a greater contribution to the fight against these diseases, for example in the form of a levy to fund research and development (R&D) for "neglected diseases" and new infectious diseases.
    Keywords: TRIPS-agreement,COVID-19,neglected diseases,new infectious diseases,patents
    Date: 2021
  8. By: Christian Gollier (TSE - Toulouse School of Economics - UT1 - Université Toulouse 1 Capitole - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)
    Abstract: Most integrated models of the covid pandemic have been developed under the assumption that the policy-sensitive reproduction number is certain. The decision to exit from the lockdown has been made in most countries without knowing the reproduction number that would prevail after the deconfinement. In this paper, I explore the role of uncertainty and learning on the optimal dynamic lockdown policy. I limit the analysis to suppression strategies where the SIR dynamics can be approximated by an exponential infection decay. In the absence of uncertainty, the optimal confinement policy is to impose a constant rate of lockdown until the suppression of the virus in the population. I show that introducing uncertainty about the reproduction number of deconfined people reduces the optimal initial rate of confinement.
    Keywords: Covid,Pandemic,SIR,Rate of confinement,Reproduction number
    Date: 2020
  9. By: Thomas Phelan; Alexis Akira Toda
    Abstract: We analyze equilibrium behavior and optimal policy within a Susceptible-Infected-Recovered epidemic model augmented with potentially undiagnosed agents who infer their health status and a social planner with imperfect enforcement of social distancing. We define and prove the existence of a perfect Bayesian Markov competitive equilibrium and contrast it with the efficient allocation subject to the same informational constraints. We identify two externalities, static (individual actions affect current risk of infection) and dynamic (individual actions affect future disease prevalence), and study how they are affected by limitations on testing and enforcement. We prove that a planner with imperfect enforcement will always wish to curtail activity, but that its incentives vanish as testing becomes perfect. When a vaccine arrives far into the future, the planner with perfect enforcement may encourage activity before herd immunity. We find that lockdown policies have modest welfare gains, whereas quarantine policies are effective even with imperfect testing.
    Date: 2021–04
  10. By: d'Hombres, Beatrice (European Commission); Barjaková, Martina (Economic and Social Research Institute, Dublin); Schnepf, Sylke V. (European Commission, DG Joint Research Centre)
    Abstract: Concerns about loneliness and social isolation are growing more than ever. With the COVID-19 pandemic entering its second year, there are fears that the toll on loneliness could have consequences long after the virus recedes. This study offers a comparative overview of the incidence and determinants of loneliness and social isolation in Europe in the pre-COVID-19 period. The empirical results indicate that 8.6% of the adult population in Europe suffer from frequent loneliness and 20.8% from social isolation, with eastern Europe recording the highest prevalence of both phenomena. Trends over time do not indicate any change in the incidence of social isolation following the widespread adoption of social media networks from 2010 onwards. The empirical analysis shows that favourable economic circumstances protect against loneliness and social isolation, while living alone and poor health constitute important loneliness risk factors. Although social isolation increases with age, the elderly do not report more frequent feelings of loneliness than other age groups, all other things being equal. The relative contributions of the different objective circumstances included in the empirical analysis — demographic characteristics, economic conditions, living arrangements, health status, religious beliefs and geographical location — to chronic loneliness and social isolation vary substantially.
    Keywords: loneliness, social isolation, risk factors, Europe
    JEL: I12 I14 I18 I30 D60
    Date: 2021–04
  11. By: Gorpudolo, C.Z.; Akello, A.C.
    Abstract: The Democratic Republic of Congo recorded its first case of the novel coronavirus (COVID-19) in the country on March 10th, 2020. The pandemic arrived in a country that was simultaneously battling its 10th Ebola outbreak, Yellow fever, and ongoing conflict. In other to mitigate the spread of COVID-19 with a health system already under severe pressure from other infectious diseases, the national government declared a state of health emergency, and a nationwide lockdown. Although these measures were instituted to mitigate the outbreak and help maintain an overburdened health system, it also contributed to an increase in anxiety, fear of economic down-turn and a worsening precarious situation, creating a confluence of disaster, conflict and disease. Using both qualitative and secondary sources for data gathering, this study analyses all factors involved in understanding conflict, disease and disaster in the Democratic Republic of Congo by analyzing government responses, top down measures and external interventions, revealing issues of police brutality, human rights and gender inequality. The study also discovered disaster coping mechanism employed by people living in the Kivu’s and how these coping mechanisms are helping to maintain hope and mental sanity in a precarious conflict state.
    Date: 2021–04–08
  12. By: Graziella Bertocchi; Arcangelo Dimico
    Abstract: The mounting evidence on the demographics of COVID-19 fatalities points to an overrepresentation of minorities and an underrepresentation of women. Using individual-level, race-disaggregated, and georeferenced death data collected by the Cook County Medical Examiner, we jointly investigate the racial and gendered impact of COVID-19, its timing, and its determinants. Through an event study approach we establish that Blacks individuals are affected earlier and more harshly and that the effect is driven by Black women. Rather than comorbidity or aging, the Black female bias is associated with poverty and channeled by occupational segregation in the health care and transportation sectors and by commuting on public transport. Living arrangements and lack of health insurance are instead found uninfluential. The Black female bias is spatially concentrated in neighborhoods that were subject to historical redlining.
    Keywords: COVID-19, deaths, race, gender, occupations, transport, redlining, Cook County, Chicago.
    JEL: I14 J15 J16 J21 R38
    Date: 2021–03
  13. By: Mistree, Dinsha; Loyalka, Prashant; Fairlie, Robert; Bhuradia, Ashutosh; Angrish, Manyu; Lin, Jason; Karoshi, Amar; Yen, Sara J; Mistri, Jamsheed; Bayat, Vafa
    Abstract: Seeking ways to encourage broad compliance with health guidelines during the pandemic, especially among youth, we test two hypotheses pertaining to the optimal design of instructional interventions for improving COVID-19-related knowledge, attitudes, and behaviors. We randomly assigned 8376 lower-middle income youth in urban India to three treatments: a concentrated and targeted fact-based, instructional intervention; a longer instructional intervention that provided the same facts along with underlying scientific concepts; and a control. Relative to existing efforts, we find that both instructional interventions increased COVID-19-related knowledge immediately after intervention. Relative to the shorter fact-based intervention, the longer intervention resulted in sustained improvements in knowledge, attitudes, and self-reported behavior. Instead of reducing attention and comprehension by youth, the longer scientific based treatment appears to have increased understanding and retention of the material. The findings are instrumental to understanding the design of instruction and communication in affecting compliance during this and future pandemics.
    Keywords: Attitudes, Behavioral interventions, Health beliefs, Health economics, Health education, India, Randomized controlled trials, Public Health, Medical and Health Sciences, Economics, Studies in Human Society
    Date: 2021–03–17
  14. By: KITAGAWA Ritsu; KURODA Sachiko; OKUDAIRA Hiroko; OWAN Hideo
    Abstract: The coronavirus disease 2019 (COVID-19) pandemic has impacted the world economy in various ways. In particular, the drastic shift to telework has dramatically changed how people work. Whether the new style of working from home (WFH) will remain in our society highly depends on its effects on workers' productivity. However, to the best of our knowledge, the effects of WFH on productivity are still unclear. By leveraging unique surveys conducted at four manufacturing firms in Japan, we identify the possible factors of productivity changes due to WFH. Our main findings are as follows. First, after ruling out the time-invariant component of individual productivity and separate trends specific to employee attributes, we find that productivity declined more for workers who worked from home than those who did not. Second, our analysis shows that poor WFH setups and communication difficulties are the major reasons for productivity losses. Third, we find that the mental health of workers who work from home is significantly better than that of workers who are unable to work from home. Our result suggests that if appropriate investments can be made in upgrading WFH setups and facilitating communication, WFH may improve productivity by improving employees' health and well-being.
    Date: 2021–03
  15. By: VojtÄ›ch BartoÅ¡; Michal Bauer; Jana Cahlíková; Julie Chytilová
    Abstract: Aggressive behavior against out-group members often rises during periods of economic hardship and health pandemics. Here, we test the widespread concern that the Covid-19 crisis may fuel hostility against people from other nations or ethnic minorities. Using a controlled money-burning task, we elicited hostile behavior among a nationally representative sample (n=2,186) in the Czech Republic, at a time when the entire population was under lockdown. We provide causal evidence that exogenously elevating salience of the Covid-19 crisis magnifies hostility against foreigners. This behavioral response is similar across various demographic sub-groups. The results underscore the importance of not inflaming anti-foreigner sentiments and suggest that efforts to restore international trade and cooperation will need to address both social and economic damage.
    Keywords: COVID-19, pandemic, scapegoating, hostility, inter-group conflict, discrimination, experiment
    JEL: C90 D01 D63 D91 J15
    Date: 2020–05
  16. By: Chi Heem Wong; Dexin Li; Nina Wang; Jonathan Gruber; Rena M. Conti; Andrew W. Lo
    Abstract: We empirically assess the potential financial impact of future gene therapies on the US economy. After identifying 109 late-stage gene therapy clinical trials currently underway, we estimate the number of new and existing patients with corresponding diseases to be treated by these gene therapies, developing and applying novel mathematical models to estimate the increase in quality-adjusted life years for each approved gene therapy. We then simulate the launch prices and the expected spending for these therapies over a 15-year time horizon. Under conservative assumptions, the results of our simulation suggest that an expected total of 1.09 million patients will be treated by gene therapy from January 2020 to December 2034. The expected peak annual spending on these therapies is $25.3 billion, and the expected total spending from January 2020 to December 2034 is $306 billion. Assuming a linear pace of future gene therapy development fitted to past experience, our spending estimate increases by only 15.7% under conservative assumptions. As a proxy for the impact of expected spending on different public and private payers, we decompose the estimated annual spending by treated age group. Since experience suggests that insurers with annual budget constraints may restrict access to therapies with expected benefit to the patient, we consider various methods of payment to ensure access to these therapies even among those insured by the most budget-constrained payers.
    JEL: G17 I11 I13 I18
    Date: 2021–04
  17. By: Tiziana Assenza (TSE - Toulouse School of Economics - UT1 - Université Toulouse 1 Capitole - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Christian Hellwig (Unknown); Fabrice Collard (TSE - Toulouse School of Economics - UT1 - Université Toulouse 1 Capitole - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Martial Dupaigne (Unknown); Patrick Fève (Unknown); Sumudu Kankanamge (Unknown); Nicolas Werquin (Unknown)
    Abstract: We develop a comprehensive framework for analyzing optimal economic policy during a pandemic crisis in a dynamic economic model that trades off pandemic-induced mortality costs against the adverse economic impact of policy interventions. We use the comparison between the planner problem and the dynamic decentralized equilibrium to highlight the margins of policy intervention and describe optimal policy actions. As our main conclusion, we provide a strong and novel economic justification for the current approach to dealing with the pandemic, which is different from the existing health policy rationales. This justification is based on a simple economic concept, the shadow price of infection risks, which succinctly captures the static and dynamic trade-offs and externalities between economic prosperity and mortality risk as the pandemic unfolds.
    Date: 2021–03–31
  18. By: Jonas E. Arias; Jesús Fernández-Villaverde; Juan F. Rubio-Ramírez; Minchul Shin
    Abstract: We present a general framework for Bayesian estimation and causality assessment in epidemiological models. The key to our approach is the use of sequential Monte Carlo methods to evaluate the likelihood of a generic epidemiological model. Once we have the likelihood, we specify priors and rely on a Markov chain Monte Carlo to sample from the posterior distribution. We show how to use the posterior simulation outputs as inputs for exercises in causality assessment. We apply our approach to Belgian data for the COVID-19 epidemic during 2020. Our estimated time-varying-parameters SIRD model captures the data dynamics very well, including the three waves of infections. We use the estimated (true) number of new cases and the time-varying effective reproduction number from the epidemiological model as information for structural vector autoregressions and local projections. We document how additional government-mandated mobility curtailments would have reduced deaths at zero cost or a very small cost in terms of output.
    Keywords: Bayesian estimation, epidemiological models, causality, policy interventions
    JEL: C10 C50 I10
    Date: 2021
  19. By: Boeing, Philipp; Wang, Yihan
    Abstract: During the COVID-19 pandemic, comprehensive, accurate, and timely digital contact tracing serves as a decisive measure in curbing viral transmission. Such a strategy integrates corporate innovation, government decision-making, citizen participation, and community coordination with big data analytics. This article explores how key stakeholders in an open innovation ecosystem interact within the digital context to overcome challenges to public health and socio-economic welfare imposed by the pandemic. To enhance the digital contact tracing effectiveness, communities are deployed to moderate the interactions between government, enterprises and citizens. As an example, we study the community-based digital contact tracing in Wuhan, a representative case of China's 'virus exceptionalism' in COVID-19 mitigation. We discuss the effectiveness of this strategy and raise critical ethical concerns regarding decision-making in R&D management.
    Keywords: COVID-19,digital contact tracing,open innovation ecosystem,community,big data
    Date: 2021
  20. By: Siflinger, Bettina M. (Tilburg University); Paffenholz, Michaela (University of Mannheim); Seitz, Sebastian (ZEW Mannheim); Mendel, Moritz (briq and University of Bonn); Gaudecker, Hans-Martin von (University of Bonn)
    Abstract: Since the start of the COVID-19 pandemic, a major source of concern has been its effect on mental health. Using pre-pandemic information and five customized questionnaires in the Dutch LISS panel, we investigate how mental health in the working population has evolved along with the most prominent risk factors associated with the pandemic. Overall, mental health decreased sharply with the onset of the first lockdown but recovered fairly quickly. In December 2020, levels of mental health are comparable to those in November 2019. We show that perceived risk of infection, labor market uncertainty, and emotional loneliness are all associated with worsening mental health. Both the initial drop and subsequent recovery are larger for parents of children below the age of 12. Among parents, the patterns are particularly pronounced for fathers if they shoulder the bulk of additional care. Mothers' mental health takes a particularly steep hit if they work from home and their partner is designated to take care during the additional hours.
    Keywords: COVID-19, mental health, gender inequality, lockdown
    JEL: I10 I14 I18 I30 J22
    Date: 2021–04
  21. By: Claudius Gros; Daniel Gros
    Abstract: We derive an analytic expression describing how health costs and death counts of the Covid-19 pandemic change over time as vaccination proceeds. Meanwhile, the disease may continue to spread exponentially unless checked by Non Pharmacological Interventions (NPI). The key factors are that the mortality risk from a Covid-19 infection increases exponentially with age and that the sizes of age cohorts decrease linearly at the top of the population pyramid. Taking these factors into account, we derive an expression for a critical threshold, which determines the minimal speed a vaccination campaign needs to have in order to be able to keep fatalities from rising. Younger countries with fast vaccination campaigns find it substantially easier to reach this threshold than countries with aged population and slower vaccination. We find that for EU countries it will take some time to reach this threshold, given that the new, now dominant, mutations, have a significantly higher infection rate. The urgency of accelerating vaccination is increased by early evidence that the new strains also have a higher mortality risk [1]. We also find that protecting the over 60 years old, which constitute one quarter of the EU population, would reduce the loss of live by 95 percent.
    Date: 2021
  22. By: Corinna Ghirelli (Banco de España); María Gil (Banco de España); Samuel Hurtado (Banco de España); Alberto Urtasun (Banco de España)
    Abstract: This paper first constructs a regional-scale indicator that seeks to gauge the volume of measures implemented at each point in time to contain the pandemic. Using textual analysis techniques, we analyse the information in press news. At the start of the pandemic, measures were taken in a centralised fashion; but from June, regional differences began to be seen and increased in the final stretch of the year. Second, using linear estimates, with monthly data and a level of regional disaggregation, the paper documents how most of the reduction in mobility observed in Spain has been due to the restrictions imposed. However, there has been a perceptible change in this relationship over recent months. In the early stages of the pandemic, the reduction in mobility was found to be greater than would be inferred by the restrictions approved. That is to say, at the outset there was apparently some voluntary reduction in mobility. Yet following lockdown-easing, the behaviour of mobility has fitted more closely with what might be attributed to the containment measures in force. Finally, the findings in the paper suggest that most of the decline in economic activity since the start of the crisis can be explained by the reductions observed in mobility. The analysis considers only the short-term effects on activity, which is very useful for preparing the projections on GDP behaviour in the current quarter. Conversely, the methodological approach pursued does not allow for evaluation of the effect of the pandemic containment measures on activity over longer time horizons. In particular, the adverse impact on the economy’s output that occurs concurrently as a result of the restrictions may be countered in the medium term by an effect of the opposite sign, to the extent that the restrictions imposed today may serve to prevent other more forceful ones in the future.
    Keywords: nowcasting, GDP, economic activity, textual analysis, sentiment indicators, soft indicators, pandemic, COVID-19, coronavirus, mobility, restrictions, panel data
    JEL: I18 I12 E32 E37 C53 C23
    Date: 2021–03
  23. By: Tommaso Ferraresi (Istituto Regionale per la Programmazione Economica della Toscana (IRPET)); Leonardo Ghezzi (Istituto Regionale per la Programmazione Economica della Toscana (IRPET)); Fabio Vanni (Sciences Po, OFCE); Alessandro Caiani (IUSS Pavia); Mattia Guerini (Université Côte d'Azur, CNRS, GREDEG, France; Sant'Anna School of Advanced Studies; Sciences Po., OFCE); Francesco Lamperti (Institute of Economics and EMbeDS, Scuola Superiore Sant'Anna; RFF-CMCC European Institute on Economics and the Environment); Severin Reissl (IUSS Pavia); Giorgio Fagiolo (Institute of Economics and EMbeDS, Scuola Superiore Sant'Anna); Mauro Napoletano (OFCE Sciences-Po; SKEMA Business School); Andrea Roventini (Institute of Economics and EMbeDS, Scuola Superiore Sant'Anna; Sciences Po, OFCE)
    Abstract: In this work, we evaluate the exposure of Italian regions to the risk associated with the spread of COVID-19 through a two-step value chain approach. First, we estimate the degree of participation of Italian regions in a plurality of value chains linked to consumption, investment and exports. We distinguish between value chains aimed at satisfying essential needs and supply chains activated by needs characterized by a lower level of necessity in line with the restriction measures implemented by the Italian government. Second, we investigate the different levels of contagion risk associated with each value chain and the possibility of reducing it through remote working. An exercise on policy measures implemented by the Italian government during Fall 2020 completes the paper. We find that regions are affected differently by lockdown policies because of their high heterogeneity in the degree of embeddedness within different value chains and because their sectoral contributions to each of them. As a result, Italian regions are associated with very diverse potentials for mitigating contagion risk via remote working practices. Finally, we find evidence that economic and contagion risks positively correlate in non essential value chains, while they are negatively associated in the production of medium-necessity and essential goods and services. In turn, strong lockdowns induce substantially different trade-offs across regions, depending on how regions participate to value chains.
    Keywords: COVID-19 lockdown, value chains, input-output models, contagion risk, remote working
    JEL: R15 R10
    Date: 2021–04
  24. By: Pascale Phélinas (CERDI - Centre d'Études et de Recherches sur le Développement International - CNRS - Centre National de la Recherche Scientifique - UCA - Université Clermont Auvergne); Valérie Hernandez (CESSMA UMRD 245 - Centre d'études en sciences sociales sur les mondes africains, américains et asiatiques - IRD - Institut de Recherche pour le Développement - Inalco - Institut National des Langues et Civilisations Orientales - UP - Université de Paris); Camille Ciriez (CERDI - Centre d'Études et de Recherches sur le Développement International - CNRS - Centre National de la Recherche Scientifique - UCA - Université Clermont Auvergne)
    Abstract: This article explores Argentinean perceptions and attitudes towards the COVID-19 pandemic. The analysis is based on a telephone survey conducted with a representative sample of 1000 respondents. The analysis shows that Argentines have overwhelmingly approved the health and economic policies followed by their government, and, as a result, have adopted the recommended health behaviour. Among the many factors that have influenced Argentines' perceptions and attitudes, trust in institutions (president, governor, mayor) and, to a lesser extent, to the medical and scientific community emerges as a major determinant. Among the emotions, fear also proves to be a powerful driver of compliance with health regulations. Finally, the results underline the importance of social shock support measures, which help to reduce the costs associated with precautionary behaviour. These findings are robust to the inclusion of a wide set of socio-demographic control variables such as age, gender, education level, place of residence, and individuals' economic status.
    Abstract: Cet article explore les perceptions et attitudes des argentins face à l'épidémie de COVID-19 à partir d'une enquête téléphonique menée auprès d'un échantillon représentatif de 1000 répondants. L'analyse montre que les argentins ont massivement approuvé la politique sanitaire et économique suivie par leur gouvernement, et, en conséquence, modifié leur comportement. Parmi les nombreux facteurs qui ont influencé les perceptions et attitudes des argentins, la confiance dans les institutions (président, gouverneur, maire) et, dans une moindre mesure, dans la communauté médicale et scientifique ressort comme un déterminant majeur de l'adhésion des argentins à l'ensemble de la politique menée ainsi que du respect des mesures de distanciation sociale et des gestes barrière. Parmi les émotions, la peur s'avère également un puissant moteur du respect des consignes sanitaires. Les résultats soulignent enfin l'importance des mesures d'accompagnement du choc social, qui permettent de réduire les coûts associés aux comportements de précaution. Ces conclusions sont robustes à l'inclusion d'un vaste ensemble de variables de contrôle sociodémographiques telles que l'âge, le genre, le niveau d'éducation, le lieu de résidence, et le statut économique des individus.
    Keywords: Amérique latine,Argentine,Politique de santé,Covid 19
    Date: 2021–02
  25. By: Matteo Picchio (Dipartimento di Scienze Economiche e Sociali - Universita' Politecnica delle Marche); Raffaella Santoloni (Dipartimento di Scienze Economiche e Sociali - Universita' Politecnica delle Marche)
    Abstract: The COVID-19 pandemic has increased the risk of participating in public events, among them elections. We assess whether the voter turnout in the 2020 local government elections in Italy was affected by the COVID-19 pandemic. We do so by exploiting the variation among municipalities in the intensity of the COVID-19 outbreak as measured by the mortality rate among the elderly. We find that a 1 percentage point increase in the elderly mortality rate decreased the voter turnout by 0.5 percentage points, with no gender differences in the behavioural response. The effect was especially strong in densely populated municipalities. We do not detect statistically significant heterogeneous effects between the North and the South or among different levels of autonomy from the central government.
    Keywords: COVID-19 outbreak, pandemic, voter turnout, mortality rate, Italian municipalities.
    JEL: D72 D81 H70
    Date: 2021–03
  26. By: Rachid Laajaj; Camilo De Los Rios; Ignacio Sarmiento-Barbieri; Danilo Aristizabal; Eduardo Behrentz; Raquel Berna; Giancarlo Buitrago; Zulma Cucunubá
    Abstract: In many developing countries, the COVID-19 pandemic has spread much faster and wider than the number of detected cases implies. By combining data from 59,770 RT-PCR tests on mostly asymptomatic individuals with administrative data on all detected cases, we capture the spread and dynamics of the COVID-19 pandemic in Bogotá from June 2020 to early March 2021. Our data provide unusually broad and detailed information on mostly asymptomatic adults in Bogotá, allowing to describe various features of the pandemic that appear to be specific to a developing country context. We find that, by the end of March 2021, slightly more than half of the population in Bogotá has been infected, despite only a small fraction of this population being detected. In July 2020, after four months of generalized quarantine that mitigated the pandemic without curving it, the initial buildup of immunity contributed to the end of the first wave. We also show that the share of the population infected by February 2021 varies widely by occupation, socio-economic stratum, and location. This, in turn, has affected the dynamics of the spread: while the first wave of infections was driven by the lowest economic strata and highly-exposed occupations, the second peak affected the population more evenly. A better understanding of the spread and dynamics of the pandemic across different groups provides valuable guidance for efficient targeting of health policy measures and restrictions.
    Keywords: SARS-CoV-2, COVID-19, CoVIDA, América Latina
    JEL: I14 I15 I18 O54
    Date: 2021–04–05
  27. By: Samson Lasaulce; Chao Zhang; Vineeth Varma; Irinel Constantin Morarescu
    Abstract: Various measures have been taken in different countries to mitigate the Covid-19 epidemic. But, throughout the world, many citizens don't understand well how these measures are taken and even question the decisions taken by their government. Should the measures be more (or less) restrictive? Are they taken for a too long (or too short) period of time? To provide some quantitative elements of response to these questions, we consider the well-known SEIR model for the Covid-19 epidemic propagation and propose a pragmatic model of the government decision-making operation. Although simple and obviously improvable, the proposed model allows us to study the tradeoff between health and economic aspects in a pragmatic and insightful way. Assuming a given number of phases for the epidemic and a desired tradeoff between health and economic aspects, it is then possible to determine the optimal duration of each phase and the optimal severity level for each of them. The numerical analysis is performed for the case of France but the adopted approach can be applied to any country. One of the takeaway messages of this analysis is that being able to implement the optimal 4-phase epidemic management strategy in France would have led to 1.05 million infected people and a GDP loss of 231 billion euro instead of 6.88 million of infected and a loss of 241 billion euro. This indicates that, seen from the proposed model perspective, the effectively implemented epidemic management strategy is good economically, whereas substantial improvements might have been obtained in terms of health impact. Our analysis indicates that the lockdown/severe phase should have been more severe but shorter, and the adjustment phase occurred earlier. Due to the natural tendency of people to deviate from the official rules, updating measures every month over the whole epidemic episode seems to be more appropriate.
    Date: 2021–04
  28. By: Rajeev K. Goel; Michael A. Nelson
    Abstract: This paper adds some formal research to the success of ongoing efforts to combat the COVID-19 pandemic by examining the drivers of the administration and delivery efficiency of coronavirus vaccines. For this purpose, we use data from the 50 US states and place the formal analysis in the context of socio-economic drivers of vaccinations. Results show that state economic prosperity and rural population aid vaccine administration and delivery efficiency. Delivery efficiency improves in states with more nursing homes per capita, in states with more COVID-19 deaths, and with more health workers. The subset of health workers, including physicians and nurses, did not significantly impact administration or efficiency. On the other hand, vaccination efficiency was lower in states with a centralized public health agency. States with a larger share of the elderly population and those with Democrats as governors were no different from others with regard to vaccinations. Robustness checks are performed using vaccination from a more recent period. Finally, a state’s legacy of corrupt activity, across two different time dimensions, is broadly consistent with the greasing effects of corruption. While the study uses data from a single nation that is among the first to start vaccinating its population, the findings have relevance for other nations, especially in the Global South, that are starting vaccinations or lagging behind in delivering vaccines.
    Keywords: Covid-19, coronavirus, vaccine, efficiency, rural, deaths, health workers, corruption, networking, United States
    JEL: H50 H75 I10 I18 K42
    Date: 2021

This nep-hea issue is ©2021 by Nicolas R. Ziebarth. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.