论文标题
计算Covid-19的成本：为什么未来的治疗期权值值很重要
Counting the costs of COVID-19: why future treatment option values matter
论文作者
论文摘要
我批评了最近的Covid-19锁定成本和收益的最近分析（Miles，Stedman＆Heald，2020年），重点是英国（英国）。 Miles等。 （2020年）认为，英国三月的封锁比挽救的生命的利益更为昂贵，使用质量调整的生命年（QALY）进行了30000英镑的评估，从6月中旬开始的13周的锁定费用比任何一个宽松的估计均可估算出来，即使在中期的估计中，还要享受7000次高度的超过7000次，这将比任何均能享受的估计值得大得多。 我在这里注意到两个关键问题，严重影响了他们的估计并对他们的结论产生怀疑。首先，他们的计算在13周后任意切断，而无需使流行病终止。也就是说，他们假设每周13或7500年的9月中旬州与相应的感染率之间的冷漠。除非有人假设（a）在可预见的将来没有任何有效的疫苗或改进的医疗或社会干预措施，（b）尽管有暂时的封锁，但Covid-19很可能会传播直到畜群免疫，这似乎是无可辩驳的。即使在这些假设下，也非常有问题。其次，他们忽略了严重疾病的成本，可能长期降低幸存者的生活质量和期望。这些是不确定的，但至少与死亡成本一样大。 总而言之，如果不估计未来的医疗干预措施和长期疾病成本的概率，就不能合理地制定有关COVID-19的政策。迫切需要在建模这些不确定性方面进行更多的工作。
I critique a recent analysis (Miles, Stedman & Heald, 2020) of COVID-19 lockdown costs and benefits, focussing on the United Kingdom (UK). Miles et al. (2020) argue that the March-June UK lockdown was more costly than the benefit of lives saved, evaluated using the NICE threshold of £30000 for a quality-adjusted life year (QALY) and that the costs of a lockdown for 13 weeks from mid-June would be vastly greater than any plausible estimate of the benefits, even if easing produced a second infection wave causing over 7000 deaths weekly by mid-September. I note here two key problems that significantly affect their estimates and cast doubt on their conclusions. Firstly, their calculations arbitrarily cut off after 13 weeks, without costing the epidemic end state. That is, they assume indifference between mid-September states of 13 or 7500 weekly deaths and corresponding infection rates. This seems indefensible unless one assumes that (a) there is little chance of any effective vaccine or improved medical or social interventions for the foreseeable future, (b) notwithstanding temporary lockdowns, COVID-19 will very likely propagate until herd immunity. Even under these assumptions it is very questionable. Secondly, they ignore the costs of serious illness, possible long-term lowering of life quality and expectancy for survivors. These are uncertain, but plausibly at least as large as the costs in deaths. In summary, policy on tackling COVID-19 cannot be rationally made without estimating probabilities of future medical interventions and long-term illness costs. More work on modelling these uncertainties is urgently needed.
