Background: In addition to reducing mortality and morbidity, COVID-19 therapies confer societal benefits by reducing the disease’s economic impact. Therapies that address COVID hospitalizations mitigate the need for government-imposed economic restrictions to reduce disease spread and hence the risk that hospitals become overwhelmed. We investigated the potential value of such therapies by estimating the cost of government restrictions imposed during late 2020, costs that COVID therapies might make less necessary. Methods: : We combined high frequency consumer spending and initial unemployment claims data (outcomes), information about when state governments restricted business activities (explanatory variable of interest), and case incidence and mortality data (proxies for the potential confounding effect of pandemic severity on voluntary economic activity reductions). We developed linear mixed models that account for nesting within US state and correlation across observations close in time. Sensitivity analyses explored the impact of: (1) limiting attention to the 10 U.S. states that “mostly closed” at some point during late 2020;(2) excluding subsets of potential confounding variables;(3) altering our outcome variable definition (i.e., for designating a state as “mostly closed”);and (4) considering alternative model correlation structures. Results: : Government-imposed restrictions reduced total consumer spending by 2% and spending on restaurants and accommodations by 5%. They increased weekly initial unemployment claims by 0.21% of the 2019 US workforce. We estimate that restrictions in the U.S. during late 2020 reduced consumer spending by $12 billion and increased initial weekly unemployment claims by 114,000. Sensitivity analyses indicated that our findings are robust. Conclusions: : Assuming that late 2020 is representative of tendencies for the government to restrict economic activity in response to high hospital utilization, therapies reducing hospital utilization have the potential to confer substantial societal value. Recognizing societal benefits in health technology assessment will help allocate resources to address the most important risks society faces.
The cost of business restrictions during the COVID-19 pandemic