Around the course of the COVID pandemic’s more than three years, both the virus and the steps taken to stop its spread have impacted people’s lives worldwide. However, how can we accurately measure these effects?
While estimates of COVID deaths worldwide (currently at just under 7 million) exist, less research has been done on the disease’s broader effects, such as mental health problems brought on by, for instance, the fear of contracting the disease or the isolation of lockdowns.
In a recent study, we used a global survey of the general people to try and quantify how the COVID pandemic has impacted global health.
The quality-adjusted life year (QALY) is a metric that health economists frequently use to measure health. According to a person’s general health, a value should be assigned to each year of their life. Scores range from one for someone in perfect health to nearly zero for someone ill.
A quick questionnaire known as the EQ-5D, which consists of five questions covering essential aspects of health, is a typical technique to calculate QALYs. One score their level of self-care, daily activities, mobility, pain and discomfort, as well as anxiety and sadness.
According to the responses, a profile of the respondent’s health-related quality of life is created, which is then summed up by the EQ-5D score. This can be used for QALYs, which are life expectancy adjustments that consider general health when assessed at various times.
For instance, a person with an EQ-5D index of 0.5 would accrue one QALY for every two years they lived. This person is considered to be in relatively poor health. This method has been extensively utilized to assess the effects of various illnesses and medical interventions on health.
By adding the EQ-5D in a global survey of the populace in late 2020, towards the conclusion of the pandemic’s first year, just before COVID vaccinations began to be delivered, we could quantify overall health-related quality of life. Over 15,000 participants from 13 different nations participated in the online poll, which was conducted.
We asked participants to rate their current health compared to a year ago to understand how they felt the pandemic had affected them.
Our study’s main drawback is that we had to rely on participants’ memories of their health before the pandemic. There is evidence that overestimation and underestimation mistakes typically cancel each other out, even if it is doubtful that someone can remember precisely how they would have reacted to the poll one year ago.
Over one-third of respondents’ health-related quality of life was significantly lower following the pandemic. The most deteriorating element of health was anxiety and sadness, especially in younger (under-35) and female populations.
The health losses were converted into a QALY measure, which revealed that, on average, perceived health was around 8% worse during the pandemic.
When results were broken down by nation, middle-income nations like Chile and India—which experienced lockdowns for more than 40 weeks and had a high proportion of COVID infections—were the most severely impacted.
Participants in China, in contrast, were notable for not reporting any appreciable decline in their state of health. Despite lockdowns occurring in China after the virus emerged in early 2020, these were quickly lifted due to low transmission rates.
To put the findings into perspective, earlier research has shown that each COVID death leads to the average loss of three to six QALYs. To calculate the effect of COVID deaths on overall QALYs in each country, we coupled these estimates with the reported number of deaths in each.
The loss in QALYs caused by the COVID pandemic and lockdowns was between five and eleven times greater than that caused by COVID-related deaths, according to our survey’s reported health changes. This demonstrates how concentrating solely on COVID cases and fatalities ignore the epidemic’s burden and the effects of strategies intended to curb it.
For instance, most nations employed lockdowns to stop the spread of the virus, but the resulting social isolation may have hurt people’s mental health and general wellness.
Similarly to that, other nations provided financial assistance to those who were struggling, which may have had a favourable effect on their mental health. The trade-offs between the advantages as well as disadvantages of various techniques can be measured using QALYs.
The few international studies that have looked at particular components of health, such as mental health, have concentrated on high-income countries, even though individual nations have attempted to measure the pandemic’s effects on general wellness. Most global analyses of the pandemic’s consequences rely on documented COVID cases and accompanying fatalities.
It would also be beneficial to utilize QALYs to enhance current measurements that concentrate on cases and deaths by tracking many facets of health. This would allow us to examine how the COVID pandemic’s impacts are dispersed among the population. For instance, while older persons are more likely to die, those under 35 are more affected by mental health issues.
We can better prepare for future health shocks by looking beyond the death toll and assessing the population’s general health internationally.
