Estimation of the economic burden of COVID-19 using disability-adjusted life years (DALYs) and productivity losses in Kerala, India: a model-based analysis

Abstract

Objectives: From the beginning of the COVID-19 pandemic, clinical practice and research globally have centred on the prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the economy and stressed healthcare systems worldwide. The present study estimates disability-adjusted life years (DALYs), years of potential productive life lost (YPPLL) and cost of productivity lost (CPL) due to premature mortality and absenteeism secondary to COVID-19 in the state of Kerala, India.

Setting: Details on sociodemographics, incidence, death, quarantine, recovery time, etc were derived from public sources and the Collective for Open Data Distribution-Keralam. The working proportion for 5-year age-gender cohorts and the corresponding life expectancy were obtained from the 2011 Census of India.

Primary and secondary outcome measures: The impact of the disease was computed through model-based analysis on various age-gender cohorts. Sensitivity analysis was conducted by adjusting six variables across 21 scenarios. We present two estimates, one until 15 November 2020 and later updated to 10 June 2021.

Results: Severity of infection and mortality were higher among the older cohorts, with men being more susceptible than women in most subgroups. DALYs for males and females were 15 954.5 and 8638.4 until 15 November 2020, and 83 853.0 and 56 628.3 until 10 June 2021. The corresponding YPPLL were 1323.57 and 612.31 until 15 November 2020, and 6993.04 and 3811.57 until 10 June 2021, and the CPL (premature mortality) were 263 780 579.94 and 41 836 001.82 until 15 November 2020, and 1 419 557 903.76 and 278 275 495.29 until 10 June 2021.

Conclusions: Most of the COVID-19 burden was contributed by years of life lost. Losses due to YPPLL were reduced as the impact of COVID-19 infection was lesser among the productive cohorts. The CPL values for individuals aged 40-49 years old were the highest. These estimates provide the data necessary for policymakers to work on reducing the economic burden of COVID-19 in Kerala.

Keywords: COVID-19; health economics; health policy.

Figure 1

Sensitivity analysis (15 November 2020): (A) effect of life expectancy on DALYs; (B) effect of increase in cases on YLDs; (C) effect of mild cases on YLDs; (D) effect of deaths on DALYs; (E) effect of isolation after recovery on YLDs; and (F) DALYs for all scenarios. DALYs, disability-adjusted life years; YLDs, years lived with disability.

Figure 2

Sensitivity analysis (10 June 2021): (A) effect of life expectancy on DALYs; (B) effect of increase in cases on YLDs; (C) effect of mild cases on YLDs; (D) effect of deaths on DALYs; (E) effect of isolation after recovery on YLDs; and (F) DALYs for all scenarios. DALYs, disability-adjusted life years; YLDs, years lived with disability.