Governments need to be honest with public as the world emerges from lockdown

Governments need to be honest with the public about the trade-offs being made to reopen large sectors of the economy post-lockdown, according to a newly-published paper by leading health economists at Glasgow Caledonian University and the University of British Columbia. 

Researchers claim political decision-makers across the world are avoiding facing up to the "uncomfortable truths" over balancing health concerns with the need to mitigate the social and economic impact of the pandemic. 

In the paper, ‘Health Economics and Emergence from Lockdown’, published by Cambridge University Press in its journal Health Economics, Policy and Law, the UK Government is criticised for favouring "meaningless large numbers" over a more systematic approach to tackling COVID-19. 

Professor Cam Donaldson, Pro Vice-Chancellor Research at Glasgow Caledonian University and one of the authors, said: "Despite denials of politicians and other advisors, trade-offs have already been apparent in many policy decisions addressing the pandemic and its social and economic consequences. 

"Governments haven't openly admitted the need for trade-offs, not only within which lives may be lost but also tolerated. 

"Trade-offs with the economy, whether at local, regional or national levels, can be made; and, indeed, are being made. 

"The economic stimuli of governments across the globe have traded-off the future against the present and sectors of the economy with each other. 

"Health and social care have been traded off against each other, with investments in large (often unused) health care capacity at the expense of services and equipment for people in care homes. Within health care, non-COVID-related care has been suspended to accommodate needs arising from the pandemic; initially for sound clinical reasons relating to do-no-harm, but less so now. 

"Indeed, it might be argued that deliberately not recognising trade-offs then allows governments to avoid these uncomfortable truths." 

Health economists are calling on governments across the world to take a more structured approach to spending and move away from high-profile announcements based on headline-grabbing numbers. 

Professor Donaldson said: "From the very start, in many countries, shortages in testing and personal protective equipment were apparent, with meaningless large numbers thrown out in attempts to appease the public, for example, the ‘100,000-per-day’ pledge in the UK. 

"Little recognition has been given to a more systematic approach to what might be needed by different groups, from which priorities for access, based on health gain for resources expended, could be established.” 

The paper calls on international governments to adopt a ‘marginal analysis’ approach which would account for situations in which the R number was below critical levels and would allow for greater levels of health risk for social and economic expansion to enhance well-being in society overall.