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Michael Droy

I'm issuing a prediction. In 2021, deaths from diabetes, dementia and heart disease will be abnormally low.

Maybe. Certainly the excess death counts I have seen in data have been very low or negative for some time, which perhaps confirms that, the effect already happened in the Summer in Europe.
I doubt actually that we will see the effect last long though.
For example in Nursing homes, one study found that while death occurred a mean time of 14 months after arrival, median death was just 5 months. When people are close, they are very close. I doubt if Covid advances death by more than 6 months for more than a handful of people (including some of those undiagnosed with serious illnesses by doctors, but identified by the grim reaper).

But the real issue is the effects of Covid restrictions on lives. How has the Covid effect on the Economy (lower wealth, unemployment, depression, murder) and the Health Services reduced lives.
An undiagnosed cancer might cut 20+ years of a patient's life. Life expectancy has gone up in many countries 10 years in the last 30 for good reasons.

So it may well be that we see increased excess deaths over the medium to longer term - out to 5 years I would guess.

QALYs are the proper measure. Quality Adjusted Life Years are the measure of how long a patient can expect to live in years adjusted for life quality (100% if fully active, less if not). In Budget-limited health services (NHS or most of Europe) they are used to calculate health policies. How much does this drug or operation cost and how many additional QALYs does it give? And does that match our targets and if so for which types of patients. Hip replacements do very well boosting both years and quality. Other procedures are deemed not suitable for the aged or obese.

So QALYs are the basic unit of health economics, and civil servants and economists have been calculating them for decades. There are very clear estimates for health service availability and for economic factors such as wealth or unemployment.
A QALY analysis to judge Covid policies is a natural civil servant task.
Ask why you have never heard of a QALY analysis?

When the big post-Covid inquiries happen to investigate Government Actions, failure to publish a QALY analysis will be top of the list.

Kaiser

MD: QALY sounds great in theory but it belongs to one of those metrics with a zillion components that are impossible to measure, and impossible to validate. So, it's hard to execute in practice. I'd support doing it, but make sure all assumptions are posted. I'm sure private insurers also do such calculations - they are just done in private in the name of profits.

The other challenge is the differential value of human life that underlies such an analysis. Some people believe their lives are worth more than others but other people believe all lives should have equal value.

Also, economic wellbeing and public health are not zero-sum.

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Kaiser Fung. Business analytics and data visualization expert. Author and Speaker.
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