Minimizing Economic Costs for COVID-19
It is often claimed that there is a trade-off between containing COVID-19 and minimizing disruption to the economy, and that eliminating COVID-19 (by which we mean getting to no community transmission—i.e. no cases from unknown sources) is too costly to be worthwhile. Here, we examine the validity of these claims.
We consider a space of policy action in which a country (or state) decreases its number of cases per day by reducing the reproductive number R below 1 for a duration of its choosing and then maintains thereafter a constant number of cases per day. The question is what is the right level at which to maintain this constant number of cases per day. The essential idea is that there are two strategies: 1) an elimination strategy in which R<1 is maintained until there is no more community transmission and after which the country reopens (save for targeted responses in specific locations to combat cases that are imported), and 2) a steady-state strategy, in which R<1 is maintained for some period of time but not long enough to eliminate community transmission and after which R=1 is maintained nationwide.
The elimination strategy requires a greater upfront cost, since R<1 is maintained for a longer duration, but requires lower costs thereafter since economic activity in the country can largely return to normal, with the exception of targeted measures in specific locations in the event of a second outbreak caused by an imported case. The steady-state strategy, on the other hand, requires the costly maintenance of R=1 nationwide in order for cases not to rise; if community transmission is not eliminated and R=1 is not maintained, a second wave will occur sooner or later, as has already occurred in many countries that have not yet chosen the elimination strategy. Because of the long time during which a country must maintain R=1 under the steady-state strategy, it is worthwhile even from a purely economic perspective for a country in almost all cases to instead choose the elimination strategy, despite its greater short-term costs.