1/7 I did a basic search on PubMed for studies that considered cost of lock-down policies per quality-adjusted-life-year (QALY) saved. QALYs r measures that consider both quantity & quality of life saved by an intervention & facilitate healthcare resource decisions @danobrien20

2/7 For example, reimbursement for drugs in Ireland and elsewhere undergo cost effectiveness analyses before a decision to reimburse them (or not) is made. Some drugs are turned down because they are too expensive. QALYs are used to inform these decisions.

3/7 I found 2 relevant studies. The first based on UK data reported that 'the lowest estimate for lock-down costs incurred was 40% higher than the highest benefits from avoiding the worst mortality cases scenario...in more realistic estimations they were over 5 times higher'

4/7 The authors added 'Future scenarios showed in the best case a QALY value of £220k (7 times what would normally be reimbursed by NICE) & in the worst case £3.7m (125 times NICE guideline) was needed to justify the lock-down.

5/7 A 2nd study, based on US data, found that 'A limited reopening to achieve partial mitigation of COvid-19 is cost effective relative to full reopening is an effective therapeutic or vaccine can be deployed within 11.1 months of late May 2020. ...'

6/7 'One additional month of shelter-in-place restrictions should only be imposed if it saves at least 154,586 lives per month before the development of an effective therapeutic or vaccine relative to limited reopening'

7/7 We badly need such analysis here . Come on health economists @HealthEconAI @HealthEconNUIG @Esri @TCDhpm @SPHeREprogramme @gillespie_p @BrendanKennell2 @Walsh_BP @economicsucc @BrianDTurner71 @aheblog @Healtheconall to paraphrase Meatloaf 'We need you more than ever'!