Objectives: From the beginning of the COVID-19 pandemic, clinical practice and research, globally, have centered on the prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the economy and stressed the 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 Kerala state, India.
Setting: Details on sociodemography, incidence, death, quarantine, recovery time, etc were derived from public sources and CODD-K for Kerala. The working proportion for 5-year age-gender cohorts and corresponding life expectancy were obtained from the Census of India 2011.
Primary and secondary outcome measures: The impact of disease was computed through model based analysis on various age-gender cohorts. Sensitivity Analysis has been conducted by adjusting six variables across 21 scenarios. We present two estimates, one till November 15, 2020, and later updated till June 10, 2021.
Results: Severity of infection and mortality were higher among the older cohorts, with males being more susceptible than females in most sub-groups. The DALYs for males and females were 15954.5 and 8638.4 till November 15, 2020, and 83853.0 and 56628.3 till June 10, 2021. The corresponding YPPLL were 1323.57 and 612.31 till November 15, 2020, and 6993.04 and 3811.57 till June 10, 2021 and CPL (premature mortality) were 263780579.94 and 41836001.82 till November 15, 2020, and 1419557903.76 and 278275495.29 till June 10, 2021.
Conclusions: Most of the COVID-19 disease burden was contributed by YLL. Losses due to YPPLL were reduced as the impact of COVID-19 infection was lesser among productive cohorts. CPL values for 40-49 year-olds were the highest. These estimates provide the data necessary for policymakers to work on, to reduce the economic burden of COVID-19 in Kerala.
Article summary
Strengths and limitations of this study
- The first study to characterize the economic burden caused by COVID-19 in Kerala state using DALYs, YPPLL, and CPL
- Use of public sourced data for analysis and presentation of results
- Exclusion of incidence of case post August 20, 2020, due to unavailability of data could lead to an underestimation of DALYs
- Psychological impacts of the mitigation strategies (e.g., lockdown, travel restrictions, etc.) that could increase mortality were not included in the scope
- Unpaid work and presenteeism data, and data on post-recovery illness and long-term effects of COVID-19 have not been considered.