Model-based estimation of burden of COVID-19 with disability-adjusted life years and value of statistical life in West Bengal, India

Abstract

ObjectivesThe COVID-19 pandemic has posed unprecedented challenges to health systems and populations, particularly in India. Comprehensive, population-level studies of the burden of disease could inform planning, preparedness and policy, but are lacking in India. In West Bengal, India, we conducted a detailed analysis of the burden caused by COVID-19 from its onset to 7 January 2022.SettingOpen-access, population-level and administrative data sets for West Bengal were used.Primary and secondary outcome measuresDisability-adjusted life years (DALYs), years of potential productive life lost (YPPLL), cost of productivity lost (CPL: premature mortality and absenteeism), years of potential life lost (YPLL), premature years of potential life lost, working years of potential life lost (WYPLL) and value of statistical life (VSL) were estimated across scenarios (21 for DALY and 3 each for YPLL and VSL) to evaluate the effects of different factors.ResultsCOVID-19 had a higher impact on the elderly population with 90.2% of deaths arising from people aged above 45. In males and females, respectively, DALYs were 190 568.1 and 117 310.0 years, YPPLL of the productive population was 28 714.7 and 16 355.4 years, CPL due to premature mortality was INR3 198 259 615.6 and INR583 397 335.1 and CPL due to morbidity was INR2 505 568 048.4 and INR763 720 886.1. For males and females, YPLL ranged from 189 103.2 to 272 787.5 years and 117 925.5 to 169 712.0 years for lower to higher age limits, and WYPLL was 54 333.9 and 30 942.2 years. VSL (INR million) for the lower, midpoint and upper life expectancies was 883 330.8; 882 936.4; and 880 631.3, respectively. Vaccination was associated with reduced mortality.ConclusionsThe losses incurred due to COVID-19 in terms of the computed estimates in West Bengal revealed a disproportionately higher impact on the elderly and males. Analysis of various age-gender subgroups enhances localised and targeted policymaking to minimise the losses for future pandemics.

Challenges in the Vaccination of the Elderly and Strategies for Improvement

“…According to a survey from Australia in 2015, it was reported that the three diseases with the largest DALYs were pneumococcal pneumonia, influenza, and herpes zoster, especially in the elderly over 65 years [ 23 ]. It seems that each country or region has different types of disease burden, which are influenced by its national budget for healthcare financing, different resources, and infrastructures between low-income and middle- or high-income countries, as shown by the results of global studies [ 27 , 28 , 29 ] as well as local studies in India [ 30 ] and China [ 31 ]. As mentioned above, the impact caused by COVID-19 during the pandemic cannot be overlooked [ 30 , 32 , 33 , 34 ].…”

“…It seems that each country or region has different types of disease burden, which are influenced by its national budget for healthcare financing, different resources, and infrastructures between low-income and middle-or high-income countries, as shown by the results of global studies [27][28][29] as well as local studies in India [30] and China [31]. As mentioned above, the impact caused by COVID-19 during the pandemic cannot be overlooked [30,[32][33][34].…”