Exploring the Trade-Off Between Economic and Health Outcomes During a Pandemic: A Discrete Choice Experiment of Lockdown Policies in Australia.

ABSTRACT

BACKGROUND: All countries experienced social and economic disruption and threats to health security from the COVID-19 pandemic in 2020, but the responses in terms of control measures varied considerably. While control measures, such as quarantine, lockdown and social distancing, reduce infections and infection-related deaths, they have severe negative economic and social consequences. OBJECTIVES: The objective of this study was to explore the acceptability of different infectious disease control measures, and examine how respondents trade off between economic and health outcomes. METHODS: A discrete choice experiment was developed, with attributes covering control restrictions, duration of restrictions, tracking, number of infections and of deaths, unemployment, government expenditure and additional personal tax. A representative sample of Australians (n = 1046) completed the survey, which included eight choice tasks. Data were analysed using mixed logit regression to identify heterogeneity and latent class models to examine heterogeneity. RESULTS: In general, respondents had strong preferences for policies that avoided high infection-related deaths, although lower unemployment and government expenditure were also considered important. Respondents preferred a shorter duration for restrictions, but their preferences did not vary significantly for the differing levels of control measures. In terms of tracking, respondents preferred mobile phone tracking or bracelets when compared to no tracking. Significant differences in preferences was identified, with two distinct classes Class 1 (57%) preferred the economy to remain open with some control measures, whereas Class 2 (43%), had stronger preferences for policies that reduced avoidable deaths. CONCLUSIONS: This study found that the Australian population is willing to relinquish some freedom, in the short term, and trade off the negative social and economic impacts of the pandemic, to avoid the negative health consequences.