The macroeconomics of pandemics around the world: Lives versus livelihoods revisited.

The COVID-19 pandemic led governments around the world to impose unprecedented restrictions on economic activity. Were these restrictions equally justified in poorer countries with fewer demographic risk factors and less ability to weather economic shocks? We develop and estimate a fully specified model of the macroeconomy with epidemiological dynamics, incorporating subsistence constraints in consumption and allowing preferences over "lives versus livelihoods" to vary with income. Poorer countries' demography pushes them unambiguously toward laxer policies. But because both infected and susceptible agents near the subsistence constraint will remain economically active in the face of infection risk and even to some extent under government containment policies, optimal policy in poorer countries pushes in the opposite direction. Moreover, for reasonable income-elasticities of the value of a statistical life, the model can fully rationalize equally strict or stricter policies in poorer countries.

Predicted COVID-19 fatality rates based on age, sex, comorbidities and health system capacity.

Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high-income to lower-income regions. Accounting for differences in the distribution of age, sex and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 1.07% for high-income Asia Pacific. However, these predictions must be treated as lower bounds in low- and middle-income countries as they are grounded in fatality rates from countries with advanced health systems. To adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood respiratory syncytial virus. This adjustment greatly diminishes but does not entirely erase the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.37% in Western Sub-Saharan Africa to 1.45% for Eastern Europe.