Estimation of the economic burden of COVID-19 using Disability-Adjusted Life Years (DALYs) and Productivity Losses in Kerala, India: A model based analysis

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.