Due to the high costs, the Ministry of Economic Affairs opposed the 'intelligent' lockdown last year, according to documents obtained via a WOB request. 'The health of the elderly should not be given an indisputable priority.'
Bas SoetenhorstJune 22, 2021 , 17:12
Is the lockdown a way too blunt a means in the corona crisis? The discussion about this dates from the spring of 2020, at the start of the 'intelligent' lockdown, and was started by professor Ira Helsloot. He warned that society would pay a huge price in the long run for what he saw as a panic response. Presenter Jort Kelder ('We are over-80s who are too fat and have smoked') and columnist Marianne Zwagerman ('dry wood') joined in with less nuanced contributions.
Prime Minister Mark Rutte thought they created a 'false contradiction' between public health and the economy. “If we release measures too early and the virus immediately spreads again at full speed, the economy will be hit even harder and longer in addition to our health,” he said at a press conference on April 7 last year. “So what we are doing now for health will contribute to our economic recovery in the future. That's not a contradiction, those are two sides of the same coin."
Helsloot did not seem to get a foothold in political The Hague. But documents released on the basis of the Government Information (Public Access) Act (WOB) now show that he had allies at the Ministry of Economic Affairs.
The WOB request comes from the Haarlem engineer, interim manager and teacher at NCOI training institute Jan van der Zanden (66), who thinks the corona measures are extreme and assumed that Economic Affairs has calculated the impact of the lockdown. That's right: a few days before Rutte's press conference, there was a note from the General Economic Policy Department. Conclusion: the social and economic costs are 'disproportionately high'.
In the cost-benefit analysis of Economic Affairs, the expected benefits of a one-year lockdown are 8 billion euros, due to the prevention of 25,000 deaths. This is nothing compared to the calculated economic damage (40 billion) and health damage for non-corona patients (25 billion). The health damage alone was therefore estimated to be more than three times higher than the health gain.
To conclude from this that 'these costs are disproportionately high, it is not necessary to make a trade-off between the economy and health', according to the memorandum. 'The indirect damage to Dutch public health already seems so serious that it overshadows the direct health gain.'
'Cost-effectiveness must be taken into account when choosing to scale up and down measures,' the authors wrote, and 'a one-sided focus on mortality rates [must] be avoided'. The cabinet should 'make difficult but necessary trade-offs' between human lives on the one hand and issues such as employment, education and regular care on the other. 'The health of the elderly should not be given an indisputable priority.'
In a slightly earlier version – dated March 27, 2020 – the cost-benefit assessment turned out even worse for the corona policy; the health benefits were six times lower than the health damage and the economic damage amounted to 100 billion. In the later version, the negative effects were roughly halved because the economy would also be hit hard without a lockdown and because of new CPB figures.
The conclusion remained the same: 'simple continuation of the current situation [is] not tenable'. The proposed alternative: expanding care and testing capacity 'to get society going again' and 'widespread' testing, so that 'infectious Dutch people can be isolated in a targeted manner and Dutch people who have built up immunity can return to work'.
The cost-benefit analysis has not had much influence on corona policy. The pressure on healthcare is and was leading. Also for Eric Wiebes, then Minister of Economic Affairs. He declined to respond to questions from this newspaper about the cost-benefit analysis. According to insiders, the cold figures did not outweigh a doomsday scenario in which a person over 60 with corona would not be able to go to the IC due to a lack of beds and would die outside the hospital. Society would not accept that, the minister assumed.
However, the cost-benefit analysis, of which Wiebes only saw the first version, was an extra incentive for him to look for options to get the economy started safely. He regularly clashed with Rutte and Minister of Health Hugo de Jonge, for whom advice from the Outbreak Management Team (OMT) was leading. Wiebes wanted to contain the virus and hit the economy as little as possible.
But Economic Affairs did not take the lead in the corona crisis. At a presentation for the professional association of economists in the late spring of 2020, also obtained by Jan van der Zanden with his WOB request, an official noted that 'the traditional economic departments' of Finance, Social Affairs and Economic Affairs were not involved in closing restaurants and schools. 'This has certainly influenced decision-making' and 'partly contributed to the rapid adoption of robust measures with major consequences for the economy and public finances'.
'In the first weeks, the prime minister, among others, often said that public health comes first. This makes economists uncomfortable,' among other things 'because we like to think in terms of costs and benefits.'
How much is a human life worth? Policymakers are asking this apparently cynical question to allocate scarce financial resources as effectively as possible. Economists use so-called qalys as a unit of account: quality-adjusted life years . This makes it possible to calculate healthcare costs for a patient and the consequences of an intervention for his/her quality of life and to compare life-prolonging measures.
In the calculation of Economic Affairs, an assumption is that a lockdown of one year will prevent 25,000 deaths (about 100,000 lost life years). The government applies 'a soft upper limit' of 80,000 euros per year of life gained. The health benefits then amount to 8 billion (100,000 x 80,000 euros). This is offset by an economic contraction of 40 billion, the cessation of regular care (minus 20 billion) and minus 5 billion due to the 'psychosocial consequences' of the lockdown (such as more suicide attempts, anxiety disorders and loneliness). That is independent of the higher government debt.
The RIVM estimates the costs for delayed care in the first lockdown at 34,000 to 50,000 less healthy life years. With that of the second lockdown, the government support package (80 billion) and an economic contraction of 3.8 percent in 2020, the actual costs approach the analysis of Economic Affairs. In the Economic Statistical Bulletin , researchers also stated at the end of last year that the costs of the lockdown are much higher than the benefits, partly because people over 80 - with a limited number of healthy life years ahead of them - die from corona. On the other hand, the Central Planning Bureau predicts economic growth of 3 percent for this year and next.