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Population Health

Challenges Estimating Total Lives Lost in COVID-19 DecisionsConsideration of Mortality Related to Unemployment, Social Isolation, and Depression

Educational Objective
To understand the challenges involved when estimating the total lives lost when making decisions during COVID-19

1 Credit CME

JAMA

Published Online: July 8, 2020

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Article Information and Disclosures

Tyler J. VanderWeele, PhD¹

Author Affiliations

¹Harvard T.H. Chan School of Public Health, Boston, Massachusetts

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The coronavirus disease 2019 (COVID-19) pandemic has claimed hundreds of thousands of lives, directly and indirectly, and threatens to claim many more. Nations have made different policy decisions that have affected the rate of infection, mortality, the economy, and the life of the country differently. The choices between various alternative policies have led to different trade-offs between what are arguably incommensurable goods, such as survival, mental health, social connection, and economic growth. It can seem difficult or impossible to weigh these numerous factors, yet policy decisions must be made, with countless implications for society. In the early stages of the pandemic, and when information was limited, a cautious approach was arguably most appropriate. As further information becomes available, it becomes possible to make better-informed decisions. However, the inherent challenges involved in the very real, and very difficult, trade-offs remain.

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Article Information

Corresponding Author: Tyler J. VanderWeele, PhD, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 (tvanderw@hsph.harvard.edu).

Published Online: July 8, 2020. doi:10.1001/jama.2020.12187

Conflict of Interest Disclosures: Dr VanderWeele reported receiving personal fees from Aetna Inc and grants from the John Templeton Foundation.

Additional Contributions: I thank Howard Koh, MD, MPH, Harvard T.H. Chan School of Public Health, and Jan Vandenbroucke, MD, PhD, Leiden University Medical Center, for helpful comments and suggestions on the article. Neither of these individuals received any compensation for their contributions.

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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.