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letter
. 2022 Jul 25;5:272. Originally published 2020 Nov 19. [Version 2] doi: 10.12688/wellcomeopenres.16380.2

Table 1. Framework for policy trade-offs in the Covid-19 response (with examples).

Policy choices/
public goals
Health Economic welfare Social welfare
Impact on Covid-19
related health
Impact on other
diseases
Physical
distancing #
Reduced infections
in overall
population
Increased mental
health problems
because of isolation;
improved health
through improved
air pollution
Reduced household income
and consumption through
reduced tourism, export,
foreign direct investment
and inflationary pressure
Compromised civil liberties; unrest; food
insecurity
School closure Reduced infections
in children; reduced
infections in overall
population
Increased mental
health problems
because of isolation

Increased morbidity and mortality from delayed presentation and treatment delays
Reduced income if parents
have to take time off work
without compensation; loss
of income for education
sector workers if they are
not compensated; increased
demand for substitutes like
online education
Increased exposure of children to
violence and exploitation; poor nutrition
if children rely on meals provided at
schools; stress for teachers for creating
and maintaining online learning;
challenges measuring and validating
learning.
Expanded
health sector
response
Reduced mortality
and morbidity
Treatment delays Increased health insurance
premiums
Displacement of other public
expenditure, such as on culture.

# Various physical distancing policies are possible, depending on duration and restrictions. Such policies have different impacts on public goals and could be listed as different policy choices here.