March 15th 2021
The deadliness of the B.1.1.7 coronavirus strain
A new paper published in the British Journal of Medicine (BMJ) investigates whether the more-infectious coronavirus strain first identified in the United Kingdom—called B.1.1.7—is associated with a higher mortality rate than other coronavirus strains.
In early-October 2020, a genomic analysis of COVID-19 cases in England’s southeast flagged the emergence of a novel lineage of SARS-CoV-2, the virus that causes COVID-19. The strain is differentiated by a spike-protein mutation called N501Y, that is now known to improve the virus’s transmissibility, making it more infectious. The new strain quickly spread through the United Kingdom—by December 31st, it accounted for 75% of all cases in the country—and is now sweeping through other countries too.
While B.1.1.7 is known to be more transmissible, whether the coronavirus strain results in a deadlier presentation of COVID-19 remained an unknown. To investigate whether infection with B.1.1.7 results in any marked difference in mortality rates, Robert Challen, Ellen Brooks-Pollock, Jonathan Read, Louise Dyson and Leon Dannon from the Joint Universities Pandemic and Epidemiological Research (JUNIPER) consortium designed a matched cohort study to compare the outcomes of patients infected with the original and B.1.1.7 strains of SARS-CoV-2. The study matched 54,906 pairs of patients—one infected with the original coronavirus strain, and one infected with the B.1.1.7 strain, respectively—chosen from similar geographic areas, demographic profiles and that were infected at similar times, and compared patients’ risk of death within 28 days of their first positive COVID-19 test result.
The results amounted to unwelcome news for public health officials worldwide. In the study, the coronavirus strain B.1.1.7 was associated with a mortality rate 64% higher than the original strain of the virus. The researchers said the finding reinforces the case for further co-ordinated and stringent measures so as to reduce deaths from COVID-19.
Pregnant women and COVID-19
A separate new paper published in the British Journal of Medicine (BMJ) reports findings on the impacts of infection with SARS-CoV-2 for pregnant women.
Under the COVID-19 pandemic, pregnant women are considered a high-risk group because of concerns over the effect of COVID-19 on them and their babies during pregnancy. To investigate the impacts of COVID-19 on women during and immediately after pregnancy, an international and multi-disciplinary team of researchers began maintaining a living systematic review and meta-analysis of all studies on COVID-19 and pregnancy, starting in April 2020. This paper constitutes their most recent update.
The researchers report that in 41,664 women involved in 59 studies, one-in-ten pregnant and recently pregnant women visiting or admitted to hospital were diagnosed with COVID-19 in the period under review. Of these, 339 women died from COVID-19 or other complications—0.02% of the total. The most common clinical symptom in pregnant women was a cough (41%), followed by fever (40%). Interestingly, compared to non-pregnant women of reproductive age, pregnant and recently pregnant women with COVID-19 were more likely to present as asymptomatic.
For pregnant women, Increased age, high body mass index, non-white ethnicity, and pre-existing comorbidities like chronic hypertension and diabetes were confirmed as risk factors in developing severe COVID-19. Fortunately, the review found that the overall rates of stillbirth and neonatal death were surprisingly low in women with a suspected or confirmed case of COVID-19.
A new paper published in the Centre for Economic Policy and Research (CEPR) publication COVID Economics investigates links between the 2008 Financial Crisis and the COVID-19 pandemic.
The 2008 Great Recession and the ongoing COVID-19 pandemic constitute the two greatest global shocks of the 21st century. The similarity between the crises in global reach and the magnitude of socio-economic damage wrought raises the question of whether the impact of the financial crisis may have compounded the effects of the COVID-19 pandemic.
To investigate whether the local impact of the 2008 Great Recession is linked to health outcomes in the ongoing COVID-19 pandemic, Antonio Moreno from the University of Navarra, Steven Ongena and Alexander Wagner from the University of Zurich, and Alexia Veghazy from the European Central Bank constructed a cross-country panel of economic and health indicators in Europe from 2008-2013 and 2020-2021, respectively. For a more fine-grained analysis, the team constructed a similar panel for the individual provinces of Spain.
Their results were unambiguous. At the European level, countries economically and financially harder hit by the 2008 financial crisis (Italy, Spain, Greece and Ireland, amongst others) experienced significantly greater loss of life (per case) due to COVID-19 than peers that weathered the 2008 crisis relatively unscathed. The analysis of Spanish provinces also showed that regions which suffered a greater output shock in the Great Recession witnessed significantly greater shortages of hospital beds and a higher ratio of deaths per cases during the first wave of the COVID-19 pandemic.
The relationship highlights an underappreciated impact of the austerity measures imposed in much of Europe in the aftermath of the Great Recession—the widespread cutting of health spending.
A separate new paper published in the Centre for Economic Policy and Research (CEPR) publication COVID Economics investigates whether the COVID-19 pandemic crisis might induce governments in the developing world to introduce tax reforms.
To prevent the spread of the virus, governments worldwide have imposed lockdowns and restrictions on economic activity of various levels of stringency. In addition, people reduced their own exposure to the virus through voluntary social distancing. The result has been a dramatic contraction in economic activity. The International Monetary Fund (IMF) estimates that global GDP declined by 3.5 percent in 2020.
To investigate whether this is likely to induce policy reforms in the developing world, Sanjeev Gupta from the Centre for Global Development and João Tovar Jalles from the University of Lisbon analysed the impact of previous epidemics and pandemics (between 2000-2018) on tax reform measures in 45 countries for which data are available.
Their results demonstrate that previous pandemics tend to significantly impact the fiscal position and tax base of governments in affected countries—not surprising given the world’s current experience with COVID-19. In the developing world, this tends to impact the revenue position of governments more than their expenditures—creating a shortfall. These pressures have historically pushed countries to implement tax reforms, particularly in corporate income taxes, excises and property taxes—but tend not to result in revenue administration reforms.
The results suggest that COVID-19 may result in significant tax reforms in much of the developing world—especially in sub-Saharan Africa.
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