Estimates of the value of life lost from COVID-19 in Ohio

The economic burden of mortality due to the novel coronavirus (COVID-19) extends beyond the lives lost. Data from the Ohio Department of Public Health and Social Security Administration was used to estimate the years of potential life lost, 72,274 and economic value of those lost lives, US$17.39 billion. These estimates may be used to assess the risk-trade off of COVID-19 mitigation strategies in Ohio.

an estimate of the society's willingness-to-pay for one year of life, and is used by state and federal policymakers to quantify the burden of disease or policy [1]. The VSLY was multiplied by the YPLL to determine the economic burden associated with the lost value of life (VSL) for each COVID-19 death. The YPLL and VSL results were summed to generate aggregate results for the state, gender and age (less than 60 & 60+).

Results
The 6 Figure 1). For those deaths under the age of 60, the average loss of potential life years was 31.0-person years (range: 27.6-35.3). Whereas, the YPLL in deaths aged 60 or greater was 9.4-person years (range: 6.8-13.0).

Discussion
Building upon the work conducted for the nation, this study estimated the YPLL and VSL due to COVID-19 in Ohio [3]. Assuming a consistent value of a year of lost life, the economic burden of premature deaths was estimated at $17.39 billion as of 30 November 2020. This value and the estimated YPLLs are rapidly changing with the current spread COVID-19 in the community. Thus, the results likely underestimate the YPLLs and VSL of the loss of life from COVID-19 in Ohio. Separating the results by gender indicated that the age distribution and corresponding YPLLs and VSL were similar (48.4% female; 52.6% male). An examination by age indicated the disproportionate effect of those under COVID-19 deaths under 60 has on the expected overall results. Of the 6429 deaths, 522 (8.1%) were under 60. However, these deaths represented 22.4% of the total YPLLs and VSL. To date COVID-19 mortalities under 60 have been relatively few. However, the much greater expected loss of potential life years, average of 31.0-person years, contributed to the higher YPLL and VSL.
The method of estimating the VSL for a particular health condition is not without controversy [8,9]. The methodology used assumed a standard value of life across all individuals. As a result, allocation and equity issues associated with the assessment of differing policies may vary by age, income and race not accounted for in the  results. Comparisons across diseases or geographic units should be made with great caution ensuring the underlying data and methods are consistent. Thus, this approach should be one of several when assessing strategies to mitigate the deleterious effects of COVID-19. Further, the ODPH does not release the specific age of the individuals who have died from COVID-19, which resulted in imputations to estimate the YPLLs and VSL. This limitation was mitigated by sensitivity analysis examining the low-and high-end of the age ranges. Finally, there is no generally accepted appropriate VSLY. The use US$247,676 VSL in this study was transparent and may easily be updated with differing amounts based upon the policymaker's own determination. These results have implications for state level policies addressing the COVID-19 pandemic. The estimates identified in this study for Ohio may provide a common and consistent framework to estimate the costs and benefits of differing COVID-19 mitigation strategies, such as vaccines, and novel treatments for COVID-19 or host response to the disease [1].
The recent announcement of two vaccines showing great promise regarding safety and efficacy raises the issue of who will receive the vaccine first [10]. The use of YPLLs may be one measure to assess the distribution of a vaccine within the state of Ohio and to whom should receive it first. As shown in the results, the burden of COVID-19 mortality is disproportionately higher in those under 60. The results of this study suggest prioritizing at-risk individuals under 60 in the vaccine distribution may substantially decrease premature mortality and increase economic productivity of the state.

Conclusion
The expected loss of life-years from premature deaths of COVID-19 in Ohio was substantial. Each death represents a number of life-years lost and the enjoyment of those years with family and friends. Further, there is a substantial future science group 10.2217/cer-2020-0245 economic loss to all Ohioans. Estimating the economic burden of COVID-19 may provide a consistent means for state level policymakers to assess interventions control and mitigate the effects of the COVID-19 pandemic.
• Mortality attributable to COVID-19 disproportionately occur in individuals over the age of 60.
• Examining mortality by age only does not convey the full burden of COVID-19.
• The use of years of productive life and value of statistical life are two additional measures that combined with mortality may explain more of the burden related to COVID-19. • The years of potential life lost and value of statistical life were estimated for the state of Ohio to illustrate the burden of COVID-19. • This study found a disproportionate share of the burden related to COVID-19 occurs in those under 60 years of age.
• Policymakers may consider this information when determining how to allocate scarce resources (i.e., vaccine) for the treatment of COVID-19. • Caution should be taken when reviewing these findings as they are only two data points in a multi-dimensional problem of allocation scare resources to address COVID-19.

Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research
This research was deemed exempt from Institutional Review Board review by Xavier University.