Policies to address the coronavirus disease 2019 (COVID-19) require a balancing of the health risk reductions and the costs of economic dislocations. Application of the value of a statistical life (VSL) to monetize COVID-19 deaths produces a U.S. mortality cost estimate of $1.4 trillion for deaths in the first half of 2020. This article presents worldwide COVID-19 costs for over 100 countries. The total global mortality cost through July 2, 2020 is $3.5 trillion. The United States accounts for 25% of the deaths, but 41% of the mortality cost. Adjustments for the shorter life expectancy and lower income of the victims substantially reduces the estimated monetized losses, but may raise fundamental equity concerns. Morbidity effects of COVID-19 affect many more patients than do the disease's mortality risks. Consideration of the morbidity effects increase the expected health losses associated with COVID-19 illnesses by 10% to 40%.
In evaluating the appropriate response to the COVID-19 pandemic, a key parameter is the rate of substitution between wealth and mortality risk, conventionally summarized as the value per statistical life (VSL). For the United States, VSL is estimated as approximately $10 million, which implies the value of preventing 100,000 COVID-19 deaths is $1 trillion. Is this value too large? There are reasons to think so. First, VSL is a marginal rate of substitution and the potential risk reductions are non-marginal. The standard VSL model implies the rate of substitution of wealth for risk reduction is smaller when the risk reduction is larger, but a closed-form solution calibrated to estimates of the income elasticity of VSL shows the rate of decline is modest until the value of a non-marginal risk reduction accounts for a substantial share of income; average individuals are predicted to be willing to spend more than half their income to reduce one-year mortality risk by 1 in 100. Second, mortality risk is concentrated among the elderly, for whom VSL may be smaller and who would benefit from a persistent risk reduction for a shorter period because of their shorter life expectancy. Third, the pandemic and responses to it have caused substantial losses in income that should decrease VSL. In contrast, VSL is plausibly larger for risks (like COVID-19) that are dreaded, uncertain, catastrophic, and ambiguous. These arguments are evaluated and key issues for improving estimates are highlighted.