Navigating Public Policy Responses to A Pandemic: The Balancing Act Between Physical Health, Mental Health and Household Income

Objective During COVID-19, governments imposed restrictions that reduced pandemic-related health risks but likely increased personal and societal mental health risk, partly through reductions in household income. This study aims to quantify the public’s willingness to accept trade-offs between pandemic health risks, household income reduction, and increased risk for mental illness that may result from future pandemic-related policies. Methods 547 adults from an online panel participated in a discrete choice experiment where they were asked to choose between hypothetical future pandemic scenarios. Each scenario was characterized by personal and societal risks of dying from the pandemic, suffering long-term complications, developing anxiety/depression, and reductions in household income. A latent-class regression was used to estimate trade-offs. Results Respondents state a willingness to make trade-offs across these attributes if the benefits are large enough. They are willing to accept 0.8% (0.7 to 1.0) lower household income, 2.7% (1.8 to 3.6) higher personal risk of anxiety/depression, or 3.2% (1.7 to 4.7) higher societal rate of anxiety/depression in exchange for 300 fewer deaths from the pandemic. Conclusion Results reveal that individuals are willing to accept lower household income and higher rates of mental illness, both personal and societal, if the physical health benefits are large enough. Respondents placed greater emphasis on maintaining personal, as opposed to societal, mental health risk and were most interested to prevent pandemic-related deaths. Governments should consider less restrictive policies when pandemics have high morbidity but low mortality to avoid the prospect of improving physical health while simultaneously reducing net social welfare.