Loss of life is one cost. So is reduced quality of life while ill, and over longer periods for those drawing that unlucky straw. Looking more and more like Covid does long-term harm to the immune system, increasing the cost of other illnesses. And also worth noting that places that never undertook NZ's lockdowns had their own impediments to economic activity when illness rates were very high.
And there remains a categorical difference between protecting people from non-communicable illness, where no real externality argument applies (recall that fiscal externalities are largely pecuniary rather than technological), and infectious disease.
I agree with your point that I should have added the longer term effects of covid to point 1 of my analysis above. However, my 2021 analysis of the long covid issue concluded that the effect was only to add about 4% to the loss of QALYs, despite the number of long covid cases being almost five times the number of deaths, because long covid reduces quality of life by much less than 100% and the average duration of symptoms was low (despite some cases with very long durations): see pp. 17-18 of https://www.medrxiv.org/content/10.1101/2021.07.15.21260606v1.full.pdf
Furthermore, even if the longer term effects of covid magnified the QALY loss by a factor of 100, this would still be exceeded by the QALY losses from both hazardous drinking and obesity.
I also agree with your point that countries that mitigated rather than locked down (such as Sweden) also suffered GDP losses, but even Prof Wilson concluded (as I did in the paper cited above in this reply) that GDP losses were expected to be much higher with lockdown: see Supplementary Table 8 of the Wilson et al paper cited in footnote 13 above.
However, I don't understand your point that infectious diseases are categorically different to non-communicable ones because of externalities. I presume these externalities are the infecting of other people, but this effect is fully reflected in the covid death toll figures that I used. Furthermore, in addition to shortening their own lives and reducing their quality of life until their premature death, hazardous drinkers adversely affect many people around them rather like covid cases infecting others around them, but I did not include these externalities from hazardous drinking and doing so would have magnified the QALY losses from hazardous drinking. Hazardous drinking might then be 200 or 300 times worse than covid rather than only 130 times in terms of the society-wide QALY losses.
If I decide to shorten my life by doing a pile of risky things that do no harm to anyone else, that's categorically different from my shortening someone else's life by imposing a pile of risks on them, involuntarily.
That means that QALY-max isn't the policy objective.
I accept that people who make lifestyle choices that lead to early death from obesity or hazardous drinking (or even fentanyl) may be maximising their utility in doing so whilst covid (like an earthquake) is a disaster that no person wants. So, policy makers should be concerned with covid, but possibly only with obesity etc to the extent that it adversely affects others. I see some merit in this point, and there is considerable philosophical and empirical work relevant to it (on both sides). However, policy makers seem to view these behaviours as afflictions to be cured rather than utility maximising choices, as evident especially in criminalising the production and consumption of some drugs, and the long-term and largely successful attempt to eradicate cigarette smoking. My point that obesity and hazardous drinking are vastly worse than covid would be relevant to these policy makers.
PS: Furthermore, if you take a middle position and view (say) half of these behaviours as utility maximisation by people, which policy makers need not be concerned except to the extent they affect others, and half due to afflictions that their 'victims' wish to be cured of (a position consistent with the existence of the diet and alcohol abstinence industries), obesity would still be 200 times as bad as covid and hazardous drinking would still be 65 times as bad. In fact, obesity and hazardous drinking would still be more severe problems than covid even if less than 1% of those engaging in these behaviours were addicts wishing to be cured of their afflictions.
Loss of life is one cost. So is reduced quality of life while ill, and over longer periods for those drawing that unlucky straw. Looking more and more like Covid does long-term harm to the immune system, increasing the cost of other illnesses. And also worth noting that places that never undertook NZ's lockdowns had their own impediments to economic activity when illness rates were very high.
And there remains a categorical difference between protecting people from non-communicable illness, where no real externality argument applies (recall that fiscal externalities are largely pecuniary rather than technological), and infectious disease.
I agree with your point that I should have added the longer term effects of covid to point 1 of my analysis above. However, my 2021 analysis of the long covid issue concluded that the effect was only to add about 4% to the loss of QALYs, despite the number of long covid cases being almost five times the number of deaths, because long covid reduces quality of life by much less than 100% and the average duration of symptoms was low (despite some cases with very long durations): see pp. 17-18 of https://www.medrxiv.org/content/10.1101/2021.07.15.21260606v1.full.pdf
Furthermore, even if the longer term effects of covid magnified the QALY loss by a factor of 100, this would still be exceeded by the QALY losses from both hazardous drinking and obesity.
I also agree with your point that countries that mitigated rather than locked down (such as Sweden) also suffered GDP losses, but even Prof Wilson concluded (as I did in the paper cited above in this reply) that GDP losses were expected to be much higher with lockdown: see Supplementary Table 8 of the Wilson et al paper cited in footnote 13 above.
However, I don't understand your point that infectious diseases are categorically different to non-communicable ones because of externalities. I presume these externalities are the infecting of other people, but this effect is fully reflected in the covid death toll figures that I used. Furthermore, in addition to shortening their own lives and reducing their quality of life until their premature death, hazardous drinkers adversely affect many people around them rather like covid cases infecting others around them, but I did not include these externalities from hazardous drinking and doing so would have magnified the QALY losses from hazardous drinking. Hazardous drinking might then be 200 or 300 times worse than covid rather than only 130 times in terms of the society-wide QALY losses.
You're missing the point on externalities.
If I decide to shorten my life by doing a pile of risky things that do no harm to anyone else, that's categorically different from my shortening someone else's life by imposing a pile of risks on them, involuntarily.
That means that QALY-max isn't the policy objective.
My starting point on externalities is here. https://offsettingbehaviour.blogspot.com/2012/06/externalities-primer.html
And far more thoroughly on external effects around alcohol:
https://ir.canterbury.ac.nz/handle/10092/2599
I accept that people who make lifestyle choices that lead to early death from obesity or hazardous drinking (or even fentanyl) may be maximising their utility in doing so whilst covid (like an earthquake) is a disaster that no person wants. So, policy makers should be concerned with covid, but possibly only with obesity etc to the extent that it adversely affects others. I see some merit in this point, and there is considerable philosophical and empirical work relevant to it (on both sides). However, policy makers seem to view these behaviours as afflictions to be cured rather than utility maximising choices, as evident especially in criminalising the production and consumption of some drugs, and the long-term and largely successful attempt to eradicate cigarette smoking. My point that obesity and hazardous drinking are vastly worse than covid would be relevant to these policy makers.
PS: Furthermore, if you take a middle position and view (say) half of these behaviours as utility maximisation by people, which policy makers need not be concerned except to the extent they affect others, and half due to afflictions that their 'victims' wish to be cured of (a position consistent with the existence of the diet and alcohol abstinence industries), obesity would still be 200 times as bad as covid and hazardous drinking would still be 65 times as bad. In fact, obesity and hazardous drinking would still be more severe problems than covid even if less than 1% of those engaging in these behaviours were addicts wishing to be cured of their afflictions.