Knowledge for policy
Briefing 4 May 2020

Socio-economic vulnerability and epidemic risk by age. Implications for the exit strategy from COVID-19


In designing an exit strategy from COVID-19, governments need to balance the risks posed by possible recrudescence of the epidemic when lifting containment measures, which is higher for vulnerable groups of populations, against the urgency to reopen established economic activities and reduce the social and psychological vulnerability of the population subjected to unprecedented social distancing measures. 
In this note we try to quantify, on the one hand, vulnerability from a socio-economic and psychological perspective and the epidemiological risk associated with the patterns of social contacts, on the other. For both aspects we have adopted a demographic perspective, looking in particular at the distribution of vulnerability and social contact patterns by age. 

Key messages

  • While the elderly are without a doubt exposed to the worst health consequences from the disease, they seem to be less affected from the potential negative economic and psychological consequences of confinement, according to the indicators that we have considered.
  • Social contact matrices indicate that most contacts take place between people of the same age groups and that the intensity of contacts is higher for children of school age.
  • With respect to a situation with complete lockdown, the reopening of schools and activities for children would have the worst impact in terms of increase of epidemic spread potential to the rest of the population.
  • Differences are noticeable in the structure of contacts by age and place across countries, for instance between generations in the home environment. However, differences are less pronounced when considering contacts at work, which could mean that the lifting of social distancing at work could have similar effects across the countries included in the analysis.
  • Our analysis faces two main limitations: in the case of vulnerability, given the unprecedented nature of the situation, there are few references in previous studies to select the most appropriate indicator and therefore our selection is subjective; in the case of risk we are simulating the effect on epidemic spread from the lifting of social distancing measures only looking at the structure of social contacts; we ignore any possible disease age specific parameter by considering a uniform susceptibility and infectiousness of COVID-19 across all age groups.