Betrachtung und Erweiterung des “Health Deficit” Modells der optimalen Alterung

Abweichender Titel nach Übersetzung der Verfasserin/des VerfassersIn ökonomischen Modellen wird oft das chronologische Alter als Maß für das Altern und den Todeszeitpunkt herangezogen. Individuen des selben Alters können sich aber massiv in ihrem Gesundheitszustand unterscheiden und der medizinische Fortschritt hat einen starken Einfluss auf die Alterung. Um den Alterungsprozess darstellen zu können, wird ein von Dalgaard & Strulik (2014) erstelltes Lebenszyklusmodell - das “Health Deficit Model” - vorgestellt. In dem Modell bestimmen optimale Gesundheitsausgaben die Dynamik der Alterung und somit auch den Todeszeitpunkt. In dieser Arbeit wird das Lebenszyklusmodell zu einem Allgemeinen Gleichgewichtsmodell erweitert und ein zweidimensionales Fixpunktproblem formuliert, welches die Gleichgewichtslösung charakterisiert. Die Formulierung des Fixpunktproblems ist nur abhängig vom gleichgewichtigen Kapitalstock und dem optimalen Todeszeitpunkt. Das Fixpunktproblem wird grafisch gelöst und mittels komparativer Dynamik analysiert. Das Lebenszyklusmodell und das Allgemeine Gleichgewichtsmodell werden für Parametervariationen miteinander verglichen.In economic modeling chronological age is often used as a measure for aging and death. However, individuals of the same age can differ drastically in health status and recent medical advancements have had a severe impact on the human life span and health. In order to model the aging process as a life cycle model - the health deficit model - developed by Dalgaard & Strulik (2014) is presented. The model draws on recent research in the fields of biology and medicine and optimal health spending determines the speed of aging and thus the time of death. In this thesis, the life cycle model is extended to a general equilibrium model and a two dimensional fixed point problem which characterizes the steady state is formulated. The formulation of the steady state is only dependent on the steady state capital and the optimal time of death. A graphical solution of the general equilibrium model is presented and analyzed with comparative dynamics. With the help of parameter variations both models are compared and it is shown that a longer lifespan can be achieved in the general equilibrium model as long as the steady state capital is below the exogenously given capital intensity employed in the life cycle model.5

Effectiveness of a fourth SARS-CoV-2 vaccine dose in previously infected individuals from Austria.

Publication status: PublishedINTRODUCTION: Evidence is limited on the effectiveness of a fourth vaccine dose against coronavirus disease 2019 (COVID-19) in populations with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. We estimated the risk of COVID-19 deaths and SARS-CoV-2 infections according to vaccination status in previously infected individuals in Austria. METHODS: This is a nationwide retrospective observational study. We calculated age and gender adjusted Cox proportional hazard ratios (HRs) of COVID-19 deaths (primary outcome) and SARS-CoV-2 infections (secondary outcome) from 1 November to 31 December 2022, primarily comparing individuals with four versus three vaccine doses. Relative vaccine effectiveness (rVE) was calculated as (1-HR) X 100. RESULTS: Among 3,986,312 previously infected individuals, 281,291 (7,1%) had four and 1,545,242 (38.8%) had three vaccinations at baseline. We recorded 69 COVID-19 deaths and 89,056 SARS-CoV-2 infections. rVE for four versus three vaccine doses was -24% (95% CI: -120 to 30) against COVID-19 deaths, and 17% (95% CI: 14-19) against SARS-CoV-2 infections. This latter effect rapidly diminished over time and infection risk with four vaccinations was higher compared to less vaccinated individuals during extended follow-up until June 2023. Adjusted HR (95% CI) for all-cause mortality for four versus three vaccinations was 0.79 (0.74-0.85). DISCUSSION: In previously infected individuals, a fourth vaccination was not associated with COVID-19 death risk, but with transiently reduced risk of SARS-CoV-2 infections and reversal of this effect in longer follow-up. All-cause mortality data suggest healthy vaccinee bias

Excess mortality in Europe coincides with peaks of COVID-19, influenza and respiratory syncytial virus (RSV), November 2023 to February 2024

Since the end of November 2023, the European Mortality Monitoring Network (EuroMOMO) has observed excess mortality in Europe. During weeks 48 2023-6 2024, preliminary results show a substantially increased rate of 95.3 (95% CI:  91.7-98.9) excess all-cause deaths per 100,000 person-years for all ages. This excess mortality is seen in adults aged 45 years and older, and coincides with widespread presence of COVID-19, influenza and respiratory syncytial virus (RSV) observed in many European countries during the 2023/24 winter season.The ‘Excess mortality monitoring in Europe to assess impact of communicable diseases’ is a project of the European Centre for Disease Prevention and Control (ECDC) run under the framework contract No. ECDC/2022/025.S