How Vaccines Saved Money and Lives, and China’s Zero-COVID Protests: COVID, Quickly Podcast, Episode 44

How Vaccines Saved Money and Lives, and China’s Zero-COVID Protests: COVID, Quickly Podcast, Episode 44
Credit: Ryan Reid

Vaccines saved New York City billions of dollars, and China faces public fury over its strict virus-control policies.

Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series!

Josh Fischman: This is your fast-track update on the COVID pandemic. We will bring you up-to-date on the science behind the most pressing questions about the virus. We help you understand the science behind the disease and dispel myths about research.

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

Lewis: And we’re Scientific American’s senior health editors. Today, we’re going to explain how vaccines helped the economy: we saved 10 dollars for every 1 dollar we spent on them, plus millions of lives…

Fischman: And we’ll talk about the protests in China against extreme lockdowns, the harm that country’s zero-COVID policy is doing, and how it could affect the rest of the world.

Lewis: COVID vaccines cost billions to develop and deliver. They had a remarkable rate of financial return for at least one large city that used them.

Fischman: We usually talk about vaccines saving lives. Tanya said that vaccines saved New York City from a huge economic hole. The city was hit hard by the pandemic in New York City. Vaccines saved the city about $28 BILLION dollars, which is what it would have lost without vaccines. As you stated, every dollar spent on shots saved ten more dollars than would have been spent if shots were not available.

Lewis: Where did the savings come from?

Fischman: A few different places. There were no long hospitalizations, emergency room visits were avoided, and workers who chose to stay healthy rather than calling in sick.

Lewis: Hmm. How did they know about things that didn’t happen? How can you count these things?

Fischman: I wondered about that too. Scientists are able to create a model of events that does not require vaccines, as it turns out. We know how effective shots are in keeping people out the hospital, and we also have estimates of how many New Yorkers were infected. Scientists can calculate how many New Yorkers would have been admitted if vaccines weren’t available. There are also data about the number of unvaccinated individuals who show up in emergency rooms and how many are vaccinated.

Lewis: That makes sense. What were the dollar amounts?

Fischman: The direct costs of COVID-related healthcare–hospitals and suchlike–were about 7 and a half billion dollars with vaccines. Without them, the cost jumped to 33 billion.

Costs like the value of lost workdays came to almost 2 billion dollars with vaccination. Without it, the dollars lost due to lost productivity more than doubled, to over 4 billion, the researchers reported in a recent issue of the journal JAMA Network Open.

Lewis: But the vaccines themselves cost a lot for city and federal governments to get and distribute. This must be taken into account.

Fischman: It was almost 5 billion dollars, including money the feds gave to the city for running the vaccine campaign and buying the actual shots.

The math of these calculations gets complicated, but at a basic level, New York spent that 5 billion and, as a result, kept at least 28 billion. If vaccines weren’t available, school or business shutdowns would have taken longer and cost more money.

Vaccines can save millions of lives. It is hard to value them. They also offer a high return on investment.

Fischman: A wave of protests broke out in China last week against the government’s strict zero-COVID policies. What do we know about the current situation?

Lewis: The protests in China are some of the biggest in decades. They started last week after a fire in an apartment building in the Western Chinese city of Urumqi [Oo-room-chi].

The fire resulted in an official death toll of 10 people, although it may have been much higher. Some claim that the COVID lockdown prevented people escaping from the building.

Fischman: What happened next? How did the protests spread in the first place?

Lewis: People in other Chinese cities, including Shanghai and Beijing, organized vigils for the victims of the Urumqi fire that quickly evolved into protests against the Chinese Communist Party’s zero-COVID policy. Some even called for the resignation of Xi Jinping as president of the country.

Fischman: That seems like a big deal for China, a country that suppresses dissent and strictly controls people’s speech.

Lewis: It’s a huge deal. Let’s talk about how zero COVID began.

China began the policy when the outbreak first began in late 2019 in Wuhan. It has been very effective in stopping the spread of the virus. China has had far fewer cases and deaths from COVID (at least officially) than other countries, especially considering China’s size.

Fischman: So in some ways, their policy seems like a good thing.

Lewis: Well, that’s how many Chinese people saw it, at least at first. We’re now almost three years into the pandemic and almost all other countries have returned to normal.

But China continues to enforce its draconian quarantine and lockdown policies. These policies have caused a lot of economic and social damage, and the Chinese people seem to be fed up.

Fischman: The Chinese government has reacted with arrests. But is this a sign that they are changing their policies?

Lewis: Authorities have said they will relax some of their COVID policies, like no longer putting up gates to restrict access to apartment buildings where COVID cases have been detected and reducing the amount of mass testing. It is committed to zero COVID.

Fischman: Is that even a feasible goal anymore, given the costs?

Lewis: I think many people would say it’s not. The problem now is how to relax the restrictions without causing massive outbreaks and deaths. Due to China’s tight control on COVID, very few people are immune to infection. It’s true that about 90 percent of the country is vaccinated. However, China’s Sinopharm vaccines and SinoVac vaccines are not as effective as Moderna’s and Pfizer’s mRNA vaccines.

Plus, fewer people over 80 have gotten the shots, and only 40 percent of that age group has gotten a booster.

China is already reporting around 40,000 COVID cases per day. It could cause a million deaths if the virus spreads unchecked.

Fischman: That sounds like a really terrible idea.

Lewis: It would be. It’s not only dangerous for China. The virus could spread to other countries if it is allowed to infect such a large population. Unchecked infection in China could also cause havoc to the global economy.

But, it doesn’t need to be all or nothing. Instead of lockdowns and mass testing, China could focus on vaccinating and boosting its elderly population–which it says it plans to do. It could offer mRNA vaccines to improve protection. It could also allow people to access antiviral drugs such as Paxlovid which can greatly reduce the risk of death.

There’s no easy way out of this. It doesn’t appear that China will soon abandon zero COVID.

Lewis: Now you’re up to speed. We appreciate you joining us. Jeff DelViscio, Tulika Bose and Tulika Bose produced and edited our show.

Fischman: It’s December, and we’re going to take a holiday break. We’ll be back in 2023 with our own new variant of the show.

Lewis: Good one, Josh. Come back to us. For the latest COVID news, visit



    Tanya Lewis is a senior editor at Scientific American who covers health and medicine. Follow Tanya Lewis on Twitter Credit: Nick Higgins


      Josh Fischman is a senior editor at Scientific American who covers medicine, biology and science policy. He has written and edited about science and health for Discover, Science, Earth, and U.S. News & World Report. Follow Josh Fischman on Twitter.

        Tulika Bose is senior multimedia producer at Scientific American. Follow Tulika Bose on Twitter

          Jeffery DelViscio is chief multimedia editor in charge of video and podcasts at Scientific American. Follow Jeffery DelViscio on Twitter

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