This Viewpoint discusses how COVID-19–related policy decisions lead to trade-offs between medical, economic, social, and psychological outcomes, and emphasizes the need to account for deaths associated with unemployment and depression when estimating excess mortality.

The author believes that with new unemployment claims in the US alone reaching 40 million, and with unemployment associated with all-cause mortality, it may be time to more seriously, and quantitatively, take the social, economic, and psychological consequences of policies into account in decision-making when calculating total lives lost from the COVID-19 pandemic.

He urges researchers and policy makers to consider other factors associated with mortality  such as delayed treatments, for example, for heart disease or cancer, and prolonged absence of preventive health care and vaccinations. It would be a mistake to ignore these other considerations, he argues, because there may come a point at which the number of lives lost from economic, social, and psychological consequences of different policy decisions will outweigh the number of lives lost from infection.