Cash transfer during the COVID-19 pandemic: a multicentre, randomised controlled trial

Abstract

ObjectiveTo evaluate the effect of a one-time cash transfer of $C1000 in people who are unable to physically distance due to insufficient income.DesignOpen-label, multi-centre, randomised superiority trial.SettingSeven primary care sites in Ontario, Canada; six urban sites associated with St. Michael’s Hospital in Toronto and one in Manitoulin Island.Participants392 individuals who reported trouble affording basic necessities due to disruptions related to COVID-19.InterventionAfter random allocation, participants either received the cash transfer of $C1000 (n=196) or physical distancing guidelines alone (n=196).Main outcome measuresThe primary outcome was the maximum number of symptoms consistent with COVID-19 over 14 days. Secondary outcomes were meeting clinical criteria for COVID-19, SARS-CoV-2 presence, number of close contacts, general health and ability to afford basic necessities.ResultsThe primary outcome of number of symptoms reported by participants did not differ between groups after 2 weeks (cash transfer, mean 1.6 vs 1.9, ratio of means 0.83; 95% CI 0.56 to 1.24). There were no statistically significant effects on secondary outcomes of the meeting COVID-19 clinical criteria (7.9% vs 12.8%; risk difference −0.05; 95% CI −0.11 to 0.01), SARS-CoV-2 presence (0.5% vs 0.6%; risk difference 0.00 95% CI −0.02 to 0.02), mean number of close contacts (3.5 vs 3.7; rate ratio 1.10; 95% CI 0.83 to 1.46), general health very good or excellent (60% vs 63%; risk difference −0.03 95% CI −0.14 to 0.08) and ability to make ends meet (52% vs 51%; risk difference 0.01 95% CI −0.10 to 0.12).ConclusionsA single cash transfer did not reduce the COVID-19 symptoms or improve the ability to afford necessities. Further studies are needed to determine whether some groups may benefit from financial supports and to determine if a higher level of support is beneficial.Trial registration numberNCT04359264.

An Unconditional Cash Transfer Program for Low-Income New Yorkers Affected by COVID-19

“…Our study also adds to the past literature by examining a cash transfer program developed and offered by the health system as part of a public–private partnership. One other study, conducted in Ontario, Canada with 392 primary care clinic patients who reported difficulty making ends meet, found that patients randomized to receive a $1000 cash transfer did not exhibit fewer COVID-19 symptoms (except in a subgroup analysis of recipients aged 50 and older) or infections or improvements in other outcomes as reported in 2-week follow-up surveys [ 20 ]. Program recipients in that study appeared somewhat “better off” at baseline than the recipients in our current study (nearly one-third reported annual incomes over $30,000), which may blunt the observed impact of a modest cash transfer.…”

“…Cash transfer programs have been implemented across the globe in response to the COVID-19 pandemic, with international studies finding effects on food security and access to healthcare [ 14 – 16 ]. In the USA, government and private philanthropy deployed various cash transfer programs during the pandemic, [ 17 – 19 ] but it is rarer for a health system to be explicitly involved in the design and implementation of such a program [ 20 ]. We add to the prior literature by presenting results from surveys and qualitative interviews conducted with recipients of the unconditional cash transfer program offered through the public health system for low-income New Yorkers affected by COVID-19.…”

Clinical trial research agenda on COVID-19 – the first two years in Germany and beyond

“…A third example is the Canadian “Direct Income SupporT and Advice Negating Spread of Epidemic COVID-19” (DISTANSE COVID) trial; a randomized social assessment whether income support of $1000 to community-living adults suffering from COVID-19-related financial disruptions and information about reducing the spread of COVID-19 compared to information alone reduced symptoms related to COVID-19. The results indicate that COVID-19 symptoms were reduced in participants above the age of 50 [34] .…”

“… NCT04872075 [46] SPRING Access to an indoor music event with systematic antigen-screening within 3 days, medical mask-wearing and optimized ventilation No access Community, France 6,678 2021-05 to 2021-06 No differences in SARS-CoV-2 infections between the study groups (primary outcome). NCT04359264 [34] DISTANSE COVID Income support of $1000 to community-living adults suffering from COVID-19-related financial disruptions and information about reducing the spread of COVID-19 over the phone and via email Information about reducing the spread of COVID-19 over the phone and via email alone Community, Canada 392 2020-04 to 2020-05 No differences in COVID-19 symptoms or SARS-CoV-2 infections between the study groups (primary outcome). Abbreviations: N = Number; NA = Not applicable; NR = Not reported.…”

The effects of emergency government cash transfers on beliefs and behaviours during the COVID pandemic: Evidence from Brazil

“…Further controlled randomised trials have focused on North American populations. Persaud et al. (2021) tested for the health effect of a one-time transfer (1000 Canadian Dollars), on individuals who self-reported as experiencing financial difficulties during the pandemic.…”